OBJECTIVE:To investigate the utilization of the most used splitting drugs in the inpatients of our hospital,and to promote rational use of splitting drugs. METHODS:The medical orders of oral tablets in the inpatients of our hospital in Jan. 2016 were analyzed statistically in respects of consumption quantity,classification dosage,department dosage and the proportion of scored tablets. RESULTS & CONCLUSIONS:There were 217389 medical orders of tablets in the inpatients of our hospital in Jan. 2016. There were 12792 medical orders of splitting drugs,with utilization rate of 5.88%. The most used splitting tablet were car-diovascular drugs and drug for nervous system,accounting for 53.31% and 20.72% of total. The splitting tablets were mostly used in respiratory and critical care medicine department. Top 10 departments in the list of the number of splitting drug medical orders prescribed 8993 splitting drug medical orders,accounted for 70.30% of total. Top 20 drugs in the list of the number of splitting drugs were involved in 8971 medical orders,accounting for 70.13%of total;there were 14 kinds of scored drugs and 7506 medi-cal orders of splitting scored drugs,accounting for 83.67% of top 20 medical orders of splitting drugs. Among splitting drugs,49 types had scored-line,which were prescribed in 9265 medical orders of splitting drug,accounting for 72.43% of all medical or-ders of splitting drug. Lacking of information in most package inserts about the tablet can or can not split,it is suggested to note this information in package inserts by pharmaceutical enterprises. For commonly used splitting drugs without scored-line,it is pro-posed to produce small-size drugs or add scored-line.

It is an urgent task to transform scientific research achievements on traditional Chinese medicine (TCM) into standard for the science and technology workers of TCM. The transformation not only improves the level of TCM standard, but also promotes the scientific research achievement on TCM into productivity. The Medium and Long-Term Strategic Development Plan for TCM Standardization issued by the State Administration of TCM of the People's Republic of China put forward reinforcement of study on method for transformation of TCM scientific research achievement into standard. Thus, this paper presented seven steps for the transformation on the basis of the TCM Standardization Regulation (trial) in order to provide some references.

Background Optic neuritis is one of the common clinical neuro-ophthalmic diseases.Spectraldomain OCT (SD-OCT) is a valuable tool in assessing the thickness changes of retina,while enhanced depth imaging (EDI) OCT can further quantitatively and morphologically evaluate the changes of retina and choroid.The pathological mechanism of optic neuritis is unclear now.Objective This study was to quantitatively measure the retinal and choroidal thickness in early optic neuritis eyes by SD-OCT and EDI OCT.Methods A prospective cohort study was carried out in Tianjin Eye Hospital from July 2015 to May 2016.Twenty eyes of 20 patients with acute optic neuritis were enrolled as optic neuritis group and 22 eyes of 20 healthy subjects with matched age and gender were included in the normal control group.The mean thickness of retinal nerve fiber layer (RNFL) and choriod in superior,inferior,nasal and temporal quadrants at 3.4 mm around optic disc was measured,and the mean thickness of RNFL,ganglion cell layer (GCL),inner plexiform layer (IPL),inner nuclear layer (INL),outer plexiform layer (OPL),outer nuclear layer (ONL) and photoreceptor layer also was measured by EDI OCT.Pattern visual evoked potential (P-VEP) and visual field were examined in all the individuals,the correlations of mean defect (MD) with the thickness of RNFL,choroid and the thickness of RNFL,GCL,IPL,INL,OPL,ONL,photoreceptor layer at macular area were evaluated.Results The RNFL thickness values were (424.00±160.30),(428.40±169.83) and (108.15 ±50.66) μm in superior,inferior,nasal quadrants at 3.4 mm arear around optic disc in the optic neuritis group,which were significantly higher than (265.68±26.25),(283.27±52.81) and (72.68± 12.01) μm in the normal control group (t=4.571,3.814,3.190,all at P＜0.01),and there was no significant difference between the two groups (t =0.849,P =0.401),and no significant differences were found in choroidal thickness of 4 quadrants between the two groups (all at P＞0.05).The thickness of RNFL,GCL and IPL at 1 mm area around macula and the thickness of GCL,IPL,INL at 3 mm area around macula were evidently thining in the optic neuritis group compared with the normal control group (all at P＜0.05).The latency of P100 wave was (133.15±11.11) seconds in the optic neuritis group and that in the control group was (94.59 ±4.38) seconds,showing a significnat difference between them (t =15.058,P＜0.05).Positive correlations were found between MD and the RNFL thickess in superior,inferior,nasal quadrants at 3.4 mm arear around optic disc (r =0.649,0.649,0.635,all at P＜0.05),however,no evidentlylinear correlations were found between MD and choroidal thickness in 4 quadrands (r =-0.120,-0.102,-0.415,0.120,all at P＞0.05),and the thickness of RNFL,GCL,IPL,INL,OPL,ONL,photoreceptor layer at macular area was significantly linear correlated with MD.Conclusions EDI OCT can reflect the RNFL edema around optic disc and thining of various layers of retina at macular area in acuter optic neuritis eyes,however,the choroidal thickess is unchanged.EDI OCT is a useful tool in quantitative evaluation of retinal and choroidal thickness of early optic neuritis.

Traditional Chinese medicine (TCM) standardization serves as an important foundation of TCM modernization and internationalization, and TCM standardization strategy is the core of the subject. Recently, some developed countries and developing countries with a better economic basis have set development strategy for TCM standardization. China is at the beginning on TCM standardization strategy study. This paper explored the methods for setting TCM standardization development strategy. Firstly, strengths, weaknesses, opportunities and threats of TCM were analyzed based on SWOT method to set development tactics. On the above basis, the authors defined the total goal and stage goal under the guidance of the relevant laws and regulations. To achieve the strategic goal, priority areas were formed by literature analysis and expert inquiry method, and the safeguard measures were formulated by expert symposium. Secondly, the draft for development strategy of TCM standardization was made based on the above content. Finally, the authors revised and formed the official development strategy of TCM standardization.

Objective:Adenoid cystic carcinoma (ACC) is an uncommon malignant neoplasm, which mostly originates from the major and minor salivary glands of the head and neck region. This study aims to provide new information on head and neck ACC with cervical lymph node metastasis. Methods:Out of the 616 patients who underwent primary tumor resection from 1995 to 2008 in the authors' hospital, 62 cases with cervical lymph node metastasis were analyzed. Results:The general incidence rate of cervical lymph node me-tastasis in ACC was approximately 10%. The base of the tongue, mobile tongue, and mouth floor were the most frequent sites of lymph node metastasis with incidence rates of 19.2%, 17.6%, and 15.3%, respectively. Most cases exhibited the classictunnel-stylemetastatic pattern of occurrence, and the levelⅠb andⅡregions were the most frequently involved areas. Primary site and lympho-vascular invasions were significantly associated with lymph node metastasis. High patient mortality rate was also significantly correlat-ed with a high number of lymph node positive cases. Conclusion:Cervical lymph node metastasis has a high tendency of occurrence in the tongue-mouth floor complex, following the classictunnel-stylemetastatic pattern. Peritumoral lymphovascular invasion could be taken as a strong predictor for the occurrence of lymph node metastasis, which ultimately leads to poor prognosis of ACC patients. A selective neck dissection should be considered as a management in such patients.

The development, application and revision of the clinical practice guideline (CPG) in traditional Chinese medicine (TCM) are a whole thing. However, the development and revision of TCM CPGs have been influenced due to lack of TCM CPGs reporting and feedback channel. Therefore, during the TCM standardization network establish-ment, we studied the application model of TCM CPGs with spontaneous reporting network, in order to provide the ba-sis for further TCM CPGs development and revision.

AIM To observe the effects of Huangdi Anxiao Capsules (Puerariae lobatae Radix,Eriobotryae Folium,Notoginseng Radix et Rhizoma,etc.) on blood glucose and insulin resistance in GK rats with type 2 diabetes mellitus (T2DM) and its possible mechanism of action.METHODS GK rats with T2DM included in the experiment were randomly divided into model group,rosiglitazone (1.44 mg/kg) group,Shenqi Jiangtang Granules (1.08 g/kg) group,Huangdi Anxiao Capsules high,medium and low (12,6,3 g/kg) group and normal control group of Wistar rats.After six weeks of consecutive administration,fasting blood glucose (FBG),serum insulin (FINS),fasting plasma glucose (FPG),and insulin resistance index (HOMA-IR) were measured in all groups.Serum biochemical indexes of (TG,TC,HDL-C,LDL-C),glycosylated hemoglobin (HbA1c),glucagon-like peptide (GLP-1) and insulin-like growth factor (IGF-1) were measured.The pancreatic tissue was obtained by routine paraffin embedding and HE staining to observe the pathological changes.RESULTS Compared with the normal group,FBG,FPG,FINS,HOMA-IR,TG,TC,HDL-C,LDL-C and HbA1c of the model group were significantly higher (P ＜0.01),and GLP-1 and IGF-1 expressions were markedly decreased (P ＜ 0.01).Compared with the model group,the levels of FBG,FPG,FINS,HOMA-IR,TG,TC,HDL-C,LDL-C and HbA1 c in Huangdi Anxiao Capsules high-,medium-and low-dose group were significantly decreased (P ＜ 0.05,P ＜0.01);GLP-1 and IGF-1 expressions were markedly increased (P ＜0.05,P ＜0.01),compared with the model group,the structure changes of pancreatic tissue in Huangdi Anxiao Capsules high-,medium-and low-dose groups largely reduced.CONCLUSION Huangdi Anxiao Capsules can reduce GK rats fasting blood glucose,insulin resistance,and its mechanism may be related to promoting the emergence and proliferation of pancreatic islet cells,improving the function of islet beta cells,and increasing insulin secretion.

Objective To evaluate the stability of U6 and let-7a as internal reference genes of miRNAs in RTqPCR by using femoral head samples of cartilage tissue from inbred DA rats.Methods Total RNA was extracted from femoral head cartilage tissues of female DA rats at three different time points,i.e.at birth (D0),ablactation (D21) and maturation (D42).The expressions of different miRNAs (miR-1,-25,-26a,-140,-146a,-150,-181a,-195,-223 and-337) were detected by RT-qPCR using U6 or let-7a as the internal reference.The two sets of miR expression were compared with the results from Solexa sequencing in our pioneer work to evaluate the stability of the two internal references.Results The relative values of U6 (P =0.045) and let-7a (P =0.021 5) revealed significant difference in the D42 sample.Both in U6 and let-7a systems,miR-26a,-140,-223,and-337 showed a similar tendency in expression and quantification but miR-1 and-146a did not have significant differences.miR-25,-150,-181a and-195 differed significantly (P＜0.05).Comparison of absolute quantification results between the two generations' sequencing showed that let-7a is more stable than U6.Conclusion Let-7a is more suitable to be used as the internal reference gene in RT-qPCR for miRNAs in cartilage tissue.

Objective To investigate the epidemiological and clinical features of patients with hepatic echinococcosis in Nanjing City. Methods Epidemiological data, clinical manifestations, laboratory and image examination results, diagnosis and treatment of twenty patients with hepatic echinococcosis from January 2009 to December 2016 at the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Results A total of 20 hospitalized cases were investigated, of which 7 cases were males and 13 cases were females, the median age was 48 years (17 - 76 years). One case came from Tibet which was the epidemic area of hepatic echinococcosis;the other 19 cases were local hepatic echinococcosis patients including 3 cases that had raised dogs for many years and 2 cases engaged in processing and selling livestock products. Among the 20 cases, 14 cases had no remarkable symptoms and not sought medical advice until imaging examination showed focal liver lesions during a routine check-up, 2 cases saw a doctor due to hepatic cyst, 1 case due to progressive enlarged hepatic hemangioma, the remaining 3 cases due to abdominal discomfort or pain. In addition, 7 cases were diagnosed definitely in 7 to 14 days, 4 cases in 15 to 30 days, 5 cases in > 30 to 60 days, 1 case in 3 months, 1 case in 7 years and 1 case in 9 years. Thirteen patients had partial hepatectomy; the other 7 patients received endocystectomy. All patients had a good prognosis during the follow-up period. Conclusions Most of the local hepatic echinococcosis cases have no definite epidemiological data and no significant manifestations, leading to misdiagnosis and missed diagnosis. Clinical medical staff should strengthen their understanding of imaging characteristics especially the sonographic features of hepatic echinococcosis.

Objective To identify the scientific research status of Ershiwuwei-Shanhu pill among the literature review. Methods The literature were retrieved from CNKI, Wanfang and VIP databases (from databases built up to 2017), and quantitative analysis was carried out in the fields of time, journals and types of literature published. Results There were 58 literatures, including 33 clinical studies, 9 pharmacological studies, 14 pharmacological studies and 2 reviews. The literature published 39 kinds of journals, among which there were 81.0％ studies published in the journals holding the impact factors more and equal to 0.15 and 7 were core journals. Conclusions The results showed that the Ershiwuwei-Shanhu pill was in the developing period, mainly focused on clinical research, although there are some studies on pharmacology and pharmacy.The study of the ancient Tibetan medicine to the mature period there is still much space for development.