Objective To explore the relationship between blood pressure variability and target organ damage in elder essential hypertension combined with type 2 diabetes mellitus (T2DM) patients.Methods One hundred and thirty-two elder essential hypertension patients were divided into two groups:single hypertension group (74 patients) and hypertension combined with T2DM group (58 patients).Thirty-nine cases of healthy person were chosen as control group and 61 single T2DM patients were as single T2DM group.Clinical data and ambulatory blood pressure monitoring indexes of 24-hour mean systolic blood pressure (24 h SBP),24-hour mean diastolic blood pressure (24 h DBP),diurnal mean systolic blood pressure (dSBP),diurnal mean diastolic blood pressure(dDBP),night mean systolic blood pressure(nSBP),night mean diastolic blood pressure (nDBP) were measured in the four groups.The percentage difference between dSBP and nSBP(△ SBP％),between dDBP and nDBP(△ DBP％) and target organ damage in four groups were also analyzed.Results Compared with single hypertension group,hypertension combined with T2DM group showed increased total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C) and carotid artery intimal-medial thickness (IMT) [(5.48 ± 1.03) mmol/L vs.(4.96 ± 1.14) mmol/L,(3.92 ± 0.63) mmol/L vs.(3.17 ± 0.55) mmol/L,(1.41 ± 0.19) mm vs.(0.93 ± 0.20) mm](P＜ 0.05).24 h SBP and nSBP was significantly higher in hypertension combined with T2DM group than that in single hypertension group,while 24 h DBP and dDBP was significantly lower[(145.3 ± 13.1) mm Hg(1 mm Hg =0.133 kPa) vs.(137.1 ± 12.8) mm Hg,(139.4 ± 9.9) mm Hgvs.(131.1 ± 11.6) mm Hg,(74.2 ± 9.6) mm Hgvs.(80.9 ± 9.2) mm Hg,(77.2 ± 9.1) mm Hg vs.(82.4 ± 9.3) mm Hg] (P ＜ 0.05).The incidence of target organ damage in hypertension combined with T2DM group was significantly higher than that in other groups [55.17％ (32/58) vs.27.87％ (17/61),21.62 ％ (16/74),10.26％ (4/39)] (P ＜ 0.05).Logistic regression analysis showed that age was a risk factor (OR =1.145,95％ CI:1.088-1.201,P ＜ 0.05),while △ SBP％ was a protective factor (OR =0.918,95％ CI:0.872-0.984,P ＜0.05).Conclusion Hypertension combined with T2DM can increase the blood pressure variability,aggravate the abnormality of the circadian rhythm of blood pressure and target organ damage.

OBJECTIVE: To prepare methazolamide eye drops and establish its quality control method.METHODS: Methazolamide eye drops was prepared using inorganic nanoparticles as carrier and methazolamide as principal agent.The content of methazolamide was determined by ultraviolet spectrophotometry.The stability of the preparation was investigated. RESULTS: The preparation was white suspension andin conformity with the description ofChina Pharmacopeia(2005 edition) inidentification and test.The linear concentration range of methazolamide was4~12?g.mL-1(r=0.999 9) and the average recovery was100.10% (RSD=1.11%).Methazolamide eye drops was unstable under highlight , while all the test items had no significant change in6-month accelerated test.CONCLUSION: The preparative method is si mple and feasible and the quality of the preparationis stable and controllable.But the preparation should be stored away formlight.

OBJECTIVE:To investigate the complexation of clonazepam with hydroxypropyl-?-cyclodextrin(HP-?-CD)in aqueous solutions.METHODS:The complexation of clonazepam with(HP-?-CD),the inclusion molar ratio of host and guest molecules and thermodynamic parameters were detected using phase solubility method,equimolar series method,UV absorption spectroscopy etc.RESULTS:The solubility of clonazepam increased linearly with the increase of(HP-?-CD)level in aqueous solutions at different temperatures(25℃,35℃and45℃)and in buffers at different pH values(4.0,6.0and7.0),the phase solubility diagram was classified as type AL.CONCLUSIONS:Under the above research condition,the incl_ usion complexes of clonazepam with(HP-?-CD)can be formed spontaneously at a molar ratio of1∶1.

OBJECTIVE:To compare the substitution between the gray relation analysis( GRA) and the orthogonal design(OD) in data processing. METHODS:Take the four factors including the molar ration of drug and cyclodextrins,the agitating time and speed,and the temperature of complexation that influenced on loaded dosage of ursolic acid complex as example to analysis with 2 kinds of methods. RESULT:The result of analysis was similar by 2 kinds of methods,the molar ration of drug and the temperature of complexation were the major influence factors. CONCLUSION:When the data cannot fit to the analysis of range of OD,GRA can be used to it.

OBJECTIVE: To study the development strategy of clinical pharmacy under the condition of New Medical Reform in China. METHODS: The status quo and obstacle factors of clinical pharmacy were analyzed to probe into the chance for clinical pharmacy in China brought out by New Medical Reform. RESULTS: The reimbursement mechanism reform of state hospitals, National Essential Drug System, medical insurance system, charge for pharmaceutical care system and the construction of primary hospitals and public health service provide development opportunities of clinical pharmacy. CONCLUSION: The development strategy of clinical pharmacy should be associated with New Medical Reform and relevant policy, laws and regulations of clinical pharmacy should be improved. Great importance should be attached to exploring the training system of clinical pharmacists and approaches of clinical pharmacy.

Objective To evaluate the diagnostic value of 2D ultrasound (2DUS)-based composite score method and contrast enhanced ultrasound (CEUS) in differentiation between thyroid microcarcinomas and benign micronodules. Methods A total of 216 consecutive patients with 258 thyroid micronodules underwent 2DUS and CEUS examinations before thyroidectomy from June 2011 to October 2013. The scoring of each nodule was based on five 2DUS features including hypoechogencity, irregular shape, macrocalcification, and taller than wide in shape. Microcalciifcation was assigned as 2 points and the remaining features were assigned as 1 point. A composite score was ifnally given to each thyroid nodule ranging from 0 to 6 points. The sensitivity, specificity and accuracy of diagnosing thyroid microcarcinoma by 2DUS composite score method and CEUS were calculated. Results The histopathologic results of all 258 nodules were acquired, including 125 papillary microcarcinomas and 133 benign micronodules. Each nodule′s 2DUS compostie score was ranging from 0 to 6 points. The area of receiver operating characteristic (ROC) curve of 2DUS in diagnosing thyroid microcarcinoma was 0.81. The 2DUS composite score method predicted the thyroid microcarcinoma with sensitivity of 78.4%(98/125), speciifcity of 72.9%(97/133), accuracy of 75.6%(195/258), when the nodule with a score greater than or equal to 3 points was deifned as malignant. Thyroid micronodules′enhancement pattern were divided into 7 types, including early hypoenhancement, hypoenhancement, isoenhancement, hyperenhancement, local nonenhancement, nonenhancement, and ring margin ring enhancement. CEUS predicted thyroid malignant micronodules with sensitivity of 87.2%(109/125), specificity of 75.9%(101/133), and accuracy of 81.4%(210/258), when early hypoenhancement and hypoenhancement pattern was defined as malignant patterns. There were no differences in sensitivity, specificity, and accuracy between 2DUS cumulative score method and CEUS in diagnosing thyroid microcarcinoma (McNemar test, P=0.099, 0.608, 0.096). Conclusion Early hypoenhancement and hypoenhancement are CEUS characteristic enhancement pattern for thyroid microcarcinoma, CEUS has higher sensitivity, speciifcity in diagnosis than 2DUS composite score method, while there are no statistical differences.

Objective To investigate the present situation of elective course,find out the problems,explain the causes and offer some suggestions.Methods Using the information collected from self-made questionnaires,and analysis data.Results The survey shows that there are the problems of elective courses in the installation,time,management,contents,teachers,exam,and so on.Conclusion The system of elective course should be made perfect in construction,management and operation.

Objective To explore the effects of Wenxin granule combined with conventional therapy on cardiac function,ventricular remodeling and local inflammatory response in patients with paroxysmal atrial fibrillation (PAF).Methods From February 2016 to February 2017,116 patients with PAF in the Integrated Traditional Chinese and Western Medicine Hospital of Taizhou were randomly divided into control group(55 cases) and combined group(61 cases) according to the digital table.The control group was treated with routine amiodarone hydrochloride tablets and enalapril maleate tablets,and the combined group was treated with Wenxin granule on the basis of the control group.The clinical efficacy of the two groups was compared,and the cardiac function,the level of inflammatory reaction and the index of ventricular remodeling before and after treatment were compared and analyzed in the two groups.The adverse reactions were observed and analyzed in the two groups.Results The total effective rate in the combined group was 93.44％,which was significantly higher than 76.36％ in the control group (x2 =6.745,P ＜ 0.05).After treatment,the left atrial diameter,the FS and CI levels in the combined group were significantly higher than those in the control group and before treatment (all P ＜ 0.05).The level of Pd in the combined group after treatment was (47.16 ± 0.80) ms,,which was significantly lower than that in the control group [(50.25 ± 0.75) ms] and that before treatment (t =21.395,48.318,all P ＜ 0.05).The levels of hs-CRP and BNP in the combined group were (7.12 ± 2.71) mg/L,(118.43 ± 11.16) ng/L,respectively,which were significantly lower than those in the control group [(11.21 ± 2.89) mg/L,(123.6 ± 11.27) ng/L] and before treatment (t =7.865,2.504,8.585,8.752,all P ＜0.05).After treatment,the LVEF level in the combined group was higher than that in the control group and before treatment (t =4.785,10.573,all P ＜ 0.05).The LVEDD and LVSV levels in the combined group were significantly lower than those in the control group and before treatment (t =9.089,2.313,10.890,4.299,all P ＜ 0.05).The total incidence rate of adverse reactions in the combined group was 6.56％,which was slightly lower than 7.28％ in the control group,but there was no statistically significant difference between the two groups(x2 =0.023,P＞0.05).Conclusion Wenxin granule combined with routine treatment in the treatment of PAF can significantly improve the clinical efficacy,improve the cardiac function obviously,delaye the ventricular remodeling,decrease the level of local inflammatory reaction significantly and the safety is high.

Platelet is an important component of human blood, which plays a key role in the physiological and pathological processes. Recently, novel drug delivery system based on platelet and platelet membrane bionics attracted much attention. Compared to the traditional drug carriers, platelet and platelet membrane-based biomimetic drug delivery system has great performances in biocompatibility, longer circulation and stronger ability of targeting. This review presented the features, classifications, drug-loading and applications of platelet and platelet membrane-based biomimetic drug delivery systems, promoting their development and application in the future.

Objective To study the effect of expression of myoglobin which mediated by adenovirus,on ATP value of liver and the protective effect on liver ischemia reperfusion injury.Methods Adenovirus carrying CMV promoter sequences linked to the human myoglobin gene(AdCMVMyo) were transfected into rats liver. Then myoglobin, hepatic ATP levels and liver function were evaluated. Results Myoglobin expression was verified in rat livers after AdCMVMyo transfection. The ATP levels in rat livers 72 hours after AdCMVMyo transfection were significantly higher than that in control group(P