We studied and reviewed the PDCA cycle theory related literature, and summarized the research related to PDCA cycle application in the research management in hospitals in china.We also analyzed the present problems and explored future direction of development.

It has been 4 years since Natural Health Products Regulations(NHPRs)was enforced by Health Canada in January of 2004.In the past time,how will it affect the marketed Traditional Chinese Medicines(TCM) in Canadian market? Recently,The two TCM products Carditionic Pill (Fufang Danshen Diwan)and Chaihu Pill from Tasly have been newly certificated by Health Canada recently.Taking them as examples,this article introduces the current status.opportunities and challenges for the regulation of TCM in Canada.and suggests that the domestic TCM corporations push the product registration as soon as possible.

Objective To investigate the changes of the N-acetylaspartate(NAA) concentrations in different brain regions and executive function skills in alcohol dependence,and to study the relationship between NAA levels and cognitive functions in subjects.Methods 49 male,non-smoking,alcohol-dependent patients and 45 healthy control subjects were measured with Proton 1H Magnetic resonance spectroscopy (MRS) and Wisconsin Card Sorting Test (WCST).Results Alcoholics had lower NAA/Cr ratios in prefrontal grey matter(GM) (1.59± 0.13) and white matter(WM) (1.58±0.12) regions and performed poorly on executive function tests compared to controls (P＜0.001).NAA/Cr in left prefrontal regions positively correlated with certain parameters of EF testing (number of correct responses 30.37± 3.73,perseverative errors 11.49± 3.39,random errors 6.18± 2.64,categories completed 2.08± 1.59)in alcoholic group (P＜0.01).NAA/Cr in prefrontal WM regions correlated with certain parameters of EF testing in alcoholic group (number of correct responses r=0.379,categories completed r=0.433,P＜ 0.05).Conclusion Long-term,chronic alcoholism will damage neuronal viability and cognitive functions,which suggests that NAA concentrations can reflect the extent of damage of cognitive functions with decreased levels reflecting neuronal loss.

[ABSTRACT]AIM:Toexploretheroleofkisspeptin/GPR54signalingpathwayinthepathogenesisofprecocious puberty based on female precocious puberty rat model induced by the single dose of danazol .METHODS:Female SD rats aged 3 d were randomly divided into normal group , vehicle group and model group .On the 5th day, the model rats were given a single subcutaneous injection of danazol with ethanol and ethylene glycol mixture .All rats were executed on 15 d, 25 d, 30 d, 35 d and 40 d, and the samples were collected to observe the sexual organ development .The levels of E2 , FSH and LH in peripheral blood were measured by ELISA .The Kiss-1 mRNA expression of Kiss-1, GPR54 and GnRH in hypothalamus was detected by real-time PCR.The kisspeptin expression in rat hypothalamus was observed by immunofluo-rescence .RESULTS:The time for puberty onset and sexual maturation in the model rats was significantly earlier than that in normal group and vehicle group .On days 25 and 30, the levels of peripheral sex hormones and uterine coefficients in model group were significantly higher than those in normal group and vehicle group .On days 25 and 30, the ovarian mor-phological development in the model rats was significantly earlier than that in normal group .On day 25, the mRNA expres-sion of hypothalamic Kiss-1 and GnRH, and kisspeptin expression of hypothalamic arcuate nucleus in the model rats signifi -cantly increased compared with normal group and vehicle group .On day 30, kisspeptin expression of hypothalamic arcuate nucleus in the model rats decreased compared with normal group and vehicle group .On day 35, the mRNA expression of Kiss-1 and GnRH in the model rats decreased compared with normal group and vehicle group .The mRNA expression of GPR54 had no obvious difference among all groups .CONCLUSION:The Kiss-1 mRNA and kisspeptin expression in the model rats with precocious puberty is significantly increased in the hypothalamus during onset of puberty , suggesting that kisspeptin is an initiating factor for precocious puberty .Kisspeptin/GPR54 signaling pathway may play an important role in the occurrence of precocious puberty .

Objective To assess alternations in left ventricular volume and systolic synchrony in patients with frequent premature ventricular complexes(PVCs) from the right ventricular outflow tract(RVOT).Methods Twenty-nine patients with frequent isolated PVCs from RVOT were included and 30 healthy subjects as control.Instantaneous full-volume imaging(IFI) was performed to evaluate left ventricle volumetric parameters,including end-systolic volume (ESV),end-diastolic volume (EDV),stroke volume (SV),ejection fraction (EF),and systolic synchrony parameters,including systolic dyssynchrony index (SDI),dispersion end-systole (DISPES),mean end-systolic time (MES),pre-contraction time volume (PreContr) and post-contraction time volume (PostContr).Contraction front mapping was performed to visualize volumetric contraction sequence.All values of patients with PVCs were recorded during sinus beats (PVC-S) and premature ventricular beats (PVC-V) respectively.Results Significant differences were observed in left ventricular systolic volumetric and synchrony parameters between PVC-V and control subjects (P＜0.01),as well as in MES and PreContr between PVC-S and control subjects (P＜0.01).Conclusions Left ventricular systolic dysynchrony was demonstrated in patients with PVCs from RVOT.IFI was a novel tool to analyze left ventricular global and regional volumetric alternations.

Objective:To investigate the influence of B-lymphocyte chemoattractant on the immune response of CVB3 fusion gene vaccine pcDNA3/C3d3-sVP1.Methods:BALB/c mice were divided into 4 groups randomly, and injected intramuscularly with pcDNA3,pcDNA3/BLC,pcDNA3/C3d3-sVP1 and the combination with the plasmid pcDNA3/BLC and pcDNA3/C3d3-sVP1.At a certain time,they were measured for the titers for neutralizing antibodies,specific CTL cytotoxic activity.The protective efficacy of DNA vaccinations was evaluated by titers of blood viruses and survival rate.Results:The titers for antibodies increased with the time of inoculation.More specifically,the antibody titers (42.17±1.43) and the specific CTL cytotoxic activity (41.3%±3.51%) of the mice in the combination group were remarkably stronger than in the mice with pcDNA3/C3d3-sVP1(P＜0.05),but the virus titers of blood was lower.After lethal CVB3 challenge,the protection of mice from death in the combination group with the plasmid pcDNA3/BLC and pcDNA3/C3d3-sVP1 was 44%.Survival curves indicated that the survive state of combination group was better than others.Conclusion:BLC can strongly enhance the specific immunity induced by C3d3-sVP1.

To study the chemical constituents of Drynariae Rhizoma, nine phenolic acids were isolated from a 70% ethanol extract by using a combination of various chromatographic techniques including column chromatography over silica gel, ODS, Sephadex LH-20, and semi-preparative HPLC. By spectroscopic techniques including 1H NMR, 13C NMR, 2D NMR, and HR-ESI-MS, these compounds were identified as 4, 4'-dihydroxy-3, 3'-imino-di-benzoic acid (1), protocatechuic acid (2), gallic acid (3), p-hydroxybenzoic acid (4), (E)-caffeic acid (5), ethyl trans-3, 4-dihydroxycinnamate (6), caffeic acid 4-O-beta-D-glucopyranoside (7), p-coumaric acid 4-O-beta-D-glucopyranoside (8), and 23(S)-12-O-caffeoyl-12-hydroxyllauric acid glycerol ester (9), separately. Among them, 1 and 9 are new compounds, and 3, 4, and 6 were isolated from Drynaria species for the first time.

Object: To investigate the effects of Huaiqihuang Granule, a compound Chinese herbal medicine, on expressions of nephrin and podocin of slit diaphragm of glomerular podocytes in rats with adriamycin-induced nephrosis and to explore the mechanism in reducing the proteinuria. Methods: Twenty SD rats were randomly divided into five groups: control group, model group, glucocorticoid group, Huaiqihuang Granule group and Huaiqihuang Granule plus glucocorticoid group. The 24-hour urine was collected 7, 14, 21 and 28 days after adriamycin injection respectively to measure 24-hour urinary protein, and all rats were sacrificed after 28-day treatment. Pathological changes in renal tissues were observed under a light microscope and an electron microscope. Expressions of nephrin and podocin mRNAs in renal cortex were determined by real-time polymerase chain reaction, and protein levels of nephrin and podocin were detected by Western blotting. Results: (1) In the model group and the treatment groups, the level of urinary protein increased significantly from the 14th day. (2) Under the light microscope, inflammatory cells and slight fibroplasia were found in renal interstitium of the model group, but there were less inflammatory cells in renal interstitium in the intervention groups than in the model group. Under the electron microscope, 29 days after adriamycin injection, extensive fusion of foot processes was observed. (3) The expressions of nephrin and podocin were higher in treatment groups than in the model group. (4) Proteinuria level was negatively correlated with the expressions of nephrin mRNA and nephrin and podocin proteins. Conclusion: The above results indicate that Huaiqihuang Granule can maintain the integrity of the slid diaphragram in podocyte, alleviate the lesion of glomerular filtration membrane, and decrease the proteinuria by up-regulating the expressions of nephrin and podocin. Huaiqihuang Granule plus glucocorticoid maybe has better effects than glucocorticoid alone.

Objective The purpose of this study was to evaluate effects of gonadotropin-releasing hormone analogs (GnRHa) on improvement of predicted adult height (PAH) in girls with idiopathic central precocious puberty (ICPP) initiating treatment at age of eight years or over and analyze its related factors.Methods Forty-nine girls with ICPP aged eight years and over were treated with GnRHa for ( 17.4 ±5.6) months initiating at age of (9.3 ± 0.6) years during 2005 and 2008.They were followed-up every three to six months to evaluate its effects on growth velocity (GV), height standard deviation score for chronological age (HtSDS-CA), height SDS for bone age (HtSDS-BA), PAH, and so on, as well as their related factors.Results PAH increased after GnRHa treatment, from ( 157.7 ± 4.5) cm six months after treatment to ( 159.2 ±4.4) cm 12 months after treatment, and to ( 160.8 ±5.0) cm by the end of treatment from ( 155.5 ±5.1 ) cm at its initiation (P ＜0.01 ).There was significant difference in PAH by the end of treatment and target height (TH) [( 157.6 ±3.4) cm].HtSDS-BA increased since six months after GnRHa treatment, from ( -0.64 ±0.68) six months to ( -0.52 ±0.70) 12 months after it and ( -0.36 ±0.68)by the its end, all significantly different from ( - 0.94 ± 0.68 ) that at the initiation of treatment ( P ＜0.01 ).There was no significant difference in HtSDS-CA before and after treatment.GV decreased from the initiation (6.3 ± 1.3) cm/yr to (4.8 ± 1.5) cm/yr by the end of treatment ( P ＜ 0.01 ).No significant association between PAH and age of the initiation of treatment and between PAH and age by the end of treatment were found (P ＞ 0.05 ).But, PAH reversely correlated with bone age, and positively correlated with HtSDS-CA, HtSDS-BA, GV, TH and length of treatment ( P ＜ 0.01 ).Conclusions GnRHa can remarkably improves PAH in girl with ICPP.PAH mainly correlates with HtSDS-BA, TH and GV at the initiation and the end of treatment.

Objective:To investigate the relationship between the distance from the upper and lower resection margin and the gastric cancer patients with R0 resection and no distant metastasis.Methods:Retrospective analysis of 281 patients with gastric cancer in our hospital,the relationship between the age,sex,tumor size,tumor size,vascular invasion,lymph node metastasis,TNM stage,type of gastric cancer,tumor location and operation mode was analyzed.To compare the survival time of patients with different upper and lower margins.Results:The increase of the distance from upper resection margin was significantly related to the tumor size＞5 cm,TNM stage,type of gastric cancer,tumor location,and the difference was statistically significant(P＜0.05);The distance of lower resection margin was significantly correlated with tumor size＞5cm,vascular invasion,lymph node metastasis and TNM stage,type of gastric cancer,and the difference was statistically significant (P＜0.05);Themedian survival timein patientsof upper resection marginr□3cm with 48 months of the 5-year follow-up period was significantly higher than that in patients of the resection margin＞3cmwith 46 months (P＜0.001).Themedian survival timein patientsof lower resection margin□3cm with 45 months of the 5-year follow-up period was significantly higher than that in patients of the resection margin＞3cm with 44 months (P＜0.001).Conclusion:Gastric cancer postoperative upper and lower resection margin was significantly related with tumor size,TNM staging factors,and the median survival time of upper and lower resection margin＞5 cm was significantly lower than that of the resection margin3 cm.