To explore the problems in environmental governance of pharmaceutical industry in China,based on the conclusion that the US has done,then propose ways for environmental management to be applied to the pharmacutical industry in China,including strengthening the ecological property research;to transite the government regulation to common control by the government and the market;to speed up the disclosure of environmental information about pharmaceutical enterprise;to try contractual governance within the pharmaceutical industry;to explore sustainable development mechanism of the Evironmental Non-governmental Orgnization(ENGO);to advocate that popularizing of environmental protection knowledge scientific,to support the dissemination of science socialized.

Objective To describe the impact of stroke clinic on the usage of statins for secondary prevention of ischemic stroke.Methods Data about the demography, social economic status, personal histories, blood lipid profiles, and the status of the usage of statins from 568 serial ischemic stroke patients were retrospectively analysed.Results A total of 51.3% patients followed up in stroke clinic ( 306 patients) and 7.6% patients followed up in general clinic (262 patients) were treated with statins.71.6% patients with and 44.8% patients without hyperlipidemia in stroke clinics were taking statins, which were higher than that patients in the general clinics(27.1% and 2.0% respectively).The patients in the stroke clinics with high LDL-C level ( ＞ 3.4 mmol/L) were more likely to be treated with statins than those with lower level (25.6% vs 14.7%, P = 0.017).Conclusions The rate of statins usage is extremely low in stroke patients followed up in a general clinic, but it can been improved greatly in a stroke clinic.Stroke clinic can narrow the gap between the clinical practice and the guideline for secondary prevention of ischemic stroke.

Objective To investigate the relationship between the acute phase blood glucose and the severity and prognosis of stroke in patients with stroke. Methods One hundred seventy-three consecutive patients with acute stroke were randomly allocated into either a hyperglycemia group (n =72) or a normal group (n = 101) according to whether their random blood glucose levels were > 7.8 mmol/L or not. The average time from stroke onset to admis-sion was 6.5 ± 5.1 hours. The patients were evaluated by the National Institutes of Health Stroke Scale (NIHSS) and Glasgow Coma Stroke (GCS) scores within 20 minutes after clinical reception, The plasma blood glucose detection and bead CT scan were completed in 40 minutes.The patients with cerebral infarction were classified according to the Oxfordshire Community Stroke Project (OCSP) criteria, and the survivors were evaluated by the modified Rankin scale (mRS) after 3 months. Results There were no significant differences between the two groups in age, gender, vascular risk factors, stroke property and treatment principle. There were significant differences between the NIHSS and GCS at the first admission and the mRS scores at 3 months (P<0.01). The proportion of the patients with the history of diabetic mellitus in the random hyperglycemia group was significantly higher than that in the normal group (P<0.01).The random blood glucose levels were not correlated with the severity of stroke between the 2 groups of patients with the history of diabetes mellitus; the increased random blood glucose levels were significantly correlated with the severity and prognosis of stroke between the 2 groups of patients without the history of diabetes mellitus (P<0.01). Conclusions The increased blood glucose in patients with stroke without the history of diabetes mellitus in acute phase is an independent risk factor for the severity and prognosis. The increased random blood glucose in patients with stroke in acute phase may also suggest having the history of diabetes mellitus.

Doxorubicin-loaded PLGA nanoparticles (DOX-PLGA NPs) was prepared by double emulsion (W/O/W) solvent evaporation method with the biodegradable materials-poly (lactic-co-glycolic acid) (PLGA) used as carrier materials. Single-factor test was used to investigate the influence of the type and ratio of the organic phase, the amount of surfactant, PLGA concentration, the ratio of external water phase and oil phase (W/O), the ratio of doxorubicin and PLGA, ultrasonic time and stirring time on the preparation of nanoparticles. The best formulation and preparation conditions were optimized by orthogonal test based on single-factor test, evaluation indicator as particle size and entrapment efficiency, and the results were analyzed by overall desirability. And the in vitro release behaviors of the nanoparticles were studied as well. The size distribution, zeta potential, morphology of DOX-PLGA NPs were characterized by laser light scattering and transmission electron microscopy; encapsulation efficiency and releasing behavior of DOX-PLGA NPs in vitro were investigated by ultraviolet spectrophotometry. The results show that the DOX-PLGA NPs are regularly spherical in shape with the mean size of (189.2 +/- 5.3) nm, and the zeta-potential of the NPs is about (-28.32 +/- 0.52) mV. Drug loading and encapsulation efficiency are estimated to be (73.16 +/- 0.43) % and (1.51 +/- 0.07) %, respectively. The cumulative percentage of the drug released is 90.34%, and the in vitro release behavior made up of initial burst release and sustained-release could be described by the bidirectional kinetic equation. The results indicate that hydrophilic small-molecule drugs could be successfully entrapped into PLGA-NPs. With optimization of the formulation and preparation conditions, we obtained uniform and stable DOX-PLGA NPs with sustained release character in vitro and pH-sensitive property, which could provide the experimental basis for the development of a new anti-tumor sustained-release formulation.

Simultaneous distillation-extractor was used for extracting the volatile substances in Phellodendron chinense Schneid.41 Volatile components were identified by gas chromatography/mass spectrometry (GC/MS) method. Of them the main components are ketones(16.38%),aldehydes(13.94%),alcohols(8.27%),phenols(50.38%),esters(3.02%),acids(2.18%).The content of the 41 identified compounds makes up 97.50% of the total volatile substances detected

Objective:To explore the influence of mindfulness meditation intervention on the professional identity and turnover tendency of the second victim of nurses.Methods:The convenience sampling method was used to select the second victim of 46 nurses who experienced medical adverse events within six months from January to June 2019 in Zhongnan Hospital of Wuhan University, and then an 8 weeks of mindfulness meditation intervention was carried out for them. In the entire intervention process, a self-control study was conducted, the Second Victim Experience and Support Scale (SVSET) and the Nurse Occupational Identity Scale were used to assess nurses' turnover intentions, absence and professional identity before the intervention and at 2 hours, 4 weeks, and 8 weeks after the intervention.Results:By analyzing the data, the results showed that after the mindfulness meditation intervention, the second victim of the nurse before intervention, 2h, 4 weeks, and 8 weeks of intervention were 3.28±0.87, 3.20±0.83, 2.85±0.92, 2.71±0.87, the difference was statistically significant ( F time value was 6.609, P<0.05). Before and after the intervention of the sense of grasp in professional identity were 4.91±0.83, 5.47±0.81, 5.83±0.91, 5.94±0.80, the difference was statistically significant ( F time value was 20.973, P<0.01). Consensus before and after intervention were 4.61±0.78, 5.09±0.85, 5.54±1.12, 5.76±0.85, the difference was statistically significant ( F time value was 22.237, P<0.01). The meaningful sense before and after intervention were 4.38±1.03, 5.04±0.75, 5.44±0.86, 5.59±0.76, the difference was statistically significant ( F time value was 23.656, P<0.01). The self-efficacy before and after intervention were 4.71±0.82, 5.33±0.63, 5.83±0.84, 5.90±0.77, the difference was statistically significant ( F time value was 28.866, P<0.01). The self-determination before and after intervention were 4.43±0.97, 5.06±0.81, 5.59±0.91, 5.62±0.87, the difference was statistically significant ( F time value was 25.237, P<0.01). Before and after intervention, the influence of tissue was 4.17±0.96, 4.71±0.85, 4.96±0.99, 5.30±0.88, the difference was statistically significant ( F time value was 16.487, P<0.01). Before and after intervention, the patients' feelings were 4.59±0.96, 5.08±0.84, 5.70±0.83, 5.83±0.68, the difference was statistically significant ( F time value was 25.406, P<0.01). Conclusion:This article provides an effective method to help nurses' second victims out of their predicament which confirms that mindfulness meditation intervention can effectively reduce turnover tendency of nurses 'second victims and improve their professional identity.

Objectives To identify the prevalence and risk factors that were associated with poststroke cognitive impairment(PSCI)among a large cohort of consecutive ischemic stroke patients.Methods 526 consecutive patients.who had suffered from ischemic stroke 3 months ago were recruited in this study. Patients were classified as having no cognitive impairment(NCI),cognitive impairment but no dementia (CIND)and vascular dementia(VaD)according to their cognitive function.They were also categorized as with subcortical ischemic vascular diseases(SIVD)or cortical ischemic vascular diseases(CIVD)with neuroimaging findings.Their demographic data.vascular risk factors and stroke characteristics were also dacumented.Results The overall prevalence of PSCI(CIND+VaD)Was 36.7%.Compared with the NCI subjects.PSCI SObjects were older,more dominant femininely,less educated,with more cases of right hemi-paralysis and higher depression scores.but did not have more specific vascular risk factor.Separately,VaD patients demonstrated lower economic level,less spouse-caring,more prevalence of dysphasia,hisher rate of incontinence and more cases with CIVD.while CIND patients had more cases with SIVD.The VaD patients had more cortical lesions and lower depression scores than the CIND patients.On logistic regression analysis,older age,female gender,lower economic level,dysphasia,SIVD,CIVD and hisher depression scores were independent risk factors for PSCI.ConclusionPSCI is common among ischemic stroke patients and related to demographic factors.stroke types,and depression.

Objective To investigate the impact of preload fasting and meal replacement in patients with metabolic syndrome.Methods A total of 92 subjects with metabolic syndrome were enrolled in the study.They were assigned into the preload fasting group (PFG),the meal replacement group (MRG),and the control group (CG) for 12-weeks intervention.Special dietary with 100 kcal was provided 30 min before each meal in the PFG,and while in the MRG the same dietary was taken just before each meal and the amount of meal was reduced appropriately.The subjects in CG took meals as usual.Body mass index,waist circumference,and insulin resistance were assessed.Satiety situation was investigated by the scale.Results After 12 weeks,improvement were found in fasting insulin(-3.29 mU/L) and waist circumference (-4.04 cm) in the PFG and significant difference was shown compared to the CG (P＜0.05).Satiety index in the PFG was the most significant among the three group.Conclusion Preload fasting is helpful in improving insulin resistance,reducing waist circumference,and enhancing satiety.

Objective To compare distribution difference in risk factors of patients with first-ever ischemic stroke (IS) of different age and gender.Methods A total of 1027 patients admitted to the neurological department in Shanghai Renji Hospital with first-ever IS were recruited and divided into young adult group ( ＜ 50 years old),middle-aged group (50-80 years old),and very old group ( ＞ 80 years old)according to their ages.Risk factor analysis included history of smoking,high alcohol consumption,hypertension (HT),diabetes mellitus (DM),heart diseases,atrial fibrillation (AF) and family history of cardiovascular diseases.Results Female patients were globally older than male patients (71.1 vs 65.7,P ＜ 0.001 ) at the first attack of IS and having higher prevalence of DM (26.8％ vs 19.2％,P =0.004 ),heart diseases (28.8％ vs 19.2％,P＜0.001) and AF (7.6％ vs 3.9％,P=0.009).However,female patients were less likely to drink heavily ( 1.0％ vs 31.6％,P ＜0.001 ) or smoke (4.4％ vs 59.9％,P ＜0.001 ) than the male patients.The rates of smoking and heavy drinking in young adult group were higher than that in other two groups.Patients in very old group had higher prevalence of heart diseases and AF but lower proportion of positive family cardiovascular diseases history than patients in other two groups.HT and DM were equally frequent among three groups.In young adult group,female patients were more likely to have heart diseases and family history of heart diseases (P =0.015 and P =0.048).In middle-old group,HT,DM,heart disease and AF were more common in women than in men (P =0.021,P =0.004,P =0.001 and P =0.039).Conclusion There are differences in risk factor distribution in patients with first-ever IS of different age and gender.Therefore,screening and health education should be performed in allusion to different risk factors.

Objective To respectively analyze the patterns and possible predictors of recurrent strokes among patients with initial ischemic stroke.Methods Three hundred and sixty-one patients with recurrent strokes (acute ischemic stroke or intracerebral hemorrhage) after initial ischemic strokes were collected from Jan 2004 to Dec 2009.The data about conventional risk factors such as smoking,heavy alcohol drinking,hypertension,diabetes,hyperlipidemia,heart diseases,head trauma,migraine,family history of cardiovascular disease,and the use of preventive medications were collected and analyzed among patients with different types of recurrent strokes.Results Patients (n =361) were divided into ischemic stroke group (n =321) and hemorrhagic stroke group (n =40) according to the recurrent stroke type.The ischemic stroke group was further divided into the anterior circulation stroke subgroup (n =234),the posterior circulation stroke subgroup (n =75) and watershed cerebral infarction or multiple infarction subgroup (n =12).Multivariate logistic regression analysis revealed that older age at initial stroke onset (OR =1.036,95 ％ CI 1.006-1.067,P =0.02) and hyperlipidemia (OR =2.253,95 ％ CI 1.092-4.647,P =0.028) were both the independent risk factors for the recurrent ischemic stroke.Comparing the subgroups,multivariate logistic regression analysis showed that atrial fibrillation (OR =4.217,95％ CI 1.489-11.942,P =0.007) was the independent risk factor for the recurrent ischemic stroke in the posterior circulation territory.Conclusion Aging and hyperlipidemia are possible predictors of recurrent ischemic stroke after the initial ischemic stroke which would be useful for individualized secondary prevention of stroke.