Objective To prepare sustained-release tablet contained paeoniflorin and evaluate its drug release mechanism.Methods Orthogonal design was used to obtain the best formula.Hydroxypropykmethyl cellulose(HPMC K4M)and ethylcellulose(EC 20CPS)were used as hydrophilic matrix material,and PVP which dissolved in ethanol was used as adhesive material,then the sustained-release tablet was prepared by the wet granule compression technique.The best formula was determined by powder technology,including compression ratio,angle of repose,flow rate,and angle of contact as indexes.The optimum formula was obtained by comprehensive scoring method.The drug release in vitro was determined,and the release formula was made to investigate the release mechanism.Results The optimized prescription was with HPMC 20%,EC 20%,PVP 0%,and ethanol concentration 80%.The dissolution curves in vitro showed that the drug release could be best described by the Higuchi equation(Q=0.367 5 t1/2-0.165 8,r=0.993 2)and Peppas equation(lnQ=0.72 lnt-1.608 6,r=0.991 8).It showed that the release mechanism was Fick diffusion and backbone corrosion.The release rate could meet the requirement of quality control on sustained-release tablet in Chinese Pharmacopoeia(2005).Conclusion The method of content determination is simple and sustained-releasing rate is significant.The release mechanism follows the kinetic model of sustained-release tablet.It is worth doing further research for the clinical use.

Objective To discuss the differences between hemiarthroplaty and dynamic hip screws (DHS) by comparing their effect in treatment of osteoporotic femoral intertrochanteric fractures. Methods A retrospective study was done on 86 patients with femoral intertrochanteric fractures treated by hemiarthroplasty and dynamic hip screws respectively. After a follow-up for six months, the operation duration time, loss of ambulatory grades and prosthesis loosing were compared between two groups. Re-suits Operation was lasted for hmgcr time in DHS group, with significant difference between two groups. Loosening rate varied with different degree of osteoporosis in high-, moderate- and low-risk groups but not in hemiarthroplaty group. Internal fixators penetrating cortical bone occurred in DHS group, with inci-dence rate of 51.2%. On the contrary, no evidence proved loosening of prosthesis in hemiarthroplaty group. Conclusion For osteoporosis patients with intertrochanteric fracture, the hemiarthroplaty is a reasonable alternative to DHS device, for it can help obtain earlier and better functional recovery and less postoperative complication.

Objective To evaluate the symptom improvement of anxiolytics and antidepressant to hemifacial spasm(HFS)patients with anxiety and depression. Methods A total of 60 HFS patients with anxiety and depression were enrolled for the study and divided into experimental group and control group. Experimental group were treated with escitalopram and BTX-A ,and control group only received BTX-A. SAS and SDS were used to test all the patients before and after treatment. Results Both experimental group and control group were significantly improved after BTX-A therapy. There was no different between two groups at 1 week and 1 month,respectively. At 2 weeks and 3 months,more obvious improvement was seen in experimental group. The SAS and the SDS standard average scores of experimental group were significantly decreased compared with the control group. There was statistical significance in control group after 1 month and 3 months treatment(P<0.05),and in experimental group,the differences appeared after 2-week treatment(P<0.05). Additionally,after 1 month treatment,there were statistical differences between the two groups(P<0.05),and experimental group shown a longer effective period compared with control group. Conclusion Anxiety and depression state serves as a complication of HFS ,which is positively correlated with HFS. HFS patients with anxiety and depression benefit better from escital-opram and BTX-A combination therapy than BTX-A alone.

Objective To investigate characteristics of glucose metabolism of non-obese and obese women with polycystie ovary syndrome(PCOS).Methods From March 2008 to July 2011,118 PCOS patients were enrolled in this study and were divided into 53 cases (body mass index(BMI) ≥25 kg/m2) in obese group and 65 cases (BMI ＜ 25 kg/m2) in non-obese group.Participants' clinical data,glucose tolerance and insulin release test results were retrospectively reviewed.The prevalence of type 2 diabetes mellitus (T2DM),results of oral glucose tolerance test,impaired fasting glucose (IFG),impaired glucose tolerance (IGT) were compared between the two groups.Results (1) Blood glucose levels:at the time points of 30,60,120 and 180 minutes,the levels of fasting glucose were (5.2 ± 1.1),(8.5 ± 2.8),(8.1 ± 2.4),(6.3 ± 2.0) and (4.8 ± 1.5)mmol/L in non-obese group and(5.4 ±0.9),(9.1 ± 1.8),(9.3 ±0.6),(7.6 ± 1.0) and (5.4 ±0.8) mmol/L in obese group.Statistical difference was observed between obese and non-obese groups at each time point (t =-6.125,-4.005,-6.074,-6.751 and-4.512 respectively,P ＜0.01).(2) The level of insulin:at the time points of 30,60 and 120 min,the level of fasting insulin were (8 ± 4),(55 ± 21),(65 ± 14) and (45 ±18)mU/L in non-obese group and (13 ± 8),(85± 30),(105± 54) and (76 ± 46)mU/L in obese group.There were significant statistical difference between the two groups at each time point (t =-17.024,-12.540,-15.791 and-16.149 respectively,P ＜ 0.01).However,at the time point of 180 minutes,the level of insulin did not exhibit significant difference between obese and non-obese groups (P ＞ 0.05).(3) The prevalence of abnormal glucose metabolism:The rates of IGT were 13.85 ％ (9/65) in non-obese group and 24.53 ％ (13/53)in obese group,which also showed remarkable difference (x2 =18.446,P ＜ 0.01).The rates of T2DM were 1.54％ (1/65) in non-obese group and 7.55％ (4/53) in obese group,which reached significant difference (x2=16.005,P ＜ 0.01).Conclusion Abnormal glucose metabolism was observed more frequently in overweight or obese PCOS women.

Research based learning (RBL) is a brand new teaching mode implicated by Shanghai Jiaotong University School of Medicine specifically designed for clinical undergraduates.The nature of RBL is about exploring unknown knowledge and designing and executing comprehensive experiments.RBL aims at creating an open,active student participation,and close student-mentor interaction teaching mode.IBL includes literature study,research aim selection,experiment design and implementation,statistical analysis,results and conclusions,final report writing and defense of the report.Our experience indicates that RBL can substantially improve students' scientific logic and critical thinking and experimental skills,and develop the spirit of a team-player.This scientific training enables students to receive more comprehensive scientific training,facilitate their subsequent clinical research and practice,and assist them to participate in more international scientific exchanges.We propose that the RBL mode should be adopted for clinical student education in other universities.

Objective To investigate whether there is exists optimal effective connections of prefrontal-amygdala in patients with major depressive disorder when they recognize dynamic positive face expressions with the technology of magnetoencephalograph (MEG),and discuss the possible aberrant mechanism of emotion processing.Methods Twenty major depressive patients and 20 well-matched healthy volunteer controls participated in the experiment.The regions of interested brain area included the primary visual cortex (V1),the precuneus (PQ),the dorsolateral prefrontal cortex (DLPFC),the anterior cingulate cortex (ACC),the amygdala (AMYG).After constructing three putative models,dynamic causal model was used to select an optimal model,then extracted all the effective connection parameters and conducted t-test under the overall optimal model between-group comparison.Results The bayesian model selection (BMS) indicated that model with top-down modulate connections between DLPFC-ACC,DLPFC-AMYG and ACC-AMYG was the most superior model,whose exceedance probability was 0.41.In the fight hemisphere of patient group,the endogenous connectivity from AMYG to ACC significantly decreased compared to healthy controls (t=-2.21,P=0.033),while the endogenous connectivity from ACC to DLPFC was enhanced significandy (t=2.50,P=0.017),which was the same with the endogenous connectivity from AMYG to DLPFC (t=2.10,P=0.040).Conclusion The effective connections of prefrontal-amygdala in major depressive disorder are exactly impaired,which may indicate that major depressive disorder have a bias toward negative.While depressed patients don' t show abnormality in the modulate connectivity under happy stimulus.

Objective To investigate on the incidence of gynecological laparoscopic operation complications within ten years.Methods From January 2003 to December 2012,clinical data and the complications of 4 897 cases undergoing gynecological laparoscopic operation in First Hospital of Peking University were studied retrospectively.Those surgeries included 876 cases with hysterectomy,662 cases with myoectomy,3 266 cases with adnexa surgery,93 cases of diagnostic laparoscopy operation.Results The complications occurred in 29 cases,the incidence rate was 0.59％ (29/4 897).The Incidence rate in Hysterectomy group was 1.83％ (16/876),which was significantly higher than 0.60％ (4/662) in myoectomy group and 0.28％ (9/3 266) in adnexa surgery group.Twenty nine cases of complications were 14 cases with organ injures (48％,14/29),5 cases with hemorrhage complications (17％,5/29),8 cases with infectious complications (28％,8/29),2 cases with incisional hernia(7％,2/29).Conclusion The major complication of gynecological laparoscopic operation complication was organs injuries,which was associated with difficulty and scope of the operation.

Objective To discuss the clinical application of reverse dorsal metatarsal artery perforator flap for reconstruction of forefoot soft tissue defects.Methods Since January,2008 to March,2016,43 patients with forefoot soft tissue defect due to various causes were reconstructed with the flap based on dorsal metatarsal artery perforator.Dorsal pedis was used as a donor site with dorsal metatarsal artery perforator as the donor artery.The flap size varied from 2.0 cm × 4.0 cm to 6.0 cm × 8.0 cm.Among them,27,8,4 and 4 cases were reconstructed with flap based on first,second,third and fourth dorsal metatarsal artery perforator flap respectively.Results All the patients were followed-up which ranged from 3 months to 24 months.Six flaps suffered from post operative venous congestion.Out of 6,4 survived with early emergency management while the remaining 2 suffered epidermal necrosis which survived with regular dressing change.Eventually,all the flaps survived.They had good texture and they were elastic,good-looking and very wear-resisting.Walking function was normal.Conclusion Reverse dorsal metatarsal artery perforator flap is an ideal choice in reconstruction of small to medium sized soft tissue defects of forefoot.

Objective To evaluate the diagnostic value of expression of MG7-Ag diflferentiation and guidance of follow-up mucosal biopsy in the patients with suspected malignanct gastric ulcer.Methods The expression of MG7-Ag in 58 patients who were suspected as having malignant gastric ulcer under routine endoscopy was studied by immuno-histochemical staining.The follow-up endoscopy was pefformed 1 to 72 weeks(mean 7 weeks)later and biopsy was taken.Results There were 19 cases of gastric carcinoma in 30 patients with positive MG7-Ag expression(63.3%)and only 5 in 28 patients with negative MG7-Ag expression(P＜0.01).Conclusion The positive expression of MG7-Ag is correlated with gastrie carcinoma in patients with suspected malignant gastric ulcer.

Objective To compare the sensitivity,accuracy and specificity between automated breast volume scanner (ABVS) and ultrasonic elastography (UE) in the diagnosis of breast mass.Methods From May 2016 to July 2017,132 patients with breast mass in the No.266 Hospital of PLA were chosen in the research.ABVS,UE and two-dimentional ultrasonography were used for diagnosis,and the diagnostic results were compared with pathological results.Results The sensitivity,accuracy and the specificity of two-dimensional ultrasonography were 76.54％ (62/81),75.0％ (114/152),73.24％ (52/71),respectively,which of UE were 80.25％ (65/81),78.95％ (120/152) and 77.46％ (55/71),respectively,which of ABVS were 88.89％ (72/81),88.16％ (134/152) and 87.32％ (62/71),respectively.The sensitivity of ABVS was higher than that of two-dimensional ultrasonography (x2 =4.318,P＜0.05),while had no statistically significant difference compared with that of UE(x2 =2.318,P ＞ 0.05).The accuracy and specificity of ABVS were higher than those of UE and two-dimensional ultrasonography (accuracy:x12 =8.756,x22 =4.692;specificity:x12 =4.449,x22 =4.135;all P ＜0.05).Conclusion The sensitivity,accuracy and specificity of ABVS in the diagnosis of breast lesions are high,and doctors from ultrasonic department are recommended to use ABVS to diagnose breast cancer.This can improve the detectable rate of breast cancer and the cure rate and survival rate of patients.