With the wide application of Chinese herbal medicine, herb-drug interaction (HDI) has become increasingly prominent. Metabolic enzymes and transporters are the main targets of HDI, because the changes in expression and function of enzymes and transporters can influence the disposition of drugs. Metabolic enzymes are responsible for the metabolic clearance of drugs, including cytochrome P450 (CYP), UDP-glucuronyl transferase (UGT) and sulfotransferases (SULT); transporters widely expressed in the intestine, kidney, liver and brain are involved in the oral absorption, distribution and excretion of drugs. Pueraria, ginkgo, ginseng, St. John's wort and other Chinese herbal medicine often induce a HDI because those herbal medicines combined with chemical medicine are widely used in clinic. The components of herb medicines mentioned above are prone to interact with enzymes and transporters, which often induce a HDI. This paper reviews the advances in the study of enzymes and transporters-mediated pharmacokinetic mechanism of HDI.

Objective To identify the occurrence and microorganism profile of device-associated healthcare-associa-ted infections (DA-HAIs)in the intensive care unit (ICU)of a university hospital in China.Methods From Janua-ry 1 to November 30,2015,patients admitted to the ICU of a university hospital in China for more than 48 hours were performed prospective descriptive study. DA-HAIs were defined according to the criteria of the Centers for Disease Control and Prevention (CDC)of U.S.,descriptive statistical analysis was performed.Results Of 254 pa-tients admitted to ICU,the overall incidence of DA-HAIs was 15.35% ,with 10.23 cases of DA-HAIs per 1 000 ICU-days;the incidence of ventilator-associated pneumonia (VAP ),catheter-associated urinary tract infection (CAUTI),and central line-associated bloodstream infection (CLABSI)were 7.05 per 1 000 ventilator-days,4.91 per 1 000 urinary catheter-days,and 3.22 per 1 000 central line-days,respectively. The main infection site was lower respiratory tract,accounting for 48. 27% ,followed by bloodstream system (27. 59% ),urinary tract (22.99% ),and gastrointestinal tract(1.15% ). The major isolated microorganism was Acinetobacterbaumannii (21 .52% ).Conclusion The surveillance system can identify the epidemiological status of DA-HAIs and make effec-tive control measures to ensure the healthcare safety.

Objective To compare the outcomes of TOT and TVT procedure treating female intrinsic sphincter deficiency (ISD).Methods From May 2010 to September 2015,42 stress urinary incontinence (SUI) patients whose abdominal leak point pressure was less than 60 cmH2O were enrolled in this study.Thirty-five patients were followed up.The mean age was (56.8 ±10.5) years,with a range of 30-80 years.The mean history was(10.5 ± 9.1)years,with a range of 4 months to 30 years,with 26 (74.3％) of them being postmenopausal,5 (14.3％) having a history of pelvic surgery,and no pelvic organ prolapsed or hormone replacement.All of them were randomly divided into 2 groups to undergo either TVT operation (13 cases) or TOT operation (22 cases).The baseline characteristics of the two groups including age,length of history,urodynamic parameters and scale scores showed no significant difference.The scales including urinary incontinence severity score (UISS),detrusor instability score (DIS),Quality of Life Scale Evaluation (I-QOL),lower urinary tract symptoms affect score (UDI-6) were used.The outcomes between TVT group and TOT group were compared.Result After procedure,patients in TVT group got a lower UISS score than TOT group(17.2 ± 2.2 vs.17.7 ± 3.1),and their severity of urinary incontinence improved significantly (P ＜ 0.05).Patients from TVT group got a lower DIS score than TOT group (12.6 ± 4.2 vs.14.2 ± 3.5),and their detrusor instability symptoms improved more significantly (P ＜ 0.05).Patients from TVT group got a higher I-QOL score than TOT group(17.5 ± 14.5 vs.16.1 ± 13.0),and their quality of life improved more significantly (P ＜ 0.05).Patients from TVT group got a lower UDI-6 score than TOT group (10.1 ± 3.0 vs.11.2 ± 3.4),and their lower urinary tract symptoms improved more significantly (P ＜ 0.05).Conclusion Urinary incontinence of female ISD patients were improved greater by TVT than TOT procedure.

Objective:To compare the effects of rotational night shifts on the micturition patterns of fe-male nurses.Methods:A total of 58 nurses without lower urinary tract symptoms were recruited,who worked in the Peking University People’s Hospital during January and June in 2014.The nurses aged 20 -43 years were divided into two groups,the night-shift group (n =28)and the non-shift group (n =30).The alcohol or coffee intaking were forbidden.In the night-shift group,nurses had worked on rota-tional shifts for at least 6 months.Their average age was (26.75 ±4.11)years.In the non-shift group, nurses took regular day-time work,whose average age was (27.80 ±5.60)years.A voiding diary was kept for 7 consecutive days at the end of 6 months,starting 2 days before their night duties until 4 days after completion of their night duties.For comparison,the non-shift group with regular shifts completed a 7-day voiding diary.In the 7-day recording voiding diary,the nurses were required to have the normal in-take of liquid about 1 500 -2 000 mL/d.The frequency volume charts of nocturia,the 8-hour interval urine production and frequency were compared between the two groups.Results:Nocturia frequency was increased in the night-shift group [0.5 (0 -2.4)]compared with the non-shift group [0 (0 -2),P =0.02].The volume of nocturia was increased in the night-shift group [125 mL (0 -660 mL)]compared with the non-shift group [0 mL (0 -340 mL),P <0.01].The 8-hour interval indices showed that urine production changed with shift (P <0.01).In the consecutive 7 days,the nocturnal volume of the night-shift group increased on the day after night shift.When the night-shift nurses returned to daytime duty, the volume of urine decreased but nocturnal urine production remained high,and the frequency of noctu-ria also increased significantly (P <0.05).Compared with the 8-hour interval indices,the night-shift group’s voiding volume [(542.35 ±204.66)mL]and voiding frequency (2.24 ±0.69)were more than those of the non-shift group at the afternoon time (from 2 pm to 10 pm).During the 8 h interval night time (from 10 pm to 6 am),the volume of nocturia in the night-shift group [(309.74 ±162.74) mL]was more than that in the non-shift group [(199.38 ±153.98)mL,P =0.01];the frequency of nocturia in the night-shift group (1.31 ±0.52)was increased than that in the non-shift group (0.82 ± 0.55,P <0.01).Conclusion:The rotational shifts affect the micturition patterns of nurses who go through the night shift work,which increases the volume and frequency of the nocturia.

Objective:To investigate the impact of preoperative urodynamic study on the diagnosis and treatment for female patients with clinical diagnosis of stress urinary incontinence by studying their diag-nosis and treatment database,and to assess its clinical significance of urodynamic study.Methods:From April 2011 to December 2015,196 female patients diagnosed clinically with stress urinary incontinence underwent preoperative urodynamics study,after excluding pelvic organ prolapse.The preoperative uro-dynamic data of these 196 cases were analyzed and the clinical significance of urodynamics on differential diagnosis and treatment for the female patients with stress urinary incontinence was evaluated.Results:In this study,23 cases (11.73%)changed or amended their diagnoses by the urodynamic study,which were inconsistent with the previous clinical diagnoses concluded by the symptoms,physical examinations, and lab tests.A total of 10 cases underwent a different surgery or conservative treatment instead of the original treatment according to urodynamic study.Of them,3 were diagnosed as detrusor overactive and undertook conservative treatment;3 were diagnosed as bladder outlet obstruction plus stress urinary in-continence and were undertaken the transurethral resection of the bladder neck (TURBN)plus tension free vaginal tape (TVT);2 were diagnosed as bladder outlet obstruction plus stress urinary incontinence and were undertaken TURBN alone;1 was diagnosed as bladder outlet obstruction plus stress urinary in-continence and was undertaken TURBN plus tension free vaginal tape obturator (TOT);1 was found no abnormal bladder function turned out to be interstitial cystitis and went for a bladder instillation of drug. The changed treatments avoided the risk of dysuria or residual urine increased after operation due to inap-propriate surgical methods.Conclusion:In order to make a correct diagnosis and suitable treatment for female patients with stress urinary incontinences,the preoperative urodynamic study is necessary besides detailed medical history,physical examination,and laboratory tests.With the help of the urodynamic study,the concomitant diseases of patients with stress urinary incontinence may be detected,the individualized treatment regimen can be developed,and more importantly,the inappropriate surgical de-cision can be avoided.

Objective To evaluate the effectiveness of immediate quantitative coronary angiography (QCA) analysis in percutaneous coronary intervention (PCI). Methods The parameters of QCA and conventional methods before and after PCI were compared and statistics was performed by using t test or ANOVA methods. Results One hundred and two patients were enrolled in our study. Significant differences between QCA and conventional methods were found in evaluation of lesion length [ ( 22.9 ± 8.9 ) mm vs (24. 8 ± 10. 6) mm,t = 9. 63, P < 0. 05 ], stenosis diameter [ (3.0 ± 0.4 ) mm vs (2. 9 ± 0. 7) mm, t = 6. 31, P < 0. 05 ] and stenosis area [ ( 87. 8 ± 10. 7 ) mm2 vs ( 85.0 ± 12.9 ) mm2, t = 2. 54, P < 0.05 ], and also in different vessels. Stenosis diameter and stenosis area after stenting in target lesion were lower than the international standards. Conclusion Immediate QCA analysis can be effective in directing stent implantation.

Objective To study the relationship between metabolic syndromes and uric acid calculi.Methods We retrospectively analyzed medical records of 640 adult patients,who were diagnosed as renal calculi and finished the stone composition analysis.Among them,394 cases were male and 246 were female.The averagc age was (50.9 ± 12.8) years old.According to the diagnostic criteria of the MS,the patients were divided as metabolic syndrome group (metabolic syndrome group /MS group and non-metabolic syndrome group (non MS group);the MS group had a total of 238 cases including 151 males and 87 females.The average age was (54.1 ± 11.0) years old.There were 402 cases in non MS group,including 243 males and 159 females,with an average age of (49.1 ± 13.4) years old.We obtained corresponding metabolic indices.By comparing the differences between each group,the statistic were analyzed with SPSS.Results In the MS group,42 cases was diagnosed with uric acid stones,and the nonMS group with 8 cases diagnose with uric acid stones.The MS included obesity,elevated blood pressure,elevated fasting plasma glucose,high serum triglycerides.In the patients obtained,123 had the 4 kinds of metabolic diseases at a time,and 23 (18.7％) cases were diagnosed as uric acid stones.115 patients had the 3 kinds of metabolic diseases in which 19 (16.5％) cases were uric acid stones.190 patients had 2 kinds of metabolic diseases and 5(2.6％) cases were uric acid stones.137 patients had only one kinds of metabolic disease in which 3 were uric acid stones.The multivariate Logistic regression analysis showed that,after the correction of gender and age,obesity patients own the OR as 1.10(0.98-1.24)(P =0.018),high blood sugar had the OR as 1.72(1.19-1.92) (P =0.006),high glycerin three fat had the OR as 0.71(0.48-1.09) (P =0.032) and high HDL-C was 0.15(0.03-0.65) (P =0.01).Conclusions The metabolic syndromes including obesity,hyperglycemia and dyslipidemia obviously might influenced the formation of uric acid calculi.

OBJECTIVE:To study the bioequivalence of suspension formulation of cefixime(A),capsule formulation of ce-fixime(B) and reference preparation(C: Cefixime Capsules or Cefspan) in human body.METHODS: The study was conducted as a 3- way crossover design in 18 healthy volunteers whose plasma concentrations of cefixime were determined by HPLC after receiving a single oral dose of 200 mg trial preparations or reference preparation.RESULTS:The main pharmacokinetics of the three preparations(A、B、C) were as follows after undergoing BIO3 program fitting:AUC0-1 were(18.54?6.31)mg?h-1?L-1, (16.10?5.51)mg?h-1?L-1 and (17.16?5.96)mg?h-1?L-1, Cmax were(2.63?0.76) mg?L-1, (2.43?0.78)mg?L-1 and (2.57?0.90)mg?L-1;tmax were(4.11?0.58)h,(4.56?0.51)h and (4.56?0.70)h,respectively .The relative bioavailability of cefixime suspensions(A) and cefixime capsules(B) were (108.8?12.3)% and (95.7?15.9)% ,respectively as against reference preparation(C) .CONCLUSION:The test formulations(A and B) were found bioequivalent to the reference formulation(C).

Aim To establish a LC-MS/MS method to measure the concentration of ginsenoside Rg1 in intrac-erebral dialysate and compare the probe recovery in vitro and in vivo. Methods The assay was conducted with a ACQUITY UPLC BEH C18(2. 1 mm × 50 mm, 1. 7 μm) . The mobile phase consisted of methanol and ultrapure water and it was detected by gradient elution. The flow rate was 0. 4 mL·min-1 . Specificity, linear range, precision and accuracy, stability were evaluated to investigate the reliability of the method. The recov-ery of ginsenoside Rg1 in probe in vitro and in vivo was compared. Results The retention time of ginsenoside Rg1 was 1. 91 min, the linear range was 0. 1 ~50 μg · L-1 , intra-day and inter-day precisions were less than 15%. The recovery of ginsenoside Rg1 was (4. 05 ± 0. 28)% in vitro and(26. 96 ± 4. 45)% in vi-vo. Conclusion The LC-MS/MS method is accurate, sensitive, and reproducible for quantitative determina-tion of ginsenoside Rg1 in microdialysate. The probe recovery of ginsenoside Rg1 in vivo is higher than in vitro, and both are stable in different concentrations.

[ ABSTRACT] AIM:To investigate the different dose of perindopril on cardiac function in the rabbits with ische-mic cardiac dysfunction .METHODS:Male rabbits weighing 2.5~3.0 kg ( n=30) were randomly divided into 3 groups (n=10):high dose perindopril group (HD group), low dose perindopril group (LD group) and cardiac dysfunction group (CD group).The Left anterior descending coronary artery of the rabbits was ligatured for model preparation .In HD group, the rabbits were treated with perindopril split normal saline solution (1 g/L)2 mL· kg-1 · d-1 .In LD group, the rabbits were treated with perindopril split normal saline solution (0.33 g/L)2 mL· kg -1 · d-1.In CD group, the rabbits were treated with normal saline solution 2 mL· kg-1 · d-1 .Four weeks after treatment , the cardiac function was measured via echocardiography , the mRNA expression of angiotensin-converting enzyme 2 ( ACE2 ) and angiotensin type 2 receptor (AT2R) was analyzed by real-time PCR, serum angiotensin (Ang)-(1-9) and Ang-(1-7) levels were detected by ELISA. RESULTS:Compared with CD group , the cardiac function of the 2 groups treated with perindopril was significantly im-proved (P<0.01), and more improvement in HD group was observed than LD group (P<0.05).The serum angiotensin ( Ang)-(1-9) and Ang-(1-7) level and the mRNA expression of ACE 2 and AT2R in the 2 groups treated with perindopril were significantly improved (P<0.01).Compared with LD group, the mRNA expression of ACE2 and AT2R and the ser-um levels of Ang-(1-9) in HD group were significant improved (P<0.05), while no difference of serum Ang-(1-7) level was observed.Correlation analysis revealed that the improvement of the cardiac function was associated with serum Ang -(1-9) level, mRNA expression of ACE2 and AT2R (P<0.01), but has no significant correlation with serum Ang-(1-7) lev-el.CONCLUSION:High dose of perindopril may improve more cardiac function in ischemic cardiac dysfunction model in rabbits.The mechanism may relate to increasing serum Ang-(1-7) level to activate AT2R.