OBJECTIVE:To study the effects of Heishun tablets combined with Rheum palmatum on the pharmacokinetics of hypaconitine in rats. METHODS:Rats were randomly divided into single drug group(Heishun tablets decoction)and drug combi-nation group(Heishun tablets-R. palmatum mixture decoction),with 18 rats in each group. They were given relevant drugs intragas-trically,by 10 g(medicinal materials)/kg of Heishun tablets. 0.3 ml blood samples were collected before(0 h)and 0.083,0.167, 0.333,0.5,0.75,1,1.5,2,3,4,6,8,10 h after medication with 6 rats at each time point,respectively. The blood concentra-tion of hypaconitine was determined by HPLC-MS using palmatine hydrochloride as internal standard. DAS 2.0.1 software was used to calculate pharmacokinetic parameters. RESULTS:The linear range of hypaconitine was 0.102 4-100 ng/ml (r=0.998 7),and the limit of quantification was 0.1 ng/ml. The pharmacokinetic parameters of single drug group vs. drug combination group were as follows as tmax of (0.50 ± 0.086) h vs. (0.75 ± 0.132)h;t1/2 of (9.967 ± 1.123) h vs. (3.708 ± 0.507) h;AUC0-10 h of (26.087 ± 0.672) μg·h/L vs.(6.516 ± 1.135) μg·h/L;cmax of (6.124 ± 2.312) μg/L vs. (1.592 ± 0.051) μg/L. Compared with single drug group,t1/2,AUC0-10 h and cmax of hypaconitine were decreased in drug combination group,with statistical significance (P<0.05). CONCLUSIONS:R. palmatum can inhibit the absorption of hypaconitine in rats,and speed up the elimination of it in rats.

Objective To discuss the barriers influencing the application of evidence-based nursing. Methods Nine hundred nurses from August 2013 to February 2014 were selected from five polyclinics in Shenzhen by randomly cluster sampling according to different departments and wards. We carried out the survey with the Chinese version of cognitive of impairment of nursing scientific research scale. Results The sores of 4 dimesions of scientific application of evidence-based nursing from high to low were effectiveness and system of research, resource to evidence-based nursing, quality of research and attitude and ability of nursing staff. The main barriers in applying scientific research payoffs by the nursing staff included the deficient resource and equipment provided by hospitals (68.09%), the jumbled medical development information confused the nurses in selecting related reference (66.75%), failing to put the scientific achievements into practice (66.01%),insufficient time to actualize new ideas (64.15%), and difficulty in obtaining the reference of scientific research (64.04%). Conclusion The barriers to scientrfic application of evidence-based nursing were the deficient resource and time and difficulties to find evidence. The nursing policy makers should adopt efficient measures aimed at the difficulties the nursing staff in applying their research results, thereby popularize the application of research achievements in hospitals.

After a description of the emergency and development of subject librarian system, the subject librarian system in universities of USA and China was comparatively analyzed in aspects ofits management mechanisms , litera-cy of subject librarians and their duties.The problems in relation to subject service in domestic academic libraries were pointed out with suggestions put forward for their solution in order to further perfect the subject librarian system in domestic academic libraries.

Many snake venoms contain complex mixtures of pharmacologically important molecules, some of which show potential therapeutic value in the treatment of cancer and other human disorders. In this review, we mainly reports the effects of snake venom active components, such as disintegrins and lectins in paralyzing cancer cells, blocking on cell migration, interaction with integrins, inhibition of tumor dissemination and angiogenesis. The advanced researches on the snake venom's apoptosis-inducing components on tumors are also introduced. [

Objective To explore the effect of band power and wavelet packet entropy in the recognition of hand imagery.Methods The data gained from brain computer interface competition in 2003 provided by Graz University of Technology.The electroencephalogram(EEG)signals between 8～16 Hz were decomposed by db3 wavelet packet at three levels.The band power(BP)and wavelet packet entropy(WPE)of C3 and C4 were calculated respectively.The BP and WPE were defined as the feature vector.The left and right hand motor imaginary tasks were distinguished.Results The proposed method was applied to the test data set with 140 trails.The satisfactory results were obtained with the highest classification accuracy 87.14%.Conclusion The band power and wavelet packet entropy of EEG changed with time is coincident with event-related desynchronization and event-related synchronization.It can be used to recognize the left and right band motor imaginary tasks.

Objective To explore job satisfaction degrees and the influencing factors among community nurses. Method General information questionnaire and the revised job satisfaction questionnaire were adopted in the investigation among 124 nurses from 28 community health service centers in Nanchong City between February to October 2016. Results The total score was (119.62 ± 15.37), at the moderate to high level. Of the eight dimensions, relationship with colleagues was scored the highest, and personal growth was the lowest. The influencing factors of the nurse's job satisfaction were found to be employment type, work positions, service duration in the community and whether they have been trained on community nursing position (all P<0.05). Conclusions The job satisfaction degree of community nurses is generally at middle level. Therefore, measures should be taken to improve the job satisfaction for the development of community nursing services.

Objective To investigate the risk factors of recurrent common bile duct (CBD) stones after treatment with endoscopic retrograde cholangiopancreatography (ERCP). Methods A total of 802 patients with CBD stone and with complete follow-up data were recruited to the study, among which 297 patients were accompanied with gallstone, 222 patients having undergone cholecystectomy before ERCP and 283 having no gallstones. The CBD stone recurrent frequency and the possible risk factors were calculated with uni- and multi-variate logistic regression analysis. Results The patients were followed up at a mean duration of 84. 8 months, and CBD stone re-occurred in 92 (11.5%). Both uni- and multivariate analysis showed gallstones, CBD larger than 1.5 cm, endoscopic mechanical lithotrity (EML) and angle of bile duct less than 120° were risk factors of recurrence. Multivariate analysis showed cholesterol stones, cholangeal stricture or sphincter of Oddis dysfunction (SOD) were all risk factors for reccurrence. Univariate analysis revealed that history of cholecystectomy or Billroth Ⅱ gastrectomy, stones larger than 1.5 cm and multiple stones were risk factors of recurrence. Conclusion For those with CBD stones undergoing ERCP, gallstone,common bile larger than 1. 5cm, EML and the angle of CBD less than 120° are major risk factors of recurrence. History of cholecystectomy and Billroth Ⅱ gastrectomy, SOD, large CBD stone ( ≥1.5 cm), cholesterol stone and multiple stones are also associating risk factors.

Objective To study on the endoscopic resection of submucosal tumors (SMT) in gastro-intestinal tract with especial regards to the effectiveness and safety, and the value of endoscopic ultrasonogra phy ( EUS) in SMT before endoscopic resection. Methods Endoscopic therapy was performed in 71 patients with gastrointestinal SMT diagnosed by endoscopy, and of them 64 patients (90. 1 % ) were examined by EUS before the procedure. The SMT located in the esophagus 36 cases, stomach 29 cases, duodenum 3 cases and rectum 3 cases. The median tumor diameter was 14. 2 mm ( ranged 6-20 mm). Endoscopic mucosal resection was performed using a two-channel endoscope after submucosal injection of saline solution in 55 cases, then the SMT resected. In 16 patients, the SMT was resected completely with one-step standard procedure using cap-fitted endoscope ( 10 cases, the SMT less than 10 mm in diameter) or two-channel endoscope (6 cases). Results Sixty-eight of seventy-one solid SMT were removed completely under endoscopy and 2 SMT (one ectopic pancreas and one gastric leiomyoma) were resected incompletely; the findings were showed at 4th week by repeated endoscopy. One patient with rectal leiomyoma required surgical resection after unsuccessful endoscopic resection. The follow up period was 18. 7 months on average, no recurrences were found in 67 cases. Histological results showed 51 (71. 8% ) leiomyomas, one granular cell tumor, 4 fibromas, 3 ectopic pancreas, 3 lipomas, 2 stromal tumors and 2 carcinoids in the SMT. Five tumors of mesenchymal tissue , their histological origin cannot be firmly defined due to lack of immunoassayed specimen. Bleeding occurred in only 9 of 71 cases and was easily managed with endoscopic haemostatic measures. One patient with stromal tumor suffered from gastric perforation after the procedure. Conclusions Endoscopic resection of gastrointestinal SMT is a safe and effective procedure and obtains the histological diagnosis simultaneously. EUS is helpful in selecting indicated cases for endoscopic resection.

Objective To assess clinicopathological features and prognosis of patients with combined hepatocellular and cholangiocarcinoma (cHCC-CC). Methods Clinicopathological and follow-up data of 115 cHCC-CC patients confirmed pathologically in Liver Cancer Institute of Fudan University from 1995 to 2007 were analyzed. Kaplan-Meier method was used to calculate 1-,3- and 5-year survival rates and tumor-free survival rates. Survival curves were analyzed using the log-rank test. The factors that impacted the prognosis of cHCC-CC were estimated. Results In 115 cases, one was Allen's type A, one was Allen's type B, and the other 113 were Allen's type C. Being with male in predominance, most of the cHCC-CC patients had liver cirrhosis background. They presented with elevated AFP or CA19-9, vascular invasion, resembling hepatocellular carcinoma(HCC)as well as lymph nodes metastasis. One-, 3-, 5-year survival rates of 115 patients were 68. 1%, 38. 1% and 33.6%, respectively, with median survival time of 13.0 months. Whereas the 1-, 3-, 5-year survival rates in radical resected patients were 78.4 % ,44.4 % and 44.4 % ,respectively, with median survival time of 16.0 months. Tumor free survival time at 1-, 3- and 5-year was 57.8 %, 12.6 % and 0.0 %,respectively,with median recurrent time of 10.0 months. One-, 3-, 5-year survival rates of 10 nonsurgical patients were 10/10,10/10 and 0/10,respectively, with median survival time of 5.3 months.TNM stage was independent factor for prognosis of the patients after resection. Whereas the lymph nodes involvement was independent factor for the tumor free survival time of radical resected patients.Conclusions Although clinicopathological characteristics of cHCC-CC are more similar to those of HCC, the prognosis of cHCC-CC is more unfavorable than that of HCC. TNM stage is an independent determinant of long time outcome for patients after resection.

Objective To explore the clinical effect of both lower extremities exercise therapy on the prevention of deep vein thrombosis.Methods According to the randomized principal,200 cases of patients with limb paralysis caused by cerebrovascular disease were divided into the experimental group and the control group by random number table,and each group contained 100 cases.The experimental group was given both lower extremities exercise therapy in addition to routine care of limbs paralysis caused by cerebrovascular diseases.The control group received routine care and simple postoperative activity health education by nurses.The occurrence of deep venous thrombosis before the intervention and one month after intervention was evaluated in two groups.Results The incidence of deep vein thrombosis in the experimental group after intervention one month was lowered more significantly than that in the control group.Conclusions Both lower extremities exercise therapy can improve lower extremity venous blood flow velocity,and safely and effectively prevent the occurrence of DVT of patients with limb paralysis caused by cerebrovascular disease.