Objective To optimize refinement of water extract from Bushen Yangxue Granules by chitosan flocculation.Methods According to the content of icariin detected by HPLC, the waters amount, extraction time and extraction times were evaluated by orthogonal design. The effects of the solution concentration, clarifying temperature and the amount of clarifying agent on the flocculation clarification processes were optimized with the content of icariin and polysaccharides.Results The optimum water extraction processes A2B1C3 were follows: 10 times amount of water, three times extraction and 1 h for each extraction process. The optimized flocculation clarification processes A1B2C3 were as follows: solution concentration was 0.4 g/mL, the clarifying temperature was 40℃ and the addition of chitosan was 0.1%.Conclusion The optimized refining process is stable and feasible.

Older patients often experience a loss of physical,cognitive and social functioning during an acute illness-caused hospitalization.The loss of function could be due to a traditional model of hospital care,which focuses only on diagnosis and treatment of acute disease.Restoration of elderly patients' lost functions is important for better prognosis of hospitalized elderly patients and would reduce the cost of additional medical treatment.Acute care for the elderly (ACE) is a new model of care aiming at function restoration by practicing a geriatric assessment in the special ACE unit of hospital.The ACE intervention includes interdisciplinary team rounds,discharge planning of hospital,medical care review,a prepared environment,and patient-centered care.Multiple randomized control trials have demonstrated that ACE unit can improve the functional status and prognosis of old patients,reduce the cost of hospitalization,and improve patients' satisfaction.Currently,ACE care model is poorly known by Chinese hospitals and doctors.This article introduces the concepts of ACE unit,technical elements and the clinical evidence of its effectiveness.

BACKGROUND: Current practice uses the latest measure of glycated hemoglobin (HbAlc) to facilitate clinical decision-making. Studies have demonstrated that HbAlc variability links the risk of death and complications of diabetes. However, the role of HbAlc variability is unclear in clinical practice. This systematic review summarized the evidence of visit-to-visit HbAlc variability regarding different metrics in micro- and macro-vascular complications and death in people with type 2 diabetes. METHODS: We searched PubMed, EMBASE (via OVID), and Cochrane Central Register (CENTRAL, via OVID) for studies investigating the association between HbAlc variability and adverse outcomes in patients with type 2 diabetes and performed random-effects meta-analysis stratified by HbAlc variability metrics in terms of standard deviation (SD), coefficient of variation (CV), and HbAlc variability score (HVS). RESULTS: In people with type 2 diabetes, the highest quantile of all three HbAlc variability metrics (HbAlc-standard deviation [HbAlc-SD], HbAlc-coefficient of variance [HbAlc-CV], and HVS) is associated with increased risks of all-cause mortality, cardiovascular events, progression to chronic kidney disease, amputation, and peripheral neuropathy. For example, the hazard ratio of HbAlc-SD on all-cause mortality was l.89 with 95% confidence interval (95% CI) l.46-2.45 (HbAlc-CV l.47, 95% CI l.26-l.72; HVS l.67, 95% CI l.34-2.09). CONCLUSIONS High HbAlc variability leads to micro- and macro-vascular complications of type 2 diabetes and related death. People with type 2 diabetes and high HbAlc variability need additional attention and care for the potential adverse outcomes.
Humans ; Adult ; Diabetes Mellitus, Type 2/complications* ; Glycated Hemoglobin ; Cardiovascular Diseases/etiology* ; Risk Factors ; Blood Glucose