Extremely severe pancytopenia induced by low dosage of azathioprine in systemic lupus erythematosus patients is rare. A 40-year-old Chinese female was diagnosed with systemic lupus erythematosus. She suffered worse erythema, oral ulceration, raised erythrocyte sedimentation rate and high anti-dsDNA in August 2013. Then she was initiated on oral azathioprine 50mg/d and extremely severe pancytopenia was seen in September 2013. She was recovered by a series of treatments. Regular monitoring of blood counts is highly recommended to reduce the possible serious myelosuppression induced by azathioprine.

OBJECTIVE:To explore the development status of regulatory policies of biosimilars in foreign countries,and to provide reference for perfecting biosimilars regulatory policies in China. METHODS:Comparative analysis was conducted,con-cerning biosimilar regulations and directories which had been issued by WHO,EMA and FDA,in aspects of biosimilars definition, the choice of reference drug,quality studies,non-clinical studies,clinical studies. RESULTS & CONCLUSIONS:Three common points found in foreign regulatory policies were that:firstly,discrepancies were allowed between biosimilars and reference drugs;secondly,the comparison was itemized between biosimilars and reference drugs on safety and effectiveness,in order to guarantee the reliability of quality research;thirdly,clinical and non-clinical studies were reduced with a premise that similarity is confirmed. Given China's current situation,several parts of policies should be improved,including stressing pertinence of reference drug selec-tion,refining preclinical and clinical study directories and establishing supporting system after listing.

The status of anesthesia and psychotropic substances use for cancer pain control was analyzed in 355 cancer patients in Huanggu District of Shenyang City.The results revealed that patients aged 60 and above accounted for 62.8％ of the total; the 5 leading diseases were lung cancer ( 132 cases,37.2％ ),colorectal cancer (34 cases,9.6％ ),liver cancer (33 cases,9.3％ ),stomach cancer ( 31cases,8.7％ ) and pancreatic cancer (20 cases,5.6％ ).There was no significant difference in constituent ratio of disease categories in the last 4 years ( x2 =18.75,P ＞ 0.05 ).The daily oral dose of morphine sulphate was 60 - 200 mg with an effective rate of 91.5％ (325/355). The side effects including constipation,nausea,vomiting and itching can be effectively reduced by prophylactic medication.

Total 150 patients with chronic pelvic pain syndrome were randomly divided into three groups with 50 cases in each group. Patients were treated with tamsulosin, Qianlie'an Shuan and tamsulosin plus Qianlie'an Shuan for 12 weeks, respectively. Patients were assessed with the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) before and after treatment. The score of NIH-CPSI decreased from 25. 1 ± 2. 2 to 19. 5 ± 1.7 after treatment in tamsulosin group; 25.0 ± 2. 2 to 19. 1 ± 1.7 in Qianlie'an Shuan group, and 24. 8 ± 1.7 to 16. 8 ± 1.4 in combined therapy group, all P ＜0. 01. The results indicated that tamsulosin, Qianlie' an Shuan or combined therapy were all effective in alleviating the symptoms and improving the quality of life, and the combined therapy was superior to single therapy in relief of symptoms.

Objective　To investigate the changes of free calcium distribution in hepatocytes after administration of phenylephedrine. Methods The changes of fluorescence intensity were observed by confocal laser scanning microscopy after administration of phenylephedrine alone or pretreated with phentolamine before phenylephedrine administration. Results　The fluorescence intensity increased rapidly after administration of phenylephedrine to hepatocytes. When liver cells were pretreated by phentolamine before phenylephedrine administration, the changes of fluorescence intensity not obvious. Meanwhile, the inconformity of the fluorescence intensity in hepatocytes suggested the existence of the second subarea of free calcium distribution. Conclusion　Ca2+ signal can be arisen by phenylephedrine via the α-receptor in hepatocytes in vitro. The distribution and dynamic changes of free calcium in hepatocytes display some characteristics.

OBJECTIVETo explore the effect of Danlou Tablet (DT) on arrhythmia model rats induced by transient myocardial ischemia/reperfusion (I/R).

METHODSTotally 45 healthy Wistar rats were randomly divided into 3 groups, the sham-operation group, the model group, and the DT group, 15 in each group. Rats in the sham-operation group and the model group were administered with distilled water by gastrogavage at the daily dose of 0.1 mL/kg. Rats in the DT group was administered with 0.53 g/mL DT suspension by gastrogavage at the daily dose of 0.1 mL/kg. All medication was lasted for 10 successive days. The myocardial I/R experiment was performed at 1 h after the last gastrogavage. ECG was performed before ligation and at I/R. The jugular arterial blood pressure of all rats was measured during the whole course. ST segment changes were observed at each time point of I/R. The ventricular fibrillation, the premature ventricular, the number and the duration of ventricular tachycardia within 30 min reperfusion were also observed. Activities of Na(+)-K+ ATPase and Ca2+ ATPase in the myocardium homogenate were detected as well.

RESULTSThe jugular arterial blood pressure and the heart rate were slightly lower in the DT group than in the model group, but with no statistical difference (P > 0.05). Compared with the sham-operation group, the degree of ST segment was obviously elevated in the model group at 0, 5, and 7 min (P < 0.05). It was significantly lower in the DT group than in the model group (P < 0.01). ST seg ment was more elevated at 5 min than at 0 min in the model group, but the degree of ST segment elevation was still obviously lower in the DT group than in the model group (P < 0.05). There was no statistical difference in the degree of ST segment elevation at 7 min between the two groups (P > 0.05). At 0 min when the decrement of ST segment exceeded one half the ischemia, there was no statistical difference in the degree of myocardial ischemia between the model group and the DT group (P > 0.05). Compared with the model group, the incidence of fatal and nonfatal ventricular fibrillation, the frequency and duration of ventricular tachycardia and premature ventricular beats were obviously lessened, and activities of Na(+)-K+ ATPase and Ca(2+)-ATPase increased (all P < 0.05).

CONCLUSIONSDT could significantly protect arrhythmias induced by transient I/R. Its effect might be related to lowering the degree of myocardial ischemia, and increasing ion transport channel related enzyme activities.

Animals ; Arrhythmias, Cardiac ; drug therapy ; etiology ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; Male ; Myocardial Reperfusion Injury ; complications ; Rats ; Rats, Wistar

Objective To explore the risk factors of newly emerging advanced schistosomiasis patients in endemic areas.Methods The study areas were selected in two counties of Dongting Lake regions and a 1 :2 match case-control study was designed.Sixty schistosomiasis patients,who newly evolved into advanced schistosomiasis from 2006 to 2007,were selected into the case group,and 120 cases with chronic schistosomiasis into the control group.Questionnaires including potential risk factors of advanced schistosomiasis were designed and the information was collected based on face to face interviews.SPSS 12.0 was used to analyze the simple factors and multi ones (logistic regression) attributable to the development of advanced schistosomiasis.Results The history of hepatitis B (OR = 10.729),models of water contact (OR = 3.919) ,yearly exposure days to the infested water (OR = 5.457) and times of chemotherapy in the nearly 10 years(OR = 1.578) were the risk factors of development of advanced schistosomiasis.The times of examinations with positive schistosome eggs were protective factors.No association was found between yearly income,education degree,times of checking for schistosomiasis,times of examination with sera positive results and the emergence of advanced schistosomiasis.Conclusion The high frequency of exposure to the infested water,repeated infections,incomplete diagnosis and treatment are the risk factors of advanced schistosomiasis.The concurrent infection with hepatitis B is associated with the acceleration of development of advanced schistosomiasis.

To explore the model of the standardized training for health management talents by referring to the standardized training for resident-doctors.This article analyzed the necessities of the model of the standardized training for health management talents from two aspects.After that,it elaborated on the significance of standardized training.At last,it proposed some ideas about constructing the standardized training for health management talents.

Objective To investigate the diagnosis and treatment of tumor of the head of pancreas(THP). Methods The clinical data of 277 cases of THP were restrospectively reviewed. All patients were diagnosed by US,CT, gastroenteric barium meal and /or operation. A comparison was made in 80 cases , who underwent pancreatoduodenectomy were divided into group A(41 patients operated during1982-1995) and group B(39 patients operated after January,1996) . Results 194 patients underwent surgical treatment,including explore laparotomy in 28,bilioenterostomy or T tube drainage in 86,pancreatoduodenectomy(PTD) in 80.Among 80 cases treated with PTD, the operation time,blood loss volume and blood transfusion volume during operation, and serious postoperative complication occurring rate in group A were significantly higher than those in group B(all P 0.05 ).The follow up results were as follows:the average survival time was (4.07 ?1.80) months in patients with bile external drainage, and (8.28 ?2.31) months in hepatojejunostomy,(P

Objective To compare the efficacy and safety of novorapid and novolin R in the treatment of patients with gestational diabetes.Methods From September 2014 to October 2015,the clinical data of 58 patients with gestational diabetes in our hospital were retrospectively analyzed.According to the drug used,the patients were divided into two groups.The observation group was given novorapid,and the control group was given novolin R.Before and after treatment,the total effective rate,fasting blood glucose (FBG),2h postprandial blood glucose (2hPBG),average blood glucose control time,body mass index (BMI),alanine transaminase (ALT),aspartate aminotransferase (AST),serum creatinine (SCr),urea nitrogen (BUN) and the frequency of hypoglycaemia,insulin dosage,the pregnancy outcome were compared between the two groups.Results After treatment,the FBG [(5.14±0.39)mmol/L],2hPBG[(7.06±1.25)mmol/L] of the observation group were significantly lower than those of the control group (t=11.72,5.67,all P＜0.05).ALT[(25.27±8.71)U/L],AST[(27.98±8.53)U/L],SCr[(69.92±11.39)μmol/L],BUN[(5.23±5.75)mmol/L] of the observation group had no obvious differences compared with the control group (t=0.14,0.07,0.04,0.30,all P＞0.05).The total effective rate (93.10％),average blood glucose control time (3.06±0.43)d,insulin dosage (36.15±4.72)U/d of the observation group were significantly better than those of the control group (χ2=4.35,t=14.30,4.92,all P＜0.05).The incidence rates of pregnancy-induced hypertension (3.45％),amniotic fluid (6.90％),cesarean delivery (17.24％),macrosomia(3.45％),high blood bilirubin(3.45％) of the observation group were significantly lower than those of the control group(χ2=5.22,5.50,4.08,9.09,7.73,all P＜0.05).Body weight [(70.6±3.09)g],BMI[(23.9±0.28)kg/m2] of the observation group were better than those of the control group(t=2.20,12.19,all P＜0.05).The incidence rate of hypoglycemic events in observation group(17.24％) was significantly lower than that of the control group(χ2=5.47,P＜0.05).Conclusion Compare with novolin R,the treatment effect of novorapid for gestational diabetes is remarkable and has high security,it is worthy of clinical implementation.