OBJECTIVE:To optimize the formulation of Budesonide sustained-release tablet. METHODS:Using the cumula-tive releases in 2,4,8 h as investigation indexes,central composite design-response surface method was used to optimize the amount of hydroxypropylcellulose L(HPC-L),amount of soybean phosphatides,and filler(fixed total 200 mg)lactose- micro-crystalline cellulose mass ratio in the formulation of Budesonide sustained-release tablet,and the verification test was conducted. The release behaviors of prepared sustained-release tablet and original preparation in pH 7.2,7.0,6.8 phosphate buffer were com-pared. RESULTS:The optimal formulation was as follow as budesonide of 9 mg,HPC-L of 46.49 mg,soybean phosphatides of 9.23 mg,filler lactose-microcrystalline cellulose mass ratio of 1:2.9;the cumulative releases in 2,4,8 h were 21.9%,50.1%, 99.5%,the relative errors with predicted values (22.0%,50.0%,98.5%) were 0.45%,0.20%,1.02%(n=3),respectively. Compared with cumulative release of original preparation,the f2 was higher than 50. CONCLUSIONS:Budesonide sustained-re-lease tablet is successfully prepared,which shows similar release behavior to original preparations.

Objective To study the effectiveness of intravenous Lidocaine on subjective tinnitus in the elderly, and analyze its correlation with the effectiveness of subsequently oral Carbamazepine.Methods A prospective case-control study was conducted in 120 elderly patients with subjective tinnitus, who were divided into two groups.The control group (n=60) was treated with oral Carbamazepine 0.1 g Bid for one month, and the treatment group (n=60) was treated with 2％ lidocaine by intravenous injection.Patients in the treatment group were observed on responses in tinnitus during the period with Lidocaine injections.The treatment group was further divided into the improvement subgroup and the no-improvement subgroup, according to responses to intravenous lidocaine.All the patients in the treatment group received oral carbamazepine 0.1 g Bid for one month following the intravenous lidocaine injection phase.Results In the control group, 5 patients showed marked improvement, 20 patients showed partial improvement, 33 patients showed no improvement, and 2 patients showed symptom deterioration, with an effectiveness rate of 41.7％ (25/60).In the treatment group, 6 patients showed marked improvement, 26 patients showed partial improvement, 24 patients showed no improvement, and 4 patients showed symptom deterioration, with an effectiveness rate of 53.3％ (32/60).Of the 32 patients in the improvement subgroup, 6 cases showed marked improvement, 16 cases showed partial improvement, 8 cases showed no improvement, and 2 cases showed symptom deterioration after subsequent oral Carbamazepine treatment, and the effectiveness rate was 68.8％ (22/32).Of the 28 patients in the no-improvement subgroup, 1 case showed marked improvement, 9 cases showed partial improvement, 16 cases showed no improvement, and 2 cases showed symptom deterioration, and the effectiveness rate was 35.7％ (10/28).The effectiveness rate in the improvement subgroup was higher than in the no-improvement subgroup (68.8％ vs.35.7％, x2 =6.55, P＜0.05).The effectiveness of lidocaine followed by carbamazepine was better than that of carbamazepine alone (68.8％ vs.53.3％, x2 =6.13, P＜0.05).Conclusions Oral Carbamazepine treatment following intravenous Lidocaine injection in elderly patients with subjective tinnitus has better therapeutic outcomes than treatment with oral Carbamazepine alone, but is not as effective in patients with negative responses to Lidocaine as in patients with positive responses.

Objective To investigate the learning outcome of clinical scenarios discussion im-plemented in teaching medical students before clinical probation. Methods Using standardized pa-tients (SP) to simulate the clinical common difficult situation, all eight year program clinical medicine students (84) of Grade 2008 who were about to enter the clinical probation were given clinical commu-nication education guidance. Through five classification variables questionnaire and return visit, the teaching effect was evaluate. Epidata 3.0 was used to input data, and the SPSS 15.0 was used to make descriptive analysis of the questionnaire and proportion comparison. Results We found 35.4%(29) and 63.4%(52) of subjects liked and approval this training, respectively;90.2%(74) of the subjects thought the diffi-culty of this train was moderate; 77.3% (65) of subjects believed that it was necessary to set the clinical scenarios discussion before clinical probation. Conclusions The implementation of clinical scenarios discussion before clinical probation was effective on inducing the medical students to pay attention to the doctor-patient communication, and deep thinking about the communication notice mat-ters and cop-ing styles in clinical environment.

Objective: To observe the clinical effect of tuina in rehabilitation following total hip replacement. Methods: 60 cases were randomly allocated into a treatment group and control group, 30 cases in each group. Cases in the treatment were treated with combined mina and rehabilitation, while cases in the control group were treated with rehabilitation alone. All treatment retained for two weeks. The results were observed 7 d, 2 weeks and 6 weeks following the total hip replacement using Harris scale and Hamilton Anxiety Rating Scale (HAMA).Results: For Harris scale, there were significant intra-group differences in different time frames (P＜0.05); there were no statistical differences between the two groups 1 d, 7 d and 6 weeks following the total hip replacement (P＞0.05); and there were statistical differences between the two groups 2 weeks following the total hip replacement. For HAMA scale, there were significant intra-group differences in different time frames (P＜0.05); there were no significant differences between the two groups 1 d following the total hip replacement; and there were substantial differences between the two groups 7 d, 2 weeks and 6 weeks following the total hip replacement. Conclusion: In a given unit time, combined mina and rehabilitation is superior to rehabilitation alone in improving the patients' post-operative pain, articular range of motion and anxiety.

Objective To study the awareness of perimenopausal hormone replacement therapy (HRT) among a part of the medical care personnel in Guiyang . Methods A survey was conducted among 500 medical staff members in 4 hospitals of Guiyang by cluster random sampling using questionnaire about HRT. Results The survey showed that 74.6% (373/500) medical staff thought that the hormone replacement therapy was necessary to perimenopausal women; 96.7% (87/90) of obstetrics and gynecology doctors believed that it was necessary for perimenopausal women to use HRT,which was significantly higher than the doctors of other specialties 68.6% (166/242) and the nurses group 71.4% (120/168) (χ2=28.509, 23.537, P<0.01). Only 5.8%(29/500) of the medical personnel were willing to recommend HRT. In light of the attitude for recommending HRT, the obstetricians and gynecologists group was more significantly higher than the other specialties doctors group (χ2=86.781, P<0.01). Conclusion The knowledge of hormone replacement therapy in part of Guiyang medical personnel is not sufficient;the recommending rate of HRT was low;the side effects of HRT was still a concern. There are differences between obstetrics and gynecology doctors and doctors other specialties and nurses in HRT knowledge.

Objective To evaluate the detection of serum pepsinogen (PG) in screening of gastric cancer. Methods (1) To calculate the detection rate of gastric cancer in PG Positive patients from northeastern, noah-western and northern China. (2) To determine the PG positive rate in patients with chronic superficial and atrophic gastritis. (3) To calculate the detection rate of gastric cancer, H. pylori infection and esophageal cancer in PG positive patients from gastric cancer high risk areas. Results (1) The detection rate of gastric cancer in PC, positive patients from Changchun (northeastern China), Xihing (northwestern China) and Beijing ( northern China) was 22. 58%, 25. 2% and 0, respectively. The sensitivity of PG to seeen gastric cancer in Changchun and Xihing was 50. 9% and 35.6%, and the specificity was 82. 56% and 85.69%, respectively. (2) Only 25% of patients with chronic atrophic gastritis were PG positive. (3) The serum PG level was measured in 2346 cases from gastric cancer high risk areas, and PG positive rate was 27.02% (634/2346), in which 496 patients (76. 65%, 496/634) received endoscopy, and gastric cancer was detected in 10 (2. 02%, 10/496), including 9 cases of early gastric caner. The prevalence of gastric cancer was 0. 43% in common population and 1.58% in PG positive population. The infection rate of H. pylori was 70. 73% in 2346 subjects and 2 cases of esophageal cancer, including 1 case of early cancer was diagnosed. Conclusion Serum PG level cannot be used as a marker for gastric cancer or atrophic gastritis, while it may be of value for gastric cancer screening in high risk areas.

Objective To study the relationship between intrauterine infection and early neonatal sepsis.Method From October 2015 to September 2016,the clinical data of pregnant mothers and their newborns in Shenzhen Longhua District Central Hospital were collected,and data of Shenzhen People's Hospital from January 2016 to June 2016 were collected.100 pairs of pregnant mothers and their newborns with confirmed or suspected intrauterine infection were selected as the observation group,and another 100 pairs without intrauterine infection during the same period as the control group.The ratio of term infants vs.premature infants was 1∶ 1.The complete blood count (CBC),CD64,procalcitonin (PCT) and C-reactive protein (CRP) were measured in peripheral blood of all mothers on the day of delivery.The CBC,CD64,CRP,PCT,blood culture of both umbilical venous blood and peripheral blood in neonates were examined and the pathological examination of placenta was performed.Result The positive rate of placental pathology and umbilical cord blood culture in observation group were significantly higher than that in the control and the positive rate in preterms was higher than the terms in observation group (P ＜ 0.05).No significant differences existed between term and premature newborns on the positive rate of peripheral blood culture (P ＞ 0.05).The positive rate of blood culture from umbilical cord blood was higher than peripheral blood in observation group (P ＜ 0.05),but no significant difference in control group (P ＞ 0.05).The incidence of septicemia in term and premature newborns in observation group was significantly higher than the control group (P＜ 0.05).The CD64,PCT in mother's peripheral blood and umbilical cord blood,and CRP in mother's blood were all higher than the control group,the differences were statistically significant (P ＜ 0.05),but CRP in umbilical cord blood in both group were similar (P ＞ 0.05).The area under ROC curve of CD64 and PCT in mother's peripheral blood,CD64 and PCT in umbilical cord blood to diagnose early-onset septicemia in newborns was 0.755,0.793,0.852 and 0.811,respectively.Conclusion The risk of neonatal infections is significantly increased because of intrauterine infection.Combination of peripheral and umbilical blood cultures can increase the accuracy of sepsis diagnosis.Both CD64 and PCT in umbilical cord blood and maternal blood can be used as indicators of intrauterine infection with a predictive value in the diagnosis of early-onset neonatal sepsis.

Objective To establish transgenic mice model with over expression of neuritin in bone mar-row,for the further study on the function of neuritin protein in the treatment of peripheral neuropathy. Methods Two pairs of transgenic mice(loxp-stop-loxp-neuritin and lyz-Cre/+)were fed and propagated,the DNA from the mice tails extracted and the genotype of transgenic mice identified by PCR. The wild type mice with B6 were as-signed as the controls,and the immunofluorescence was used to detect the accuracy of the neuritinloxp/+ _lyz -Cre/+. Results The two trensgenetic homozygous mice had the ability to reproduce,and the hybrid offsprings were neuritinloxp/+_lyz-Cre/+,neuritinloxp/-_lyz-Cre/+,neuritinloxp/+_lyz-Cre/-,neuritinloxp/-_lyz-Cre/-. The re-sults were met with the Mendel′s law. The results of immunofluorescence showed that the expression of neuritin of neuritinloxp/+_lyz-Cre/+ mice in bone marrow was significantly higher than the wild type mice(P < 0.05). Con-clusion The PCR method is of high reliability for identification of sub pus genotype and the female neuritinloxp/+mice mating with the male lyz-Cre/+ ones is an effective way for obtaining the neuritinloxp/+_lyz-Cre/+ mice.

Objective To investigate the effects of α-linolenic acid (ALA) on acute inflammation and neurological functional recovery of mice with traumatic brain injury (TBI). Methods The C57BL6/N mice were divided into high ALA dietary group (20 pregnant and 88 new-born mice) and low ALA dietary group (20 pregnant and 84 new-born mice) in this study. The contents of polyunsaturated fatty acids in the brain of the two groups were detected by gas chromatography. Mouse TBI model was established by control cortical impact method. The expression levels of inflammatory cytokines and cellular markers of the two groups were detected by reverse transcription-quantitative polymerase chain reaction and enzyme linked immunosorbent assay or Western Blotting at 0, 4, 24 and 96 h after TBI, respectively. The neurological functions were analyzed by the rotarod, beam walk test and fear conditioning experiment. Results The content of brain docosahexoenoic acid (DHA) was significantly higher in the high ALA dietary group than in the low ALA dietary group (15.48±1.20% vs 9.98±1.10%, P<0.05). The expression levels of TNF-α, IL-1β , IL-6 and CCL12 were lower in high ALA groups than in low ALA group after TBI (P<0.05). The motor function recovery 24 h after TBI was faster in the high ALA dietary group than in the lower ALA diet group. The cognitive function 24 h after TBI was better in the high ALA dietary group than in the low ALA group. Conclusion Increasing DHA levels in the brain can reduce acute inflammation and improve neurological function recovery after TBI.

Objective To study and compare the efficacy of surgery and conservative treatments for patients with critical(30 to 50 ml) spontaneous deep supratentorial intracerebral hemorrhage. Methods The clinical data of 420 patients diagnosed as spontaneous deep supratentorial intracerebral hemorrhage in Affiliated Hospital of Yan'an and Central Hospital of Baoji from August 2011 to September 2016 in this study were retrospectively analyzed. All patients were divided into surgery group(210 cases) and conservative group(210 cases) according to the difference of treatment methods. Large trauma craniotomy was used by the operation group, external ventricular drainage as the standby in necessary. The treatment of conservative group mainly included reduction of intracranial pressure, blood pressure management, prevention of complications and other individualized treatment. The primary outcome was neurological functional status of patients at 6 months of discharging, and the secondary outcomes included the mortality at 1 month and 6 months of discharging, and complications. Continuous data were presented as (x)± s and were compared using the t test, while categorical data were presented as number and percentage and were compared using the χ2 test. Results No obvious difference on mRS score and NIHSS score occurred between two groups(All P>0.05). Stratified analysis, patients with midline shift >5 mm and with intraventricular hemorrhage were more likely to have a favorable outcome from surgery compared with conservative group(18.2％ vs.8.1％, X =4.099, P=0.043; 17.3％ vs.5.0％, χ2 =4.836, P=0.028). The mortality at 1 month days and 6 months in surgery group were significantly lower than that in conservative group(19.0％ vs.31.0％, X2 =7.937, P=0.005; 23.8％ vs.36.7％, X2=8.228, P=0.004). Meanwhile, the incidence of pulmonary infection and with long-term pipe in surgery group were significantly higher than those in conservative group(31.9％ vs.15.7％, X2 =15. 173, P=0.000; 28.6％ rs.19.5％ =4.706, P=0.030). Conclusion Surgery can reduce the 1 month and 6 months mortality in patients with spontaneous deep supratentorial hemorrhage and improve the functional outcomes in patients with large midline shift or with intraventricular hemorrhage compared with conservative treatment.