Objective:To optimize the formula of nifedipine nanoemulsion (NFNE) to lay foundation for the development of nifedipine transdermal preparation.Methods:The content of nifedipine as the index,the compositions in the formula were screened out by single factor experiments,and then the formula of NFNE was optimized by orthogonal tests with the ratio of emulsifier to co-emulsifier,ratio of mixed emulsifiers to oil phase and the amount of water as the influencing factors.N-Trimethyl chitosan (TMC) was used as the transdermal enhancer.The formula of TMC-NFNE was optimized by orthogonal tests with the degree of quaternization of TMC,the concentration of TMC solution and the amount of TMC solution as the influencing factors.The quality evaluation of TMC-NFME was determined including appearance,type identification,particle size and drug content.Results:The optimal formula was as follows:7% ethyl oleate,32% Tween 80,16% alcohol,45%water and the mass ratio of TMC of 0.45%.The type of the emulsion was O/W.The content of NFNE,TMC20-NFNE,TMC40-NFNE and TMC60-NFNE was (12.76±0.22),(14.76±0.16),(12.26±0.18) and (12.92±0.27) mg·ml-1,respectively.The particle size was 13.62,17.10,16.26 and 17.25 nm,respectively.The morphology of the nanoemulsion was spherical.Conclusion:The optimal formula and preparation process of TMC-NFNE are simple with high drug content,which is worthy of further studies.

Objective To investigate the effect of Guizhi Fuling pills on levels of serum MAPK, ERK and VEGF in patients with endometriosis. Methods 60 patients with endometriosis were selected and according to the random control table were divided into the experiment group and the control group, 30 cases each.The control group were treated with conventional acetate goserelin sustained-release implantation agent subcutaneous injection, the experiment group were treated by Guizhi Fuling pill treatment.After treatment, the clinical efficacy, serum MAPK, ERK-5, VEGF, ERK, T-cad and VE-cad levels of the patients were compared.Results Compared with the control group, the clinical total effective rate was higher in the experiment group (P<0.05);MAPK and ERK-5 levels in serum were lower (P<0.05), ERK level in serum was lower(P<0.05);T-cad and VE-cad levels in serum were lower(P<0.05);VEGF level in serum was lower(P<0.05).Conclusion Guizhi Fuling pill can block the cell signal transduction pathway through inhibition of MEK and ERK activity, thereby inhibit abnormal endometrial proliferation and cell division cycle, can effectively inhibit the proliferation and differentiation of the tumor.

Objective:To observe the change of endogenous erythropoietin(EPO) in patients undergoing elective major surgeries and the impact of recombinant human erythropoietin(rhEPO) on blood viscosity of animalsunder normal physiologic al conditions. In addition, the effect of rhEPO on postoperative anemia in cardiac surgery patients was evaluated. Methods:Ten patients scheduled for elective major procedures were studied. Included criteria were no preoperative anemia, moderate intraoperative blood loss and no postoperative transfusion. Serum EPO levers were measured prior to operation, immediately after the operation, as well as on postoperative days(PODs) 1, 2, 4, 6, 8. The change of Hct was measured too. (EPO group) Six adult rabbits received 300IU/kg of rhEPO weekly for two weeks. Specimens of Hb, Hct, RBC, serum ALT, serum potassium and blood viscosity were obtained before, during and after administration of rhEPO. Six patients with postoperative anemia (Hb＜100g/L) who underwent cardiac surgeries received 300IU/kg of rhEPO weekly for two weeks. The changes of Hb,Hct were compared(rhEpO group). Results: In EPO group serum EPO concentration increased immediately after the operation, reached a peak level during 24-48h postoperatively and remained significantly elevated above the operative value until POD 8. Hct significantly declined after the operation and was still significantly lower than the preoperative value on POD 8.On the 12th day after applying rhEPO, Hb, Hct and RBC of the rabbits were increased significantly, (P＜0.01 ) but serum ALT, potassium and blood viscosity did not changed significantly. In rhEPO group, Hb, Hct increased significantly on the 14 days after applying rhEPO. Conclusion: It is effective and safe to treat postoperative anemia with a high dose of rhEPO in patients undergoing cardiac procedures. The administration of rhEPO corrects postoperative anemia quickly, then precludes many complications related to decrease oxygen delivery capacity.

[Objective] To observe the therapeutic effect of oral use of heat-clearing, damp-removing and toxicity-clearing herbal medicine combined with ultrasonic wave and herbal medicine mask treatment in treating acne simplex (AS). [Methods] Two hundred and ten cases of AS were randomized into groups A and B. Group A ( n=113) was treated with modified Yinchenhao Decoction and Qingfei Decoction for oral use and added with ultrasonic wave and mask prepared with herbal medicine including Borneolum Syntheticum, Flos Lonicerae, Radix Scutellariae, Radix Salviae Miltiorrhizae, Fructus Forsythiae; group B ( n=97) was treated with metronidazole 0.2 g, tid, and vitamin Bg 20mg, tid, as well as erythromycin ointment for external application. After a 4-week treatment, the therapeutic effect was compared. [Results] The total effective rale was 80.6% in group A and 41.3% in group B, and the markedly effective rate was 50.5% in group A and 28.9% in group B, the difference being significant (P

Objective To investigate the drug resistance and risk factors of hospital-acquired pneumonia (HAP) induced by imipenem-resistant Acinetobacter baumannii.Methods Clinical data on 114 patients with Acinetobacter baumannii-related HAPs admitted in Wujiang First People' s Hospital in Suzhou during January 2013 and December 2014 were retrospectively analyzed.According to the results of drug sensitivity test,patients were divided into imipenem-resistant group and non imipenem-resistant group.Drug resistance to 20 commonly used antibiotics was observed in two groups,and multivariate Logistic regression analysis was performed to identify the risk factors of imipenem-resistant Acinetobacter baumannii infection.Results Among 114 strains ofAcinetobacter baumannii,66 strains (57.89％) were imipenem-resistant and 48 strains (42.11％) were non-imipenem-resistant.The resistance rates to β-lactams,quinolones and aminoglycosides were significantly higher in imipenem-resistant group than those in non-imipenem-resistant group (P ＜ 0.01),and no tigecycline-resistant strain was found in both groups.Univariate analysis showed that acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score ≥ 15,plasma level of albumin ≤ 25 g/L,intensive care unit (ICU) stay,indwelling gastric tube,deep venous catheterization,establishment of artificial airway,mechanical ventilation time ≥ 7 d,use of broad-spectrum antibiotics ≥ 14 d and combined use of antibiotics were risk factors of imipenem-resistant Acinetobacter baumannii related HAP (x2 =13.06,6.86,25.40,15.09,17.87,21.46,17.94,6.91 and 10.10,P ＜0.01).Multivariate Logistic regression analysis revealed that establishment of artificial airway [OR =72.014,95％ confidetial interval (CI):19.566-265.061,P ＜ 0.01],and use of broad-spectrum antibiotics ≥ 14 d (OR =3.892,95％ CI:1.092-13.879,P ＜ 0.05) were independent risk factors of imipenem-resistant Acinetobacter baumannii related HAP.Conclusion Imipenem-resistant Acinetobacter baumannii strains are highly resistant to most antibiotics.Strict control of invasive procedures and long-term combined use of antibiotics may reduce the occurrence of imipenem-resistant Acinetobacter baumannii related HAPs.

Objective To explore drug resistance and distribution of multidrug-resistant(MDR)Mycobacterium tuberculosis (M.tuberculosis)in a county-level hospital,so as to strengthen the prevention and control of health-care-associated infection with M.tuberculosis .Methods Specimens with positive sputum smear were performed M. tuberculosis culture and drug resistance testing,and distribution of MDR tuberculosis patients in the departments before isolation were investigated retrospectively.Results Of 488 patients with tuberculosis,254 were positive for sputum smear,122 M.tuberculosis strains were isolated from positive sputum smear patients,120 isolates were per-formed drug susceptibility testing,results revealed that 86 isolates were drug-resistant strains,46 of which were monodrug-resistant,40 were MDR.Of MDR strains,16 were all resistant to isoniazide,rifampicin,streptomycin, and ethambutol.The percentage of monodrug-resistance,MDR,pandrug resistance was 9.43%,8.20%,and 3.28% respectively.Medical imaging department,ultrasound department,and respiratory disease department were the main units of M.tuberculosis exposure.Conclusion The percentage of MDR M.tuberculosis is high among M. tuberculosis ,surveillance should be intensified,so as to prevent the transmission in hospital.

Aim:To develop a practical chiral CE method for the quantitative determination of the unwanted enantiomer[( R )-enantiomer]presented in zolmitriptan. Methods:The background electrolyte was 20 mmol/L sodium dihydrogenphosphate solution with 1% S-β-CD,adjusted to pH 3.50 with phosphoric acid. A fused-silica capillary(60 cm×50 μm ID,effective length 51.5 cm)was used at 20 ℃ for the separation. The applied voltage was -30 kV. The samples were loaded by hydrodynamic injection(50 mbar pressure,6 s). UV was measured at 220 nm. Results:Zolmitriptan and its chiral impurity were baseline resolved ( R s=6.66). The linearity was good over the concentration range from 4 to 80 μg/mL( r =0.999 8) of ( R )-enantiomer. The injection precision (expressed as CV%) was 2.83%. The average recovery was 99.97%( n =9). The limit of detection was 1.5 μg/mL. The host-guest complex binding constants were 964 and 905 mol-1 for ( R )-enantiomer and zolmitriptan,respectively. Conclusion:The method is suitable for the determination of ( R )-enantiomer in zolmitriptan and binding constants of zolmitriptan enantiomers to S-β-CD.

OBJECTIVE:To establish a method for content determination of matrine in it's liposomes by acid dye colorime_ try.METHODS:Sephadex gel G-50 column was established by swelling of matrine liposomes sample in distilled water for at least 12 hours,distilled water was used as mobile phase,after eluting,the column was mixed with 0.0 125%of bromothymol bl_ ue buffer solution and chloroform,and then the mixture was shaken,standing and demixed,the absorbability of chloroform layer was detected at the wavelength of 413 nm.RESULTS:The detection concentration of matrine showed good linearity with its absorbability within the range of 0.04～0.20mg/ml(r=0.9 972),the average recovery was 94.10%(RSD=1.86%).CONCL_ USION:The established method is simple and accurate,which can be used for quality control of matrine liposomes.

Objective To investigate the serum and urine levels of neutrophil gelatinase‐associated lipocalin(NGAL) in patients with primary hypertension and related clinical significance .Methods A total of 107 patients with primary hypertension and 100 healthy subjects were enrolled ,and detected for serum and urine levels of NGAL and urinary micro‐albumin .Results Serum and u‐rine levels of NGAL in hypertension patients were (1 .98 ± 1 .49) and (1 .29 ± 0 .54)μg/L ,higher than the (0 .69 ± 1 .02) and (0 .55 ± 0 .35)μg/L in healthy subjects(P< 0 .05) .Urinary micro‐albumin level in hypertension patients was also higher than healthy subjects (P<0 .05) .Conclusion Serum and urine levels of NGAL in patients with primary hypertension could be signifi‐cantly increased ,which might be with important clinical significance in diagnosis ,treatment and prognosis of hypertensive nephropa‐thy .

Objective To explore effect of rehabilitation training on deglutition disorders of children with cerebral palsy . Methods Twenty-seven children patients from January to June in 2013 were set as control group and thirty-one patients from July 2013 to January 2014 as experiment group. The children in the control group were treated with tube-feeding combined with spoon feeding and bottle-feeding by professional nurse. Children in the experiment group were treated with oral rehabilitation training by professional therapists and nurses apart from the same feeding as in the control group. The two groups were compared in terms of effect of deglutition within 4 weeks, time and rate of removing the stomach tube. Results The recovery of deglutition function in the experiment group was much better than that in the control group , the total effective rate and rate of removing the stomach tube within 3 months were higher and the intubation duration was significantly lower as compared with those of the control group (P < 0.01). Conclusion Rehabilitation training can improve the recovery of deglutition disorders, improve active feeding ability of children with cerebral palsy, shorten time of tube feeding and improve their life quality.