Objective: To establish the quality standard for Ganmaoling Tablets (Radix Ilex asprella, Flos Chrysanthem Indici, Ramulus et Radix Evodia leptae, acetaminophe, etc.). Methods:The acetaminophen, chlorphenamini maleas, caffeine, Radix Ilex asprella, Flos Chrysanthem Indici, Ramulus et Radix Evodia leptae were identified by TLC. The acetaminophen and chlorogenic acid were determined by HPLC. Results:The average recovery of acetaminophe was 101.36%, and RSD was 0.93%, respectively. The average recovery of chlorogenic acid was 100.8%, and RSD was 0.9%, respectively. Conclusion:The method developed is accurate and the reproducibility is good. The method can be used for quality control of the Ganmaoling Tablets.

Objective: To study the changes of andrographolides in the drying process of the extract of Andrographis paniculata Nees. Methods: HPLC method was applied to analyze andrographolide and 14 deoxy 11, 12 didehydroandrographolide in the process. Results: The content of andrographolide descended rapidly in the whole drying process, while the content of 14 deoxy 11, 12 didehydroandrographolide ascended at first 12 hours, declined in content was slowly to follow. Conclusion: Baking temperature is not the only main factor to stimulate the transformation of andrographolide and 14 deoxy 11, 12 didehydroandrographolide.

Objective To analyze and identify the chemical constituents of essential oil from the fruits of Cinnamomum camphora chvar. Borneol. Methods The essential oil from the fruits was extracted by steam distillation and its chemical constituents were analyzed and identified by GC-MS. Results Fifty compounds were separated, and 42 kinds of which accounting for 99.536% were identified. D-borneol was the most abundant compound, of which the amount was 50.684%of the total constituents. Conciusion This present study demonstrated higher content of natural D-borneol, providing scientific basis for further exploration and utilization of the fruits of Cinnamomum camphora chvar. Borneol.

Objective To identify the gene mutations of an inherited coagulation factor Ⅶ deficiency pedigree.Methods PCR and DNA sequencing were used to identify the FⅦ gene mutations in the proband.The identified mutations were validated by PCR followed by restriction fragment length polymorphism technique or DNA sequencing.100 healthy volunteers were chosen randomly as controls. Results R1S2Q and IVS6+1G→T double heterozygous mutations were discovered in the Droband.The pedigree analysis showed that R152Q missense mutation inherited from his father,and IVS6+1G→Twas from his mother. The R1S2Q missense mutation in exon 6 was not found in 100 healthy volunteers. Conclusion The congenital deficiency of F Ⅶ in the proband might be caused by the coinheritance of the R152Q missense mutation in exon 6 and the splicing donor site mutation ( ⅣS6+1G→T)in intron 6.

Objective To explore the effect of doctor-nurse integrated ward round performed in the training of professional nurses′ core competence.Methods 18 nurses trained for core competencies in ICU and hemodialysis room were selected as research objects.All nurses were trained with doctor-nurse integrated ward round for one year.The professional knowledge, skills and clinical comprehensive ability of all nurses were tested before and after training.Results After doctor-nurse integrated ward round, the scores of professional knowledge, skills and clinical comprehensive ability of professional nurses were significantly higher than that of before training (P<0.05).Conclusion Doctor-nurse integrated ward round can improve the core competencies of professional nurses.

Objective:To further improve the understanding of paroxysmal nocturnal hemoglobinuria (PNH), we retrospectively analyzed and summarized the clinical characteristics, treatment status, and survival status of patients with PNH in Zhejiang Province.Methods:This study included 289 patients with PNH who visited 20 hospitals in Zhejiang Province. Their clinical characteristics, comorbidity, laboratory test results, and medications were analyzed and summarized.Results:Among the 289 patients with PNH, 148 males and 141 females, with a median onset age of 45 (16-87) years and a peak onset age of 20-49 years (57.8% ). The median lactic dehydrogenase (LDH) level was 1 142 (604-1 925) U/L. Classified by type, 70.9% (166/234) were classical, 24.4% (57/234) were PNH/bone marrow failure (BMF), and 4.7% (11/234) were subclinical. The main clinical manifestations included fatigue or weakness (80.8%, 235/289), dizziness (73.4%, 212/289), darkened urine color (66.2%, 179/272), and jaundice (46.2%, 126/270). Common comorbidities were hemoglobinuria (58.7% ), renal dysfunction (17.6% ), and thrombosis (15.0% ). Moreover, 82.3% of the patients received glucocorticoid therapy, 70.9% required blood transfusion, 30.7% used immunosuppressive agents, 13.8% received anticoagulant therapy, and 6.3% received allogeneic hematopoietic stem cell transplantation. The 10-year overall survival (OS) rate was 84.4% (95% CI 78.0% -91.3% ) . Conclusion:Patients with PNH are more common in young and middle-aged people, with a similar incidence rate between men and women. Common clinical manifestations include fatigue, hemoglobinuria, jaundice, renal dysfunction, and recurrent thrombosis. The 10-year OS of this group is similar to reports from other centers in China.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.