A chiral high-performance liquid chromatography method was developed for the simultaneous determination of ibuprofen enantiomers in dog plasma. It was used to study the pharmacokinetics in the Beagle dog after intravenous administration of racemic-ibuprofen, S-ibuprofen and R-ibuprofen. Ketoprofen was chosen as the internal standard. After a simple precipitation using methanol as the precipitating solvent, both analytes and IS were separated on a Kromasil 100-5CHI-TBB chiral column (250 mm x4.6 mm, 5 μm) with isocratic elution using acetonitrile - 20 mmol x L(-1) phosphate buffer (pH 3.0, containing 5% methanol) (6 : 4) as the mobile phase. The detection wavelength was 220 nm. Liner calibration curves for both of the ibuprofen enantiomers were over the concentration range from 0.5 to 50 μg x mL(-1) with a lower limit of quantification of 0.5 μg x mL(-1), the accuracies were all in standard ranges. The intra- and inter- assay precisions were all below 7%. The recovery rate was 93.1% to 100.4%. The experiments proved that the method was simple, rapid and sensitive. It can be used in the quantitative determination of ibuprofen enantiomers in dog plasma. The method was used to determine the concentration of ibuprofen enantiomers in Beagle dog plasma after a single intravenous administration of racemic-ibuprofen, S-ibuprofen and R-ibuprofen (9 mg x kg(-1)) and the pharmacokinetics parameters were calculated based on the concentration-time curves. The C(max) of S-ibuprofen in Beagle dog plasma after a single intravenous administration of racemic-ibuprofen, S-ibuprofen and R-ibuprofen were 30.8 ± 4.7, 46.1 ± 5.9 and 20.0 ± 2.6 μg x mL(-1), respectively. In terms of the exposure of active ingredient, it revealed a significant difference between the administration of S-ibuprofen and the other two groups. The systematical R- to S- chiral inversion was discussed. Comparing the pharmacokinetic parameters at different doses, chiral inversion were 70.1% ± 36.6% and 76.4% ± 36.2%, respectively, after intravenous administration of racemic- and R-ibuprofen. This study provides a theoretical basis for the safety of ibuprofen formula of injection drug.

AIM: To elucidate the effect of ginsenoside Rb1 (Gs-Rb1) on the glucose metabolism to improve the viability of the cardiomyocytes under hypoxia, and whether hypoxia-inducible factor 1α(HIF-1α) and/or AMPKαare involved in the process.METHODS: The neonatal rat cardiomyocytes were cultured, and randomly divided into control group, hypoxia (1% O2 , 94% N2 and 5% CO2 ) group, Gs-Rb1 (200 μmol/L) group, Ara-A (500 μmol/L) group, Gs-Rb1 +Ara-A group, YC-1 (5 μmol/L) group, Gs-Rb1 +YC-1 group, Ara-A +YC-1 group and Gs-Rb1 +YC-1 +Ara-A group.After the intervention for 8 h, the cell viability was analyzed by MTT assay.The protein levels of AMPK, HIF-1αand glucose transporter-4 (GLUT-4) were determined by Western blot.The activities of heterophosphatase (HK), phos-phofructokinase (PFK) and lactic dehydrogenase (LDH) were measured by ELISA.RESULTS: Gs-Rb1 significantly im-proved the viability of hypoxic cardiomyocytes, which was significantly inhibited by YC-1 and Ara-A.In addition, YC-1 and Ara-A had a synergistic effect.Gs-Rb1 increased the protein levels of AMPK and HIF-1αin the hypoxic cardiomyo-cytes, which was significantly inhibited by Ara-A and YC-1.Gs-Rb1 significantly increased the expression of GLUT-4 on the cytomembrane of hypoxic cardiomyocytes, which was significantly inhibited by YC-1 or Ara-A, especially Ara-A +YC-1.Gs-Rb1 significantly increased the activities of HK, PFK and LDH, all those were significantly inhibited by YC-1 or Ara-A.Besides, YC-1 and Ara-A had a synergistic effect.CONCLUSION: Gs-Rb1 improves the viability of hypoxic car-diomyocytes, which may be related to the regulation of glucose uptake and enhancement of glycolysis by synergy of both
HIF-1αand AMPK.

Objective To observe the effect of psychological intervention on the anxiety of middle-aged and elderly patients with hypertension. Methods 378 middle-aged and elderly patients with hypertension accepted the intervention (health education and psychological intervention). They were assessed with the Zung Self-rating Anxiety of Scale (SAS) before and after the inertvention. Results The scores of the SAS in patients were higher than the Chinese normal. Female, younger, and higher eduction background were related to the anxiety symptom. The anxiety of the pateints were released after the intervention. Conclusion Health education and psychological intervention is effective on the anxiety of the middle-aged and elderly patients with hypertension at outpatient.

Objective:To analyse the causes of early implantation failure and the therapeutic measures with re-implantation after the failures.Methods:6 cases of implantation failure including early infections,loosening and non-osteointegration were reviewed and trea-ted by re-implantation therapy,and the causes of failure were discussed and the effects of re-treatment were evaluated.Results:2 cases were found to be with infection of adjacent teeth after implantation and were treated by removal of the implant,socket curettage,root ca-nal therapy(RCT)and antibiotics followed by reimplantation.Implant loosening and non-osteointegration were observed in 4 cases, which were treated by the similar methods for the implant socket.Reimplantation was successful in all 6 cases followed-up for 1 -3 years.Conclusion:Preventive measure for implantation failure should include indication selection,control of infections in adjacent teeth and periodontosis,use of GBR technic and so on.Re-implantation following proper treatment of adjacent teeth and the socket of implant is effective for the treatment of implantation failure.

, but the amount decreased significantly. Conclusions Peri-operative nursing can promote the recovery of patients with pelvic floor hernia, rectal prolapse combined with colonic slow transit constipation.

Objective To compare the yield and speed of detection of Salmonella subsp, enterica serotypo Paratyphi A from the blood of patients with suspected paratyphoid fever A. Methods With the BacT/ALERT 3D system and paired aerobic and anaerobic bottles (AEB, ANB) that were each filled with 5 ml of blood, the blood culture of 13 500 suspected paratyphoid fever A patients were performed. Results A total of 4 060 isolates were detected. About 3 149 were detected from both AEB and ANB. Four hundred and sixty-one isolates were detected only from the AEB and 450 were only from the ANB. The detection rates of the AEB and ANB were all 26.7% (χ<'2>=0.023, P=0.880). The increased detection rate attributed to the additional blood volume in the AEB and ANB were 11.3% and 11.1%, respectively. The detection speed differed between the two medium formulations. The time to detection was (23.66±15.89) h and (25.48±16.92) h for3 149 isolates, respectively (t=7.007, P<0.01).The mean time to detection was 31.80±20. 97 for 461 isolates discovered with AEB and (33.45±20.72) h for 450 isolates discovered with ANB. Conclusion The blood volume is an important factor in determining the detection rate of blood culture. Although no statistical difference for positive rate was found between the AEB and ANB, more isolates was detected earlier in AEB.

To implement the effective docking and optimization of a new community comprehensive management information system and cardiocerebrovascular disease-related auxiliary system for a communitybased information platform for intelligent chronic disease management.The cooperation of community team and a distinct division of labors were enforced according to standard operating procedures.This mode of patient-centered medical home (PCMH) could offer scientific and effective management,promote the rational classification of medical and two-way referral systems and improve service efficiency and management capabilities for the goals of achieving a reasonable allocation of medical resources and saving medical costs.

AIM: To observe the levels of triglyceridemia(TG),uricemia(UA),glycemia(GLU),the activity of 3-glyceraldehyde phosphate dehydrogenase(GAPDH) in blood and the gene expression in the liver in the animal model of hypertriglyceridemia,hyperuricemia and hyperglycemia.METHODS: SD rats were randomly divided into three groups,control group,fructose group,fructose and fenofibrate treated group.Rats in control group were fed with standard chow.Rats in fructose group were fed with high fructose diet.Rats in fructose and fenofibrate group were fed with high fructose diet,and treated with fenofibrate 100 mg?kg-1?d-1 by intragastric administration at the same time.Rats in control group and fructose group were given distilled water by intragastric administration.The levels of TG,UA and GLU were detected.Improved method was used to measure the activity of GAPDH.Quanti Gene technology was applied to determine the transcriptional level of GAPDH mRNA.RESULTS: During 7-28 d,the level of TG in fructose group was significantly and persistently high.During 14-28 d,the level of UA was higher.The level of GLU higher than that in control group was only observed at 28th day.The GAPDH activity change in blood and the expression in liver were significantly lower than that in norma1 during 7-28 d.Fenofibrate had the effect on reducing TG only at 7th day and reduced the level of GLU significantly at 28th day.Fenofibrate also increased the GAPDH activity in blood and the expression in liver at 7th day.CONCLUSION: ① The level of TG is significantly and persistently high in the early days by feeding with excessive fructose.The levels of UA and GLU are higher with the time cause of the model development.② The significantly higher level of TG,UA and GLU may be correlated with the reduction of the GAPDH activity in blood and the expression in liver.③ Fenofibrate has the effect of reducing the TG level only in the condition of hypertriglyceridemia,but not in the condition of accompanying hyperuricemia and hyperglycemia.④ The mechanism of reducing the TG level by fenofibrate may be correlated with the increase in GAPDH activity in blood and the expression in liver.

Objective:To investigate the current situation of insomnia in patients with acute coronary syndrome (ACS), and analyze the influencing factors of insomnia in the ACS patients, so as to provide information on the development of new strategies for the treatment of insomnia in ACS patients.Methods:This is a multicenter and prospective observational study. A total of 771 ACS patients who met the criteria were selected from March 2013 to June 2015. The baseline social demographic information, sleep quality questionnaire, general anxiety disorder scale-7(GAD-7),patient health questionnaire-9(PHQ-9), short-form 12 health survey questionnaire(SF-12), and enhancing recovery in coronary heart disease patients social inventory(ESSI) were completed within 7 days after admission. Logistic regression analyses were used to analyze the influencing factors of insomnia in ACS patients.Results:A total of 741 subjects with valid questionnaires were collected, including 510 males (68.8%) and 231 females (31.2%). Among them, 487 (65.7%) subjects had at least one insomnia symptom: 308 (41.6%) subjects had difficulty in falling asleep, 369 (49.8%) subjects were easy to wake at night, 116 (15.7%) subjects woke up earlier than they expected, 74 (10.0%) subjects experienced both woke up earlier and difficulty in falling asleep, and 53 (7.2%) subjects woke up earlier, woke up at night and had difficulty in falling asleep at the same time. Logistic regression analyses showed that before admission physical activity ( OR =0.636, 95% CI 0.411-0.984), depression ( OR=1.908, 95% CI 1.101-3.305) and low social support ( OR=0.278, 95% CI 1.198-3.301) were independent factors of insomnia in ACS patients. Conclusions:Nearly 2/3 ACS patients have symptoms of insomnia. Difficulty in falling asleep and easy to wake up at night are the most common manifestations. Physical activity, depression and social support independently are associated with insomnia.

Objective To access the influence factors of diagnostic delay of endometriosis. Methods We designed a questionnaire of diagnostic delay of endometriosis. From February 2014 to February 2016,400 patients who had dysmenorrhea and diagnosed with endometriosis by surgery in Peking University Third Hospital were surveyed retrospectively. Time and risk factors of diagnostic delay were analyzed.Results The diagnostic delay of 400 patients was 13.0 years(0.2-43.0 years),78.5%(314/400) patients thought pain was a normal phenomenon and didn′ t see the doctor. Patients who suffered dysmenorrhea at menarche experienced longer diagnostic delay than those who had dysmenorrhea after menarche(18.0 vs 4.5 years;Z=191.800,P<0.01).Patients who suffered aggravating dysmenorrhea experienced shorter delay time than those who suffered stable or relieving dysmenorrhea(11.0 vs 12.5 vs 18.0 years;Z=8.270, P<0.05), with the difference statistically significant, single factor analysis shows. Severe dysmenorrhea, deep infiltration endometriosis(DIE), family history of dysmenorrhea or endometriosis, previous surgical history of endometriosis,high stage,with infertility,adenomyoma or other symptoms,could help to shorten diagnostic delay with no significant difference(P>0.05). By multiple logistic regression analysis,the results shown that whether have dysmenorrhea at menarche and clinical diagnosis time were the independent factors affecting delayed diagnosis(P<0.01).Conclusions Diagnostic delay of endometriosis is common and the mean delay time is 13.0 years mainly due to the unawareness of dysmenorrhea. Dysmenorrhea at menarche,clinical diagnosis time and dysmenorrhea intensity are the factors affecting time of diagnostic delay.