OBJECTIVE:To observe the efficacy and safety of atorvastatin in the treatment of hypertension with unstable angi-na. METHODS:80 patients with hypertension with unstable angina were randomly divided into control group and treatment group. All patients were given anti-platelet aggregation and other conventional treatment;based on it,control group was orally treated with Amlodipine besylate tablet 5 mg,once a day+Metoprolol tartrate controlled-release tablet 25 mg,twice a day+Isosorbide dini-trate injection 10 ml by intravenous infusion,twice a day;treatment group was additionally treated with Atorvastatin calcium tablet 20 mg,orally,qd. 3 months was a treatment course,and it lasted 6 courses. Clinical efficacy,and systolic blood pressure,diastol-ic blood pressure,angina frequency and duration,changes of TC,TG,LDL,HDL levels before and after treatment and adverse reac-tions in 2 groups were observed. RESULTS:Total effective rate in treatment group was significantly higher than control group,the difference was statistically significant(P<0.05). After treatment,systolic blood pressure and diastolic blood pressure in 2 groups were significantly lower or shorter than before,the difference was statistically significant(P<0.05),however,there was no signifi-cant difference between 2 groups(P>0.05);angina frequency and duration were significantly lower than before,and treatment group was lower than control group,TC,TG and LDL in treatment group were significantly lower than before and control group, HDL was higher than before and control group,the differences were statistically significant(P<0.05),there was no significant dif-ference between before and after treatment in control group(P>0.05). There was no significant difference in the adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Based on the conventional treatment, atorvastatin can effectively reduce the long-term angina frequency and duration of patients with hypertension with unstable angina,improve the ischemia myocardial and reduce the lipid levels with good safety.

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 summarize radiographic manifestations of granulocytic sarcoma (GS),in order to investigate its radio-graphic feature.Methods Nine patients of GS confirmed by surgery pathology and immunohistochemistry were collected.There were four cases underwent CT scan,2 underwent MRI,3 underwent CT and MRI meanwhile.Results There were 4 cases in the lymph nodes,4 cases in the bone,1 case in the enterocoelia.The density of enlarged lymph node was inhomogeneous,and smaller lymph node was homogeneous density,both enhanced obviously.The density or intensity of the lesions occurred in the canalis verteb-ralis and paravertebra was also homogeneous,slightly enhanced,with bone and medulla ossea invasion.Lesions in the enterocoelia was inhomogeneous desity with clear boundary,enhanced inhomogeneously.Conclusion GS is a rare extramedullary malignant tumor composed of immature myeloid cells.CT and MRI can provide a certain diagnostic value.The perplexity in diagnosing such lesions highlighted the need of careful interpretation of all clinacal,radiographic,histopathological and immunochistochemical details as it is one of the most frequently misdiagnosed disorder.

Jervine, a novel steroidal alkaloid from Veratrum nigrum L., exhibits both antitumor effect and potential toxicity. The aim of study was to characterize the pharmacokinetic behaviors and enterohepatic circu-lation of jervine in rats. A rapid and simple ultra-high performance liquid chromatography-tandem mass spectrometric method was developed and validated for quantification of jervine and alpinetin (internal standard) in rat plasma. After extraction from rat plasma by a simple protein-precipitation method, the analyte was separated on a C18 column (2.1 mm × 50 mm, 1.7μm) using water with 0.1％formic acid and acetonitrile as the mobile phase delivered at a flow rate of 0.4 mL/min. Jervine and alpinetin were determined in the positive mode with multiple reaction monitoring (MRM) of the ion transitions at m/z 426.3→108.8 and m/z 271.0→166.9, respectively. Molecular docking method was used to investigate the binding of jervine to p-glycoprotein and dehydroepiandrosterone sulfotransferase. The method was well validated within acceptance limits including specificity, matrix effect, recovery, precision, accuracy, and stability, and was successfully applied to the pharmacokinetic study of jervine after oral and intravenous administration to rats. Jervine presented a small volume of distribution, fast absorption, high oral bioavailability, and enterohepatic circulation. The enterohepatic circulation was first observed in veratrum alkaloids, and was further investigated by molecular docking studies, which was related to the binding of jervine to p-glycoprotein and dehydroepiandrosterone sulfotransferase. The pharmacokinetic properties and enterohepatic circulation of jervine in rats provided a significant basis for the drug-drug interaction and toxicity study in the future.

Objective:To investigate the prevalence of post-traumatic stress disorder(PTSD)symptoms in middle school students after Wenchuan earthquake.Methods:The PTSD Checklist-Civilian version( PCL-C),which included three symptom groups(A,B,and C),was used to assess the PTSD symptoms in 1960 middle school students in the disaster region through self-questionnaire.Results:(1)The general positive rate of PTSD symptoms was 78.3%,and that of B group was the highest(68.9%).(2)The rates of general PTSD and three symptom groups of PTSD were higher in girls,high grade students,minority groups,rural students,injured in earthquake and those who lost family property than in boys,low grade students,the Han nationality,urban students,not injured in earthquake and those who did not lost family property[such as,the general positive rate of PTSD symptoms:girls 82.2%,boys 73.9%,P<0.05].(3)The rates of severe PTSD symptoms in girls and rural students were higher than that in boys and urban students(27.9% vs.19.9%,26.7% vs.21.4%,Ps<0.05).Conclusions:PTSD symptoms are common among middle school students in earthquake region.Targeted measures should be taken to protect middle school students from PTSD in earthquake region.

ObjectiveTo investigate the clinical effects and side-effect of mesenchymal stem cell(MSCs) transplantation on spinal cord injury(SCI),traumatic brain injury(TBI),multiple sclerosis(MS) or Parkinson's disease(PD).MethodsThe bone marrow(222～350 ml) of 11 patients with SCI(n=6),TBI(n=3),MS(n=1) or PD(n=1) were harvested from the patients' ilia and then MNCs were isolated.The MNCs were injected intravenously or into subarachnoid space by lumbar puncture.The neural function and side-effect were observed before and after MSCs transplantation and the patients were followed up.ResultsThe data demonstrated the improvement of sense and motor function in 5 patients with SCI,one had no improvement by 2 months following-up.These patients' sense and motor levels improved obviously.Their muscle strength of lower extremity increased,the muscular tone decreased and urinary bladder function improved.Changes in neurological deficits and improvements in function may appear within 2 days after transplantation,most of them within 2 weeks.There were significantly amelioration in 3 patients with TBI treated with MSCs transplantation,one of them could walk with cane independently after 3 months.One's PVS score elevated from 5 to 8 scales after transplantation.The tremor was alleviated after 1 week,and the muscular tone decreased,which lead to reduce the dose of Madopar after 3 months,in patient with PD.The patient with MS showed no improvement in short time.The side-effect included fever(7/11),headache(2/11) and abdominal dissension(1/11).1 patient feel numb in his legs while injection into subarachnoid,and appeared meningeal stimulation after injection.ConclusionThere were significantly clinical effects in treatment of SCI,TBI,MS,and PD with MSCs transplantation in short time,and with few side-effect. The long-term clinical effects need more observation with larger samples.

OBJECTIVE:To explore the association between the mitochondrial DNA(mtDNA)3537A/G,5351A/G variant and type 2diabetes mellitus(T2DM)in northem Chinese population.METHODS:The subjects including 614 patients with T2DM in Dalian City,61 of them were collected from family survey,497 of them were collected from Department of Endocrine,Dalian Municipal Central Hospital,and the remained 56 were selected from diverging T2DM patients in Dalian City.Additional 344 cases with normal carbohydrate toierance were served as controls.The mtDNA 3537A/G.5351A/G variants in 614 patients with T2DM and 334 healthy control subjects were examined.By sequencing the mtDNA in 24 cases and 26 controls,2 candidate SNPs in mtDNA were determined,and then genotyping was carried out by using PCR restriction fragment length polymorphism(PCR-RFLP)analysis.RESULTS:The frequency of mtDNA A3537G and A5351G mutation was 2.0%and 2.6% in T2DM patients,respectively,which was 2.1%and 4.2% in the control group.No significant difference had been observed between case and control(P＞0.05).After stratifying by body mass index and blood pressure,we found that the frequency of A5351 G in obesity patients with T2DM was 1.61%,and in obesity control was 15.38%,which had significant difference(P_(Fisher)=0.02,OR=2.76),however,A3537G stili showed no significant difference in all groups(P＞0.05).CONCLUSION:5351A/G in mtDNA ND2 gene may be a variance associated with T2DM in northem Chinese.

Objective To systematically evaluate the optimal dose of early enteral nutrition support in critically ill patients.Methods Systematic search database including PubMed,Web of science,Scopus,CINAHL,CBM,CNKI.RCTs about early enteral nutrition dose selections in critically ill patients were chosen according to include and exclude criteria by two researchers independently.Cochrane system evaluation manual bias risk assessment was used to evaluate quality of literature.RevMan5.3 Meta analysis software was used to analyze the data.Results A total of 1 571 literatures were retrieved and 8 RCT studies were included,2 713 subjects in total.Meta analysis results showed that there were statistically significant differences in mechanical ventilation time,incidence of diarrhea,and utilization rate of gastro dynamic drugs between trophic feeding and full feeding (P＜0.05).There were no statistically significant differences in mortality,length of stay,incidence of nosocomial infections,reflux,vomiting,constipation,etc.(P＞0.05).Conclusions Trophic feeding has familiar effects on mortality,length of hospital stay compared to full feeding,but it can help to shorten ICU mechanical ventilation time,improve the gastrointestinal tolerability.

The occurrence and development of chronic insomnia involves subjective and objective factors, which can be classified as predisposing factors, precipitating factors and perpetuating factors. Cognitive behavioral therapy for insomnia (CBT-I) evolves from the pathopsychological analysis of chronic insomnia patients, and selectively combines the sleep hygiene, cognitive therapy and behavioral therapy to improve the symptoms of patients. With the popularity of internet, the digital cognitive behavioral therapy for insomnia has an convenient advantage over the traditional therapy, and has become the focus of research. Researchers have proposed multiple therapies for chronic insomnia, including drug therapy and non-drug therapy, which improve the treatment effect of chronic insomnia from different perspectives.

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.