This study discussed problems in consistency assessment of generic drugs and analyzed effect of polymorphs on drug quality and its influence on consistency of curative efficiency.Relationship between evaluation method of polymorphs and curative efficiency was investigated.It showed that establishment of curative efficiency related evaluation indicators was necessary and improvment of techniques was important.Drug quality criteria should be added with requirement of curative efficiency control.Related information based on polymorphs could be provided for technical research in consistency assessment.

Objective Irrational pharmacotherapy is a common and severe phenomenon which happened in elderly people, it easily induces adverse outcomes, for example, increasing adverse drug reaction, mortality in hospital and the cost of drugs.The geriatric irrational pharmacotherapy are caused by lots of factors, and it is a challenge to clinical works in rational and optimized pharmacotherapy because of elderly complications and multiple pharmacotherapy which faced to doctors.Practical and effective treatment strategies and interventions are keys to geriatric rational pharmacotherapy.This paper will propose various of pharmacotherapy strategies in order to promote rational pharmacotherapy for the elderly patients.

Objective To evaluate the reliability and validity of Chinese multi-dimensional health assessment questionnaire (MDHAQ-C) in patients with systemic lupus erythematosus (SLE) in China.Methods One hundred and twelve SLE patients were recruited in the evaluation.The reliability of the questionnaire was tested by intra-class coefficient (ICC) and Cronbach's alpha.Convergent validity and divergent validity were assessed by Spearman correlation coefficient of MDHAQ-C with health assessment questionnaire (HAQ),the 36-item short-form health survey (SF-36) and the hospital anxiety and depression scales(HAD).Discriminant validity was tested in groups of patients with varied disease activities and status of damage.Results The Cronbach's alpha was 0.886 in the function scale (FN) and 0.774 in the scale of psychological status (PS).The corrected item-total correlation ranged from 0.409-0.866.The ICC was 0.615-0.920(P＜0.05).MDHAQ-C correlated with the questionnaires satisfyingly in most scales (from P＜0.5 to P＜0.001).The scores of MDHAQ-C could discriminate different groups of patients (P＜0.05).Conclusion MDHAQ-C is a reliable,valid instrument for functional measurement and quality of life assessment in Chinese SLE patients.

Objective To investigate the protective effect and possible mechanisms of erythropoietin (EPO) on myocardial ischemia-reperfusion injury(MIRI) in rats.Methods Ninety male SD rats were randomly divided into three groups,the sham operation group (n =20),I/RI group (n =20),and EPO treatment combined I/RI group (n =20).The left anterior descending coronary artery was ligated for 30min utes and then loosed for 150min utes to establish the rat model of MIRI.Rats of EPO + I/RI group were injected with EPO(5000u/kg) in abdominal cavity,the others were injected with nomal sodium.The serum MDA content was determined in a method of the thiobarbituric (TBA),the cardiac injury markers(cTn Ⅰ,CK,CK-MB) contents were determined by ELISA.Results The serum MDA and MPO levels of the I/RI group were significantly higher than the sham group,difference was significant(t =10.445,9.848,all P ＜ 0.05) ; Intervention by EPO,the serum MDA and MPO levels of the EPO + I/RI group were significantly lower than the I/RI group,the difference was significant (t =5.087,6.683,all P ＜ 0.05).The serum cTn Ⅰ,CK and CK-MB levels of the I/RI group were significantly higher than the sham group,the difference was significant (t =8.153,5.411,3.729,P ＜ 0.05) ; Intervention by EPO,the serum cTn Ⅰ,CK and CK-MB levels of the EPO+ I/RI group were significantly lower than the I/RI group,the difference was significant(t =4.808,4.089,3.002,all P ＜0.05).Conclusion EPO has protective effect on MIRI,the effect may be through EPO's antioxidant,antiinflammatory and protective effect on myocardial cells in the MIRI rats.

Background Matrix metalloproteinases (MMPs) play important roles in the formation of choroidal neovascularization (CNV),but its mail origin is not ocular cells in situ.Bone marrow-derived cells (BMCs) participate in the formation of CNV and is probably a primary source of expressing MMPs in CNV.MMP-2/MMP-13 is speculated to be the regulating target genes of miR188-5p.Objective This study was to verify whether BMCs are the main source of MMPs,and whether the MMP-2/MMP-13 expression is potentially regulated by miR188-5p.Methods BMCs expressed green fluorescent protein (GFP) from transgenic female C57BL/6J mice were transplanted to female wild-type C57BL/6J mice to establish C57BL/6J.GFP chimeras models,and 42 mice with chimerisms more than 85％ by flow cytometry were included as the experimental group.Other 42 wild-type C57BL/6J mice without the BMCs transplantation were enrolled as the control group.CNV was induced by laser coagulation of retinas on the mice of both groups.MMP-2/MMP-13 levels in the retinochoroid tissue were quantified by ELISA at day 1,3,5,7,10,14,and 28 after photocoagulation.The expression of miR188-5p mR NA in the retinochoroid tissue was assayed by real-time quantitative PCR (RT-qPCR).Immunofluorescence stain and fluorescent in situ hybridization were used to identify the MMP-2/MMP-13 and miR188-5p expressed by GFP-positive BMCs in CNV,and the expression level was quantified by images analysis.Results The proportion of GFP+ mouse mononuclear cells was (90.67±3.02) ％ in the C57BL/6J.GFP chimeras.The concentration changes of MMP-2/MMP-13 in retinochoroid homogenate showed a same tendency with the lapse of time between the experimental group and the control group (MMP-2:F=0.060,P =0.810 ; MMP-13:F =0.012,P =0.915).The expression level was zoomed in retinochoroid tissue after induce of CNV with the maximal value on the third day in both groups,and the proportion in the experimental group was 64.21％ ;while the expression level of MMP-13 was slowly raised after induce of CNV with the peak at the seventh day,and the proportion in the experimental group was 79.61％.A complementary association point of miR188-5p was exhibited in the 3 '-untranslated regions of MMP-2 or MMP-13 by target gene prediction.The expression level of miR188-5p mRNA in the BMCs of CNV area was sharply declined after induce of CNV with the lowest value on the seventh day.A negative correlation was found between the expressing level of miR188-5p and MMP-13 protein (r=-0.868,P＜0.05) as well as early stage of expression level of MMP-2 protein (r=-0.997,P＜ 0.05).Conclusions The elevation of MMP-2/MMP-13 expression levels is associated with the formation of CNV,and the regulation of miR188-5p expression in the BMCs of CNV area is responsible for increase of MMP-2/MMP-13 expression.The tendency of miR188-5p expression is inversed with MMP-2/MMP-13.

Gastroenteropancreatic neuroendocrine neoplasms are a group of heterogeneous tumors originated from the gastrointestinal peptidergic neurons and neuroendocrine cells.Rectum is one of the major sites of gastroenteropancreatic neuroendocrine neoplasms.Although the progression of rectal neuroendocine neoplasms (rNENs) is relatively slow,metastasis could occurs and liver is the major target organ invaded by distant metastatic rNENs.Surgical operation can be used as the preferred method for the treatment of rNENs and its metastasis at present.If the clinical situations of tumors are not eligible for the operation,interventional treatment can be considered as an alternative treatment.The chemotherapies and molecule-targeted drugs for rNENs are primarily in the light of therapeutic methods for pancreatic neuroendocrine neoplasms,it may help patients achieve partial response or stable disease,and prolong patients survival time.However,there has been few clinical researches directed toward rNENs and no an extensive consensus for treatment of rNENs up to now,and more evidences of evidence-based medicine should be necessitated.This paper has discussed and summarized treatment progression of rNENs and its metastasis.

Objective To investigate the clinical characteristics and therapeutic plan of Miller Fisher syn-drome( MFS) complicated with Guillain-Barrésyndrome( GBS) .Methods The clinical data of one patient of MFS complicated with GBS was reviewed retrospectively,and analysis combined with literature review was given.Results The patient had infectious history before the onset of MFS and GBS.Clinical manifestations included MFS triad,bulbar paralysis,bilateral facial paralysis,protein-cell dissociation of cerebrospinal fluid and neurogenic damages in electro-myography.Plasm exchange and adrenocortical hormones treatment were effective.Conclusion MFS complicated with GBS is an independent disease which is different from MFS or GBS.It has its distinct clinical features which should apply appropriate treatment.

Objective To investigate the effects of dexmedetomidine pretreatment on lung injury for patients after liver surgery. Meth-ods Sixty patients who had liver surgery in our hospital from August 2009 to February 2014 were equally divided into the treatment group and the control group, with 30 patients in each group. Both of the two groups were given one-lung ventilation anesthesia. Patients in the treatment group were given continuous intravenous infusion of dexmedetomidine after induction of anesthesia while paitents in the control group were not. In the time of before induction of anesthesia (T0), closed chest (T1), immediately after surgery (T2), all patients were given the gas analysis, expression of inflammatory cytokines and lung function testing and analysis. Results The diastolic blood pressure and heart rate at time points of T0, T1 and T2 in the two groups showed no significant difference (P> 0. 05). And the expression of TNF-αand SP-D at time points of T1 and T2 in the two groups were significantly higher than those at T0 (P<0. 05);while the expression of TNF-αand SP-D in the treatment group were significantly lower than those in the control group at time points of T1 and T2 (P<0. 05). The plateau air-way pressure and airway resistance in the treatment group at T2 and T3 were significantly lower than that at T1 (P<0. 05), and there were statistically significant differences compared with the control group (P<0. 05). Conclusion The dexmedetomidine pretreatment for the liver surgery patients can inhibit the inflammatory response, while improve lung airway plateau pressure and airway resistance. It has no significant effect for blood, so it can play a protective role for lung function.

Pancreatic neoplasm is one of the most commonly-appeared digestive tumors and has been well-recognized as the poor diseases which have the difficulties in diagnosis,treatment and prognosis estimation.Recently,the detection of circulating tumor cells (CTCs) has been a pretty highlight of the research on detecting tumor cells in peripheral blood,and furthermore,the clinical value in the diagnosis,treatment and prognosis prediction has already been verified through a large amount of samples analyses in various kinds of tumor diseases.This paper aims to review and conclude the techniques of CTCs enrichment,detection and clinical implications in pancreatic neoplasms.In addition,the existing papers have been summarized and prospect of application of CTCs is also presented.

Objective To investigate the expressions of microRNA-21,microRNA-143,and microRNA-145 in the sera of patients with nasopharyngeal carcinoma (NPC),and their assessment vales in the recurrence,metastasis,and prognosis of NPC patients.Methods From January 2012 to January 2014,80 NPC patients in our hospital Department of Internal Medicine and Head and Neck Surgery was used as tumor group,80 cases of healthy volunteers as control.The real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to detect the expression levels of microRNA-21,microRNA-143,and microRNA-145 in the sera.Results Expression of microRNA-21 in NPC patients was significantly higher than that in healthy control group with statistically significant difference (P ＜ 0.05).The expressions of microRNA-143 and microRNA-145 in NPC patients was significantly lower than those in healthy control group with significant difference (P ＜ 0.05).At the same time,those microRNAs were significantly associated with tissue differentiation,invasion,and metastasis.Conclusions Increased microRNA-21 expression level in NPC patients,and decreased expression of microRNA-143 and microRNA-145 in NPC patients play an important role in differentiation,invasion,and metastasis in the development process of NPC.microRNAs can be used as a new index in the auxiliary diagnosis of NPC and the evaluation of recurrence,metastasis,and prognosis evaluation.