An approach was proposed to evaluate preparation technology by means of fingerprint-peak matching technology of high performance liquid chromatography with diode array detector （HPLC-DAD）. Similarity and hierarchical clustering analysis （HCA） were applied to identify the 15 batches of Xiaochaihu granules from different manufacturers and our laboratory, and peak pattern matching between the composite formulae and Radix Bupleuri Chinensis, which was one of the main ingredients of Xiaochaihu granules, was utilized to evaluate the preparation technology of Xiaochaihu granules via the indexes of the relative deviation of retention time （RT） and UV spectrum feature similarity of their corresponding peaks. Eleven matching peaks were found between Xiaochaihu granules and Radix Bupleuri Chinensis. However, the saikosaponin A and saikosaponin D, which are the important active components in Radix Bupleuri Chinensis, were not found in Xiaochaihu granules from any manufacturers. The peak areas of 11 characteristic peaks of Xiaochaihu granules samples formed a matrix of 11 × 15. The result of HCA showed that Xiaochaihu granules samples were divided into four kinds of category. Xiaochaihu granules samples from the same manufacturer were basically clustered of the same category. The results suggested that the saikosaponin A and saikosaponin D are prone to structural transformation under the condition of decoction and in the presence of the organic acidic components. These active components, existing in raw herb, might transform to a series of non-active secondary saikosaponin due to unfavourable preparation technology. So the conventional decoction-based preparation technology of Xiaochaihu granules might greatly affect its quality and therapeutic effectiveness. This study demonstrates that fingerprint-peak matching technology can not only be used for quality control of this composite formulae, but also provide some guidance for preparation technology of Xiaochaihu granules.

OBJECTIVE:To study the extraction process of ginsenoside.METHODS:The optimal extraction process was selected with the orthogonal design.The content of ginsenoside in ginseng was determined by UV-Spectrophotometry.RESUL_TS:The amount and concentration of alcohol and extraction time showed significant influence on extract obtained.CONCLUSI_ON:The optimal extraction process is as follows:adding 75% alcohol into crude ginseng(6∶1 in weight) and extracting 6 times for 45 min each extraction.

OBJECTIVE:To investigate the effects of Wenxin granule on the related indexes of senile patients with primary hy-pertension and acute left cardiac failure. METHODS:160 senile patients with primary hypertension and acute left cardiac failure were randomly divided into control group(80 cases)and observation group(80 cases). Control group received 12.5 mg captopril, orally,twice to 3 times a day (if patients had taken plenty of diuretic drugs,in low sodium and/or low blood volume,patients with normal or low blood pressure,the initial dose was 6.25 mg,3 times a day). Observation group additionally given 9 g of Wenxin granule,3 times a day. The treatment course for both groups was 4 weeks. SBP,DBP,PP,SDANN,SDNN-Index,RMS-SD,PNN50,improvement of cardiac functions before and after treatment,and incidence of adverse reactions in 2 groups were ob-served. RESULTS:After treatment,the SBP,DBP and PP in 2 groups were significantly lower than before,and observation group was lower than control group,SDNN,SDANN,SDNN-Index、RMSSD and PNN 50 were significantly higher than before,and ob-servation group was higher than control group,the differences were statistically significant(P<0.05). And there was no significant difference in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Based on conventional treatment,wenxin granule can significantly reduce the bloop pressure of senile patients with primary hypertension and acute left cardiac failure,improve cardiac functions and inhibit autonomic disorders,with good safety.

Objective The study was designed to evaluate the clinical efficacy of azithromycin in lung function of patients with IPF.Methods Randomized controlled trials were searched in CNKI,data-base of Wanfang and WeiPu,where azithromycin was used to patients with IPF.We extracted all data on lung functions,standardized mean difference (SMD)with 95% confidence intervals (CI )were pooled with Stata 11.0.Results Seven unique trials with 516 participants were identified.Be compared to pred-nisone,the patients with IPF received azithromycin experienced no improvement in FVC% [SMD = -2.00,95% CI =(-2.05,-1.95)],but it was found that azithromycin was superior to prednisone in in-crease the percentage of carbon monoxide diffusing [SMD =1.16,95% CI =(-2.83,5.16)]and de-cline the percentage of residual volume[SMD =3.00,95% CI =(1.04,4.96)].Azithromycin combined with prednisone were statistically superior to prednisone alone in improvement of FEV1 %[SMD =7.80, 95% CI =(5.92,9.67)],FVC%[SMD =7.23,95% CI =(4.89,7.56)]and lung carbon monoxide diffusion function[ml/(min·kpa))][SMD =40.62,95% CI =(38.96,42.28)].Conclusions Our study suggests that azithromycin significantly improvement pulmonary diffusion function in patients with IPF. Azithromycin combined with prednisone were more effective in improvement of FEV1 %,FVC% and lung diffusion function.

Objective To determine the relationship between time management disposition and subjective well-being among the head nurses.Methods Totally 388 cases in third-grade class-A hospitals in Chengdu were investigated with Time Management Disposition Scale and Subjective Well-being Scale.Results The higher the scores in time management disposition,the higher the scores of the head nurses in subjective well-being.There was a significant positive correlation between time management disposition and subjective well-being.Among which,time efficacy feeling and time monitoring view had significant predictable effect toward subjective well-being.Conclusions Time management disposition had significant influences on subjective well-being.It indicates that we can improve subjective well-being and promote mental health of the head nurses to a certain extent through strengthening time management training to improve time management disposition level.

Objective To learn about the status of stress to the life affairs of Tibetan nursing students on 9+3 free Education Programs,and corresponding intervention of mental health problem were put forward.Methods 120 Tibetan nursing students through random sampling were evaluated with Adolescent Self-Rating Life Events Check List (ASLEC).Results The average scores of items such as study pressure,interpersonal relationship and health adaptation were above the median level.The scores of interpersonal relationship,punishment and loss in the 1st grade were significantly higher than those in the 2nd grade and 3rd grade.The score of study pressure in the 2nd grade was higher compared with that in the other grades.In comparison with the other grades,the score of health adaptation in the 3rd grade was higher,and there was significant difference.Conclusions Influence of stress to the life affairs on psyche of Tibetan nursing students in different grades is different.Tibetan nursing students should be given directed intervention of mental health problem according to their risk factors of stress to the life affairs.

Purpose To explore the predictive value of myocardial perfusion in assessing myocardial systolic function recovery after primary percutaneous coronary intervention (PPCI),in order to improve poor prognosis by early detection of myocardial no-reflow.Materials and Methods Forty nine patients with acute myocardial infarction (AMI) who had received PPCI were chosen as subjects.All the patients underwent two-dimensional strain (2DS) images and resting real-time myocardial contrast echocardiography (MCE) within one week after surgery,and 2DS measurement was repeated after three months.2DS imaging was used to acquire longitudinal peak systolic strain (LPSS) at all myocardial segments.Based on the graphs of LPSS,left ventricular myocardium was divided into normal contractile function myocardium (red) and impaired contractile function myocardium (light red,blue).According to the myocardial perfusion scores (MPS) qualitatively assessed by MCE visual interpretation,the myocardia with impaired systolic function were categorized into three groups with different perfusion level.The changes of LPSS within one week and three months after surgery (△ LPSS) among the three groups were analyzed.The correlation between MPS and LPSS within one week and three months after PPCI was also analyzed respectively.Results The △ LPSS increased significantly among the three groups with the improvement of myocardial perfusion level [(-5.78±6.23)％ vs.(-4.37±6.60)％ vs.(-1.21 ±4.77)％,all P＜0.05].The MPS measured one week after PPCI was both positively correlated with the LPSS detected within one week after surgery and that after three months (r=0.47,0.58,P＜0.001).The consistence of myocardial perfusion scores given by two evaluators was good (Kappa=0.785,P＜0.05).Conclusion The level of myocardial perfusion after PPCI in patients with AMI is closely related to regional myocardial systolic function,and the improvement of myocardial perfusion can forecast the recovery of regional systolic function.

BACKGROUND: Enthesitis is the most important pathologic change and one of the characteristic manifestations of spondyloarthropathy(SpA). However, its clinical manifestations lack specificity, and medical imaging techniques become an important auxiliary means in its diagnosis. Currently, ultrasound has been applied to examine the entheses of patients with SpA abroad, but so far there is no investigation about the ultrasonic manifestations of entheses in healthy volunteers.OBJECTIVE: To comprehend the acoustic imaging manifestations of entheses in healthy volunteers, and primarily investigate the feasibility of ultrasound in detecting entheses and the possible impact factors of acoustic imaging manifestations.DESIGN: A nonrandomized inter-controlled trail.SETTING and PARTICIPANTS: A total of 30 young healthy workers and medical students who worked or studied in the Third Affiliated Hospital of Sun Yat-sen University were included in our study, including 22 male and 8 female. None of them suffered from any arthropathies or chronic low back pain.INTERVENTION: High frequency and Color Doppler ultrasound were adopted to detect 540 entheses of 30 healthy volunteers, the entheseal thicknesses were compared respectively according to left and right sides, as well as the gender. X-ray was used to inspect if there were any abnormal findings at the attaching bones.MAIN OUTCOME MEASURES: The thickness, the echo inside entheses, the entourage, the attaching bone and the entheseal blood flow were detected.RESULTS: In normal entheses, there was a little lower but equal resonance, in which there was clear funicular fibrin resonance but without blood signal. Most entheses had a little higher membrane resonance, which was clearly divided from entourage. The surface of attaching bone was smooth and continuous. The mean thickness of the lower insertion of rectus femoris tendon, the upper insertion of patellar ligament, the lower insertion of patellar ligament, the lower insertion of tibial collateral ligament, the lower insertion of fibular collateral ligament, the insertion of Achilles tendon and plantar aponeurosis in male volunteers were(0.50 ±0.06), (0. 50 ±0. 07),(0.42±0.04), (0.20±0.03), (0.38±0.04), (0.52±0.07)and (0. 32 ±0.03) cm respectively, while the mean thickness of the corresponding insertions in female volunteers were (0.44 ± 0. 04), (0. 46 ± 0. 03 ),(0.39±0.03), (0.19±0.02), (0.32±0.02), (0.41±0.06)and (0. 28 ± 0.03) cm respectively. All entheses except for the lower insertion of tibial collateral ligament were thicker in male than in female( P ＜ 0. 05 ),but there were no significant differences in the thickness between left and right insertions ( P ＞ 0. 05 ). Calcification, erosion and hyperplasia of the attaching bone or increasing blood flow were found in 11 entheses of 8 volunteers(2.0% of all the 540 entheses detected) . There were 15 items of abnormal signs all together. Some of the abnormal sites had traumatic histories.CONCLUSION: The thicknesses are almost the same in the corresponding insertions between left and right sides, but the thicknesses of most insertions in male are thicker than those in female. Stature, body mass and exercise might impact on entheseal thickness. Trauma can cause abnormal acoustic imaging manifestations of entheses. Ultrasound is an available approach to detecting etheses.

BACKGROUND: Human leukocyte antigen (HLA)-B27 is closely connected to the occurrence of some rheumatic diseases such as ankylosing spondylitis and can be used as an important factor for evaluating the diagnosis of ankylosing spondylitis. Immunomagnetic separation and enzymelinked immunosorbent assay (IMS-ELISA) has been applied to the detection of HLA-B27.OBJECTIVE: To explore the accuracy, sensitivity and specificity of IMSELISA for detecting HLA-B27 and its value in the auxiliary diagnosis of ankylosing spondylitis.DESIGN: A clinical trial in comparison with the gold standard.SETTING: Departments of Rheumatology and Clinical Laboratory, Third Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Eighty-six patients suffering from low back pain and/or arthritis who were treated for the first time in Department of Rheumatology from December 2002 to April 2003. Inclusion criteria: ① Presence of manifestations of low back pain and/or arthritis; ② Thorough documentation of clinical and other examinations; ③ Informed consent to HLA-B27 examination; ④ Treatment for the first time in the Third Affiliated Hospital of Sun Yet-sen University. Those with other serious diseases or with incomplete record of clinical and/or accessory examinations were excluded. The 86 patients included 56 male and 30 female patients aged from 12 to 65 years.METHODS: Blood sample was detected for HLA-B27 by both IMS-ELISA and microlymphocytotoxicity test, and the latter was selected as the gold standard. The coincidence rate of the results detected by the two methods as well as the sensitivity, specificity, positive and negative predictive values of IMS-ELISA were calculated.MAIN OUTCOME MEASURES: ① The coincidence rate of the results of the two methods. ② The sensitivity and specificity of IMS-ELISA for detecting HLA-B27.RESULTS: None of the patients was lost. For the 33 patients with ankylosing spondylitis, the positivity rate of IMS-ELISA (90.9％) was higher than that of microlymphocytotoxicity test (87.9％), but the difference was not statistically significant (P＞0.05). The total coincidence rate of the two methods was 93.0％ in all the 86 patients. The sensitivity, specificity, positive and negative predictive values of IMS-ELISA were 90.0％, 95.7％,94.7％ and 91.7％ respectively.CONCLUSION: Both IMS-ELISA and microlymphocytotoxicity test are capable of reliable examination of HLA-B27 with high sensitivity and specificity.