Objective To evaluate the reliability and validity of Chinese multi-dimensional health assessment questionnaire (MDHAQ-C) in patients with systemic lupus erythematosus (SLE) in China.Methods One hundred and twelve SLE patients were recruited in the evaluation.The reliability of the questionnaire was tested by intra-class coefficient (ICC) and Cronbach's alpha.Convergent validity and divergent validity were assessed by Spearman correlation coefficient of MDHAQ-C with health assessment questionnaire (HAQ),the 36-item short-form health survey (SF-36) and the hospital anxiety and depression scales(HAD).Discriminant validity was tested in groups of patients with varied disease activities and status of damage.Results The Cronbach's alpha was 0.886 in the function scale (FN) and 0.774 in the scale of psychological status (PS).The corrected item-total correlation ranged from 0.409-0.866.The ICC was 0.615-0.920(P＜0.05).MDHAQ-C correlated with the questionnaires satisfyingly in most scales (from P＜0.5 to P＜0.001).The scores of MDHAQ-C could discriminate different groups of patients (P＜0.05).Conclusion MDHAQ-C is a reliable,valid instrument for functional measurement and quality of life assessment in Chinese SLE patients.

Objective Irrational pharmacotherapy is a common and severe phenomenon which happened in elderly people, it easily induces adverse outcomes, for example, increasing adverse drug reaction, mortality in hospital and the cost of drugs.The geriatric irrational pharmacotherapy are caused by lots of factors, and it is a challenge to clinical works in rational and optimized pharmacotherapy because of elderly complications and multiple pharmacotherapy which faced to doctors.Practical and effective treatment strategies and interventions are keys to geriatric rational pharmacotherapy.This paper will propose various of pharmacotherapy strategies in order to promote rational pharmacotherapy for the elderly patients.

This study discussed problems in consistency assessment of generic drugs and analyzed effect of polymorphs on drug quality and its influence on consistency of curative efficiency.Relationship between evaluation method of polymorphs and curative efficiency was investigated.It showed that establishment of curative efficiency related evaluation indicators was necessary and improvment of techniques was important.Drug quality criteria should be added with requirement of curative efficiency control.Related information based on polymorphs could be provided for technical research in consistency assessment.

Objective To investigate the effects of dexmedetomidine pretreatment on lung injury for patients after liver surgery. Meth-ods Sixty patients who had liver surgery in our hospital from August 2009 to February 2014 were equally divided into the treatment group and the control group, with 30 patients in each group. Both of the two groups were given one-lung ventilation anesthesia. Patients in the treatment group were given continuous intravenous infusion of dexmedetomidine after induction of anesthesia while paitents in the control group were not. In the time of before induction of anesthesia (T0), closed chest (T1), immediately after surgery (T2), all patients were given the gas analysis, expression of inflammatory cytokines and lung function testing and analysis. Results The diastolic blood pressure and heart rate at time points of T0, T1 and T2 in the two groups showed no significant difference (P> 0. 05). And the expression of TNF-αand SP-D at time points of T1 and T2 in the two groups were significantly higher than those at T0 (P<0. 05);while the expression of TNF-αand SP-D in the treatment group were significantly lower than those in the control group at time points of T1 and T2 (P<0. 05). The plateau air-way pressure and airway resistance in the treatment group at T2 and T3 were significantly lower than that at T1 (P<0. 05), and there were statistically significant differences compared with the control group (P<0. 05). Conclusion The dexmedetomidine pretreatment for the liver surgery patients can inhibit the inflammatory response, while improve lung airway plateau pressure and airway resistance. It has no significant effect for blood, so it can play a protective role for lung function.

Myocardial fibrosis is the pathological basis of hypertensive heart disease, which is the key to control cardiovascular complications. Traditional Chinese medicine (TCM) has the advantage of targeting many components of a system and providing more integrated regulation than modern medicine. While, modern medicine tends to target a single pathological link. This study was aimed to investigate effects and mechanisms in the treatment of myocardial fibrosis in hypertension with TCM from a different perspective, which provided references for clinical treatment.

Objective To investigate the clinical characteristics and therapeutic plan of Miller Fisher syn-drome( MFS) complicated with Guillain-Barrésyndrome( GBS) .Methods The clinical data of one patient of MFS complicated with GBS was reviewed retrospectively,and analysis combined with literature review was given.Results The patient had infectious history before the onset of MFS and GBS.Clinical manifestations included MFS triad,bulbar paralysis,bilateral facial paralysis,protein-cell dissociation of cerebrospinal fluid and neurogenic damages in electro-myography.Plasm exchange and adrenocortical hormones treatment were effective.Conclusion MFS complicated with GBS is an independent disease which is different from MFS or GBS.It has its distinct clinical features which should apply appropriate treatment.

Objective To explore the risk factors of the chronic subdural hematoma(CSDH) drilling drainage recurrence.Methods The clinical data of 252 CSDH patients were retrospectively analyzed.All patients underwent trephination and drainage treatment,there were 40 cases with postoperative recurrence of hematoma.Multivariate logistic analysis of linear regression was used to analyze the risk factors for postoperative hematoma recurrence.Results In this study,of 252 CSDH patients received trepanation and hematoma,the probability of recurrence was 15.9 ％ (40/252).Single factor analysis showed that the size of hematoma,CT shows the density of hematoma,postoperative drainage volume,operation time,review the CT intracranial pneumatosis,age,hematoma midline shift could increase the recurrence possibility.Logistic multivariate analysis showed that he size of hematoma,CT shows the density of hematoma,postoperative drainage volume,age were independent risk factors of recurrence of hematoma drainage in patients with CSDH after drilling.Conclusion The influence factor of recurrence of hematoma in CSDH patients received trepanation and drainage is complex,we should strengthen the intraoperative,postoperative nursing and operation to reduce postoperative recurrence of CSDH.

Objective To investigate the influences of Xuebijing injection on organs' ultra-microstructure in septic shock rats. Methods Fifteen male Sprague-Dawley (SD) rats of clean grade were selected. According to the method of random digits table, all of them were divided into three groups: sham operation group, model group and Xuebijing treated group, 5 rats being in each group. Cecal ligation and puncture (CLP) was adopted to reproduce abdominal cavity infection leading to sepsis model formation. While the rats in sham operation group just underwent abdominal median incision, abdominal exploration and closure of abdominal wall after flipping retrocecal region. In the Xuebijing treated group, within 1 hour after the operation, Xuebijing injection (4 mL/kg) was transfused through the catheter inserted in the femoral vein, and then normal saline (2 mL·kg-1·h-1) was continuously transfused until the rat being sacrificed. In the sham operation group and model group, equal volume of normal saline was given after operation. The blood pressure of all the rats was monitored continuously by a pressure device connected with a catheter inserted in the right carotid artery. The rats were observed for 12 hours, afterwards they were sacrificed, the samples of heart, lung, kidney and liver were taken, and their ultrastructural changes were observed under an electron microscope. Results The blood pressure of sham operation group was decreased a little with time extension, but within normal limits. The mean arterial pressure (MAP) of model group and Xuebijing treated group developed into a state of sepsis shock at 9 hours and 10 hours after operation respectively, and MAP were lower than 70 mmHg (1 mmHg=0.133 kPa). The MAP levels of model and Xuebijing groups at 11 hours after operation were lower significantly than those of sham operation group (mmHg:58.7±7.0, 58.7±8.3 vs. 91.0±8.2, both P<0.01), and they were persistently decreased at 12 hours after operation;the MAP in Xuebijing group was a little higher than that of model group at the same period (mmHg:55.4±4.0 vs. 48.8±12.9, P>0.05). The results of the observation with electron microscope:the structures of heart, lung, liver and kidney in sham operation group were basically normal;all the organs of model group appeared different degrees of structural damage. Compared with model group, the injury of heart and lung in Xuebijing treated group was milder, especially, the changes of cellular mitochondria were obvious;however, there was no significant difference in injury of kidney and liver between the model and Xuebijing treated groups. Conclusion Xuebijing injection can play a certain role in stabilizing the circulatory system in rats with septic shock, and can possibly ameliorate the heart and lung damage caused by infection and shock.

Objective To investigate the impact of rivaroxaban and low molecular weight heparin on hidden blood loss after unilateral first half artificial hip replacement surgery.Methods According to the digital table,a total of 80 cases because of femoral neck fractures in elderly patients with unilateral arthroplasty artificial hip and a half after surgery were randomly divided into the rivaroxaban group and low molecular weight heparin (LMWH) group,40 cases in each group.In both groups,respectively,after 12 h begin daily oral rivaroxaban 10 mg and subcutaneous low molecular weight heparin 5 000 u,compared the two groups around the actual amount of perioperative blood loss,blood loss was dominant,recessive blood loss and hidden blood loss accounts,the actual percentage of total blood loss,and recorded 35d bleeding events.Results The total amount of blood loss,dominant blood loss,hidden blood loss and the hidden blood loss accounted for the actual percentage of the total amount of blood loss of the rivaroxaban group were (671.00 ± 55.61) mL,(313.88 ± 14.53) mL,(350.00 ± 29.41) mL,(52.00 ± 5.22) ％,respectively,which of the the LMWH group were (662.00 ± 30.19) mL,(288.87 ± 15.33) mL,(372.00 ± 35.10) mL,(56.00 ± 6.71) ％,there were no significant differences between the two groups (t =0.93,0.93,0.83,1.03,all P ＞ 0.05).Conclusion For patients first underwent unilateral hip replacement surgery artificial half,perioperative using rivaroxaban or LMWH has no significantly differences in hidden risk of bleeding and bleeding event rate.

Objective To investigate the protective effect and possible mechanisms of erythropoietin (EPO) on myocardial ischemia-reperfusion injury(MIRI) in rats.Methods Ninety male SD rats were randomly divided into three groups,the sham operation group (n =20),I/RI group (n =20),and EPO treatment combined I/RI group (n =20).The left anterior descending coronary artery was ligated for 30min utes and then loosed for 150min utes to establish the rat model of MIRI.Rats of EPO + I/RI group were injected with EPO(5000u/kg) in abdominal cavity,the others were injected with nomal sodium.The serum MDA content was determined in a method of the thiobarbituric (TBA),the cardiac injury markers(cTn Ⅰ,CK,CK-MB) contents were determined by ELISA.Results The serum MDA and MPO levels of the I/RI group were significantly higher than the sham group,difference was significant(t =10.445,9.848,all P ＜ 0.05) ; Intervention by EPO,the serum MDA and MPO levels of the EPO + I/RI group were significantly lower than the I/RI group,the difference was significant (t =5.087,6.683,all P ＜ 0.05).The serum cTn Ⅰ,CK and CK-MB levels of the I/RI group were significantly higher than the sham group,the difference was significant (t =8.153,5.411,3.729,P ＜ 0.05) ; Intervention by EPO,the serum cTn Ⅰ,CK and CK-MB levels of the EPO+ I/RI group were significantly lower than the I/RI group,the difference was significant(t =4.808,4.089,3.002,all P ＜0.05).Conclusion EPO has protective effect on MIRI,the effect may be through EPO's antioxidant,antiinflammatory and protective effect on myocardial cells in the MIRI rats.