Objective To study the clinical effect of treating mild and moderate hypertension in the elderly with flavored liuwei dihuang decoction.Methods From January 2016 to January 2017,120 cases of elderly patients of mild and moderate hypertension with the diagnosis and treatment in our hospital are divided into two groups, the control group was treated with nifedipine zyban, and the observation group was treated with flavored liuwei dihuang decoction;Record two groups of patients with various experiment data, make an analysis of the relevant data obtained and discuss the clinical effect of flavored liuwei dihuang decoction to treat the mild and moderate elderly hypertension.Results The clinical results of the treatment of observation group were better than that of the control group.The patients had fewer adverse reactions, and the differences between two groups were statistically significant (P< 0.05).Conclusion The treatment which using the flavored liuwei dihuang decoction in the mild and moderate elderly hypertension receives significant improvement in the clinical symptoms and little adverse reactions.It is worth using widely in clinical practice.

OBJECTIVE:To systematically review the efficacy and safety of different doses of canagliflozin in the treatment of type 2 diabetes,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,Clinical Trails.gov,CJFD,Wangfang Database and VIP,randomized controlled trials (RCT) about different doses of canagliflozin in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extract and quality evaluation by Cachrane 5.10. RESULTS:Totally 11 RCTs were enrolled,involving 5 399 patients. Results of Meta-analysis showed,canagliflozin 300 mg/d were superior to 100 mg/d in reducing HbA1c[MD=0.14,95%CI(0.09,0.19), P<0.001],FPG[MD=0.40,95%CI(0.20,0.61),P<0.001] and reduction rate of body mass[MD=0.69,95%CI(0.42,0.96),P<0.001],the differences were statistically significant;and there were no significant differences in the incidence of total adverse reac-tions [RR=0.97,95%CI(0.94,1.01),P=0.10],hypoglycemia [RR=1.02,95%CI(0.94,1.10),P=0.67],urinary tract infection[RR=0.96,95%CI (0.78,1.18),P=0.69] in 2 groups;There was significantly different of genital mycotic infection in 2 groups[RR=0.84,95%CI(0.70,1.00),P=0.04]. CONCLUSIONS:Canagliflozin 300 mg/d is better than 100 mg/d in controlling HbA1c,fasting blood glucose and body mass of patients with type 2 diabetes,and the genital mycotic infection should be attentioned.

OBJECTIVE:To develop a HPLC method for the assaying of the principal agent in oxiracetam sodium chloride injection.METHODS:The separation was performed on Intersil CN-3column;the mobile phase was a mixture of acetonitri_ le-water(6∶94)with detection wavelength at214nm,flow rate at0.6ml/min and sample size at5?l under room temperature. RESULTS:The linear correlation of oxiracetam was observed over the concentrations of0.5625to288?g/ml(r=0.9999).The average recovery was99.95%(RSD=1.36%).CONCLUSION:The method is accurate,convenient specific and repro-ducible,and suitable for the determination and quality control of Oxiracetam.

BACKGROUND:Clinicaly, patients with constipation often have depression and depression is often associated with symptoms of constipation, but the mechanisms remain unclear. OBJECTIVE:To observe the relation between constipation and depression by establishing animal models. METHODS:A total of 60 specific-pathogen-free rats were divided randomly into three groups: normal group, chronic stress-induced depression model group and slow transit constipation model group. Slow transit constipation model was created by giving the solution of compound diphenoxlate 8 mg/kg daily, for 120 consecutive days. On day 100, chronic stress model rats were subjected to successive unforeseen stimulus for 21 days. Rats in the normal group were regularly housed. Fecal number, dry weight of feces and body weight were recorded once a week. After successful model establishment, fecal number, dry weight of feces, time of first dark stools defecation, sucrose preference, open-field behavior score and forced swim time were detected in each group, and statisticaly analyzed. RESULTS AND CONCLUSION:Fecal number was less in the chronic stress-induced depression model group than in the normal group (P = 0.00), and time of first dark stools defecation was longer (P = 0.00). Fecal number was more in the chronic stress-induced depression model group than in the slow transit constipation model group (P = 0.00), but time of first dark stools defecation was shorter (P = 0.00). No significant difference in fluid consumption, sucrose preference, horizontal and vertical scores of open-field test, and forced swim time was detected between slow transit constipation model group and normal group (P > 0.05). However, above indexes were higher in the slow transit constipation model group than in the chronic stress-induced depression model group (P < 0.01). Results verified that constipation was observed in chronic stress-induced rat model, but depression was not observed in slow transit constipation rat model, suggesting that depression can induce constipation, but constipation does not necessarily lead to depression.

Objective To evaluate the effects of prophylactic cranial irradiation (PCI) on the survival and brain metastatic rates in patients with limited stage small cell lung cancer (SCLC) in complete remission. Methods Fifty one patients with limited stage SCLC in complete remission after chemoradiotherapy were randomly divided into prophylactic cranial irradiation (PCI) group (n=26) and control group (n=25). Patients in PCI group received irradiation to a dose of 25.2～30.6?Gy by 1.8～2.0?Gy per fraction. With the survival rates of the two groups analyzed by life table and compared by Log Rank test, the difference in cranial metastatic rates between the two groups were tested by ? 2 test. The patients' clinical features such as age, sex, effect of treatment before PCI were comparable between the two groups. Results The incidence of cranial metastasis was 3.8% in the PCI group as compared with 32.0% in the control group, with the difference significant (? 2=5.15, P= 0.02 ). The 1 , 3 , 5 year survival rates were 84.6%, 42.3%, 34.6% in the PCI group and 72.0%, 32.0%, 24.0% in the control group, with no significant difference between the two groups (? 2=2.25, P=0.13). No serious complications were observed in patients who received PCI. Conclusion For patients with limited stage SCLC complete response after chemoradiotherapy, PCI can decrease the incidence of cranial metastasis and tends to improve the survival rate.

Based on the collation and analysis of 178 informed consent forms of clinical research projects related to human accepted by the ethical review committee of one hospital in 2007 and 2008,major problems were summarized as follows:the expression was difficult to be understood and was unsuitable for popular apprehension;lack of basic elements or insufficiently informed;inductive or advertising expressions existed,etc.Accordingly,the discussion was made for some recommendations of improvement.

This paper introduced the background, contents, methods and main results, as well as its strategic goals for the next decade and strategic development planning for the next five years. The authors believed that inherent logic, supports from the governments and other authorities as well as the executive power of the hospital in question were the basic factors for the success of its strategic planning and implementation. The authors also held that a package of actions would be conducive to correctly positioning tertiary hospitals and that medical services pricing ought to be rational for the costs, technology and policy guidelines of medical care.

Objective To investigate the effect of early intervention on general movements (GM) in preterm infants during fidgety movement. Methods 315 preterm infants during fidgety movement period were divided into intervention group (n=160) and control group (n= 155). The intervention group accepted very early intervention program consisted of hospital intervention and family intervention, and the control group accepted routine treatment and nursing. The incidences of different kinds of GMs were compared. Results There is no statistical difference (χ2=0.641, P=0.726) in writhing movement before intervention, and the fidgety movement presented more in the intervention group than in the control group (χ2=8.710, P=0.003), while the absence of fidgety movement was significantly fewer (χ2=5.685, P=0.017) after intervention. Conclusion Very early intervention can reduce the incidence of absence of fidgety movement and improve fidgety movement.

OBJECTIVETo investigate the effects of nano-lead exposure on learning and memory and iron homeostasis in the brain of the offspring rats on postnatal day 21 (PND21) and postnatal day 42 (PND42).

METHODSTwenty adult pregnant female Sprague-Dawley rats were randomly divided into control group and nano-lead group. Rats in the nano-lead group were orally administrated 10 mg/kg nano-lead, while rats in the control group were administrated an equal volume of normal saline until PND21. On PND21, the offspring rats were weaned and given the same treatment as the pregnant rats until 42 days after birth. The learning and memory ability of offspring rats on PND21 and PND42 was evaluated by Morris water maze test. The hippocampus and cortex s amples of offspring rats on PND21 and PND42 were collected to determine iron and lead levels in the hippocampus and cortex by inductively coupled plasma-mass spectrometry. The distributions of iron in the hippocampus and cortex were observed by Perl's iron staining. The expression levels of ferritin, ferroportin 1 (FPN1), hephaestin (HP), and ceruloplasmin (CP) were measured by enzyme-linked immunosorbent assay.

RESULTSAfter nano-lead exposure, the iron content in the cortex of offspring rats on PND21 and PND42 in the nano-lead group was significantly higher than those in the control group (32.63 ± 6.03 µg/g vs 27.04 ± 5.82 µg/g, P<0.05; 46.20 ±10.60 µg/g vs 36.61 ± 10.2µg/g, P<0.05). The iron content in the hippocampus of offspring rats on PND42 in the nano-lead group was significantly higher than that in the control group (56.9 ± 4.37µg/g vs 37.71 ± 6.92µg/g, P<0.05). The Perl's staining showed massive iron deposition in the cortex and hippocampus in the nano-lead group. FPNl level in the cotfex of offspring rats on PND21 in the nano-lead group was significantly lower than that in the control group (3.64 ± 0.23 ng/g vs 4.99 ± 0.95 ng/g, P<0.05). FPN1 level in the hippocampus of offspring rats on PND42 in the nano-lead group was significantly lower than that in the control group (2.28 ± 0.51 ng/g vs 3.69 ± 0.69 ng/g, P<0.05). The escape latencies of offspring rats on PND21 and PND42 in the nano-lead group were longer than those in the control group (15.54 ± 2.89 s vs 9.01 ± 4.66 s; 6.16 ± 1.42 s vs 4.26 ± 1.51 s). The numbers of platform crossings of offspring rats on PND21 and PND42 in the nano- lead group were significantly lower than those in the control group (7.77 ± 2.16 times vs 11.2 ± 1.61 times, P<0.05; 8.12 ± 1.51 times vs 13.0 ± 2.21 times, P<0.05).

ONCLUSIONn Nano-lead exposure can result in iron homeostasis disorders in the hippocampus and cortex of offspring rats and affect their learning and memory ability.

Animals ; Cerebral Cortex ; drug effects ; metabolism ; Female ; Hippocampus ; drug effects ; metabolism ; Homeostasis ; Iron ; metabolism ; Lead ; toxicity ; Learning ; drug effects ; Maternal Exposure ; adverse effects ; Memory ; drug effects ; Pregnancy ; Rats ; Rats, Sprague-Dawley

ObjectiveTo investigate the clinical pharmacokinetics (PK) and pharmacodynamics (PD) of gemifloxacin tablet in healthy Chinese volunteers and to provide evidences for optimal clinical dosing.MethodsTwenty volunteers were enrolled in the randomized (1∶1) double-blind study,and divided into administration group and control group.Each group received multiple oral doses of 320 mg of gemifloxacin tablet or placebo.The plasma and urine samples for gemifloxacin were analyzed by igh-performance liquid chromatogram(HPLC)-fluorometricmethod. Theminimuminhibition concentrations (MIC)of gemifloxacin against190clinical isolateswere determinedby broth microdilution method.The fAUC0～24 h/MIC and fCmax/MIC,with target value of 25 and 5,were used as the indices to evaluate PK and PD characteristics of gemifloxacin. The cumulative fraction of response (CFR) of gemifloxacin against each bacterium and the probability of target attainment (PTA) under various MIC level were evaluated using Monte Carlo simulation following multiple administration at steady state.ResultsThe Cmax of gemifloxacin after once-daily oral doses for 7 days were (1.55 ±0.32) μg/mL and (1.57±0.31) μg/mL for the first and last dose,while the AUC0～24 h were (7.91±1.52) and (8.91±1.15) h · μg · mL-1,respectively.The accumulation factor was 1.13±0.05.The time-profile of gemifloxacin could be described using two-compartment model and the half-life of distribution and elimination phase were (0.64 ± 0.17) and (7.10 ± 2.10) h,respectively. The cumulative urinary excretion rates within 24 h of gemifloxacin were 34.83 ％ and 38.95 ％ for the first and the last dose,respectively.PD study showed that the MIC90 of gemifloxacin were 0.25 mg/L and 0.125 mg/L against Streptococcus pneumoniae and Moraxelle catarrhalis,respectively,while the MIC90 was 2 mg/L against Hemophilus influenza. However,most of Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA) were resistant to gemifloxacin ( MIC90 ＞ 32mg/L).The PTA values of fAUC0～24 h/MIC and fCmax/MIC of gemifloxacin 320 mg daily for 7 days were close to 100％ when MIC was ≤0.06 mg/L.ConclusionsGemifloxacin is rapidly absorbed after oral administration of single doses in healthy Chinese volunteers,and the plasma concentration could reach steady state at the third day,while a minimal accumulation is shown after consecutive 7 days dosing.The PK/PD analysis suggests that the favorable clinical and bacteriological efficacy could be obtained when using thisregimen in treatment of sensitive patients with community-acquired pneumonia and acute exacerbation of chronic obstructive pulmonary disease.