OBJECTIVE: To investigate the shortage of small package of Chinese herbal pieces and to put forward some problems to be settled. METHODS: Some shortages of small package of Chinese herbal pieces were found out, and the improvement suggestion were put forward. RESULTS&CONCLUSION: The development of small package of Chinese herbal pieces requires the effective monitoring of drug regulatory agency.

OBJECTIVE To comprehend characteristics and risk factors of lower respiratory tract infection after tracheotomy.METHODS Lower respiratory tract infection condition of 60 cases with tracheotomy was investigated.Risk factors were analyzed.RESULTS The prevalence of nosocomial infection was 93.3%,mainly lower respiratory tract infection(82.1%).The most common pathogens were Gram-negative bacilli.This group of patients had the seriously underlying diseases.In the treatment they carried on the trachea intubation,the tracheotomy,oxygen inhalation,sputum aspiration,atomization and so on.The time the tracheotomy and days in hospital be longer,the lower respiratory tract infection be higher.CONCLUSIONS The trachea intubation,the tracheotomy,the time of tracheotomy and the longer days in hospital may be the risk factors which can cause the lower respiratory tract infection.

Objective To observe the expression of inducible factor 1(HIF‐1) ,vascular endothelial growth factor(VEGF) and miRNA‐210 and explore the regulatory mechanism after unilateral ureteral occlusion (UUO) .Methods UUO models are made by ligation unilateral ureteral with silk ,and they were divided into sham group and UUO group .All the mice were sacrificed by cer‐vical dislocation after 2 ,5 ,9 and 14 d of UUO .The kidney samples were examined for HIF‐1 mRNA ,VEGF mRNA and miRNA‐210 by quantitative real time reverse transcription polymerase chain reaction (RT‐PCR) ,and HIF‐1 protein by Western blot . Results The expression level of HIF‐1 mRNA was gradually raised after UUO (P<0 .05) ,and compared with the sham group ,the expression level of VEGF mRNA and miRNA‐210 were up regulated after 2 d of UUO and down regulated after 5 ,9 and 14 d of UUO compared with the sham group (P<0 .05);the expression level of HIF‐1 protein increased after UUO compared to the sham group .Conclusion The results of the level of HIF‐1 protein increased and VEGF mRNA and miRNA‐210 were up regulated ,which might be related to the adaptive response of kidney hypoxia and ischemia after UUO .

Objective To investigate the spontaneons recovery of calculation and number processing in patients with stroke.Methods Assessment of calculation and number processing were performed in 30 stroke patients with stable conditions (21 cerebral infarction and 9 cerebral hemorrhage) within 3 weeks after stroke,and they were followed up for one year.Calculation and number processing was assessed using the Revised EC301 Calculation and Number Processing Battery in Chinese version at 3,6,and 12 months after stroke onset.Results The scores in the areas of numerical sequences,numerical understanding,numerical transcoding,numerical calculation,numerical knowledge and the total scores increased significantly with the passage of time (all P ＜0.001).There were significant differences between each area and total scores at 3,6,and 12 months after stroke and those at 3 weeks (all P ＜0.01),however,there were no significant differences among the three time points.The total scores and the scores in each area increased significantly with the passage of time in the cerebral infarction group and the hemorrhage group (all P ＜0.001),however,there were no significant differences in each area at the same time point between the two groups.There was significant difference in the recovery of the total scores between the cerebral hemorrhage group and the cerebral infarction group (P =0.008).Pearson correlation analysis showed that the recovery of the calculation and number processing in all patients (R =0.452,P =0.012) as well as in the cerebral infarction group (R =0.683,P=0.001) and the cerebral hemorrhage group (R =0.250,P =0.049) within one year showed a significant positive correlation with the total score of the first assessment.Conclusions The impaired calculation and number processing may partly spontaneously recover after stoke,and it shows significant improvement within 3 months after onset.The recovery in patients with cerebral hemorrhage may be better than that in those with cerebral infarction.The more serious the impairment in initial calculation and number processing,the worse the spontaneous recovery will be.

Objective To investigate the adverse reactions by stereotactic body radiation therapy(SBRT)for advanced hepatocellular carcinoma and summarize nursing experience.Methods Forty-one patients with advanced hepatocellular carcinoma from the radiation department of Sun Yat-sen University Cancer Center from July 2010 to May 2012 were enrolled in this retrospective study.The adverse reactions were closely observed and the patients were given pertinent nursing.Results The effectiveness rate was 56.2%.During the therapy,36 patients developed nausea/vomiting of grade 1-2,taking up 87.8%,18 had grade 1-3 elevation of liver enzymes,taking up 43.9%,16 had grade 1-2 decrease of white blood cells,taking up 39.0%,8 had grade 1 anemia,taking up 19.5%and 21 had grade 1-2 decrease of blood platelet,taking up 51.2%.The adverse reactions were contained satisfactorily through careful observations and pertinent nursing.Conclusions The toxic reactions by SBRT are nausea,vomiting,enzymes elevation and decrease of whole blood cell.Therefore,nurses need to observe these toxic reactions carefully and give pertinent care to the patients so as to prevent the complications,especially radiation-induced liver injury.

Objective To explore the key points of graded nursing care to rectal cancer patients with radioactive proctitis induced by preoperative neoadjuvant chemoradiotherapy.Methods The clinical data of 162 rectal cancer patients undergoing neoadjuvant chemoradiotherapy were analyzed retrospectively. The experience of grading nursing care for patients with radioactive proctitis induced by neoadjuvant chemoradiotherapy was summarized.Results Of 162 patients,radioactive proctitis occurred in 110 patients(67.9%).Among the 110 patients with proctitis,62(38.3%)were grade I radioactive proctitis,29(17.9%)gradeⅡand 19(11.7%)gradeⅢ.The graded nursing was done to the patients with radioactive proctitis and achieved good effect.Conclusions Radioactive proctitis has a high incidence in rectal cancer patients with preoperative neoadjuvant chemoradiotherapy and graded nursing care can reduce the distress of patients with radioactive proctitis effectively and promote wound healing,thus to improve their quality of life.

Objective To investigate errors and the mechanism of acalculia in patients with left or right hemisphere cerebral infarction.Methods Fifty-six patients with single hemisphere cerebral infarction and 56 normal adults who were matched in age,sex and years of education were tested with EC301-CR.The patients were divided into a left hemisphere cerebral infarction group(n =34)and a right hemisphere cerebral infarction group(n =22).Results The scores on 30 out of 32 EC301-CR items were significantly lower among the patients than in the normal control group.Scores on 14 EC301-CR items were significantly lower in the left hemisphere group than in the right hemisphere group.In the left hemisphere group the item scores of aphasia patients were significantly lower than those of no-aphasia patients except on digit identity.Conclusion Mathematical processing and calculation were impaired in patients with single hemisphere cerebral infarction.Calculation was significantly worse among left hemisphere patients compared with right hemisphere cerebral infarction.There was a highly significant correlation between acalculia and aphasia.

Objective To investigate the effect of exogenous stromal cell-derived factor-1 α (SDF-1 α) on angiogenesis peri-infarct region in cerebral cortex in adult rats and its possible mechanisms.Methods Twenty-four adult male Sprague-Dawley rats were randomly divided into four groups:sham operation,solvent control,SDF-1α treatment,and SDF-1α + CXCR4 antagonist (n =6 in each group).A model of focal infarct in the cerebral cortex was induced by permanent ligation of the cortical branch of the right middle cerebral artery with temporary clip occlusion of both common carotid arteries.At 1 h after cortical branch occlusion of the right middle cerebral artery,SDF-1 α (1 μg/d) or equal volume of normal saline were injected via the lateral ventricle in the SDF-1α treatment group and solvent control group,and continued for 6 days.CXCR4 antagonist AMD3100 (1 mg/d) was injected subcutaneously before injecting SDF-1 α in the SDF-1 α + CXCR4 antagonists group,and continued for 6 days.Before all the rats were sacrificed,5-bromo-2-deoxyuridine (BrdU) was injected intraperitoneally and their newly proliferated cells were labeled.At day 7 after modeling,the rats were sacrificed after neurological scores.Immunofluorescence staining was used to detect the vascular density,the numbers of neovasculature endothelial cells and the CXCR4 + cells in the peri-infarct regions or sham operation regions.Results At 7 d after modeling,the neurological function of the SDF-1α treatment group was improved significantly compared with those of the solvent control group and the SDF-1α + CXCR4 antagonist group (all P＜ 0.01).The vascular densities in the peri-infarct or sham operation regions in the groups of sham operation,solvent control,SDF-1α treatment,and SDF-1α+ CXCR4 antagonist were 2.1±0.3％,7.0±0.3％,10.0 ±0.9％ and 7.1 ±0.3％,respectively (F=232.469,P＜0.001),and that in the sham operation was significantly lower than that in the SDF-1α group (P ＜0.001),SDF-1 α group significantly higher than both groups of solvent control (P =0.002) and SDF-1oα + CXCR4 antagonist (P =0.001).The numbers of BrdU+/laminin+ cells in the peri-infarct regions in the groups of sham operation,solvent control,SDF-1α treatment,and SDF-1α + CXCR4 antagonist were 21.7 ± 3.1,79.7 ± 6.0,176.0 ± 12.5 and 90.3 ± 6.9,respectively (F=391.550,P＜0.001),and that in the sham operation was significantly less than that in the SDF-1 α group (P ＜ 0.001),SDF-1 α group was significantly more than both groups of solvent control and SDF-1 oα + CXCR4 antagonist (all P ＜0.001).The numbers of CXCR4 + cells in the peri-infarct regions in the groups of solvent control,SDF-1α treatment,and SDF-1α+ CXCR4 antagonist were 59.3± 4.5,120.3 ± 13.9 and 62.9 ± 5.9,respectively (F =85.052,P ＜ 0.001),and that in SDF-1α group was significantly more than those in the both groups of solvent control and SDF-1 α + CXCR4 antagonist (all P ＜ 0.001).Conclusions SDF-1α treatment may improve the neurological function after focal infarction in the cerebral cortex in adult rats and promote angiogenesis in peri-infarct region.The SDF-1/CXCR4 signal pathway may play an important regulatory role in the process of angiogenesis after cerebral infarction.

Objective To observe that antiretroviral efficacy, immune reconstitution of four-year highly active antiretroviral therapy (HAART), and evaluate its side effect in Chinese HIV-1-infected patients. Methods A total of 258 HIV-1 infected patients, given HAART regimens composed of two nucleoside reverse transcriptase inhibitor (NRTI) and one non-nucleoside reverse transcriptase inhibitor (NNRTI) for mean 51.5 months, measured HIV RNA viral load(VL) and the counts of CD4+ T cell,CD8+ T cell at the baseline and 6, 12, 24, 36 and 48 months after HAART initiation, respectively,monitoring side effect, blood routine, main biochemical parameters, and other disadvantageous accidents during the 51.5-month treatment. Results Plasma HIV-1 RNA level was determined by fluorescent quantitative polymerase chain reactions (FQ-PCR) at the baseline and 6, 12, 24, 36 and 48 months after starting HAART, and showed 5.27, 2.97, 2. 74, 2. 62, 2. 67 and 2.75 lg (copies/ml), respectively. The counts of CD4+ T cell from (127±63) cells/μl at the baseline increased to (190±115), (248±93),(269±127), (296 ± 156) and (317 ± 195) cells/μl at 6, 12, 24, 36 and 48 months after starting HAART. A total of 149 treated patients (57.8%)had gastrointestinal side effects, peripheral polyneuropathy, various rashes, central nervous system disorders, fever or baldness. Twenty-two patients changed one of three medicines to another because toxicity. Sixteen changed the regimen to the second line HAART for lactic acidosis or other serious toxicities. Conclusions A total of 258 HIV-1 infected Chinese patients treated with two NRTI and one NNRTI as first line HAART regimen during mean 51.5 months,showed a good antiretroviral efficacy and immune reconstitution, but a few site-effects at the parts of patients. It is necessary to treat adverse effect and change HAART regimen for severe toxicity in time.

Objective To investigate the risk factors,severity and infarct site features and clinical characteristics of the elderly patients over 80 years with cute cerebral infarction.Methods One hundred and sixty-two patients with acute cerebral infarction in Red Cross Hospital of Guangzhou,The Forth Affiliated Hospital of Medical College of Jinan University from January 2012 to May 2015 were enrolled and randomly divided into the elderly patients (≥ 80 years old) and the middle aged patients (＜ 60 years old).The risk factors,national institutes of health stroke scale (NIHSS) scores and Oxfordshire community stroke project (OCSP) criteria were compared between the two groups.Results Coronary artery disease,atrial fibrillation and NIHSS in the elderly patients (25％ (22/88),13.6％ (12/88),7.74 ± 4.986) were significantly higher than those of the middle aged group (12.2％ (9/47),4.1％ (3/74),5.04± 4.305),and the differences were significant (x2 =4.281,4.393,t =-3.649;P＜ 0.05 or P＜ 0.001).The logistic regression analysis finally showed that smoking,hyperlipemia,NIHSS scores and gender(male) were the independent risk factors(OR=3.851,3.609,1.100 and 2.670;P＜0.05).There were more LACI patients in the elderly group than he middle aged group ((40.9％,36/88) vs.(60.8％,45/74),x2 =6.369,P ＜ 0.05).Conclusion Compare to the middle aged patients,occurrence of the elderly patients with acute cerebral infarction is more severe,and the clinical features and risk factors have its particularity.Secondary prevention strategy should be emphasized on the control of different risk factors based on the patients' age.