In Qin Han periods,the long-storaging method for Chinese materia medica(CMM) has been used in traditional Chinese medicine.People have named the Prescription with "chen" in the Song Dynasty,such as "Er Chen Tang".With the traditional Chinese medicine storing and treating with different methods in appropriate period,medicine becomes old medicine from the new,there by,reaching property of a medicine of reducing the poisonous or over-strong property,strengthening the medicine function and processing effect,getting rid of stench taste,increasing fragrant purpose,so as to further consistent with the demands of clinical treatment.By now,this traditional and distinct processing technique is on the verge of extinct.In order to fully reflect the superiority of long-storaged medicine by therapy,it is imminent to conserve,investigate and develop such medicine and such method.We should reinforce to research the changing of its effective component and pharmacology effect before and after processing drugs,discuss the contribution of the long-storaging method on the quality of CMM,so as to make this method applying and developing further.

Objective To investigate nurses' satisfaction to APN scheduling,and analyze the impact of APN scheduling on nurses' work and their families.Methods To investigate the satisfaction of 51 practicing nurses in two sections to APN scheduling using the self-designed questionnaires. Cronbach' s a of the questionnaire was 0.724.Results Satisfaction of the married,highly educated nurses were 69.75％ and 88.89％,respectively; and satisfaction of the unmarried and lower education nurses were 39.29％ and 47.62％ ; the differences were significant ( x2 =4.647,5.098,respectively ; P ＜ 0.05 ).APN scheduling was thought to enhance the cooperation between the nurses,increase the communication chance,strength the amateur time and alleviate the psychological pressure.Conclusions Nurses were more satisfied with APN scheduling than the traditional work schedule.APN scheduling work shifts considered on the nurses' health,family life and their part-time study.This work schedule is humane and scientific,and can help to mobilize the enthusiasm of nurses and stable team of nurses.

Objective To study the prognostic factors of primary duodenal papilla carcinoma.Methods The clinical data of 73 patients with primary duodenal papilla carcinoma who were admitted to the Dongnan Hospital of Xiamen University from June 1995 to June 2005 were retrospectively analyzed.Ten factors including gender,age,jaundice,tumor size,course of disease,total bilirubin,tumor differentiation,lymphatic metastasis,type of surgery and degree of resection were analyzed by Log-rank test.Prognostic factors with significant difference were further analyzed by the Cox regression model.The survival curve was drawn by using the Kaplan-Meier method.Results The median survival time of the patients was 34 months.Age,jaundice,tumor size,course of disease,total bilirubin,tumor differentiation,lymphatic metastasis,type of surgery and degree of resection were correlated with the prognosis (x2 =18.315,4.562,7.989,10.660,11.138,7.995,5.423,114.464,83.383,P＜0.05),while no significant difference was found between gender and prognosis ( x2 =1.720,P ＞ 0.05 ).Multivariate analysis demonstrated that tumor differentiation,type of surgery and degree of resection were the factors influencing the prognosis of patients with duodenal papilla carcinoma (RR =2.039,2.178,5.798,P＜0.05).Conclusions Tumor differentiation,type of surgery and degree of resection are the dependent factors influencing the prognosis of patients with duodenal papilla carcinoma.The standard type of surgery and degree of resection are important for the prognosis of patients.

Objective: To compare the efficacy of moxibustion with different doses for knee osteoarthritis (KOA), and explore the correlation between moxibustion dose and clinical efficacy. Methods: Sixty-eight patients with KOA who met the inclusion criteria were randomly divided into a 20-minute moxibustion group and a 40-minute moxibustion group by the random number table method, with 34 cases in each group. Dubi (ST 35), Neixiyan (EX-LE 4) and Heding (EX-LE 2) were used for moxibustion in the two groups. Each treatment lasted 20 min or 40 min for each point in the 20-minute moxibustion group and 40-minute moxibustion group, separately; the treatment was given 3 times a week and lasted for 4 weeks. The visual analog scale (VAS), Western Ontario and McMaster University osteoarthritis index (WOMAC) and traditional Chinese medicine (TCM) symptom scores were evaluated before and after treatment to compare the efficacy between different moxibustion doses for KOA. Results: After treatment, the total effective rate was 87.5％ in the 40-minute moxibustion group, versus 70.0％ in the 20-minute moxibustion group, and the difference in the total effective rate between the two groups was statistically significant (P<0.05). After treatment, the VAS scores, the total WOMAC scores and the component scores of pain, stiffness and dysfunction, and the TCM symptom scores in both groups all changed significantly when compared with those before treatment (all P<0.05). After treatment, the between-group differences in the VAS score, the total WOMAC score and the component scores of pain and dysfunction, and the TCM symptom score were statistically significant (all P<0.05), while the difference in the stiffness score in WOMAC showed no statistical significance (P>0.05). Conclusion: Either 20-minute moxibustion or 40-minute moxibustion can relieve pain, improve stiffness, dysfunction, and TCM symptoms for KOA; and 40-minute moxibustion is better in relieving pain, improving dysfunction and TCM symptoms.

Objective To evaluate the significance of serum matrix metalloproteinase-3 (MMP-3) and joint ultrasonography in assessing the activity of rheumatoid arthritis (RA) by comparing MMP-3 level and the ultrasonic 7 joints (US7) score in RA patients.Methods Serum MMP-3 level and US7 score were measured in 133 RA patients by immune turbidity and Doppler ultrasound.Synchronous 53 healthy subjects were recruited as controls.Clinical data were collected.Erythrocyte sedimentation rate (ESR),serum level of anti-cyclic citrullinated peptide (CCP) antibody,health assessment questionnaire (HAQ) and disease activity score 28 (DAS28) were measured.The level of disease activity is interpreted as remission(DAS28 ＜2.6),low(DAS 28≥2.6-＜3.2),moderate(DAS 28≥3.2-＜5.1),high(DAS28≥5.1).The discriminating validity of MMP-3 and US7 score in disease was evaluated using receiver operating characteristic (ROC) curve analysis with DAS28 as the reference standard.Results Compared with that in healthy controls [35.20(25.90,48.90) μg/L] and remission patients[33.40(22.60,678.40) μg/L],the MMP-3 level in moderate [105.1 (61.70,172.70) μg/L] and high [363.1 (161.50,475.90) μg/L]groups increased dramatically.US7 score in patients with high disease activity was significantly higher than that in other groups.The level of MMP-3 was significantly correlated with DAS28,HAQ,US7 score,yet did not have correlation with anti-CCP antibody.Serum level of MMP-3 was positively correlated with US7 score (r =0.566,P ＜ 0.001).In evaluating the disease activity,US7 score combined with MMP-3 (AUC 0.863 2) was not superior to MMP-3 alone (AUC 0.854 3),but significantly better than single US7 score (AUC 0.7643,P ＜ 0.05).Conclusions MMP-3 is an effective and simple index in evaluating RA disease activity.The combination of MMP-3 and US7 score does not further improve the efficacy to evaluate disease activity than MMP-3 alone in patients with RA.

OBJECTIVE:To synthesize the aryl-pyridazinone acid and curcumin ester. METHODS:With the raw material of 5-methyl-2-(3-chloro-4-fluorophenyl)-2-oxo-pyridazine acid (compound 1) and curcumin,there was ester-forming in the two sides of a phenolic hydroxyl and pyridazin-6-one carboxyl in curcumin by the catalysis of N,N-dicyclohexyl carbodiimide(DCC)/4- dimethylaminopyridine (DMAP). The targeted product,MS and NMR characterization of the structure were obtained through column chromatographic separation. Single factor was adopted to detect the effect of mixture ratio of curcumin and compound 1,re-action temperature and time and catalyst on the reactions. RESULTS:The productivity of targeted product (aryl-pyridazinone acid and curcumin ester)was 56.3%(in curcumin),the content by HPLC was 98.1%. The optimum conditions were as follows as the mixture ratio of curcumin and compound 1 was 1∶3,reaction temperature was 50 ℃,reaction time was 10 h and the catalyst was DCC/DMAP. CONCLUSIONS:The aryl-pyridazinone acid and curcumin ester is successfully synthesized with stable process.

Objective To evaluate the efficacy of fexofenadine hydrochloride tablets at tapering doses for the treatment of chronic spontaneous urticaria. Methods After receiving evaluation of medical history and undergoing autologous serum skin test (ASST), 80 patients with chronic spontaneous urticaria were randomly divided into two groups:conventional dose group administrating fexofenadine hydrochloride tablets 120 mg/d for 12 consecutive weeks, tapering dose group administrating fexofenadine hydrochloride tablets 120 mg/d for the first 4 weeks followed by dose tapering of fexofenadine hydrochloride tablets by 30 mg at the 5th and 9th weeks. The urticaria activity score(UAS) and dermatology life quality index(DLQI)were evaluated before the treatment(baseline)as well as after 4?, 8?and 12?week treatment, and the total dose of fexofenadine hydrochloride was calculated. Results A total of 76 patients completed the 12?week treatment, including 37 patients in the conventional dose group and 39 patients in the tapering dose group. After 4?, 8?and 12?week treatment, a significant decrease was observed in the UAS in the conventional dose group(0.64 ± 0.82, 0.37 ± 0.68 and 0.27 ± 0.56 vs. 4.08 ± 0.79, all P<0.01)and tapering dose group(0.61 ± 0.87, 0.48 ± 0.72 and 0.28 ± 0.61 vs. 4.07 ± 0.81, all P<0.01)compared with that at baseline in the corresponding groups. DLQI scores also significantly decreased after 4, 8 and 12 weeks of treatment in the conventional dose group(3.62 ± 1.82, 2.81 ± 1.65 and 1.37 ± 1.14 vs. 16.19 ± 3.79, all P<0.01)and tapering dose group(3.79 ± 2.57, 2.74 ± 2.11 and 1.15 ± 1.47 vs. 15.92 ± 4.2, all P < 0.01) compared with those at baseline. However, there were no significant differences in the UAS or DLQI scores between the conventional dose group and tapering dose group at any of the post?treatment time points(all P>0.05). After 8?and 12?week treatment, symptoms were controlled in 71.79%(28/39)and 82.05%(32/39)of patients in the tapering dose group, respectively, with the total dose of fexofenadine hydrochloride being significantly lower in the tapering dose group than in the conventional dose group (both P<0.001). Conclusion After 4- 8 weeks of treatment with fexofenadine hydrochloride, the tapering dose regimen and conventional dose regimen show similar clinical efficacy in patients with chronic spontaneous urticaria.

Two cases of nevus of Ota resistant to multiple sessions of Q-switched laser treatment are reported.Both of the patients were females,who developed beige or blue patches on the left side of the face (zygomatic region,cheek)several months after birth.No conjunctiva or sclera was involved.The lesions spread to the left retroauricular region and posterior neck during pregnancy in one patient.Histopathological examination of the lesions showed scattered melanocytes and melanophages in lower dermis and subcutaneous adipose tissue as well as apparent proliferation of collagen.Immunostaining for CD34 showed no abnormality in the distribution of vascular endothelial cells in these tissues.No obvious improvement was observed in either of the patient after more than 10 sessions(12 sessions in 1 case,and 13 sessions in the other case)of treatments with Q-switched alexandrite(755 nm)or Q-switched Nd:YAG laser(1064 nm).The immediate response of lesions to laser irradiation was unusual.Purpura or errhysis was absent in the lesions after repetitive irradiation with high-energy laser,but both were visible in the adjacent normal skin even after irradiation with low-energy laser.

BACKGROUND: In the field of intervertebral disc tissue engineering, seed cells primarily consist of nucleus pulposus cells (NPCs) and mesenchymal stem cells (MSCs). NPCs have been known to have several shortcomings: limited source, inconvenient collection, poor proliferative capacity, and difficult in vitro culture.OBJECTIVE: To investigate the proliferation of MSCs after co-culture with NPCs in alginate beads-simulated three-dimensional environment.DESIGN, TIME AND SETTING: A cell observation was performed at the Laboratory of Orthopedics, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology between December 2007 and October 2008.MATERIALS: Six healthy New Zealand rabbits of 4 months old were provided by the Laboratory Animal Center, Tongji Medical College of Huazhong University of Science and Technology and were used for the present study.METHODS: Rabbit MSCs were isolated and purified using density gradient centrifugation and adherence methods. Rabbit NPCs were isolated and purified using collagenase Ⅱ digestion and adherence methods. Following liposome-mediated green fluorescent protein tranfection and G418 screening, MSCs of passage 3 were cultured either alone (control group) or with NPCs at a ratio of 1:1 (co-culture group) in alginate beads. After 14 days of culture, alginate beads were dissolved and MSCs were collected by flow cytometry sorting.MAIN OUTCOME MEASURES: The expression of collagen Ⅱ and aggrecan in MSCs was detected by RT-PCR and Western blot techniques.RESULTS: mRNA and protein expression of collagen Ⅱ and aggrecan was observed in the co-culture group, but not in the control group, after 14 days of culture.CONCLUSION: MSC differentiation towards nucleus pulposus-like cells can be induced by co-culture with NPCs in a three-dimensional environment.

Objective To analyze the change of surgical route and range of hysterectomy in the past 10 years.Methods From January 2000 to December 2010,the clinical data of patients with hysterectomy were analyzed retrospectively,including clinical features,surgical path and scope of operation.Results There were 1980 patients.The predominant reason for hysterectomy was leiomyomas (52.88％,1047/1980),adenomyosis (17.78％,352/1980),cervical intraepithelial neoplasia (12.17％,241/1980).The age of the patients with hysterectomy for abdominal,transvaginal and laparoscopic was (46.54 ± 7.35),(58.73 ± 10.49),(44.10 ±5.12) years.In 2000-2005,the proportion of abdominal,transvaginal and laparoscopic proportion were 81.78％ (615/752),8.64％ (65/752) and 9.57％ (72/752).In 2006-2010 were 64.50％ (792/1228),6.51％ (80/1228) and 28.99％ (356/1228).In 2006-2010,the proportion of abdominal significantly decreased and laparoscopic significantly rised compared with those in 2000-2005,there were statistically significant differences (P ＜ 0.01).In 2000-2005,unilateral and bilateral annex removal ratios were 15.43％ (116/752),12.23％ (92/752),in 2006-2010 were 8.63％ (106/1228),7.49％(92/1228).Unilateral and bilateral annex removal ratios in 2006-2010 were significantly lower than those in 2000-2005,there were statistically significant differences (P ＜ 0.01 or ＜ 0.05).Conclusions Over the past 10 years,hysterectomy route and range changed with the percentage of laparoscopic increasing,and concomitant unilateral or bilateral annex removal decreased.