OBJECTIVE:To study the determination method of the percutaneous rate of Kechuan xuewei patch and its in vitro drug release profile.METHODS:The content of ephedrine hydrochloride(an index composition)in percutaneous reception fluid and release fluid were determined by HPLC,and the percutaneous penetration rate and the in vitro drug release rate were computed.RESULT:Ephedrine permeated at a constant rate of 6.467 9 ?g?cm-2?h-1/2 and the in vitro drug release rate was 21.382 ?g?cm-2?h-1/2,fitting Higuchi equation.CONCLUSION:Kechuan xuewei patch can be prepared as controlled release matrix system of skin permeation rate-limited type.

Objective: To study Blood Stasis Syndrome by molecular-biology in kidney-deficiency of diabetes pedigree.Methods: 18 members in diabetes pedigree were closed to make routine physical & chemical test and the macroscopic diagnosis of kidney-deficiency and blood stasis,3 diabetics with blood stasis syndrome and 2 healthy people in the same family,were selected to make 14000 genes chips hybrid test.Results: The pedigree maps and the comparative syndrome score tables of kidney-deficiency and blood stasis syndrome were obtained,and the 446 genes of different expressions,in particular,5 genes such as the TBXAS1,which was used to illustrate the possibility of effects on the blood stasis were also selected Conclusion: There was an exceeding preponderance of pedigree research method,which was used to search the macroscopic syndrome and the microscopic expressions of different genes.And it would help us to understand the relationship between the syndrome of kidney-deficiency & blood stasis diabetes and the genes of different expressions.

Objective To study the changes of the humoral immune parameters in patients after infusion of irradiated platelets and the correlation with platelet transfusion refractoriness(PTR).Methods 126 patients with malignant blood diseases of transfusion in our hospital by more than twice were randomly divided into observation group and control group by randomized single-blind allocation method.The observation group was treated with transfusion note γ irradiated platelets,and the control group was treated with infusion ordinary way of apheresis platelets.Before and after transfusion,the changes of vivo complement(C3,CA),immune globulin (IgG,IgM,IgA),C-reactive protein (CRP) and circulating immune complexes(CIC) were detected andplatelet transfusion efficiency and the correlation between changes of immune parameters and the occurrence of invalid infusion.Results The infusion of platelets in patients of C3,C4,IgG,IgM and CIC of the control group were significantly higher than the observation group(all P ＜0.05).There was no significant changes in IgA of the two groups,but the CRP had the high trends.The infusion efficiency of the observation group was 87.3％,which was significantly higher than that of the control group(61.9％)(χ2 =8.92,P ＜ 0.05),blood transfusion after the PTR immune parameters in patients with C3,C4,IgG,IgM,CRP,CIC significantly higher than before,the difference was statistically significant(all P ＜0.05).Conclusion The bodyimmune parameters with PTR is closely related to humoral immune parameters,and the infusion of γirradiated platelets alleviate to some extent,further improve clinical infusion effective rate.

Objective To study the impact of nursing intervention on the sleep quality of postoperative elderly patients who had sleep disorder. Methods 260 cases of postoperative elderly patients with sleep dis-orders were randomly divided into the experimental groupand the control group with 130 cases in each group. Conventional care was given to the control group, the experimental group received appropriate nursing interven-tion such as psychological nursing, rehabilitation,etc. Pittsburgh sleep quality index (PSQI) was used to evaluat-ed sleep quality of two groups before and after intervention, t test was adopted. Results No difference was seen in each sleep index in the two groups. While each index evidently alleviated after intervention in the ex-perimental group and was better than those of the control group. Conclusions Nursing interventions have certain effects on improving sleep quality of postoperative elderly patients with sleep disorders.

Ischemic cerebrovascular disease is a common and frequently occurring disease in the elderly.It has the characteristics of high disability rate,high mortality rate,and high recurrence rate,which seriously threatens the life and health of the elderly.At present,clinical diagnosis and evaluation are mainly based on medical history,neurological symptoms and signs and imaging examination.The incidence of ischemic cerebrovascular disease is rapid,the existing diagnostic methods have different degrees of hysteresis and limitations in the diagnosis time.Related clinical study found that in the process of ischemic cerebrovascular disease accompanied by serum S-100 beta,matrix metalloproteinase-9 (MMP-9)-related indicators of change.This article reviews the recent progress of S-100 beta and MMP-9 in ischemic cerebrovascular disease.

The rational prescription evaluation is important for improving the medical quality and ensuring prescription safety.For the last few years, the health authorities have issued a series of files in order to regulate clini-cal medical conducts, and reduce the irrational prescription.Hospitals are also paying more attention to the rational medicine evaluation.The evaluation is likely to be doubted and resisted for the difference of evaluation personnel, e-valuation personnel quality and evaluation criterion.Therefore, the smooth development of hospital rational prescrip-tion evaluation need to adopt effective management measures, which is connected with responsibilities, guaranteed by rewards and punishments and based on actualities, and establish various evaluation management mechanism to ensure continuous correction and updating at work.

Objective To learn the prevelance of Acinetobacter baumannii and its drug resistance related with Ⅰ class integron. Methods 22 kinds of antibiotics commonly used in our hospital were used to detect the sensitivity of the clinically separated Acineto-bacter baumannii.Methods PCR was used to detect Ⅰ class integron enzyme gene of Acinetobacter baumannii,and then parts of variable region of Ⅰ class integron enzyme gene were amplified and analyzed for gene sequence.Results The drug resistance of Acinetobacter baumannii phenomenon was very serious,which was multiple drug resistance.The resistance rate of Acinetobacter baumannii to CPZ/SB was 1.2%.And the resistance rates to tigecycline,ofloxacin,imipenem,biapenem,and amikacin were 1 5.4%-69.5%,but the resistance rates to other antibiotics were above 71%.There were 72 of 102 strains including Ⅰ class integron (positive rate was 70.2%).The resistance of strains with Ⅰ class integron was stronger than that of the strains without.The varia-ble area of Ⅰ class integron produced the same enzyme bands when analyzed with double enzyme,suggesting the Acinetobacter bau-mannii was homologous.The gene sequence analysis of Ⅰ class integron showed that the Ⅰ class integron of the Acinetobacter bau-mannii carried kinds of resistant genes such as aacA4,catB8 and aadA13.Conclusion From 2010 to 2013,the Acinetobacter bau-mannii in our hospital is highly resistant to cephalosporins,broad-spectrum penicillin,aminoglycosides and fluoroquinolones and is severely multiple drug resistant.So the antimicrobial drugs for the treatment of infections caused by Acinetobacter baumannii are limited.Ⅰ class integron is closely related to the multiple drug resistance of Acinetobacter baumannii.

Objective]To explore the basic connotation of “fire stagnation requiring dissipation”and analyse ancient physicians' discussion about the fever, in order to expand its application in the clinical treatment.[Method] Using the method of conceptual thinking to explain the etiology and pathology of“fire stagnation”,the specific connotation of“fire stagnation requiring dissipation”,collecting ancient physicians' exposition on“fire stagnation requiring dissipation”,and listing the relevant prescriptions in order to deepen the thinking.[Result] Fire stagnation produces nothing more than exogenous ,internal injuries,the mechanism is in the human body, the anger's ascending-descending and coming in-going out is out of balance by some factors ,the anger stagnates and can't get out. Neijing first recorded“fire stagnation requiring dissipation”,that is treating the fire stagnation disease needs making the gas opening,lifting,entry becomes coordinate,finally the body goes back to health. In the Shang Han Lun, Zhang Zhongjing expounded the meanings and mechanism of“fire stagnation requiring dissipation”perfectly. Since Jin and Yuan Dynasties, ancient physicians have come up with several prescriptions and have promoted the development of the doctrine.[Conclusion] Since the Neijing proposed the theory of“fire stagnation requiring dissipation”,physicians' understanding of fire stagnation syndrome has been gradually deepening,and provided a broader ideas for clinical treatment.In recent years,the theory of“fire stagnation requiring dissipation”is widely used in various kinds of diseases,its academic value is worth summarizing,inheritance,extension.

Headache is a common complaint in children and adolescents.While the majority of headaches are self-limited and benign,headaches occasionally herald a life-threatening illness such as meningitis,intracranial hemorrhage,brain tumor or hydrocephalus.The primary objective of the emergency department pediatrician is to diagnose and manage any acute life-threatening cause of headache.For the non-emergency headache,the goal is to relieve the pain and the associated symptoms.

OBJECTIVE:To evaluate the improvement effects of sitagliptin on islet B-cell function in type 2 diabetic patients systematically,and to provide evidenced-based reference. METHODS:Retrieved from PubMed,Cochrane library,EMBase, CJFD,Wanfang database,VIP and CBM,RCTs about sitagliptin alone or combined with routine plan(trial group)vs. placbo alone or combined with routine plan(control group)in the treatment of type 2 diabetes were collected. Two reviewers independent-ly screened studies according to exclusion and inclusion criteria,extracted data,and assessed the methodological quality according to Cochrane Manual 5.1.0. Meta-analysis was performed by using RevMan 5.3 software. RESULTS:A total of 5 RCTs were includ-ed,involving 1253 patients. The result of Meta-analysis showed that changes of islet B cell function index(Homa-B)[sitagliptin alone group:MD=9.21,95%CI(4.16,14.25),P<0.001;drug combination group:MD=7.24,95%CI(0.80,13.68),P=0.03] and changes of insulin resistance index(Homa-IR)[sitagliptin alone group:MD=-0.40,95%CI(-0.44,-0.36),P<0.001;drug combination group:MD=-0.35,95%CI(-0.63,-0.07),P=0.02] of trial group were significantly better than those of control group,with statistical significance. CONCLUSIONS:Sitagliptin shows certain therapeutic efficacy in improving islet B cell func-tion and insulin resistance.