This study was aimed to introduce the key link in the process of granulating of small-dose methyl can-tharis amine tablets. Combined with practical experiences in daily jobs, related literatures in recent years from the fineness of raw materials, choice of main materials mixing, selection of adhesive, drying methods and grain quality were analyzed. The results showed that in order to ensure the content uniformity of small-dose tablets and conform to requirements of the Chinese Pharmacopoeia, the fineness of raw materials should be appropriate; the main supple-mentary material must be evenly mixed with enough time; the choice of adhesive should be scientific and reasonable;the drying method should be practical; and the grain quality should meet the technological requirements.

Objective To evaluate the value of Compas technique( computed optimun method for profile angle of singht,Compas) in displaying intracranial aneurysms. Methods DSA images of 31 cases of subarachnoid hemorrhage diagnosed by CT were studied. The DSA images in routine A-P and Lateral projections were compared with the images obtained by Compas technique in the same equipment. Results 23 of 31 were diagnosed as intracranial aneurysms by Compas and confirmed by operation, while only 5 were diagnosed definitely with routine A-P & Lateral projections. The other 18 studies were discovered as blurred margin of the artery but indefinite for the diagnosis of aneurysms. There is a statistical difference between the two methods. ?~2=14.93,P

Objective To explore the effects of pretreatment with different doses of curcumm on the expression of p-CREB and PGC-1α in hippocampus after global cerebral ischemia-reperfusion (IR) injury in rats.Methods Three hundred male SD rats weighing 200-250 g were randomly divided 5 groups ( n = 60 each): sham operation group (group S), IR group, low, median and high dose curcumin group (group LC, MC, HC). Global cerebral ischemia was produced by occlusion of 4 vessels (cauterization of bilateral vertebral arteries and 15 min occlusion of bilateral common carotid arteries) according to the method described by Finkbeiner. Bilateral common carotid arteries were only exposed but not ligated in group S. Intraperitoneal curcumin 30, 100 and 300 mg/kg were injected at 1 h before ischemia in group LC, MC and HC respectively. Equal volume of dimethylsulfoxide (DMSO) was injected intraperitoneally in group S and IR. The rats were killed at 2, 6, 24 and 72 h and 7 d after reperfusion (12 at each time point). Brains were immediately removed and hippocampus was isolated. The number of apoptosis neurons was counted using TUNEL. The expression of p-CREB and PG C-1α protein in hippocampus was detected by Western blot. Results The number of apoptosis neurons, p-CREB and PG C-1α protein expression were significantly higher at each time point in the other 4 groups than in group S ( P ＜ 0.05). The number of apoptosis neurons was significantly lower at T2-4 in group LC and MC, while p-CREB and PG C-Ⅰα protein expression wes significantly higher at T1-4 in group LC, MC and HC than in group IR (P ＜ 0.05). The number of apoptosis neurons was significantly higher, while p-CREB and PGC-1α protein expression was significantly lower at T2-4 in group LC and HC than in group MC ( P ＜ 0.05). Conclusion Curcumin can inhibit neuronal apoptosis in hippocampus and reduce global cerebral IR injury by up-regulating p-CREB and PG C-1α expression in rats and the effect was dose-related.

This study was aimed to explore the molecular mechanism of nano-realgar in treatment of systematic lupus erythematosus (SLE) lupus nephritis (LN). Intragastric administration of equal volume of high-, middle-, low-dose nano-realgar suspension, and normal saline (NS) were given to MRL/lpr mice, respectively. The observations were made on levels of ANA, ds-DNA antibody, IgG and IgM in blood serum, as well as TWEAK, NF-κB, MCP-1 mRNA and protein expression levels in renal tissues. The results showed that compared with the NS group, levels of ANA, ds-DNA antibody, IgG and IgM were obviously reduced (P < 0.05); the levels of TWEAK, NF-κB and MCP-1 mRNA were obviously reduced (P < 0.05); the protein expression levels of TWEAK, NF-κB and MCP-1 mRNA were obviously reduced (P < 0.05) in the high-, middle-, low-dose nano-realgar group. It was concluded that nano-realgar intervened the TWEAK-NF-κB signal pathway through downregulating MCP-1 expression among MRL/lpr mice, in order to reduce the levels of ANA, ds-DNA antibody, IgG and IgM for relieving autoimmune damages in the treatment of SLE (LN).

The human resistin expression vector was constructed and transfected into cells to observe its effects on glucose uptake in adipocytes,cell proliferation and differentiation.The results suggested that human resistin impaired glucose uptake in adipoeytes via stimulating proliferation of preadipocytes and suppressing adipocyte differentiation.Metformin reversed the inhibition imposed by resistin on adipogenesis.

Objective To investigate the relationship between subclinical hypothyroidism and diabetic nephropathy in type 2 diabetic patients (T2DM).Methods We retrospectively analyzed the clinical data of 218 patients with T2DM treated at the Department of Endocrinology,Shanghai Tongren Hospital from January 2015 to December 2016.Based on the level of thyroid stimulating hormone (TSH),patients were divided into a hypothyroidism group (TSH＞4.20 mU/L) and a control group (TSH 0.35-4.20 mU/L),and the relationship between subclinical hypothyroidism and diabetic nephropathy was evaluated.Results There were 46 cases in the subclinical hypothyroidism group and 172 cases in the control group.The incidences of diabetic nephropathy were significantly different between the two groups (P ＜0.05).Furthermore,the incidence of diabetic nephropathy was significantly higher in patients with high levels of TSH (≥10.0 mU/L) than in those with low levels of TSH (＜10.0 mU/L) (P＜0.05).Conclusions Diabetic patients with subclinical hypothyroidism are prone to diabetic nephropathy,so it is necessary to screen thyroid function.

Objective:To investigate the factors and mechanisms in forming uric acid stones in patients with type 2 diabetes (T2DM).Methods:106 patients with diabetes were divided into observation group and control group according to the combination of urinary calculi,53 cases in each group,The differences of clinical data and biochemical indexes between the two groups were compared,The relationship between type 2 diabetes mellitus and urinary stones was analyzed by multi factor regression analysis.Results:There were no significant difference in observation group and control group in age,sex,SBP,DBP,TC,FBG,2hPBG and HbA1C (P＞0.05),and there were of statistical difference significance in BMI,urinary pH,HOMA-IR,SUA,TUA in the two gruops (P ＜0.05) and the Logistic regression analysis showed blood uric acid,the urinary pH,HOMA-IR,SUA were independent risk factors in urolithiasis in T2DM (P ＜ 0.05).Conclusion:High uric acid hematic disease,high uric acid excretion,insulin resistance,overweight or obesity,high blood triglycerides in patients with type 2 diabetes is risk factors for urinary stone formation,in which blood uric acid,urinary pH,HOMA-IR is the independent risk factor for type 2 diabetic patients with urinary calculi.

In view of the challenges and opportunities presented in the new century and after rational deliberations on five occasions, the completely new model of "hi tech+humanistic solicitude=the green hospital" was put forward and the overall framework of "one line of thought", "two cornerstones", and "three goals" was carefully formulated. In the meantime, all staff members of the hospital were called on to be involved in the "six major activities". As a result, great changes have taken place in the appearance and development of the hospital. It has been proved through practice that "the green hospital" is a successful model conforming to the trends of the times.

Anaphylaxis is increasingly in children, which is currently undernotified, underdiagnosed, and undertreated in China.In order to further improved the understanding and management of anaphylaxis, this issue reviews the pathogenesis, triggers and risk factors, clinical diagnosis and management of anaphylaxis, thus offers the recommedations of anaphylaxis in Chinese children based on previous published evidence-based guidelines and practice parameters.Recommendation aims to develop guiding principles for the diagnosis and management of anaphylaxis in children, and provide a framework for the development of new guidelines.

Objective To evaluate the efficacy and safety of different antimicrobial regimens in patients with bloodstream infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP).Methods The clinical date of patients with CRKP bloodstream infections were retrospectively analyzed at the First Affiliated Hospital of Zhejiang University Medical College between January 2017 and January 2018.All subjects were separated into three groups based on antibiotics regimens over 72 hours,including meropenem 2.0 g every 8 hours,tigecycline 200 mg as initial dose and 100 mg every 12 hours,and polymyxin B 1.25 mg/kg every 12 hours as salvage treatment of tigecycline.Results A total of 86 patients were finally recruited,including 14,52 and 20 patients in groups of meropenem,tigecycline and polymyxin B salvage,respectively.All of the strains were resistant to meropenem and susceptible to tigecycline and polymyxin B initially,while 2 of them became resistant to tigecycline during treatment.The 28-day mortality was significantly higher in meropenem group (13/14) than that in tigecycline group and polymyxin B salvage group (61.5％,32/52) and (12/20),respectively (P＜0.01),while as no significant difference was seen in the last two groups (x2=0.014,P＞0.05).The incidences of hepatic impairment [3.8％(2/52) vs.1/20] and renal dysfunction (0 vs.1/20) between tigecycline group and polymyxin B salvage group were both comparable (P＞0.05).Conclusion The meropenem-based therapy is not recommended for CRKP-related bloodstream infections.Tigecycline-based therapy is still disappointing despite salvage use of polymyxin B after 72 hours.Hepatic and nephretic toxicities caused by additional polymyxin B are acceptable.