Objective To evaluate the efficacy of estradiol drospirenone treatment on palpitation in postmenopausal women.Methods Retrieved nearly a decade PubMed,Science Direct,EBSCO Host,EMbase,The Cochrane Library,CNKI,Wanfang database,CQVIP.The evaluation methodology included.The researchers rigorously evaluated he quality of the included studies and extracted data,used the Review manager 5.0 software to meet the quality standards of randomized controlled clinical trials (RCT) line system evaluation.Results Thirteen RCTs were included 1 156 patients,506 cases in the control group,650 patients in the treatment group.The results of the evaluation of the system showed:estradiol drospirenone treatment could significantly improve the efficacy of postmenopausal symptoms,compared with hormone therapy [relative risk (RR) =-11.89,95％ confidence interval (95 ％ CI)-13.06--10.72],versus placebo therapy (RR =-12.99,95％CI-14.46--11.52).Conclusion Estradiol drospirenone can significantly enhance the efficacy of postmenopausal symptoms,be worthy of promotion.

Humans ; Pneumoconiosis ; diagnostic imaging ; Radiography, Thoracic ; standards ; X-Ray Film

OBJECTIVE: To identify a suitable polymer system for iguratimod (T-614), a poorly water-soluble compound with high melting point, and prepare a chemically stable single phase solid dispersion (SD) of T-614 by hot-melt extrusion (HME) technique to enhance its dissolution rate. METHODS: Melting method and adsorption based screening techniques were utilized to screen hydrophilic polymers suitable for immediate release formulations. T-614 SDs were prepared with polymer carriers such as PVP/VA 64, Soluplus, HPMC AS-LF and HPC-SL via HME below the drug melting point, and suitable temperature and plasticizer for HME were chosen. The dissolution behaviors of SD powder and SD tablets were compared with those of T-614 powder and commercial T-614 tablets, respectively. State of T-614 in HME SDs was characterized by X-ray powder diffraction. The homogenous SD tablets were analyzed further for physical stability in an influencing factors test. The bioavailability of SD tablets was assessed in rats. RESULTS: Results of the screening studies demonstrated that PVP/VA 64, Soluplus, HPMC AS-LF and HPC-SL provided higher degree of miscibility and dissolution enhancement. The HWE SD tablets showed significantly enhanced dissolution. The supersaturation state of HME SD powder in water was maintained for at least 120 min, suggesting that PVP/VA 64 had an inhibitory effect on recrystallization of T-614 from a supersaturated solution. Samples prepared via HME at 160°C were substantially amorphous, which were unchanged in the influencing factors test at high temperature and strong light, but recrystallization occurred at high humidity. PEG1500 appeared to be a promising plasticizer. Same bioavailability was achieved when compared with commercial T-614 tablets. CONCLUSION: The polymersas carriers for T-614 SD have significant impact on the dissolution behavior and state of T-614. Using PVP/VA 64 as the carrier, hot-melt extrusion is an effective technology for improving the in vitro dissolution of T-614.

AIM:To evaluate the efficacy and safety of methazolamide in treating refractory uveitic macular edema.METHODS: Retrospective self-controlled study was designed.A total of 15 patients (20 eyes) with refractory uveitic macular edema which used methazolamide as adjuvant therapy were enrolled in Shanghai First People`s Hospital from January 2015 to June 2016.The changes of central macular thickness (CMT) and best corrected visual acuity (BCVA) were observed at baseline and 2, 4, 8wk after treatment.We also focused on the incidence of complications and relapse.RESULTS: The CMT was 445.95±154.10μm, 338.83±138.34μm, 251.50±40.20μm, 244.90±35.68μm at baseline, 2, 4 and 8wk after treatment, respectively.The differences among them were statistically significant (F=15.467, P<0.05).The BCVA (log MAR) were 0.40±0.17, 0.28±0.21, 0.19±0.20, 0.18±0.21 at baseline, 2, 4 and 8wk respectively, with a significant difference among them (F=5.208, P<0.05).When the cumulative dose reached to 700mg and 1400mg, no one had methazolamide-related complications;and when it came to 2800mg, 5 patients (33%) had methazolamide-related complication.After the withdrawal of methazolamide 1wk, 1 and 3mo, 3 patients (20%), 5 patients (33%) and 8 patients (53%) relapsed, respectively.CONCLUSION: Methazolamide is beneficial in improving macular edema and vision in 4wk.When the cumulative dose is more than 1400mg, we need pay attention to the complications.After discontinuing methazolamide for 1wk, macular edema relapsed in some patients, and more than half of patients recurred after 3mo.So the patients should be followed closely in 3mo after withdrawal of methazolamide.

Only by working out and implementing scientific and rational developmnent strategies can hospitals contend for the initiative and have a leading edge in the fierce market competition. At present, it is imperative for hospitals to develop the new century-oriented market competition strategy in view of their respective current conditions and circumstances, the talent developnent strategy based on the reform of the personnel system, the strategy of scientific and technological development, and the strategy of the socialization of rear services. Hospital managers ought to promote the construction of their hospitals in light of the above strategies. Nevertheless, in implementing hospital development strategies, it is important to guarantee the continuity and stability of the overall development strategies and not to make unpredictable changes. Only by doing so can the development of hospitals be pushed forward via working out hospital development strategies.

Objective To evaluate the renal involvement and therapeutic effect on ANCA-associated vasculitis(ASV) . Methods Fifty-six cases were diagnosed as ASV from Oct 1997 to Mar 2001. Among them, 21 cases received renal biopsies. According to disease activity and severity, Use following treatment protocols were choosed: (1) double pulse therapy; (2) single pulse therapy; (3) oral prednisone and/or low dose of CTX; (4) blood purification technique and/or immunosuppressive therapy. Remission rate was also analyzed. Results 96. 4% of case suffered with renal involvement. 91. 1% with acute renal failure, 96.4% with severe renal failure, 98. 2% with multiple organs involvement. The mortality was 19. 6% and the remission rate 67. 9%. 12. 5% of cases lost follow-up. ConclusionsRenal involvement is common and serious in ASV patients. Individualized and early therapy, as well as valuable urgent renal biopsy are necessary. To those who have entered ESRD, immunosuppressive agents could be used to decrease the extra-renal complication.

Objective To investigate the value of serum thyroglobulin (Tg) and antithyroglobulin antibody (TgAb) in differentiated thyroid carcinoma complicated with Hashimoto's thyroiditis after thyroid ablation.Methods Serum Tg and TgAb levels and the status of illness in 154 differentiated thyroid carcinoma patients with coexistent Hashimoto's thyroiditis and confirmed pathology after surgery followed by remnant ablation were performed during three years follow up.Tg and TgAb levels were assessed by chemiluminescent immunoassay assay.The cases were divided into three groups (according to the level of Tg):Tg ≤ 1 μg/L group,1 μg/L＜Tg ≤ 10 μg/L group and 10 μg/L＜Tg≤ 100 μg/L group.TgAb＞40 kIU/L was considered as positive,Cox's proportional hazard model was used to analyse prognostic value in different levels of Tg and TgAb for disease-free survival and recurrence.Results Compared with 1 μg/L＜Tg≤ 10 μg/L group and 10 μg/L＜Tg≤ 100 μg/L group,the relative risk in reflecting cancer recurrence (TgAb＞40 kIU/L) in Tg ≤ 1 μg/L group was 27.000 (95 ％ CI 6.727-108.374).The value of TgAb＞40 kIU/L in Tg≤ 1 μg/L group was greatly increased and highly correlated with metastasis.However,In the condition of Tg＞ 1 μg/L,the disease will be based on the level of TgAb.Conclusion The value of TgAb＞40 kIU/L in Tg ≤ 1 μg/L group seems to be the optimal cutoff value correlated with recurrence and metastasis of differentiated thyroid carcinoma.

Objective To systematically review the influence of propofol orsevoflurane on postoperative cognitive dysfunction(POCD) in elderly patients undergoing non-cardiac surgery.Methods Eight databases including Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Pubmed, CNKI, VIP, CBM and Wanfang Database were searched for randomized controlled trials (RCT) about the influence of propofol orsevoflurane on POCD in elderly patients from the time of database establishment to June, 2016.At the same time, the reference materials of included literature were retrieved manually.All data were selected and evaluated by three independent reviewers according to the inclusion and exclusion criterions.RevMan 5.1 was used for the data analysis.Results A total 14 trials were discovered involving 790 elderly patients undergoing non-cardiac surgery.The results of Meta-analysis showed that the eye opening time and extubation time in the propofol group were significant shorter than sevoflurane group[SMDeye opening=-0.83,95%CI(-1.05,-0.61),P<0.05;SMDextubation=-0.85,95%CI(-1.09,-0.62),P<0.05].The MMSE scores at 1,3 and 6 h respectivelyafter the operation were obviously higher than those of sevoflurane group[SMD1h =0.84,95%CI(0.61,1.08),P<0.05;SMD3 h=1.12,95%CI(0.86,1.38),P<0.05;SMD6h=0.61,95%CI(0.40,0.82),P<0.05].One day after the operation,the difference was not significant[SMD1d=0.14,95%CI(-0.03,0.31),P>0.05].Three days after the operation, the values returned to normal levels, and was still higher in propofol group than in sevoflurane group[SMD3d=-0.32,95%CI(-0.56,-0.07),P<0.05] until 7 d [SMD7d=-0.18,95%CI(-0.51,0.15),P>0.05].The odds ratio of POCD incidence between propofol and sevoflurane groups was 0.35 [95%CI(0.21,0.58),P<0.05].Conclusion Propofol may lead to shorter eye opening time and extubation time compared to sevoflurane in elderly patients undergoing non-cardiac surgery.Both groups may lead to POCD, while propofol is a better choice for elderly patients when choosing general anesthesia.

Objective To investigate the effects of desflurane and/or nitric oxide (NO) on the lung injury induced by ischemia-reperfusion ( I/R) during cardiopulmonary bypass (CPB) in children with pulmonary hypertension secondary to congenital heart disease (CHD) .Methods Forty children with CHD and pulmonary hypertension (24 male, 16 female) aged 0.6-3.7 yrs weighing 7.1-11.9 kg undergoing cardiac surgery under CPB were randomly divided into 4 groups ( n = 10 each): group control; group DES; group NO and group DES + NO. The patients were premedicated with oral midazolam 0.5 mg?kg-1. Anesthesia was induced and maintained with fentanyl and vecuronium. Radial artery was cannulated for MAP monitoring and blood sampling. Pulmonary catheter was placed under direct vision after chest was opened. The patients received inhalation of desflurane (1-1.3 MAC) (group DES)/NO (10-20 ppm) (group NO) /DES + NO (group DES + NO) immediately after pulmonary catheterization until the start of CPB. MAP, PAP, peak airway pressure (Ppeak) and compliance of respiratory system (Crs) were recorded at 5 min after induction (T0 ), 5 min before CPB (T1 ), 5 min after start of CPB (T2) and at the end of surgery (T3) . Blood samples were taken at T0 and T3 for determination of methemoglobin (Met-Hb), soluble intercellular adhesion molecule-1 (sICAM-1), XOD and MDA.Results The four groups were comparable with respect to age, M/F ratio, body weight, duration of CPB and type of operation performed. MAP was significantly decreased after inhalation of desflurane alone or desflurane + NO before CPB ( at T1) as compared to the baseline value at T0; while PAP was significantly decreased after inhalation of NO alone or NO+ desflurane before CPB (at T1) as compared to the baseline value. Ppeak was significantly lower while Crs was significantly higher at end of surgery (T3) in group NO and NO + desflurane than in control group. Blood sICAM-1 and MDA concentrations and XOD activity were significantly lower at the end of surgery (T3 ) in group DES, NO and DES + NO than in control group. Met-Hb was significantly increased at the end of surgery (T2) as compared to the baseline (T0) in group NO and DES + NO but was still within normal range. Conclusion Inhalation of desflurane and/or NO can ameliorate the lung injury during CPB in children with pulmonary hypertension secondary to CHD, in addition to inhibit the pulmonary hypertension.

Glaucoma,especially common primary open-angle glaucoma and primary angle-closure glaucoma,shows high genetic heterogeneity. The causing-disease genes known are difficult to explain some glaucomatous cases,and the study on the susceptibial gene of glaucoma do not achieve new breakthroughs. Combined with the newest progression in genetic study of glaucoma,some views were proposed in this paper in order to better understand the updating study of the pathogenesis mechanism.