Humans ; Nose ; anatomy & histology ; surgery ; Petrous Bone ; anatomy & histology ; surgery

Endoscopy ; education ; Humans ; Skull Base ; surgery

Under physiological conditions, many vital functions of the body are controlled by transient release of bioactive substances at a specific time and site. Based on the circadian rhythm character of disease and chronotherapeutic conceptions, pulsatile delivery system has been designed to achieve optimal therapeutic effect and reduce the toxic and side-effect. In recent years, more and more studies are focused on the pulsatile multiparticulate drug delivery system. Pulsatile multiparticulate system possesses many benefits, such as no risk of dose dumping, predictable gastric emptying, flexible release patterns and increased bioavailability. Based on these premises, the aim of this review is to summarize the major design methods of pulsatile multiparticulate and the research progress.

Aim: To investigate the chemical components in Zhizidahuang decoction( ZZDHD) to reveal the possible material therapeutic basis. Methods: High performance liquid chromatography coupled with photodiode array detector and tandem mass spectrometry ( HPLC-PDA-MS/MS) was applied to simultaneously characterize the chemical components and their structures in ZZDHD. The analysis was preformed on a Lichrospher C_(18) column using a binary eluent of 0. 1% acetic acid( A) and methanol( B) mixed under the gradient mode; UV spectra were scaned from 210 nm to 480 nm; negative ESI experiments in data-dependent scan mode were performed. Results: HPLC-PDA-MS/MS chromatogram of ZZDHD was achieved. Based on UV spectral data, information of molecular weight and mass fragmentation behaviors connected with extracted ion current( EIC) chromatogram, twenty kinds of components were detected and identified, including flavonoids, anthraquinones, iridoids and other constituents. Conclusion: The method presented in this study, which combined HPLC with UV and MS, allowes the characterization of compounds in the complex herbal system even without the reference standards.

Objective To develop a rapid specific method to detect HBV gene mutation by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Methords The patients of YMDD and YIDD mutation were detected by DNA sequencing.Results the DNA sequencing demonstrated that not only YMDD and YIDD/YVDD mutation, but LLLL,LMLL,DLHD,DMHD,LLAQ and LMAQ mutation were also detected in different hepatitis B patients. The results of PCR-RFLP indicated that there were different restricted sites in the distinct mutation.Conclusion The results above indicated that all these mutants exist in the initiator codon of ATG(Met). The mutation of LMLL DMHD LMAQ was associated with Lamivordin treatment. Whether mutation of Met links with the second replicating of HBV needs to be further studied.

Objective To investigate the status of hold vaccination contraindication knowledge by Zhengzhou Municipal vaccination staff for improving the vaccination service.Methods To sample 54 vaccination clinics with Stratified random samping 216 Expanded Program on Immunigation (EPI) staff were suvveyed by questionnaire and analyse the data with descriprive method.Results The knowledge rate on contraindications was 56.9%,knowledge was mainly come from vaccine manual,professional books and tranining.Conclusion The EPI staff's contraindications knowledge was weak,and vaccination contraindication rules should be developed to guide actual work as soon as possible.

Objective To study the effects of biofeedback combined with the fixed functional appliance in the modification of mandible in patients with Angle Class Ⅱ malocclusion and retruded mandible.Methods A Iotal of 30 orthodontic patients were divided into two groups,all patients with retruded mandible and normal maxilla,ANB>6°,aged from 9 years and three months to 14 years and 11 months.All patients were treated with Forsus fixed functional appliance combined with MBT straight-wire appliance.Muscular activity of the superficial masseter muscle before,during,and after treatment.was evaluated by assessing the average integrated eleetromyogram (EMG) .The biofeedback was performed during functional treatment in the study group,the muscular activity of the superficial masseter muscle was turned into the signal which can be read and seen by patients,and the patient can control the muscular activity of the superficial masseter muscle in a certain extent under the help of instrument.After 6 weeks fixed functional appliance treatment,the biofeedback treatment was performed in the study group with the help of instrument and trained for 10 times,and the patients could trained by themselves for 20 minutes everyday.Results The biofeedback treatment was able to regulate the muscular activity of the masseter muscle and prevent the return of muscle function and the tendency to seat the condyle back toward the fossa,maintain the treatment effect;after biofeedback treatment the decreased postural EMG activity in the masseter muscle was steady,but without statistical significance (P>0.05).Conclusion The biofeedback treatment can maintain the muscular activity of the masseter muscle effectively,enhance the effect of functional treatment and keep the stability of the mandibular position.

Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; complications ; Coronary Vessels ; Humans ; Syphilis, Cardiovascular ; complications

Objective To learn the clinicians'attitude towards the “Drug and Medical Service Separation” reform in Beijing.Methods A number of pilot hospitals of “Drug and Medical Service Separation” reform in Beijing were pinpointed,for a random questionnaires survey among 800 clinicians,to learn their awareness,evaluation and attitudes to the reform.Results The clinicians were found with good awareness and understanding of the reform,with an awareness rate of 99.5％ ; 72.0％ of them hold that the pricing of “medical service charge” of the reform as reasonable; most of them believe that the reform plays a positive role in relieving the difficulties of seeing doctors and affordability of medical treatment; their approval rate for the reform pilot project is 97.3％; their satisfaction for the reform implementation is 90.8％,and their support for full implementation of the reform is 94.0％.Conclusion The clinicians from those pilot hospitals are sufficiently aware of and understand this policy,and are supportive of the pilot with useful suggestions.The recommended strengthened publicity and training,higher medical service charges,better pay for medical workers,improved incentive mechanism and evaluation mechanism,and better clinicians' satisfaction.

Objective To observe the effects of puhnonary rehabilitation on the symptoms and quality of life of persons with chronic obstructive pulmonary disease (COPD).Methods COPD patients were recruited from a hospital and community health centers and given pulmonary rehabilitation in the community.The rehabilitation program included health education and nutrition guidance,medication,breathing exercises,and physical exercise.Each patient was followed up every 4 weeks by telephone.The outcome measures included pulmonary function (FEV1％,FEV1/FVC％),St George's questionnaire (SGRQ),the Medical Research Council scale (MRC),Borg scoring,evaluation of anxiety and depression,the six-minute walk test (6MWT),and an evaluation of nutritional status.All of the patients were observed for one year.Results A total of 85 patients completed the program and were included in the final statistical analysis.There was no difference in FEV1 ％ before and after rehabilitation.Six-minute walking distance improved significantly in statistical terms but the average increase was only from (416.1 ±99.84)m to (437.51 ±116.17)m.The SGRQ scores decreased by an average of 4.8 points after a year of rehabilitation,with significant improvements among the moderately and severely impaired.Incidents of COPD exacerbation also decreased significantly.Patients with a low body mass index had the greatest SGRQ score improvments.Few patients showed depression or anxiety in this research population.Conclusions Pulmonary rehabilitation in the community can improve exercise tolerance and the quality of life for persons with COPD,reducing incidents of acute exacerbation.Patients may benefit from such pulmonary rehabilitation regardless of disease severity.The compliance was good despite the infrequent monitoring.Pulmonary rehabilitation in the community is worthy of more widespread use.