OBJECTIVE:To study the effects of particle size of ticagrelor crude drug on in vitro dissolution behavior of Ticagre-lor tablets. METHODS:Ticagrelor crude drug and different particle size of ticagrelor powder A,B,C,D,E after smashing for dif-ferent time(15,30,40,60 s)were used to prepare the tablet by wet granulation method. Accumulative in vitro dissolution rate of prepared tablets within 60 min were determined by UV spectrophotometry at 300 nm(using 0.2% tween as medium,paddle meth-od). Using original tablet as reference preparation,the similarity factor(f2)method was used to compare the similarity of dissolu-tion behavior between 5 prepared tablets and original tablet. RESULTS:d(0.9)of powder A,B,C,D,E were 69.181,40.778, 24.805,12.611,3.083 μm,respectively. The corresponding f2 were 27.77,36.79,50.06,67.68,79.99. CONCLUSIONS:The par-ticle size of ticagrelor crude drug is much smaller,and the dissolution behavior of prepared tablet is closer to that of original tablet. The in vitro dissolution rate of Ticagrelor tablets is improved remarkably by micronization technology. In order to produce Ticagre-lor tablets with the same bioavailability as original tablet,particle size of ticagrelor crude drug powder should be controlled with d(0.9)≤20μm.

Objective To evaluate the clinical characteristics,diagnosis and treatment method of pancreatic sinistral portal hypertension caused by tumors in the body and tail of the pancreas.Methods A retrospective review of 40 patients diagnosed with pancreatic sinistral portal hypertension at Peking Union Medical College Hospital from January 2007 to December 2012 was performed.Results The Initial symptoms were epigastric pain and discomfort (n =12),emaciation (n =5),low-back pain (n =4),splenomegaly (n =2),hematemesis and melena (n =4),hypoglycemic coma (n =1).All 40 patients had splenomegaly and varices in the gastric fundus with normal liver function.8 had combined esophageal varices.24 had hypersplenism and 26 had elevated serum CA19-9 level.25 patients received surgical intervention and 15 were treated conservatively.Pathology confirmed malignancy in 29 patients and benign lesions in 11.Thirty-five patients (35/40,88％) were followed up for 12 to 72 months.For patients undergoing surgery,hypersplenism and varices in the gastric fundus were all relieved.There was no upper gastrointestinal bleeding occurred during follow-up.For patients treated conservatively,hypersplenism remained stable and among them 4 patients had upper gastrointestinal bleeding,and successfully treated by medication,therapeutic endoscopy and interventional therapy.Conclusions Patients with pancreatic sinistral portal hypertension caused by tumor in the body and tail of the pancreas can be cured successfully by surgery.In those patients portal hypertension can present as initial clinical manifestation.

A plasmids of continuous expressing shRNAs targeting the NDV NA-1 Phosphoprotein (P) gene was designed.Virus titration,Real Time RT-PCR,CPE indicated that P-specific siRNA could inhibit virus replication at 36 h post-virus infection.In future studies,a combination of siRNAs targeting the NP and L gene may be used as a tool to study NDV replication and antiviral therapy.

One strain of PRRSV was isolated from tissue of piglets died of obvious respiratory syndrome and high fever.It was identified as a strain of American type PRRSV by serological test and gene sequencing.According to American type PRRSV VR-2332,we designed 3 pairs of primers to aim directly at N gene,GP5 gene and variation sequence of NSP2.The results of sequence analysis indicated a discontinuous deletion of 30 amino acids in nonstructural protein 2 (NSP2).N and GP5 gene is conservative relatively.

Objective To determine effects of activating protein kinase C (PKC) on ventricular action potential duration restitution (APDR) and Burst stimulus induced arrhythmia in Langendorff-perfused rabbit hearts.Methods Male rabbits were equally divided into three groups randomly: control group (Tyrode's solution perfusion),PKC agonist phorbol-12-myristate-13- acetate (PMA,100 nmol/L) group and PKC inhibitor bisindolylmaleimide (BIM,500 nmol/L) group.Thirty minutes after perfusion,the monophasic action potential (MAP) and effective refractory period (ERP) were determined in right basal ventricle (RB),right apex ( RA ),left basal ventricle (LB) and left apex (LA) of all the animals,and APDR curve was drawn.Burst stimulus method was used to induce ventricular arrhythmia in perfused rabbit hearts; Real-time PCR was used to detect the mRNA expression of PKC in four different areas of ventricle.Results Compared with the control group,the ERP,90％ of monophasic action potential duration ( MAPD90 ) and ERP/MAPD90 were significantly shortened ( all P ＜ 0.01 ),the max slopes ( Smax ) of APDR curve were significantly steeper (RB:1.22 ±0.23 vs.0.65 ± 0.19 ; RA:2.99 ± 0.29 vs.1.02 ± 0.18 ;LB:1.84 ±0.21 vs.0.85 ±0.12; LA:4.02 ±0.32 vs.1.12 ±0.23,all P ＜0.01 ) and the incidences of ventricular arrhythmia were significantly increased in the PMA group.All parameters were similar between the BIM group and the control group (all P ＞ 0.05).Conclusion Activating PKC could enhance the max slopes of APDR curve at various ventricular areas and subsequently increase arrhythmia susceptibility in Langendorff-perfused rabbit hearts.

Objective To identify the prevalence and profile of psychological difficulties in a sample of women seeking the breast reconstruction, and to study the effect of the reconstructive surgery on their psychology. Methods Before and after the breast reconstruction, 50 breast-loss women were tested with the self-rating anxiety scale (SAS), the self-rating depression scale (SDS), the self-esteem scale (SES),the self- rating body dysmorphic disorder scale (SBDDS), and the Eysenck personality questionnaire (EPQ), respectively. The proportion of the abnormally psychological patients was counted, their personality characters were analyzed, and the postoperative psychological changes were obverved. Results It was found that the 64 percent of the breast-loss patients were in anxiety, 30 percent were in depression, and 18 percent were in body dysmorphic disorder. The characteristics of their personality were more extravert, sociable and easily emotional agitation. The scores in SES of the preoperative patients were 27.46±8.95, and those of the postoperative patients were 33.05±6.12 (P＜0.05). The scores in SBDDS of the preoperative patients were 25.74±13.23, and those of the postoperative patients were 18.22±8.08 (P＜0.05).Conclusion The proportion of the anxiety, depression and BDD is high in the breast-loss women, and the postoperative psychology of esteem and body dysmorphic disorder is improved effectively.

The application of electronic informed consent has the advantages of speeding up the recruitment of subjects, helping the less educated to understand research and recruit groups, facilitating direct communication between subjects and researchers, minimizing human omissions and errors, and effectively improving the efficiency of clinical research. However, there are also some challenges, such as privacy, ethical censorship, hardware costs and so on. On the basis of the above discussion, this paper believed that electronic informed consent, as a new form, would provide a more powerful tool for clinical research in an era full of opportunities and challenges, with research value and potential.

BACKGROUND: The gut is capable of inducing multiple organ dysfunction syndrome (MODS). In the diagnosis and treatment of critical ill patients, doctors should pay particular attention to the protection or recovery of intestinal barrier function. However, no reliable diagnostic criteria are available clinically. This study aimed to assess the changes of intestinal mucosal barrier function in surgically critical ill patients as well as their significance. METHODS: Thirty-eight surgically critical ill patients were enrolled as a study group (APACHE II>8 scores), and 15 non-critical ill patients without intestinal dysfunction were selected as a control group (APACHE II<6). General information, symptoms, physical signs, and APACHE II scores of the patients were recorded. The patients in the study group were subdivided into an intestinal dysfunction group (n=26) and a non-intestinal dysfunction group (n=12). Three ml venous blood was collected from the control group on admission and the same volume of plasma was collected from the study group both on admission and in the period of recovery. The plasma concentrations of endotoxin, diamine oxidase (DAO), D-lactate, and intestinal fatty-acid binding protein (iFABP) were detected respectively. The data collected were analyzed by the SPSS 17.0 software for Windows. RESULTS: The levels of variables were significantly higher in the study group than in the control group (P<0.01). They were higher in the intestinal dysfunction group than in the non-intestinal dysfunction group (DAO P<0.05, endotoxin, D-lactate, iFABP P<0.01). In the non-intestinal dysfunction group compared with the control group, the level of endotoxin was not significant (P>0.05), but the levels of DAO, D-lactate and iFABP were statistically significant (P<0.05). The levels of variables in acute stage were higher than those in recovery stage (P<0.01).The death group showed higher levels of variables than the survival group (endotoxin and D-lactate P<0.01, DAO and iFABP P<0.05). CONCLUSION: The plasma concentrations of endotoxin, DAO, D-lactate, and intestinal fatty-acid binding protein (iFABP) could reflect a better function of the intestinal mucosa barrier in surgically critical ill patients.

Abstract: Objective　To collect and organize malaria case data in Hubei Province from 2017 to 2021, compare and analyze the malaria epidemic characteristics on the before and after malaria elimination, and provide scientific support for Hubei Province to further optimize the comprehensive strategies to prevent re-transmission after the elimination of malaria. Methods The study was conducted by collecting the data of reported malaria cases of Hubei during 2017-2021 from the Infectious Disease Surveillance Reporting and Management System, and conducting the epidemiological characteristics of malaria on pre-elimination (2017-2019) and post-elimination (2020-2021). Results A total of 429 cases of imported malaria were reported in Hubei Province from 2017 to 2021, and the malaria epidemic showed an obvious trend of rising first and then falling. On the pre-malaria elimination, 374 malaria cases were reported, including 262 cases of P.falciparum (70.05%); on the post-malaria elimination, 55 malaria cases were reported, including 25 cases of P.falciparum (45.45%). There was a statistically significant difference in the proportion of infections caused by the four types of malaria parasites before and after the elimination of malaria (χ2=14.248, P<0.05). On the pre-malaria elimination, the peak of disease onset mainly occurred in January, July, and November; on the post-malaria elimination, the peak of disease onset mainly occurred in January to February, and December. Both before and after malaria elimination, the reported cases were mainly concentrated in Wuhan, Yichang, Huangshi, Xiangyang, Shiyan and Huanggang, but the range of cases showed a clear trend of narrowing. Before and after malaria elimination, malaria cases in Hubei Province were mainly among young and middle-aged males aged 30-49. The proportions of workers and migrant workers increased from 37.70% and 9.09% before the elimination to 50.91% and 18.18% after the elimination, respectively, with a statistically significant difference (χ2=17.839, P<0.05). The percentage of interval from onset of illness to initial diagnosis ≥ 5d decreased from 21.66% before the elimination to 10.91% after the elimination (χ2=6.448, P<0.05). The percentage of definitive diagnosis of malaria at initial diagnosis in town clinic increased from 18.18% before the elimination to 50.00% after the elimination. The proportion of malaria cases diagnosed by county-level medical institutions increased from 22.73% before the elimination to 34.55% after elimination. There was no statistically significant difference in the proportion of malaria cases diagnosed by medical institutions at all levels before and after the elimination of malaria (χ2=5.630, P>0.05). The proportion of cases with the interval between initial diagnosis and diagnosis within 24h increased from 43.85% before the elimination to 70.91% after the elimination. There was a statistically significant difference in the proportion of cases with the interval between initial diagnosis and diagnosis before and after the elimination of malaria (χ2=14.006, P<0.05). Before and after malaria elimination, all reported cases were mainly imported from African countries. Conclusions There are imported malaria cases reported every year in Hubei Province before and after the elimination of malaria, which poses a great challenge to the prevention of re-transmission. Therefore, it is necessary to strengthen the surveillance system, detect and standardize the treatment of imported malaria cases in a timely manner, conduct targeted retransmission risk surveys and assessments, and consolidate the achievements of malaria elimination.

Objective To observe the action potential duration restitution (APDR) change and potential association with ventricular arrhythmia (VA) in Langendorff-perfused chronic heart failure rabbit hearts.Methods Male rabbits were randomly divided into two groups:control ( CTL,n =15 ) group and chronic heart failure (CHF,n =15) group.CHF was induced by injecting isoproterenol (300 &mu;g · kg-1 ·d -1 ) for 14 days.Four weeks later,cardiac function and structure change of both groups were assessed by echocardiography.In the whole Langendorff-perfused hearts,the monophasic action potential (MAP) and the effective refractory period (ERP) were recorded from left anterior basal ventricle,left anterior free wall,left anterior apex and left posterior basal ventricle,left posterior free wall and left posterior apex,the APD curves were also constructed in both groups:at the six sites of every isolated heart,the programmed electrical stimulation and burst pacing were used to induce action potential duration (APD) alternans and VA,respectively.Results Left ventricular ejection was reduced and end-dimension was enlarged in rabbits of CHF group.Compared with the same sites of CTL group,the 90％ of MAP duration ( MAPD90 ),the ERP,the max slope ( Smax ) of APDR curves,the pacing cycle length of inducing the APD alternans and the VAs were significantly increased ( all P ＜ 0.05 ) in CHF group:the spatial dispersions of MAPD90,E RP and Smax of APDR curves in CHF group were also greater than in CTL group ( all P ＜0.05 ).Conclusion The ventricular APD alternans might be linked with occurrence of the VA in CHF rabbits.Increase of the Smax from APDR curves and the spatial dispersions of Smax in this CHF model might facilitate the development of ventricular arrhythmia.