Objective To discuss the selection of indication for using uterine artery perfusion and embolization in tubal pregnancy. Methods Fifty one cases of tubal pregnancy were treated by superselective trans-uterine artery (TUA) catheterization with perfusing Methorexate (MTX) and then embolized the uterine arteries by gelfoam. The comparisons among serum P-HCG concentration, abdominal bleeding and the size of the ectopic mass could state the importance of the indication selection preprocedurally. Results Forty eight of the 51 cases were cured by this method, when the ectopic mass size≥5 cm, the cure rate was low, 33.33% (P

Objective To compare left ventricular (LV)synchronization of direct His-bundle pacing (DHBP)and right ventricular apical pacing (RVAP)with two-dimensional speckle tracking imaging (2D-STI)and tissue Doppler imaging (TDI),and discuss the diagnostic value of 2D-STI and TDI in evaluation of left ventricular systolic synchronicity.Methods Twenty-four patients implanted with DHBP and RVAP were observed.Conventional echocardiography examination were undergone both at the mode of DHBP or RVAP respectively.The time to peak radial strain of LV 1 8 segments were derived from the parasternal short-axis views by 2D-STI,then calculated the standard deviations (SD ) and the maximal temporal difference of LV 1 8 segments (Trs-SD and Trs-Dif),and the interval of time to peak radial strain between the anteroseptal wall and the posterior wall (Tas-post).The time to peak systolic velocity of LV 12 segments were derived from the apical axis views by TDI.The SD and the maximal temporal difference of 1 2 segments (Ts-SD and Ts-Dif)were calculated as the LV dyssynchrony index.Results All the systolic synchrony parameters derived from 2D-STI and TDI were more significantly shortened in DHBP than in RVAP (all P <0.01).For DHBP,the detection rate of LV synchronization was higher by 2D-STI than by TDI.For RVAP the detection rate of LV dyssynchronization was also higher by 2D-STI than by TDI with RVAP lead (all P <0.05).Conclusions DHBP is more beneficial than RVAP in LV syschronization and LV function,RVAP may induce left ventricular systolic asynchrony.Both 2D-STI and TDI can assess the LV synchronization quantitatively,but 2D-STI may be more superior on the detection rate than TDI.

Objective To investigate effects of different sedation methods on the mechanical ventilation patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A total of 101 patients with mechanical ventilation in our hospital was randomly divided into observation (58 cases) and control (43 cases) groups.The observation group was given to strengthen psychological care during the day, and the night was given to the patients with AECOPD.The control group was treated with continuous analgesia and sedation, and the daily morning was executed to wake up the plan 1 ～ 2 hours.A set of indexes were observed, including white cell count, C-reactive protein, oxygen index, B-type natriuretic peptide, delirium occurred rate, unexpectedly drawn tube rate, and duration of mechanical ventilation.Results White blood cell number, C reactive protein, and oxygen index group in the observation group were significantly better than the control group [(10.1 ± 2.4) × 109/L vs (11.2 ± 2.8) × 109/L,(40.6 ± 11.6) mg/L vs (45.8 ± 12.2) mg/L, and (285.6 ±45.1) vs (268.2 ±42.6)] (P ＜0.05).The incidence of delirium rate in the observation group was significantly lower than the control group [30/58(51.7％) vs 31/43(72.1％)] (P ＜0.05).The mechanical ventilation time in the observation group was significantly shorter than the control group [(8.41 ± 3.96) d vs (10.35 ± 5.57) d] (P ＜ 0.05).There was no significant difference between B type natriuretic peptide and accidental extubation rate (P ＞ 0.05).Conclusions The night program sedation program can significantly improve AECOPD mechanical ventilation in patients with inflammatory index and oxygen index, reduces the incidence of delirium in patients with acute exacerbation of chronic obstructive pulmonary disease, does not increase the accidental extubation rate, and significantly shortens the AECOPD patients with mechanical ventilation duration of mechanical ventilation, as a mechanical ventilation in AECOPD patients who killed one of the options.

[ ABSTRACT] AIM:To observe the effect of endogenous nitric oxide synthase ( NOS) inhibitor asymmetric dimeth-ylarginine ( ADMA ) and its signaling pathways on NO levels and skeletal muscle contractility in 4-week running rats. METHODS:The 4 weeks running rat model was established.The twitch tension, tetanic tension and the fatigue test of sole-us muscle induced by electrical stimulation ex vivo were detected.The ATP content, mitochondrial DNA levels and the mR-NA expression of peroxisome proliferator-activated receptor γcoactivator-1α(PGC-1α), nuclear respiratory factor (NRF) were measured to reflect the mitochondrial function and biosynthesis in the skeletal muscle.Serum ADMA concentration was detected by high performance liquid chromatography.The endogenous ADMA enzymes PRMT1 and 2 subtypes of ADMA me-tabolism enzyme DDAH, 3 subtypes of NOS protein expression in the skeletal muscle were determined by Western blot.NOS activity and nitric oxide ( NO) content were analyzed by colorimetric method.RESULTS: Compared with normal control group, the twitch tension, tetanic tension and the anti-fatigue capability of soleus muscle in running group were significantly enhanced, ATP content, mitochondrial DNA content and the mRNA expression of PGC-1αand NRF were significantly in-creased (P<0.01).In addition, the protein expression of constitute type NOS (cNOS) and NOS activity were significantly increased (P<0.01), but the increase in NO content was relatively smaller in soleus muscle in exercise group (P<0.05). Moreover, serum ADMA concentration in running group was increased, while the DDAH2 expression in skeletal muscle was decreased.CONCLUSION:Short-term endurance exercise enhances the twitch tension, tetanic tension and fatigue resist-
ance of soleus muscle.The mechanism may be that increased cNOS expression feedbacks to increase ADMA concentration, thus maintaining the increase in NO synthesis at a relatively low level, and resulting in promoting skeletal muscle mitochon-dria biosynthesis and mitochondrial function.

Objectives:To study the pharmacokinetics and relative bioavailability of glipizide in healthy male volunteers. Methods:The glipizide concentrations in plasma were determined by HPLC UV. The column: Lichrospher C18 (5 ?m,150 mm?4.6 mm),the mobile phase: methanl∶0.01 mol/L sodium acetale buffer (pH 4.8) (59 ∶41); the flow rate:1 ml/min, the detection wavelength: 225 nm. The test and reference formulations of glipizide were given to 20 healthy male volunteers. Results: The calibration curve was linear within the range of (25～1 000)?g/L, r =0.999 4. The minimum detection limit was 25 ?g/L. The mean recovery was 89.84%, CV of inter day and intra day were no more than 5%.After a single oral dose of 10 mg glipizide test or reference tablet, the main pharmacokinetic parameters AUC 0-15, AUC 0-∞, T max ,C max and t 1/2 were (3 502.78?635.82) , (3 214.23?590.46)?g/( L?h),(3 868.22?699.93), (3 593.94?638.60)?g/(L?h),(3.85?1.44), (3.76?1.13)h, (550.80?110.19), (531.15?148.42)?g/L,(3.57?1.11)h and (3.80?1.06)h ,respectively. The relative bioavailability F 0-15 ,F 0-∞ were (110.6?19.8)% and (108.8?17.9)%. Conclusions: No significant difference exists among the pharmacokinetic parameters for the experimental tablets and the reference. The two formulations were bioequivalent.

AIM: To study the pharmacokinetics and rela ti ve bioavailability of naftopidil in healthy male volunteers. METHODS: The naftopidil concentrations in plasma were determined by HPLC. The test and reference formulations of naftopidil were given to 18 healthy male volunteer s. The calibration curve was linear within the range of 1.6 - 400 ?g?L -1 , r=1. The minimum detection limit was 1 ?g?L -1 . The mean recovery rate was 85.2 %- 89.9 %, RSDs of inter-day and i ntra-day were no more than 8.0 %. RESULTS: After a single o ral dose of 50 mg naftopidil test capsules or reference tablets, the main pharma cokinetic parameters AUC 0-24 : 295.6 ? 90.9 and 291.6 ? 89.3 ?g?L -1 ?h -1 ; AUC 0-∞ : 320.0 ? 97.2 and 318.0 ? 98.3 ?g?L -1 ?h -1 ; T max : 0.6 ? 0.2 and 0 .6 ? 0.2 h ; C max : 129.1 ? 60.7 and 138.3 ? 72.5 ?g? L -1 ; T 1/2 : 5.9 ? 1.7 and 6.4 ? 2.1 h , respectively. The relative bioavailability F 0-24 ,F 0-∞ were 101.9 ? 12.9 % and 101.2 ? 12.3 %, respectively. CONCLUSION: No signifi cant difference exists among the pharmacokinetic parameters for the test capsule s and the reference tablets of naftopidil. The two formulations were bioequivale nt.

AIM:To study the pharmacokinetics and relative bioavailability of citalopra hydrobromide in human plasma.METHODS:The citalopra hydrobromide concentrations in plasma were determined by HPLC-UV.The column was Lichrospher ODS(5 ?m,250 mm?4.6 mm).The mobile phase was acetonitrile-0.1 mol/L KH2PO4 buffer-triethylamine(35:65:0.3,v/v/v).The flow rate was 1 mL/min.The detection wavelength was 240 nm.The test and reference formulations of citalopra were given to 18 healthy male volunteers.RESULTS:The calibration curve was linear within the range of 2-128 ?g/L,r=0.9992.The minimum detection limit was 1 ?g/L.The recovery was 80%-88%,the RSDs of inter-day and intra-day were not more than 15%.After a single oral dose of 20 mg citalopra hydrobromide was given,the main pharmacokinetic parameters tmax were(4.6?1.0),(4.4?1.4) and(4.0?1.4) h;Cmax were(70?19),(71?17) and(66?21) ?g/L;and t1/2 were(37?9),(37?6) and(36?6) h respectively.CONCLUSION:No significant difference exists among the pharmacokinetic parameters of the three formulations.They are bioequivalent.

Objective To investigate the service requirements and health and safety problems in home care among senile cerebrovascular disease patients above 65 years old and provide the direction and basis for the home care.Methods 78 cases of elderly patients with cerebrovascular sequela 2 years after discharge were selected as the research objects.One-on-one interviews with patients and their families,the self-made questionnaire were sent out,the patients' service item requirements and the main health and safety problems were reorganized,then the corresponding nursing intervention was implemented.One year later,patients were revisited and investigated again.Results In elderly patients,there were many health and safety issues in home care,their nursing service demand was high.After giving corresponding nursing intervention of health guidance,the incidence of aspiration,fall,falling out of bed,bedsore,sleep disorders,urinary tract infection was effectively reduced.Conclusions The mode of family care should be established on the basis of demand of home care by elderly cerebrovascular disease patients,which conforms to the ac-tual situation of our country,in order to improve patients' self-care ability and life quality.

Objective: To conduct an epidemiological investigation on a cluster of overseas imported cases of coronavirus disease 2019(COVID-19)in Qingtian County, Lishui,so as to provide reference for the prevention and control of COVID-19 imported from abroad. Methods: According to the COVID-19 Prevention and Control Program (FiFth Edition) issued by National Health Commission of China,a field investigation was employed and the close contacts of the case were tracked down ;the real-time reverse transcription polymerase chain reaction (RT-PCR) assay was performed to detect the nucleic acid of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from the sputum specimens or throat swabs of cases;the epidemiological characteristics,source of infection,route of transmission and disposal of the cluster were analyzed. Results: From March 1 to March 6,2020,eight confirmed cases and one asymptomatic case of COVID-19 were reported. Their median age was 33 years old. The nine cases all had no fever,no decrease in leukocyte and lymphocyte levels,and the clinical symptoms of seven cases were not obvious. The asymptomatic case had been tested negative for SARS-CoV-2 for six times,but had been weakly positive for IgM antibody and strongly positive for IgG antibody. Nine cases were all the employees of the same restaurant in Begamo,Italy. They lived in three independent villas and usually had lunch and dinner in the restaurant where they worked. Begamo had COVID-19 epidemic,but the staff of the restaurant did not take any protective measures such as wearing masks and environmental disinfection. Eight cases reported to have cold symptoms in Italy during mid February. Through a closed-loop management of“all people,all sites,all chains ”,such as treatment of current cases,screening and isolation of close contacts and health education,totally 372 close contacts were traced back,yet no fever or respiratory symptoms have been found. Conclusions It was a cluster of COVID-19 cases imported from abroad. The clinical symptoms of the cases were not obvious. Qingtian County adopted the closed-loop management in time,and effectively controlled the spread of the epidemic. No second-generation cases have been found.

To analyze the difficulty, distinction and result of the first national public health practice skills competition among college students, it showed the general situation of this competition, and discussed the present situation, problems and countermeasures of skills training for students majoring in preventive medicine. Based on such competition, educators can promote teaching reform and post competency training.