OBJECTIVE:To evaluate the clinical efficacy and safety of guaifenesin,pseudoephedrine hydrochloride- codeine phosphate oral solution in relieving cough,eliminating phlegm,relieving nasal stuffiness and other cold symptoms. METHODS:A total of 240 patients with cold symptoms(120 cases in trial group and another 120 cases in control group) were enrolled in our multicenter,randomized,double-blinded and parallel controlled study and treated with guaifenesin-pseudoephedrine hydrochloride-codeine phosphate oral solutionI or compound codeine phosphate liquor 10mL tid for(5?2)d.RESULTS:227(112 in trial group and 115 in control group) were the valid cases with completed trial.Compared with pre-treatment,both of the 2 groups had a significant improvement in symptoms including cough,expectoration and nasal stuffiness after treatment(P

OBJECTIVE:To systematically review the efficacy and safety of ramucirumab in the treatment of adenocarcinoma in stomach or gastroesophagealjunction,and provide evidence-based reference for clinic. METHODS:Retrieved from Wanfang database,CJFD,PubMed,EBSCO,Medline and Cochrane Library,randomized controlled trials(RCT) oframucirumab and (or) other medicines or other chemotherapy (test group) versus placebo or and Clinical Trials. gov other antibiotics(control goroup) were collected with time limit from establishment to Sept. 2015. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by Cochrane systematic review manual 5.1.0. RESULTS:Totally 3 RCTs involving 1 188 patients were enrolled,including 652 patients in the test group and 536 patients incontrol group. Results of Meta-analysis showed, the overall survival[HR=0.83,95%CI(0.72,0.95),P=0.006] and progression-freesurvival[HR=0.66,95%CI(0.47,0.92),P=0.01] in test group were significantly longer than control group,the difference was statistically significant;there was no significant difference in the objective response rate[RR=1.31,95%CI(0.81,2.11),P=0.28]. The incidence of severe adverse reactions(degree level:3-4 grade) in test group was significantly higher than control group,the difference was statistically significant [RR=1.14, 95%CI (1.00,1.29),P=0.04].CONCLUSIONS:Ramucirumab can extend overall survival and progression-free survival of adenocarcinoma in stomach or gastro-oesophageal junction,but the incidence of adverse reactions should be noticed.

Objective To investigate the resting-state functional connectivity of the two hemispheres between multiple system atrophy (Parkinsonian type,MSA-P) and Parkinson's disease (PD).Methods A total of 25 MSA-P,29 PD patients and 29 well-matched healthy controls recruited in the Nanjing Brain Hospital Affiliated to Nanjing Medical University from June 2013 to December 2015 were scanned with resting-state functional magnetic resonance imaging for voxel mirrored homotopic correlation (VMHC) analysis.The Mini Mental State Examination,Montreal Cognitive Assessment,Frontal Assessment Battery and Unified Parkinson's Disease Rating Scale-Ⅲ (UPDRS-Ⅲ) were used to assess the clinical symptom.Then the relationship between the change of VMHC values and severity of clinical symptoms was investigated.Results Compared with healthy controls,MSA-P and PD patients both showed decreased VMHC in bilateral cerebellum posterior lobe,precuneus gyrus,middle temporal gyrus,and postcentral gyrus.Compared with PD or healthy controls,MSA-P patients exhibited lower VMHC in bilateral putamen.Significant negative correlation between VMHC values of putamen and UPDRS-Ⅲ scores was found in MSAP patients (r =-0.607,P =0.001).Conclusion These functional changes suggest that the abnormal interhemispheric synchrony probably plays an important role in pathophysiology of both MSA-P and PD,and abnormal VMHC values in putamen of MSA-P may be helpful in differentiating MSA-P from PD.

Objective To assess the effectivity and safety of oxycodone plus acetaminophen for postoperative acute pain re‐lief .Methods Randomized controlled trials (RCT ) on combination of oxycodone plus acetaminophen treating postoperative pain re‐lief were searched from the following data‐bases as PubMed ,EMbase ,MEDLINE(Ovid) ,the Cochrane Library ,CNKI and WAN‐FANG from the date of their establishment to September 2014 .The data of RCT meeting the inclusive criteria were extracted ac‐cording to Cochrane methods by two reviewers independently ,and after the quality was evaluated and cross checked ,meta analyses were conducted using RevMan 5 .2 sotware .Results A total of 18 studies involving 2 213 patients were included .The results of Meta‐analyses showed that compared with placebo group or the equal dosage oxycodone alone group ,the combinations of oxycodone plus acetaminophen were more effective in postoperative pain relief (P<0 .01) .However ,there are no significant difference in the effective between the combinations of oxycodone plus acetaminophen and the higher dosage oxycodone alone group or the acetamin‐ophen alone group for postoperative pain relief (P>0 .05) .Adverse events occurred more frequently with combination therapy than placebo or acetaminophen alone group ,but were generally described as mild to moderate in severity and rarely led to withdrawal . There are no significant difference in the adverse events between the combination of oxycodone plus acetaminophen and the oxyc‐odone alone group .Conclusion The present study showed that combination of oxycodone plus acetaminophen is effective and high safe in postoperative acute pain relief .

Objective To assess the efficacy and safety of different dosages of oxycodone plus acetaminophen for treating acute pain after oral surgery,in order to provide a reasonable dosage of combination in clinic. Methods Randomized controlled trials ( RCTs ) on effect of combination of oxycodone plus acetaminophen on pain relief after oral operation were searched from the following data-bases:PubMed,EMbase,MEDLINE ( Ovid) ,the Cochrane Library,CNKI,and WANFANG from the date of their establishment to January 2015. The data of RCTs meeting the inclusive criteria were extracted according to Cochrane methods by two reviewers independently,and after the quality was evaluated and cross-checked,meta-analyses were conducted using RevMan 5.2 software. Results A total of 11 studies in 10 literatures involving 1 028 patients were included and were designated to 3 different dosage groups (5 mg/325 mg,10 mg/650 mg,10 mg/1 000 mg,respectively). The results of Meta-analyses showed that pain remission rate was significantly higher in the 3 different dosages of oxycodone plus acetaminophen groups than in the placebo group (RR5 mg/325 mg=3.35,95%CI [1.74,6.45],I2=38%,P=0.000 3;RR10 mg/650 mg=6.88,95%CI [4.00,11.83],I2=0%,P<0.000 01;RR10 mg/1 000 mg=4.94,95%CI [3.23,7.56],I2=81%,P=0.005). In additional,the RR of oxycodone 10 mg/acetaminophen 650 mg and placebo groups for pain remission rate was higher than that of the other 2 dosages groups,moreover,more studies were enrolled and its low heterogeneity led to high reliability. Usage rate of remedial painkillers was significally lower in oxycodone plus acetaminophen groups than in the placebo group (RR5mg/325mg=0.71,95%CI [0.60, 0.85],P<0.000 01;RR10mg/650mg=0.50,95%CI [0.41,0.61],P<0.000 01;RR10mg/1000mg=0.77,95%CI [0.66,0.90],P=0.001) ,In addition, the RRs of usage rate in oxycodone 10 mg/acetaminophen 650 mg and placebo groups were significantly lower than the other 2 dosages groups. Incidence rates of adverse effects were similar in the 3 different dosages groups and higher than that of the placebo group. However,the adverse events were generally described as mild to moderate in severity and rarely led to drug withdrawal according to all reports in the studies ( only one event ) . Conclusion The present study showed that combination of oxycodone plus acetaminophen can provide better analgesia in acute pain after oral surgery with high safety. In addition,combination of oxycodone 10 mg plus paracetamol 650 mg may be better for acute pain relief after oral surgery.

ObjectiveTo observe the influence of rehabilitation training on heart rate of stroke patients in the early stage.MethodsThe heart rate (HR) of 30 patients within one week after the onset of stroke was evaluated by FUKUDA DS 880A teleelectrocardiograph and the rating of perceived exertion (RPE) was collected during practicing bridging, rolling and moving the arms.ResultsThe HR of 30 patients was only increased 7.57, 6.23 and 6.57 beats per minute during practicing bridging, rolling and moving the arms. RPE of all patients was less than 11.ConclusionAppropriate rehabilitation training is safety and unable to increase the loading of heart in the early stage after the onset of stroke.

OBJECTIVE:To establish an RP-HPLC method for content determination of s-omeprazole sodium and its related substances.METHODS:The separation of s-omeprazole sodium and the related substances was carried out on a Phenomenex Luna C18 column,the mobile phase consisted of methanol-0.033 mol?L-1 ammonium dihydrogen phosphate-triethylamine (58∶41.8∶0.2,adjusted to pH 7.0 by phosphate acid).The detection wavelength was 302 nm,the flow rate was 1.0 mL?min-1,the column temperature was 25 ℃,and the sample size was 20 ?L.RESULTS:The linear range of omeprazole sodium was 10～500 mg?L-1 (r=0.999 7).The average recovery rate was 100.27% (RSD=0.74%).The average content of the related substances in samples was 0.42%.CONCLUSION:This method is simple,accurate,specific and applicable for content determination of s-omeprazole sodium and its related substances.

Objective: To present the evolutionary path of Chinese Medical Ethics, analyze the development vein of periodical, explore the journal' s research focuses, and provide reference for related personnel to understand the development of the current research status in the field through visualization technology. Methods:Using biblio-metric method,taking "China National Knowledge Infrastructure" as source of data collection, we used the visual-ization software CiteSpace to draw scientific knowledge maps and analyzed literatures published from 1990 to 2014 in Chinese Medical Ethics. Results:The annualvolume of journal articles fluctuated upwards,with peaks in 1992, 2000 and 2009, and of which the most was in 2009, with 393 articles. "Medical Ethics" and "Doctor-patient Relationship" were hotwords in this field. The publications of domestic and foreign scholars promoted the interna-tional exchange and the development of Chinese medical ethics, and the most productive institutions were often col-leges or universities. Conclusion:Chinese Medical Ethics has effectively promoted the development of bioethics in China, more and more scholars are involved in the relative research of medical ethics, and the old, middle and young scientists and research teams inherit, cooperate and develop with each other. The cross-regional, inter-a-gency and interdisciplinary collaboration remains very limited, whichwill become the important factorinfluencingthe development of the field of Chinese medical ethics in the future.

OBJECTIVE: To explore the treatment and pathophysiology of extra-axil cerebrospinal fluid accumulation aft er skull surgery. METHODS: The treatment of 46 cases of pineal regional tumor was retrospectively studied. RESULTS: The CT showed that all patients had postoperative extra-axil cerebrospinal fluid accumulation in 6 hours after operation. 5 cases displayed symptomatic accumulation of extra-axil cerebrospinal fluid. 1 died 30 days aft er discharge, 4 performed S-P shunt and 3 of them switched to V-P shunt after S-P shunt failed. CONCLUSION Much more attention should be paid to postoperative accumulation of extra-axil cerebrospinal fluid. Both V-P and S-P are the effective strategies of therapy.
Cerebrospinal Fluid Shunts ; Humans ; Pinealoma ; cerebrospinal fluid ; surgery ; Postoperative Period ; Retrospective Studies ; Skull ; surgery

Objective:To investigate the current situation of nurses′ professionalism in secondary and tertiary general hospitals, analyze its influence factors, and establish norms of nurses′ professionalism in secondary and tertiary hospitals, so as to provide references for evaluation the level of professionalism in nurses.Methods:From May to December 2016, the nurses′ professionalism evaluation system was used to investigate 3 315 nurses in 35 secondary and tertiary general hospitals in 14 cities of 7 regions in China by using random cluster sampling, and the corresponding norm, classification norm and delimitation norm were defined.Results:The average norm scores of nurses′ professionalism in the secondary and tertiary general hospitals was (71.02 ± 16.70), and the average norm scores of each dimension were professional ethics (18.97 ± 4.52) , comprehensive capabilities (17.99 ± 4.46), professional skills (17.07 ± 4.80), professional emotions (16.98 ± 4.70) . According to the differences in characteristics, the classification norms for different gender, age, working years, educational background, professional title, position, department, marital status, with or without children were formed. The level of nurses′ professionalism was divided into five grades: the total score in the interval [90.92, 100.00] was excellent, in the interval [78.31, 90.92) was good, in the interval [64.27, 78.31) was general, in the interval [50.49, 64.27) was relatively poor, in the interval [0.00, 50.49) was poor.Conclusions:Nurses′ professionalism in secondary and tertiary hospitals was in the general level and affected by a variety of factors, medical managers and nursing managers should take corresponding measures to improve nurses′ professionalism.