OBJECTIVE:To observe the efficacy of levoamlodipine besylate combined with piracetam for vascular dementia(VD).METHODS:66 patients with VD were enrolled:33(treatment group) were assigned to receive Levoamlodipine besylate 2.5～5 mg q.d plus piracetam 0.8 g tid for 3 months,and another 33(control group) to receive piracetam 0.8 g tid plus basic treatment based on patients' blood glucose,blood pressure and blood lipid levels.The patients were given 3-month follow-up.Mini-Mental State Examination(MMSE),Activity of Daily Living Scale(ADL),Hasegawa Dementia Scale(HDS) and Wechsler Memory Scale(WMS) were used to evaluate the patient's cognitional function and mental state before and after treatment.RESULTS:MMSE,ADL,HDS,and WMS scores after treatment were(22.48?3.25),(25.16?8.96),(23.14?2.91),(71.14?19.01),respectively in treatment group versus(20.56?3.18),(29.74?13.01),(20.41?6.25),(60.35?20.60),respectively in control group.The treatment had a better improvement in symptoms than control group did and there was statistical difference between groups(P

Objective To investigate the gamma glutamine carboxylase (GGCX ,rs6738645) genotype distribution in Chinese Han population and the correlation between GGCX (rs6738645) polymorphism and the warfarin stable dose in the patient after valve replacement .Methods The genotypes of 228 cases were detected by the Snapshot technology in order to explore the genotype and allele frequencies .The correlation between the gene polymorphism in 176 cases after valve replacement and the stable dose of warfa-rin was compared .Results In total of 228 research subjects ,the number of TT ,GT and GG genotype were 84(36 .84% ) ,122 (53 .51% ) and 22(9 .65% ) .The frequencies of T and G allele were 63 .60% and 36 .40% respectively ;in 176 patients after the valve replacement ,the maintenance stable dose of warfarin was lower in GG group than in the TT and GT groups ,the differences between the groups showed statistical significance (P<0 .01) .The PT value and INR value had no statistical difference among 3 genotype groups(P>0 .05) .Conclusion The GGCX(rs6738645) polymorphism in Chinese Han population may be the influencing factor of warfarin individual dose difference in the patients after valve replacement .

Objective To establish a rapid, sensitive and selective liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of acyclovir (the metabolite of valacyclovir hydrochloride) in human plasma. Methods After addition of ganciclovir as internal standard (IS), plasma samples were prepared by one-step protein precipitation using acetonitrile as precipitant, followed by an isocratic elution with 0.1% formic acid 3.5μm) column. Detection was performed on a triple-quadrupole mass spectrometer utilizing electrospray ionization (ESI) interface operating in positive ion and selected reaction monitoring (SRM) mode with the precursor to product ion transitions m/z 226.2→152.1 for acyclovir and m/z 256.2→152.1 for the IS. Results The analytical results demonstrated a good linearity over the ranges from 0.005 to 4μg/mL (r=0.9999) for valacyclovir hydrochloride. The relative standard deviations (RSD) of intra-batch and inter-batch were less than 4.06% and 9.23%, respectively. The limit of detection and lower limit of quantification in human plasma were 2ng/mL and 5ng/mL, respectively. Conclusion The method was simple, sensitive, accurate and reproducible and has been successfully applied to a bioequivalence study of valacyclovir hydrochloride capsules in Chinese healthy male volunteers.

The paper introduced a therapeutic method of lower-resistant state therapy in the treatment of hysterical aphasia.This method was rapid and effective comparing to other therapeutic methods,showing great clinical values.

Will-powered technique training in the lower resistant state is an important therapy method of TCM psychology. The therapy refers to five aspects of improving cognitive and emotional function by using TIP technique, making imaginary training in the lowered resistant state, strengthening will-power training with situation and image technique, adopting information module imprinted technique and developing training technique. The content includes cultivating abilities in independence, resolution, firmness, and self-control. The technique has application value in clinic.

Objective To understand the adherence to current treatment guidelines after training in man-agement of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in emergency department (ED),and to assess the patients' prognosis. Methods Were ED doctors trained with a standard management flow-sheet for AECOPD. The treatment of 152 AECOPD patients recruited from November 1,2008 to April 30,2009 in our hospital and their prognosis were compared to those of 133 AECOPD patients who were treated between Novem-ber 1,0007 to April 30,2008. Results After training, the ED doctors' management of AECOPD is more standard. The rate of the combination of inhaled anticholinergics and short-acting β_2-agonists was increased from 12.0% (16/133) to 27.6% (42/152), the use of inhaled glucocorticosteroids was increased from 52.6% (70/133) to 88.8% (135/152), and the early use of noninvasive imermittent positive pressure ventilation(NIPPV) for the mod-erate to severe was increased from 10.5% (14/133) to 16.4% (25/152). The use of theophylline was decreased from 69.2% (92/133) to 49.3% (75/152). The in-ED mortality rate was decreased from 15.8% (21/133) to 12.5% (19/152). All the difference were significant (P< 0.05). The rate of inhaled β_2-agonists was increased from 78.2% (104/133) to 82.9% (126/152), the use of systemic glucocorticosteroids was decreased from 63.2% (84/133) to 56.6% (86/152),the use of antibiotics was increased from 88.0% (117/133) to 92.8% (141/152), and the use of invasive mechanical ventilation was increased from 14.3% (19/133) to 15.1% (23/152) ,the in-hos-pital mortality rate was decreased from 6.0% (8/133) to 5.3% (8/152), the average days in hospital was decreased from 13.3 to 12.4 days, but the difference was not significant (P > 0.05). Conclusions There are still some differences exist between guideline recommendations and actual ED management of AECOPD. After training ED doctora with a standard flow-sheet, their management of AECOPD is improved. The rate of the combination of inhaled anticholinergics and short-acting β_2-agonists, use of inhaled glucocorticosteroids, and early use of NIPPV is increased. The use of theophylline and the in-ED mortality rate is decreased.

Thought Imprint Psychotherapy under Hypnosis(TIP)and Narrative Therapy are two different kinds of psychotherapy, both with the characteristic of story treatment. The psychotherapist uses re-growth means in TIP treatment, and Narrative Therapy uses means such as externalizing problems, reconstructing story, and so on. This article chiefly discusses two treatments, to confirm some similarities and differences between them and provide guidance for the actual treatment.

Objective To prepare sustained-release tablet contained paeoniflorin and evaluate its drug release mechanism.Methods Orthogonal design was used to obtain the best formula.Hydroxypropykmethyl cellulose(HPMC K4M)and ethylcellulose(EC 20CPS)were used as hydrophilic matrix material,and PVP which dissolved in ethanol was used as adhesive material,then the sustained-release tablet was prepared by the wet granule compression technique.The best formula was determined by powder technology,including compression ratio,angle of repose,flow rate,and angle of contact as indexes.The optimum formula was obtained by comprehensive scoring method.The drug release in vitro was determined,and the release formula was made to investigate the release mechanism.Results The optimized prescription was with HPMC 20%,EC 20%,PVP 0%,and ethanol concentration 80%.The dissolution curves in vitro showed that the drug release could be best described by the Higuchi equation(Q=0.367 5 t1/2-0.165 8,r=0.993 2)and Peppas equation(lnQ=0.72 lnt-1.608 6,r=0.991 8).It showed that the release mechanism was Fick diffusion and backbone corrosion.The release rate could meet the requirement of quality control on sustained-release tablet in Chinese Pharmacopoeia(2005).Conclusion The method of content determination is simple and sustained-releasing rate is significant.The release mechanism follows the kinetic model of sustained-release tablet.It is worth doing further research for the clinical use.

Aim To study the inhibitory effect of ginkgolide B (BN52021) on the PAF induced changes of chemotaxis of murine peritoneal macrophages and the related polymerization of F-actin.Methods Chemotaxis assays were performed using a modified 48-well Boyden chamber. Actin polymerization of murine peritoneal macrophages was analyzed by flow cytometry using a specific fluorescent stain. Results Peritoneal macrophages significantly migrated toward platelet-activating factor(PAF) through a micropore filter; however, in the presence of PAF receptor antagonist BN52021 (0. 01the actin polymerization of murine peritoneal macrophages induced by PAF in the presence of Ca2+ , but not in Ca2+ -free medium. Conclusion The results suggested that preventing polymerization of F-actin may be a pathway by BN52021 to inhibit the chemotaxis of macrophages, and this effect seems to be Ca2+dependent. The data further indicated that inhibition of PAF induced macrophage chemotaxis is an important mechanism underlying the anti-inflammatory action of BN52021.