Aromataseinhibitors(AI)aretheleadingcarefortheadjuvanttreatmentofhormone responsive carcinoma of the breast as demonstrated in a number of large international phase III randomised tri-als.Aromatase inhibitor-associated arthralgia (AIA )was a somewhat unexpected side effect of this class of agents and has proven to be potentially problematic in clinical practice.The pathogenesis of AIA is not very clear currently,with the cause of most research focusing on estrogen deprivation,immune abnormalities,tenosy-novial changes and joint effusions.It is extremely urgent that we evaluate this syndrome and select appropriate therapeutic strategies to reduce the incidence of AIA,thereby improving breast cancer-related outcomes.

Objective To explore and identify the correlation of CTP classification,MELD score of patients with cirrhosis after hepatitis between different TCM syndromes.Methods For 135 patients comply with hepatitis B cirrhosis standard,standardized TCM syndrome differentiation and laboratory tests is executed so as to analyze the correlation of CTP classification,MELD score of patients with cirrhosis after hepatitis between different TCM syndromes.Results The liver function CTP classification in liver Qi stagnation syndrome and dump-heat accumulation syndrome patients mainly scores to Class A,and the MELD score less than 10 points-based.The liver function CTP classification in Yin deficiency of Liver and kidney,Yang deficiency of spleen and kidney and blood stasis syndromes mainly scores to Class B-C,and the MELD scores more than 10 points basically.Yin deficiency of Liver and kidney,Yang deficiency of spleen and kidney and blood stasis syndromes take majority in advanced cirrhosis patients compared with liver Qi stagnation syndrome and dump-heat accumulation syndrome take majority in early stage cirrhosis patients.Conclusion Matches the traditional view in TCM that form Qi stagnation,to damp heat-water stopped,to blood stasis-Yang and Yin deficiency is the regular pathogenesis evolution pattern of post-hepatitis cirrhosis.

Based on ninety three acetylcholinesterase inhibitors (AChEIs) which have the same mechanism of action but are different in structural characteristics, the pharmacophore model for acetylcholinesterase inhibitor was constructed by the CATALYST system. The optimal pharmacophore model with three hydrophobic units, a ring aromatic unit and a hydrogen-bond acceptor unit were confirmed (Weight=3.29, RMS=0.53, total cost-null cost=62.75, Correl=0.93, Config=19.05). This pharmacophore model will act on the double active site of acetylcholinesterase and is able to predict the activity of known acetylcholinesterase inhibitors that are used for clinical treatment of Alzheimer's disease (AD), and can be further used to identify structurally diverse compounds that have higher activity treating with Alzheimer's disease (AD) by virtual screening.

There are a wide range of gap junction proteins and pannexins between brain cells. The neurovascular unit, which are composed of neurons, glial cells and vascular cells, integrate and process information through cell membrane channels composed of gap junction proteins and pannexins, so as to maintain the dynamic balance of the nervous system. After cerebral ischemia, cell membrane channels play an important role in ischemic brain injury by participating in excitatory toxicity, inflammatory response, blood-brain barrier injury and other pathological mechanisms. Therefore, maintaining the normal function of gap junction proteins and pannnexins is essential to protect neurons from ischemic brain injury.

An HPLC pre-column derivatization detection method was established to detect and analyze the formaldehyde and acetaldehyde in polysorbate 80 and polysorbate 20 from different manufacturers.The effects of aldehyde and acetaldehyde on the aggregation of adalimumab under different conditions were monitored.Based on the control of genotoxic impurities and the influence on the stability of monoclonal antibody preparations, the control limits of the two chemicals were preliminarily obtained.2, 4-dinitrophenylhydrazine (2, 4-DNPH) was applied as the derivatization reagent in HPLC pre-column derivatization; acetonitrile and water were used as mobile phase to perform a gradient elution on a C8 (4.6 mm × 150 mm, 5 μm) chromatographic column.The detection wavelength was 360 nm, and the external standard method was used for quantification.Verification results showed that the method was suitable for the quantitative analysis of trace formaldehyde and acetaldehyde in polysorbate 80 and polysorbate 20 . The detection and analysis of formaldehyde or acetaldehyde in different batches of polysorbate 80 and polysorbate 20 from different manufacturers showed that the content of formaldehyde and acetaldehyde were quite different. The content of formaldehyde and acetaldehyde in polysorbate 80 were significantly higher than those of polysorbate 20. After monitoring the changes of adalimumab aggregates treated by formaldehyde and acetaldehyde by size exclusion chromatography (SEC), it was found that the effect of formaldehyde on adalimumab aggregation was significantly higher than that of acetaldehyde.According to the requirements of ICH M7 (International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use, M7: Assessment and Control of DNA Reactive (Mutagenic) Impurities in Pharmaceuticals to Limit Potential Carcinogenic Risk), the impurity limits of formaldehyde and acetaldehyde in polysorbate 80 and polysorbate 20 for monoclonal antibody preparations were calculated from the perspective of risk assessment.Combined with the influence on the aggregation stability of monoclonal antibodies, the preliminary limis for acetaldehyde and acetaldehyde were recommended to be ≤ 7 μg/g and ≤ 765 μg/g, respectively.

OBJECTIVE: To evaluate the efficacy and safety of Mahuang Zhisou Capsule (MHZSC), a compound traditional Chinese herbal medicine, in treatment of acute upper respiratory tract infection of wind-cold syndrome. METHODS: A multi-center, double-blind, double dummy, randomized controlled trial was conducted. A total of 240 patients were randomized into treatment group (120 cases, treated with MHZSC) and control group (120 cases, treated with Mahuang Zhisou Pill). The therapeutic course was 3 days. RESULTS: Seven cases were excluded and three cases lost to follow-up. Two hundred and thirty-three cases entered intention-to-treat (ITT) analysis and 230 cases fitted in per-protocol population set (PPS) analysis. After treatment, the therapeutic effect of upper respiratory tract infection was calculated by ITT and PPS analysis respectively. The significant response rate and total response rate in the treatment group were 78.07% and 98.25% (ITT and PPS), while the significant response rates in the control group were 70.59% (ITT) and 70.69%(PPS), and the total response rates were 95.80% (ITT) and 95.69% (PPS) respectively. There were no significant differences in clinical efficacy between the two groups (P>0.05). CONCLUSION: MHZSC is effective and safe in treatment of acute upper respiratory tract infection of external wind-cold syndrome.

Objective: To explore the effect of Baduanjin combined with health education in patients of heart failure with preserved ejection fraction (HFPEF). Methods: According to the method of random numbers, 100 HFPEF patients were divided into the observation group and the control group, 50in each group. The control group was given routine therapy and health education, while the observation group was given Baduanjin on the basis of the therapy of control group. With 3 months follow-up, heart function, symptom distress and quality of life in HFPEF patients were observed and compared. Results: After intervention, the observation group's 6-minute walking test results were significantly higher than the control group (505.10 ± 52.08 m vs. 442.50 ± 41.35 m; t=-2.977, P=0.008). The improvement of dyspnea, edema, fatigue, palpitations, loss of appetite, chest strength and body weight in the observation group was significantly higher than that in the control group (t were 2.885, 5.422, 9.333, 5.444, 5.199, 5.020, 5.657, 5.081, all Ps<0.05), and the improvement of the observation group in the physical, emotional and other areas of life quality was significantly better than that in the control group (t were 2.764, 3.818, 3.623, all Ps<0.05). Conclusions Baduanjin combined with health education can improve heart function, symptom distress and quality of life of patients of heart failure with preserved ejection fraction.

Objective:To investigate the status of aged nursing assistants post competency under the regional linkage mechanism in the elderly and the impact on nursing staff post competency factors.Methods:In December 2019, in Baoshan district of Shanghai elderly regional linkage center, the 159 nursing staff from 8 medical institutions were selected by stratified cluster random sampling method and investigated by the post competency questionnaire.The post competency of nursing staff was evaluated from three dimensions of work attitude, work ability and communication adjustment.Results:A total of 157 elderly care workers participated in the survey, age was (50.9±5.4)years old. The total score of post competency was (73.21±14.26) points, which belonged to the general level. In three dimensions,the work attitude dimension scored the highest, (28.92±7.40) points, and the communication adjustment dimension score was the lowest, (21.08±6.41) points. Among the items, the item of "ethics" had the highest score, and the item of "resolving contradictions" had the lowest score. Single factor analysis showed that there were differences in job competency of aged nursing assistants with different educational levels, with or without work experience, length of service ( F values were 1.229, 0.068, t value was 1.147, all P<0.05). Multiple linear regression analysis showed that the work experience of senior care workers ( B value was 0.435, P<0.05), length of service ( B value was -1.792, P<0.05) were the factors that affected the competency of aged nursing assistants. Conclusions:The work attitude, basic knowledge, work enthusiasm, and basic care skills of elderly care workers in the district have been effectively supervised under the regional linkage mechanism for the elderly, but they are relatively weak in solving conflicts, communication skills, thinking skills, and listening skills. Therefore, the role of the regional linkage mechanism for the elderly should be strengthened to improve the job competence of the elderly care workers in the grass-roots medical institutions, thereby improving the service level of the elderly and improving the quality of elderly care.

Objective:To explore the relationship between the expression level of micro RNA-133a(miR-133a) and the indexes of heart failure in patients with ischemic heart failure and its clinical application value.Methods:From January 2018 to September 2019, the clinical data of 80 patients diagnosed as ischemic heart failure in Shenyang Fourth People′s Hospital were analyzed prospectively.According to the classification of New York Heart Association(NYHA), 20 cases were divided into NYHA class Ⅰ group, class Ⅱ group, class Ⅲ group and class Ⅳ group, and 20 healthy people in the same period were selected as the healthy control group.The concentration of brain natriuretic peptide (BNP) in peripheral blood was detected by automatic immune analyzer, the indexes of cardiac function were detected by echocardiography, the expression of miR-133a in serum was detected by qRT-PCR, the difference of expression concentration of miR-133a in different functional grades was compared, and the correlation between the concentration of miR-133a and BNP and the indexes of echocardiography was analyzed.Results:The expression of miR-133a in healthy control group(0.167±0.024), NYHA Ⅰ group(0.289±0.012), NYHA Ⅱ group (0.415±0.034), NYHA Ⅲ group(0.981±0.217) and NYHA Ⅳ group(1.238±0.249) was statistically significant( F=106.4, P<0.001). Pearson correlation analysis showed that miR-133a was positively correlated with BNP in NYHAⅡ, Ⅲ and Ⅳ grade( r=0.815, 95% CI: 0.582-0.924, P<0.001; r=0.465, 95% CI: 0.029-0.753, P<0.05; r=0.749, 95% CI: 0.459-0.895, P<0.001). MiR-133 was negatively correlated with EF( r=-0.811, 95% CI: -0.875--0.719, P<0.001), positively correlated with LVPW, LV and EDV( r=0.331, 95% CI: 0.120-0.513, P<0.01; r=0.845, 95% CI: 0.764-0.896, P<0.001; r=0.705, 95% CI: 0.572-0.803, P<0.001). Conclusion:The expression of miR-133a in patients with ischemic heart failure is increased, which is related to the index of cardiac dysfunction, and has certain diagnostic and prognostic value.