OBJECTIVETo evaluate the clinical efficacy and safety of Qiangji Recipe (QR) in ad- junctive treatment of axial undifferentiated spondyloarthritis (axuSpA) through a four-week open study.

METHODSFifty-four axuSpA patients of Shen-deficiency Du-channel cold syndrome (SDDCS) in line with inclusive criteria were recruited and assigned to the treatment group and the control group according to random digit table, 27 in each group. Patients in the control group took Celecoxib Capsule (0.2 g each time, twice per day). Patients in the treatment group additionally took QR (consisting of Herba Epimedii 15 g, antler glue 15 g, Cibotium Barometz 15 g, eucommia bark 20 g, dipsacus asper 10 g, two toothed achyranthes root 15 g, drynaria 15 g, Taxillus Chinensis 20 g, ground beetle 10 g, scorpion 5 g, wild celery 10 g, notopterygium incisium 10 g, cow-fat seed 10 g, white mustard seed 6 g, and licorice root 6 g, one dose per day, twice daily). The therapeutic course for all was 4 weeks. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath AS Metrology Index (BASMI), total body pain and spinal pain, patient and physician global assessment on a four-point scale, the Ankylosing Spondylitis Quality of Life (ASQoL), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured before and after 4 weeks of treatment. The primary end point in this study was the proportion of patients with a 20%improvement response accord- ing to the ASAS International Working Group Criteria (ASAS 20 responders) at week 4.

RESULTSTotally 50 patients completed this trial, 26 in the treatment group and 24 in the control group. Improvement of BASDAI, BASFI, BASMI, ASQoL, ESR, and CRP was shown in both groups after treatment. Better effect was shown in the treatment group in all indices except ESR and BASMI after treatment (P < 0.05, P < 0.01). Twenty cases (accounting for 76.92%) in the treatment group achieved ASAS 20 response at week 4, while 12 cases (accounting for 50.00%) in the control group achieved ASAS 20 response at week 4 (P < 0.05). No obvious adverse reaction occurred in the two groups.

CONCLUSIONQR combined Celecoxib Capsule showed better effect in treating axuSpA patients than using Celecoxib Capsule alone.

Blood Sedimentation ; C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Pain ; Quality of Life ; Spondylitis, Ankylosing ; drug therapy

Outpatient care services are usually the patient's first contact between the patients and the most bas-ic health care. The provision of outpatient care contributes to immediate and large gains in health status. The pay-ment method is one of the most common incentive methods applied by purchasers to guide the performance of outpa-tient care providers. This systematic review applied cochrane review method, and searched, screened, assessed and synthesized the relevant original studies. 19 studies were finally included. It was found that existing payment methods combined with P4 P interventions could probably slightly improved the health professionals' use of some tests and treat-ments ( adjusted RR median = 1 . 095 , range 1 . 01 to 1 . 17 ) , but may have led to little or no difference in patients' utilisation of health services ( adjusted RR median = 1 . 01 , range 0 . 96 to 1 . 15 ) and may have led to little or no difference in the control of blood pressure or cholesterol ( adjusted RR = 1 . 01 , range 0 . 98 to 1 . 04 ) . Pay for per-formance involves a complex design, each detail design may contain different incentive effect, therefore policy makers intend to apply pay-for-performance to guide the behavior of health providers, the design on each components of pay for performance should be analyzed in order to find more potential intervention points.

Objective To investigate the expression and significance of interkeulin 10 (IL-10)in children patients with mycoplasma pneumoniae pneumonia(MP). Methods Twenty-six children patients with MP( MP group)and20 health control( contrl group)were sequentially enrolled in this study. The production of IL-10 mRNA was measured by fluorescent quantitative polymerase chain reaction. Results Expression of IL-10 mRNA in MP group (33 893.22±5 207.60) copy/μg was significantly lower than that in control group(59 341.92 ±6 712.98) copy/μg(t = - 14. 49, P ＜ 0. 01 ). Expression of IL-10 mRNA in heavy degree MP group was significantly lower than that of mild degree MP group ( t= - 2. 20, P ＜ 0. 05 ). Conclusion The expression of IL-10 was low, and played an important role in the development of patients with MP.

To explore one-step method for the preparation of Ganoderma lucidum multicomponent microemulsion, according to the dissolution characteristics of triterpenes and polysaccharides in Ganoderma lucidum, formulation of the microemulsion was optimized. The optimal blank microemulsion was used as a solvent to sonicate the Ganoderma lucidum powder to prepare the multicomponent microemulsion, besides, its physicochemical properties were compared with the microemulsion made by conventional method. The results showed that the multicomponent microemulsion was characterized as (43.32 +/- 6.82) nm in size, 0.173 +/- 0.025 in polydispersity index (PDI) and -(3.98 +/- 0.82) mV in zeta potential. The contents of Ganoderma lucidum triterpenes and polysaccharides were (5.95 +/- 0.32) and (7.58 +/- 0.44) mg x mL(-1), respectively. Sonicating Ganoderma lucidum powder by blank microemulsion could prepare the multicomponent microemulsion. Compared with the conventional method, this method is simple and low cost, which is suitable for industrial production.

Pulmonary vein isolation (PVI) is a new ,effective and radical method to cure atrial fibrillation .Within a period after radiofrequency ablation (RFA) ,coagulation system is activated in patients ,then thrombus incident such as cerebral embolism may happen .The present article made a review on its mechanism .

Objective To explore clinical and muscular pathological features of statin-induced myopathy.Methods Nine patients were enrolled in this study,who were diagnosed as statin-induced myopathy by muscle biopsy in Peking University First Hospital from April,2012 to October,2014.The clinical data and pathological findings were analyzed.Results The exposure time to statins varied from 4 days to 4 years in the total of 9 patients,6 males and 3 females,with the average age of 63 ± 6 (55 to 74) years old.Three patients suffered from myalgia and 6 patients complained of weakness mainly at the proximal limbs,while no symptoms occured in 3 patients.Serum creatine kinase (CK) increased in all patients with the maximum value varied from 468 to 8 000 U/L.Serum myositis antibodies were tested in 7 patients and all were negative.Electromyogram was performed in six patients with myogenic damage found in 2 patients.MRI of bilateral thigh muscle was carried out in six patients with muscle edema and mild fatty infiltration found in 2 patients.All patients underwent skeletal muscle biopsy with histochemical and immunohistochemical staining.The main muscular pathological features were muscle fiber atrophy,necrosis,regeneration and increased lipid droplets.Ragged blue fiber,cytochrome C oxidase-negative muscle fibers and decreased NADH activity were observed in some patients.MHC-Ⅰ expressed in the sarcolemma of muscle fibers at various levels.Mild C5b-9 staining was found in the endomysium,capillary and cytoplasm.Symptoms and the level of CK were improved in 7 patients after discontinuing statins or changing to another statin,while the immunosuppressive therapy were used in 2 patients and shown to be effective.Conclusions Statin induced myopathy is self-limiting in most patients,with improvement after discontinuation of statins.Few patients with autoimmune necrotic myopathy need immunosuppressive therapy.

Three strains having degrading poly(?-hydroxybutyrate)(PHB) activity were isolated from activated sludge of different ecological environments and areas,named DS9701, DS9710 and DS9713.The properties of PHB depolymerase produced by DS9701, DS9710 and DS9713 were studied. All the PHB depolymerases are extracellular enzyme and are induced enzyme. The time that enzyme activities of the PHB depolymerases reach the maximum is 96 hours after inoculation. The apparent optimal temperature range for crude enzymes extract is 40℃～45℃.

Recently , the country actively explores the pattern of an integrated healthcare which enables the as-sociation among hospitals of different levels , aimed to achieve maximum utilization of medical resources and lead a reasonable distribution of the patients .By reviewing the practices related to the integration of healthcare in Beijing , Shanghai , Zhenjiang and Wuhan city , this paper sums up in five typical mechanisms , i.e.organization and manage-ment mechanism , human resource management mechanism , interest distribution mechanism , service continuity and resources sharing mechanism .The effects of these practices were analyzed and the faced challenges were discussed . The following points were made clear during analysis and discussion:the sustainability of the collaboration mode and organization structure , human resource supports and incentive methods , health insurance guidance for hospitals and patients , two-way referral system and supporting measures , and building of information system .Then we put forward some suggestions , hoping to offer some references to the establishment of integrated healthcare in other regions .

OBJECTIVE: To analyze the features of drowning victims with psychiatric disorders to support further investigation on such cases. METHODS: One hundred and five archives of drowning victims with psychiatric disorders from January 2010 to June 2014 in Harbor Public Security Subbureau, Shanghai Public Security Bureau were reviewed. The decedents' general information, autopsy findings, case investigation data and disease histories were statistically analyzed. RESULTS: Of the 105 cases, 104 were suicides. Most decedents were poorly educated. Most suicides occurred in warm climate, and the corpses were usually found within 2 days. Most decedents had no suicide history and notes, but had abnormal mental or behavior changes before suicide. Depression, depression status and schizophrenia were the main types of psychiatric disorders, and only 9 decedents had received regular therapies before their deaths. CONCLUSION Mental disorder is a high risk factor in the drowning victims. Guardians should be aware of psychotic abnormal behaviors, especially during warm climate seasons.
China/epidemiology* ; Depression/epidemiology* ; Depressive Disorder/epidemiology* ; Drowning/psychology* ; Female ; Humans ; Male ; Mental Disorders/psychology* ; Psychotic Disorders ; Retrospective Studies ; Risk Factors ; Schizophrenia ; Seasons ; Suicide/statistics & numerical data*

The Z-drugs (zolpidem, zopiclone, and zaleplon), as the innovative hypnotics, have an improvement over the traditional benzodiazepines in the management of insomnia. Z-drugs have significant hypnotic effects by reducing sleep latency and improving sleep quality, though duration of sleep may not be significantly increased. As benzodiazepines, Z-drugs exert their effects through increasing the transmission of γ-aminobutyric acid. Z-drugs overdose are less likely to be fatal, more likely would result in poisoning. Z-drugs can be detected in blood, urine, saliva, and other postmortem specimens through liquid chromatography-mass spectrometry techniques. Zolpidem and zaleplon exhibit significant postmortem redistribution. Z-drugs have improved pharmacokinetic profiles, but incidence of neuropsychiatric sequelae, poisoning, and death may prove to be similar to the other hypnotics. This review focuses on the pharmacology and toxicology of Z-drugs with respect to their adverse effect profile and toxicity and toxicology data in the field of forensic medicine.
Acetamides/poisoning* ; Azabicyclo Compounds/poisoning* ; Drug Overdose ; Forensic Medicine/trends* ; Forensic Toxicology/trends* ; Humans ; Hypnotics and Sedatives/poisoning* ; Piperazines/poisoning* ; Pyridines/poisoning* ; Pyrimidines/poisoning* ; Sleep Initiation and Maintenance Disorders/drug therapy* ; Zolpidem