Objective To discuss the promoting effect of clinical pathway in the standard and reasonable medication by the application of clinical pathway in the anticoagulation treatment of warfarin and health education for patients with atrial fibrilation.Methods Sixty eight patients with atrial fibrilation and receiving anticoagulation treatment of warfarin were divided randomly into the intervention group(36 cases)and the control group(32 cases).The control group received routine nursing while the intervention group underwent nursing intervention with clinical pathway based upon routine nursing intervention.The time cost to achieve the aims,compliance,incidence rate of complications and satisfaction degree were compared between the two groups.Results All the items in the intervention group were superior to those of the control group except for the items of satisfaction degree and health knowledge score(P<0.05).Conclusion Application of clinical pathway in the anticoagulation treatment of warfarin for patients with atrial fibrilation could ensure standard and reasonable medication in order to decrease medical cost,lower the incidence rate of complications,improve patients compliance and increase nursing quality.

OBJECTIVE:To observe the distribution of fluorescent material in the respiratory tract of animals with the use of small animal imaging technology to quickly evaluate the effects of respiratory drug delivery. METHODS: The Kunming mice in the experimental group were administered with Cy5.5 fluorescent-labeled aerosol,meanwhile,a positive control group was set up by injecting same amount of compound anhydrous diethyl ether solution via tracheal incubation,with negative control group inhaled the same amount of non-Cy5.5 fluorescently-labeled aerosol. The fluorescent distribution of the aerosolized particles in the respiratory tract was observed. RESULTS: Fluorescently-labeled aerosol was observed in both the experimental group and the positive control group but not in negative control group. CONCLUSION: The small animal imaging technology is expected to be used as a rapid and effective method for evaluating the efficacy of respiratory drug delivery.

36 gestational weeks. Venous blood was taken to measure the level of glycosylated hemoglobin. Results The mean value of glycosylated hemoglobin in normal pregnant women was 4.1%(95%CI=2.5～5.7%). No difference was shown among different gestational weeks. Conclusions The normal value of glycosylaed hemoglobin in pregnancy is 2.5%~5.7%.

OBJECTIVE:To investigate the effect of liposome formulation in promoting hepatocytes' uptake of tenofovir and cytotoxic effect. METHODS: The tenofovir cationic liposomes were prepared by tert-butyl lyophilization, and its encapsulation efficiency and physico-chemical property were determined. Using human hepatic carcinoma cells SMMC-7721 as a model to investigate the effect of liposome formulation in promoting hepatocytes' uptake of tenofovir. MTT assays were used to examine the toxicity of tenofovir cationic liposomes in different conditions. RESULTS: The prepared tenofovir cationic liposomes had an encapsulation efficiency of (88.3?1.6)%, a size distribution of (278.4?67.6)nm and a Zeta potential of (31?5)mV. The results showed that the liposome formulations containing galactose and PEG modifying lipids resulted in significantly higher and prolonged drug accumulation inside cells as compared with free drugs. The cell survival rates were above 80% when the tenofovir liposome was at a concentration of 7.5?g?mL-1 and lipids at a concentration of 30?g?mL-1, and little toxicity was noted. CONCLUSION: The prepared cationic liposome can greatly enhance hepatocytes' uptake and protection of tenofovir, which is expected to become a highly effective drug delivery system of antiviral drugs such as tenofovir etc.

Objective To establish a simple and rapid method for extraction and determination promethazine and its metabolite in urine.Methods The urine was added to celite column and the elutions was effected with dichloromethane.The eluat was evaporated on a water bath at 50℃.The dry residue was redissolved with 3.0ml H2SO4 solution of 0.05mol/L,and then zinc dust was added,in order to make it reaction on the water bath of 100℃ for 3min.The promethazine and its metabolite concentration were determined with the second derivative UV spectrum.Resvlts The extraction rate was 90% for both promethazine and its metabolite.The linear range of determination was 0.5～5.0?g/ml.Conclusion The method for determinating promethazine and its metabolite in urine is simple,convenience,and with high extraction rate.

Cationic polymers are being developed quickly as gene delivery vectors. For in vivo gene delivery, the cationic polymers are usually further modified by hydrophilic polymer grafting or ligand conjugation, which have been shown to increase the vector stability, gene delivery efficiency and specificity greatly. Some previous research had shown that modified hydrophilic polymer may partly shield the targeting ligand and result in poor delivery specificity. Developing a method to evaluate the influence of PEG modification on targeting delivery is particularly critical to cationic polymer design and gene therapy development. One of most commonly used cationic polymer polylysine (PLL) was chosen as a model. Targeting ligand epidermal growth factor(EGF)was conjugated with PLL to form PLL-EGF. Then hydrophilic polymer polyethylene glycol (PEG) with molecular mass 7 000 and 20 000 were used to modify PLL-EGF respectively to generate PEG7000-g-PLL-EGF and PEG20000-g-PLL-EGF. In BIAcore experiments, epidermal growth factor receptor (EGFR) was conjugated onto BIAcore chip and various PEG modified PLL-EGF solutions were flowed over the chip. By observing the change of RU value, the specific interaction of EGF to EGFR was compared. Compared with PLL-EGF, PEG modified PLL-EGF showed lower association rate and higher disassociation rate to EGFR. Furthermore, compared to PEG7000 modified PLL-EGF, PEG20000 modified PLL-EGF got lower association rate and higher disassociation rate to EGFR. The Scatchard analysis results showed that the interactions between EGFR and PLL-EGF or PEG-PLL-EGF are non-linear. It can be concluded that PEG modification indeed reduced the association rate and enhanced the dissociation rate of EGF to EGFR. The length of PEG chain was also a key factor to influence interaction between ligand and receptor. The results showed that it was critical important to evaluate the influence of PEG modification on delivery specificities. The BIAcore method developed in this paper can successfully evaluate the influence, which would be important for cationic polymer design and its application as potential non-viral gene delivery vectors.

Objective To observe the effect of Anshenbunao Syrup on learning and memory capability in mice. Methods The learning and memory capability of mice was investigated by Y-water maze test and step-down test. The contents of protein, DNA and RNA were investigated by Lowry methods, the diphenylamine reagent method and Oricinol reagent method. Result Anshenbunao Syrup could enhance the memory capability of normal mice and improve the memory emersion disorder of mice induced by ethanol. In addition, it could increase the contents of protein and DNA in brain of mice. Conclusion Anshenbunao Syrup could improve the learning and memory capability of normal and memory emersion disorder mice, and its mechanism may be related to promoting protein synthesis in brain.

The maturity and scientific research strength of medical subjects between PRC and India and between PRC and Japan were demonstrated by comparing the scale and production distribution of international papers authors between PRC and India and between PRC and Japan according to the SCADC(2011), SCIE, InCites Statistical Analysis Database, non-regression fitting curve, K-S Test and Rnew fitting goodness, which showed that SCADC(2011) and SCIE displayed 53 specific medical subjects.Lotka distribution and author scale analysis showed that the maturity and scientific research strength of tropical medicine and pediatrics were lower while those of drug abuse, combined traditional and western medicine, primary health care, medical informatics, parasitology, audiology, speech and language pathology were higher in PRC than in Japan.

Objective To evaluate the value of HbA2 level determined by capillary electrophoresis (Hb-CE)in screening and diagnosis of thalassemia.Methods HbA2 level of 249 thalassaemia carriers and 142 healthy controls confirmed by molecular biological detection were determined by Hb-CE method.The thalassaemia carrier subjects were divided into different groups and subgroups according to their results of gene detection.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value for the diagnosis ofα-thalassemia,β-thalassaemia,α,β-thalassaemia were calculated under different HbA2 cut-off value.Results Mean value of HbA2 in healthy controls was (3.03±0.27)%.Mean values of HbA2 inα-thalassemia group and its subgroups of silentα-thalassemia,standardα-thalassemia and hemoglobin H disease were (2.38± 0.55)%,(2.61±0.46)%,(2.47 ± 0.32)% and (1.07 ± 0.17)%,respectively.Mean values of HbA2 inβ-thalassaemia group and itsβ0 subgroup,β+ subgroup were (5.65±0.47)%,(5.71±0.48)% and (5.56±0.43)%.Mean value of HbA2 in compoundαandβ-thalassaemia group was (5.7±0.82)%.Compared with healthy controls,HbA2 level inα-thalassemia group,silentα-thalassemia subgroup,standardα-thalassemia subgroup and hemoglobin H disease group decreased signifi-cantly (t values of 11.73,5.02,12.91 and 33.46,respectively,P<0.01).HbA2 level in hemaglobin H disease was signifi-cantly lower than silent and standardα-thalassemia subgroups (t values of 15.62 and 21.31,respectively,P<0.01),but there were no differences in HbA2 level between silent and standardα-thalassemia subgroups (t=1.50,P>0.05).HbA2 level inβ-thalassaemia group,β0 subgroup,β+ subgroup and compoundαandβ-thalassaemia group increased significantly (t values of 55.12,44.33,38.94 and 9.10,respectively,P<0.01),but there were no differences in HbA2 level betweenβ0 andβ+ subgroups (t=1.79,P>0.05).Of 249 thalassemia carriers,all 124β-thalassaemia carriers were distinguished with ele-vated HbA2 level (>3.5%)determined by Hb-CE and only 57 were distinguished from 117α-thalassemia carriers by Hb-CE.Under the cut-off value of 2.5%,the sensitivity,specificity,positive predictive value,negative predictive value and accu-racy for the diagnosis ofα-thalassemia were 48.72%,97.18%,93.44%,69.70%,75.29%,respectively.Under the cut-off value of 3.5%,they were 100.00%,98.59%,98.41%,100%,and 99.25% for the diagnosis ofβ-thalassaemia,respectively. The analysis of ROC curve showed that the optimal HbA2 cut-off values for diagnosis ofα,β-thalassaemia by capillary elec-trophoresis were 2.8% and 3.7%,respectively.Conclusion When no abnormal bands,the elevated HbA2 (>3.7% in this study)determined by Hb-CE could be used as a marker forβ-thalassaemia diagnosis,but theβ-thalassaemia co-existingα-thalassemia could not be differentiated fromβ-thalassaemia diagnosis.Decreased HbA2 level (<1.5% in this study)and HbH band could be used for the diagnosis of hemoglobin H disease.Only HbA2 determination by Hb-CE has no clinical sig-nificance for the screen and diagnosis ofα-thalassemia.

Objective To investigate the effect of tramadol combined with sufentanil on postop-erative analgesia in patients received upper-abdominal surgery.Methods One hundred and fifty pa-tients scheduled for selective upper-abdominal operation were randomly divided into five groups (n=30 each):Tramadol group (T);large dose sufentanil combined small dose tramadol group (TS1 );balanced tramadol and sufentani group (TS2 );small dose sufentanil combied large dose tramadol group (TS3);sufentanil group (S).Postoprative VAS scores were recorded respectively at 1,4,8, 12,24,36,48 h when be in quiet and turning 90 degree,Ramsay sedation score,analgesia pump pressing times and side effects were also recorded.Results VAS scores in group TS2,group TS3 and group S at each time point both be in quiet and turning 90 degree were significantly lower than that of group T and group TS1 (P <0.05).Group S sedation score significantly higher than group T (P <0.05).No significant difference in other groups.Conclusion Balanced tramadol and sufentanil group has best analgesic effect and least side effects.With the increasing doses of sufentanil,its analgesic effect was not obvious enhancement.