AIM:In order to improve the clarity and quality of Ginkgo leaf water-extraction solution,and optimize the production process. METHODS:The experiment was based on the optical absoiption and scattering rate,flocculation rate and loss in flavanones were used as two main parameters to estimate the effect of influencing factors on flocculation.It could be proved by analyzing the particle size in water-extraction solution before and after flocculation. RESULTS:The best flocculation technological parameters of water-extraction solution of Ginkgo leaf with chitosan were as follows:at flocculant concentration of 1.071 g/L,flocculation temperature of 40(?C),pH of 4.9. CONCLUSION:The flocculation of water-extraction solution of Ginkgo leaf with chitosan is effective and selective,it has the advantage over ethanol precipitation method.

As the key phase for medical students to be doctors,clinical internship plays a vital role in the whole medical education process.Interns in the department of gastrointestinal surgery face series of difficulties,such as wide variety of diseases and emergence of new technology and new concepts.In addition,because of the uneven levels of teachers and low enthusiasm of interns,the result of clinical practice teaching is not satisfactory.Based on the above-mentioned problems,measures have been introduced during the process of clinical practice teaching,including selection of typical diseases and surgical procedures,construction of clinical practice teaching team,adoption of pluralistic teaching methods,reinforcement of participation of interns during the clinical practice.Finally,the quality of teaching in our department has been irmproved significandy.

The medical records of all 12 patients diagnosed as chronic active Epstein-Barr virus (CAEBV) infection at our hospital were analyzed retrospectively.There were 7 males and 5 females with a median onset age of 28 years.CAEBV was characterized by fever,splenomegaly,hepatomegaly and lymphadenopathy,etc.The abnormalities of laboratory examination included liver dysfunction,thrombocytopenia,anemia and leucopenia.EBV-DNA detected by real-time polymerase chain reaction was (1.7 × 103-3.5 × 107) copies/μg DNA in peripheral blood mononuclear cell.Among them,the outcomes were death (n =5),lost to follow-up (n =2) and T cell lymphoma (n =1).It is necessary to improve our awareness of CAEBV infection because of its poor prognosis and high mortality.

Objective To improve the diagnosis and treatment of Q fever endocarditis.Methods From 2008 to 2013,four cases of Q fever endocarditis were diagnosed in Peking Union Medical College Hospital.Clinical features,laboratory test,management and prognosis were analyzed with literature review.Result All four cases had long period of fever and heart murmur.Two patients represented with respiratory symptom and one with non-specific rash.General laboratory tests including complete blood cell count,ESR,C-reactive protein(CRP),liver function and radiology of lung did not show specific abnormalities.Signs of endocarditis were shown by ultrasound and important for diagnosis.Repeated blood culture was negative.All of the diagnoses were confirmed by serum antibody detection and the patients recovered well with treatment based on doxycycline or minocycline.Conclusions Endocarditis is the most common form of chronic Q fever,which is easily misdiagnosed because its blood culture is negative and may accompanied with varied manifestation such as pneumonia and liver injury.For the patients with chronic fever and blood culture negative endocarditis,chronic Q fever should be considered as differential diagnosis.The confirmatory method for diagnosis is serum antibody detection.Early and sufficient treatment may improve the prognosis.

BACKGROUND: Anemia after kidney transplantation has a clinical incidence rate of 30%-40%, is the important risk factor for cardiovascular diseases and kidney failure after kidney transplantation and is also the independent prediction index of patient's death. OBJECTIVE: To analyze the factors related to anemia after kidney transplantation. RESULTS AND CONCLUSION: In the anemia group (n = 225, 27.2%, aged 26-65 years), the incidence rate of anemia in female and male patients was 23% and 37%, respectively (P < 0.05), 46 patients had hypertension and used angiotensin-converting enzyme inhibitor or angiotensin Ⅱ receptor antagonist and 16 patients had chronic erosive gastritis or upper gastrointestinal tract ulcer, with the human survival rate of 85.3% and kidney failure rate of 25.3%. In the non-anemia group (n = 601, 72.8%, 405 males, 196 females, aged 18-71 years), 35 patients had hypertension and used angiotensin-converting enzyme inhibitor or angiotensin Ⅱ receptor antagonist and 14 patients had chronic erosive gastritis or upper gastrointestinal tract ulcer, with the human survival rate of 92.1% and kidney failure rate of 12.6%. There was significant difference in above-mentioned indices between anemia and non-anemia groups (P < 0.05). These results suggest that gender, age, kidney function, digestive tract disease history, and drug application are closely related to anemia after kidney transplantation.

Objective To evaluate prescribing antibiotics in medical patients visiting the polyclinic at 2008 Beijing Olympic Village for its further reasonable use. Methods Clinical prescriptions for all the medical patients at the polyclinic were reviewed retrospectively. Consistency between antibiotics prescriptions and their indications formulated before 2008 Beijing Olympic Games was evaluated, as well as related factors for their overuse. Results In total, 1537 patients visited the polyclinic and 1233 recipes were prescribed,with 956 patients (62. 2% ) with infections, including 809 (52. 6% ) of respiratory infections. One hundred and forty-nine of 1537 patients (9. 7% ) were treated with antibiotics, accounting for 12. 1 percent of all prescriptions, and 43 cases (28.9%) were identified as antibiotics overuse, including 39 cases with respiratory infections. Prevalence of antibiotics overuse was significantly more for patients of domestic employees than that for non-employees (34. 6% vs. 14.3% , P <0. 01 ), with art independent association between them (OR 3.07, 95% CI 1.11 - 8. 50). Conclusions Although the polyclinic has successfully reduced unnecessary antibiotics use, their overuse remains to be reduced, and physicians' strict adhesion to indications for antibiotics use and patient education are essential for their rational use in primary care of China.

Objective To investigate clinical service delivered at the Polyclinic of Beijing 2008 Olympic and Paralympic Village and outcomes of the medical patients visited there.to provide experiences in medical care service for other mass-gatherings in the future.Methads Clinical data of all the medical patients evaluated at the Polyclinic during July 27 to August 27 and during August 29 to September 19,2008 were reviewed retrospectively.with univariate and multivariate analyses.Results In total.1537 and 1206 medical patients visited the Polyclinic at the Olympic and Paralympic Village,respectively.Proportion of athletes visited was hisher during the Paralympic Games than that during the Olympic Games(14.2% vs.9.8%,P<0.01).We reeeived 775 patients(50.4%)with acute respiratory tract disorders,including 16 cases(1.0%)with asthma,during the Olympic Games,and 686(56.9%),including eight cases (0.7%)with asthma,during the Paralympic Games,and antibiotics were prescribed for 149(9.7%)and162(13.4%)of them,respectively.Twelve(0.8%)patients were hospitalized during the Olympic Games and four(0.3%)during the Paralyrnpie Games,and age equal to or nlore than 55 years and digestive disease were independent risk factors for hospitalization,with odds ratios(ORs) of 5.3 and 9.5 and their 95% confidence intervals(Cls)of 1.4-19.6 and 2.5-36.4,respectively.Conclusions Acute respiratory disorder was the most connnon cause for medical visits in the Polyclinic.Asthma did not play a significant role to iniluence athletes'performance in the Beijing 2008 Olympic and Paralympic Games.Antibiotic prescription in the Polyclinic had been controled to an acceptable level.Conditions in elder patients and those with digestive disorder tended to be severe.deserving more attention infuture's mass gathering.

One hundred patients with type 2 diabetic neuropathy were divided into L-carnitine group and control group with 50 eases in each group. Data showed significant improvements in clinical symptoms scores, visual analogue scale and quantitative sense test after 16-week L-earnitine treatment (all P < 0.05). The study demonstrates that L-earnitine has affirmative effect on patients with diabetic neuropathy, especially in alleviating pain.

Objective:To develop a chemiluminescent microparticle immunoassay ( CMIA) method for the determination of meco-balamin in human serum to investigate the pharmacokinetics and bioequivalence of mecobalamin. Methods:A single oral dose of two kinds of mecobalamin was given to 19 healthy volunteers in a randomized three-period crossover study. The concentrations of mecobal-amin in serum were assayed by CMIA, the main pharmacokinetic parameters were analyzed by DAS 3. 0 software, and the bioequiva-lence was evaluated. Results: The main pharmacokinetic parameters of test and reference mecobalamin tablets were as follows: tmax were (4.2 ±1.9)h and (4.4 ±2.4)h,Cmax were (322.0 ±145.4) ng·L-1 and (282.2 ±108.1) ng·L-1,t1/2 were (19.2 ±5.3) h and (20.0 ±6.3)h,AUC0-72 were (6 769.1 ±2 169.4) ng·h·L-1 and (6 400.6 ±1 921.5) ng·h·L-1. F(0-72) and F(0-∞) of the test tablets was 105. 9% ± 13. 2% and 104. 9% ± 12. 6%,respectively. Conclusion:The method is simple and precise. The two tablets are bioequivalent.