Objective To observe the clinical efficacy of acupuncture plus contralateral needling in treating post-stoke myodystonia. Method Totally 120 patients with post-stroke myodystonia were randomized into group A, B, C and D, 30 in each group. Group A was intervened by yin-reducing and yang-tonifying needling method plus contralateral needling; group B was by ordinary acupuncture plus contralateral needling, group C was by yin-reducing and yang-tonifying needling alone, while group D by ordinary acupuncture. Clinical Spasticity Index (CSI) was observed before and after intervention. Result After treatment, the CSI scores (tendon reflex, muscle tension, episodic spasm scores and total score) were significantly changed in the four groups (P<0.01, P<0.05). The tendon reflex score, muscle tension score and total score in group A were significantly different from that in the other three groups after intervention (P<0.01,P<0.05). There was a significant difference in comparing the episodic spasm score between group A and D after intervention (P<0.01). There were significant differences in comparing the tendon reflex score, muscle tension score and total score between group B and D after intervention (P<0.05). The total score in group C was markedly different from that in group D after intervention (P<0.05). Conclusion Yin-reducing and yang-tonifying needling method plus contralateral needling is an effective method in treating post-stroke myodystonia.

OBJECTIVE:To reduce patient waiting time for drugs by improving work efficiency via the optimization of the in-telligent workflow of outpatient pharmacy. METHODS:The problems existing in each link in the workflow after the adoption of au-tomated drug dispensing machine in the outpatient pharmacy of our hospital were analyzed. Measures were developed and imple-mented,on the basis of the factors affecting each link including adding drugs,making up a prescription and dispensing drugs,to optimize the workflow. The effect after the optimization was evaluated,with the time it takes to make up a prescription and to dis-pense drugs and patient waiting time for drugs as the indexes. RESULTS:The averaged time it takes a pharmacist to make up a pre-scription and to dispense drugs and patient waiting time for drugs significantly reduced from 3.4 min,9.3 min and 12.7 min to 1.0 min,6.1 min and 7.1 min respectively,after taking measures such as adjusting the number of the drug types,tracks and positions in the machine,adding the contrasting pictures of the drugs which were similar on the system interface for adding drugs,standardiz-ing the process of adding drugs,improving and allocating information labels,adjusting the process of dispensing drugs and adding new small packages of drugs within 6 months. CONCLUSIONS:The optimized intelligent workflow in the pharmacy can reduce pa-tient waiting time for drugs,increase patient satisfaction and promote the development of intelligent pharmacy.

Objective To investigate the quality of life(QOL) and symptoms of community patients with advanced cancer,and analyze their correlation.Methods 94 advanced cancer patients in 3 communities of Yangpu district in Shanghai were surveyed by self-designed questionnaire,FACT-G and MDASI.The correlation between QOL and symptoms was analyzed.Results QOL of advanced cancer patients was poor,and the main influencing factors were gender,age,stage of cancer,KPS score,marital statusand economic burden.There was significant negative correlation between symptoms and QOL.Fatigue,amnesia,uneasy sleep,insensible feeling,distress and dry mouth were the symptoms patients suffered mostly.Conclusions For patients with advanced cancer,evaluation of the influencing factors of QOL and better control of symptoms could improve their QOL.

OBJECTIVE:To optimize the purification process of the extract from Yiqi guben granules. METHODS:The purifi-cation effect of the process was investigated with transfer rate of polysaccharide,calycosin glucoside and dry paste as evaluation in-dexes,using ZTC1+1 type Ⅱ,and shell poly sugar and 95% ethanol as clarifying agents. The purification process of the extract from Yiqi guben granules was optimized by orthogonal test using the ratio of material to liquid,the amount of clarifying agent and standing time as factor. The validation test was conducted. RESULTS:Selecting ZTC1+1 type Ⅱ as a clarifying agent,the best trans-fer rate of effective component had been obtained;optimal purification process was as follows as the ratio of material to liquid 1:2, the ratio of ZTC1+1 type Ⅱ A liquid 5%,the ratio of B liquid 10%,standing time of 5 h. The results of verification test showed transfer rates of dry paste in 3 tests were 71.54%,70.98%,69.21%,respectively;those of polysaccharide were 82.55%, 81.78%,82.15%,respectively;those of calycosin glucoside were 91.92%,92.34%,91.58%,respectively (all RSD≤1.72%, n=3). CONCLUSIONS:The optimized purification process is effective,stable and practical,and can be used for the purification of the extract from Yiqi guben granules.

5 cm?5 cm) (n=6).All patiens with complications were successfully treated except 8 with side branch closure,who were failed to response but cured by drugs after procedure.Three elder patients died,from sudden death(n=1),stoke (n=1),and kidney failure (n=1) after PCI. Conclusion:The complication incidence in patients with CTO lesions is relatively low and most of the complications can be cured by proper management.Revascularization by PCI for patients with CTO is an effective and safe treatment method.

Objective To characterize rpoB gene mutations in rifampin-resistant Mycobacterium tuberculosis (M.tuberculosis) in Zhejiang Province.Methods A total of 188 clinical isolates of M.tuberculosis from 188 patients with pulmonary tuberculosis in Tongde Hospital of Zhejiang Province and Integrated Chinese and Western Medicine Hospital of Zhejiang Province were collected.Conventional drug resistance analysis was performed and the mutation of rpoB gene was detected by PCR-based DNA sequencing.The association between gene mutations in rifampin-resistance determining region of M.tuberculosis and clinical resistance was analyzed.Results Fifty-seven out of 188 isolates (30.3％) were drug-resistant strains,including 18 isolates (9.6％) with single-resistance to rifampin,28 isolates (14.9％) with single-resistance to other anti-tuberculosis drugs (10 to isoniazid,12 to streptomycin and 6 to ethambutol),and 11 isolates (5.9％) with multi-drug-resistance (rifampin plus one or more drugs of isoniazid,streptomycin and ethambutol).Among 29 rifampin-resistant strains,rpoB gene mutation existed in 27 strains (93.1％),and the most frequently mutated sites were codons 526 (55.6％,16/27),513 (22.2％,5/27),531 (14.8 ％,4/27)) and 529 (7.4％,2/27).Among 28 strains which were resistant to other anti-tuberculosis drugs,rpoB mutations existed in 4 strains (14.3％),and the mutated sites were codons 526 (2 strains) and 513 (2 strains).All 13 sensitive isolates had no mutation in rpoB gene.Conclusion Rifampin resistance in M.tuberculosis is closely correlated with rpoB gene mutations in Zhejiang province,and the most frequent sites of mutation are at codons 526 and 513.

Objective To evaluate the effect of lumbar multifidus muscle training on muscle thickness.Methods The morphological changes in volunteers' lumbar multifidus muscles were observed in response to 11 kinds of training.Muscle thickness was measured at rest and during contraction using ultrasonography and two examiners.The rate of change in muscle thickness and the contraction rate were calculated.Results There was no significant difference in the contraction rates determined by the two examiners using ultrasound imaging.There was no significant difference in average contraction rate between the males and females.Pairwise,there was no significant difference among contralateral leg-raising,ipsilateral leg-raising,contralateral hand-raising,ipsilateral hand-raising and contralateral leg-lifting.Pairwise,there was no significant difference among ipsilateral leg-lifting and ipsilateral arm-lifting compared with contralateral leg-lifting,contralateral arm-lifting or contralaleral lower limb-lifting.There was no significant difference between contralateral arm-lifting and ipsilateral arm-lifting.There was no significant difference between ipsilateral arm-lifting with contralateral leg-lifting and contralateral arm-lifting with ipsilateral leg-lifting.Pairwise,there was a significant difference in lumbar multifidus muscle contraction rates among these actions.Conclusion Lumbar multifidus muscle training has various effects.Muscle thickness as measured using ultrasonography can provide a basis for formulating a rehabilitation training plan.

Objective To discuss the application and significance of homocysteine (Hcy),renal function and serum lipid levels in renal transplantation,by testing those from patients after renal transplantation.Methods Hcy,creatinine (Cr),urea nitrogen (BUN),uric acid (UA),total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were detected in transplantation group(n=63) and control group(n=60).Serum Hcy,Cr and BUN of transplantation group were continuously monitored before and 1,3,7,14 days after operation,and the relationship between Hcy and renal function before and after renal transplantation were compared.Results Compared with control group,Hcy,Cr and BUN in transplantation group all increased and the difference between two groups was statistically significant (P<0.05).Hcy,Cr and BUN in transplantation group all decreased after renal transplantation and the differences between two groups had statistical significance (P<0.05).Compared with that before surgery,Hcy,Cr and BUN in transplantation group gradually reduced 1,3,7 and 14 days after surgery,and the differences were statistically significant (P<0.05).Cr and BUN were positively correlated with Hcy (r=0.627,P<0.05).TC and LDL-C in transplantation group were higher than that in control group and the differences had statistical significance (P<0.05) while the difference of TG and HDL-C didn′t have statistical significance (P>0.05).Conclusion Hcy,Cr and BUN can be used as monitoring indicators of efficacy after renal transplantation,also which can be used to observe the incidence and severity of hyperlipidemia.

Objective To optimize the prescription of flaxseed lignans sustained release tables by central composite design-response surface methodology.MethodsWith HPMC, EC and starch dosage as factors, and flaxseed lignans in 2, 6 and 12 h of cumulative release as evaluation indexes, central composite design-response surface optimization method was used to conduct prescription optimization experiments, and optimized prescription analysis was carried out.Results The optimal prescription of flaxseed lignans sustained release tables was as following: HPMC dosage was 43%; EC was 26%; starch content was 17%. Optimized index forecast values were very close to the observed values. In vitro release test of three selected optimal formulations indicated that there existed high approximation between the observed and estimated values.Conclusion It shows that the established model is suitable for flaxseed lignans sustained release tables, which can be used in the optimization of the prescription of flaxseed lignans sustained release tables.

Objective To observe the efifcacy and safety of ticagrelor in patients received percutaneous coronary intervention (PCI). Methods 50 patients with non-responding platelet aggregation rate and CYPC219 gene after clopidogrel treatment were given ticagrelor and enrolled in the study. All enrolled patients received aspirin loading dosage 300 mg, followed by maintenance dosage 100 mg, once daily and ticagrelor maintenance dosage 90 mg twice daily, for 1 year. The primary endpoint for the study were the incidence of major cardiovascular events (including death, stent thrombosis, stent restenosis, nonfatal myocardial infarction, target vessel revascularization) and stroke after followed up for a month. The secondary endpoint were the incidence of general events (including minor bleeding, allergies, breathing dififculties) and platelet count changes. Results No occur major cardiovascular and stroke events record after 1 month of ticagrelor treatment. The general events rates included 2 cases of dyspnen, 1 case of epitaxis and 1 case of subcutaneous bleeding. The platelet aggregation with ticagrelor was signiifcantly lower than clopidogrel without signiifcant decrease in platelets count. Conclusions Using ticagrelor for antiplatelet in patients with coronary artery stenting in clopidogrel resistance cases is safe and effective.