5R-5-hydroxytriptolide (LLDT-8) is a new drug candidate which is in clinical trial treating rheumatoid arthritis. Polymorph screening of the compound was carried out in this study. Polymorph of LLDT-8 was prepared by evaporative crystallization and antisolvent crystallization methods and was characterized by powder X-ray diffraction (p-XRD), infrared spectrometry (IR), differential scanning calorimetry (DSC) and thermogravimetric analysis (TG). It was found that p-XRD patterns, DSC curves, TG curves and IR spectra of the LLDT-8 samples prepared by the above recrystallization methods were all consistent. The 20 of main peaks in the p-XRD patterns appeared at 7.58 degrees, 8.14 degrees, 8.66 degrees, 15.46 degrees, 16.46 degrees, 29.54 degrees, 31.16 degrees and 38.26 degrees, while the infrared absorption peaks appeared at 3 471.3, 2 962.2, 2 887.0, 1 762.6, 1 677.8, 1 432.9, 1 365.4, 1 247.7, 1 080.0, 1 031.7 and 877.5 cm(-1). LLDT-8 was decomposed at 271.2 degrees C based on the determination from DSC and TG. It was showed in single crystal X-ray diffraction study that LLDT-8 crystal was monoclinic with the space group being P2 (1). The cell parameters were found to be: a = 11.460 1 (11), b = 6.320 5 (6), c = 13.028 1 (12), alpha = 90.00, beta = 115.557 (2) and gamma = 90.00. The crystal was a hydrogen-bonded dimmer. The slurry experiments, which were further conducted in solvents with different polarities, confirmed the stability of solid state of LLDT-8 based on the p-XRD determination. The polymorph of LLDT-8 made assurance of its efficacy consistence during its clinical trials.

Three hundred and thirty eight patients with type 2 diabetes mellitus( DM) admitted from January 2006 to June 2009 and 50 healthy subjects (control group) were enrolled in the study. Platelet glycoprotein PAC-1 and CD62P levels were measured in both groups. Compared with control group, plasma PAC-1 and CD62P levels of DM patients increased significantly (P ＜0.01). Patients were divided into three groups according to their urinary albumin excretion rate ( UAER) . PAC-1 and CD62P levels in macroalbuminuria group (UAER≥200μg/min) were significantly higher than those in normoalbuminuria group( UAER <20μg/min) and microalbuminuria group (20μg/min≤UAER ＜ 200μg/min) (both P＜ 0.05). The results indicate that plasma levels of PAC-1 and CD62P, which reflect platelet activation, are the independent risk factors for diabetic nephropathy.

Objective To find out the living condition of the elderly adults and their needs for community bealthcare services so as to provide evidence-based guidance for our govemment. Methods A total of 925 participants aged ＞ 60 years were personally interviewed for questionnaire and ADL scale evaluation. Chi-square test and Kmskal-Wallis H test were used for data analysis. Results The subjects showed relatively lower education level and the illiteracy rate was high. Their marriage was stable and a decreased divorce rate was found. The economic situation was satisfactory. Their life satisfaction was farbeyond the health satisfaction. Most of the elderly did not live with their offspring,although 21.8% could not take care of themselves. The prevalence rate of chronic diseases was 81.5% ,which resulted in more demands for social activities, health consultation, rehabilitation nursing, and home healtheare services in the community. Conclusion They need to pay more attention to physical and mental health of the elderly. A community healthcare system that could provide services in an-all-round way,including medical care, should be established and improved.

Objective To analyze the clinical characteristics of children with cyclic vomiting syndrome (CVS), summarize the clinical experience, and improve the awareness,diagnosis and treatment level of CVS.Methods The clinical data and results of long-term follow-up of the children with CVS were collected and analyzed from 1995 to 2009 in our department.Results Forty-six children were enrolled in the study, including 22 boys and 24 girls.Mean onset age was 4.5 years(ranged from 1 to 11 years)and the mean age at final diagnosis was 8.5 years (ranged from 4.5 to 14.5 years).Sixty-six and seventy-four percent of patients had family history of migraine and motional sickness respectively,whereas 83% patients had triggers.The clinical manifestation of CVS was severe episodic vomiting.The episodes had a rapid onset and sudden ending,persisted for several hours to days,and were separated by symptom-free intervals.The incidental symptoms were pallor, lethargy,intractable nausea,abdominal pain,headache,photophobia and dizzy.Twenty-nine patients diagnosed were followed up for 5 years at average.Five patients were treated with valproate,4 with cyproheptadine, 5 with cyproheptadine and valproate,5 with amitriptyline,cyprohep tadine and valproate,and 3 with cyproheptadine and flunarizine.All treated patients recovered mean 10 months(1.5 months to 2 years) years later and displayed the reduced number of episodes or the severity of episodes except 3 patients.Twenty-eight percent (8/29) of patients progressed to migraine headaches.Conclusion CVS is a relatively common disease in children and awareness of the condition should be increased.CVS should be considered when patients had recurrent vomitting and were completely healthy between the two episodes after excluding other pathological conditions.

Aim To assess the effect of HMG-CoA inhibitors simvastatin on collagen remodeling in rats after myocardial infarction. Methods Myocardial infarction models were induced by ligation of anterior descending coronary artery. 24 hours later the survivals were randomly divided into 3 groups: (1) MI group; (2) 20 mg Sim group(20 mg? kg-1? d-1); (3) 40 mg Sim group(40 mg? kg-1? d-1). Rats with sham ligation formed into Sham group. After 8 weeks, the ratios of LV and RV weight to body weight (RVWI, LVWI) were examined and the collagen content was detected. The type Ⅰ and type Ⅲ collagen volume fraction (CVF) and Ⅰ/Ⅲ ratio in infarcted and non-infarcted zones were examined with PSR dyeing; also the mRNA expressions of type Ⅰ and type Ⅲ collagen in non-infarcted zone (NIZ) were detected with RT-PCR.Results Comparing with Sham group,the RVWI and LVWI in MI group increased significantly. The type Ⅰ CVF and type Ⅲ CVF in NIZ and the Ⅰ/Ⅲ ratio were increased in MI group. The mRNA expressions of type Ⅰ and type Ⅲ collagen in NIZ in MI group were higher than those in Sham group. Comparing with MI group, the RVWI and LVWI in both Sim groups were decreased significantly. The type Ⅰ CVF and type Ⅲ CVF in NIZ and the Ⅰ/Ⅲ ratio were depressed in both Sim groups, and the mRNA expressions of collagens were also lower than those in MI group, but higher than those in Sham group. Conculusion Simvastatin could attenuate the development of myocardial interstitial fibrosis in non-infarction zone to improve myocardial interstitial remodeling in rats after MI.

Aim To study the effect of simvastatin(Sim) on left ventricular remodeling and heart function in rats with myocardial infarction(MI).Methods Myocardial infarction models were successfully induced by ligation of anterior descending coronary artery.24 h later the survivals were randomly divided into 3 groups.① MI group;② 20 mg Sim group(20 mg?kg~(-1)?d~(-1));③ 40 mg Sim group(40 mg?kg~(-1)?d~(-1)).The rats with sham ligation formed sham group.After 8 weeks,hemodynamic parameters,blood serum lipids,the ratio of RV and LV weight to body weight(RVWI,LVWI) were examined.The pathomorphological change and the collagen volume fraction(CVF) were analyzed by PSR dyeing.Results There were no significant differences in values of serum lipids among 4 groups.Compared with sham group,the left ventricular end-diastolic pressure(LVEDP) was increased and left ventricular systolic pressure(LVSP) was depressed significantly in MI group; the RVWI and LVWI and the CVF in border infarcted zone and Ⅰ/Ⅲ ratio were increased in MI group too.Compared with MI group,Sim partially normalized LVSP and LVEDP;abated ventricular weight index;reduced CVF in non-infarction zone in both Sim groups.Conculusion Simvastatin improves LV remodeling and heart function in rats with MI,which is associated with the effect of limiting myocardial hypertrophy and interstitial fibrosis.

Objective To investigate the current status of application of resources on medical exposure in Dongying, China, and to provide fundamental data for setting up the health information management system of occupational radiation diseases and implementing health supervision and management strategies. Methods According to the requirements of monitoring program on radiation health of Dongying in 2021, a general survey was carried out in all medical institutions (other than dental clinics) providing radiodiagnosis and radiotherapy services by the field investigation method using the unified questionnaires and survey content, and a descriptive analysis was conducted on the results. Results There were 92 institutions of radiodiagnosis and radiotherapy in Dongying, 1112 radiation workers who accounted for 5.9% of all workers on duty, including 679 (61.1%) males and 433 (38.9%) females, and 364 pieces of radiation equipment, including 339 for X-ray diagnosis, 8 for radiotherapy, 2 for nuclear medicine, and 15 for interventional radiology. The allocation of personal protective equipment for interventional radiology staff in tertiary hospitals was higher than that in secondary hospitals, in which there were 0.36 and 0.23 pieces of lead-rubber aprons, 0.43 and 0.30 pieces of lead-rubber hats, 0.50 and 0.35 pieces of lead-rubber collars, 0.05 and 0 pairs of lead-rubber gloves, and 0.31 and 0.17 pairs of lead protection glasses per capita, respectively. The allocation rates of lead-rubber collars and lead protection glasses in the nuclear medicine staff were higher than those in the interventional radiology staff, with 0.63 collars and 0.88 pairs per capita, respectively. The annual frequency of medical exposure was calculated to be 864.3 person-times per 1000 population for radiodiagnosis and 5.2 patients per 1000 population for radiotherapy. Conclusion The allocation and application of resources on medical exposure in Dongying is unbalanced, so it is demanded to set up a health information management system of occupational radiation diseases for continuously mastering the application of medical exposure and adopting differentiated regulatory measures such as rating classification in Dongying.

Objective To investigate the prevalence and risk factors of adult chronic kidney disease (CKD) in the Xishuangbanna district of Yunnan province with a big population of minorities. Methods Residents aged 20 years and older in the area of Xishuangbannan were randomly selected by using a stratified, multi-stage sampling method. All the residents were tested for morning spot urine of albumin tO creatinine ratio (ACR) (abnormal≥ 30 mg/g); morning spot urine dipstick of hematufia (abnormal 1+ or greater) was confirmed by urine microscopy (abnormal ＞ 3 red blood cells/HP); and modified simplified MDRD equation for Chinese adult was applied to characteristics, health characteristics (e.g. hyperglycemia, hyperlipidemia and hypertension) and indicators of kidney damage were also examined. Results Eligible data of 5566 subjects were included in the study. The prevalence of albuminuria was 8.06%, hematuria was 4.01% and reduced eGFR was 2.89%. Apart from the repetition among microalbuminuria, hematuria and reduced eGFR, approximately 12.53% subjects had at least one indicator of kidney damage. The prevalence of CKD in stratified subgroups with age, gender, nations and CKD risk factors was coincidence with the Logistic regression results. Age increase, hypertension, byperlipidemia and fasting plasma glucose increase were independently associated with albuminuria; age increase, hypertension were independently associated with reduced renal function; age increase was independently associated with hematouria. Conclusions The prevalence of adult chronic kidney disease is 12.53% in the Xishuangbanna district of Yunnan province. Independent risk factors associated with kidney damage are age, hyperglycemia, hyperlipidemia and hypertension.

Objective To investigate the potential effect of depression on overweight and obesity in Tangshan city .Methods A total of 2 180 subjects were enrolled into this cross‐sectional survey conducted in Kailuan community .Anthropometric measurement and structured questionnaire survey were administered to each subject .Status of depression was assessed by Patient Health Ques‐tionaire‐9(PHQ‐9) .The potential effect of depression on overweight and obesity was analyzed with Logistic regression .Results The average score of PHQ‐9 as well as the prevalence of moderate or major status of depression in people with overweight and obe‐sity was significantly higher than those with normal weight .The multivariate logistic regression showed that the score of PHQ‐9 was a risk factor for prevalence of overweight and obesity (OR=1 .43 ,95% CI:1 .05-1 .95 ,P<0 .05;OR=1 .07 ,95% CI:1 .04-1 .10 ,P<0 .05) .In comparison to the none/mild depression ,moderate and major depression could significantly increase the risk for overweight (OR=2 .28 ,95% CI:1 .49-3 .49 ,P<0 .05 ;OR=3 .47 ,95% CI:2 .06-5 .84 ,P<0 .05) and obesity (OR=1 .22 ,95%CI:1 .03-1 .45 ,P<0 .05 ;OR=1 .81 ,95% CI:1 .44-2 .29 ,P<0 .05) .Conclusion The depression status could contribute to the development of overweight and obesity and the role of psychological elements should be taken into consideration in overweight and obesity management .

Objective To explore the relationship between Adult-onset Still's disease (AOSD) and macrophage activation syndrome (MAS). Methods A total of 78 patients with AOSD who had completed medical information were included in this study. Eleven patients who were diagnosed as rheumatic disease associated hemophagocytic syndrome among 26 patients who had hemophagocytic syndrome with histological evidence consisted of the MAS group. Clinical and laboratory data were analyzed in 78 patients with AOSD and 11 patients with MAS. Results Among 78 cases of AOSD, 9 patients (12%) could be diagnosed as MAS but didn't have hemophagocytic histological evidence. In the 11 MAS cases with hemophagocytic phenomenon, 6 patients fulfilled the diagnostic criteria of AOSD, 2 cases with panniculitis, 1 case with SLE, 1 case of dermatomyositis and 1 case of systemic vasculitis. Logistic analysis showed that splenomegaly (OR =2.13, 95%CI=1.11-3.42), leukopenia (OR=3.57, 95%CI=2.30～4.86), anaemia (OR=0.85, 95%CI=1.03～2.76), thrombocytopenia (OR=2.98, 95%CI=1.17-4.30) and hypertriglyceridemia (OR=1.66, 95%CI=1.02～2.74) were associated with development of MAS in AOSD. Conclusion The development of MAS in AOSD patient is frequent and hemophagocytic histological evidence could be found in severe cases. When splenomegaly and hypocytomsis present in AOSD patients, bone marrow examination should be done and the level of triglyceride and fibrinogen and activity of NK cells should be measured for early diagnosis.