Objective:To establish a method for the determination of cinnabar and realgar in Xiao' er Zhibao pills. Methods:Mercury in cinnabar and arsenic in realgar in Xiao'er Zhibao pills were determined respectively by atomic absorption spectrometry (AAS) and inductively coupled plasma atomic emission spectrometry(ICP-AES). Results: A good linear correlation of mercury and arsenic was observed within the range of 5-100 μg·ml-1(r=0. 999 9) and 2-50 μg·ml-1(r=0. 999 2), and the average recovery was 99. 3% with RSD of 3. 0% (n=6) and 104. 5% with RSD of 2. 1% (n=6) by AAS. A good linear correlation of mercury and arsenic was observed within the range of 0.1-20.0 μg·ml-1(r=0.999 97) and 0.1-20.0 μg·ml-1(r=0.999 99),respectively, and the average recovery was 96. 6% with RSD of 1. 4%(n=6) and 104. 1% with RSD of 1. 1% (n=6) by ICP-AES,respectively. Conclusion:The method is accurate and specific, and can be used for the quality control of Xiao'er Zhibao pills.

Objective To explore the clinical efficacy and safety of mifepristone combined with misoprostol in the treatment of missed abortion.Methods According to the digital table,184 patients with missed abortion were randomly divided into study group and control group,92 cases in each group.The control group was given oral diethyl-stilbestrol underwent curettage,while the study group was given mifepristone combined with misoprostol therapy under-went curettage.The clinical therapeutic effect and adverse reaction were compared between the two groups.Results The effective rate of the study group after treatment was 95.65%,which was significantly higher than 86.96% of the control group,the difference was statistically significant(χ2 =4.38,P <0.05).Compared with the control group,in the study group,the operative time[(7.22 ±1.11)minute]observed significant relationship,intraoperative hemorrhage volume[(35.68 ±5.62)milliliter]decreased significantly,pregnancy natural rate of discharge(81.52%)was obvi-ously improved,artificial abortion syndrome incidence rate(3.26%)and again the rate of curettage(5.43%)was obviously decreased,and the differences were statistically significant(t =16.10,12.52,χ2 =7.84,8.87,15.93,all P <0.05).The clinical adverse reaction rate in the study group was 16.30%,which was significantly lower than 29.35% in the control group,the difference was statistically significant(χ2 =4.44,P <0.05).Conclusion Mife-pristone combined with misoprostol plays a complementary role,can improve the treatment of missed abortion and has good operation condition.It also can reduce the adverse reactions,complications and pain of patients.It is worth of clinical promotion.

Objective To probe into the relevant factors of unexpected psychological obstacle of blood vessel of brain and treat the countermeasure.Methods To adopt Chinese dense of anxious quantity form(HAMA) brain blood vessel unexpected patient in hospitalled to have illness coming on go on psychological obstacle evaluate for the first time to 132 and use supporting psychotherapy and routine medication mainly.Results Patient accounting for 63.3% had psychological obstacles of 132,the female's incidence of disease was higher than that of the male.The smaller the age was,the apter to present the psychological obstacle the age was.Every symptom had improvement in various degree before and after carrying on the psychotherapy.Conclusion The incidence of the unexpected patient's psychological obstacle of blood vessel of brain is relatively high.To take the effective psychological measure of rehabilitation is helpful to the whole recovery of the unexpected patient of blood vessel to brain.

Objective To study the changes of leptin and insulin-like growth factor-Ⅰ (IGF-Ⅰ) in adoles-cents with anorexia nervosa(AN) before and after three months of therapy. Methods The plasma levels of leptin and IGF-Ⅰ were measured in 11 adolescents with AN before and after three months of therapy and 11 normal ado-lescents of the same age,and their height,weight were examined and their body mass index(BMI) was calculated,and the results were compared before and after therapy, and were compared with those from age-matched normal adolescents respectively. Results (1)The plasma levels of leptin and IGF-Ⅰ , as well as the BMI in the AN patients after three months of therapy were significantly higher, than those before the therapy, and both were significantlylower than those in the controls. (2)Significant correlations between the plasma leptin levels and IGF-Ⅰ and BMI were detected in the AN patients both before and after the therapy, as well as in the controls. (3)Significant correla-tions between the plasma leptin levels and IGF-Ⅰ were detected in the AN patients both before and after the thera-py, as well as in the controls. Conclusion The plasma levels of leptin and IGF-Ⅰ resulted in significant changes, and these changes were consistent with body fat content in adolescents with AN.

Objective To investigate the relation of the expressions of matrix metalloproteinase-2(MMP-2)and-9(MMP-9)with polymyositis/dermatomyositis(PM/DM).Methods Blood samples were obtained from 8 patients with PM,12 patients with DM and 10 normal human controls.Real-time quantitative RT-PCR and Western-blot were applied to examine the mRNA and protein expressions of MMP-2 and MMP-9 respectively in the peripheral blood mononuclear cells(PBMC)of these patients.Results The mRNA expression levels of MMP-2 and MMP-9 in the PBMC of patients with PM or DM were 2.41 and 1.66 folds as high as those of the normal controls,respectively;these difierences were significant between the two groups.Increased expressions of MMP-2 and MMP-9 were also noted in the patients with PM or DM.Conclusion MMP-2 and MMP-9 may play a part in the development of polymyositis and dermatomyositis.

Transfusion -related iron overload damage iron homeostasis of organism ,which damages the structure of the vital organs and leads to the dysfunction of important organs .Iron overload affects the prognosis of the patients,which promotes myelodysplastic syndrome transformation to acute leukemia and reduces the total sur -vival rate of patients with hematopoietic stem cell transplantation ,which increases the treatment related mortality after hematopoietic stem cell transplantation and increases the chance of infection .Iron depletion therapy can de-lay the progression of acute leukemia and prolong the survival time of the patients with acute leukemia and show a certain anti-proliferative activity .

The essay explained the application of objective structural clinical examination (OSCE) in the graduation examination for clinical medical students.It also summarized the preparation before the examination on OSCE and the flow process,analyzed the existing question of OSCE and the OSCE circumstance of the students,and put forward some suggestions about consummating OSCE and promoting clinical practice teaching reformation.

Objective To detect the expression of RXR? gene protein in gastric cancer, superficial gastritis, normal gastric mucosa, in order to explore the relationship between the development of gastric cancer, combined with clinical and pathological analysis of its clinical significance. Methods Using immunohistochemical detection RXR? protein in gastric cancer, superficial gastritis, gastric mucosa in the normal expression. Results RXR? protein mainly located in the nucleus of cells, there are a small number of cytoplasmic staining, a brown or yellow granular, in gastric cancer, superficial gastritis, normal gastric mucosa, RXR? protein expression rates were 25.0%, 81.1%, 96.1%; group and the normal mucosa and superficial gastritis, gastric cancer group RXR? expression rate has dropped, there were significant differences (P0.05). The lymph node metastasis and tumor pathology and clinical phases closely related (P

Objective To evaluate the efficacy of gabapentin for prevention of post-thoracotomy pain syndrome (PTPS).Methods Sixty-nine ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 46-69 yr,weighing 47-78 kg,scheduled for elective resection for lung cancer under general anesthesia combined with epidural block,were randomly divided into 2 groups using a random number table:group A (n =36) and group B (n =33).In group A,gabapentin 300 mg was given orally at 2 h before operation and gabapentin 100 mg was given orally three times a day from 1st day after operation until 10th day after operation.Group B received placebo instead of gabapentin.Epidural blockade with ropivacaine and sufentanil was performed before induction of anesthesia and the level of block was controlled at T4-10.Patient-controlled epidural analgesia (PCEA) was performed within 3 days after operation and VAS scores were maintained ≤ 3.The development of pain (numeric rating scale score ＞ 4) within 6 months after operation and the duration were recorded.The consumption of propofol and remifentanil during operation and the number of attempts for PCEA after operation were recorded.The adverse reactions such as postoperative drowsiness,dizziness,fatigue were also recorded.Results Compared with B group,the incidence of pain within 6 months after operation was significantly decreased,the duration of pain was shortened (P ＜ 0.05),and no significant changes were found in the consumption of propofol and remifentanil during operation and the number of attempts for PCEA after operation in A group (P ＞ 0.05).No adverse reactions developed in group B.Mild dizziness and fatigue occurred in 2 patients in group A.Conclusion Gabapentin (continuous application at 2 h before operation and 10 days after operation) can reduce the development of PTPS in patients with no obvious adverse reactions.

Objective:To investigate the efficacy and safety of insulin glarsine combined with sitagliptin in elderly type 2 diabetic patients whose blood glucose levels were inadequately controlled by oral anti-diabetic drugs ( OAD) . Methods: In the open-labeled, randomized and parallel study, 98patients (≥60 years) were randomly divided into two groups: insulin glargine/sitagliptin combina-tion group (n=52, the observation group ) and insulin Aspart 30 injection group (n=46, the control group). The dose was adjusted according to the blood glucose. The fasting blood glucose (FBG), 2h postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA1c), the incidence of hypoglycemia and body mass index (BMI) after the 12-week treatment were compared between the two groups. Results:The fasting glucose and the incidence of hypoglycemia in the observation group were lower than those in the control group (P<0. 05). There were no significant differences in 2h postprandial blood glucose, HbA1c and BMI between the two groups (P>0. 05). Conclusion:The treatment of insulin glargine combined with sitagliptin is safe, effective and convenient in elderly type 2 diabetes patients with poor glycemic control. By diabetic education, the lower incidence of hypoglycemia treatment will be a better choice for elderly type 2 diabetic patients.