Objective To predict the potential targets of apigenin by virtual screening .Methods The targets preliminarily forecast by PharmMapper ,were validated by associating data mining and Autodock Vina in PyRx 0 .8 .Subsequently ,receptor‐ligand interactions were analyzed by Discovery Studio 3 .5 .Results The virtual screening by PharmMapper indicated that apigenin coupled well with the disease‐related targets including insulin receptor ,estradiol 17‐beta‐dehydrogenase 1 ,and cathepsin K .According to the data mining ,insulin receptor was found in related experimental researches ,while the other two had few reports previously .And then ,the interactions between apigenin and the target proteins were analyzed by Autodock Vina and Discovery Studio Visualizer 3 .5 ,involving hydrogen bonds ,electrostatic forces ,van der Waals forces etc .Conclusion The most potential targets of apigenin were insulin receptor ,while 17‐beta‐dehydrogenase 1 and cathepsin K were also possible .

OBJECTIVE:To evaluate the efficacy and adverse effects of paroxetine alone or in combination with small dose of doxepin for somatization disorder.METHODS:280 patients with somatization disorder were randomly assigned to receive paroxetine alone or in combination with small dose of doxepin for 8 weeks.Clinical global impression scale(CGI)and symptom check list(SCL-90)were used to assess the efficacy,and treatment emergent symptom scale(TESS)was used to assess the adverse effects.RESULTS:After treatment for 8 weeks,CGI score showed the total effective rate was 87.5% in the patients treated with paroxetine alone versus 93.8% in those treated with paroxetine in combination with small dose of doxepin(P0.05).CONCLUSION:Paroxetine in combination with small dose doxepin showed better efficacy for somatization disorder yet without increasing adverse effects as compared with paroxetine alone.

Objective:To explore grouping methods of subdividing adjacent diagnosis related groups(DRGs) by introducing patient clinical complexity level(PCCL) principle and provide references for exploring DRG grouping method in line with context in China.Methods:Clinical complexity level of each complication was assigned by clinicians.PCCL model was selected to calculate the scores of clinical complexity cases.Each adjacent DRG was subdivided into DRG groups by classification and regression trees(CART) model.The rank-sum test was applied to test the statistical significances of the grouping results.Results:9 surgical adjacent DRGs were subdivided into 18 DRG groups.There were statistical significances in the differences of hospitalization expenses and length of stay among different DRG groups in each adjacent group.Conclusion:PCCL model showed high performance in DRG subdivision.The unification of the quality of medical records and coding were the key factors to ensure the reasonable grouping results.

Objective To evaluate the rationality, safety and efficiency of the time-limited rescue angioplasty following thrombolytic therapy in acute myocardial infarction (AMI).Methods Among the patients within 6 hours from the onset of symptoms of AMI, forty-four cases (group A) underwent primary coronary angioplasty and fifty-eight cases (group B) underwent firstly intravenous thrombolytic therapy. According to clinical early reperfusion indication within 90 minutes following thrombolytic therapy, group B was divided into two subgroups, the patients with early reperfusion (subgroup C) underwent delayed interventional examination 7～10 days after AMI and that with non-reperfusion (subgroup D) underwent rescue angioplasty. The reperfusion rates and complications in different groups were analyzed and compared. Cardiac function (left ventricular ejection fraction, LVEF) was evaluated by echocardiograph 4 weeks after AMI. Results The results showed that the rate of reperfusion, in group A, was 95.45% (42/44),that of subgroup C was 32.76 % (19/58) within 90 minutes following thrombolytic therapy (16 of subgroup C underwent delayed interventional examination and 12 of them underwent PTCA+stent) and that of subgroup D was 97.43% (38/39); There were no serious complications that occurred in subgroups C and D. The LVEFs in group A, subgroups C and D were not significantly different, but there was a significant difference between reperfusion within 6 hours and beyond after AMI (62.7% vs 56.8%, P

Nutrition support includes three parts: supplementation, support, and therapy. When? and how? to use nutrition support which should be related with clinical outcome of the patients. Parenteral nutrition became widely accepted in the States since the presentation at American College of Surgeons Congress 1967 by Dudrick et al. More detail study of baby growth and development receiving all nutrients exclusively by vein from Wilmore et al 1968. In China, it was Jiang et al reported the clinical applications of parenteral nutrition at Surgical Congress of Chinese Medical Association 1978. Enteral elemental diet and parenteral nutrition for intestinal fistulae illness by Jiang et al 1979 which enrolled by Medline. Although nutrition support has become a standardized technology in China, but evidences on improving the patients' outcomes were still insufficient. After Kondrup et al estsblished Nutritional Risk Screening 2002 tool, the nutrition support could use an evidence-based approaching with outcome. One prospective cohort study based on hospitals in Baltimore and Beijing, using Nutrition Risk Screening 2002 as the tool, have evaluated the impact of nutritional support (both parenteral and enteral nutrition) on the infective complications among patients at nutritional risk and demonstrated that the overall incidence of complications was significantly lower in patients who had received nutritional support, which was achieved mainly due to the decline of the incidence of infective complications. Therefore, support with appropriate nutrients being necessary for patients at nutritional risks or already with malnutrition. However, more cohort studies and randomized controlled studies with larger samples are still required.

Objective To investigate the relationship of iPTH levels, calcium and phosphorus metabolism with cardiovascular event status in the chronic renal failure (CRF) patients. Methods This article retrospectivly studied the clinical and laboratory data of 87 CRF patients. 66 patients of A group didnt occur cardiovascular events,and 21 cases of B group occurred cardiovascular and cerebrovascular events. This article analyzed iPTH levels,serum calcium, phosphorus, calcium and phosphorus product and therelationship between cardiovascular and cerebrovascular events between the two groups. Results Decreased iPTH,increased serum C reactive protein and increased lipoprotein(a) had relationship with cardiovascular and cerebrovascular events in patients with chronic renal failure,but calcium,phosphorus,calcium and phosphorus product has nothing to do with the cardiovascular and cerebrovascular events. Cardiovascular and cerebrovascular events increased significantly in dialysis patients than in non - dialysis patients. Conclusiou Chronic renal failure patients on dialysis levels of serum iPTH, CRP level, LP(a) level and dialysis could lead to cardiovascular and cerebrovascular events.

Hypoxia exists in a wide range of advanced solid tumors and is often associated with poor prognosis.Hypoxia can enhance tumor invasion, promote tumor angiogenesis, impact genomic stability and change the tumor microenvironment by activating expression of relevant genes through hypoxia-induced factors (HIFs).Hypoxia provides favorable conditions for tumor metastasis and relapse, and it is involved in all aspects of tumor development.The study of hypoxia in tumors may provide useful information for pre-clinical evaluation, individualized treatment and clinical prognosis.Positron emission tomography (PET) is a non-invasive imaging method, which can be used for assessing and quantifying tumor hypoxic microenvironment.This article reviews the mechanisms of hypoxia-induced tumor biological behavior changes and the research progress of the application of radiotracers for PET imaging of tumor hypoxia.

Idiosyncratic adverse drug reactions (IDR) induce severe medical complications or even death in patients. Alert structure in drugs can be metabolized as reactive metabolite (RM) in the bodies, which is one of the major factors to induce IDR. Structure modification and avoidance of alert structure in the drug candidates is an efficient method for reducing toxicity risks in drug design. This review briefly summarized the recent development of the methodologies for structure optimization strategy to reduce the toxicity risks of drug candidates. These methods include blocking metabolic site, altering metabolic pathway, reducing activity, bioisosterism, and prodrug.

From August 6 to 8, 2010, the 23 rd "Nutritional risk, malnutrition, nutritional support, outcome, and cost-effective" workshop was held in Beijing. There were 30 participants from Beijing, Tianjin,Chongqing, Chengdu, Kunming, Guiyang, Guangzhou, Songyuan, Weifang, Guilin, Urumqi, Qingdao, Yueyang, and Qinhuangdao. The workshop has 2 sections. Section 1: Learn the published papers from ( 1 ) Jie B,Jiang ZM, Nolan MT, et al. Impact of nutritional support on clinical outcome in patients at nutritional risk: a multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals. Nutrition, 2010, (9); (2)Braga M, Gianotti L. Preoperative immunonutrition: cost-benefit analysis. JPEN J Parenter Enteral Nutr,2005, 29 ( 1 Suppl): S57-S61; and ( 3 ) Jiang ZM, Wilmore DW, Wang XR, et al. Randomized clinical trial of intravenous soybean oil alone versus soybean oil plus fish oil emulsion after gastrointestinal cancer surgery. Br J Surg, 2010, 97 (6): 804-809. Section 2: Discuss two protocols for cohort study and for randomized clinical trial (RCT). The cohort study is to continue the investigations of the impact of nutritional support for inflammatory bowel disease (IBD) on outcome and cost/effectiveness, and the RCT protocol is to plan a new protocol about the impact of fish oil on postoperative outcome and cost/effectiveness. The second protocol also asked Professor Kondrup to join with as the co-principal investigator. At the pilot period, the fish oil study is an open RCT because the costs of nutrients need to be paid by patients himself (herself). To apply the support for nutrients is on the schedule. The 24th workshop will bo held on December 17-19, 2010 in Beijing.

Artery cannulation is one of the clinical skills that should be mastered by the internships of anesthesiology. In consideration of its invasiveness,teachers should carry out the clinical teaching strictly and patiently,and assist the internships to establish a correct opinion on clinical practice. We should train the internships step by step,improve their success rates on artery cannulation and avoid complications as far as possible.