In order to favor the growth and development of the fetus,the maternal-placental-fetal unit is characterized by profound physiologic changes.These adaptations may affect maternal and fetal absorption,distribution,placental transfer,metabolism and excretion of drugs.When evaluating drug use in pregnancy,understanding both pregnancy physiology and the gestation-specific pharmacokinetics of different drugs is necessary to achieve effective treatment and limit maternal and fetal risk.This topic will focus on the pharmacokinetics and safety of drugs during pregnancy in light of changes in maternal physiology and function of placental.

Antiviral Agents ; therapeutic use ; Biomarkers ; blood ; Biopsy ; Diagnostic Imaging ; methods ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Hepatitis B, Chronic ; complications ; diagnosis ; pathology ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; drug therapy ; pathology ; Reproducibility of Results

OBJECTIVETo analyze the efficacy and medication principles of Professor Xu Fu-songs traditional Chinese medicine (TCM) protocols for male diseases.

METHODSWe reviewed and descriptively analyzed the unpublished complete medical records of 100 male cases treated by Professor Xu Fu-song with his TCM protocols from 1978 to 1992.

RESULTSThe 100 cases involved 32 male diseases, most of which were difficult and complicated cases. The drug compliance was 95%. Each prescription was made up of 14 traditional Chinese drugs on average. The cure rate was 32% , and the effective rate was 85%. Professor Xu Fu-song advanced and proved some new theories and therapeutic methods.

CONCLUSIONProfessor Xu Fu-song's TCM protocols can be applied to a wide range of male diseases, mostly complicated, and are characterized by accurate differentiation of symptoms and signs, high drug compliance, and excellent therapeutic efficacy.

Objective To summarize the clinical features,treatment and follow-up of patients with severe coronary artery spasm.Methods Twenty-one patients with confirmed coronary artery spasm were selected.The study reviewed the patients' general conditions including age,gender,complication,smoking and drug situations.The clinical features,electrocardiogram and coronary angiography data were analyzed.Their diagnosis,treatment and prognosis were evaluated.Results Male (86％,18/21) had higher incidence in severe coronary artery spasm.Smoking (62％,13/21) was a major risk factor.Coronary artery spasm often happened on the base of a fixed narrow (57％,12/21),and the clinical process was treacherous.Coronary angiography was very important for early diagnosis.Calcium antagonist was the core of the treatments and should be sustained at full dose.Interventional therapy was not efficacious.Although patients in acute phase had higher risk,long-term prognosis was good.Conclusions Coronary artery spasm is a common problem,but it is often overlooked.Timely diagnosis is the key to prevent fatal events.Calcium antagonist is the core of the coronary artery spasm drugs.The long-term prognosis of coronary artery spasm is good.

Objective To evaluate the clinical efficacy and toxicity of paclitaxel liposome combined with cisplatin chemotherapy in NSCLC with brain metastasis. Methods Twenty-eight patients were newly diag-nosed NSCLC with brain metastasis(confirmed by pathology or cytology). The patients were treated with pacli-taxel liposome(135 mg/ m2 )on day 1 intravenous drip for 3 hours,cisplatin,25 mg/ m2 on day 1-3. The course of treatment was 21 days. The patients accepted the anti-allergy treatment before chemotherapy. Results Twenty-eight patients could be evaluated,and 101 treatment cycles were completed( 3. 6 cycles per patient). General lesion assessment presented that no patient got complete remission( CR),13 patients (46. 43% )got a partial response(PR),11(39. 28% )had a stable disease(SD)and 4(14. 29% )had a progressive disease( PD). The objective response rate( RR)was 46. 43% ,and the disease control rate (DCR) was 85. 71% . Local cerebral response assessment showed that no patient got CR,6 patients (21. 43% )got a PR,15(53. 58% )had a SD and 4(14. 29% )had a PD. The RR was 21. 43% ,and the DCR was 85. 71% . There was a significant difference in the RR(χ2 = 3. 90,P = 0. 03)but not in the DCR (χ2 = 0. 15,P = 0. 3)between the local cerebral disease and the general lesion. The median time to disease progression(TTP)for general lesion and local cerebral were 7. 2 months and 6. 2 months,respectively(χ2 =6. 43,P < 0. 05). The adverse reactions included bone marrow suppression,gastrointestinal reactions,elevated transaminases,alopecia,neurotoxicity,etc. All of these could be well controlled. Conclusion Paclitaxel liposome combined with cisplatin regimen demonstrates a higher efficacy and well tolerable against main metas-tasis of NSCLC,and the adverse effects are minor.

Objective:To compare the difference of serum levels of M-phospholipaseA2 receptor ( PLA2R) antibodies in patients with idiopathic membranous nephropathy(IMN) detected by two different methods and evaluate the diagnostic value of two methods. Methods:Patients diagnosed as membranous nephropathy and other diseases with biopsy-proven from december 2014 to october 2015 in Shengjing Hospital of China Medical University were enrolled and devided into IMN group and non-IMN group. The serum levels of anti-PLA2R antibody were detected by both indirect immunofluorescence assay(IFA) and enzyme linked immunosorbent assay(ELISA). Results:The sensitivity of IFA and ELISA in IMN were 71. 3% and 68. 5%,and the specificities of two methods were the same as 100%. The area under ROC curves of anti-PLA2R antibody for IMN diagnosis were 0. 860 and 0. 839. The diagnostic value of IFA and ELISA was no statistically significant differences in IMN ( P>0. 05 ) , and the consistency of two methods was better (κ=0. 876). The IMN patients of positive anti-PLA2R antibody be susceptible to the low level of serum albumin (P<0. 05). The higher levels of PLA2R antibody were linked with the worse hypoproteinemia and the higher rate of nephrotic-range proteinuria in IMN patients. Conclusion:Two methods of detecting sera PLA2R antibody have higher sensitivity and specificity,so the sera anti-PLA2R antibody was a better biomarker in the diagnosis of idiopathic membranous nephropathy.

Objective To explore the pathological basis and clinical characteristics of children with congenital choledochal cyst(CCC) combined with liver damage.Methods According to the age,38 patients with CCC were divided into 2 groups:group A had 24 cases(ranged 6 months to 3 years old);group B had 14 cases(ranged 4 to 14 years old).A comparative analysis of them was conducted retrospectively in the clinical characteristics,hepatic pathological changes,perioperatively liver function and operation.Results Group A was obvious higher than group B in jaundice,white bole stool and abdominal mass,but group B was more in stomachache.Group A was obvious higher than group B in liver function lesion,alkaline phosphatase,bilirubin increase and blood coagulation disfunction(Pa

Objective To investigate the relationship of placental vascular anastomosis and physical development and morbidity of the disease in twin neonates.Methods Fourteen pairs of twin neonates deliveried from Sep.2005 to Aug.2009 were enrolled in Newborn Intensive Care Unit,the Third Affiliated Hospital of Zhengzhou University.These twins were divided into 2 groups according the conditions of placental vascular anastomosis:significant placental vascular anastomosis group(group A) and no significant vascula anastomosis group(group B).Birth weight,head circumference,length,the morbidity of disease were all investigated in 2 groups.Clinic follow-up included neonatal behavioral neurological assessment(NBNA) and children′s development center of China(CDCC).The correlation of neonates placental vascular anastomosis between twin neonates were compared.Results There were statistically significant differences between group A and group B in birth weight,head circumference and body length(t=6.070,5.237,5.784,Pa

It was introduced in this paper the concrete measures of medical humanistic education which is in harmony with the teaching of human parasitology. The necessity of humanistic education for the medical students in the present age and the feasibility of humanistic education in basic medical education were discussed according to the feedback on the survey of the medical students. This study aimed to explore an ideal teaching model for medical humanistic education and comprehensively improve the humanistic accomplishment in medical students.