Doxorubicin (DOX)belongs to anthraquinone anti-tumor antibiotics,which is now one of most widely used anti-cancer drugs in clinic,but it possesses cardiotoxicity.How to reduce its cardiotoxicity is still a hot problem in current research.This article made an overview for monitoring and prevention of DOX cardiotoxicity.

Objective To investigate the characteristic and clinical value of echocardiography in pregnant women with sinus tachycardia.Methods Thirty pregnant women with sinus tachycardia (experiment group) and 30 healthy pregnant women (control group) were selected.The echocardiography results and clinical data were compared between the 2 groups.Results There were no statistical differences in age,gestational age,blood pressure,weight between the 2 groups (P ＞ 0.05).The heart rate in experiment group was significantly higher than that in control group [(123.20 ± 13.23) times/min vs.(86.17 ± 6.78) times/min],there was statistical difference (P ＜ 0.01).The left ventricular posterior wall thickness and the rates of mitral regurgitation,tricuspid regurgitation,aortic regurgitation in experiment group were significantly higher than those in control group [(10.23 ± 1.30) mm vs.(8.79 ± 1.90) mm,63.33％ (19/30) vs.16.67％ (5/30),66.67％(20/30) vs.30.00％(9/30),26.67％(8/30) vs.6.67％(2/30)],the left ventricular posterior wall motion amplitude was significantly lower than that in control group [(8.07 ± 1.00) mm vs.(9.26 ± 1.71) mm],there were statistical differences (P ＜ 0.01 or ＜ 0.05).There were statistical differences in the indexes of left ventricular systolic function and diastolic function between the 2 groups (P ＜0.01 or ＜0.05).Conclusion The anatomical indexes and function indexes of echocardiography in pregnant women with sinus tachycardia are used to change,and the echocardiography in time can provide the basis of treatment.

Objective To establish the quality control method for Sanhuang Suppository. Methods Coptidis rhizoma, Scutellariae radix and Phellodendri chinensis cortex in Sanhuang Suppository were identified by TLC. The contents of baicalin and berberine hydrocholride were determined by HPLC which was performed on an Agilent Zorbaxsb C18 column (4.6 mm×250 mm, 0.45 μm) with a mobile phase of methanol-water-phosphoric acid (47∶53∶0.2), with flow rate of 1.0 mL/min. The wavelength of detector was set at 280 nm for baicalin and 365 nm for berberine hydrochloride, with column temperature of 30℃.Results Chromatographic characteristics of qualitative identification were evident. The linear range of baicalin was 0.248-2.48 μg (r=0.999 9) and the average recovery rate was 99.77% (RSD=1.05%). The linear range of berberine hydrocholride was 0.336-1.68 μg (r=0.999 9) and the average recovery rate was 97.74% (RSD=1.48%).Conclusion The method of qualitative and quantitative analysis is accurate, feasible and suitable for effective quality control of Sanhuang Suppository.

Objective To compare the micromeritics properties and external dissolution rates of Sanhuang Powder in different particle sizes;To provide references for its direct use and application as raw materials for TCM preparation.Methods Particle size, bulk density, tap density, angle of repose, and hygroscopicity ofSanhuang micro-powder and common powder were investigated and evaluated. External dissolution rates ofSanhuang micro-powder and common powder were detected by ultraviolet spectrophotometry.Results The flowability of bothSanhuang micro-powder and common powder were not very well. With the sizes decreasing, the hygroscopicity of micro-powder became stronger. The external dissolution ofSanhuang micro-powder was more sufficient and much more quickly than common powder.Conclusion Properties ofSanhuang micro-powder and common powder are obviously different.Sanhuang micro-powder has stronger hygroscopicity and worse flowability compared with common powder. However, external dissolution ofSanhuang micro-powder is more sufficient and much more quickly than common powder. WhenSanhuang micro-powder is used directly and used as raw materials for TCM preparation, much more discretion should be considered.

Objective To discuss the teaching outcomes of problem-based learning method in classroom teaching of TCM pharmaceutics.Methods Fifty students majoring in 2009 science of Chinese materia medica were taught by using traditional teaching method in teaching of TCM pharmaceutics, and 56 students majoring in 2009 TCM pharmaceutics by using of problem-based learning method. This study evaluated students’ adaption to the two teaching methods through score analysis and questionnaire of the two classes.Results Students taught by problem-based learning method generally believed that this teaching method can stimulate their learning interest, improve self-study ability, thinking ability, creativity, and language competence, and enhance team spirit.Conclusion Problem-based learning method shows better teaching outcomes than traditional teaching method. It can guide students to look for ways to tackle problems in the course of solving problems, and cultivate all-round ability and comprehensive quality of students.

Objective To discuss the teaching outcomes of project draft design combined with PBL teaching method in TCM pharmaceutics technology.Methods Fifty students majoring in 2009 TCM Pharmaceutics Technolgy were divided into A and B groups. 25 students in group A were set as experimental group by using project draft design combined with PBL teaching method, while 25 students in group B were set as control group by using traditional teaching method. This study evaluated the effects of teaching methods through questionnaire and score analysis of the two groups.Results Students taught by project draft design combined with PBL teaching method generally believed that this teaching method can stimulate their learning interest, improve their ability of locating problems, solving problems, and comprehensively applying knowledge and enhance test scores.Conclusion Project draft design combined with PBL teaching method shows better teaching outcomes than traditional teaching method, which can cultivate students’ all-round ability and comprehensive quality.

Background and purpose:At present, color Doppler ultrasound scoring and radionuclide imaging are two important imaging methods for diagnosing thyroid nodules, but their checking principle is different. Which method is better? Or combining them will be the best method for diagnosing thyroid nodules? This study aimed to compare the value of99mTcO4- combined with99mTc-methoxyisobutylisonitrile (MIBI) imaging, ultrasound scoring method and ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging in diagnosis of thyroid nodules.Methods:The results of ultrasound scoring method and99mTcO4- combined with99mTc-MIBI imaging were compared in 50 patients with 54 thyroid nodules, and then compared with pathological findings. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the methods were calculated.Results:A total of 54 thyroid nodules were found pathologically including 20 malignant and 34 benign nodules. The sensitivity, specificity, accuracy, PPV and NPV of99mTcO4- combined with99mTc-MIBI imaging were 80.00% (16/20), 70.59% (24/34), 74.07% (40/54), 61.54% (16/26), 85.71% (24/28), re-spectively. Those of ultrasound scoring method were 80.00% (16/20), 88.24% (30/34), 85.16% (46/54), 80.00% (16/20), 88.24% (30/34), respectively. And those of ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging were 100.00% (20/20), 64.71% (22/34), 77.78% (42/54), 62.50% (20/32), 100.00% (22/22), respectively. The sensitivity of ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging was higher than ultrasound scoring method or99mTcO4-+99mTc-MIBI imaging along (100.00%vs 80.00%, 100.00%vs 80.00%,χ2 value was 4.444 4 and 4.444 4,P value was 0.035 0 and 0.035 0, respectively). The specificity of ultrasound scoring method was higher than those of two methods combined together (88.24%vs 64.71%,χ2 value was 5.230 8,P value was 0.022 2). However, no factorial negative thyroid nodule was found by ul-trasound scoring method+99mTcO4-+99mTc-MIBI imaging.Conclusion:Ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging can offer comprehensive diagnosis of thyroid nodules from their structure and function to avoid missed diagnosis.

ObjectiveTo systematically evaluate the association between smoking and the risk of primary biliary cirrhosis (PBC) from the perspective of evidence-based medicine. MethodsA literature search was performed in PubMed, EMBASE, CBM, CNKI, Wanfang Data, and VIP database to collect the case-control studies on the association between smoking and the risk of PBC published in the last two decades. Chinese search words were “吸烟”, “香烟”, “原发性胆汁性肝硬化”, “危险因素”, “队列研究”, and “病例对照研究”, and English search words were “smoking”, “cigarette”, “tobacco”, “risk factors”, “primary biliary cirrhosis”, “cohort studies”, and “case-control studies”. And then a meta-analysis was performed using Review Manager 5.2. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated, and the publication bias was analyzed by funnel plots. ResultsA total of 7 case-control studies involving 5459 subjects (2652 patients with PBC vs 2807 controls) were included in the meta-analysis. The analysis results showed that smokers had a significantly higher risk of PBC compared with non-smokers (OR=1.49, 95% CI: 1.11-2.00, P=0.009). The geographical subgroup analysis results showed that there was a significant difference in the risk of PBC between non-smokers and smokers in North America (OR=1.57, 95% CI: 1.20-2.04, P=0.0008). However, there was no significant difference in the risk of PBC between non-smokers and smokers in Europe (OR=1.41, 95% CI: 0.73-2.73, P=0.31). ConclusionSmoking can increase the risk of PBC. However, it needs to be confirmed in high-quality prospective studies with larger samples because of the heterogeneity of current included studies.

Objective To investigate the influence of preoperative anxiety-depression status on the postoperative pain in patients undergoing gynecologic laparoscope surgery.Methods Ninety pa-tients,aged 18-65 years,BMI 18-30 kg/m2,ASA physical status Ⅰ or Ⅱ,undergoing gynecologic laparoscope surgery were included in this single-center observational study.All the patients were in-terviewed by anesthetists the afternoon before surgery and completed a Hospital Anxiety and Depres-sion Scale (HADS)to evaluate the anxiety-depression status.Then the patients were divided into two groups,low HADS group (group L)(HADS score≤9)and high HADS group (group H)(HADS score>9).Patients'visual analogue scores (VAS)were recorded at the time 30 min,60 min,6 h, 12 h,24 h after operation.The correlation analysis between HADS before operation and VAS scores at different time point was performed.The use of analgesia medicine,exhausting time and complica-tions such as nausea, vomiting, dizzy, pain of shoulder and back were also recorded. Results Compared to group H,VAS score was lower in group L at 6 hour after surgery but no sig-nificant different was found at 30 min,60 min,12 h,24 h after surgery.There was a significant asso-ciation between preoperative HADS scores and VAS at 6 hour after surgery (r=0.634,P=0.01);but no significant association was found between preoperative HADS scores and VAS at the other time point after surgery.The exhausting time was significantly longer in group H than group L (P<0.05).There was no significant difference in the incidence of nausea,vomiting,dizzy or pain of shoulder and back between the two groups.Conclusion Preoperative anxiety-depression status has a positive influence on postoperative pain at 6 hour after gynecologic laparoscope surgery,and also can delay the recovery of gastrointestinal function.

Objective To summarize the clinical characteristics of and our experience in managing Klebsiella pneumoniae liver abscess.Methods The clinical data of 323 patients with bacterial liver abscess treated at three hospitals in Shanghai from January 2013 to March 2016 were analyzed retrospectively.Results Bacterial culture Klebsiella pneumoniae was identified in 70 cases.Compared with the patients with K.pneumoniae,the patients without K.pneumoniae had significantly higher prevalence of biliary tract complications (P=0.038),higher neutrophil percentage (P=0.002) and greater abscess diameter (P=0.015).However,the patients with K.pneumoniae showed relatively higher rate of treatment failure.Invasive syndrome was identified in 7 (10％) of the patients with K.pneumoniae,such as endophthalmitis,meningitis.The patients with invasive syndrome showed significantly higher prevalence of biliary tract diseases (P=0.078),more severe thrombocytopenia at early stage (P=0.004) and higher serum bilirubin level (P=0.043).The patients receiving surgical treatment (surgical operation and ultrasound-guided puncture) were associated with significantly shorter hospital stay (15.5± 8.6)d than the patients managed with medical therapy alone (20.1 ± 17.4) d (P=0.029).Conclusions K.pneumoniae is one of the most common pathogens of bacterial liver abscess.K.pneumoniae is relatively susceptible to cephalosporins and fluoroquinolones.Attention should be paid to the incidence of invasive syndrome at early stage.Antimicrobial therapy should be administered timely,especially for the patients complicated with thrombocytopenia or apparent jaundice.Ultrasound-guided percutaneous drainage can shorten hospital stay and reduce mortality.