Under physiological conditions, many vital functions of the body are controlled by transient release of bioactive substances at a specific time and site. Based on the circadian rhythm character of disease and chronotherapeutic conceptions, pulsatile delivery system has been designed to achieve optimal therapeutic effect and reduce the toxic and side-effect. In recent years, more and more studies are focused on the pulsatile multiparticulate drug delivery system. Pulsatile multiparticulate system possesses many benefits, such as no risk of dose dumping, predictable gastric emptying, flexible release patterns and increased bioavailability. Based on these premises, the aim of this review is to summarize the major design methods of pulsatile multiparticulate and the research progress.

Objective To systematically observe the damage of pancreas and changes of serum amy-lase and lipase in septic rat at different time points after the septic rat model being established. Methods Fifty-four male rats were randomly divided into sham group,sepsis group and normal control group. In the sepsis group,rats were given cecal ligation and puncture so as to produce a model of the rat′s intestinal septic shock. In sham group,after opening the abdominal cavity of the rats,only the cecum was pulled out of the abdominal cavity,then the abdominal cavity was satisfied and stitched. The arterial blood and pancreatic tis-sues of the rats in both sepsis and sham groups were collected for detection of serum amylase and lipase and observation of damage of pancreas by light and electron microscopy at 3 h,6 h,12 h,24 h after the model be-ing established. Results The levels of serum amylase of sepsis group showed a rising trend over time,and peaked at 24 h(2 779. 83 U/L), which showed no difference among 4 time points. There was no significant difference of serum amylase among 3 groups at each time point except for 12 h value. The levels of serum li-pase in both sepsis and sham group were higher than that in normal control group at 3 h(P<0. 05),while de-creased to the level of normal control group at 24 h. By light microscope,pathological changes of pancreas in the sham groups were that lobule was slightly widened; mild interstitial edema,vasodilation and a little in-flammatory cell infiltration were occasionally found;most of the lobular structure was complete. In the sepsis group,pancreatic pathological changes aggravated with time prolonged. Pancreatic lobules gap widened,inter-stitial were infiltrated by the inflammatory cell,flocculus brim structure was fuzzy,focal necrosis was found occasionally,islet structure was complete at 3 h. Pancreatic lobule was significantly wider,more inflammatory cell infiltrated,necrosis enlarged at 6 h,and pancreatic lobule was obvious edema,more inflammatory cell in-filtration and focal necrosis were found at 12 h. Vascular of pancreatic lobule was dilatation and congestion, pancreatic lobule and islet edge blurred,more lobular necrosis at 24 h. The modified Schmidt scoring of sham group and sepsis group at 3 h,6 h,12 h,24 h were 2. 0,3. 6,3. 4,3. 6 and 4. 6,6. 0,6. 8,7. 6,respectively. By transmission electron microscope,the ultrastructure of pancreatic cell in sham group was normal,mitochondri-al and lysosomal swelling were found occasionally. When in the sepsis group,the nucleus was normal,some mitochondria was swelling and cracking, lysosomes was swelling at 3 h, nucleus was complete, a part of swelling mitochondria and lysosomes appeared vacuolated necrosis at 6 h,and karyopyknosis and chromatin condensation were found,more mitochondria and lysosomes were swelling necrosis and vacuolar degenerated, rough endoplasmic reticulum was swelling at 12 h,cell karyopyknosis and chromatin condensation were obvi-ous,a large number of mitochondria and lysosome, endoplasmic reticulum were swelling, dilatation and vacuolar necrosis at 24 h. The modified Schmidt scoring showed no significant correlation with the levels of serum amylase and lipase in sepsis group(r=0. 472,P=0. 199;r=0. 260,P=0. 499). Conclusion The pancreas was damaged in the septic rat. The pathological changes of pancreas were obvious at 6 h after sepsis onset. The characteristics of the pancreas ultrastructure change includes the changes of the mitochondria and lysosome in the early period,clear vacuoles necrosis of mitochondria and lysosome,and destruction of nucleus and the endoplasmic reticulum. There is no significant correlation between pancreatic pathological changes and serum amylase as well as lipase,serum amylase and lipase can′t indicate the extent of pancreas damage in sepsis.

Objective To investigate the relationship between early brain menifestation such as white matter damage and ventriculomegaly detected by magnetic resonance imaging(MRI) and adverse neurodevelopmental outcome in preterm infants.Methods From March 15,2007 to April 12,2011,122 preterm infants accepted MRI examination 8-14 days after birth in Chinese People's Liberation Army 202 Hospital.Totally,115 preterm infants were followed up at 12 months old and mental development index(MDI) and psychomotor development index (PDI) score were measured.MDI＜70 was as mental dysfunction,-84 as borderline dysfunction and-114 as normal; PDI＜70 was as psychomotor dysfunction,-84 as borderline dysfunction and-114 as normal.The relationship between clinical characteristics of preterm infants,MRI abnormalities and neurodevelopmental outcome were analyzed by analysis of variance,LSD and Kruskal-Wallis H test.Results The 122 premature infants included 69 males and 53 females with the median gestational age of 32 weeks(28-36 weeks)and the median birth weight of 2050 g (1270-3110 g).In 24 premature infants with mentaldysfunction,the average gestational age [(28.7 ± 1.7) weeks],birth weight[(1520.1-44.8) g] and 1 min Apgar score (5.5 ± 0.8) were all lower than those in normal infants [n =59,(33.5 ± 2.2)weeks,(2240.4 ± 47.1) g and 7.1 ± 0.8],while the average mechanical ventilation time was longer [(20.4±5.8) dvs (5.6±2.7) d](t=2.37,2.49,2.13 and 2.44,P＜0.05).In 20 premature infants with psychomotor dysfunction,the average gestational age [(27.9 ±± 1.4) weeks],birth weight [(1515.6±43.7) g],1 min Apgar score (5.6t0.5) were lower than those in normal infants [n=62,(33.2±2.4) weeks,(2264.3±42.5) g and 7.2±0.6],while the mechanical ventilation time was longer [(18.2±4.7) dvs (5.3±2.2) d](t=2.28,2.52,2.09 and 2.38,P＜0.05).Among thirteen preterm infants with severe white matter damage,eleven and nine developed mental or psychomotor dysfunction respectively.Among eleven preterm infants with moderate and severe ventriculomegaly,seven and six developed mental or psychomotor dysfunction respectively.The more severe the white matter damage and ventriculomegaly,the higher the incidence of mental (H=16.23 and 14.33,P＜0.05) and psychomotor dysfuction (H =18.63 and 12.69,P ＜ 0.05).Conclusions White matter damage is common in preterm infants.Prognosis of preterm infants with mental and psychomotor dysfunction is related with the degree of white matter damage and ventriculomegaly.

Objective To study the clinical and pathological characteristics, treatment results and prognosis of primary parotid non-Hodgkin's lymphoma (NHL). Methods All of our 21 patients received operative resection first and were histologically comfirmed as having T-cell (intermediate grade) and 20 B-cell lineage (2 high grade, 6 intermediate grade ,12 low grade) including 7 mucosa-associatied lymphoid tissue (MALT) phenotype. Ann Anbor stages were 16 stage Ⅰ E and 5 stage Ⅱ E lesions. All patients were treated by radiotherapy,of them 11 were also given 2～6 cycle chemotherapy. Results The overall 5-year survival rate was 77.0%. All 5 patients who died did so of distant involvement. Conclusions Our data show that MALT lymphoma can be present as a primary paroid NHL,although it is not included in the Working Formulation. Low-dose radiotherapy is of choice in the treatment. Patients with intermediate or high grade NHL should be given multi-modality therapy.

Objective To observe the effect of estrogen on H2O2-induced apoptosis and to explore the mechanism of protection by estrogen.Methods Setting up the experimental model of apoptosis induced by H2O2 in PC12 cells. The viability of cells was assessed by MTT assay. The activity of lactate dehydrogenase was detected by colorimetry. Hoechst 33258 was used as indicator of apoptosis. Apoptotic cells were measured by flow cytometry (FCM) with propidium iodide stain. The activity of caspase-3 was detected by colorimetry. Results H2O2 significantly decreased the viability of cell, increased LDH release and promoted apoptosis as well as caspase-3 activity in PC12. Estrogen markedly reduced these changes. Conclusion Estrogen reduces apoptosis induced by H2O2, and its mechanisms may be explained by inhibition of activation of caspase-3.

Infected pancreatic necrosis (IPN) is a serious complication which may cause organ failure and death in patients with acute pancreatitis. Surgical debridement is an important therapeutic approach for IPN. With the development of evidence-based medicine, more and more high-level evidences emerge for surgical debridement of pancreatic necrosis tissue, and the traditional treatment strategy has also changed. In the era of minimally invasive surgery, whether 'delayed surgery' should still be executed and how to achieve 'delayed surgery' are the research hotspots in the treatment of IPN. Research evidences reveal that the 'step-up' strategy is not the best strategy for all IPN patients, and alternatives should be explored. In addition, the indications, advantages and disadvantages of open surgery, surgical minimally invasive surgery and endoscopic surgical debridement of pancreatic necrosis tissue have been widely discussed in recent years, and no consensus has yet been reached. At present, the personalized, multidisciplinary, and minimally invasive treatment of IPN is still the mainstream development direction. The authors investigate the timing and strategy of surgical treatment for IPN in order to provide theoretical basis for clinical practice.

By analyzing the acupuncture taboos in Neijing (Internal Classic) on clinical application of mind conduction of acupuncture therapy in going against the actual situation, astronomy and others, it is found that the relevant acupuncture taboo implies many subtle mysteries of human body, qi, mind and astronomy, which have not been discovered yet in modern science and are very significant in qi protection. In Neijing, the acupuncture physicians have been highly required in the mind treatment, in which, accurately regulating qi circulation is the target in the treatment. The mind conduction is used for qi circulation to accomplish accurately the reinforcing or reducing in the deficiency or excess condition. All of the taboos are provided to normalize the accuracy of reinforcing and reducing technique of acupuncture therapy and avoid the damage of qi in human body. Hence, those taboos must be obeyed so as to prevent from serious consequence and ensure the safety of this acupuncture therapy.
Acupuncture Therapy ; history ; psychology ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Mind-Body Therapies ; history ; psychology

By analyzing the articles in Huangdi Neijing (Inner Canon of Yellow Emperor), combined with the verification of consciousness in vitro in clinic and modern science, it is found Huangdi Neijing has made special requirements of treating spirit for physicians using spirit-qi acupuncture. The physicians consciously use different methods to motivate the spirit of physician and patients, especially patients, to transform it to the physiological effect of patients, which could minimize the psychological factors that make negative influence on treatment; also the psychotherapy is considered as the most important principle of treating spirit. The reinforcing and reducing methods in later generations, mainly lifting-thrusting twirling method, unintentionally lead patients into a basic or strong status of treating spirit or keeping spirit during the process of achieving stimulation and needle sensation. To partially perform the special role of treating spirit for physicians in Huangdi Neijing on patients could cause the chages including patient-based using spirit to move qi. It not only inspires the body's natural resistance to disease and self-healing, but also motivates the self-protection mechanism of keeping spirit.
Acupuncture Therapy ; history ; instrumentation ; methods ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Needles ; Qi

OBJECTIVETo compare the efficacy between the reducing technique with consciousness conduction involved and the reducing technique by needle rotation of acupuncture in the treatment of lunbar strain of cold damp pattern.

METHODSOne hundred and eight patients were randomized into group A and group B, 54 cases in each one. Ashi points were the main points in the two groups. In the group A, the reducing technique with consciousness conduction involved was applied to ashi points. In the group B, the reducing technique with needle rotation was adopted. Cupping and the irradiation specific electromagnetic wave apparatus (TDP) were used in the two groups as the adjuvant therapy. The treatment was given once every two days, and 10 treatments made one session. The treatment stopped till pain disappeared. The efficacy was evaluated in 1 session of treatment. The numerical rating scale (NRS) and the Oswestry disability index (ODI) were observed before and at the end of treatment. NRS of acupuncture itself was observed at the end of treatment. The recurrence rate was compared between the two groups.

RESULTSThe curative and remarkably effective rate was 87.0% (47/54) in the group A, better than 63.0% (34/54) in the group B (P < 0.01). After treatment, NRS and ODI scores were all reduced as compared with those before treatment in the two groups (both P < 0.01). The results in the group A were better than those in the group B (both P < 0.01). Three months after treatment, the recurrence rate was 3.8% (2/52) in the group A, better than 17.7% (9/51, P < 0.05) in the group B. Pain induced by acupuncture itself was mild in the two groups and NRS score in the group A was lower than that in the group B (P < 0.01).

CONCLUSIONAcupuncture with the consciousness conduction involved is superior to the reducing technique with needle rotation in the treatment of lumbar strain of cold damp pattern, in which, pain induced by acupuncture itself is much milder than that induced by the reducing technique with needle rotation.

Acupuncture Therapy ; methods ; psychology ; Adult ; Aged ; Back Muscles ; injuries ; Consciousness ; Female ; Humans ; Male ; Middle Aged ; Myalgia ; therapy ; Sprains and Strains ; therapy ; Young Adult

Ascites ; etiology ; Child, Preschool ; Enteritis ; complications ; Eosinophilia ; complications ; Female ; Gastritis ; complications ; Humans ; Recurrence