Adult ; Amyloidosis ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Muscular Diseases ; pathology ; surgery ; Neck Muscles ; pathology ; surgery

Objective To prepare and characterize nanoparticles in-loaded one-way release-controlled chitosan membrane,and to explore the release-controlled rule of the film in vitro.Methods The chitosan nanoparticles were prepared by inverse crosslinking-emulsion method.The one-way release-controlled membrane was prepared by a casting method.Transmission electron microscope (TEM) was used to evaluate the morphological properties and particle size analyzer was used to analyze particle size distribution.The morphology of the membrane was inspected through scanning electron microscope (SEM).MTT assay was applied to determine the biological safety of chitosan nanoparticles.The distribution of the nanoparticles was observed by fluorescence microscope.The in vitro release studies were adopted to evaluate the release-controlled rule.Results The four kinds of nanoparticles had spherical shapes and uniform particle size.The size of the hyaluronic acid-coated chitosan nanoparticle was (255.40±39.10) nm.Hyaluronic acid-coated chitosan nanoparticles showed the best property of sustained release and biocompatibility.The membrane had a loose inner layer and a dense outer layer,and the distribution of the nanoparticles was uniform in the inner layer of the membrane.The release of protein from membrane was unidirectional and the membrane displayed good controlled release property.Conclusions The nanoparticles in-loaded one-way release-controlled chitosan membrane presents good one-way sustained release performance.It is potentially useful in delivery system of growth factors.

Objective To evaluate the effect of therapeutic touch on continuous positive airway pressure titration with obstructive sleep apnea hypopnea syndrome (OSAHS) patients.Methods Fortyeight patients diagnosed with OSAHS were randomly allocated to the therapeutic group and the control group with 24 patients in each group.Therapeutic touch was used in the therapeutic group before CPAP titration and the control group received usual care.Anxiety was measured post intervention with State-trait Anxiety Inventory(SAI) and Visual Analogue Scale(VAS).CPAP therapy satisfaction was also evaluated by VAS.Results Compared with the control group,those patients with therapeutic touch showed significant reductions in SAI scores,better sleep quality,and higher satisfaction with CPAP treatment.Conclusions Results suggest that 15-min of therapeutic touch pre CPAP titration night significantly reduced anxiety and improved sleep quality in patients with OSAHS.

Objective To investigate the effect,security and tolerance of pregabalin combined with sertraline hydrochloride for refractory neuropathic pain.Methods Forty-six patients with refractory neuropathic pain were divided into two groups by random digits table.The patients in pregabalin group (24 patients) were treated by pregabalin combined with sertraline hydrochloride,and the patients in carbamazepine group (22 patients) were treated by carbamazepine combined with sertraline hydrochloride.They were treated for 4 weeks.The scores of visual analogue scales (VAS),Hamilton rating scale of depression (HAMD),Hamilton rating scale for anxiety (HAMA) and the dose,adverse reaction were compared between two groups.Results The total effective rate of pregabalin group was 83.3％(20/24) and carbamazepine group was 86.4％ (19/22),there was no significant difference (P＞ 0.05).After treatment of 1,2,4 weeks,the scores of VAS in two groups were significantly decreased compared with those before treatment[pregabalin group:(5.90 ± 1.11),(4.59 ± 1.33),(3.59 ± 1.94) scores vs.(6.50 ± 0.85) scores; carbamazepine group:(5.50 ± 1.06),(4.18 ± 1.71),(3.73 ± 1.88) scores vs.(6.50 ± 0.80) scores] (P ＜0.05).After treatment of 2 weeks,the scores of VAS in carbamazepine group was significantly lower than that in pregabalin group (P ＜ 0.05).In pregabalin group,the scores of HAMD/HAMA after treatment of 1 week had no significant difference compared with before treatment (P ＞ 0.05),and the scores of HAMD/HAMA after treatment of 2,4 weeks were significantly increased [(15.25 ± 4.15),(11.29 ± 4.16)scores vs.(16.08 ± 3.56) scores and (14.21 ± 4.72),(11.63 ± 4.50) scores vs.(15.25 ± 4.05) scores] (P ＜0.05).In carbamazepine group,the scores of HAMD/HAMA after treatment of 1,2 weeks was decreased compared with those before treatment,but there was no significant difference (P ＞ 0.05).The scores of HAMD/HAMA after treatment of 4 weeks was significantly decreased [(13.18 ± 2.42) scores vs.(15.20 ±1.05) scores,(12.32 ± 2.64) scores vs.(14.55 ± 4.43) scores] (P ＜ 0.05).The scores of HAMD/HAMA in pregabalin group after treatment of 4 weeks was significantly lower than that in carbamazepine group (P ＜0.05).There was no severe adverse reaction.Conclusion Pregabalin combined with sertraline hydrochloride is worth to recommend for refractory neuropathic pain,and has no serious adverse reaction.

OBJECTIVE:To investigate the concepts and contents of the Chinese precision medicine,and to provide reference for the development of precision medicine in China.METHODS:By evidence-based evaluation method,using jingzhun yixue jingzhun yiliaoprecision medicineas keywords,all literatures were retrieved from CBM,CNKI,Wanfang,VIP,PubMed and Ovid EMBase databases up to Nov.17th,2015.The relevant information were extracted,including researchers (first author or correspondence author's unit belonged to China),domains and concepts.The concepts and contents of the Chinese precision medicine based on China's national condition were summarized and analyzed,and the difference between precision medicine and personalized medicine was compared.RESULTS:54 studies were included,the results indicated most studies (51 literatures) were published in 2015 by hospitals (28 literatures) and high schools (14 literatures);most literatures (23 literatures) presented the concept of precision medicine,followed by disease precision medicine (19 literatures) and relevant technology of precision medicine (7 literatures);a total of 39 literatures presented the specific concept of precision medicine.Besides genetic information involved in American precision medicine,the Chinese one expanded the disease diagnosis and treatment technology,as well as the application.Personalized medicine and precision medicine were in common partially,however,the latter one underlined the disease classification and diagnosis,which was more practicable.CONCLUSIONS:Chinese precision medicine involves disease diagnosis and treatment technology as well as influential factors based on genetic information,and includes disease classification and diagnosis so as to perform personalized precision intervention.The Chinese precision medicine is overall developed and focused.

OBJECTIVE:To analyze the clinical features and correlation factors of ADR caused by second generation antihistamine drugs for references of clinical rational drug use.METHODS:A total of 128 cases ADR cases induced by second generation antihistamine drugs that met our criteria were obtained by retrieving the domestic literature database between 1986 and 2006,which were categorized and analyzed in accordance with the ADR categorization stipulated by WHO international drug monitoring cooperation center.RESULTS:Of the 128 ADR cases,more were seen in male than in female,38 presented cardiovascular system lesions,accounting for 29.69%,followed by lesions of skin and its appendants(28.13%) and systemic reactions(20 cases,15.63%).However,the prognosis of these ADR was satisfactory.CONCLUSION:The ADR caused by second generation antihistamine drugs are associated to many factors such as patients’ sex and physical condition as well as drug combination etc.Clinic should be alert to such ADR such as allergic shock and arhythmia in patients treated with second generation antihistamine drugs.

Objective To assess the efficacy and safety of topiramate monotherapy in the treatment of alcohol de?pendence. Methods The Cochrane library, PunMed, EMBase, CNKI, VIP and CBM database were searched to collect the randomized contolled trials (RCTs) of topiramate monotherapy to compare with placebo or positive control drug in al?cohol dependence. Data were extracted from the included literatures after the literatures’qualities were assessed. The meta-analyses were conducted with RevMan 5.2 software. Results Thirteen trials were included. Compared with place?bo, topiramate reduced score of obsessive compulsive drinking scale(MD=-5.90,95%CI:-10.99~-0.82,P=0.02), de?creased drinks per drinking day(MD=-6.94,95%CI:-12.20~-1.68,P=0.01), and increased percentage of days absti?nent(MD=15.36,95%CI:4.15~6.56,P<0.01). The incidence of paraesthesia, taste perversion, weight loss, memory or concentration impairment, dizziness, psychomotor retardation in topiramate group was higher. But the incidence of other adverse events was similar between groups. Compared with naltrexone, topiramate significantly postponed the days to first relapse(MD=2.10,95%CI:0.23~3.97,P=0.03). The adverse events were similar between groups. Conclusions Topira?mate in treatment of alcohol dependence is effective and safety.

Objective To investigate the career resilience and its influencing factors among nurse specialists.Methods Totally 288 nurse specialists were investigated by General Information Questionnaire,Career Resilience Scale,Core Self-Evaluations Scale and Simplified Coping Style Scale.Results The score was 37.12±4.78 for career resilience,35.46±4.78 for core self-evaluations,23.57±5.2 1 for positive coping,and 9.39±3.74 for negative coping,respectively.There were statistic difference (P＜0.01) among the total score and 2 dimensions score of career resilience on different level of self-assessment of health among specialist nurses.Specialist nurses,career resilience had a obvious positive correlation with the age,nursing age,core self-evaluations,and positive coping(P＜ 0.01).The results of multivariate linear regression analysis showed that age,self-assessment of health,positive coping and core self-evaluations entered the regression equation of career resilience.Positive coping was a partial intermediate variable of core self-evaluations and career resilience.Conclusion The level of career resilience is medium and it should be enhanced among nurse specialists.The age,self-assessment of health,positive coping and core self-evaluations are possible influencing factors of career resilience.And core self-evaluations can improve career resilience of specialist nurses via the effects of positive coping.

Objective To prepare three kinds of biodegradable film materials used for protein drug carrier,and compare their degradation and drug release behavior.Methods Three different biodegradable and controlled release films,gelatin,chitosan oligosaccharides and crosslinked chitosan oligosaccharides films were prepared.Protein release behavior was determined by the Bradford.At the same time,degradation rate and swelling rate were tested,and the biocompatibility of film was investigated by MTT assay.Results The release time of crosslinked chitosan oligosaccharides film was 168 h,which was longer than that of chitosan oligosaccharides film,and different in different solution.The degradation rate and the swelling rate of crosslinked chitosan oligosaccharides was 60％ (360 h) and 110.45％,respectively,while the chitosan oligosaccharides membrane was 80％ (360 h) and 113.03％.The MTI assay revealed that the crosslinked chitosan oligosaccharides film had better biocompatibility.Conclusions By comparing different properties,the crosslinked chitosan oligosaccharides film is the best choice for protein drug carrier.