Aim To explore the best way of calculating antihypertensive effect of nifedipine GITS on trough to peak ratio (T/PR), and smoothness index (SI) of the drug from ambulatory blood pressure monitoring (ABPM). Methods 32 cases of mild to moderate essential hypertension patients were enrolled and each was given 30 mg of nifedipine GITS once daily. ABPM was repeated for four weeks. ABPM data were analyzed statistically and T/PR calculated by both individual and whole group way. Results The casual blood pressure(CBP) and ABP were lowered by (24?12)/(12?8) mmHg and ( 14.5 ? 3.9 )/( 11.2 ? 3.0) mmHg .The T/PR by individual way was 0.65 ? 0.23 for SBP and 0.66 ? 0.25 for DBP, while by whole group way 0.62 for SBP and 0.68 for DBP. The smoothness index (SI), a new method for assessing the homogeneity of 24 hour blood pressure reduction by antihypertensive therapy, was 3.74 for SBP and 3.77 for DBP after treatment. Conclusion Nifedipine GITS lowers blood pressure effectively and smoothly for 24 hours long. Antihypertensive effects can be reflected by T/PR and SI.

Objective:To study the standardization path of medical ultrasound equipment management based on total quality management,and to improve the service level of medical ultrasound equipment in clinical diagnosis and treatment activities.Methods:According to the process of medical ultrasound equipment use,the risk nodes were determined,the formation path and damage probability of equipment use risk were analyzed by probabilistic graphical model,and the standardized path of medical ultrasound equipment use was formulated based on time control and standardized use mode.35 medical ultrasound equipment in clinical use in The People's Hospital of Jianyang from 2022 to 2023 were selected,the use and management of 33 medical ultrasound equipment in 2022 were managed in the conventional management mode(33 units),and the use and management of 35 medical ultrasound equipment in 2023(2 new units)were adopted in the total quality management mode.The difference in equipment operation quality,risk ratio and service effect under different modes were compared.Results:The failure rates of medical ultrasound diagnostic equipment,medical ultrasound treatment equipment and other medical ultrasound equipment using the total quality management model were(0.763±0.68)%,(0.833±0.65)%and(0.969±0.64)%,respectively,which were lower than those of the conventional management mode,the difference was statistically significant(t=3.331,5.348,5.940,P<0.05).The proportion of risk problems such as component damage,delayed diagnosis and treatment,resource waste and social impact of medical ultrasound equipment using total quality management mode were(2.023±0.99)‰,(1.569±0.89)‰,(2.541±1.05)‰ and(1.238±0.63)‰,respectively,which were lower than those of the conventional management mode,the difference was statistically significant(t=3.935,3.676,5.699,3.189,P<0.05).The scores of clinicians,nurses,operating technicians,equipment engineers and management personnel involved in the use and management of medical ultrasound equipment were for the service effect of the total quality management model were(95.797±2.13)points,(93.880±2.12)points,(94.605±1.91)points,(91.387±3.20)points and(96.275±1.82)points,respectively,which were higher than those of the conventional management mode,the difference was statistically significant(t=4.536,5.477,6.869,2.943,4.673,P<0.05).Conclusion:The standardized path of medical ultrasound equipment management based on total quality management can improve the operation quality of equipment,reduce the incidence of clinical use risk,and enhance the level of clinical service.

Alzheimer disease(AD),commonly known as senile dementia,is the most common type of dementia,resulting in progressive impairment of cognitive function,and is often accompanied by a variety of psychiatric symptoms,such as agitation.Agitated symptoms in AD patients often cause an increasing burden on caregivers,and current psychiatric medications may exacerbate adverse effects such as cognitive impairment and motor retardation in patients.Therefore,non-drug intervention is a very important adjuvant treatment option.This article reviews the clinical manifestations,possible mechanisms,drug therapy and non-drug intervention measures of agitation in order to provide reference for more effective treatment of AD.

BACKGROUND: The effects of environmental chemical exposure on blood pressure (BP) have been confirmed, but the association between exposure to secondhand smoke (SHS) and hypertension risk and BP in the general population remains unknown. METHODS: Cross-sectional associations between SHS exposure and hypertension risk and BP values were evaluated using data for subjects who participated in the National Health and Nutrition Examination Survey (NHANES), 1999-2016. Logistic regression and linear regression were performed after adjusting for age, sex, race, alcohol consumption, poverty-to-income ratio (PIR), body mass index (BMI), estimated glomerular filtration rate, physical activity, diabetes, cardiovascular disease, and NHANES cycle. Restricted cubic spline models were created to display the potential nonlinear association between SHS and BP levels. RESULTS: Higher risk of hypertension was found at the highest SHS concentrations (OR = 1.13, 95% CI 1.04, 1.24, P for trend = 0.007). Additionally, SHS exposure had a strong positive association with systolic blood pressure (SBP) but was negatively associated with diastolic blood pressure (DBP). Furthermore, the nonlinear model result showed a significant association between SHS and SBP (P = 0.017); however, the nonlinear model result was not significant for SHS or DBP. CONCLUSIONS Our results suggest a potential association between high SHS exposure and the risk of hypertension. Further research is needed to elucidate the underlying mechanisms.
Adolescent ; Adult ; Aged ; Blood Pressure ; China/epidemiology* ; Female ; Humans ; Hypertension/epidemiology* ; Incidence ; Male ; Middle Aged ; Risk Factors ; Tobacco Smoke Pollution/statistics & numerical data* ; Young Adult

OBJECTIVE To evaluate the correlation between the solid dispersion(SD) powder properties and the relative crystallinity(RC) during SD recrystallization. METHODS Andrographolide was used as model drug, polyvinylpyrrolidone K30, polyethylene glycol 8000, Poloxam 188, Soluplus® as carrier materials, 12 SD powders were prepared by three preparation processes, and then the SD powder properties were determined. Afterwards, the principle component analysis and partial least squares analysis(PLS) were used to evaluate the correlation between the SD powder properties and RC during SD recrystallization. RESULTS The correlation model was successfully established by partial least square method between the SD powder properties and the RC. The VIP value of particle size parameter D(0.5) was >1.2, which indicated that the particle size was the key factor affecting the recrystallization of SD powder. CONCLUSION In practical work, SD powder with different particle size parameters can be obtained by different preparation methods or by adjusting the process parameters of the selected preparation method, so as to improve the recrystallization stability of SD.

OBJECTIVE：To study the ef fects of Gegen qinlian decoction （GGQLD）on blood lipid and blood glucose of hyperlipidemia（HLP）model rats ，and to explore its mechanism from the perspective of intestinal flora. METHODS ：Totally 48 rats were randomly divided into blank control group （n＝8）and modeling group （n＝40）. For consecutive 5 weeks，model group was given high-lipid diet to induce HLP model ；blank control group was given routine diet. After modeling ，30 modeling rats were randomly divided into model group ，simvastatin group （positive control ，10 mg/kg），GGQLD high-dose ，medium-dose and low-dose groups （14.85，4.95，1.65 g/kg，by crude drug ），with 6 rats in each group. Blank control group and model group were given constant volume of normal saline intragastrically ；administration groups were given relevant medicine intragastrically ，once a day，for consecutive 11 weeks. At the same time ，each group was continuously given corresponding diet. After the last medication ， body mass and body length of rats were determined ，and Lee ’s index was calculated. Serum levels of TG ，TC，HDL-C，LDL-C and fasting blood glucose （FBG）were determined in rats. DNA of rat caecum content was extracted for 16S rRNA V 3-V4 region sequencing. The Two-part model was used to analyze the correlation between intestinal flora with lipids and blood glucose. RESULTS：After 11 weeks of administration ，compared with blank control group ，the body mass ，body length ，Lee’s index ， serum levels of TC ，TG，HDL-C and FBG of model group were increased significantly （P＜0.05 or P＜0.01），while the level of HDL-C was decreased significantly （P＜0.05）. Compared with model group ，body mass and Lee ’s index and serum levels of TG ， FBG of rats in GGQLD high-dose group ，and serum levels of TC ，TG in GGQLD medium-dose group ，as well as serum level of TG of rats in GGQLD low-dose group was decreased significantly （P＜0.05 or P＜0.01）. Correlation analysis with intestinal flora showed that TC and TG shared 3 operational taxonomic units （OTU），including OTU 559，OTU701 and OTU 135（OTU135 was also shared with FBG ），which were all positively correlated with the level of TC ，TG and FBG （P＜0.01）. The three OTU were annotated as Tyzzerella of Spirillaceae ，Anaerotruncus of Verrucaceae and Peptoclostridium of Streptococcidae ，respectively. High-dose and low-dose GGQLD had a down-regulating effect on Tyzzerella and Anaerotruncus（P＜0.05 or P＜0.01），while had up-regulating effect on Peptoclostridium（P＜0.01）. CONCLUSIONS ：High-dose GGQLD （14.85 g/kg）can effectively reduce the body mass and blood lipid of HLP model rats ，and can prevent the abnormal increase of blood glucose of model rats. The mechanism may be associated with that the reduction of intestinal flora （Tyzzerella，Anaerotruncus）content.