Purpose To evaluate the relative bioavailability of a domestic sustained-release metformin tablets (SRM) compared against an immediate-release metformin tablets (IRM) using a multiple-dose,two-way crossover design after a single-dose study. Methods Eighteen healthy adult male volunteers,aged 18 to 22 years (mean,20 years),weighing 55 to 76 kg (mean,64 kg) and with height ranging from 166 to 180 cm (mean,173 cm),and blood glucose levels from 4.0 to 5.9 mmol/L (mean,4.3 mmol/L) participated in the study.The concentrations of metformin in plasma were determined using a ion-pair liquid chromatographic method. Results In single-dose study,the mean residence time (MRT),Tmax,and apparent elimination half-life (T1/2) for SRM were significantly longer and Cmax significantly lower than the corresponding values determined for IRM.The similar results were also demonstrated in multiple-dose study.The mean values of the relative bioavaibility of SRM compared with IRM in two administration ways were (85.95±0.97)% and (86.44±7.88)%,respectively.The single-dose and multiple-dose administration of the 90% confidence interval for the ratio of the logarithmic transformed AUC values of SRM over those of IRM were calculated to lie between 0.83 and 0.88,0.83 and 0.89,respectively,being within the acceptable bioequivalence limit of 0.80～1.25. Conclusion SRM was of the characteristic of sustained-release pharmacokinetics.The relative bioavailability for single dosing was similar to that of multiple dosing,and both of the administration ways demonstrated bioequivalence in absorption between SRM and IRM.

Objective:To retrospectively evaluate the prognostic risk factors of T1-2 stage breast cancer patients with one to three positive node(s) and their effects on the benefits of post-mastectomy radiation therapy (PMRT). Methods:We retrospectively analyzed 457 breast cancer patients with T1-2 stage and one to three positive axillary lymph nodes treated in our hospital between 2000 and 2002. The independent prognostic factors of the patients were calculated by the Cox proportional hazards model. The patients were fur-ther classified into high-risk and low-risk subgroups according to the risk factors to explore the benefit of PMRT on the prognosis of dif-ferent subgroups using survival analysis. Results:PMRT was not an independent beneficial factor of overall survival (OS) (HR=0.949;CI:0.435-2.074;P=0.896) or loco-regional recurrent free survival (LRRFS) (HR=0.611;CI:0.231-1.614;P=0.320) in all patients. Ex-tracapsular extension (ECE) and pathological grades were independent prognostic risk factors, and the benefits of PMRT were signifi-cantly different on the prognosis of high-risk subgroup patients (group ECE+OS:P=0.020, LRRFS:P=0.014;group GradeⅢOS:P=0.002, LRRFS:P<0.001). Meanwhile, PMRT failed to prolong the OS and LRRFS of low-risk subgroup patients (group ECE+OS:P=0.353, LRRFS:P=0.796;group GradeⅠtoⅡOS:P=0.267, LRRFS:P=0.589). Conclusion:ECE and gradeⅢwere the independent risk factors of death and loco-regional recurrence in the T1-2 breast cancer patients with one to three positive lymph node(s). PMRT was an effective adjuvant therapy to improve the prognosis of patients with high-risk factors. However, the benefit of PMRT had no sig-nificance in patients with ECE-or gradeⅠ-Ⅱ.

Objective To investigate job burnout and related influencing factors in community medical staff in Nanchong,China.Methods From June to July,2015,cluster random sampling was performed to select 181 medical staff members in Nanchong Community Health Service Center as study subjects.The Chinese Maslach Burnout Inventory (CMBI) was used to measure the level of job burnout.Results The overall detection rate of job burnout in community medical staff in Nanchong was 95.0％,and among these staff members with job burnout,119(65.7％) had mild job burnout,44(24.3％) had moderate job burnout,and 9(5.0％) had severe job burnout.There were significant differences in the scores of emotional exhaustion and reduced sense of personal accomplishmentbetween the medical staff members with different ages (F=5.820 and 3.180,both P＜0.05).There was a significant difference in the score of emotional exhaustion between the medical staff members with different working years(F=2.909,P＜0.05).There was also a significant difference in the score of reduced sense of personal accomplishment between the medical staff members with different types of work (F=5.797,P＜0.05),and the nurses had the lowest score.Conclusion The medical staff members in Nanchong have a high incidence rate of job burnout,with the feature of reduced sense of personal accomplishment.An old age,long working years,and nursing occupation are major risk factors for job burnout.

Objective To investigate job burnout and related influencing factors in community medical staff in Nanchong,China.Methods From June to July,2015,cluster random sampling was performed to select 181 medical staff members in Nanchong Community Health Service Center as study subjects.The Chinese Maslach Burnout Inventory (CMBI) was used to measure the level of job burnout.Results The overall detection rate of job burnout in community medical staff in Nanchong was 95.0％,and among these staff members with job burnout,119(65.7％) had mild job burnout,44(24.3％) had moderate job burnout,and 9(5.0％) had severe job burnout.There were significant differences in the scores of emotional exhaustion and reduced sense of personal accomplishmentbetween the medical staff members with different ages (F=5.820 and 3.180,both P＜0.05).There was a significant difference in the score of emotional exhaustion between the medical staff members with different working years(F=2.909,P＜0.05).There was also a significant difference in the score of reduced sense of personal accomplishment between the medical staff members with different types of work (F=5.797,P＜0.05),and the nurses had the lowest score.Conclusion The medical staff members in Nanchong have a high incidence rate of job burnout,with the feature of reduced sense of personal accomplishment.An old age,long working years,and nursing occupation are major risk factors for job burnout.

Objective To investigate the relationship between ultra early stage cerebral vasospasm and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage (SAH) surgery.Methods Sixty-five patients with aneurysmal SAH,admitted to our hospital from January 2016 to December 2016,were selected as research objects.The patients underwent aneurysm clip surgery and accepted middle cerebral artery M2 segment transcranial Doppler (TCD) in ultra early stage (within 48 h of onset) to determine the occurrence of vasospasm examination.Perioperative acute physiology and chronic health evaluation scale Ⅱ (APACHE Ⅱ) and Glasgow coma scale (GCS) scores and delayed cerebral infarction rate within 2 weeks in patients with different ulna early vasospasm occurrences were compared,and four-diagnostic tests were applied in analyzing the value of ultra early cerebral vasospasm in predicting postoperative delayed cerebral infarction.Results Ultra early vasospasm rate of the patients was 49.23％ (32/65).As compared with the patients without ultra early stage vasospasm,perioperative APACHE Ⅱ scores and rate of delayed cerebral infarction of the patients with ultra early vasospasm were significantly increased,while GCS scores of the patients with ultra early vasospasm were significantly decreased (P＜0.05).And the results of four diagnostic tests showed that the sensitivity,specificity and accuracy of ultra early stage cerebral vasospasm of the patients with aneurysmal SAH predicting the delayed cerebral infarction were 77.27％,65.12％ and 69.23％.Conclusion Ultra early stage cerebral vasospasm of the patients with aneurysmal SAH is high,which can evaluate the risk of postoperative delayed cerebral infarction.