Objective To investigate the clinical effect of psychological intervention combined with insulin and glimepiride on the the treatment of elderly patients with diabetes. Methods 150 cases of elderly patients with diabetes in our hospital from July 2012 to March 2017 were treated as the research object, the single and double number (hospital admission order) 150 cases of elderly patients with diabetes were randomly divided into study group (n=75) and control group (n=75). The control group of elderly diabetic patients receiving insulin combined with glimepiride treatment in the study group received the basic treatment combined with psychological intervention. Results After treatement, 2 hPG, FBG and HbAlc were better than those in the control group (P<0.05). HAMD score in the study group after treatment decreased significantly than that before treatment(P<0.05). The difference of HAMD score in the control group had no statistically significant. Conclusion Psychological intervention combined with insulin and glimepiride on the treatment of elderly patients with diabetes can improve the depression, has a positive significance to improve the effect of blood glucose.

Objective To observe the effects of Xingnaojing injection on cytokine and clinical efficacy of patients with acute cerebral infarction (ACI) and blood stasis syndrome (BSS).Methods A prospective randomized controlled trial was conducted. Seventy hospitalized patients with ACI in the Neurological Department of the First People's Hospital of Jingmen of Hubei Province were enrolled, and they were randomly divided into a combination of traditional Chinese and western medicine group and a control group, 35 cases in each group. Both groups received conventional treatment. The combination therapy group additionally received Xingnaojing intravenous drip 30 mL, once a day on the basis of the control remedy. The therapeutic course in both groups was 14 days. In the two groups before and after treatment, the serum levels of γ-interferon (IFN-γ) and interleukins (IL-2, IL-5 and IL-10) were detected; the neurological function defect scale (NFDS) score, the modified Rankin scale (MRS) score and the daily living activity (ADL) score were observed.Results Compared with the levels before treatment, serum levels of IFN-γ and IL-2 were significantly decreased after treatment [IFN-γ (ng/L): the control group was 32.62±5.34 vs. 45.89±9.28, combination therapy group was 20.45±6.39 vs. 46.02±8.15; IL-2 (ng/L): the control group was 8.62±1.51 vs. 14.23±2.19, combination therapy group was 3.47±0.76 vs. 13.09±1.32], while the levels of IL-5 and IL-10 were obviously increased [IL-5 (ng/L): the control group was 68.39±8.89 vs. 36.80±6.32, combination therapy group was 89.20±9.17 vs. 37.26±6.08; IL-10 (ng/L): the control group was 27.66±5.47 vs. 15.59±3.27, combination therapy group was 38.54±7.66 vs. 16.17±4.29], and the changes in the combination therapy group were more significant [IFN-γ (ng/L):20.45±6.39 vs. 32.62±5.34, IL-2 (ng/L): 3.47±0.76 vs. 8.62±1.51, IL-5 (ng/L): 89.20±9.17 vs. 68.39±8.89, IL-10 (ng/L): 38.54±7.66 vs. 27.66±5.47, allP < 0.05]. Compared with the scores before treatment, NFDS score and MRS score were significantly decreased after treatment (NFDS score: the control group was 12.38±4.26 vs. 27.16±6.35, the combination therapy group was 7.59±2.09 vs. 28.53±7.57; MRS score: the control group was 3.39±1.51 vs. 4.58±1.07, the combination therapy group was 1.39±0.76 vs. 4.65±1.12), but the ADL score was significantly increased after treatment (the control group was 38.17±2.24 vs. 24.25±3.53, the combination therapy group was 48.43±1.32 vs. 23.51±2.17), and the improvement in the combination therapy group was more significant (NFDS score: 7.59±2.09 vs. 12.38±4.26, MRS score: 1.39±0.76 vs. 3.39±1.51, ADL score: 48.43±1.32 vs. 38.17±2.24, allP < 0.05).Conclusion The Xingnaojing injection can significantly regulate the levels of serum cytokines IFN-γ, IL-2, IL-5, IL-10, and improve the recovery of function of damaged nerve and the ADL in patients with ACI.

Objective To ohaerve the behavior of PD rat models treated with different dosages of levodopa and analyze the relation- ship between levodopa - induced dyskinesia (LID) and dosage of levedopa. Method The successful PD rat models were set up by 6-OHDA injection into right MFB. Two groups were divided according to the different treatment dosages of levodopa, which were given through perito- neal injection twice a day for 21days. One group was given for 10 mg/kg body weight, the other for 50 mg/ kg body weight. The score of AIM and rotational behavior were observed. Results Among altogether 28 female SD rats, 22 were chosen as the successful PD models and the successful rate arrived at 78. 57%. LID could be induced in both groups, but there were great differences in occurrence and duration time of AIM, AIM score, pharmacodynamic action time, and rotational behavior between these two groups( P<0.05). Conclusions The be- havior of LID has great relationship with the given dosage of levodopa.

OBJECTIVE:To explore the role of clinical pharmacists in the treatment of critical patients at perinatal stage. METHODS:During the treatment process of 4 critical patients at perinatal stage,according to the patients'special pathophysiolog-ic status (such as urea cycle disorder,dyslipidemia,severe infection,can not recover circulating blood volume rapidly,etc.), weighing the order of priority,based on relevant guidelines and literatures,clinical pharmacists provided individual medication ad-vices in respects of drug selection,medication timing,treatment course,drug combination and dosage adjustment,such as using cefuroxime,reduced glutathione,ursodesoxycholic acid,etc.,stopping drugs timely or adjusting antibiotics therapy plan. They al-so provided pharmaceutical care as lab index determination and ADR monitoring. RESULTS:Physicians adopted clinical pharma-cists'advices,and then 4 critical patients were all recovered. CONCLUSIONS:During the treatment course of critical patients at perinatal stage,clinical pharmacists should select safe and effective drugs as much as possible and adjust therapy plan in time ac-cording to clinical symptoms. When the security runs counter to effectiveness,clinical pharmacists should fully weigh the advantag-es and disadvantages and guarantee the maximum safety of pregnant or delivery women and fetuses.

Objective To study the molecular mechanism of MPTP-induced neuronal degeneration of substantia nigra in C57BL mice. Methods The C57BL mice model of Parkinson's disease were prepared by peritoneal administration of MPTP. These differentially expressed sequenced tags (EST) were obtained with mRNA differential display technique. Reverse Northern blotting was employed to eliminate the false positive ESTs. The true positive EST were cloned and sequenced. Results One of the two specific EST in degenerative substantia nigra was sequensed to be 121 bp and showed low homology with human v-abl Abelson murine leukemia viral oncogene (abl) exon 1b. Conclusions Our data suggested that MPTP may induce altered expression of promoting apoptotic genes to cause neuronal degeneration in substantia nigra.

OBJECTIVE:To evaluate the efficacy and safety of salmon calcitonin plus Xianling gubao for osteoporosis and ostealgia in postmenopausal women. METHODS:160 women with postmenopausal osteoporosis and ostealgia were randomized to 3 groups (treatment group and 2 control groups):the treatment group received(500 IU q.d) salmon calcitonin nasal spray plus Xianling gubao(1.5 g b.i.d orally); the control group Ⅰ received(500 IU q.d) salmon calcitonin nasal spray alone and the control group Ⅱ received Xianling gubao(1.5 g b.i.d orally) alone. All the patients received oral Caltrate D (1 tablet q.d). A course was defined as 30 days. After treatment for a total of 3 courses,the nature and degree of ostealgia in all the patients were assessed,and the outcome indexes were measured and the adverse drug reactions were recorded. RESULTS:There were significant differences between the treatment group and two control groups in total effective rates(92.59% for treatment group vs. 69.81% for control group Ⅰ and 67.92% for control group Ⅱ,P0.05). CONCLUSION:Treatment of osteoporosis and ostealgia in postmenopausal women with salmon calcitonin plus Xianling gubao has been proved to be safe and effective in that the bone density can be increased effectively and the osteoporotic pain of lumbar and back of the patients can be relieved.

Objective To explore the effect of xuezhikang on blood lipids,vascular endothelial function and redox balance in patients with carotid atherosclerosis.Methods A total of 108 inpatients with carotid atherosclerosis in cardiology department were randomly divided into two groups:xuezhikang group (n = 54) and cholestyramin group (n= 54).Before and after treatment,the levels of total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),nitric oxide (NO),endothelin-1 (ET-1),reduced glutathione (GSH) and oxidized glutathione (GSSG) of all patients were measured.The GSH/GSSG as redox potentials were calculated according to Nernst equation.Results After 12 weeks of treatment,the levels of blood lipids were lower than before treatment in xuezhikang group [TC:(3.94±1.36) mmol/L vs.(5.68±1.47) mmol/L;LDL-C:(2.28±1.11) mmol/L vs.(3.43±1.36) mmol/L;TG:(1.54±0.59) mmol/L vs.(1.73±0.66)mmol/L;t=3.915,4.160,2.187;P<0.01,0.01,0.05,respectively],and the levels of blood lipids also decreased in cholestyramin group [TC:(4.15 ± 1.29) mmol/L vs.(5.73 ± 1.52)mmol/L;LDLC:(2.56± 1.06) mmol/L vs.(3.37± 1.35) mmol/L;TG:(1.69±0.57) mmol/L vs.(1.72±0.67) mmol/L;t=3.760,4.035,1.893;P<0.01,0.01,>0.05,respectively].In xuezhikang group,ET-1,GSSG and GSSG/GSH ratios decreased significantly [(121.71 + 59.11) ng/L vs.(154.43±63.06) ng/L;(30.42± 1.59) μmol/L vs.(33.93±1.74) μ mol/L;-146.1±4.4vs.-142.3±4.3;t=2.168,2.325,4.168;P<0.05,0.05,0.01,respectively],and NO,NO/ET-1 ratios,GSH and GSH/GSSG increased significantly [(64.40 ± 18.86) μmol/L vs.(48.41 ±16.53) μmol/L;(0.54±0.19) vs.(0.33±0.16);(321.27±56.47) μmol/L vs.(286.11±38.23)μmol/L;(10.56±1.70) vs.(8.65±1.18);t=3.725,3.987,3.894,4.168;all P<0.01].Conclusions For patients with carotid atherosclerosis,both xuezhikang and cholestyramin could lower blood lipids efficiently,but only xuezhikang could protect vascular endothelial function partly,and makes plasma redox imbalance shift the balance.

Objective To assess the prevalance and distribution of pain in Parkinson' s disease (PD) patients, and to describe the relationship between pain and development of disease and its impact on the quality of life. Methods 113 PD patients were assessed with Visual Analog Scale (VAS), Brief Pain Inventory (BPI), Unified Parkinson' s Disease Rating Scale (UPDRS), Hoehn-Yahr Scale (H-Y), Hamilton Anxiety and Depression Scale (HRSD, HAMA) and Pittsburgh Sleep Quality Index (PSQI). Patients were divided into no pain group, PD-pain group and non-PD-pain group. PD-pain group was divided into PD-pain direct group and PD-pain indirect group. And statistical analysis was performed for each group. Results The incidence of PD-pain was 42. 5% (48/113). And compared with no pain group, PD-pain group had earlier age at onset of disease, longer duration, higher HAMA, HRSD, UPDRS and H-Y score, higher daily L-dopa dose, with statistical significance. Compared with non-PD pain group, the differences in the onset of age (57.4±9.6 vs 65.9±8.7, t= -2.596, P =0.012), HRSD(12. 9±7.9 vs 8.7±3.7, t =2.605, P=0.014) and VAS (61.6±25.9 vs 38.0 ± 30. 1, U = -2.290, P =0.022) were also statistically significant. BPI was different between PD-pain direct group and PD-pain indirect group except normal work and relations with other people. Conclusion Pain is frequent in Parkinsonian population. Most pain was chronic and related to PD (PD-pain). These patients always have earlier onset age and poorer quality of life.

Objective To investigate the effects of valproic acid ( VPA ) on SD rats with experimental autoimmune encephalomyelitis ( EAE) and its possible immunomodulatory mechanism .Meth-ods Fifty female Sprague-Dawley ( SD) rats were randomly divided into five groups by random digit table , including control group (n=10), EAE group(n=10), low dose VPA treated group (100 mg/kg, n=10), median dose VPA treated group (300 mg/kg, n=10) and high dose VPA treated group (600 mg/kg, n=10).The SD rat model of EAE was induced by immunizing with a guinea pigs′spinal cord homogenate (GPSCH).Normal saline and various doses of VPA were given to rats in according groups twice a day from day 0 to day 19 ( close to the peak stage of EAE ) .The severity of EAE was scored according to the signs and symptoms.Pathological changes were observed through Hematoxylin-Eosin staining, and then the degrees of inflammatory infiltration were evaluated .The numbers of activated neuroglia that expressed Iba-1 in cerebral and lumber cords were counted by immunohistochemistry .The expression of IFN-γ, IL-17 and IL-10 in cer-ebral and lumber cords were measured by ELISA .Results Compared with EAE group , rats in the low, me-dian and high dose VPA treated groups had lower incidence of EAE and prolonged latency , but only the me-dian dose treated group showed significant alleviation in clinical symptoms (P<0.05).Both the median and the high dose treated group showed decreased inflammatory cell infiltration in CNS (P<0.05).Immunohisto-chemistry results showed that the numbers of activated microglia were significantly inhibited in rats treated with median and high dose of VPA in comparison with those in EAE group (P<0.05).Results of ELISA demonstrated that the expression of IFN-γand IL-17 in both median and high dose VPA treated groups were significantly decreased compared with those in EAE group (P<0.05), but only the median dose treated group showed a remarkably increased expression of IL-10 (P<0.05).Conclusion VPA, especially medi-um dose of VPA ( 300 mg/kg ) , had neuroprotective effects on rats with EAE .The possible mechanism might be associated with the inhibited activation of microglia and the increased percentage of anti -inflammato-ry cytokines .