Ultrasound-guided transgluteal puncture and catheter drainage in the treatment of deep pelvic abscess with pelvic adhesion / 中华超声影像学杂志

Objective:To investigate the safety and efficacy of transgluteal ultrasound-guided puncture and drainage in prone position in the treatment of deep pelvic abscess with pelvic adhesion.Methods:A total of 24 cases of deep pelvic abscess with pelvic adhesion treated in the ultrasound intervention room of the First Affiliated Hospital of Zhengzhou University from October 2018 to May 2021 were selected.Ultrasound-guided puncture and drainage were performed through the buttocks. The operation time, blood loss and distal limb pain during the operation were recorded. The decreasing trend of body temperature, the white blood cell, C-reactive protein and abscess size were observed. The incidence of complications such as bleeding, pain, infection and intestinal injury were counted.Results:There were 28 abscesses in 24 patients were successfully intubated through the buttocks, the abscesses disappeared after drainage, and there were no serious complications after operation. During the follow-up of 3-22 months, there was no abscess recurrence and no long-term complications.Conclusions:Ultrasound-guided transgluteal puncture and drainage is safe and effective in the treatment of deep pelvic abscess with pelvic adhesion.

Efficacy analysis of ultrasound-guided percutaneous radiofrequency ablation in the treatment of nonmetastatic pheochromocytoma / 中华超声影像学杂志

Objective:To investigate the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of nonmetastatic pheochromocytoma.Methods:A retrospective analysis was performed on 7 patients with nonmetastatic pheochromocytoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2020, all of whom underwent ultrasound-guided percutaneous radiofrequency ablation. The changes of postoperative blood pressure, improvement of symptoms, intraoperative and postoperative complications were observed.Plasma free methoxypinephrine (MN) and normetanephrine (NMN) levels were recorded before and 2 weeks after operation. The reduction rate of ablation lesion volume at 1, 3 and 6 months after operation was calculated.Results:Postoperative blood pressure of all 7 patients was reduced to the normal range within 3 days, and symptoms such as headache were significantly relieved immediately after operation.No serious complications occurred during or after operation. Plasma free MN and NMN levels decreased to normal levels 2 weeks after operation. The mean reduction rates of the ablation lesions at 1, 3 and 6 months after operation were (46.61±13.42)%, (67.21±10.54)% and (85.73±4.15)%, respectively. Postoperative follow-up of 12-30 months showed that the blood pressure, plasma free MN and NMN levels of the patients were all in the normal range, and no symptoms such as headache and palpitation occurred again. All the tumors were completely ablated, and no recurrence was observed.Conclusions:Ultrasound-guided percutaneous radiofrequency ablation in the treatment of nonmetastatic pheochromocytoma is minimally invasive, safe and effective, and can retain adrenal cortex function, which is worthy of clinical promotion.

Ultrasound-guided radiofrequency ablation for treatment of gallbladder polyps / 中华肝胆外科杂志

Objective:To study the safety and efficacy of ultrasound-guided radiofrequency ablation in treatment of gallbladder polyps.Methods:The clinical data of 13 patients who underwent ultrasound-guided radiofrequency ablation for gallbladder polyps at the First Affiliated Hospital of Zhengzhou University from April 2019 to March 2020 were retrospectively analyzed. These were 8 males and 5 females, with ages ranging from 20 to 49 years. The incidence of adverse reactions and complications after treatment, the complete ablation rate of polyps and the absorption of postoperative lesions were studied, and the gallbladder systolic function of patients before and after treatment were compared.Results:Of 13 patients, surgery was successfully carried out and there was no serious complications of gallbladder perforation, bleeding and collateral organ injury. The median radiofrequency ablation time was 30 s, and the complete ablation rate was 100.0%(13/13). After 6 months of follow-up, the rate of reduction of lesion volume was 100.0(98.0, 100.0)% at 6 months after surgery, which was significantly higher than the rates of 46.0(40.0, 54.0)%, 72(64.0, 100.0)% and 87.0(81.0±100.0)% at 1, 2 and 3 months after surgery ( P<0.05). The gallbladder contractility rate at 3 months after operation was (78.38±10.83)% compared with that before operation (77.46±11.28)%, and there was no significant difference ( P>0.05). Conclusion:Ultrasound-guided radiofrequency ablation for gallbladder polyps was safe. It had a significant short-term efficacy for treatment of gallbladder polyps.

Clinical efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of ectopic pregnancy / 中华超声影像学杂志

Objective:To investigate the clinical efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of ectopic pregnancy.Methods:A retrospective analysis was performed on 8 patients with ectopic pregnancy admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2020, all of whom underwent ultrasound-guided percutaneous radiofrequency ablation. Contrast ultrasonography was performed immediately after the operation to observe the changes of pregnancy sac. The length of hospital stay, mass absorption time and menstrual recovery time of the patients were recorded. Postoperative complications and serum human chorionic gonadotropin (HCG) negative conversion time were observed. At 3 months after the operation, hysterosalpingography was performed 3-7 days after the menstruation to observe the patency of the fallopian tubes, all patients were followed up for 1 year to observe the postoperative intrauterine pregnancy and re-ectopic pregnancy.Results:All the 8 patients were successfully treated with radiofrequency ablation, and postoperative ultrasonography showed that the mass remained unenhanced. The length of hospital stay was (3.0±0.8)d. The packet absorption time was (32.4±14.3)d. The recovery time of menstruation was (39.6±2.7)d. There were no serious complications.Blood HCG levels decreased rapidly within a week, and all returned to normal level of non-pregnancy 2-3 weeks after the operation. Three months after the operation, the salpingogram showed that the fallopian tubes were recanalized in 3 patients. After a follow-up of 1 year, 1 patient had a natural intrauterine pregnancy, and there was no case of recurrent ectopic pregnancy.Conclusions:Ultrasound-guided percutaneous radiofrequency ablation is effective in the treatment of ectopic pregnancy with minimal trauma and rapid recovery, and can retain the reproductive ability of patients to some extent, which is worth popularizing in clinical application.

Clinical application of percutaneous ultrasonography-guided gallbladder polyp biopsy and radiofrequency ablation: a primary study / 中华超声影像学杂志

Objective:To analyze the feasibility and efficacy of ultrasound-guided percutaneous biopsy and radiofrequency ablation of gallbladder polyps.Methods:From April 2019 to January 2021, 25 patients with gallbladder polyps underwent ultrasound-guided biopsy and radiofrequency ablation in the ultrasound department of the First Affiliated Hospital of Zhengzhou University were collected, the maximum diameter of the lesion was 11.00(10.00, 12.50)mm. Under general anesthesia, ultrasound-guided injection of water into the gallbladder serosa layer was performed to make the gallbladder edema thicker than or equal to 10 mm. Percutaneous biopsy and radiofrequency ablation of gallbladder polyps were performed to ablate the gallbladder mucosa layer of polyps and polyp attachment.Intraoperative contrast-enhanced ultrasound was used to evaluate the need for supplementary ablation.The operation time, intraoperative and postoperative conditions were recorded. The complete ablation rate of gallbladder polyps, the reduction rate of lesion volume after ablation, the incidence of complications and the effect of operation on gallbladder wall thickness and gallbladder contraction rate were evaluated.Results:Biopsy and radiofrequency ablation of gallbladder polyps were successfully performed in 25 patients.There were 14 cases of cholesterol polyp, 5 cases of adenoma, 5 cases of inflammatory polyp and 1 case of gallbladder adenomyosis. Twenty-nine gallbladder polyps showed changes after ablation, and the lesion volume was reduced to varying degrees. In the first, third and sixth months, the volume reduction rates of ablation focus were 70.74%(58.55%, 77.56%), 89.47%(85.04%, 96.87%) and 100%(95.68%, 100%) respectively, and the differences were statistically significant ( P<0.05). There were no significant differences in gallbladder wall thickness and gallbladder contraction rate before and 1 month after operation ( P>0.05). The operation time was 14-39(23.32±6.68)min. During the operation, 3 patients(12.0%) had a decrease in heart rate, 2 patients(8.0%) had mild abdominal pain and 1 patient(4.0%) had obvious abdominal pain, which was relieved after treatment. No bleeding, gallbladder perforation, abdominal infection and other complications occurred. All patients were followed up for 1 to 22 months, with a median of 6 (3, 7) months. No patients were lost or follow-up, polyp recurrence, or new polyps, or secondary gallstone. Conclusions:Ultrasound-guided biopsy and radiofrequency ablation of gallbladder polyps is a feasible choice for gallbladder preserving treatment of gallbladder polyps with low complication rate.

Development and validation of a predictive model for the differential diagnosis of diabetic nephropathy and non-diabetic renal disease in patients with type 2 diabetes mellitus / 中华肾脏病杂志

Objective:To develop and validate a predictive model for the differential diagnosis of diabetic nephropathy (DN) and non-diabetic renal disease (NDRD) in patients with type 2 diabetes mellitus.Methods:A retrospective study with patients with type 2 diabetes who underwent renal biopsy in the First Affiliated Hospital of Zhengzhou University from February 2012 to January 2015 was conducted. The dataset was randomly split into development (70.0%) and validation (30.0%) cohorts. Baseline predictors for model development was selected by using univariable and multivariable logistic regression. The model's performance in the two cohorts, including discrimination and calibration, was evaluated by the C-statistic, calibration curve and the P value of the Hosmer-Lemeshow test. Results:Among the 931 patients with type 2 diabetes, 478 cases (51.3%) diagnosed as DN alone, 214 cases (23.0%) as NDRD alone and 239 cases (25.7%) as DN plus superimposed NDRD (MIX). Among NDRD and MIX patients, membranous nephropathy was the most common pathological type, followed by IgA nephropathy. The variables selected in the final predictive model were age, duration of diabetes, diabetic retinopathy, systolic blood pressure, hemoglobin, fasting blood glucose, glycosylated hemoglobin, cystatin C. The model performed well with good discrimination and calibration. The C-statistics were 0.913(95% CI 0.892-0.935) in the derivation cohort and 0.897(95% CI 0.876-0.919) in the validation cohort. The model had the best P value of 0.934 of the Hosmer-Lemeshow test. Conclusions:A simple predictive model with high accuracy is constructed for predicting the presence of NDRD and MIX for type 2 diabetic patients. The nomogram can be used as a decision support tool to provide a non-invasive method for differential diagnosis of DN and NDRD, which may help clinicians assess the risk-benefit ratio of kidney biopsy for type 2 diabetic patients with renal impairment.

Clinical efficacy of percutaneous radiofrequency ablation in the treatment of gestational trophoblast tumor / 中华超声影像学杂志

Objective:To investigate the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation for gestational trophoblast tumor.Methods:The clinical data of 5 patients with gestational trophoblast tumor treated by ultrasound-guided percutaneous radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2019 were retrospectively analyzed, the postoperative complications, changes in blood human chorionic gonadotropin (hCG), and the volume reduction rate of ablation lesion at 1, 3, and 6 months after surgery were observed.Results:None of the 5 patients with gestational trophoblast tumor had postoperative complications.Blood hCG decreased to normal level on 7 d, 8 d, 8 d, 12 d and 26 d, respectively. The volume reduction rates of ablation lesions 1, 3 and 6 months after operation in cases 1-5 were respectively 34.7%, 62.5%, 87.5%; 45.3%, 60.4%, 84%; 85.6%, 89.9%, 92.2%; 38.3%, 72.6%, 85.5%; 40.8%, 57.3%, 87%.Conclusions:Percutaneous radiofrequency ablation is minimally invasive, low risk, safe and effective treatment for gestational trophoblast tumors.

Assessment of quality of life in patients with chronic Keshan disease and analysis of its influencing factors / 中华地方病学杂志

Objective:To evaluate the quality of life of patients with chronic Keshan disease, and to explore related influencing factors, in order to provide a theoretical basis for improving the quality of life of patients with chronic Keshan disease.Methods:According to the standard of "Diagnosis of Keshan Disease" (WS/T 210-2011), 110 patients with chronic Keshan disease treated in the Jingchuan People's Hospital, Pingliang City, Gansu Province were selected as the research subjects, and demographic and disease data of the patients were collected by questionnaire survey; the quality of life of patients was assessed by the Minnesota living with heart failure questionnaire (MLHFQ); and correlation analysis was used to analyze and explore the influencing factors of patients' MLHFQ score.Results:Among the 110 patients with chronic Keshan disease, 66 were males and 44 were females, aged (60.93 ± 8.22) years; the education level was mainly junior high school or below, accounting for 92.73% (102/110); average annual family income was 20 700 yuan; the cardio-thoracic ratio of the patient was 0.64 ± 0.09; the ejection fraction (EF) was (36.71 ± 7.55)%; the labor ability classification was mainly based on simple activities, accounting for 60.91% (67/110); and the cardiac function classification was mainly Grade Ⅲ, accounting for 67.27% (74/110). The total MLHFQ scores of chronic Keshan patients were (69.17 ± 16.14) points, and the scores of physical, emotional and other fields were (26.32 ± 6.70), (15.86 ± 4.96) and (26.94 ± 6.10) points, respectively. The total MLHFQ scores had statistically significant differences among patients with different education level, cardio-thoracic ratio, EF, labor ability classification, cardiac function classification and annual family income ( F=7.121, 6.236, 4.515, 3.427, 5.418, Z=2.346 , P < 0.05). The results of correlation analysis showed that educational level and labor ability classification were negatively correlated with scores in physical field and other fields ( r=- 0.302, - 0.206, - 0.343, - 0.285, P < 0.01), and annual family income was negatively correlated with scores in emotional field ( r=- 0.263, P < 0.01). The cardiac function classification was positively correlated with scores in physical and other fields ( r=0.233, 0.210, P < 0.05). Conclusions:The quality of life of patients with chronic Keshan disease is poor. The quality of life of patients is affected by their educational level, annual family income, labor ability classification, cardiac function classification, etc.

Ablation of gut microbiota alleviates obesity-induced hepatic steatosis and glucose intolerance by modulating bile acid metabolism in hamsters

Since metabolic process differs between humans and mice, studies were performed in hamsters, which are generally considered to be a more appropriate animal model for studies of obesity-related metabolic disorders. The modulation of gut microbiota, bile acids and the farnesoid X receptor (FXR) axis is correlated with obesity-induced insulin resistance and hepatic steatosis in mice. However, the interactions among the gut microbiota, bile acids and FXR in metabolic disorders remained largely unexplored in hamsters. In the current study, hamsters fed a 60% high-fat diet (HFD) were administered vehicle or an antibiotic cocktail by gavage twice a week for four weeks. Antibiotic treatment alleviated HFD-induced glucose intolerance, hepatic steatosis and inflammation accompanied with decreased hepatic lipogenesis and elevated thermogenesis in subcutaneous white adipose tissue (sWAT). In the livers of antibiotic-treated hamsters, cytochrome P450 family 7 subfamily B member 1 (CYP7B1) in the alternative bile acid synthesis pathway was upregulated, contributing to a more hydrophilic bile acid profile with increased tauro--muricholic acid (TMCA). The intestinal FXR signaling was suppressed but remained unchanged in the liver. This study is of potential translational significance in determining the role of gut microbiota-mediated bile acid metabolism in modulating diet-induced glucose intolerance and hepatic steatosis in the hamster.

Pharmaceutical Care for the Treatment of Hypertension for a Cerebral Hemorrhage Patient / 中国药师

Clinical pharmacists joined the team for treating a cerebral hemorrhage patient with hypertension. Medications were as-sessed by learning guidelines and consulting the related literature reports,and the regimen was adjusted according to the condition of the disease and drug characteristics during the whole process of pharmaceutical care. As a result, the clinical medication became more rea-sonable. The patient's blood pressure was controlled within the target range timely, and the vital signs were sufficiently stable so that the patient could be transferred to a general ward for the further treatment.

Practice and Experience of Microbiological Examination Training for Hospital Pharmacists / 中国药师

The pharmaceutical microbiological examination in medical institutions is an important method to ensure the safety of preparations.It is of great significance to popularize the techniques of drug microbiological examination in primary medical institutions.This article started with the purpose, plan and training contents of the microbiological examination training program, which combined with theory teaching and practical operation, two-phase practical teaching, group teaching and collective teaching and guided students to design and plan experiments to carry out the teaching work,and then explored the ways and improving measures of the pharmaceutical microbiological examination training for hospital pharmacists, which could provide reference for the training and teaching of hospital pharmaceutical microbiological examination.

Apolipoproteins as Differentiating and Predictive Markers for Assessing Clinical Outcomes in Patients with Small Cell Lung Cancer

PURPOSE: The present study aimed to investigate the value of apolipoproteins, including ApoA-1, ApoC-III, and ApoE, in patients with small cell lung cancer (SCLC) as potential biomarkers for diagnosis, prognosis, and cancer progression. MATERIALS AND METHODS: Lung samples were collected from 89 patients with SCLC. Nineteen lung samples from non-small cell lung cancer (NSCLC) patients and 12 normal lung tissues were used as controls. Expression profiles of ApoA-1, ApoC-III, and ApoE in different samples were examined using immunohistochemical methods, and the expression levels were correlated with cancer types, treatment, and outcomes using chi-square and Mann-Whitney tests. RESULTS: Expression of ApoA-1 and ApoC-III in SCLC was significantly different, compared with that in NSCLC and normal lung tissues, and was correlated with recurrence of SCLC. Patients undergoing neoadjuvant chemotherapy before surgery showed significantly reduced expression of ApoA-1 and increased expression of ApoC-III and ApoE. Nevertheless, the expression levels of ApoA-1, ApoC-III, and ApoE were not correlated with SCLC staging. CONCLUSION: ApoA-1 and ApoC-III may be used as differentiating and predictive markers for SCLC. ApoA-1, ApoC-III, and ApoE may be used to monitor the efficacy of chemotherapy.

Meta-analysis of Olanzapine in the Prevention and Treatment of Chemotherapy-related Nausea and Vomiting / 中国药房

OBJECTIVE:To systematically review the effectiveness and safety of olanzapine in the prevention and treatment of chemotherapy-induced nausea and vomiting(CINV),and provide evidence-based reference for clinical treatment. METHODS:Re-trieved from Medline,PubMed,EMBase,Cochrane Library,Clinical Trials.gov,CBM,CJFD,VIP and Wanfang Database,ran-domized controlled trials (RCT) about olanzapine (test group) versus other drugs or conventional antiemetic regimen (control group)in the prevention and treatment of CINV were collected,Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by modified Jadad. RESULTS:Totally 19 RCTs were included,involving 1 794 patients. Re-sults of Meta-analysis showed,olanzapine can significantly improve the complete control rate of patients with acute CINV [RR=1.12,95%CI(1.06,1.18),P0.05). CONCLUSIONS:Olanzapine is safe and effective in the prevention and treatment of CINV and can be recommended in treating breakthrough and refractory CINV. Besides,olanzapine in the prevention and treatment of CINV belongs to“off-label use”,so the clinicians should have a comprehensive consideration of chemotherapy and patients’consent.

Content Determination of Ethacridine Lactate in Compound Ethacridine Ointment by HPLC / 中国药房

OBJETCTIVE:To establish a method for the content determination of ethacridine lactate in Compound ethacridine ointment. METHODS:HPLC was performed on the column of Agilent ZORBAX SB-C18 with mobile phase of 0.1% Octanesulfon-ic acid sodium solution-acetonitrile(70∶30,V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 270 nm,the column temperature was 30℃,and the injection volume was 10 μl. RESULTS:The linear range of ethacridine lactate was 10.002-50.010μg/ml(r=0.999 9);RSDs of precision,stability and reproducibility tests were less than 1%;recovery was 98.96%-100.36%(RSD=0.49%,n=9). CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for content determina-tion of ethacridine lactate in Compound ethacridine ointment.

Practice and Experience of Medication Consultation Wechat Platform in Our Hospital / 中国药房

OBJECTIVE:To provide reference for medication consultation Wechat platform in the hospital. METHODS:The medication consultation Wechat platform of our hospital was introduced,including main method,content and effect. The consulting pharmacist team was set up,and Wechat public number was applied and operated experimentally;information pharmacist was re-sponsible for its daily maintenance. We released pharmacy news,accumulated consumers and expanded influence through other me-dia at regular intervals. RESULTS & CONCLUSIONS:According to the medical practice,two modules“medication consultation”and“pharmacy news”were set up. From Dec. 2014 to Jul. 30th 2015,medication consultation system had accumulated 1 121 con-sumers,with an increase of 5 to 8 ones everyday;average number of consultation records was 10 everyday;we also had published 22 batch of medication news(79 messages),including 31 original messages and 3 video messages. Several messages gained much attention from network media and offline media. As new pharmaceutical care mode,Wechat platform contribute to realize a individ-ual,convenient and mobile medication consultation service,medication health science popularization,and improves medication compliance of patients and the awareness of medication safety in field of pharmaceutical administration Wechat platform,so as to improve pharmaceutical care effect of“taking patients as the center”and promote the propaganda of hospital brand. Thus it has a good prospect of application and popularization.

Preparation and Oral Pharmacokinetics of Fenofibrate PEG2000-DSPE Micelles in Rats / 中国药师

Objective:To prepare fenofibrate PEG2000-DSPE micelles in order to improve the solubility of fenofibrate, and study the oral pharmacokinetics of the micelles in SD rats. Methods:Fenofibrate PEG2000-DSPE micelles were prepared and characterized. The rats were administrated with fenofibrate PEG2000-DSPE micelles and fenofibrate suspension, respectively. The blood samples were collected from eye socket and determined by HPLC. The compartmental pharmacokinetics was analyzed by DAS software. Results:Fenofibrate PEG2000-DSPE micelles were prepared successfully. The mean particle size was (23. 40 ± 3. 62) nm, the drug loading and the entrapment efficiency was (97. 65 ± 3. 32) % and (1. 33 ± 0. 32) %, respectively. The mean plasma concentration-time curves of fenofibric acid were both in accordance with two-compartment mode after oral administration of fenofibrate PEG2000-DSPE micelles and fenofibrate suspension in rats. After the oral administration, AUC(0-24) and Cmax of fenofibrate PEG2000-DSPE micelles was respectively 7-fold and 14-fold higher than that of fenofibrate suspension [(61. 41 ± 5. 71)μg·h·ml-1 vs (8. 49 ± 0. 66)μg·h·ml-1, and (9.67±1.65) μg·ml-1 vs (0.71 ±0.09) μg·ml-1]. The relative bioavailability of fenofibrate PEG2000-DSPE micelles was 723. 3%. Conclusion:The bioavailability and absorption rate of fenofibrate are both increased by the micelles remarkably when com-pared with those of fenofibrate suspension after oral administration. The PEG2000-DSPE micelles served as drug carrier for oral delivery present promising application perspectives.

Simultaneous Determination of Triamcinolone Acetonide Acetate and Chloramphenicol in Chloramphenicol and Triamcinolone Acetonide Acetate Cream by HPLC-DAD / 中国药师

Objective:To establish an HPLC method for the simultaneous determination of triamcinolone acetonide acetonide ( TAA) and chloramphenicol in the cream. Methods:The chromatographic system consisted of a ZORBAX SB-C18 column (250 mm × 4. 6 mm, 5μm). The mobile phase consisted of methanol and phosphate buffer with gradient elution at a flow rate of 1. 0 ml·min-1, the detection wavelength was 240nm, the column temperature was ambient, and the sample size was 20 μl. Results:The calibration curve was linear for TAA and chloramphenicol within the concentration range of 6. 12-48. 96 μg·ml-1 and 62. 1-745. 2 μg·ml-1 with the recovery of 99. 7% (RSD=1. 3%, n=9) and 99. 4%(RSD=1. 0%, n=9), respectively. Conclusion: The method is sensitive, accurate and specific, and can be used to control the quality of chloramphenicol and triamcinolone acetonide acetate cream.

Systematic Review of Efficacy and Safety and Pharmacoeconomics Analysis of Acarbose versus Metformin in the Treatment of Type 2 Diabetes / 中国药房

OBJECTIVE:To systematically review the efficacy,safety and economy of acarbose versus metformin in the treat-ment of type 2 diabetes,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from PubMed, Medline,CJFD,Wanfang database,VIP database,randomized controlled trails (RCT) about acarbose (test group) versus metfor-min(control group)in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.2 statis-tics software,and the decision tree model was used to do the cost-effectiveness analysis by using TreeAge Pro 2011.1.0.12.1 soft-ware. RESULTS:A total of 8 RCT,involving 418 patients. Results of Meta-analysis showed 2 h postprandial blood glucose (2 h PG)in test group [MD=-2.21,95%CI(-2.92,-1.51),P<0.001] was lower than that of control group,there was no signifi-cant diffcrencc in the glycated hemoglobin levels[MD=0.02,95%CI(-0.38,0.34),P=0.91],fasting blood glucose level[MD=0.05,95%CI(0.91,1.01),P=0.92] and incidence of adverse reactions [OR=1.84,95%CI(0.80,4.24),P=0.92] between 2 groups. Results of decision tree analysis showed the cost-effectiveness ratio in test group and control group was 847.15 and 272.53,respec-tively;and incremental cost-effectiveness ratio was 13 776. CONCLUSIONS:Acarbose shows an obvious advantage on decreasing the 2 h PG of type 2 diabetes,however,pharmacoeconomics shows metformin has higher economic effects. Due to the limit of methodological quality,large-scale and high quality RCT are required for further validation of the conclusions.

Simultaneous Determination of Neomycin Sulfate and Hydrochloric Dyclonine in Compound Twain Oint-ments by HPLC-DAD-ELSD / 中国药师

Objective:To establish an HPLC-DAD-ELSD method for the simultaneous determination of neomycin sulfate and hy-drochloric dyclonine in compound Twaln ointments. Methods:The assay was performed on an Agilent ZOR BAXSB-C18 column(250 mm × 4. 6 mm, 5μm) with acetonitrile-water as the mobile phase with gradient elution at a flow rate of 1. 0 ml·min-1 . The detection wavelength of DAD was 282 nm. The evaporator temperature of ELSD was set at 50℃ and the nebulizer temperature was set at 60℃with the gas flow rate of 1. 6 L·min-1 . The column temperature was kept at 35℃. Results:The linear range of neomycin sulfate was 141. 54-323. 52 μg·mL-1(r=0. 999 6) with the average recovery of 98. 87%(RSD=0. 95%, n=9). The linear range of hydro-chloric dyclonine was 28. 00-64. 00 μg·mL-1(r=0. 999 6) with the average recovery of 99. 57%(RSD=1. 10%, n=9). Conclu-sion:The method is accurate, sensitive and reproducible, and under the same chromatographic conditions, the determination of all the active ingredients in compound Twaln ointments is achieved, which provides basis for the quality control.

The establishment of biological reference intervals of immunoglobulin in serum for children in Changchun / 中华检验医学杂志

Objective To establish the biological reference intervals of serum immunoglobulin ( Ig) for children ( neonates to young adults) in our laboratory.Methods This was a retrospective study.Serum IgG, IgA and IgM of the neonatal ( 1-28 days ) to 18 years old who visited the First Hospital of Jilin University during January 2011 to July 2014 were measured.The inclusion criteria were normal C-reactive protein content, normal liver and kidney function and without history of chronic diseases, allergic reactions, connective tissue diseases, rheumatic diseases and human immunodeficiency diseases.Children whose Ig tests were below upper limit of adult reference range were divided into 19 age groups.By eliminating outliers within each group, 9 466 cases of reference individuals conformed to the establishment of reference intervals were selected.Rank sum test was applied in comparing Ig levels of each two adjacent age groups, if there was not statistical significance ( P>0.05 ) , the two age groups were merged; otherwise not merged.The upper and lower limit of Ig reference range for each age group were calculated using nonparametric method, and biological reference intervals of children′s serum Ig were established.Results The neonatal serum IgG decreased grually after birth and reached the lowest point at 29 days-3 months, then the concentration increased gradually along with age growth and reached adult level by 11 years old.Neonatal serum IgA and IgM levels were at the lowest point and the concentration increased along with age growth then reached adult levels by 11 and 2 years old respectively.The children′s serum Ig reference intervals were as below:IgG:3.59-7.90, 2.26-5.40, 2.72-6.62, 2.87-7.74, 3.38-8.07, 3.80-9.08, 4.86-11.40, 4.97-11.70, 5.51-12.40, 6.17-13.10, 6.41-13.60, 6.53-14.20 and 6.84-14.30 g/L for neonatal, 29 days-3 months, 4-6 months, 7 months, 8-9 months, 10 months-1 year old, 2, 3, 4, 5-6, 7, 8 and 9-10 years old, respectively;IgA:0.23-0.45, 0.24-1.02, 0.23-0.79, 0.23-0.92, 0.24-1.03, 0.24-1.56, 0.26-1.93, 0.31-2.16, 0.44-2.56, 0.56-2.85, 0.52-3.35 and 0.63-3.23 g/L for neonatal-3 months, 4 months, 5-7 months, 8-9 months, 10 months-1 years old, 2, 3, 4, 5-6, 7, 8, and 9-10 years old, respectively;IgM:0.16-0.70, 0.21-1.20, 0.30-1.62, 0.38-2.16 and 0.44-2.17 g/L for neonatal, 29 days-3 months, 4-7 months, 8-9 months and 10 months-1 years old, respectively.Conclusions There were great differences of the serum Ig concentrations between children and adults, thus children′s immunologic function should not be assessed based on adult Ig reference intervals.According to the research, reference intervals of Ig were obtained for children at different age groups in the laboratory and reference in evaluating children′s immunologic function was provided for clinicians.