Objective To observe the clinical curative effect of Xiaoer Chiqiao Qingre granule in the treatment of infantile upper respiratory tract infections.Methods 100 children with upper respiratory tract infection were selected,and they were randomly divided into observation group and control group,50 cases in each group.The observation group was treated with Xiaoer Chiqiao Qingre granule,the control group was given ribavirin effervescent granules.The effects of the two groups were observed.Results The total effective rate of the observation group was 96％,which was significantly higher than 78％ of the control group (x2 =9.500 6,P ＜ 0.05).The fever,symptoms and signs of improvement time in the observation group were better than those in the control group.Conclusion Xiaoer Chiqiao Qingre granule in the treatment of infantile upper respiratory tract infection can defervesce quickly,and has quick curative effect,so it is worthy of promotion.

The experience of various countries proves that the hierarchical diagnosis and treatment model can lead to reasonable resources allocation and utilization, however, the waste of China''s disordered treatment model has not been estimated.Nowadays, it is very important to establish a hierarchical diagnosis and treatment system during China''s healthcare system reform.Therefore, it is necessary to estimate the benefit the reform may bring.We take Zhejiang Province as an example, and adopted the system dynamics model to build the health delivery system, to emulate the hierarchical diagnosis and treatment model and the disordered model, and to evaluate the benefit.Results showed that if first option at the primary health institutions increased 10%, it could save 0.251 billion yuan, and if increased 15%, it could save 0.39 billion yuan.If the first option at the primary health institution reached 72.35% and the treatment in county reached 90%, the outpatient in tertiary hospital could reduce by 13 million, and those in primary healthcare institutions could increase by 74 million yuan.The direct healthcare cost could reduce 3.016 billion Yuan.

Objective: To explore the effect of intravenous recombinant human brain natriuretic peptide (rhBNP) on regional myocardium deformability in patients with anterior acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI). Methods: A total of 35 patients with anterior AMI who received primary PCI within 12 hours of symptom onset in our hospital from 2013-06 to 2013-12 were enrolled in this study and randomized into 2 groups: rhBNP group, the patients received intravenous rhBNP,n=18, Control group, the patients received standard intravenous nitrates,n=17, and the intravenous pumping administration maintained for 72 hours in both groups. The echocardiography was conducted at immediately, 7 days and 1 month after PCI respectively to compare the relative parameters. The occurrence of major adverse cardiac events (MACE) were followed-up for 6 months in all patients. Results: The baseline condition was similar between the two groups,P>0.05 , the parameters of echocardiography as LVEF and WMSI at immediately and 7 days after PCI were similar between the two groups,P>0.05. Compared with Control group, rhBNP group had the increased LVEF and decreased WMSI at 1 month after PCI ,P<0.05; rhBNP group had increased SRs at 7 days after PCI,P<0.05, while SRe and SRa were similar between the two groups,P>0.05; SRs, SEe and Sra were increased at 1 month after PCI, allP<0.05. The cTnI value in rhBNP group was lower than that in Control group as (50.09 ± 16.88) ng/ml vs (63.24 ± 18.60) ng/ml,P=0.036. The occurrence of MACE was similar between the two group,P>0.05. Conclusion: Intravenous administration of rhBNP could improve the regional myocardium deformability and the systolic/diastolic function in patients with anterior AMI after primary PCI.

Objective To find a selection method system appropriate for China's essential drug list.Methods Collection and analysis of technical paper literature on essential drug list developement,adjustment technical papers,and literature on evidence-based medicine,pharmacoeconomics evaluation,and medical insurance budget analysis from WHO and other countries.On such basis,a method system for selecting China's essential medicine list can be proposed,with its feasibility analyzed and demonstrated.Results The GRADE assessment proposed by WHO was used to evaluate the efficacy and safety of the drug;the pharmacy economics evaluation is added to assess the economic efficiency;these were aided by the pharmacoeconomics evaluation for a comprehensive evaluation of the pharmacoeconomics of the drug in question,supplementing analysis of the medical insurance,and ensuring its affordability of essential medicine so selected.The theory of this system is well developed,and supporting software ready for application.Examples in Zhejiang Province regarding essential medicine for diabetes have proved this method feasible.Data acquisition constitutes a major roadblock for scientific selection due to barriers against medical insurance data sharing.Conclusions Theoretic basis and method tools are fully available for essential medicine selection,and the selection method system as proposed in this study prove feasible to some extent.Decision makers are recommended to scientifically select the essential drugs,and to encourage data sharing,in order to make the list more scientific and pragmatic.

Objective To measure the morphological parameters of cervical endplate of Chinese by using computed tomography (CT)scans,and to provide an accurate morphometric basis for designing and developing the cervical disc prostheses.Methods 80 healthy subjects were scanned by CT.The parameters of each cervical vertebra from C3 to C7 were measured by CT scans including upper anteroposterior length (APLu),upper center mediolateral length (CMLu),lower anteroposterior length (APLl) and lower center mediolateral length (CMLl).These parameters were compared between genders and among different vertebral levels.Results The values of APLu, CMLu,APLl and CMLl were increased with the decreasing of cervical segment (P APLu = 0.023,P CMLu = 0.007, P APLl =0.035,P CMLl < 0.001).There was statistically significant difference in morphological parameters between genders (P < 0.05).Compared with the reported data of other different populations,the statistically significant difference in morphological parameters also existed in the study.Conclusion The study provides an accurate morphological basis for designing the suitable artificial cervical disc for Chinese population.

Adult ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Humeral Fractures ; diagnostic imaging ; physiopathology ; surgery ; Male ; Middle Aged ; Radiography

OBJECTIVE： To establish the method for the content determination of related substance in Terazosin hydrochloride tablets. METHODS： HPLC and principal component self-control with correction factor were adopted. The determination was performed on Agilent Zorbax Eclipse XDB C18 column with mobile phase consisted of acetonitrile-perchloric acid solution （20 ∶ 80， V/V） at the flow rate of 1.0 mL/min. The detection wavelength was set at 246 nm， and sample size was 20 μL. The column temperature was 50 ℃. The linear equations of terazosin hydrochloride， impurity A， B， C were drawn. The correction factors of each impurity related to terazosin hydrochloride were calculated by slope， and relative retention time was used to determine the position of impurities. The contents of impurity A， B and C in 3 batches of Terazosin hydrochloride tablets were determined and compared with the results of impurity control method. RESULTS： The relative retention time of impurity A， B， C was 0.39， 0.74， 2.77， respectively； the linear range of them were 0.25-3.0 μg/mL， respectively. The correction factors were 0.75， 1.09， 0.84， respectively. The detection limits were 0.35， 0.51， 0.43 ng， and the limits of quantification were 0.70， 1.02， 0.86 ng， respectively. The contents of impurity A， B and C in 3 batches of Terazosin hydrochloride tablets were 0.11％-0.13％， 0.03％ and 0.09％-0.12％； impurity B did not detected. The results are consistent with the determination of impurity control method. CONCLUSIONS： The method is simple， rapid and accurate for the content determination of related substances A， B， C in Terazosin hydrochloride tablets.

Objective: To explore the glycemic control of newly-diagnosed type 2 diabetes with different levels of baseline body mass index (BMI) after 6 months treatment under the standardized metabolic disease management model. Methods: (1) 163 patients of newly-diagnosed type 2 diabetes were divided into normal weight (BMI 18.5-23.9 kg/m²), overweight (BMI 24.0-27.9 kg/m²), and obese (BMI≥28 kg/m²) groups according to baseline BMI, the blood glucose and lipids levels were compared among 3 groups. (2) The blood glucose levels were compared among 3 groups after 6 months of standardized management. (3) The overweight and obese patients were divided into group weight loss≥5% and group weight loss<5% or weight gain in 6 months. The blood glucose levels were compared. Results: (1) At baseline, overweight and obese groups had higher homeostasis model assessment for insulin resistance and lower high density lipoprotein-cholesterol compared with normal weight group. (2) After 6 months of treatment, HbA_1C and HbA_1C reduction showed no difference among 3 groups (normal, overweight and obese) after adjusted by baseline HbA_1C. The rate of HbA_1C<7% among 3 groups were 77.78%, 83.95%, and 80.43% (P>0.05). (3) After 6 months of treatment, 32.28% overweight and obese patients lost weight by ≥ 5%, while HbA_1Cand HbA_1Creduction showed no difference between 2 groups (weight loss≥5% and weight gain or weight loss<5%) after adjusted by baseline HbA_1C. Both groups achieved good glycemic control [(6.27±1.38 vs 6.43±0.66)%], but have no significantly(P>0.05). Group weight loss≥5% had better glucose control (92.68% vs 77.91%, P<0.05). Conclusions As BMI increased, insulin resistance and lipid disorders were more serious in newly-diagnosed type 2 diabetes. After 6 months of standardized metabolic management, newly-diagnosed type 2 diabetes with different baseline BMI and weight changes both achieved good glycemic control. In addition, patients losing weight equal to or more than 5% achieved higher attainment of HbA_1C targets.

OBJECTIVETo assess the detection of maternal serum alpha fetoprotein (MSAFP) and free beta-HCG levels of second trimester for screening of fetal gastroschisis and omphalocele.

METHODSClinical data of 622 639 pregnant women from 5 prenatal screening centers in Hangzhou during October 2007 and September 2016 were analyzed retrospectively. Thirty cases of gastroschisis and 30 cases of omphalocele diagnosed by ultrasonography and postmortem findings were enrolled in the study and 116 cases of pregnant women with normal fetal development during the same period were selected as control group. The cut-off value and area under ROC curve (AUC) of MSAFP and free β-hCG for diagnosis of fetal gastroschisis and omphalocel were analyzed.

RESULTSMSAFP levels of women with fetal gastroschisis and omphalocele were 4.41 (0.88-11.69) MOM and 2.31 (0.72-23.20) MOM, which were significantly higher than that of control group[0.98 (0.41-2.26) MOM, all<0.01]. Free β-hCG level of women with fetal gastroschisis was 1.25 (0.35-19.94) MOM, which was significantly higher than that of control group[0.86 (0.17-6.11) MOM,<0.05). But there were no significant difference in free β-hCG between fetal omphalocele group[1.03(0.21-8.95)]and control group (>0.05). The AUCs of MSAFP for diagnosis of gastroschisis and omphalocele were 0.897 (95%:0.822-0.972) and 0.852(95%:0.762-0.942), respectively (all<0.01). Taking 1.655 MOM as the cut-off value of MSAFP for abdominal wall defects (gastroschisis and omphalocele), the sensitivity was 68.30%, specificity was 99.60% and Youden index was 0.649.

CONCLUSIONSMSAFP of second trimester is a better biomarker than free β-hCG in screening abdominal wall defects.