Hydroxypropyl methylcellulose (HPMC) propels self-emulsifying drug delivery systems (SEDDS) to achieve the supersaturated state in gastrointestinal tract, which possesses important significance to enhance oral absorption for poorly water-soluble drugs. This study investigated capacities and mechanisms of HPMC with different viscosities (K4M, K15M and K100M) to inhibit drug precipitation of SEDDS in the simulated gastrointestinal tract environment in vitro. The results showed that HPMC inhibited drug precipitation during the dispersion of SEDDS under gastric conditions by inhibiting the formation of crystal nucleus and the growth of crystals. HPMC had evident effects on the rate of SEDDS lipolysis and benefited the distribution of drug molecules across into the aqueous phase and the decrease of drug sediment. The mechanisms were related to the formed network of HPMC and its viscosities and molecular weight. These results offered a reference for selecting appropriate type of HPMC as the precipitation inhibitor of supersaturatable SEDDS.

Objective　The aim of this paper was to investigate the changes in cyclic 3'5'-guanosine monophosphate (cGMP) before and after hemodialysis to estimate the value of cGMP to the dry boby-weight. Methods: Plasma cGMP levels (by radioimmunoassay), cardiothoracic ratio (CTR), and the body weight (BW) before and after hemodialysis were determined in chronic hemodialysis patients and clinical signs and symptoms were observed at the same time. Results　① The predialytic cGMP value of the patients was significantly higher than that of healthy controls (P<0.05). ② The postdialytic cGMP level was significantly lower than the predialytic cGMP level (P<0.01). ③ Postdialytic CTR and BW values were significantly lower than predialytic values (P<0.01). ④Compared to those of predialysis, postdialytic clinic signs and symptoms of the patients were significantly relieved. Conclusions　① The plasma cGMP level can sensitively reflect the hydration state and is a reliable marker for dry body-weight estimation.②The measurement of plasma cGMP combined with clinical parameters and radiological indexes permit a more accurate dry body-weight estimation.

Objective To evaluate the influence of tracheal intubation guided with light wand on hemodynamics in patients with obstructive sleep apnea syndrome.Methods Seventy-four patients with obstructive sleep apnea syndrome were randomly divided into light wand group (n =37) and laryngoscope group (n =37).The time to successful intubation,rate of successful intubation,changes of heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP) and complications were compared in two groups.Results The time to successful intubation of light wand group was significantly shorter than that of laryngoscope group,while the rate of successful intubation in light wand group was significantly higher than that in laryngoscope group (P＜0.05).The HR,SBP and DBP at T1 were significantly lower than those at T0 in two groups (P＜0.05).The HR,SBP and DBP in two groups at T2,T3 were significantly higher than those at T1 (P＜0.05),and those indexes of light wand group were significantly lower than laryngoscope group at T2 and T3 (P＜0.05).The incidence rates of complications in light wand group were significantly lower than those in laryngoscope group (P＜0.05).Conclusion With the advantage of higher success rate,shorter time to successful intubation,more stable hemodynamics and fewer complications,tracheal intubation guided with light wand is worthy of popularization and application in clinical.

Objective To explore the effects of different pressures of carbon dioxide pneumoperitoneum under laparoscopic surgery on IL-1β, IL-6, and TNF-α. Methods Ninety patients with ASA Ⅰor Ⅱwho were scheduled to elective operation under laparoscopic surgery from October 2010 to June 2012 were randomly divided into three groups .After endotracheal intubation , different carbon dioxide pressures , 10 mm Hg, 12 mm Hg, and 15 mm Hg, were orderly given to group 1, 2, and 3 to build pneumoperitoneum .The serum levels of IL-1β, IL-6, and TNF-α, as well as hemodynamic parameters , were assessed at the time after anesthesia ( T0 ) , after pneumoperitoneum development ( T1 ) , of position placement before operation ( T2 ) , after dismissing pneumoperitoneum (T3), and 24 hours after operation (T4), respectively. Results The measures of MAP, HR, and PETCO2 had no significant differences between each other of the three groups ( P >0.05), and the MAP and HR results showed significant differences among the three groups at different time points (P<0.05) whereas no difference for PETCO2 values (P>0.05).There were statistical significances between the three groups in levels of IL-1β, IL-6, and TNF-αat time points of T1 , T2 , T3 , and T4 , respectively (P<0.05).As compared with T0, there were significant differences in levels of IL-1βat the time points of T1 and T2 in the three groups (P<0.05).There were no significant differences in IL-6 levels between the group 1 and group 2 at every time points (P>0.05).In the group 3, the levels of IL-6 were significantly higher at time points of T 1, T2, and T3 than at T0(P<0.05).In the group 2 and group 3, the levels of TNF-αat T1, T2, and T3 were significantly different from at T0(P<0.05), whereas in the group 1, significant difference was seen only between the time points of T 0 and T1(P<0.05). Conclusion Low pneumoperitoneum pressure leads to minor stress effects .A 10 mm Hg carbon dioxide pneumoperitoneum is recommended .

Objective To explore the effect of gliclazide and Sig Leo Dean on insulin treatment for poor glycemic control in obese patients with type 2 diabetes mellitus. Methods 80 cases of insulin treatment for poor glycemic control in obese patients with type 2 diabetes mellitus treated in our hospital from March 2015 to January 2017 were randomly divided into two groups,with 40 cases in each group.The control group was treated with gliclazide The observation group was treated with Sig Leo Dean.The therapeutic effects of the two groups were observed and compared. Results 2 hours postprandial blood glucose levels improved in the observation group was better than that of the control group, the body weight, blood pressure, fasting blood glucose of two groups were improved, and there were no significant difference between the two groups; The incidence rate of adverse reactions was 2.5% in the observation group, 10% in the control group, the difference was not statistically significant (P<0.05). Conclusion Analysis of gliclazide and Sig Leo Dean on insulin treatment for poor glycemic control in obese patients with type 2 diabetes mellitus curative effect, Sig Leo Dean for the glycaemic improvement effect is higher, reduce the incidence of adverse reactions, so more medication safety, it is worthy of clinical promotion Application.

Objective To study the analysis of insulin glargine combined with acarbose in type 2 diabetes compared with pre mixed insulin treatment efficacy and safety. Methods 100 patients with type 2 diabetes mellitus treated in our hospital from March 2015 to August 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group were treated with premixed insulin treatment, the experimental group were treated with basal insulin combined with acarbose. The clinical indexes of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the fasting blood glucose level of the control group was (7.56 ± 1.13) nmol / L, and the fasting blood glucose level of the experimental group was (7.01 ± 0.92) nmol / L. The level of fasting blood glucose in the experimental group was significantly lower than that in the control group, with statistical difference (P<0.05). The level of HbA1c in the experimental group was (7.01 ± 0.82)％, significantly lower than that in the control group, and the level of HbA1c (7.45 ± 0.91)％, with statistical difference (P<0.05). Among the 50 patients in the control group, hypoglycemia occurred in 20 patients, the incidence of hypoglycemia was 40％, significantly higher than that in the experimental group, and the incidence of hypoglycemia was 14％, which was statistically significant (P<0.05). Conclusion Basal insulin combined with acarbose compared with premixed insulin treatment of type 2 diabetes treatment can significantly hypoglycemic effect, high safety, with further clinical promotion and application significance.

Objective To study the rationality of hypoglycemic drugs in patients with gastroparesis. Methods The mechanism of gastroparesis was analyzed, and the mechanism, indications, adverse reactions and contraindications of common hypoglycemic agents were studied. Results There were significant differences in the mechanism of gastric hypoglycemia and hypoglycemic therapy. The mechanism of action and the application of the patients were obvious. According to the characteristics of the patients, the selection of the appropriate drugs could improve the clinical curative effect and ensure the safety of the drug. Conclusion The pathogenesis of gastroparesis is more complicated. The clinical practice should be based on the pathogenesis of the patients and the hypoglycemic drug regimen.

Objective To investigate the application value of Tangniaole capsule combined with metformin in patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods 120 cases of patients with newly diagnosed T2DM were divided into the control group and the observation group.The control group was treated with metformin while the observation group was additionally treated with Tangniaole capsule.Symptoms and signs, changes in blood glucose, urine glucose, insulin resistance index (HOMA-IR) and insulin secretion (HOMA-β) were compared between the two groups.The incidence of adverse reactions was statistically analyzed.Results The curative effect in the observation group was better than control group (P<0.05).After treatment, scores of symptoms and signs, blood glucose, glycosylated hemoglobin (HbA1c), 24 h urine glucose quantitation and HOMA-IR were lower, and HOMA-β was higher in the observation group than in the control group (P<0.05).Conclusion Tangniaole capsule combined with metformin is effective in the treatment of newly diagnosed T2DM, and it can reduce blood glucose, urine glucose and insulin resistance.

OBJECTIVETo observe the therapeutic effect of Yangxue Tongluo Recipe (YTR) combined with immunosuppressive agents in the treatment of rheumatoid arthritis (RA).

METHODSTotally 88 RA patients were randomly assigned to the treatment group [47 cases, YTR combined Methotrexate (MTX) + Leflunomide (LEF) treatment] and the control group (41 cases, MTX + LEF therapy). All patients received 12-week treatment. Clinical symptoms and signs, laboratory tests [erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), and C reactive protein (CRP)], and adverse reactions were observed before and after treatment.

RESULTSThe total effective rate was 91.5% (43/47 cases) in the treatment group, and the total effective rate was 75.6% (31/41 cases) in the control group. There was statistical difference between the two groups (P < 0.05). The morning stiffness, the rest pain, the number of tender joints, the number of swollen joints, tender joint index, swollen joint index, ESR, RF, and CRP were significantly improved in the two groups after treatment (P < 0.01). Besides, clinical symptoms and signs, ESR, RF, and CRP were more improved in the treatment group after treatment, when compared with those in the control group (P < 0.05). Gastrointestinal discomfort was the main adverse reaction in the two groups, but the occurrence was lower in the treatment group than in the control group (P > 0.05).

CONCLUSIONSThe clinical efficacy of YTR combined MTX + LEF in the treatment of RA was better than using Western medicine alone. It was more safe with less adverse reactions.

Adult ; Antirheumatic Agents ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Methotrexate ; therapeutic use ; Middle Aged ; Phytotherapy ; Treatment Outcome

Cell Differentiation ; Culture Media ; Humans ; Interleukin-3 ; physiology ; Megakaryocytes ; cytology ; physiology ; Stem Cell Factor ; therapeutic use ; Thrombopoietin ; physiology