Objective: To make an impersonal evaluation on the effect of TCM on main biochemical indexes of non-alcoholic fatty liver disease (NAFLD),including ALT,AST,GGT,TC,TG,and HDL-C.Methods: We searched all the randomized controlled trials (RCTs) of TCM for NAFLD from CBM, CNKI,and VIP (1999-2008).RevMan4.2 was used in the analysis. Results: 11 RCTs,including 1078 patients,met the inclusion criteria.All of the trials were not adequate in methodological quality. None of them was double-blinded trial.The result of analysis showed that compared with basic Western medicine,TCM could increase the content of HDL-C,reduce the content of ALT,AST,GGT,TC and TG.Conclusion: The present meta-analysis suggested that TCM was beneficial over Western medicine for NAFLD which indexes including ALT,AST,GGT,TC,TG,and HDL-C.But we can not make a final conclusion due to low quality of RCT.

OBJECTIVE:To explore the necessity of developing pharmaceutical services on the retailed pharma?cy.METHODS:The current state of the pharmacy retailers in China and the necessity of developing pharmaceutical services on the retailed pharmacy were analyzed.RESULTS&CONCLUSION:Only through developing specialized pharmacy services actively can the pharmacy retailer strengthen their competitive ability in the pharmacy market.

Purpose To evaluate the diagnostic values of Clusterin, CXCL13, Podoplanin (D2-40), CD21 and CD35 in follcular den-dritic cell sarcoma. Methods The expression levels of 10 cases of follcular dendritic cell sarcoma ( FDCS) and 12 types of FDCS mimics (83 cases in total) were investigated by immunohistochemical methods, the latter including solitary fibrous tumor, leiomyosar-coma, gastrointestinal stromal tumor and others. The diagnostic validities of the five biomarkers were compared. Results ( 1 ) The positive rates of Clusterin, CXCL13, D2-40, CD21 and CD35 in the FDCS group were 100%, 70%, 60%, 90% and 80%, respec-tively, the corresponding rates in the control group were 30%, 4%, 11%, 2% and 0 in turn. (2) The five biomarkers could be cate-gorized into 3 groups, according to their diagnostic values in FDCS. The first group included CD21 and CD35, which had much higher sensitivities (90%, 80%), specificities (100%, 98%) and accuracies (98%, 96%), compared with the other biomarkers. The second group included CXCL13 and D2-40, which had a relatively lower sensitivities (70%, 60%), specificities (96%, 89%) and accuracies (94%, 86%), compared with CD21 and CD35. The third group included Clusterin, which had the highest sensitivity (100%), while the specificity (70%)and accuracy (73%) were inferior to the first and second groups. (3) The diagnostic values of CD21 and CD35 combination were 100%, 98%, 98%, 83% and 100%, respectively. Conclusions (1) CD21 and CD35 are the most valuable biomarkers for FDCS. The combined diagnostic effect of the two markers is generally superior to that of single marker. (2) Clusterin has the highest sensitivity for FDCS. However, the frequent expression in FDCS mimickers restricts its diagnostic values for FDCS. (3) CXCL13 and D2-40 may be used as a marker for FDCS, but are not recommended as the first selection based on their diagnostic performance. (4) On the reasons that FDCS mimickers may not uncommonly express Clusterin and D2-40, and rarely show positivity for CD21 or CXCL13, more attention should be paid to the phenomenon to avoid misdiagnosis.

Objective To build a simulation model for outpatients queuing,using data from a general outpatient cardiovascular clinic of a general hospital in Shanghai and different rules in the process.The study employs time-interval controlled mode for appointment registration,for the purpose of analyzing characteristics of different queues.Methods Extraction of data of the clinic in a given month by means of HIS system to determine the parameters of the queuing models.Building the simulation model with Matlab to develop the plan of mixed queues and that of discrete queues,for analyzing the waiting time variations,with different number of doctors on duty and different number of appointments in one time interval.Resnlts In the Monday mornings for example,the mean waiting time of appointments or no-appointments are calculated by simulation with different queuing rules,different number of doctors on duty and different appointment quantities of one time interval.Conclusion The mean waiting times of appointments and no-appointments can be both sizably cut short by means of time-interval controlled appointment; different queuing plans are recommended for different departments; the simulation model should be further verified and optimized in practice.

Objective To summarize the diagnosis and treatment experience of the pancreatic fistula secondary to abdominal operations.Methods The clinical data of 27 patients with pancreatic fistula due to abdominal operations were analyzed retrospectively.Results 25 patients were diagnosed by the amylase concentration of the drainage fluid and 2 patients were diagnosed by the percutaneous puncture fluid amylase concentration.Four patients underwent percutaneous puncture drainage by BS-guide.Five patients underwent re.operation drainage.Enteral feeding,total parenteral nutrition,total parenteral plus oral nutrition were applied to 15,6 and 6 patients,respectively.Altogether 3 patients died,all of these patients were in the total parenteral nutrition group.13 cases were discharged with draining tubes,including 2 patients who developed Dseudocyst and received surgical treatment,and the others 1 1 patients were discharged with tubes for(9.0±3.2)months.The mean hospital stays for oral feeding,jejunum tube nutrition and total parenteral nutrition groups were(36.3±10.2)d,(57.6±17.3)d and(63.3±33.4)d,respectively;and difference was statistically significant(F=3.49,P=0.049).The mean hospital stays for patients with or without somatostatin treatment were(53.5±20.3)d and(51.5 ±21.0)d,and difference was not statistically significant(t=0.207,P=0.838).Conclusions hereasingthe understanding ofpancreaticfistula,adequate drainage and rational nutrition phyed a key role in impmving the treatment effects of pancreatic fistula.

Objective To investigate parenteral nutrition and enteral nutrition therapy for esophageal cancer patients nutritional status improvement.Methods Totally 63 patients with esophageal cancer were chosen,preoperative Nutritional Risk Screening 2002 (NRS2002) nutritional screening through joint after parenteral nutrition and enteral nutrition therapy.Patients with intestinal tolerability and complications after surgery on days 1 and 7 days nutrition indicators were observed,including total serum protein,albumin,prealbumin,hemoglobin,and lymphocyte count.Results Preoperative risk malnutrition occurred in 39 patients.Compared to patients on day 1 after the first 7 days,serum levels had no significant difference in total protein.Albumin,prealbumin,hemoglobin,and lymphocyte counts were significantly different statistical significance (P ＜ 0.05).Conclusions NRS2002 for nutritional screening patients at risk of malnutrition can be determined,and the combined parenteral and enteral nutrition therapies can improve nutritional status of patients with esophageal cancer.

OBJECTIVETo study the therapeutic effect of Angelica Injection (AI) in treating acute cerebral infarction (ACI).

METHODSOne thousand four hundred and four patients, who were treated with AI (692 patients in Group A), compound salvia (390 patients in Group B) and low molecular dextran injection (322 patients in Group C) respectively. Indexes such as CT scanning on infarcted volume, scoring of clinical neuro-function deficit taking on the 1st, 3rd, 7th, 15th and 25th day, clinical therapeutic effectiveness evaluated by the end of the 2nd week and the improvement of Barthel index scores were observed.

RESULTSThe total effective rate in Group A, B and C was 78.7%, 63.6% and 59.3% respectively, that in Group A was significantly higher than in the other two groups (P < 0.05). The improvement of neuro-function deficit scores and Barthel scores in Group A were better than those in Group B and C (on the 25th day, P < 0.01), and the decrement of infarcted volume in Group A was larger than that in Group C (P < 0.01).

CONCLUSIONAI has evident therapeutic effect in treating ACI.

Aged ; Aged, 80 and over ; Angelica sinensis ; chemistry ; Cerebral Infarction ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Phytotherapy

?AlM: To analyze and study the changes of intraocular pressure ( lOP) , visual field and P-ERG on patients with big cup/disk (C/D) in 24h.
?METHODS: A total of 120 cases ( 240 eyes ) diagnosed with big C/D (C/D>0. 3) were divided into group A (C/D<0. 6, 67 cases, 114 eyes ) and group B ( C/D≥0. 6, 73 cases, 126 eyes). Forty cases (80 eyes) with small C/D (C/D≤0. 3) were chosen as control group. All cases underwent 24h lOP examination, vision examination of 30-2 SlTA - standard static threshold and pattern electroretinogram ( P-ERG) examination. The differences between the examination indexes of the three groups were analyzed.
?RESULTS:There was no significant statistical difference in the 24h average lOP (P>0. 05) among the three groups, while the amplitudes had significant statistical differences (P<0. 05). Compared with the control group, the lOP amplitudes of group B were obviously higher, and the difference was of statistical significance (P<0. 05). ln terms of static threshold visual fields, the mean deviations (MD) and pattern standard deviations (PSD) of the three groups had significant statistical differences ( P < 0. 05 ). Comparison between every two groups:compared with the control group, the MD and the PSD were significantly increased in group B, and the difference was of statistical significance (P<0. 05); while there was no significant statistical difference in group A (P>0. 05);Compared with group A, the MD and the PSD were significantly higher in group B, and the difference was of statistical significance (P<0. 05). ln terms of P-ERG examination, there was no significant statistical difference in P50’s latent periods among the three groups (P>0. 05), but there were significant statistical differences in amplitudes (P<0. 05). Comparison between every two groups: compared with the control group, the P50’s amplitude was significantly decreased in group B, and the difference was of statistical significance (P<0. 05), while there was no significant statistical difference in group A (P>0. 05); Compared with group A, the P50’s amplitude of group B was significantly lower, and the difference was of statistical significance (P<0. 05).
?CONCLUSlON: When the patients’ C/D is no less than 0. 6, there are obvious changes of 24h lOP, static threshold visual field and P-ERG’s P50 wave. For patients with big C/D, a single lOP examination is far from sufficient, so an in-depth visual function examination should be performed. Meanwhile, it’s feasible to regard C/D 0. 6 as a screening criterion for suspected glaucoma.

Objective: To observe the effects of acupuncture at the Governor Vessel acupoints plus language training on the language function and cerebral blood flow in patients with motor aphasia after ischemic stroke. Methods: Eighty-six patients were randomized into a control group and an observation group, with 43 cases in each group. Conventional symptomatic treatment was offered to both groups. Besides, the control group received language training, while the observation group received language training plus additional acupuncture at the Governor Vessel acupoints. Before and after treatment, the aphasia battery of Chinese (ABC) and Chinese functional communication profile (CFCP) were tested, and the mean velocity (Vm) and resistance index (RI) of the left middle cerebral artery (MCA) were detected. Results: The total effective rate was higher in the observation group than in the control group (P<0.05). After treatment, the observation group gained higher scores in oral expression, comprehension, repeating, naming objects, reading, and writing, as well as the general score of ABC (all P<0.05), higher than those in the control group (all P<0.05). The CFCP score increased in both groups after intervention, showing significant intra-group differences (both P<0.05), and the CFCP score was higher in the observation group than in the control group (P<0.05). After treatment, Vm of the left side MCA increased in the control group (P<0.05), while no significant change was observed in RI (P>0.05); in the observation group, Vm of the left side MCA increased and RI decreased significantly compared with the baseline (both P<0.05), and were markedly different from those in the control group (both P<0.05). Conclusion: Acupuncture at the Governor Vessel acupoints plus language training can produce valid efficacy in treating motor aphasia after ischemic stroke; it can notably improve the language function, everyday oral communication ability, and increase cerebral perfusion of the patients.

Objective To investigate the expression of granulocyte-macrophage colony-stimulating factor (GM-CSF) and its associated mechanism during the wound healing. Methods The animal model with the full-thickness skin injury was used in the study. Fifty male mice were involved in the study and divided randomly into control group (n = 25) and GM-CSF group (n = 25). Each group had five time points (5 mice per time point). All the mice received full-thickness skin defect (1 cm × 1 cm) through the panniculus camosus on the midline of the back near the neck after anesthesia. Recombinant human granulocyte-macrophage colony stimulating factor (RhGM-CSF) gel (10 μg/cm2) were applied in the GM-CSF group and gel matrix without RhGM-CSF applied in the control group. The wound healing time and rate were observed at days 3, 5, 7, 10 and 14 after injury. The wound specimens were collected to detect the histopathological change. The microvessel density of the wound was counted based on the results of CD31 immunohistochemistry. RT-PCR was employed to detect the expression changes of GMCSF, platelet-derived growth factor (PDGF) , vascular endothelial growth factor ( VEGF) and stromal cell derived factor-1 (SDF-1). Results RT-PCR results showed that the gene expression of GM-CSF reached the peak at day 3 after injury (P＜0. 01) and kept the high level at days 3-10 after injury (P＜ 0. 05) , followed by a sharp decrease to a normal level at day 14 after wound. The wound healing time was average (2.4 ±0. 3) days earlier than the control mice after application of rhGM-CSF, with significant increase of the wound healing rate during 7-14 days after injury ( P ＜ 0. 05 ). In the GM-CSF group, the early histology of trauma wound showed a small number of neutrophils, obvious epithelial cell proliferation in the wound margin, marked hyperplasia of the granulation tissue, high cell density with quantity of spindle-shaped and oval-shaped cells and increased number of new blood vessels. The microvessel density was also increased significantly (P ＜ 0. 05) at days 7-14 after injury. The gene expressions of VEGF and SDF-1 were significantly increased at day 7 and day 10 respectively after injury (P＜0.05) and the gene expression of pro-healing factor PDGF was significantly increased in every time point (at days 5, 7 and 10,P＜0.05;at day 14,P＜0.01). Conclusion GM-CSF expresses highly in the early stage after injury and can promote the wound healing, when the mechanism may relate to the up-regulated expressions of pro-angiogenic factors and pro-healing growth factors.