OBJECTIVE:To study the relative bioavailability and pharmacokinetics of Mycophenolate mofetil capsules vs.Mycophenolate mofetil soft capsules in healthy volunteers.METHODS:In double period randomized crossover study,20 healthy volunteers were given a single oral dose of trial capsule and reference capsule 4 pills(0.25 g per pill).The concentration of mycophenolate(MPA) was determined by HPLC.Pharmacokinetic parameters were calculated using DAs 2.0 software and the bioequivalence of 2 formulations were evaluated.RESULTS:Main pharmacokinetic parameters of trial capsule vs.reference capsule were as follows:AUC0→t:(69.95?14.13)?g?h?mL-1 vs.(66.95?19.05)?g?h?mL-1;AUC0→∞:(85.18?20.51)?g?h?mL-1 vs.(77.39?23.78) ?g?h?mL-1;Cmax:(31.26?13.09)?g?mL-1 vs.(31.90?14.45)?g?mL-1;tmax:(0.875?0.358)h vs.(0.775?0.291)h.The relative bioavailability of Mycophenolate mofetil soft capsules in 20 healthy volunteers was(109.6?26.9)%.CONCLUSION:Results of study indicated the 2 formulations are bioequivalent.

OBJECTIVE:To establish a RP-HPLC method for simultaneous determination of 4 flavonoids in Herba Euphorbiae Humifusae.METHODS:The samples were separated on Hypersil BDS C18 column(150 mm?4.6 mm,5 ?m)with CH3OH-0.3%H3PO4 as mobile phase(gradient elution)at a flow rate of 1.0 mL?min-1.The column temperature was maintained at 30 ℃ and the detective wavelength was set at 360 nm.RESULTS:The linear ranges of 4 flavonoids including rutin,quercetin,luteolin and kaempferol were 0.127 2～2.034 4 ?g(r=0.999 9),0.089 1～1.425 6 ?g(r=0.999 8),0.076 6～1.226 4 ?g(r=0.999 7),0.113 0～1.808 0 ?g(r=0.999 8)respectively,and their average recoveries were 97.6%,99.4%,98.1% and 101.9%,respectively with RSD at 0.94%,0.73%,0.99% and 1.34%,respectively(all n=9).CONCLUSION:This method was proved to be simple,accurate,reproducible and applicable for the quality control of Herba Euphorbiae Humifusae.

Objective To evaluate the efficacy and safety of domestic Holmium laser lithotriptor for the treatment of ureteral calculi.Methods The clinical data of 160 cases of ureteral calculi treated by trans-ureteroscope with domestic Holmium laser lithotriptor were retrospectively analyzed.Among these patients,85 were male,and 75 were female,59 in the upper uremr and 101 in the mid-lower ureter.Results The overall Successful operation rate for all level of ureteral stones in single procedure was 91%(146/160),while the upper one and mid-lower were 85%(50/59)and 95%(96/101),respectively.The average postoperative hospital stay was(4.7±1.4)d.The average clearance time to calculi-free was(21.5±10.1)d.Only 1 patient had urinary infection.No complication such as ureteral perforation or secondly hematouria were seen in this post cohort operation.The postoperative follow-up from 3 to 7 months revealed that the stone-free rate was 98%(147/150).Conclusion Treatment of ureteral calcuh by trans-ureteroscope with domestic Holmium laser lithotriptor is safe and effective.

Objective To explore the effectiveness of flipped classroom teaching mode in the course of Introduction to Nursing. Methods Two classes of nursing students in grade 2014 were randomly assigned to the experimental group (n=34) and the control group (n=32) by lottery. Flipped classroom teaching mode and traditional teaching were used in the experimental group and the control group respectively. The final exam score, learning attitude, autonomous learning ability and critical thinking ability were compared between the two groups after the course. Results The final exam score of the experimental group was significantly higher than the control group (t=2.53,P < 0.05). Besides, the learning attitude (t=4.25,P<0.01), autonomous learning ability (t=11.45,P<0.01) and critical thinking ability (t=2.53,P < 0.05) were significantly higher than those of the control group and also improved significantly compared with the pre- teaching. Conclusion Flipped classroom teaching mode can effectively improve students’final exam score, learning attitude, autonomous learning ability and critical thinking ability.

BACKGROUND:Spinal surgery requires a relatively high accuracy. At present, the study of pedicle screw fixation is more focused on the safety and stability, but the premise is the safe and effective screw placement. Selection of the insertion point is the key to success.
OBJECTIVE:To analyze stress distribution of different pedicle screw implantation methods for thoracolumbar fractures by using finite element analysis.
METHODS:T9-L3 segments of a thoracolumbar burst fractures patient were scanned in the Department of Orthopedics, Zhaoqing City First People’s Hospital in January 2015. 616 CT Dicom images were obtained and introduced into engineering software. Finite element geometric model was established. Posterior approach orthopedic surgery was simulated. Stress distribution after pedicle screw fixation for thoracolumbar fractures was analyzed.
RESULTS AND CONCLUSION:(1) The three-dimensional motion range of the fixation with six screws and two rods was small in anteflexion, lateral bending, and axial rotation, followed by five screws and two rods by posterior approach (single right vertebral fixation). The motion range of the fixation with four screws and two rods was biggest, but biomechanical stability was poorest. (2) In different fixation models, upper screw stress was larger in anteflexion than other states in the fixation with four screws and two rods by posterior trans-traumatic-vertebra, four screws and two rods by posterior injured vertebra, six screws and two rods by posterior injured vertebra, five screws and two rods by posterior approach (single right injured vertebra) and six screws and two rods by posterior approach (upper injured vertebra), followed by left axial rotation and right axial rotation. Significant differences in screw stress were found in different motion states (P < 0.05). (3) In different fixation modes, the stress ratio of upper and lower screws was significantly larger in the fixation with four screws and two rods by posterior trans-traumatic-vertebra, four screws and two rods by posterior injured vertebra, six screws and two rods by posterior injured vertebra, five screws and two rods by posterior approach (single right injured vertebra) and six screws and two rods by posterior approach (upper injured vertebra) than other motion states (P < 0.05), followed by right axial rotation and right lateral bending. Significant differences in stress ratio of upper and lower screws were detectable in different motion states (P < 0.05). (4) Results suggested that finite element analysis could better simulate complex spine mechanical system, accurately reflect the stress distribution of spinal pedicle screw model, and provide the basis for making pedicle screw program.

Objective To study ,analyse and applicate improved reagent bottles′efficacy of improving the stability after opening of biochemical reagents .Methods We divided into observation group and matched groups ,the observation groups were biochemical reagents ,compared with common reagents ,and we tested the stability after opening on Na + ,Cre ,Lp (a) ,ALP ,TBA ,etc .using im‐proved reagent bottles by automatic biochemical analyzer ,and observed their experimental results .Results After the examination , the mixed serum′normal figures and pathological figures of Na + 1 were (134 .6 ± 4 .23) mL and (154 .8 ± 5 .54) mL ,Na+ 2 were (129 .1 ± 1 .5)mL and (149 .1 ± 1 .35) mL ,TBA l were (4 .66 ± 0 .43)mL and (36 .67 ± 3 .17) mL ,TBA 2 were (5 .53 ± 0 .21)mL and (41 .67 ± 1 .13) mL ,Cre 1 were (108 .5 ± 5 .9)mL and (336 .8 ± 19 .0) mL ,Cre 2 were (115 .1 ± 1 .9) and (349 .7 ± 4 .12) mL , ALP l were (148 .3 ± 6 .7) and (324 .7 ± 11 .9) mL ,ALP 2 were (153 .6 ± 1 .6) and (331 .2 ± 4 .6)mL ,Lp (a) 1 were (183 .0 ± 5 .4) and (401 .9 ± 21 .4) mL ,Lp (a) 2 were (201 .1 ± 6 .5) and (429 .1 ± 10 .2)mL .Conclusion The improved reagent bottles had obvi‐ous effect on improving the stability and period of validity after opening the bottles of Na + ,Cre ,Lp (a) ,ALP ,TBA ,etc .,if Reagent formula ingredients do not change ,it will not have a negative impact ,the improved reagent bottles can replace traditional reagent bottles and widely used in Automatic Biochemical Analyzer ,will have broad prospects .

Narcolepsy is a common chronic sleep disorder attacking adolescence,characterized by a typical tetrad of excessive daytime sleepiness,cataplexy,sleep paralysis and hypnagonic/hypnopompic hallucinations,affecting both mental and psychological aspects of children.Thus,making an early diagnosis and therapy is of great importance.Clinical diagnosis mainly depends on the multiple sleep latency test across the video electroencephalogram.In this article,we mainly describe the diagnosis and treatment progress of pediatric narcolepsy and clinical value of video-electroencephalogram.

Chronic myelomonocytic leukemia (CMML) is a rare malignant disorder of hematopoietic system.It is classified by WHO as MDS/MPN and many gene mutations are invovled such as RAS,TET2 and CBL.Hypomethylating drugs are effective in the management of CMML and may alter the prognosis.Allogeneic stem cell transplantation is still the only way to cure the disorder.

Risk factors of children with autism is reviewed in this paper,from the genetic and biochemical factors,changes in the structure of the brain,physiological factors,maternal factors were discussed,and these factors in children plays a role in the onset of autism There are some scholars are studying some imprecise factors.

Normal flora of intestine can transit under several clinical conditions,which may result in bacterial translocation and lead to various dysfunctions.Mild hypothermia,as an effective therapeutic method,not only has protective effects on vital organs such as heart and brain,but also impacts bacterial translocation,including intestinal mucosal blood flow,intestinal permeability,production of reactive oxygen species and cytokines.This paper reviewed the researches on the effect of mild hypothermia on intestinal bacterial translocation in recent years.