As the repeated emergence of accounting communication distortion and criminal behaviors among accounts,the absence of accounts′ professional ethics is drawing increasing attention from the general public.The professional ethics absence is partially related to the imperfect self-discipline of accountants.However,self-discipline by its own can never solve the absence of accounts′ professional ethics to some extent.Certain social factors are also responsible,which are analyzed in this thesis,aiming to provide a welcoming external environment for the improvement of professional ethics among accountants.

Objective To establish a liquid chromatographic-mass spectrometric method ( LC-MS/MS method ) for determination of dextrorphan in human liver microsome. Methods LC-MS/MS was adopted with carbamazepine serving as an internal standard.The separation was performed on Agilent ZORBAX XDB-C18 column (2.1 mm×50 mm, 3.5μm), with mobile phase consisting of 0. 05% formic acid methanol-0. 05% formic acid in gradient elution. Dextrorphan and carbamazepine were detected on multiple reaction monitoring(MRM)mode by transitions from precursor to production(m/z 258.1→199.1, 237.1→194.1). Results The linear range of dextrorphan concentration was 19.22-768 960 ng.L-1(r=0.999 8), and the lowest quantification limit was 19.22 ng.L-1.The relative recoveries were 94.02%-98.74%, and the RSDs of intra-day and inter-day were within 10%.IC50 of psoralen on CYP2D6 was 0.6μmol.L-1. Conclusion The LC-MS/MS method is proved to be rapid, sensitive and reproducible, psoralen is a strong inhibitor of CYP2D6.

OBJECTIVE To investigate the pathogenic change and bacterial antibiotic resistance in lower respiratory tract infection in inpatients of chronic pulmonary heavt disease(CPHD) for recently 3 years and to provide reference for clinical treatment.METHODS Retrospective analysis was conducted on sputum cultivation from CPHD patients who were hospitalized from Jan 2004 to Dec 2006.RESULTS A total of 772 pathogenic strains were isolated,60.1 % of which were Gram-negative bacilli.Pseudomonas aeruginosa,Klebsiella Pneumoniae,Escherichia coli and Acinetobacter baumannii were the main Gram-negative pathogens.Gram-positive bacilli accounted for 13.7%,most of which were Streptococcus pneumoniae,Staphylococcus aureus and so on.Fungi accounted for 26.2%.Imipenem/cilastatin sodium was the most sensitive drug for P.aeruginosa,Acinebacter and Enterobacteriaceae.And vancomycin hydrochloride was the most for S.aureus.Their multiple drug-resistance to anti-microbial agents was serious.CONCLUSIONS Gram-negative bacteria are the majority of the pathogens from CPHD of lower respiratory tract infection in hospital.The pathogens show multiple drug-resistance in drug sensitive test.It is suggested that there be urgent need for surveillance of bacterial resistance and rational use of anti-microbial agents during the clinical therapy.

Objective To establish a method to determine genotoxic impurities in saxagliptin bulk drug. Methods The gas chromatography(GC) was carried out with INNOWAX capillary column. The inlet temperature was 120°C. The injection volume was 5 µl and separation ratio was 1:10. The column temperature was programmed: the initial temperature was 70°C, maintained for 1 min, raised to 190°C with a rate of 16 °C/min, and then maintained for another 5 min. The detector was flame ionization detector(FID), with temperature of 250°C. The carrying gas was N2 with the flow rate of 1 ml/min. Methanol was used as solvent for saxagliptin. Results Methyl mesylate, ethyl mesylate and isopropyl mesylate could be separated completely with good linear relationship between 2.44- 36.6, 2.38-35.7 and 2.46-36.9 µg/ml, respectively. The average recovery was 96.94%, 95.96% and 105.47%(n=9), respectively. Conclusion This method is simple, reproducible and accurate enough for the determination of genotoxic impurities in saxagliptin bulk drug.

AIM:To explore the protective effect of ischemic preconditioning on myocardial capillary bed. METHODS: Anesthetized open-chest dogs in ischemic preconditioning (IP) group ( n =6) were subjected to 5 min ischemia and 5 min reperfusion for 4 times in left descending coronary artery (LDA) while the dogs in sham-operated (SO) group ( n =6) were observed for 40 min without any stimulating. Myocardial contrast echocardiography (MCE) was performed before the surgery, at the end of the first and the fourth ischemia and reperfusion period, respectively. Myocardial samples in ischemic area were obtained for capillaries ultrastructure examination and their quantitative analysis was conducted by corresponding imagine analyzing system, then compared within group and between control group. RESULTS: (1) Comparing fourth 5 min ischemia with first one, the percents of area defect in minimum (AD min%) by MCE decreased from 32.6%?5.7% to 21.8%?5.2%( P

[Objective]To study the academic characteristics of the diagnosis and treatment of measles in FENG's Secret Book of Medicine,so as to provide schemes for the diagnosis and treatment of measles.[Methods]Taking the section of measles in FENG's Secret Book of Medicine as the main object of the study,the article systematically studied the characteristics of FENG's diagnosis and treatment of measles by combining the relevant contents in Inner Canon of Huangdi,Yi Guan and some other writings.[Results]FENG Zhaozhang was one of the physicians who systematically studied measles earliest in the history of Chinese medicine.In terms of diagnosis,he judged the severity of the disease by color,shape,location of the erythra and general condition of the patient,and differentiated measles from febrile diseases,smallpox and other diseases.In terms of treatment,he agreed with the predecessors on treating measles by cooling and diffusing,and he specialized in dissipating excessive stagnation of fire and eliminating fire by diaphoresis and purgation respectively.However,he clearly pointed out that the pathogenesis of measles was not only fire in lung and stomach,but also deficiency in spleen,stomach and Mingmen,and treating deficiency syndromes should always be based on strengthening the vitality,which had corrected the abuse of cooling and diffusing medicine in the treatment of measles through the ages.In addition,FENG's experience of nursing and treating pregnancy combined with measles was also of significance.[Conclusion]FENG Zhaozhang was well-experienced in the diagnosis and treatment of measles,and established complete theories,methods and prescriptions,which provided theories and methods for the diagnosis and treatment of measles,and was of significant value.

OBJECTIVETo discuss the therapeutic effects of electroacupuncture on benign prostatic hyperplasia and the impacts on hormone levels in the patients.

METHODSSixty patients were randomized into an electroacupuncture group and a medication group, 30 cases in each one. In the electroacupuncture group, electroacupuncture was applied to Zhongji (CV 3) and Qugu (CV 2), once a day, 5 times a week. In the medication group, tamsulosin hydrochloride sustained-release capsules were prescribed for oral administration, 0.2 mg, once a day. The duration of treatment was 6 weeks in both of the two groups. The changes in serum testosterone (T), estradiol (E) and E/T, the international prostate symptom score (IPSS) and its erectile function score (ⅡEF5) and serum prostate specific antigen (PSA) as well as the adverse reactions were observed before and after treatment in the two groups. The clinical therapeutic effects were compared between the two groups.

RESULTSBefore and after treatment, the differences in serum T, Eand E/T were not significant in the electroacupuncture group (all>0.05); the difference in E/T was significant in the medication group (<0.05). The differences in serum T, Eand E/T were not significant between the two groups (all>0.05). IPSS was reduced as compared with that before treatment in the electroacupuncture group (<0.05) and was not different significantly as compared with that before treatment in the medication group (>0.05). The difference was significant in comparison of the two groups after treatment (<0.05), and the electroacupuncture group was better. After treatment, the symptom severity was reduced apparently in the electroacupuncture group and the overall situation was better than that in the medication group (<0.05). ⅡEF5 score and PSA were not different significantly before and after treatment in the two groups and between the two groups (all>0.05). The total effective rate was 60.7% (17/28) in the electroacupuncture group, apparently better than 30.8% (8/26,<0.05) in the the medication group.

CONCLUSIONSElectroacupucnture at Zhongji (CV 3) and Qugu (CV 2) apparently relieves the symptoms in the patients and the therapeutic effects are better than the oral administration of tamsulosin hydrochloride sustained-release capsules, but electroacupuncture has not apparent impacts on serum T and Elevels.

OBJECTIVETo explore the syndrome factors of leukoaraiosis patients with mild cognitive impairment (LACI), thus providing evidence for syndrome typing.

METHODSThe prospective schedule was adopted including 103 LACI patients (as the LACI group) and 100 leukoaraiosis patients without mild cognitive impairment (as the control group). Syndrome factors were extracted from the patients' symptoms with frequency statistics and factor analysis.

RESULTSFifteen common factors were extracted from the LACI group, and 12 common factors from the control group. After analyzed the distribution of syndrome factors in the LACI group, the most common factors were ranked as follows: yang deficiency (33.98%), phlegm (22.33%), yin deficiency (19.42%), qi deficiency (10.68%), fire (9.71%), blood deficiency and blood stasis (3.88%). As for the control group, the most common factors were ranked as follows: yang deficiency (31.00%), qi deficiency (27.00%), yin deficiency and fire (24.00%), blood deficiency and blood stasis (12.00%), phlegm and yang deficiency and blood deficiency (6.00%).

CONCLUSIONSThe main syndrome factors of LACI were yang deficiency, phlegm, yin deficiency, and fire. The secondary syndrome factors were qi deficiency, blood deficiency, and blood stasis. It was mainly involved with Shen and Pi, with secondary organs as Gan and Xin. Deficiency syndrome is its pathogenesis. Phlegm and fire, and other pathological factors are essential for its development and aggravation, with more syndrome factors accompanied in complex condition.

Aged ; Aged, 80 and over ; Case-Control Studies ; Cognition Disorders ; diagnosis ; Female ; Humans ; Leukoaraiosis ; diagnosis ; psychology ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Prospective Studies

Objective To establish the pipeline and evaluate the feasibility of high-throughput sequencing method used in the detection of severe pneumonia pathogens.Methods Clinical control study was used.Bronchi alveolar lavage fluids (BALF) samples from 76 patients with severe pneumonia (treatment group) and 18 patients with tracheal malacia (control group) and without clinical detected pathogens were collected during March 2015 to December 2016 in Shenzhen Children′s Hospital.The pathogens in the samples were detected using clinical tests and high-throughput sequencing respectively.The results of high-throughput sequencing were confirmed by real-time quantitative PCR and the high-throughput sequencing method used in the detection of severe pneumonia pathogens was evaluated.The χ2 test was used to analyze the correlation of detection rate between the high-throughput sequencing group and the non high-throughput sequencing group.Results The pipeline and method of high-throughput sequencing used in the severe pneumonia pathogens detection was established.The pipeline included sample collection, DNA extraction, library construction, sequencing, and bioinformatic analysis.In 76 cases of patients with severe pneumonia, the results of high-throughput sequencing in 66 cases of bronchoalveolar lavage fluid specimens were positive.The sensitivity was 86.84%, which was significantly higher than the total sensitivity of traditional clinical detection methods including bacterial culture, immunofluorescence and quantitative PCR(68.42%,52/76),χ2=7.426,P<0.001.A total of 13 pathogens were detected in 66 positive samples of high-throughput sequencing, including Mycoplasma pneumoniae, Streptococcus pneumoniae, Haemophilus influenzae and adenovirus, etc.Nine kinds of pathogens were detected in these samples through non-high-throughput sequencing.In the experimental group, the results obtained by clinical test and high-throughput (80.26%) were entirely consistent in 61 samples and not completely consistent in 15 samples (19.74%) specimens.These inconsistent results were mainly concentrated in the detection of adenovirus, Streptococcus pneumoniae and Haemophilus influenzae through high-throughput sequencing, whereas clinical cultures and immunofluorescence methods were not able to detect these pathogens.PCR validation showed that there was no significant difference between the results of high-throughput sequencing and the PCR tests (χ2=0.517,P=0.472), and the difference between the results of high-throughput sequencing and traditional clinical detection methods was statistically significant (χ2=11.671,P<0.001).Conclusion The method for the detection of severe pneumonia pathogens based on high-throughput sequencing is highly sensitive and can detect unknown pathogens, which is superior to those used in traditional clinical detection.

AIM: To study glucagon-like peptide-1(GLP-1)analogues(liraglutide)in patients with mild to moderate nonproliferative diabetic retinopathy(NPDR)and the clinical efficacy of retinal neuroprotection.

METHODS: Sixty patients with type 2 diabetes mellitus with mild or moderate NPDR were treated in our department of endocrinology. They were randomly divided into two groups. Patients in the experimental group used metformin, insulin combined with liraglutide to regulate blood glucose, while the control group used metformin, insulin for hypoglycemia. Comparing the two groups of patients before and after the treatment, including HbA1c and pattern visual evoked potential(P-VEP)P100 amplitude and P100 latency, full field electroretinogram(F-ERG)oscillatory potentials(Ops)total amplitude, and light and dark adaptation 3.0 the amplitude of the a-, b-wave varies.

RESULTS: After 6mo treatment, the total amplitude of Ops in the experimental and control groups increased compared with that before treatment. The difference was statistically significant(all P<0.01). And the total amplitude of Ops in the experimental group was higher than that of the control group, the difference was statistically significant(P=0.049). Meanwhile the b-wave amplitudes of the light and dark adaptation 3.0 in the experimental group were higher than those in the control group(P=0.001, P=0.014); however, there was no statistical significance in a-wave amplitude between the light and dark adaptation 3.0 in both groups after treatment(P=0.505, 0.441, 0.193, respectively). the b-wave amplitudes of the experimental group with dark and light adaptation 3.0 increased compared with that before treatment, and the difference was statistically significant(P<0.01, P=0.019). The a-wave amplitude of light and dark adaptation in the experimental group increased compared with that before treatment, but the difference was not statistically significant(P=0.130, 0.147).

CONCLUSION: GLP-1 analogues can improve the function of retinal neurons in patients with mild to moderate NPDR to a certain extent, and have a positive effect on the prognosis of DR.