ObjectiveThe investigate the action of self-care in geriatric type 2 diabetes patients.Methods96 geriatric type 2 patients were investigated through questionnaire. Results47 patients determined their blood sugar once or twice a week. 68 cases took medicine strictly.56 cases were good on alimentary control. 52 patients did exercise more than 1.5 h every day. The patients below 75 age old understood more about diabetes than that upward of 75.ConclusionTo improve the level of self-care on geriatric type 2 patients, the health care education must be done.

Objective To observe the clinical effect of Jiawei Zuojin Pills combined with western medicine on reflux esophagitis with liver-stomach disharmony syndrome. Methods Totally 90 cases were divided into observation group (45 cases) and control group (45 cases). The control group was given rabeprazole sodium enteric-coated capsule and domperidone tablets, and the observation group was given Jiawei Zuojin Pills additionally for four weeks. The clinical effect, TCM syndrome score and endoscopic improvement were observed. Results The total effective rate of observation group was 95.5%(43/45), control group was 93.3%(42/45), with no significant difference between the two groups (P>0.05). The excellent rate of observation group was 77.8% (35/45), control group was 57.8% (26/45), with significant difference (P<0.05). TCM syndrome score was improved in both groups (P<0.001), and the degree of improvement in the observation group was better than control group (P<0.05). The total effective rate rate under endoscopic of observation group and control group was 96.5% (43/45) and 77.8% (35/45) respectively, with significant difference (P<0.05). Conclusion Jiawei Zuojin Pills combined with western medicine has obvious efficacy in treating reflux esophagitis with liver-stomach disharmony syndrome.

OBJECTIVE:To optimize the purification technology of total flavones from Ampelopsis grossedentala with macro-porous resins. METHODS:4 kinds of macroporous resins for the purification of total flavones from A. grossedentala were screened by using drug-loading amount,desorption rate,recovery and purification rate as indicators. Single factor test and central composite design-response surface methodology were used to optimized eluant mass fraction,adsorption time,flow rate of eluant,eluant pH and other factors of purification technology,and validation test was also conducted. RESULTS:D-101 macroporous resin was the best. The optimal condition was as follows as the concentration of sample solution 2 mg(by extract weight)/ml,the volume of sam-ple solution 1.1 BV,ethanol 86.0%,adsorption time 36.7 min,flow rate of eluant 3.81 BV/h,pH 7. In validation test,mass frac-tion of total flavones increased from 66.83% to 85.00% in validation test(RSD=0.15%,n=3),and were close to predicted val-ue(85.08%). CONCLUSIONS:Central composite design-response surface methodology is feasible and stable for the optimization of purification technology of total flavones from A. grossedentala with macroporous resins.

Objective To explore the prevalence,mechanism and dissemination of β-lactam resistant streptococcus pneumoniae isolates in Nanjing area.Methods A collection of 130 strains of streptococcus pneumoniae isolated from seven teaching hospitals in Nanjing between 2010 and 2012 were included in this study.MICs of 14 common antibiotics were determined by agar dilution test. pbp1A、pbp2B、pbp2X genes were amplified.All the isolates were analyzed by pbp fingertyping to e-valuate their gene relateness. Results The resistance rates of clinical isolates to penicillin, cefuroxime ,cefotaxime ,cefepime ,ceftiaxone ,amoxicillin and meropenem were 5 1 .5 % ,6 9 .2 % , 17.7%,12.3%,3.1%,6.2%,16.9% respectively.The penicillin resistant rate in children was higher than that in adult.A good correlation had been found between penicillin and cefuroxime, cefepime,amoxicillin.5 isolates exhibited type A1-B1-X1 in molecular typing might be the same clone.Conclusion The penicillin resistant rate in children is high,a small range of clone dissemina-tion is found in Nanjing.

Objective To explore the prevalence,mechanism and dissemination of β-lactam resistant streptococcus pneumoniae isolates in Nanjing area.Methods A collection of 130 strains of streptococcus pneumoniae isolated from seven teaching hospitals in Nanjing between 2010 and 2012 were included in this study.MICs of 14 common antibiotics were determined by agar dilution test. pbp1A、pbp2B、pbp2X genes were amplified.All the isolates were analyzed by pbp fingertyping to e-valuate their gene relateness. Results The resistance rates of clinical isolates to penicillin, cefuroxime ,cefotaxime ,cefepime ,ceftiaxone ,amoxicillin and meropenem were 5 1 .5 % ,6 9 .2 % , 17.7%,12.3%,3.1%,6.2%,16.9% respectively.The penicillin resistant rate in children was higher than that in adult.A good correlation had been found between penicillin and cefuroxime, cefepime,amoxicillin.5 isolates exhibited type A1-B1-X1 in molecular typing might be the same clone.Conclusion The penicillin resistant rate in children is high,a small range of clone dissemina-tion is found in Nanjing.

Objective: To investigate the effects of miR-203 a-3 p overexpression on pulmonary fibrosis after acute lung injury induced by lipopolysaccharide(LPS) in rats and its possible mechanism. Methods: The rat model of pulmonary fibrosis after acute lung injury was established by multiple low-dose injections of LPS. The successfully modeled rats were randomly divided into model group, agomir-negative control group(agomir-NC group) and miR-203 a-3 p agomir group(agomir group), and another control group was set, with 15 rats in each group. One day before modeling and one week after modeling, miR-203 a-3 p agomir was injected by caudal vein for intervention. Two weeks after modeling, the wet/dry specific gravity(W/D) and hydroxyprolinic acid(Hyp) content of lung tissue were determined. The pathological changes and the degree of pulmonary fibrosis of lung tissue were observed by HE staining and Masson staining. The levels of interleukin-1β(IL-1β), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in broncholveolr lavage fluid(BALF) were determined by ELISA. The expression levels of miR-203 a-3 p and follicle-statin like 1(Fstl1) mRNA in the lung tissues of rats were detected by qRT-PCR. The protein expression level of Fstl1 in lung tissue of rats was detected by Western blot. The targeting relationship between miR-203 a-3 p and Fstl1 was detected by dual luciferase reporting system. Results: Compared with control group, the degree of lung injury and pulmonary fibrosis in model group were relatively serious, the W/D value and Hyp content of lung tissue increased(P<0.05), the levels of IL-1β, IL-6 and TNF-α in BALF increased(P<0.05), the expression of miR-203 a-3 p in lung tissue decreased(P<0.05), while the mRNA and protein expression levels of Fstl1 increased(P<0.05). Compared with model group, the degree of lung injury and pulmonary fibrosis were improved in agomir group, the W/D value and Hyp content of lung tissue decreased(P<0.05), the levels of IL-1β, IL-6 and TNF-α in BALF decreased(P<0.05), the expression of miR-203 a-3 p in lung tissue increased(P<0.05), while the mRNA and protein expression levels of Fstl1 decreased(P<0.05). The luciferase reporter gene assay confirmed that Fstl1 was the target gene of miR-203 A-3 p. Conclusion Overexpression of miR-203 a-3 p improves pulmonary fibrosis after LPS-induced acute lung injury, and the mechanism may be related to the targeted down-regulation of Fstl1 expression.

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.