Paclitaxel is one of the most effective broad-spectrum chemotherapeutic agents in the treatment of cancers.However,its clinical application has been limited due to its poor water solubility.Its current clinical administration results in serious side effects and has undesired pharmacokinetics and biodistribution.Therefore,it is need to develope alternate drug delivery systems of paclitaxel to enhance its solubility,permeability and stability,furthermore to promote a sustained,controlled and targeted delivery.Hyaluronic acid as the carrier of drug delivery system can solve the problems.Hyaluronic acid-paclitaxel nanoparticles have high anticancer efficiency in drug encapsulation and tumor cellular uptake,due to their appropriate size,surface modification and interaction with CD44.This review focuses on recent applications of hyaluronic acid-paclitaxel nanoparticles in a variety of malignant tumors.

Objective To explore the clinical effects of arginine-rich enteral nutritional support therapy in patients undergoing gastrectomy.Methods The clinical data of 84 patients with gastric carcinoma who were admitted to the Wuhan Central Hospital from January 2013 to December 2014 were retrospectively analyzed.Mter gastrectomy,42 patients undergoing arginine-rich enteral nutritional support therapy were allocated to the argininerich enteral nutrition (AEN) group and 42 patients undergoing standardized enteral nutritional support therapy were allocated to the enteral nutrition (EN) group.The indexes of nutrition [BMI of patients were calculated and serum total protein (TP),albumin (Alb) and prealbumin (PAB) were detected] and immunology [T-lymphocyte subsets,total number of lymphocyte,white blood cell (WBC) and CD4 +/CD8 + were detected by flow cytometry],postoperative complications and indexes of prognosis were analyzed.The measurment data with normal distributionwere presented as (x) ± s.The comparision between groups were evaluated with the t test and repeated measures ANOVA.The count data were analyzed using the chi-square test.Results The value of TP from preoperation to postoperative day 7 was from (64 ± 16)g/L to (55 ± 13)g/L in the AEN group and from (65 ± 21)g/L to (52 ±11) g/L in the EN group,with no significant difference between the 2 groups (F =29.653,P ＞ 0.05).The values of Alb and PAB from pre-operation to postoperative day 7 were from (33 ± 17) g/L to (32 ± 3) g/L and from (0.20 ± 0.01) g/L to (0.26 ± 0.06) g/L in the AEN group and from (32 ± 19) g/L to (27 ± 5) g/L and from (0.20 ±0.03)g/L to (0.22 ±0.03) g/L in the EN group,respectively,with significant differences in the Alb and PAB between the 2 groups (F =21.784,10.653,P ＜ 0.05).The number of WBC,number of lymphocyte and percentage of CD8 + T-cell in the AEN group were (5.3 ± 0.7) × 109/L,(1.39 ± 0.06) × 109/L and 17.3 ％ ±3.5％ before operation and (5.9 ±0.7) × 109/L,(1.33 ± 0.03) × 109/L and 18.4％ ± 3.8％ after operation.The number of WBC,number of lymphocyte and percentage of CD8 + T-cell in the EN group (5.1 ± 0.5) × 109/L,(1.40±0.04) × 109/L and 16.4％±2.8％ before operation and (5.4±0.5) ×109/L,(1.23±0.04) ×109/L and 17.3％ ± 3.1％ after operation.There was no significant difference in the above indexes between the 2 groups (F =17.429,20.461,38.820,P ＞ 0.05).The percentages of CD4 + T-cell and CD4 +/CD8 + before operation and at postoperative day 10 were 34.7％ ± 5.4％,39.5％ ± 3.9％ and 1.80 ± 0.29,2.23 ± 0.32 in the AEN group,and 33.2％±4.6％,34.6％±2.4％ and 1.73 ±0.26,1.82 ±0.42 in the EN group,respectively,with no significant difference in the above indexes between the 2 groups (F =14.398,7.473,P ＜ 0.05).The incidences of postoperative complication in the AEN group and in the EN group were 9.5％ (4/42) and 31.0％ (13/42),showing a significant difference between the 2 groups (x2=4.459,P ＜ 0.05).The duration of postoperative systemic inflammatory response syndrome (SIRS) were (1.3 ± 0.6)days in the AEN group and (2.4 ± 1.0) days in the EN group,with a significant difference between the 2 groups (t =6.360,P ＜ 0.05).The time to anal exsufflation and time of bowel movements were (2.6 ± 0.3) days and (3.6 ± 0.5) days in the AEN group and (2.5 ± 0.3) days and (3.5 ± 0.5) days in the EN group,respectively,with no significant difference between the 2 groups (t =1.570,0.897,P ＞ 0.05) . There was no perioperative death.The hospital expenses were (17 000 ±4 000) yuan in the AEN group and (22 000 ±5 000) yuan in the EN group,with a significant difference between the 2 groups (t =3.860,P ＜ 0.05).Conclusion Arginine-rich enteral nutritional support therapy is superior to standardized enteral nutrition in effectively improving postoperative nutrition status,immune function and prognosis of patients undergoing gastrectomy.

Objective To observe the clinical effect of the Placenta Polypeptides injection combined with paclitaxel plus paraplatin(TC)chemotherapy in the treatment of advanced ovarian cancer.Methods Eighty patients with advanced ovarian cancer receiving tumor cytoreductive surgery were divided into the treatment group and control group,40 cases in each group.The control group accepted single TC chemotherapy,while on this basis the treatment group was added with the Placenta Polypeptides injection.The short-term effect,KPS scores and occurrence of chemotherapeutic toxic reactions were observed in both groups.Results The short-term effective rates in the treatment group and control group were 90.00％ and 87.50 ％ respectively,the difference was not statistically significant (P＞0.05);the living quality KPS score in the treatment group was significantly better than that in the control group,the difference indicated statistical significance(P＜0.05).The occurrence rates of adverse reactions,including leukopenia,nausea and vomiting,liver function damage,heart toxicity,muscle and joint pain were significantly lower than those in the control group (P＜0.05).Conclusion The Placenta Polypeptides injection combined with TC chemotherapeutic regimen in the treatment of advanced ovarian cancer could improve the quality of life of the patients,reduce the toxic and adverse reactions of chemotherapeutic drugs.

BACKGROUND:A cross-emulsification patented product of microporous polysaccharide hemostatic powder was prepared using potatoes as raw material with independent intel ectual property rights.
OBJECTIVE:To observe hemostasis effects of microporous polysaccharide hemostatic powder on soft tissue trauma.
METHODS:A wound, about 3 cm long and 0.5 cm deep, was made on the abdominal soft tissue of rabbits in the experimental group 1, and then microporous polysaccharide hemostatic powder, 1.0-2.0 g, was sprayed directly on the wound. In the experimental group 2, a wound, about 3.0 cm long and 1.0 cm deep, was made on the abdominal soft tissue of rabbits, and then microporous polysaccharide hemostatic powder, 1.0-2.0 g, was sprayed directly on the wound. Another rabbits with untreated wound served as controls.
RESULTS AND CONCLUSION:Microporous polysaccharide hemostatic powder formed a“pasty gel”covering the bleeding wound that achieved hemostatic effect. The bleeding time was (15.25±1.04) seconds in the experimental group 1 and (11.25±1.89) seconds in the experimental group 2. The marked effective and effective rates for hemostasis were 87.5%and 100%, respectively. In the control group, the bleeding time was more than 5 minutes. Hematoxylin-eosin staining showed mild muscle edema, vasodilatation of smal blood vessels, and few scattered endoplasmic neutrophils infiltrated at 24 hours after treatment with microporous polysaccharide hemostatic powder;til the 7th day, inflammation subsided, mild fibrosis was visible on muscle tissue surface, the hemostatic powder was completely absorbed, the wound tissue was close to the normal tissue, and there were no significant changes in muscle cells. These findings suggest that microporous polysaccharide hemostatic powder can be used for hemostasis of soft tissue trauma.

OBJECTIVE: To study the relationship among the dosage, serum concentration and clinical effect of phenytoin(PHT) in treating epileptic patients .METHODS: 130 steady -- state serum concentrations of PHT were determined by fluores-cence polarization immunoassay(FPIA) in 70 patients with or without other drugs used in combination .RESULTS: The indi-vidual difference among the patients who received routine dosage of PHT was very significant. Intoxication occurred ex-tremely often in patients whose PHT serum concentrations were over 30?g/ml .CONCLUSION: It is necessary to perform TDM(Therapeutic Drug Monitoring) and individualize the use of PHT,so that the safe and effective use of drug can be ensured.

Objective To establish an assessment scale for hospital stroke patients with Delphi method,by using it to help the nurses evaluate patients' existing and potential problems,and to provide foundations for specific assessment on different patient groups.Methods The first-level indicators and second-level indicators were developed on the basis of the Omaha system.210 nursing records of hospital stroke patients were then combined with to form concrete items.Totally 22 nursing specialists were interviewed with two rounds in order to further collect the opinions and suggestions about the assessment scale.Results 4 first-level indicators,35 second-level indicators and a number of items were included in the assessment scale.Conclusions The assessment scale for hospital stroke patients established by Delphi method comprehensively shows the environmental,physical,mental and behavioral condition in hospital,and it could be used as a tool to assess the hospital stroke patients.

Objective Systemic analysis the effect of the application of continuity nursing in community diabetes.Methods Retrieve documents from the PubMed,Cochrane Library,EMBASE,Science Direct,CBM,WANFANG Data and CNKI.Dating from the dates of establishment to May,2014.Randomized controlled trials (RCTs) on continuity of patient care for patients with diabetes were included.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted the data and assessed the quality of the included studies,and then meta-analysis was performed by RevMan 5.1 software.Results 5 RCTs (156 cases with diabetes) were involved into this Meta-analysis.The experimental group was superior to the control group in FBG,2h PBG,HbA1c and the level of treatment compliance,with statistically significant differences,P＜0.05.The descriptive analysis showed that the differences in the score of diabetes knowledge and the quality of life were statistically significant,P＜0.05,because the data could not be converted.Conclusions The continuity nursing can improve the compliance and the quality of life of community diabetes,ameliorate certain biochemical indicators.Study of large sample and RCTs should be take because of the existence of some restraining factors.

Objective To study preparation of micronized Shuanghuangpo hydrogel patch and its characteristics of transdermal penetration in vitro. Methods Micronized Shuanghuangpo hydrogel patch was prepared with some macromolecular water-soluble materials as gel base.The content of berberine was determined by HPLC method.Its transdermal penetration in vitro was determined according to the method of Chinese Pharmacopoeia 2010 edition. The rat skin penetration test in vitro was performed by modified Franz diffusion cell method. Results The hydrogel patch had constant content of berberine. Its release property in vitro conformed to Higuchi equation. The penetration of berberine in the hydrogel patch through the rat skin followed zero-order dynamics in 12 h.Its release rate was 7.934μg??(cm2)-1??h1/2 and percutaneous rate was 0.571μg??(cm2)-1??h-1. Conclusion The micronized Shuanghuangpo hydrogel patch is a new transdermal agent with sustained release property.

Objective To evaluate the efficacy of adjustable oral appliance (OA) on ventilation of patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Databases were searched from Junuary 1990 to July 2014 for randomized controlled trials on the use of adjustable OA for the promotion of ventilation in OSAHS.Meta analysis was performed with RevMan5.2 software,and descriptive analysis of the data that could not be converted and merged was performed.Results Totally 6 RCTs involved,including 1 109 patients,which involved 4 random parallel controlled trials and 2 random crossover controlled trials.Meta-analysis showed that adjustable OA were associated with a decreased apnea-hypopnea index(AHI) [fixed effect model,WMD=-2.38,95％CI (-3.59--1.17),P＜0.01] and an improvement in minimum arterial oxygen saturation (SaO2)[randomized effect model,WMD=3.09,95％CI(1.16-5.02),P＜0.01] of OSAHS patients.The descriptive analysis showed that the difference in the sleep score was not statistically significant because the data could not be converted.Conclusions Compared to fixed oral appliance,adjustable oral appliance produced greater effect in reduction of AHI and the improvement in minimum SaO2,but the sleep score is not improved significantly,the large sample and multi-center randomized controlled test needs to be designed for the verification of comprehensive effect of adjustable oral appliance.

BACKGROUND:Microporous vacuum polysaccharide hemostatic microspheres are derived from degenerated potato plant starch and prepared through special processing. It is an ideal absorbable polymer styptic material with independent intelectual property rights. OBJECTIVE: To observe the degradation of microporous vacuum polysaccharide hemostatic microspheres and detect the safety indicators of body fluids by implanting microporous vacuum polysaccharide hemostatic microspheres in rats. METHODS:0.1-0.2 g microporous vacuum polysaccharide hemostatic microspheres were implanted subcutaneously on the left side of the spine in 12 rats. At the 1st, 3rd, 7th and 14th days after implantation,the degradation of microporous vacuum polysaccharide hemostatic microspheres in the tissue was observed. Another 15 rats were selected, of which 5 rats were taken as the control group and fed normally, and 10 rats were subjected to anesthesia. Two incisions were made on both sides of the spine, about 5 cm, deep into the muscular layer of 0.3 cm. The right amount of hemostatic microspheres were sprayed on the incisions and covered the entire wound, then the incisions were sutured. The 10 rats were raised normally for 14 days. The various indicators of body fluids such as appearance features, activities, excretion, feeding were detected. Finally, the rats were dissected, and the gross morphology and color changes of main organs were observed. RESULTS AND CONCLUSIONS: The microporous vacuum polysaccharide hemostatic microspheres buried in rats were completely degraded and absorbed within 7 days. After spraying the right amount of microporous vacuum polysaccharide hemostatic microspheres on the incision, the vital signs and biochemical indicators, such as blood and urine tests were all normal. The gross morphology and color of main organs such as liver, spleen, brain and kidney were not found significant anomalies. These results demonstrate that microporous vacuum polysaccharide hemostatic microspheres can be degraded into monosaccharide by amylase and can be completely degraded and absorbed within 7 days, without any side effects to tissues and organs.