OBJECTIVE:To investigate influential factors of standardization of clinical research on therapeutic efficacy of Yao-tongning capsules,and to provide direction for reasonable and standard development of clinical research. METHODS:Retrieved from CJFD,VIP and Wanfang database,RCTs about Yaotongning capsules in the treatment of related disease were collected. After data extraction and quality evaluation,Meta-analysis was conducted by using Rev Man 5.3 statistical software. The effects of the di-alectical situation,treatment course and route of administration on the evaluation of therapeutic efficacy of Yaotongning capsules were compared;based on this,the concepts of index evidence-based value which reflected clinical standardization were put for-ward,and its effects on Yaotongning capsules were investigated. RESULTS:A total of 71 RCTs were included,involving 11009 patients. Results of Meta-analysis showed therapeutic efficacy of Yaotongning capsules was better than that of other drugs in dialecti-cal case(P=0.02),while therapeutic efficacy of Yaotongning capsules was inferior to that of other drugs in non-dialectical case(P<0.01);therapeutic efficacy of Yaotongning capsules was inferior to that of other drugs when treatment course was shorter than 30 days(P<0.05),while treatment course was longer than 30 days,there was no difference in therapeutic efficacy between Yaotongn-ing capsules and other drugs(P=0.99). When did not take medicine according to the instruction,therapeutic efficacy of Yaotongn-ing capsule was inferior to that of other drugs(P<0.05);when taking medicine according to the instruction,there was no differ-ence in therapeutic efficacy between Yaotongning capsules and other drugs(P=0.94). When evidence-based value was ≥5,thera-peutic efficacy of Yaotongning capsules was better than that of other drugs(P=0.03);when evidence-based value was equal to 4, there was no difference in therapeutic efficacy between Yaotongning capsules and other drugs(P=0.56);when evidence-based val-ue was ≤3,therapeutic efficacy of Yaotongning capsules was inferior to that of other drugs(P<0.05),with statistical significance. CONCLUSIONS:It is an important guarantee of playing therapeutic efficacy of Yaotongning capsules to regularly use drugs strictly according to the principle of dialectical treatment,and take drugs according to treatment course and instructions. Clinical trials should be standardized strictly in accordance with the instructions,so as to provide objective and fair clinical findings.

Objective To evaluate the impact of fish oil (ω-3 fatty acids) parenteral nutrition (PN) on outcomes for non-ICU postoperative patients.Methods PubMed,Embase,Cochrane,China National Knowledge Infrastructure (CNKI) and Wanfang Database etc.were searched to retrieve the eligible studies published from January 2010 to June 2016.The studies included were randomized controlled trials (RCTs) that evaluated the effects of supplementation of fish oil (Omegawen) in PN regimens for postoperative patients on clinical outcomes.The methodological quality assessment was based on Jadad scale and Schulz allocation concealment tool.Meta-analysis was conducted by RevMan 5.3 software.Results 19 RCTs,1 170 surgical patients,were included.Meta-analysis indicated that short-term fish oil supplementation significantly reduced the incidence of infectious complications [RR =0.44,95％ CI (0.31,0.64),P ＜0.000 1] and shortened the length of hospital stay [MD =-0.85,95％ CI (-1.67,-0.03),P=0.04],while with no significant effect on mortality [RR =0.42,95％ CI (0.07,2.63),P =0.36] and total expenditure of hospitalization [MD =-216.60,95％ CI (-718.94,285.75),P =0.40].Sensitivity analysis showed similar results.Conclusion According to existing evidence,fish oil in PN for surgical patients could reduce the incidence of postoperative infectious com-plications and shorten the length of hospital stay.

In order to improve the efficiency and quality of medical services,the authors applied the lean production and system simulation into optimizing the transfusion system of a hospital.By means of describing and analyzing the current situation and problems of a transfusion system of the hospital,the paper presented the cause-effect diagram for overlong patient waiting.5W1H and ECRS were adopted to analyze the infusion processes,while Simio was used to simulate the existing infusion system and simulation data so obtained were used to draw a value stream mapping for the system.In line with the ideas of Shojinka and one stream production,nurses deployment and conveyor speed were reconfigured.Based on these ideas,a reform plan is presented and the simulation method is used to verify the outcomes.The study proved that lean production and system simulation can effectively improve the hospital transfusion system,medical efficiency and medical service level.

Objective To investigate the diagnostic value of gluocose-6-phosphate isomerase (G6PI) detected by an enzy-me linked immunosorbent assay (ELISA) in patients with rheumatoid arthritis (RA). Methods The G6PI was detected by ELISA in serum samples from 106 patients with RA, 53 non-RA controls with various rheumatic diseases, and healthy individuals. The level of rheumatoid factor (RF), anti-CCP antibodies and AKA were also assessed in RA patients. The correlation analysis beween G6PI and anti-CCP, IgM-RF. G6PI, anti-CCP, IgM-RF and AKA were carried out between patients with erosion and with non-erosion diseases . Results ① G6PI serum level of patients with RA was (1.61 ±1.20) μg/ml, and was (0.11 ±0.17) in patients with other rheumatic diseases, and (0.06±0.07) μg/ml in healthy individuals. There was statistical significant difference between RA patients and patients with other rheumatic diseases (P<0.05). Receiver operator curve analysis (ROC) showed an opitium cut off level for C6PI at 0.225 μl/ml. The sensitivity of G6PI was 0.868, the specificity was 0.853 in RA. C6PI was associated with RF, but was not associated with anti -CCP. C6PI ws not associated with disease activity index by Spearman' s correlation analysis. The association between above parameters with bone erosion was not detected, however. Conclusion C6PI is abnormally increased in some RA so it may be a new diagnostic marker for RA. G6PI has a reasonable sensitivity (86.8%) and with high specificity(85.3%) to RA and it is valuable for RA diagnosis. C6PI is associated with RF, but not completely overlaps. C6PI is not associated with diseases activity. No association is found between G6PI and bone erosions.

There are many subjects related to anesthesiology and the band between anesthesiology and clinical practicevery is close. So students can not be proficient in anesthesiology by traditional teaching methods. The use of three-dimensional case teaching method in anaesthesiology teaching is a good attemptment. three-dimensional case teaching method integrate case method, multimedia technology and clinical case. It can help medical students analyze and solve clinical problems, improvetheir academic performance and enhance their clinical basic skills.

Objective To study the effect of ultrasound-mediated microbubble on the concentration of cefuroxime in rat prostate. Methods Twenty male SD rats were randomly divided into the experimental group ( ultrasound-mediated microbubble+cefuroxime group) and the control group ( cefuroxime group) . The experimental group was given cefuroxime and microbubble via the tail vein, and then the prostates were exposed to ultrasonic irradiation for five minutes. The control group was given cefuroxime and the same amount of normal salin via the tail vein, and then given sham ultrasonic irradiation for five minutes. After the prostate was taken, cefuroxime concentration in pros-tate was measured by high performance liquid chromatograph. Results Concentration of cefuroxime in the experimental and the control group were (16. 274 ± 9. 515) μg/mg and (8. 336 ± 6. 743) μg/mg respectively. Compared to the control group, the concentration of cefuroxime was significant higher in the experimental group, and the difference is statistically significant (P <0. 05). Conclusion Low-dose ultra-sound-mediated microbubble can significantly improve the permeability of rat prostate tissue, thereby enhancing the drug concentration in prostate tissue.

[ ABSTRACT] AIM:To explore the effect of dexmedetomidine ( DEX) on the CCAAT/enhancer-binding protein-homologous protein ( CHOP) pathway during lung ischemia-reperfusion ( I/R) in mice.METHODS:C57BL/6J male mice were randomly divided into sham operation group ( sham group) , lung ischemia/reperfusion group ( I/R group) , ischemia/reperfusion +normal saline group ( I/R+NS group ) and ischemia/reperfusion+dexmedetomidine group ( I/R+DEX group) .Dexmedetomidine was infused intraperitoneally with 25 μg/kg for 30 min prior to the ischemia period in I/R+DEX group, the normal saline was administrated with the same volume of dexmedetomidine in I/R+NS group.After fini-shed the 3 h-reperfusion period , the left lung tissues were harvested to determine lung wet/dry weight ( W/D) , the total lung water content ( TLW) , and index of quantitative evaluation for alveolar damage ( IQA) .Morphological observation and terminal-deoxynucleotidyl transferase mediated nick end labeling ( TUNEL) were applied to evaluate the structure changes and the apoptosis index (AI) of the lung tissues.The expression of CHOP and glucose-regulated protein 78 (GRP78) at mRNA and protein levels in the lung tissues was detected by Western blot and RT-PCR.RESULTS:Compared with sham group, the W/D, TLW, IQA, AI, the mRNA and protein expression of CHOP and GRP78 obviously increased, and the left lung tissues structure were damaged more obviously both in I/R group and I/R+NS group.Compared with I/R group, the W/D, TLW, IQA, AI and the protein and mRNA expression of CHOP in I/R+DEX group decreased, the injury of the left lung tissue structures induced by I/R in I/R+DEX group were also alleviated .CONCLUSION:DEX alleviates the
lung I/R injury, which may be related to inhibition of apoptosis mediated by CHOP pathway.

BACKGROUND: The reason for the short of cornea donator is the olden donating conception or the limit knowledge of cornea transplantation remains poorly understood. OBJECTIVE: To explore the awareness level of the medical staff to corneal transplantation and corneal donation. METHODS: The study consisted of 820 medical staff from different departments of 5 hospitals, including doctor, nurse, technician, and administrator. Awareness level was evaluated with an interviewer-study. RESULTS AND CONCLUSION: Totally 805 interviewer-studies were effect. The correct answer fill rate in department of ophthalmology was higher than other departments. Different measures should be taken to teach the medical staff to improve the awareness level of the transplantation and corneal donation.

Objective To investigate the relationship between polymorphisms of N-acetyltransferase 2(NAT2)genes and anti-tuberculosis drug induced hepatic-injury(ADIH).Methods A 1:1 matched case-control study was conducted.One hundred and six cases fulfilling the criteria of ADIH were selected as ADIH group from the patients who received anti-tuberculosis therapy.whereas those patients without any hepatic inj ury related elinical symptoms during three months of follow-up period were selected as control.The genetic polymorphisms of the loci,NAT2481C/T,NAT2-590G/A and NAT2-857G/A,were determined by polymerase chain reaction and restriction fragment length polymorphism technique(PCR-RFLP)in patients who received antituberculosis therapy.The major environmental factors and genotypes were analyzed by univariate and multivariate conditional Logistic analyses.Results The T,AA allele frequencies of NAT2-481C/T,NAT2-590G/A and NAT2-857G/A were 7.5%,28.8%and 17.9%respectively in ADIH group,and 6.6%,18.9%and 17.5%,respectively in the control group.Univariate analysis demonstrated that the frequency of NAT2 slow acetylation genotype in ADIH group was significantly higher than that in control group with a crude OR(95%CI)of 2.250(1.140-4.441).Among 6 potential risk factors,i.e.education level,occupation,body mass index(BMI),smoking,drinking and the type of tuberculosis,the low BMI and drinking were two risk factors for ADIH.In multivariate analysis,ADIH remained associated with acetylation genotype after adjusting for BMI and drinking status.The adjusted OR(95%CI)was 2.246(1.086-4.644).Conclusion NAT2 slow acetylation genotype may be associated with the occurrence of ADIH.

Objective:To study the effects of different duty cycles [modulated by pulse repetition frequency(PRF)] of diagnostic ultrasound on enhancing blood perfusion in hypovascular tumors.Methods:Walker-256 tumor cells were injected subcutaneously into the inner thigh of 15 SD rats, and the rats were randomly divided into 3 groups according to PRF: group A(PRF=50 Hz), group B(PRF=1.0 kHz) and group C(PRF=2.0 kHz), with 5 rats in each group. The tumor-bearing rats in each group were treated with ultrasound combined with microbubbles for 10 minutes. Contrast-enhanced ultrasound was performed before treatment, immediately after treatment, and 4 hours after treatment, respectively, to compare the peak intensity(PI), area under curve(AUC), and tumor perfusion area in each group.Results:Immediately after treatment, PI and AUC values of group A and B increased compared with those before treatment (all P<0.05); 4 hours after treatment, PI and AUC values of group B continued to increase, superior to that immediately after treatment (all P<0.05), while PI and AUC values of group A and C were decreased compared with those immediately after treatment (all P>0.05). Immediately after treatment, the tumor blood perfusion area in group A and B increased significantly compared with that before treatment (all P<0.05); 4 hours after treatment, the tumor blood flow perfusion area of group B continued to increase, which was better than that immediately after treatment ( P<0.05), and the tumor blood perfusion areas of group A and C decreased compared with that immediately after treatment (all P>0.05). Conclusions:Low-intensity diagnostic ultrasound stimulated microbubble cavitation with PRF=1.0 kHz can enhance tumor blood flow significantly which can last for more than 4 hours.