OBJECTIVE:To observe therapeutic efficacy and safety of Compound digestive enzyme capsule in the treatment of dyspepsia. METHODS:154 patients with dyspepsia were selected and randomly divided into observation group and control group, with 77 patients in each group. Control group received routine treatment,Polyzyme tablet 600 mg,tid,30 min after meal;observa-tion group was additionally given Compound digestive enzyme capsule 600 mg,tid,30 min after meal. Treatment course of 2 groups lasted for 2 weeks. The improvement of dyspepsia,clinical efficacy,clinical manifestation score,improvement duration and ADR were observed in 2 groups after treatment. RESULTS:The total effective rate of observation group(89.61%)was significant-ly higher than that of control group(74.03%),with statistical significance(P<0.05). After treatment,the improvement of abdomi-nal distension,early satiety,belching,epigastric discomfort,epigastrium pain,epigastric burning sensation,nausea,vomiting and other clinical digestive symptoms in observation group were significantly better than control group,while clinical symptom score and improvement duration were significantly lower or shorter then control group,with statistical significance(P<0.05). There was no statistically significant difference in the incidence of ADR between observation group (3.90%) and control group (5.19%), with statistical significance (P>0.05). CONCLUSIONS:Compound digestive enzymes capsule has good effect on dyspepsia with less ADR.

Objective To investigate factors and neonatal outcomes associated with histologic chorioamnionitis (HCA) in preterm premature rupture of membranes (PPROM).MethodsFrom Jan.2008 to Jun.2011,230 women with PPROM at 28 -33 +6 weeks of gestation undergoing deliveries in the Second Affiliated Hospital of Wenzhou Medical College were studied retrospectively.According to placental histopathologic findings,those patients were categorized into two groups,including 138 cases in histologic chorioamnionitis (HCA group ) and 65 cases in non-chorioamnionitis (control)group.Age,parity,gestational age of PPROM and delivery,latency period,oligohydramnios,white blood cell (WBC) count and serum C-reactive protein (CRP) level at admission and before delivery,the incidence of neonatal respiratory distress syndrome (NRDS),neonatal pneumonia,bronchopulmonary dysplasia,necrotizing enterocolitis,early-onset neonatal sepsis,abnormal brain sonography findings and mortality were compared between two groups.Results( 1 ) The incidence of HCA was 68.0.％ ( 138/203 ) in all 203 cases with PPROM.(2) The occurring ruptured membrane gestation in HCA group was ( 31.1 ± 1.5 ) weeks,which were significantly earlier than (32.0 ± 1.3 ) weeks in control group ( P ＜ 0.05 ).The level of CRP of (8.2 ± 14.9) mg/L before delivery in HCA group was significantly higher than (5.5 ±7.2) mg/L in control group (P ＜ 0.05).The rate of oligohydramnios and cesearean sections were 55.1％ (76/138) and 45.7％ (63/138) in HCA group,which were significantly higher than 30.8％ (20/65) and 29.2％ (19/65) in control group (P ＜0.05).There were no significant difference in patient's age,parity,WBC count and CRP at admission between two groups (P ＞ 0.05 ).The latency period did not show significant difference between (140± 116) hours in HCA group and (129 ± 125) hours in control group (P ＞ 0.05).(3) Using multivariable logistic regression models,oligohydramnios ( OR =2.937 ),gestational age of PPROM ＜ 32 weeks ( OR =2.352),serum CRP level ＞ 8 mg/L before delivery ( OR =4.923 ) and latency period ＞ 48 -168 hours (OR =4.439) were significantly associated with HCA (P ＜0.05).(4) The gestational age of delivery and birth weight of HCA group were significantly lower than those of control group [ ( 32.0 ± 1.5 ) weeks vs.( 32.7 ± 1.5 ) weeks,( 1680 ± 379) g vs.(2017 ± 333) g,respectively,P ＜ 0.05 ].The incidence of Apgar ＜7,abnormal brain sonograhy findings, neonatal pneumonia,bronchopulmonary dysplasia,early-onset neonatal sepsis and mortality in HCA group were significantly higher than those in control group [20.3％ (28/138) vs.7.7％ (5/65),14.5％ (20/138) vs.4.6％ (3/65),12.3％ (17/138) vs.3.1％(2/65),5.8％ (8/138) vs.0,6.5％ (9/138) vs.0,12.3％ (17/138) vs.3.1％ (2/65),respectively,P ＜ 0.05 ].The incidence of necrotizing enterocolitis ( 1.5％,2/138 ) in HCA group was higher than that of controlgroup(0) and the incidence of NRDS ( 18.8％,26/138) in HCA group did not show statistical difference with 21.4％ ( 14/65 ) in control group ( P ＞ 0.05 ).ConclusionsIt was found that HCA was significantly correlated with lower gestational age of PPROM,higher serum CRP level before delivery,prolonged latency period and oligohydramnios in PPROM.HCA could increase the neonatal morbidity and mortality.

OBJECTIVE To investigate and compare the enzyme kinetic characters of psoralen (PRN)and isopsoralen(IPRN)in rat and human liver microsomes. METHODS PRN and IPRN in liver microsomes incubates were determined using LC-MS/MS. The enzyme kinetic and metabolic stability of PRN and IPRN were investigated by employing the optimized rat and human liver microsomes incubations. The Vmax and Km values were calculated using the nonlinear regression method. RESULTS The quanti?tative method showed good linearity within the range of 0.1-50.0 μmol · L-1 and was suitable for the assay in biological samples. The in vitro elimination was linear with the substrate concentrations lower than 1 μmol,the protein concentration within 0.5 g · L-1,and the incubation time within 40 min. The t1/2 values of PRN and IPRN in rat and human liver microsomes were 74.5,95.0,74.5 and 173.3 min, respectively. The Vmax values of PRN in rat and human liver microsomes were(1.140±0.080)μmol·min-1·g-1 protein,(0.620±0.060)μmol·min-1·g-1 protein,while Km values of PRN in rat and human liver microsomes were (12.9 ± 0.3)μmol · L- 1,(7.4 ± 1.3)μmol · L- 1,respectively. The Vmax values of IPRN in rat and human liver microsomes were(0.251±0.012)and(0.103±0.014)μmol·min-1·g-1 protein,while Km values of IPRN in rat and human liver microsomes were (3.0 ± 0.4)μmol · L-1,(3.4 ± 0.7)μmol · L-1,respectively. CONCLUSION The enzyme kinetic characters and metabolic stability of PRN and IPRN show species and chemical structures related differences. Interestingly,the metabolic eliminations of PRN and IPRN are similar in rats. However,the metabolic elimination of IPRN in humans involved in CYP enzymes may be much slower than that of PRN.

Objective To determine the clinical value of the multi-slice spiral CT virtual endoscopy (CTVE) for the detection of biliary pancreatic junction lesions. Method MSCT and virtual endoscopic reconstruction were performed in 30 healthy volunteers, 18 cases of common bile duct stones and 7 cases of ampullary carcinoma to observe patterns of duodenal papilla and measure its size.Results Reconstructed image of CTVE showed that the normal duodenal papilla was nodular in 16,shaped like "V" in 8 "Y-shaped" in 6 of the healthy volunteers. Its diameter was (0.84±0.17)cm. In the patients with common bile duct stones, it was nodular and its diameter (1.72±0.32)cm. In the patients with ampullary cancer, it was of irregular protruded type and its diameter (2.30±0.85)cm.There was significant difference among the 3 groups in the overall mean values (P＜0.01). Conclusion CTVE is a convenient, non-invasive and precise clinical examination to observe the shape of duodenal papilla and determine its size.

ObjectiveTo evaluate left ventricle partial and global diastolic function in patients with silentmyocardial ischemia (SMI) by Doppler tissue imaging (DTI) combined with dobutamine stress echocardiography(DSE).Methods30 cases of silent myocardial ischemia(SMI) and 30 cases of normal control underwent dobu-tamine stressechocardiography(DSE). DTI was acquired at baseline and stress, and waveforms in mitral valve clos- ing, and the base and mid segments of left ventricle were used to measure diastolic early velocity(Ve), diastolic latelyvelocity(Va) ,and E deceleration time(Te). ResultsⅤ in control group increased accompanied with the increasingdose of dobutamine, Ve/Va decreased a little but not significantly. Ⅴ in the group with silent myocardial ischemia(SMI) increased at 10μg·kg-1·min-1 ,but decreased at 40μg·kg-1·min-1 compared with 10μg·kg-1·min-1 ,T inboth control and DSE group decreased at 40μg/kg accompanied with 10μg·kg-1·min-1, T in both control and DSEgroup decreased accompanied with the increasing dose of dobutamine, and there were significant differences betweenthe groups(P < 0.05). ConclusionDTI-DSE could quantificadvely detect the partial and global diastolic function ofleft ventricle.

Objective To analyze regional left ventricular systolic function before and after percutaneous translumial coronary angioplasty(PTCA),quantitative tissue velocity imaging(QTVI)was used tO detect wall motion of left ventricule.Methods 20 patients with isolated left anterior descending coronary artery(LAD)stenosis(≥70%)and 16 normal control subjects were included in this study.QTVI was performed one day before PTCA+stent,a week and a month after successful PTCA+stent.Peak systolic myocardial velocity(Vs)were measured with QTVI at different wall segments(basal and medial segments).Results Before PTCA+stent,Vs of all segments assigned by LAD were significantly lower than those of corresponding segments in normal subjects(P＜0.01).After PTCA+stent,the above segments showed a significant improvement of Vs in a week and a month(P＜0.01).Conclusion QTVI can quantitively detect changes of myocardiac motion and real-time quantify regional left ventricular systolic function before and after PTCA.

Objective To evaluate the clinical significance of peripheral atheral atherosclerosis after treatment by folicacid in combination with mecobalarain in uremia patient using vascular ultrasound.Methods 99 cases of uremia patients with carotid atherosclerosis were treated with folie acid tablets and mecobalamin tablets for six months.The carotid intimia-media thiclmess(IMT),total plaque area,numbers and ultrasound types of carotid atherosclerotic before and after treatment were observed.Results After six months,carotid IMT became tinner significantly,and the totsl plaque area decreased(P＜0.05).The ultrasound types of carotid atherosclerotic plagues have changed after six montha.and the plaque numbers decreased significantly(P＜0.05).Conclusion Threatment by folie acid combination with mecobalamin in uremia patients maybe helpful to the progression of carotid athereaclerotie disease.

Objective To investigate the expression of phosphorylated protein kinase B1 (pAkt1) and human telomerase reverse transcriptase (hTERT) in ovarian epithelial carcinoma (EOC) and its relationship with prognosis, and to analyze the correlation between pAkt1 and hTERT expression. Methods 92 patients with EOC in Tangshan Gongren Hospital from January 2012 to December 2016 were selected. The expressions of hTERT and pAkt1 proteins were detected by immunohistochemistry. The relationship between the expressions of pAkt1 and hTERT proteins and their relationship with clinical prognosis were analyzed. Results Of the 92 patients with EOC, 68 cases (73.9 %) had positive expression of pAkt and 52 cases (56.5 %) had positive expression of hTERT. There was no significant correlation between expressions of pAkt1 and hTERT proteins in EOC (r= 0.284, P= 0.633). The expressions of pAkt1 and hTERT proteins were not related with age, tumor pathology type and the International Federation of Gynecology and Obstetrics (FIGO) staging (all P> 0.05), but had significant association with tumor pathology differentiation (χ2= 2.694, P= 0.005; χ2=2.284, P=0.018). The disease-free survival of patients with both pAkt1 and hTERT positive was shorter than that of the other groups (P= 0.013). Conclusion The prognosis of EOC patients with high expression of pAkt1 and hTERT proteins is poor.

Health coaching is a patient-centered intervention process, which had conducted many years in patients with chronic obstructive pulmonary disease (COPD) and made many positive outcomes. This article reviews the concept of health coaching, specific implementation measures, application effects, existing deficiencies and inspiration in patients with COPD, with a view to providing reference for the further development of health coach technology in patients with COPD.

Adult ; Aged ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Shoulder Dislocation ; therapy