Usage of the fruit and bark of a Melia-family plant as a digestive tract-parasiticide and agricultural insecticide was recorded about two thousant years ago in ancient China. Toosendanin (TSN), a triterpenoid, is an effectual ingredient extracted from the plant. Studies have demonstrated that TSN selectively affects neurotransmitter release, effectively antagonizes botulism, induces cell differentiation and apoptosis and inhibits proliferation of various human cancer cells, inhibits feeding and dovelopment in insects and modifies K+- and Ca2+-channel activity. The research data to demonstrate that TSN inhibits K+-channel and facilitates L-type Ca2+-channel are summarized, and the mechanism of action of TSN is discussed.

OBJECTIVE:To discuss the necessity of clearing the pharmaceutical butyl rubber stoppers for infusion bottles before use.METHODS:Pharmaceutical butyl rubber stoppers for infusion bottles produced by manufacturer A and B were se-lected and washed at least once before a preliminary test was performed.Then product A was chosen for further test.The stoppers of two different batch numbers by manufacturer A were selected,one washed with injecting water and another not washed,all of which were used in the production of all kinds of transfusions in the hospital where the authors worked,then infusible motes in these products were measured.RESULTS:The infusible motes in the products with unwashed stoppers was not in accordance with the requirements in China Pharmacopoeia,while those with washed ones was in accordance.CONCLU_ SION:The pharmaceutical butyl rubber stoppers for infusion bottles must be washed by injecting water at least once before use to ensure the quality of the products.

OBJECTIVE:To study the cost-effectiveness of4dose regimens in treating chronic prostatitis/chronic pelvic cavity pain syndrome(CP/CPPS).METHODS:A total of140patients with CP/CPPS were randomly divided into4groups:Baiyanjing tablets and tamsulosin hydrochloride modified release capsules were administered for Group A;minocycline micro pills and alfuzosin retard tablets for Group B;rexithromycin tablets and doxazosin mesylate controlled release tablets for Group C;and levofloxacin tablets and terazosin tablets for Group D.The cost-effectiveness analysis was performed using pharma?coeconomics.RESULTS:The costs for the Group A,B,C and D were268.8yuan,641.8yuan,660.8yuan and666.4yuan,respectively.The effective rates were71.4%,91.4%,88.6%and91.4%,respectively.The cost-effectiveness ratios were3.76,7.02,7.46and7.29,respectively.The incremental cost-effectiveness ratios of Group B,C and D were18.65,22.79and19.88,respectively as against Group A.CONCLUSION:The treatment cost of CP/CPPS was composed of2parts:an?tibiotics? 1 -receptor blockers.Doctors should make an optimum choice based on patients'previous medication,economic status and physical condition,etc.

OBJECTIVE To investigate the antibiotic resistance status in clinical strains of Staphylococcus aureus (SAU) in Xiangfan and provide scientific evidence for reasonable use of antibiotics. METHODS Retrospective review was performed to analyzed the specimen source and the clinical distribution of 359 strains of SAU. BioMerieux Vitek 32 was used to identify the species of bacteria. Antibiotic susceptibility test was performed by K-B method and drug-resistance results were read according to CLSI2006. RESULTS Isolating rate of methicillin resistant S. aureus (MRSA) arrived at 54.9%. The results of susceptibility test showed that SAU had been resistant to the diverse antibiotics in different degree. The drug sensitivity rate of glycopeptide antibiotics and linezolid were all 100%. CONCLUSIONS The different grade hospitals should practically perform the management of antibiotics to postpone the resistance development and control outbreak and prevalence of nosocomial infections.

Objective To compare the medical selection standards of flying cadets in the nervous and mental system between Air Force of PLA(PLAAF) and the US Air Force(USAF), and to offer suggestions on revising PLAAF medical standards for flying cadets .Methods All our candidates who had participated in the final medical selection of flying cadets were subjected to neurological examinations , and determined as qualified or not according to USAF Medical Standards Directory.Results 123 people were disqualified during the neurological examination , accounting for 1.1% of the total. According to USAF Medical Standards Directory , 13 of them were disqualified , 24 of them were qualified , and 86 of them needed a second examination .There was marked difference between disqualification rates of PLAAF and USAF .Conclusion There are some differences in medical selection standards for flying cadets in the nervous and mental system between PLAAF and USAF, and we could revise PLAAF standards using USAF standards for reference .

Objective To investigate the possible protective effect of adenoviral vector expressing interleukin-1β (IL-1β) small hairpin RNA (shRNA) on spinal cord injury (SCI) and its mechanism in rats.Methods Forty-eight adult male Sprague-Dawley rats were randomly assigned to 4 groups including the Sham, the Vehicle,the Ad-GFP and the Ad-shIL-1β groups.SCI was induced by epidural compression.Motor function of hind limbs was evaluated by Basso-Beattie-Bresnahan (BBB) score, the expressions of green fluorescence in injured spinal cord tissue were observed by fluorescence microscope.Enzyme-linked immunosorbent assay (ELISA) and immunofluorescence were also performed.Results The expressions of green fluorescence in injured spinal cord tissue were observed in the Ad-GFP and Ad-shIL-1β groups one day after SCI.Significant functional improvement was observed in the Ad-shIL-1β group (8.17 ± 1.17, 10.17 ± 0.98 and 11.33 ± 0.82, respectively) compared to the Vehicle (4.00 ± 0.89, 5.67 ± 1.03 and 6.17 ± 1.17, respectively) and Ad-GFP (3.83 ± 0.98, 5.33 ± 1.21 and 5.67 ± 1.03, respectively) groups at 7, 14 and 21 days after SCI (P ＜ 0.05).Rats in the Ad-shIL-1β group had less neuronal loss 21 days after SCI.In addition, IL-1β downregulation significantly decreased IL-1β, tumor necrosis factor-or (TNF-α) and IL-6 levels (138.83 ± 7.96,143.38 ± 10.20 and 120.43 ± 9.79 in Ad-shIL-1β group;169.33 ± 11.45, 172.33 ± 8.26 and 163.00 ± 9.57 in Vehicle group;172.83 ± 10.85,167.48 ± 8.19 and 159.48 ± 10.98 in Ad-GFP group, respectively) one day after SCI (P ＜ 0.05).Conclusion This study demonstrated that the IL-1β downregulation may have potential therapeutic benefits for improving the outcomes after SCI.

Objective To evaluate the effect of wire-reinforced polyurethane epidural catheters on the success rate of epidural catheterization in the patients undergoing caesarean section.Methods A total of 182 pregnant patients,aged 25-43 yr,with body height of 145-178 cm,weighing 51-100 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective caesarean section under combined spinal-epidural anesthesia,were divided into 2 groups using a random number table:polyvinyl chloride epidural catheter group (group Ⅰ,n =94) and wire-reinfnrced polyurethane epidural catheter group (group 11,n=88).Spinal or epidural puncture was performed at L2,3 or L3,4 interspace,and the corresponding epidural catheter was inserted in each group aficr succcssful puncturc.Thc dcvclopment of difficult insertion,intravascular catheter insertion or paresthesia during puncture or insertion was defined as a failure of epidural catheterization.The occurrence of failed epidural catheterization was recorded.Results The failure rate of epidural catheterization was significantly lower in group 1Ⅱ than in gronp Ⅰ (P＜0.05).Conclusion Wire-reinforced polyurethane epidural catheters can raise the success rate of epidural catheterization in the patients undergoing caesarean section.

Objective: To investigate the role of des-gamma-carboxy prothrombin (DCP) in assessment of liver function and prognosis of patients with liver cirrhosis. Methods: From January 2013 to August 2016, a total of 137 patients with liver cirrhosis in Shanghai Changzheng Hospital were enrolled. The serum DCP level was measured, the clinical data was collected and the complication and survival situation was followed up. The 137 patients were divided into DCP negative group (DCP≤40 mAU/mL, 118 cases) and DCP positive group (DCP>40 mAU/mL, 19 cases). Forty-five patients with compensated liver cirrhosis were divided into high-level DCP group (DCP>16.5 mAU/mL, 32 cases) and low-level DCP group (DCP≤16.5 mAU/mL, 13 cases). Chi square test was used to analyze the difference in the positive rate of DCP in patients with different Child-Pugh classification. Spearman correlation test was performed to analyze the correlation between DCP and model for end-stage liver disease (MELD) scores. Kaplan-Meier survival curve was used to analyze the correlation between DCP and liver disease related mortality. Results: Compared to that of DCP negative group, albumin level of patients in DCP positive group decreased (35 g/L, 20 to 57 g/L vs. 29 g/L, 17 to 42 g/L), however, total bilirubin (TBil), prothrombin time (PT), and international normalized ratio all increased (12.9 mg/L, 1.80 to 83.0 mg/L vs.22.2 mg/L, 6.4 to 169.0 mg/L; 15.5 s, 11.7 to 35.7 s vs.17.5 s, 13.9 to 33.4 s; 1.24, 0.96 to 3.72 vs.1.44, 1.09 to 3.22), and the differences were statistically significant (Z=-2.785, -2.891, -2.945 and -2.879, all P<0.01). The DCP positive (DCP>40 mAU/mL) rates of Child-Pugh A, B and C patients were 1.8% (1/55), 21.2% (11/52) and 23.3% (7/30), respectively, and the difference was statistically significant (χ²=11.246, P=0.003). The DCP levels of patients with Child-Pugh class B and C cirrhosis were significantly correlated with MELD scores (r=0.259, P=0.021). There were 16 and three patients with ascites and spontaneous bacterial peritonitis (SBP) of DCP positive group, and the incidence was higher than that of DCP negative group (55.1%, 65/118 and 1.7%, 2/118), and the differences were statistically significant (χ²=5.744 and 97.636, both P<0.05). Patients in high-level DCP group had a higher proportion of clinical decompensation than low-level DCP group (53.1% (17/32) and two cases), the difference was statistically significant (χ²=5.397, P=0.024). The overall survival rate of DCP positive group (nine survival cases) were lower than that of DCP negative group (87.9%, 87/99), and the difference was statistically significant (χ²=5.442, P=0.020). Conclusions Serum DCP level is closely related to liver function, ascites and SBP in patients with liver cirrhosis. Furthermore, it is associated with occurrence of decompensation in compensated patients and liver-related mortality in patients with liver cirrhosis. DCP may be a useful serum marker for evaluation of disease severity and prognosis in patients with liver cirrhosis in clinical practice.

Objective To explore the effect of lifestyle intervention on risk factors for cardiovascular diseases in perimenopausal women, so as to determine the healthy lifestyle for them.Methods From March to December 2015, by cluster sampling, 130 perimenopausal women in Changchun were selected and divided randomly into experimental group (n=66) and control group (n=64). Conventional health education was conducted by community nurses to those in the control group, while those in the experimental group were given health education lectures, with lifestyle intervention schemes made on an individual basis. After the six-month intervention, lifestyles and indexes such as blood pressure, blood fat, etc. were compared between the two groups.Results Lifestyle comparison of perimenopausal women in the control group showed no statistic significance before and after the intervention (P>0.05), while in the experimental group, there was (P<0.05). Lifestyle comparison between the two groups showed no statistic significance before the intervention (P>0.05), while after the intervention, there was (P<0.05). Comparison of blood pressure, fasting blood glucose, and body weight in the control group showed no statistic significance before and after the intervention (P>0.05), while comparison of systolic pressure, body weight, waist hip rate and total cholesterol level in the experimental group showed statistic significance before and after the intervention (P<0.05). Before the intervention, comparison of blood pressure, fasting blood glucose, and body weight between the two groups showed no statistic significance (P>0.05). while after the intervention, comparison of waist hip rate, systolic pressure, and body weight between the two groups showed statistic significance (P<0.05). After the intervention, comparison of BMI, fasting blood glucose and total cholesterol level between the two groups showed no statistic significance (P>0.05).Conclusions Lifestyle intervention can significantly reduce cardiovascular disease risk factors for perimenopausal women.

Objective:To analyze the effect of different gastric mucosa preparation programs on the quality of painless gastroscopy, so as to provide reference for developing mucosal preparation programs.Methods:This was a prospective, randomized controlled study. A total of 150 patients with painless gastroscopy from March 2021 to December 2022 in Shanxi Yuncheng Central Hospital were selected by convenience sampling in this study, they were assigned to control group, water group, and soda water group by random digits table method, each group contained 50 patients. All patients received oral administration of pronase + dimeticone + sodium bicarbonate solution. In addition, control group: prohibited from drinking 4 hours before examination; water group: drinking 200 ml of pure water 2 hours before examination; and soda water group: drinking 200 ml of soda water 2 hours before examination. The clarity score of gastric mucosa and the detection rate of small lesions were compared among the three groups.Results:There were 28 males and 22 females in the control group, aged (47.62 ± 13.83) years old. There were 30 males and 20 females in the water group, aged (44.68 ± 13.61) years old. There were 24 males and 26 females in the soda water group, aged (46.92 ± 12.79) years old. The difference of esophagus, gastric body, gastric antrum and total mucosal clarity scores among the three groups were statistically significant ( F values were 3.68-25.75, all P<0.05). Multiple comparison showed that the esophagus, gastric antrum and total mucosal clarity scores were (1.87 ± 0.58), (1.37 ± 0.34), (6.72 ± 0.92) points in the control group, which were higher than (1.47 ± 0.41), (1.18 ± 0.31), (5.97 ± 0.86) points in the water group, and (1.42 ± 0.41), (1.02 ± 0.22), (5.50 ± 0.79) points in the soda water group, the differences were statistically significant ( t values were 2.67-5.95, all P<0.05). The gastric antrum and total mucosal clarity scores in the water group were higher than in the soda water group, the differences were statistically significant ( t=7.11, 2.71, both P<0.05). The gastric body mucosal clarity score was (1.98 ± 0.74) points in the control group, which was higher than (1.64 ± 0.54) points in the soda water group, the difference was statistically significant ( t=2.66, P<0.05). The gastroscopy examination time and flushin times were (135.20 ± 21.60) s and (1.37 ± 0.43) times in the control group, while (115.52 ± 14.74) s, (0.90 ± 0.29) times and (107.48 ± 13.02) s, (0.62 ± 0.23) times in the water group and soda water group, the control group was higher than the water group and the soda water group, and the water group was also higher than the soda water group, the differences were statistically significant ( t values were 2.38-11.40, all P<0.05). However, there was no statistically significant difference in the detection rate of small lesions among the three groups (all P>0.05). Conclusions:Drinking soda water 2 hours before painless gastroscopy can significantly improve the clarity of patients′gastric mucosa, shorten the examination time and reduce flushing times, but it does not improve the detection rate of small lesions.