Objective:To evaluate the in vitro release behavior of doxorubicin(Dox)-loaded microspheres and the stability of Dox during encapsulation process and in vitro release.Methods: Dox-loaded microspheres were prepared by double emulsion(W/O/W) method with poly(lactic-co-glycolic acid)(PLGA) as the carrier material.The physical and chemical characteristics of microspheres,including the mean diameter,morphology,drug entrapment efficiency and loading rate,were evaluated.The in vitro release behavior and its influencing factors were determined by ultraviolet spectrophotometry.Dox stability was evaluated by HPLC method during the encapsulation process and in vitro release.Results: The prepared microspheres had a complete spheric shape and dispersive quality.The mean diameter of the microspheres was 85 ?m;the drug entrapment efficiency was 95.1%;and the loading rate was 14.8%.Releasing rate of the microspheres slowed down with the increase of PLGA concentration and the decrease of W/O value.The encapsulation process had no obvious effect on the stability of Dox,while Dox degraded during in vitro release as the prolongation of time.On day 10,the peak area of degraded material accounted for 2.46%.Conclusion: Dox can be encapsulated in the microspheres by double emulsion method and different release rates of Dox can be achieved by adjusting PLGA concentration and W/O volume ratio.

In this paper,a unique case of organ transplantation was inspected by organ transplant ethics committee,through which we try to investigate the mode of current operation,problems and confusion of organ transplant ethics committee in China by the constitutive principles,inspection scope,process,content,especially the functional authority and other relevant contents of hospital ethics committee.

BACKGROUND: Early clinical researches suggest that mediodespidine capsule can decrease blood pressure of patients with primary hypertension on the basis of yanggan qinggan pinggan technique.OBJECTIVE: To observe the effect of mediodespidine capsule on primary hypertension and angiotensin Ⅱ (Ang- Ⅱ ) of patients in the types of yin deficiency, yang excess and liver fire.DESIGN: Randomized controlled case observation.SETTING: Department of Cardiology, First Affiliated Hospital, Hunan University of Traditional Chinese Medicine.PARTICIPANTS: Patients were selected from the Inpatient Department and Out-patients Clinic of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine between April 1999 and April 2000. Inclusion criteria: Patients, who were diagnosed with the criteria of primary hypertension, who belonged to the types of yin deficiency, yang excess and liver fire, who could endure this test, who were coincidence with the criteria of mental-stress test, were all consent. Exclusion criteria: Patients who had severe congestive heart failure, atrophic arthritis and unable tolerance were excluded. There were 60 cases in total, including 29 males and 31females. All patients were divided into mediodespidine group and verapamil group with 30 in each group on the basis of randomly digital table.METHODS: Patients who had positive results of awaken mental-stress test were involved in this study. Cases in mediodespidine group were treated with mediodespidine capsule, which was made of tall gastrodia tuber, spine date seed and fourstamen stephania root at the dosage of 0.43 g/pill and were provided by the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine (wei yao ji zi: 05-047, batch number: 990503), five pills each for 3 times a day. Cases in verapamil group were treatedwith verapamil (40 mg/pill, Shanghai Huanghe Liya PharmaceuticalCompany Limited,batch number: 980301B) 80 mg each for 3 times a day. The course in both groups was 4 weeks. ① Effect of blood pressure: Average value of blood pressure tested for 3 successive days were regarded as the blood pressure before treatment, and average value of blood pressure tested for 3 times after treatment was regarded as the blood pressure after treatment. ② Effect of symptom:Scores were recorded as four levels according to main symptoms, such as vertigo, headache, pain and weakness of waist and knees, before and after treatment. ③ Values of Ang- Ⅱ were measured with radioimmunoassay before and after cold pressor test. Effect on Ang- Ⅱ was evaluated with effect of decompression, effect of clinical symptom and criteria of clinical effect.MAIN OUTCOME MEARUSES: Clinical symptoms, values of blood pressure, heart rate and Ang- Ⅱ before and after cold pressor test.RESULTS: A total of 60 patients with primary hypertension were involved into the final analysis.① Totally effective rate of clinical symptoms of patients in mediodespidine group was higher than that of patients in verapamil group, but the effect of decompression was not significant between the two groups (P ＞ 0.05). ② There was remarkably significant difference of heart rate in both groups before and after treatment (P ＜ 0.01), especially the decrease in verapamil group was great, and there was significant difference (P ＜ 0.05). ③ Values of systolic pressure and diastolic pressure were decreased in both groups after cold pressor test (P ＜ 0.01), but there was no significant difference between the two groups (P ＞ 0.05). ④ There was no significant difference in clinical effect between the twogroups (P ＞ 0.05).⑤ After treatment, concentration of Ang- Ⅱ at basic level in both groups was decreased, and there was significant difference between them (P ＜ 0.01);concentration of Aug-Ⅱ was decreased in both groups after cold pressor test as compared with that before treatment, but there was no significant difference between them (P ＞ 0.05).CONCLUSION: Mediodespidine capsule can decrease blood pressure stably, and the effect is stronger than that of verapamil at the aspect of decompression and improving symptoms. Blood pressure of patients with primary hypertension in the types of yin deficiency and yang excess or liver fire can be decreased by decreasing the level of plasma Ang-Ⅱ to a certain degree.

Objective:To study the chemical constituents in methanol parts of Toddalia asiatica ( Linn) Lam. Methods: The compounds were isolated by silica gel, Sephadex LH-20 column chromatograph and TLC. The structures were elucidated by physico-chemical properties and spectral analysis. Results:Nine compounds were obtained and elucidated as dictamnine(1), hesperetin(2), 4-hydroxy-N-methylproline(3), 8-hydroxy-dihydrochelerythrine(4), hesperetin7-O-β-D-glucopyranoside(5), daucosterol(6), hes-peridin(7), diosmin(8) and neohesperidin(9). Conclusion:Compound 5, 6, 8 and 9 are isolated from the plant for the first time.

Objective To investigate the factors that induce constipation in bedridden patients undergoing replantation of severed finger and find countermeasures. Methods A retrospective investigation was carried out in 92 patients undergoing replantation of severed finger, their constipation and factors influencing constipation were recorded. Results 61 patients suffered from constipation in total 92 cases,the rate being 66.30%. 76 patients reduced food intake, and 59 cases presented constipation (the rate being 77.63%). Factors influencing constipation included being unaccustomed to defecate in bed (the rate that present with constipation being 87.09%),reluctant to trouble others(75.47%), side effects of drugs(55.56%) and lack of dietary knowledge (71.87%), decreasing food intake was closely bound up with constipation. Conclusions Proper psychological counseling, strengthening of health propaganda, comfortable facility for defecation, improved family support and oral food intake can significantly reduce the proportion of constipation and increase comfort degree of patients.

Objective To explore the impact of nursing intervention on quality of life of blood dialysis patients.Methods 60 cases of hemodialysis patients were selected and divided into the experimental group and the control group with 30 patients in each group.The control group was given conventional nursing,while the experimental group was given systematic health education and psychological nursing.The differences in life quality before and after the intervention in the experimental group was evaluated with self-designed questionnaire.The changes in motor function,psychological function,social function,and material life were compared before and after the intervention between two groups.Results After the intervention,the score of motor function,psychological function and total evaluation of the experimental group were higher than those of the control group.Conclusions Nursing intervention can effectively alleviate the discomfort feeling of patients,reduce their mental pressure,increase their quality of life.Nursing intervention is closely related with quality of life.

Objective To study tirofiban intravenous injection,coronary artery injection of the two different methods in acute ST segment elevation myocardial infarction,the application of emergency PCI.Methods Patients underwent emergency PCI with acute ST segment elevation myocardial infarction as the research subjects,a total of 108 cases,the patients were randomly divided into the observation group and control group,54 patients in each group. In the observation group,the first dose of tirofiban was injected into the coronary artery.The control group was treated by intravenous injection.The results of the two groups were compared.Results Before treatment,TIMI level 2 and level 3 ratio,initial corrected TIMI frame count of the observation group were significantly lower than the control group (χ2 /t =4.32,4.59,5.25,all P <0.05).After treatment,MBG level 2 or level 3 ratio,post -operative corrected TIMI frame count of the observation group were significantly higher than the control group (χ2 /t =4.11,4.85,5.87, all P <0.05).1 h after PCI treatment,the number of cases of ST fully back,the added value of EF,plague index scores of observation group were 53 cases,(8.02 ±6.94)%,(0.41 ±0.28)respectively,which were significantly higher than those of the control group 36 cases,(5.87 ±6.54)%,(0.28 ±0.27)(χ2 /t =5.32,4.32,3.65,all P <0.05).Adverse events of the two groups had no significant difference (χ2 =0.52,P >0.05).Conclusion Compared with intravenous injection,tirofiban in the treatment of acute ST segment elevation myocardial infarction by intracoronary injection can improve the level of myocardial perfusion after PCI operation,promote the recovery of left ventricular function,and has high security.

Objective To study the effect of acupuncture combined with clean intermittent catheterization in the treat-ment of neurogenic bladder. Methods A total of 46 patients were randomly divided into test and control groups. There were 23 patients in the each group. The clean intermittent catheterization only used in the control group. However inte-grated acupuncture and clean intermittent catheterization were used in the test group. Final the residual urine volume and the incidence of bacteriuria were researched after 5 months. Results There were 17 cases restored the micturating function in the test group, however only 7 cases in the control group. There were 3 cases suffered bacteriuria in the test group, but there were 11 cases suffered bacteriuria in the control group. The difference between the two groups was sta-tistical ly significantly (P<0.05). Conclusion Combined acupuncture with clean intermittent catheterization can effi-ciently maintain the normal function of bladder, decrease the residual urine volume, and reduce the incidence of bac-teriuria.

Objective: To investigate the prevalence of somatization symptoms and its correlation with social support in patients with depressive disorder. Methods: Two hundred and fourteen hospitalized patients with depressive disorder were recruited. Patients were evaluated with Somatic Symptom Inventory (SSI), Perceived Social Support from Family Scale (PSS-Fa), Social Support Rating Scale (SSRS) and the general questionnaire. Results: The average SSI scores of depressive patients was 49.63±15.53, with 26.2% (56/214) of the patients having moderate to severe level of somatic symptoms. The most common moderate to severe somatic symptoms in depressive patients were "feeling fatigued (61.3%, 131/214), weak (49.5%, 106/214), not feeling well (47.7%, 102/214), feeling faint or dizzy (48.6%, 104/214), or constipation (29.9%, 64/214)" . The average SSRS scores of patients was low (33.24±7.16). The SSI scores and its non-painful dimension (39.05±12.14) were significantly negatively correlated with family support (11.03±3.45) (r=-0.150, P=0.03; r=-0.153, P=0.02) .The SSI scores, and its somatization dimension scores (49.63±15.53) and painful dimension scores (10.58±4.18) were negatively correlated with the total scores of social support (33.24±7.16) (r=-0.164, P=0.02; r=-0.183, P=0.01; r=-0.136, P<0.05) and subjective support (19.14±4.81) (r=-0.167, P=0.02; r=-0.163, P=0.02; r=-0.177, P=0.01) . The SSI scores and its non-painful dimension of patients were negatively correlated with support utilization (r=-0.179, P=0.01; r=-0.194, P=0.01) . Conclusion Somatic symptoms are prevalent and severe in patients with depressive disorder. The somatic symptoms of depressive patients was closely correlated with decreased social support, especially low subjective support and support utilization.

Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.