Objective To study the etiology of severe acute pancreatitis (SAP) in Tibetan population at high altitude area.Methods Data of patients with acute pancreatitis (AP) from January 2013 to January 2016 were retrospectively collected.Tibetan and Han patients were selected.According to AP diagnosis criteria, the patients were divided into SAP and non-severe acute pancreatitis (NSAP).Chi square test and multiple Logistic regression analysis were used for data analysis.Results There were 53 Tibetan SAP patients, 98 Tibetan NSAP patients, and 47 Han SAP patients.The results of etiology analysis indicated that the ratios of biliary diseases caused pancreatitis in Tibetan SAP patients, Tibetan NSAP patients and Han SAP patients were 5.7% (3/53), 51.0% (50/98) and 6.4% (3/47), respectively;those alcohol caused pancreatitis were 39.6% (21/53), 10.2% (10/98) and 34.0% (16/47), respectively;those hyperlipidemia caused pancreatitis were 39.6% (21/53), 9.2% (9/98) and 40.4% (19/47), respectively;those drug caused pancreatitis were 1.9% (1/53), 2.0% (2/98) and 2.1% (1/47), respectively;those infection caused pancreatitis were 1.9%(1/53), 6.1%(6/98) and 2.1%(1/47), respectively;those trauma caused pancreatitis were 1.9%(1/53), 5.1%(5/98) and 2.1%(1/47), respectively;those other reasons were 3.8% (2/53), 13.3% (13/98) and 4.3% (2/47), respectively;and those unexplained pancreatitis were 5.7% (3/53), 3.1% (3/98) and 8.5% (4/47), respectively.The ratio of biliary diseases caused pancreatitis in Tibetan SAP patients was lower than that of Tibetan NSAP patients (5.7%, 3/53 vs 51.0%, 50/98), however the ratios of alcohol and hyperlipidemia higher than those of Tibetan NSAP patients (39.6%, 21/53 vs 10.2%, 10/98;39.6%,21/53 vs 9.2%, 9/98), and the differences were statistically significant (x2=31.069, 18.246 and 20.019, all P<0.01).Biliary disease was the independent etiology of NSAP in Tibetan (odd ratios (OR)=20.668, 95% confidence interval (CI) 5.072 to 59.427, P<0.01), but alcohol (OR=16.007, 95%CI 3.700 to 45.654) and hyperlipidemia disease (OR=11.590, 95%CI 2.581 to 33.859) were the independent etiologies of SAP (both P<0.01).There was no statistically significant difference in etiology of SAP between Tibetan and Han (P>0.05).Conclusion The etiology of SAP in high altitude Tibetan people is different from that of NSAP, however there is no difference in etiology of SAP between Tibetan and Han in the same area.

OBJECTIVE: To strengthen the standardized management in dispensary for outpatients,ensure drug quality and medication safety. METHODS: Systemic regulatory system and the operation rules which included the detailed management regulations,work procedure,division of labor of post and management system of different category of drugs etc were established. RESULTS & CONCLUSION: The institutionalization and standardization of the management contributed to the standardization of personnel's behavior,reduction of conflicts between pharmacists and patients,enhancement of patients' trust degree and satisfaction,and the medication safety of patients.

Objective: To evaluate the cytotoxic effect of PEM? induced by HSPgp96 on anti-tumor in vitro. Methods; PEM? separated from mice induced by thioglycolate were divided into three groups randomly: Culture medium in control; LPS-induced group; HSPgp96-induced group. The production of NO, the cytotoxic effect to H22 cells and the morphologic change of PEM? were investigated separately by enzyme method, MTT assay and scanning electron microscope. Results: In vitro, HSPgp96 can increased NO production from PEM? of mice and significantly enhance the cytotoxic effect of PEM? to H22 cells as well as LPS. Conclusion: HSPgp96 can effectively induce the cytotoxic effect of PEM? on anti-tumor in which NO is one of the capital effective molecules in vitro.

Cytarabine nanoparticle was prepared through emulsion polymerization method, and its releasing properties were studied. The results showed that releasing principle complied with biexponential equation and had characteristics of sustained releasing. The pharmacokinetics in rabbits complied with two-department model. Compared with cytarabine injection, cytarabine nanoparticle had prolonged t 1/2beta and MRT and reduced CL, which showed nanoparticle could significantly prolong the retention time of Ara-C and possess significant sustained releasing character.
Animals ; Cytarabine ; pharmacokinetics ; Delayed-Action Preparations ; Drug Compounding ; methods ; Nanoparticles ; Rabbits

Salicylic acid is a kind of active metabolite of aspirin in vivo. In this study, its concentration in plasma was detected by RP-HPLC after twenty four healthy male volunteers were given each a single dose of oral Afenca test and reference preparations. The experiment data were calculated with 3P97 program. The results were analyzed by ANOVA and two- and one-sided t tests. The relative bioavailability of salicylic acid was 105.36% +/- 14.15%; AUC0-T of salicylic acid of test and reference preparations were 103.10 +/- 11.92 micrograms.h/ml and 98.45 +/- 13.49 micrograms.h/ml respectively; Tmax were 1.5 +/- 0.5 h and 1.5 +/- 0.5 h; Cmax were 19.31 +/- 2.47 micrograms/ml and 18.95 +/- 2.49 micrograms/ml. Bioequivalent evaluation of two preparations by analyzing with two- and one-sided t tests showed that the two preparations were bioequivalent on the basis of salicylic acid (t1 > or = t1-0.05(22), t2 > or = t1-0.06(22)).
Administration, Oral ; Adult ; Area Under Curve ; Aspirin ; administration & dosage ; pharmacokinetics ; Cross-Over Studies ; Humans ; Male ; Salicylic Acid ; blood ; Tablets ; Therapeutic Equivalency

Objective:To investigate the correlation between the location and volume of cerebral microbleeds (CMBs) and lacunar infarction (LI) in patients with cerebral small vessel disease (CSVD).Methods:Participants from the CSVD cohort in the Department of Neurology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University from February 2017 to March 2019 were enrolled retrospectively. All participants underwent magnetic resonance imaging scans, standardized clinical assessment and diagnosis. AccuBrain, an automatic brain segmentation and quantification software developed by the Chinese University of Hong Kong, was used to quantitatively analyze the volume of CMBs and white matter hyperintensities (WMHs). Ordered multi-class logistic regression analysis was used to determine the independent influencing factors of LI, and then multiple linear regression analysis was used to investigate the correlation between the volume of deep or infratentorial CMBs (DI-CMBs) and the number of LI. Results:A total of 317 patients with CSVD were included in the analysis, including 214 (67.5%) in the non-LI group, 43 (13.6%) in the single LI group, and 60 (18.9%) in the multiple LI group. The comparison of the three groups showed that older age, male, smoking, drinking, history of previous stroke or transient ischemic attack (TIA), lower levels of high-density lipoprotein cholesterol, larger CMBs and WMHs volume, higher enlarged perivascular spaces (EPVS) grade might be the risk factors for LI. Ordinal multivariable logistic regression analysis showed that male (odds ratio [ OR] 2.058, 95% confidence interval [ CI] 1.084-3.909; P=0.027), previous stroke or TIA history ( OR 1.962, 95% CI 1.089-3.535; P=0.025), larger WMH volume ( OR 8.716, 95% CI 4.034-18.832; P<0.001), higher EPVS grade ( OR 1.915, 95% CI 1.292-2.839; P=0.001), larger DI-CMB volume ( OR 1.022, 95% CI 1.006-1.038; P=0.008) or more DI-CMB number ( OR 1.187, 95% CI 1.005-1.403; P=0.044) were the independent related factors of LI. Multiple linear regression analysis showed that there was a significant correlation between the volume of DI-CMB and the number of LI ( r=0.330, P<0.001). Conclusion:In patients with CSVD, there is a significant correlation between DI-CMBs and LI.

Focusing on the field of palliative care，the Rodgers evolutionary concept analysis method was used to analyze the literature related to good death in the context of Chinese culture.The development history and application，definition and characteristics，influencing factors and their impacts，measuring indicators and tools of the concept of good death were elaborated，and further discussions were conducted.Good death refers to an individual’s peaceful and painless journey towards death，without subjective pain or concern，and calmness under the premise of sufficient longevity，while receiving care and companionship during the process of death from family，especially children and grandchildren，as well as achieving moral fulfilment and transcendence.The characteristics of good death in the context of Chinese traditional culture include the indirect expression of physical and mental pain being “understood” and properly handled，the construction of dying dignity based on virtue rather than autonomy，the emphasis on filial piety and emotional connections in the family，making after-death arrangements and realizing intergenerational inheritance，as well as the emphasis on achieving the integrity of life at the moment of death，which have distinct Chinese cultural characteristics.In the future，the connotation and extension of the concept of good death should be further explored，so as to assist in the development of localized theory and practice systems of good death.

From the perspective of hospice care,focusing on the entire process before and after the occurrence of a death event,taking the interpretation of the concept of death value in hospice care as the starting point,this paper explored the value connotation implied in the process of death from the perspectives of the terminal person,caregivers,and social culture,as well as summarized the characteristics of the death value.Meanwhile,in the current social context of the difficulty in achieving good death due to the shallow understanding of death,this paper analyzed the great significance of the construction of the death value concept in hospice care for improving the personal death quality of the terminal person,promoting the quality of end-of-life,and accelerating the formation of a social environment of good death,with a view to stimulating academic attention to the construction of the death value of terminal person,and providing conceptual reference for improving the quality of hospice care services.

Objective:To compare the early efficacy of direct anterior approach versus posterolateral approach for total hip arthroplasty in elderly patients.Methods:The 48 elderly patients receiving total hip arthroplasty from September 2017 to September 2019 were divided into two groups: DAA group(n=23, 30 hips)receiving direct anterior approach for total hip arthroplasty, and PLA group(n=25, 33 hips)receiving posterolateral approach for total hip arthroplasty in this retrospective study.The operation time, blood loss, length of hospital stay, acetabular abduction angle, anteversion angle, and intraoperative and postoperative complications were recorded and compared between the two groups.The hip function was compared with Visual Analogue Scale(VAS)and Harris Hip Score(HHS).Results:All the 48 patients were followed up for 7-31 months, with an average of 22.8 months in DAA group, and 24 months in PLA group.The operation time was less in PLA group than in DAA group[(49.3±5.7)min vs.(70.3±6.2)min, t=12.22, P=0.00], while the hospital stay was longer in PLA group than in DAA group, with a statistically significant difference[(7.8±1.5)d vs.(5.6±1.3)d, t=-5.40, P=0.00]. There was no significant difference in intraoperative blood loss between the two groups[(173.1±47.9)ml vs.(189.6±48.7)ml, t=1.18, P=0.24]. The VAS and HHS scores were better at 1 month after operation and at the last follow-up than before operation in both DAA and PLA group(all P<0.05). The VAS and HHS scores were better in DAA than in PLA groups( P<0.05)at 1 month after surgery.However, at the last follow-up, there was no significant difference in VAS and HHS scores between the two groups( P>0.05). Conclusions:The early results of direct anterior approach for total hip arthroplasty are satisfactory in patients aged 85 years and older.It has the advantages of less trauma, faster postoperative recovery and shorter hospital stay.

Objective: To observe the effect of moxibustion on the colonic mucosal barrier of rats with ulcerative colitis (UC) induced by dextran sulfate sodium (DSS). Methods: Forty male Sprague-Dawley rats were randomly divided into a normal group and a modeling group, with 20 rats in each group. Rats in the modeling group were subjected to preparing experimental UC models by drinking 4％ DSS for seven consecutive days. Two modeled rats and two normal rats were randomly selected for model identification. After the success of UC model was confirmed, the remaining 18 modeled rats were randomly divided into three groups, a model group, a model + herbal cake-partitioned moxibustion group, and a model + mild moxibustion group, with six rats in each group; the remaining normal rats were randomly divided into three groups, a normal group, a normal + herbal cake-partitioned moxibustion group, and a normal + mild moxibustion group, with six rats in each group. After 7 d of intervention with the herbal cake-partitioned moxibustion or the mild moxibustion, hematoxylin-eosin (HE) staining technique was used to observe the pathological changes of colon tissue under a light microscope; Western blotting and/or immunohistochemical techniques were used to detect the protein expression levels of Occludin, Claudin, junction adhesion molecular 1 (JAM1), mucin 2 (MUC2), and transforming growth factor beta1 (TGF-β1) in rat colon tissue. Results: Compared with the normal group, the colon tissue was severely damaged, the pathological score was significantly increased, and the protein expression levels of Occludin, Claudin, JAM1, MUC2, and TGF-β1 were significantly decreased in the model group (P<0.01); while there were no significant differences in the colonic histopathological score, protein expression levels of Occludin, Claudin, JAM1, MUC2, and TGF-β1 in the normal + herbal cake-partitioned moxibustion group and the normal + mild moxibustion group (P>0.05). Compared with the model group, the model + herbal cake-partitioned moxibustion group and the model + mild moxibustion group showed repaired colon tissue, ulcer healing, significantly reduced pathological score, and significantly increased protein expression levels of JAM1, MUC2, and TGF-β1 (P<0.05); the Occludin protein expression level in the colon tissue of the model + mild moxibustion group was increased (P<0.01). Conclusion: Neither herbal cake-partitioned moxibustion nor mild moxibustion influences the colonic histopathology and intestinal mucosal barrier-related protein expression in the normal rats; both herbal cake-partitioned moxibustion and mild moxibustion can up-regulate the protein expression levels of JAM1, MUC2, and TGF-β1 in the colon tissue of UC rats. Mild moxibustion can up-regulate Occludin protein expression. This may be a mechanism of moxibustion in reducing colonic mucosa inflammation in UC.