The randomized controlled trials (RCTs) of treating diabetic nephropathy (DN) with alprostadil and valsartan were collected from CNKI,Wan fang date,VIP,PubMed,Embase,and Cochrane Library.The selected data was analyzed with RevMan 5.1 software.The effect of combination of valsartan and alprostadil in treating DN was evaluated.In 19 RCTs,675 cases were co-treated with alprostadil and valsartan and 670 were treated with valsartan.The results indicated that 24 h urine microalbumin excretion [WMD =-53.23,95％ CI (-67.55,-38.91),P＜0.01] and24 h urine protein[WMD=-0.38,95％ CI(-0.69,-0.07),P=0.02] in patients treated with combination of valsartan and alprostadil were reduced more markedly than in those treated with valsartan alone.There was no significant difference in blood urea nitrogen [WMD =-0.791,95 ％ CI (-20.62,4.79),P =0.22] and serum creatinine[WMD=-5.82,95％ CI(-19.22,7.58),P=0.39] between two kinds of treatment.These results suggest that combined treatment with valsartan and alprostadil shows advantageous effect on reducing urinary protein in DN.

China launched the nationwide resident standardized training (residential training) project since 2013 and has trained a large number of general practitioners. The primary health care institutions and general practitioners have played an important role during the prevention and control of COVID-19 epidemic, which not only presented the remarkable effect of residential training project, but provided new ideas for the further training program of general practitioners. It is proposed in this paper that we should adjust the training and assessment priorities in the following aspects: highlight the characteristics of general practice in the future training, so as to train general practitioners with more comprehensive ability, such as strengthening the ability to deal with public health emergencies, strengthening the consciousness and capability of scientific research, and increasing the proportion of humanistic quality training; At the same time, we should enhance career attractiveness of general practitioners to keep the excellent general residents stay for their career;All mentioned above will further improve the overall quality of general practitioners, and enable them to better deal with public health emergencies.

Objective To compare the diagnostic value of digital breast tomosynthesis (DBT) versus digital mammography (DM) in the evaluation mass like lesions in dense breasts. Methods Eight hundred and fifty eight patients, who had DBT and DM, with breast diseases confirmed by pathology were retrospectively reviewed. The breast density and the imaging features were classified according to the standard of American College of Radiology(2013) and breast imaging reporting and data system (BI?RADS) scores. Six hundred and thirty one patients with mass lesions in dense breasts were chosen to included. All 631 patients had DM of both breasts and DBT of affected breast prior to mastectomy. Pathological results were used as the golden standard. Detection rate and diagnostic accuracy of masses, sensitivity and specificity of diagnosis, false negative and recall rates, the margins and spicules and BI?RADS category were calculated. The detection rate and diagnostic accuracy, the margins and spicules of masses were compared with Chi?square test, the BI?RADS scores were analyzed with rank test. Results With DBT, average detection rate increased from 77.3%(488/631) to 84.3% (532/631), average diagnostic accuracy rate increased from 73.4%(463/631) to 82.3%(519/631),with statistical significant difference between groups (c2=27.191,36.890,P<0.01).Sensitivity for DBT and DM were 68.1%(205/301) and 58.8%(177/301), respectively. Specificity for DBT and DM were 95.2%(314/330)and 86.7%(286/330), respectively. Recall rate for DBT and DM were 3.6%(23/631)and 9.8%(62/631), respectively. One hundred and seventy two cases and 75 cases with circumscribed masses of benign cases were detected by DBT and DM, respectively. One hundred and eighty-two cases and 115 cases with spiculated masses of malignant cases were detected by DBT and DM, respectively, with statistical significant difference between groups (c2=70.471 and 21.707, P<0.01). Of 330 malignant cases, the numbers of BI?RADS category 0, 2, 3, 4A, 4B, 4C, 5 on DM images were 19,4,8,13,52,93,141, respectively, the numbers on DBT images were 3,1,7,5,52,83,179, respectively, with statistical significant difference(Z=-2.235,P=0.025). Of 301 benign cases, the number of BI?RADS category 0, 2, 3, 4A, 4B, 4C, 5 on DM images were 43,10,60,117,58,11,2, respectively, the number on DBT images were 20,4,64,150,55,7,1, respectively, with no statistical significant difference between groups(Z=-1.846,P=0.065). Conclusion DBT significantly improves the detection of mass?like lesions in dense breasts, display of mass margin and architectural distortion of surrounding tissue.

OBJECTIVE:To provide reference for teaching reform of Pharmaceutical English in our university. METHODS:According to the theory of needs analysis,by the means of classroom observation,questionnaire survey combined with personal in-terview,the participation of students majoring in Pharmaceutical Engineering,Pharmaceuticals and TCM Source of Grade 2013 in Pharmaceutical English classrooms of our university were investigated to investigate target needs and learning needs of students and analyze main influential factors of students'enthusiasm. RESULTS:It was found that the students participated passively in the Pharmaceutical English classrooms,mainly targeted at credit hour(88 students,58.28%)and aimed at the improvement of read-ing ability(73 students,48.34%). From aspect of learning needs,the students presented evenly enthusiasm for between traditional teaching method and modern teaching method;expected teachers asked more difficult questions;the study focused on actual and ef-fective feedback from the students. Their participation was mainly influenced by course property,teaching content and teaching method. The students'learning objectives were greatly affected by course propevty;to the students,the teaching content was more important than teaching method. CONCLUSIONS:It is to be improved in course property and location,teaching content and teach-ing method of Pharmaceutical English in our university. Pharmaceutical English should be included in required course;teaching content is combined with pharmaceutical practice;various teaching mode is formulated according to teaching content so as to meet students'need and improve teaching effect.

One hundred and thirty general practitioners ( GP ) who received standard training ( training group ) and 189 GPs who did not receive standard training ( non-training group ) were selected with cluster random sampling method from five districts in Beijing.A questionnaire survey was conducted from April to May 2013, including basic information , working condition , professional competency and continuing education of the interviewees.The survey showed that 72.3%(94/130) in training group had physician titles;89.3%(116/130 )had work experience <10 y;97.0%(126/130)of them had bachelor degree or above;82.3%(107/130) expressed their interest in scientific research , but the 95.4% of them had no research projects;and 96% had no teaching appointment.GPs in non-training group were in a favorite position of education level and professional competency over those in training groups ; however , the latter were highly enthusiastic in further training and scientific research , and had strong potential for career development.

Objective The study aimed to explore the growth status of children under 3 years of age in Nankai district of Tianjin city,provide reference evidence for children's health care work of the local area.Methods Convenience sampling was used to collect physical examination records of children under 3 years old from Wangdingdi hospital in Nankai district of Tianjin city.The records of 2 880 children' physical examination data were collected.Results The median scores of weight for height (WHZ) of children of 6,9,12,18 months old were 0.74 (0.01,1.49),0.73 (0.08,1.38),0.58 (0.11,1.27),0.54 (0.14,1.22),while children of 3,24,36 months old were 0.29 (0.45,1.03),0.17 (0.61,0.95),0.22 (0.36,0.80),the difference between them had statistical significance,x2=21.71,P＜0.05.The median scores of height for age (HAZ) of children of 3,6,9,12,16 months old were 1.05 (0.33,1.76),1.09 (0.32,1.85),1.22 (0.41,2.02),1.00 (0.20,1.79),1.09 (0.19,1.99),while children of 18,24 months old were 0.79 (0.06,1.51),0.86 (0.15,1.56),the difference between them had statistical significance,x2=27.83,P＜0.05.The median scores of weight for age (WAZ) of children of 3,12,18,24,36 months old were 0.88 (0.29,1.46),0.96 (0.31,1.61),0.85(0.19,1.51),0.64 (0.04,1.23),0.91 (0.28,1.54),while children of 6,9 months old were 1.10 (0.43,1.76),1.09 (0.43,1.74),the difference between them had statistical significance,x2=36.95,P＜0.05.The prevalence of stunting,wasting and overweight were 0.3％ (10/2 880),0.8％ (22/2 880) and 9.3％ (267/2 880).The physical condition between premature and full term infants and post-mature infants had statistical significance,t=140.23,100.64,P＜0.05.Conclusions The growth and development status of children in Tianjin Nankai district under 3 years old was generally good,and there was no significant difference between boys and girls,however,overweight has been the most serious problem at present.Compared with full-term and post-mature infants,the physical condition of premature newborn was lower.

Objective:To compare structure and function of mite Der f 3,Der p 3 and Eur m 3.Methods: Obtained mite allergens amino acid sequences from the International Union of Immunological Societies nomenclature database .Then physiochemical characterization,sequence alignment,secondary structure,three dimensional (3D) structure and epitopes of three proteins were analyzed by bioinformatics methods.Results:According to results of alignment ,Der f 3,Der p 3 and Eur m 3 displayed 88.51%sequence iden-tity.Der f 3,Der p 3 and Eur m 3 all contained three active sites and two trypsin functional domains ,which showed high identity of amino acid residues.Active sites of three proteins ,which closing to each other in three dimensional (3D) structure,constituting the active center of the enzyme.Secondary and 3D structure of three proteins all contains α-helices,β-sheets and random coils.Epitopes analysis revealed that Der f 3,Der p 3 and Eur m 3 all have 5 main potential epitopes located in random coils.Epitope sequences of Der f 3,Der p 3 and Eur m 3 overlapping in three domains (peptides of 79-81aa,129-135aa and 172-174aa),but the residues in these three domains were not identical.Conclusion:These studies lay the foundation for biochemical and genetic analysis of these 3 allergens,and may contribute to vaccine development for allergen-specific immunotherapy.

OBJECTIVE:To establish a method for the content determination of verbascoside in Naosaitong honeyed pill. METHODS:HPLC was performed on the column of Zorbax ODX with mobile phase of acetonitrile-0.1% phosphoric acid(16∶84, V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 334 nm,column temperature was 30 ℃,and the injection volume was 10 μl. RESULTS:The linear range of verbascoside was 0.200-1.000 μg(r=0.999 8);RSDs of precision,stability and repro-ducibility tests were lower than 1%;recovery was 95.16%-99.78%(RSD=1.80,n=6). CONCLUSIONS:The method is simple and accurate,and suitable for the content determination of verbascoside in Naosaitong honeyed pill.

Objective To study the apoptosis of human colorectal cancer HT-29 cells induced by Aralia elata Seem leaf total saponin (ETS) and its effects on the expression of relevant proteins. Methods MTT assay was used to detect the proliferation of human colorectal cancer HT-29 cells cultivated with different concentrations (6.25, 12.5, 25, 50, 100, 200 mg/kg) of ETS. Hoechst33258 staining and laser confocal imaging were used to detect the apoptotic cells. Morphological changes were observed. The expressions of Bcl-2 and Bax were detected by immuno-histochemistry. Results ETS could induce apoptosis of HT-29 cells and apoptosis was in a dose-dependent manner in a certain range. ETS could decrease the expression of Bcl-2 and increase the expression of Bax in HT-29 cells (P<0.05, P<0.01), showing a significant dose-effect relationship. Conclusion ETS can induce the apoptosis of HT-29 cells, and the mechanism may be related to reducing the expression of Bcl-2 and increasing the expression of Bax.

Objective To study the effect of Zhimaikang Granules (Granules for lipid abnormality) on atherosclerosis of hyperlipidemia patients of phlegm turbidity retention type.Methods Totally 120 hyperlipidemia patients were randomized into treatment group and control group, 60 cases in each. The treatment group was administered Zhimaikang Granules, each time 1 bag, twice a day. The control group was given Simvastatin Tablets, oral taking before sleeping. Both groups were treated for 45 days. Changes of superoxide dismutase (SOD), malondialdehyde (MDA), and nitric oxide (NO) were observed.Results After treatment, activity of NO and SOD were significantly higher than before in both groups (P0.05).Conclusion Zhimaikang Granules was proved to enhance the activity of antioxidase, promote anti-free radical reactions, inhibit lipid peroxidation and protect endothelial cells in atherosclerosis patients.