Objective:To compare the clinical efficacy and safety of nalmefene hydrochloride injections and Naofukang injections in the treatment of the patients with severe head injury. Methods:Totally 60 cases of patients with severe head injury were randomly divided into the observation group and the control group. The two groups were all given the conventional therapy, such as dehydration, expansion and anti-infective therapy. On the basis of the conventional therapy, the observation group was treated with nalmefene hydro-chloride injections, 0. 4-0. 6 mg in 0. 9% sodium chloride injections, ivd, qd, while the control group was given Naofukang injections, 4-9 g in 5% or 10% glucose injections, ivd, qd. The treatment course was 2 weeks. After the 3-day treatment, the heart rhythm, the incidence of respiratory abnormalities and intracranial pressure were compared between the two groups. After the 10-day treatment, the total efficacy and complications in the two groups were also recorded and compared. Results:After the 3-day treatment, the incidence of abnormal heart rhythm and respiratory abnormalities in the observation group were significantly lower than that in the control group (P<0. 05), the intracranial pressure in the observation group was better than that in the control group (P<0. 05). After the 10-day treatment, the total effective rate of the observation group was 93. 3%, which was much higher than that in the control group ( P<0. 05). After the treatment, the incidence of respiratory infections, acid-base unbalance and upper gastrointestinal bleeding in the ob-servation group was significantly lower than that in the control group (P <0.05). Conclusion: The clinical efficacy of nalmefene hydrochloride injections in the treatment of patients with severe traumatic brain injury is significant with promising safety, which is bet-ter than that of Naofukang injections.

Although there is emerging evidence that BJ46a can function as potent inhibitor of the SVMPs proteolytic activities,its anticancer effect on invasion and metastasis has not yet been evaluated.Inhibition effect of BJ46a on experimental pulmonary metastasis in mice inoculated with B16 melanoma cells at the protein level was investigated. First,BJ46a was produced in baculovirus expression system. SDS-PAGE and Western blot analysis confirmed that BJ46a recombinant protein was produced by Sf9 cells infected with high-titer viral stock. Then,recombinant fusion protein was purified by ProBondTM at the point of maximal expression. B16 cells pre-treated with recombinant BJ46a injected into C57BL/6 mice via the tail lateral vein to form experimental pulmonary metastasis model. The numbers of metastatic lesions in C57BL/6 mice changed dramatically:BJ46a different concentrations of recombinant protein group were 1.1 ? 0.83,0.9 ? 0.7,significantly lower than the control group (6.3?3.00,P

Objective:To discuss the methods and effects of clinical pharmacists in the Chinese and western medicine pharmaceu-tical care for one myelitis patient infected by brucellosis. Methods:Taking one myelitis patient infected by brucellosis as the example, clinical pharmacists provided Chinese and western medicine pharmaceutical care through making individualized drug regimen, perform-ing drug education and so on. Results:Clinical pharmacists participated in the therapeutic process actively, and performed Chinese and western medicine pharmaceutical care. As a result, the body temperature, look,tongue coating and excrement of the patient were obvi-ously improved. Conclusion:Performing Chinese and western medicine pharmaceutical care in clinics is very important for safety and effectiveness of drugs and improvement of drug use level.

Background The operation mode of automobile manufacturing industry (AMI) makes workers have different degrees of occupational stress and burnout, which may lead to negative emotions and depressive symptoms. Objective To study the relationship between occupational stress, job burnout, and depressive symptoms in AMI workers. Methods In this study, 1300 workers from a Guangzhou AMI company were selected as subjects by cluster random sampling method. Occupational stress, job burnout, and depressive symptoms of the workers were assessed by using the Effort-Reward Imbalance (ERI) questionnaire, the Maslach Burnout Inventory general survey questionnaire, and the Patient Health Questionnaire-9, respectively. Hierarchical regression was used to analyze the effects of occupational stress and job burnout on depressive symptoms in AMI workers. Mediating effect model was used to analyze the mediating effect of job burnout on the relationship between occupational stress and depressive symptoms. Results There were 1300 questionnaires distributed, 1228 valid questionnaires collected, with a 94.5% recovery rate. The ERI ratio of 1228 AMI workers was 1.06±0.72, and the positive rate of occupational stress was 37.3% (458/1228). The score of job burnout was 2.18±1.37, and the positive rate of job burnout was 62.6% (769/1228). The score of depressive symptoms was 10.27±6.42, and the positive rate of depressive symptoms was 47.1% (578/1228). The dimensional scores of effort and over-commitment in occupational stress as well as emotional exhaustion and depersonalization in job burnout of AMI workers were positively correlated with the depressive symptom scores (r_s=0.415, 0.571, 0.573, 0.593, P＜0.05). The dimensional scores of reward and personal achievement were negatively correlated (r_s=−0.454, −0.339, P＜0.05). The percentages of variance in depressive symptoms score explained by occupational stress and job burnout were 26.7% and 16.6%, respectively. Job burnout had a partial mediating effect between the three dimensions of occupational stress and depressive symptoms, and the mediating effect values were −0.2832 (95%CI: −0.3250– −0.2434), 0.3553 (95%CI: 0.3071–0.4041), and 0.4193 (95%CI: 0.3681–0.4725), respectively. Conclusion AMI workers' occupational stress affects job burnout, but also indirectly affects depressive symptoms. Job burnout partially mediates the association between occupational stress and depressive symptoms. Reducing occupational stress and burnout levels of AMI workers may alleviate depressive symptoms.

Objective To explore the relationship between serum adiponectin concentration and hyperuricemia in Han people in Hunan.Methods Cluster random sampling method was used to carry out the survey during October to December 2008 in Changsha Health Checkup Center of the Second Xiangya Hospital.All subjects completed the questionnaires,physical examination,biochemical measurements,and the data were analyzed by t test,Pearson's correlation analysis and multiple linear regression analysis.Results The Age,WC,TG,SBP,DBP,SUA,BMI were significantly higher in hyperuricemia group compared with the normal uric acid group.The concentration of adiponectin in hyperuricemia group was significantly lower than that in the normal uric acid group (5.0±2.7 vs 6.8±4.2 μg/ml,t=3.961,P＜0.05).In the normal serum uric acid group,the serum adiponectin concentration in female was significantly higher than that in male (t=4.99,P＜0.05).Pearson's correlation analysis showed that serum adiponectin concentration was negatively correlated with the serum uric acid level,but the adiponectin level was not significantly correlated with Age and blood pressure.Stepwise analysis showed that the main factors that could affect the adiponectin level were SUA,gender and BMI (P＜0.05).Conclusion The decreasing of serum adiponectin concentration might be one of the mechanisms of hyperuricemia,therefore,detecting serum adiponectin concentration may provide the basis for the prevention and treatment of hyperuricemia.

Objective To assess the prevalence of metabolic syndrome (MS) and explore the associated risk factors with MS among 35 ～ 80 years elderly people in Changsha.Methods The survey used by cluster random sampling method (from October to December,2008 ) was carried out by the Physical Examination Center of the Second Xiangya Hospital,Changsha.All subjects aged from 35 to 80 years old had the questionnaires,physical examination,and biochemical measurements.MS was defined by IDF 2005.Results The prevalence of MS was 24.3％ among elderly people in Changsha.The prevalence of MS in male and female was 27.9％ and 19.3％,respectively; which in male was significantly higher than in females ( P ＜0.01).According to census of 2000 in Changsha,the age-adjusted rate of MS was 24.4％ among elderly people,27.8％ in male and 21.9％ in female,respectively.The metabolic abnormalities and the prevalence rate of MS were different in gender and age.Except the essential component of the central obesity in the 194 cases of MS patients,there are 80 cases include other two kinds of metabolic abnormalities,accounting for 41.2％,most of them with elevated blood pressure + sugar metabolism disorders; the most common three kinds of metabolic abnormalities of the 78 cases,accounting for 40.2％ of the people with MS,most of them with high TG + elevated blood pressure + sugar metabolism disorders; With 4 kinds of metabolic abnormalities of 36 patients,accounting for 18.6％ of the MS patients.Increasing age,male,overweight and (or) obesity,high LDL-C hematic disease,high uric acid hematic disease,diabetes were all the risk factors of the elderly people in Changsha city.Conclusions Elderly people in Changsha have a relatively high prevalence of MS,especially for male.The prevalence of MS is considerably high in Changsha,which may continue to rising with the social economic development and population aging.There is an urgent need to take actions to reduce the burden of MS.

Objective To explore the efficacy of simultaneous reconstruction of composite tissue defects in two adjacent metacarpophalangeal joints of hand by split the 2nd toes.Methods From December 2006 to December 2011,the second toe composite flap pedicled with the dorsalis pedis artery-first,second metatarsal dorsal artery-dorsal artery were designed,and split it into the second metatarsophalangeal joint composite flap pedicled with the dorsalis pedis artery-first dorsal metatarsal artery-tibial artery and the proximal interphalangeal joint composite flap pedicled with dorsalis pedis artery-second dorsal metatarsal arteryfibular dorsal artery.Then they were used to repair composite tissue defects in two adjacent metacarpophalangeal joints of hand at the same time after reconstruction.Results This group includes 14 metacarpophalangeal joints of 7 cases,twelve joints was successful,two joints of 1 case to give up because the first dorsal metatarsal artery variation.At 6-24 months follow-up study in 12 out of 14 cases showed that there was no joint degeneration in X-ray manifestation and the recovering of joint function was satisfying.According to the function evaluation standard of reconstraction of thrumb and finger issued by Hand Surgery Society Chinese Medical Association,the excellent and good rate was 83.3％.Conclusion It is feasible to reconstruct of composite tissue defects in two adjacent metacarpophalangeal joints of hand at the same time by split the 2nd toes,and can effectively improve the functions of injury metacarpophalangeal joint.

Abstract Enhancing the health literacy of the entire population is a prerequisite for improving the health of the entire population, and since the health attitudes and behaviors formed during childhood and adolescence have a profound impact on the health patterns of adulthood, the enhancement of health literacy of children and adolescents is of particular importance. As the main place for children and adolescents to receive education, schools should better fulfil the function of education and promotion of health literacy. China has been carrying out the pilot and promotion of health promoting schools (HPS) since 1995, and is currently in the stage of comprehensive improvement of HPS construction. This paper introduces the background and characteristics of Health-Literate Schools (HeLit-Schools) in foreign countries and compares them with HPS in China, drawing on the advantages of HeLit-Schools to provide a new idea and a new way of thinking for the construction of HPS in China and for the practice of the "Healthy China Initiative".

Objective To discuss the security and reliability of preoperative thoracoscopic pericardial exploratory and to evaluate of the surgical indications.Methods Video full-assisted thoracoscopic pericardioscopy has been implemented in 41 central type lung cancer cases before radical resection.Results Video assisted pericardioscopy group underwent thoracotomy lung resection with procession of intrapericardial pulmonary artery in 8 cases (partial pericardial resection in 2 cases),with pulmonary vein in 10 cases,and out-pericardial lung resection in 9 cases.Spiral CT projections were consistent with surgery was only 65.8 ％.The average time of explorationa was (23±10) min.Conclusion Except for widely used in pulmonary wedge resection and lobectomy,video-assisted thoracoscopic pericardial exploration can improve resection rate and survival rate in central type lung cancer patients which can reduce the need for exploratory thoracotomy.

To improve the oral bioavailability of insulin, an insulin-loaded enteric polymer-lipid hybrid nanoparticles(INS-NPs L100)was prepared using methoxy PEG-poly(D, L-lactide)(PEG-PLA), phospholipid s75 and Eudragit L100; in vitro and in vivo behaviors of INS-NPs L100 were evaluated. Insulin-loaded polymer-lipid hybrid nanoparticles(INS-NPs)were prepared by W/O/W double emulsion solvent evaporation method. INS-NPs formulation was optimized by single factor experiment using encapsulation efficiency, particle size, and in vitro release behavior of the corresponding INS-NPs L100 as evaluation indexes. The morphology, in vitro drug release profile and hypoglycemic effect of the INS-NPs L100 using the optimal INS-NPs and Eudragit® L100(used as enteric polymer)were assessed. The results showed that the encapsulation efficiency of the optimal INS-NPs was(62. 18±4. 51)%. The average particle size, PDI and Zeta potential was(225. 2±94. 3)nm, 0. 191±0. 068, and -(14. 84±1. 26)mV, respectively. The cumulative drug release from the INS-NPs L100 was only 8. 01% at 2 h in pH 1. 0 HCl solution, exhibiting a slow drug release behavior; while the drug release from INS-NPs L100 was 67. 31% at 6 h in phosphate buffer of pH 6. 8. Mereorer, after oral administration of INS-NPs L100 with a dose of 38 IU/kg, the blood glucose concentration of healthy rats was reduced to 76% of the initial values at 3. 5 h, exhibiting a sustained hypoglycemic effect. In summary, the INS-NPs L100 prepared in this study could effectively decrease the release rate of insulin in gastric juice, improve the stability of protein in the gastrointestinal tract, and provide a new approach for the oral administration of peptides and protein drugs.