Monographs of Chinese medicine into the United States Pharmacopeia and the European Pharmacopoeia is the prerequisite and foundation for the aim of Chinese medicine standards leading the international standard-set-ting. By comparative analysis of the key issues of quality standards among Chinese, American and European Phar-macopoeia, thoughts and suggestions are proposed on how to implement the construction of international quality stan-dard of traditional Chinese medicine. Meanwhile, under the pressure of the present international environment, the pa-per can also provide some reference and advices which can help to break down the difficult situation for the process of internationalization of traditional Chinese medicine.

To investigate the effect of Cornu Cervi Oral Liquid (mainly composed of Cornu Cervi, Fructus Psoraleae, Herba Epimedii, Fructus Corni, Fructus Ligustri Lucidi and Lignum Aquilariae Resinatum) in reversing myocardial fibrosis in rats with congestive heart failure caused by pressure overload and to explore its mechanism. Thirty six male Wistar rats were randomly allocated to mimic operation group (Group A), model group (Group B) and Cornu Cervi Oral Liquid group (Group C). Rat models of congestive heart failure were induced by constriction of abdominal aorta. Left ventricular mass index(LVMI) was observed; contents of collagen type Ⅰ and Ⅲ in left ventricular cardiac muscle were detected by immunohistochemical method and their mRNA expression by RT PCR; and plasma levels of angiotensin Ⅱ (AngⅡ), atrial natriuretic factor (ANF) and serum aldosterone (ALD) level were measured by radioimmunoassay method. LVMI, contents of collagen type Ⅰ and Ⅲ and their mRNA expression, levels of plasma and myocardial AngⅡ, plasma ANF and serum ALD were higher in Group B than those in Group A (P0 05).[Conclusion]Cornu Cervi Oral Liquid is effective in reversing myocardial fibrosis in rats with congestive heart failure caused by pressure overload and its mechanism may be related to the decrease of contents of collagen type Ⅰ and Ⅲ and their mRNA expression, levels of plasma and myocardial AngⅡ, plasma ANF and serum ALD.

BACKGROUND: Congestive heart failure (CHF) is the clinical syndrome of all kinds of heart disease on the serious or final stage. About half of patients with organic heart disease will have heart failure that has a high incidence rate and mortality. The survival of heart failure was inferior to that of malignant tumor.OBJECTIVE: To confirm the clinical effect of Lujiao prescription on CHF and elucidate its possible mechanism.DESIGN: A control observation on CHF patients.SETTING: Department of Cardiovasology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.PARTICIPANTS: A total of 60 patients with CHF were selected from the department of cardiovasology in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1996 to December 1998. There were 31 male and 29 female. Included criteria: ①All of patients were consistent with Framinham diagnostic criteria. ② Above Ⅲ degree by New York Heart Association(NYHA). ③ Three months case history. ④Accept quantity sufficient diuretic and vasodilating agent (exclude angiotensin converting enzyme inhibitor ). ⑤ Left ventricle hypertrophy was proved by echocardiogram or chest X-ray. ⑥ Differentiation of symptoms and signs of Traditional Chinese Medicine refers to asthenia syndrome of differentiation of symptoms and signs of Traditional Chinese Medicine (1986, Researching Association of Chinese integrated medicine) General state of health and basic disease of the patients in the two groups were not significant deviation.METHODS: 60 patient s of CHF were randomly divided into Lujiao prescription group(n=40) and Digoxin group (n=20) at the rate of 2:1. Lujiao prescription group: Orally liquid decoction of Lujiao Prescription 35 mL (1 mL contain crude drug 1.6 g) Bid. po. Course of treatment: 4 weeks. Digoxin group: Digoxin tablet, 0.125-0.25 mg, qd. po. course of treatment: 4 weeks.After 4-week treatment, the patients' clinical effect, integrals of the symptoms of renal deficiency, classification of function capacity of the NYHA,Lee's heart failure score, heart rate(HR), myocardium oxygen consumption (MOC), proportion of heart to chest, echocardiogram, measurement of plasma angitention Ⅱ (Ang Ⅱ ) and plasma atrial natriuretic factor (ANF) were observed.MAIN OUTCOME MEASURES: ① The total clinic effective rate. ②Integrals of the symptoms of renal deficiency. ③ Classification of function capacity of the NYHA. ④ Lee's heart failure score. ⑤HR and MOC. ⑥The proportion of heart to chest. ⑦ Ejection fraction(EF), cardic output (CO), interventricular septal thickness (IVST), posterior wall thickness (PWT) and left ventricular mass index (LVMI) through echocardiogram. ⑧The measurement of plasma Ang Ⅱ and plasma ANF.RESULTS:Totauy 60 patients entered the final analysis. ① The total clinical effective rate of the Lujiao prescription group was 90 %, which showed no significant difference from the Digoxin group (90 %, P ＞ 0.05).② Improvement was significantly observed in the integrals of the symptom of renal deficiency of the patients in the Lujiao prescription group after treatment (P ＜ 0.01), but which was not significant in the Digoxin group(P＞ 0.05). ③ It was found that classification of functional capacity of NYHA between Lujiao prescription group and Digoxin group after treatment was obviously decreased (P ＜ 0.01). ④ Lee's heart failure score of patients in Lujiao prescription group and Digoxin group after treatment was decreased (P ＜ 0.01). ⑤Myocardium oxygen consumption and HR of the patients in the Lujiao prescription group and Digoxin group after treatment was decreased (P ＜ 0.01). ⑥ The proportion of heart to chest between Lujiao prescription group and Digoxin group after treatment was decreased (P ＜ 0.01).⑦ EF and CO were increased by Lujiao prescription and by Digoxin (P＜ 0.01,vs pretreatment, respectively). IVST, PWT, LVMI of Lujiao prescription group after treatment were obviously decreased (P ＜ 0.01), while those of the Digoxin group were not obviously decreased (P ＞ 0.05). ⑧ Thlevel of plasma Ang Ⅱ of the patients in the Lujiao prescription group after treatment were obviously decreased (P ＜ 0.01), while that of the Digoxin group were not obviously decreased (P ＞ 0.05). The level of plasma ANF was decreased by Lujiao prescription and by digoxin(P ＜ 0.01, vs pretreatment, respectively).CONCLUSION: There is increasing cardiac constriction power and regressing left ventricular hypertrophy of patients with CHF by Lujiao prescription. The therapeutical effect of Lujiao prescription for CHF is better than that of Digoxin. The effect may be related to the regulation of circular or local endocrine(plasma Ang Ⅱ and ANF) disorder.

BACKGROUND: Left ventricular hypertrophy (LVH) is an important ring-joint of congestive heart failure (CHF). It is also considered to be independent risk factor of cardiovascular disease, so how to reverse or relieve LVH is valuable to cure CHF.OBJECTIVE: To observe the effect of Lujiao prescription on degree of LVH in patients with CHF.DESIGN: A random-control observation on CHF patients.SETTING: Department of Cardiovasology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.PARTICIPANTS: A total of 20 patients with CHF were selected from the Special Clinic and Department of Cardiovasology in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1996 to December 1998. All of them were consistent with the Framirham diagnostic criteria and following standardizations: ①above Ⅲ degree of cardiac functional grading by New York Heart Association (NYHA);②over 3 months case history;③accepted basic treatment of quantity sufficient diuretic and vasodilating agent excluding angiotensin converting enzyme inhibitor (ACEI);LVH was proved by echocardiogram or chest X-ray. They were informed of treatment items and consented.METHODS: According to random lot, the patients were divided into Lujiao prescription group and Digoxin group, each containing 10 patients.①Oral administrations of Lujiao prescription (35 mL, two times per day, produced by Shanghai Shuguang Hospital) and Digoxin (0.125-0.25 mg per tablet, batch number: 970757, once daily) were given in the corresponding groups, and the treatment duration was 3 months. After treatment, all the patients were detected in①NYHA cardiac functional grading; ②interventricular septal thickness (IVST) and posterior wall thickness (PWT) in diastolic phase through echocardiogram, myocardium weight of left ventricular by Devereux formula, left ventricular mass index (LVMI) corrected by bodysurface area, and degree of LVH;③the level of plasma angiotensin Ⅱ (Ang Ⅱ ) by radioactive immunoassay.MAIN OUTCOME MEASURES: NYHA cardiac functional grading, e-chocardiogram (IVST, PWT, LVMI, degree of LVH), the level of plasma Ang Ⅱ.RFSULTS: All 20 adopted patients entered the result analysis.①The classification of NYHA cardiac functional grading ( Ⅰ , Ⅱ ,Ⅲ,Ⅳ) were respectively 2, 5, 3, 0 case in Lujiao prescription group and 2, 4, 4, 0 case in Digoxin group after treatment, and difference was significant compared with those before treatment (0, 0, 7, 3, P ＜ 0.05).②IVST, PWT and LVMI of Lujiao prescription group were obviously decreased after treatment [(11.20±0.42), (12.10±0.32) mm, P ＜ 0.01; (10.60±0.84), (11.40±1.10) mm,P ＜ 0.01; (139.4±12.4), (155.3±15.4) g/m2, P ＜ 0.01], while those of the Digoxin group were untouched (P ＞ 0.05). The degree of LVH of Lujiao prescription group after treatment was obviously decreased [normal, mild,moderate, sever: 2, 6, 2, 0; 0, 3, 4, 3, P ＜ 0.01], while that of the Digoxin group was not obviously decreased (P ＞ 0.05).③)The level of plasma Ang Ⅱin the Lujiao prescription group was obviously decreased [(97.7±19.5),(144.0±18.5) ng/L, P ＜ 0.01], while that of the Digoxin group was not obviously increased (P ＞ 0.05).CONCLUSION: Lujiao prescription can reverse or relieve the degree of LVH in patients with CHF.

BACKGROUND: Pressure overload can lead to the activation of reninangiotensin-aldosterone system, and then left ventricular remodeling occurs.Captopril can reverse this progress.OBJECTIVE: To observe the effect of captopril in reversing left ventricular remodeling in rats with pressure overload and to elucidate its possible mechanism.DESIGN: A randomized controlled trial.SETTING: Department of Integrated Traditional Chinese Medicine and Western Medicine, Nanjing General Hospital () Nanjing Military Area Command of Chinese PLA; Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine; Postdoctor Institute of Hebei Medical University.MATERIALS: The experiment was conducted in the Laboratory of Shanghai University of Traditional Chinese Medicine between January 1998 and October 1998. Totally 153 male Wistar rats were recruited.There were 5 experiments, 36 rats in each experiment except 9 rats in the fourth one.METHODS: A total of 36 Wistar male rats selected for each experiment were randomly divided into sham operation group, model group and captopril group. Rats in model group received modeling for 4 weeks, then gastric perfusion with 15 mL/kg of distilled water once per day for 4 consecutive weeks. Abdominal aorta of the rats in sham-operation group were separated without closure by sliver clip, then 4 weeks later the procedure was the same as that in model group. In captopril group, 4 weeks after modeling, the rats were performed gastric perfusion with diluted captopril of 100 mg/kg, once a day for 4 consecutive weeks.MAIN OUTCOME MEASURES: The effect of captopril on left ventricular mass index (LVMI), mRNA expression of collagen type Ⅰ and Ⅲ, content of plasma angiotensin Ⅱ (Ang Ⅱ ) and left ventricular tissue Ang Ⅱ,plasma atrial natriuretic factor (ANF), and serum aldosterone (ALD) level.RESULTS: Totally 153 rats entered the result analysis. During the test for detecting the absorbance (A) of collagen type Ⅰ, 3 rats in sham operation group and 3 in captopril group died, and 1 rat died in model group; finally 29 rats were involved. During the test for detecting the absorbance (A) of collagen type Ⅲ, 3 rats died in sham operation group, 4 rats diedin model group, and 2 rats died in captopril group; finally 27 rats were involved. All in sham operation group and captopril group was lower than that in model group [(2.24±0.12)/1 000, (2.67±0.40)/1 000, (3.15±0.47)/1 000, t=2.649,cantly lower in sham operation group and captopril group than in model group [(0.57±0.19, 0.86±0.25, 2.79±2.00), t=3.661, 3.170, P ＜ 0.01, 0.05].operation group and captopril group than in model group [(0.48±0.10,sion of mRNA of collagen type Ⅰ: It was significantly lower in sham operation group and captopril group than in model group [(79.1 ±18.6)%,plasma Ang Ⅱ content: It was significantly lower in sham-operation group and captopril group than in model group [(130.2±30.2),(137.6±39.5),was significantly lower in sham operation group and captopril group than in model group [(170.6±51.6), (202.5±64.2), (339.3±115.4) μg/L, t=4.623,P ＜ 0.01].type Ⅲ and mRNA expression in rats with pressure overload, suggesting its captopril on left ventricular remodeling might be related to decreasing circulating or local Ang Ⅱ level, plasma ANF and serum aldosterone as well as affecting the expression of collagen type Ⅰ and type Ⅲ mRNA.

Objective To determine the value of 18F-FDG PET/CT in the detection of subsolid pulmonary nodules.Methods The 18F-FDG PET/CT imaging data of 44 patients (35 males,9 females,mean age (68.05±9.89) years) with 49 subsolid pulmonary nodules were retrospectively analyzed.There were 28 pure ground-glass nodules (pGGN) and 21 part-solid nodules (PSN),which were all confirmed by postsurgical pathology or imaging results during follow-up.The lesion size (dmax),ground-glass opacity (GGO) percentage,SUV retention index (RI),and the positive rates on PET images were accessed.The correlation between SUVmax and lesion size and GGO percentage was analyzed by Pearson correlation analysis.The SUVmax between benign and malignant pGGN,and that between malignant pGGN and PSN,were compared using two-sample t test.The diagnostic accuracy was compared using x2 test.Results (1) Six pGGN were benign while 43 nodules (including 22 pGGN and 21 PSN) were malignant among the 49 nodules.(2) SUVmax was positively correlated with lesion size (r=0.500,P＜0.05) and was negatively correlated with GGO percentage (r=-0.605,P＜0.05) for PSN,while SUVmax was positively correlated with lesion size (r=0.375,P＜0.05) for pGGN.(3) SUVmax was not significantly different (t =-0.813,P＞0.05) between 6 benign pGGN (0.78±0.25,range:0.50-1.20) and 22 malignant pGGN (0.91±0.34,range:0.40-1.70);SUVmax of 21 malignant PSN (2.10±1.16,range:0.60-5.60) was higher than that of 22 malignant pGGN (t=-4.645,P＜0.05).(4) When a nodule's activity being equal to or greater than that of mediastinal blood-pool was defined as malignancy,the accuracy rate of PSN (66.7％,14/21) was significantly higher than that of pGGN (9.1％,2/22; x2 =15.244,P ＜0.05).Based on the criteria for malignancy of RI＞10％,the accuracy rates for PSN and pGGN were 65.0％ (13/20) and 45.8％ (11/24),respectively (x2 =1.616,P＞0.05).Conclusion 18F-FDG PET/CT shows no clear advantage for diagnosis of pGGN,but is helpful for PSN.

Objective To explore the effect of timeliness motivation theory-based continuing care on the self-care ability and healthy behavior in elderly patients with type 2 diabetes. Methods A total of 202 elderly patients with type 2 diabetes in our hospital were selected,and were randomly divided into observation group and control group according to the random number table, with 101 cases in each group. The control group were given healthy related education during hospitalization , and post-discharge telephone follow-up every month, lasting 10~15min each time.The observation group were additionally given timeliness motivation theory-based continuing care by telephone follow-up each month , including emotional arousal , need motivation , examples stimulating and benefit motivation, lasting 6 months. Their self-care ability and healthy behavior in the two groups were compared. Result The self-care ability in the observation group was significantly significantly better than that of the control group (P<0.001), and had significantly much more healthy behaviors than the latter (P < 0.001). Conclusion Timeliness motivation theory-based continuing care can improve the self-care ability and healthy behavior in elderly patients with type 2 diabetes.

Objective To observe the therapeutic effect of hoop circumference drug,Hongzhongxiao tincture,on the treatment of skin abscess in rats under the guidance of defended field theory.Methods Forty SpragueDawley (SD) rats were randomly divided into normal control group,model group,western medicine control group,Hongzhongxiao pretreatment group and Hongzhongxiao treatment group according to the computer generated random number.Subcutaneous abscesses models were reproduced by subcutaneous injection of 1 mL (3-5 × 109 cfu/mL) of staphylococcus aureus,and the normal control group was subcutaneously injected with the same amount of normal saline.After molding,the rats in the model group were treated with normal saline for change of dressing;the western medicine control group was treated with mupirocin ointment for external use;Hongzhongxiao pretreatment group was treated with 2 mL of Hongzhongxiao for dressing 4 hours after the modeling;in Hongzhongxiao treatment group,2 mL dressing was given after the emergence of hard swelling,and the Hongzhongxiao drug range applied was 1 cm over the swelling range.Each group was dressed once daily.The changes of mental state,body weight,skin temperature,range and time of abscess formation,wound ulceration and healing time,transcutaneous oxygen pressure (TcPO2) at the periphery of abscess were observed in each group.Results ① After modeling,the activity of the rats was decreased,the appetite became worse,and the food intake less.Except the normal control group,the rats in other groups had different degrees of mental listlessness.② After 3 days of treatment,the body weight gain of the model group was significantly lower than that of the normal control group (g:8.75 ± 9.85 vs.31.67 ± 7.92,P ＜ 0.01),and continued to 18 days after treatment (g:27.13± 11.70 vs.98.00 ± 8.94);after treatment for 18 days,the body weight gain in the western medicine control group,Hongzhongxiao pretreatment group and Hongzhongxiao treatment group was significantlyhigher than those of model group (g:53.28 ± 19.69,49.12 ± 7.23,44.71 ± 12.42 vs.27.13 ± 11.70,all P ＜ 0.05).③ After 3 days of treatment,the body temperature of the model group was obviously lower than that of the normal control group (℃:33.75 ± 0.68 vs.35.03 ± 0.41,P ＜ 0.01) and continued to 10 days (℃:34.30 ± 0.35 vs.35.03 ± 0.41,P ＜ 0.01).The body temperature of the rats in Hongzhongxiao pretreatment group was significantly lower than that in the normal control group,the model group and the western medicine control group on the 14th day after treatment (℃:33.97 ± 0.83 vs.35.10 ± 0.57,35.01 ± 0.68,35.25 ± 0.23,all P ＜ 0.05).The body temperature of Hongzhongxiao treatment group was significantly higher than that of the Hongzhongxiao pretreatment group (℃:34.87 ± 0.94 vs.33.97 ± 0.83,P ＜0.05).④ After treatment for 13,15,17 days,the contraction rates of swollen area in western medicine control group,hongzhongxiao pretreatment group and hongzhongxiao treatment group were greater than the rate in model group,and the change was most significant on the 17th day after treatment [(96.37 ± 5.09)％,(92.76 ± 13.56)％,(98.41 ± 3.85)％ vs.(77.46 ± 19.07)％,all P ＜ 0.05].⑤ Compared with the model group,the times of abscess localization in the western medicine control group,the Hongzhongxiao pretreatment group and the Hongzhongxiao treatment group was shorter than that in the model group (days:9.28 ± 1.38,7.33 ± 1.97,7.67 ± 1.63 vs.12.63 ± 1.99,all P ＜ 0.05);the time of wound healing in Hongzhongxiao pretreatment group aud Hongzhongxiao treatment group were significantly shorter than those of the model group (days:17.67 ± 1.03,16.83 ± 1.51 vs.19.92 ± 2.33,P ＜ 0.05).⑥ TcPO2 in the Hongzhongxiao pretreatment group was significantly higher than that in the model group on the 7th day after treatment [mmHg (1 mmHg =0.133 kPa):63.33 ± 9.77 vs.39.51 ± 8.42],and the Hongzhongxiao treatment group (44.25 ± 6.41) was significantly lower than that of the Hongzhongxiao pretreatment group,and the Hongzhongxiao treatment group was significantly higher than that of the model group (59.50 ± 7.34 vs.49.52 ± 10.17) on the 14th day after drug application,and the western medicine control group was significantly lower than that of the model group (37.71 ± 5.63 vs.54.33 ± 7.74),the Hongzhongxiao pretreatment group and Hongzhongxiao treatment group were significantly higher than those of the western medicine control group,the difference being statistically significant (all P ＜ 0.05).Conclusions The Hongzhongxiao tincture applied on top and circumferentially around the periphery of the abscess can reduce the local inflammatory response,improve the body weight and mental state,increase the blood supply around wound periphery for anti-infection and anti-inflammation in order to promote the formation of defending field of nursing.Although the early application of Hongzhongxiao tincture cannot reduce the local infectious symptoms and kill the Staphylococcus aureus,it can make skin abscess localization as soon as possible and shorten the wound healing time.

Objective To compare the anesthetic effects,safety and side effects of the mixture with different ratios of etomidate to propofol in painless gastroscopy.Methods Two hundred patients scheduled for painless gastroscopy,95 males and 105 females,aged 18 to 65 years,BMI 18.5-27.0 kg/m2,ASA physical status Ⅰ or Ⅱ,were randomized into two groups,group A (the ratio of eto-midate and propofol volume 1:1);group B (the ratio of etomidate and propofol volume 1:2).All of the patients were injected with sufentanil 0.1 μg/kg at first.All patients were given the first dose of 0.15-0.2 ml/kg intravenously slowly.Repeated doses of 1-2 ml etomidate-propofol were administered to maintain an adequate level of sedation.HR,SBP,DBP and SpO2were monitored.The dosages of etomidate and propofol were recorded.At the same time the induction time,the operation time,the recovery time and the leaving time were recorded.And low blood pressure,hypoxia saturation,re-spiratory obstruction,muscle fibrillation,nausea and vomiting and other adverse reactions were re-corded.Results There was no significant difference between group A and group B in the induction time,the operation time,the recovery time,the leaving time,perioperative hypotension,periopera-tive hypoxia and injection pain.The dosage of etomidate in the group A was significantly more than in the group B (P<0.01).The dosage of propofol in the group A was significantly less than in the group B(P<0.05).The incidence of myoclonus in group A was notably higher than that in the group B (P<0.01),The incidence of nausea and vomiting in group A was higher than that in the group B (P<0.05).Conclusion Etomidate plus propofol (1:2)had less incidence of myoclonus and nausea and vomiting,and it is more suitable for gastroscopy than 1:1 EP mixture.

Through comparative analysis on the quality standards in Japanese Pharmacopoeia Seventeenth Edition,Korean Pharmacopoeia,Taiwan herbal Pharmacopoeia and pharmacopoeias of neighboring countries and regions,thoughts and suggestions are proposed on how to use the advantages of them,and research thoughts for available reference are provided for the construction of more scientific and feasible quality standards of traditional Chinese medicine.