This paper reported that a new type of floating osmotic pump of ambroxol hydrochloride was designed. Third method apparatus (Chinese Pharmacopeia 2010, appendix XD) was employed to simultaneously evaluate the release and floating behavior in vitro. The system was optimized using central composite design-response surface methodology. Similar factor (f2) between the release profile of self-made formulation and the target release profile was chosen as dependent factor. The amount of glucose (A, mg), pore former (B, %) and weight of coating (C, %) were employed as independent factors. Optimized formulation was: A (100.99 mg), B (1.70%), C (4.21%). The value of f2 (89.14) was higher than that of market capsules (69.02) and self-made tablets (72.15). It was showed that self-made capsules possessed character of zero-order release (r = 0.994 4) and drug release completely (>90%). It was showed in result of in vivo study that tmax and Cmax of self-made capsules were significantly lower than that of market capsules and self-made tablets. The correlation coefficient between the fraction of absorption in vivo and the release rate in vitro was 0.985 1, and relative bioequivalence of self-made capsules was 110.77%. Accordingly, self-made capsules displayed obviously characteristics of controlled release both in vivo and in vitro.

Objective To investigate the effects of different doses of dexmedetomidine on the minimum alveolar concentration (MAC) of sevoflurane required to inhibit the body movement evoked by skin incision.Methods ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,with body mass index of 21-27 kg/m2,undegoing elective lower abdominal surgery under general anesthesia,were randomly divided into 4 groups:control group (group C) and different doses of dexmedetomidine groups (groups D1,D2 and D3 ).Dexmedetomidine 0.2,0.4 and 0.6 μg/kg in 15 ml of normal saline was infused over 30 min before induction of anesthesia in groups D1,D2 and D3 respectively.While 15 ml of normal saline was given instead in group C.Anesthesia was induced with inhalation of 8％ sevoflurane.The patients were mechanically ventilated after tracheal intubation.Anesthesia was maintained with inhalation of sevoflurane.The initial end-tidal concentration of sevoflurane was set at 3.0％,3.0％,2.5％,2.0％ in groups C,D1,D2 and D3 respectively.The ratio between the two successive concentrations was 0.9.Skin incision was made after 15 min of equilibratiton.At least 7 independent crossover pairs were observed in each group.The MAC of sevoflurane was the mean of the end-tidal concentration of sevoflurane of each crossover pair,and 95 ％ confidence interval (CI) was calculated.Results In groups C,D1,D2 and D3,18,20,20 and 22 patients were enrolled respectively.The MAC (95 ％ CI) of sevoflurane was 2.5 ％ (2.3 ％-2.8 ％ ),1.5 ％ ( 1.3 ％-1.7％),1.3％ (1.0％-1.6％) and 1.1％ (0.7％-1.5％) in groupsC,D1,D2 and D3 respectively.The MAC of sevoflurane was significantly lower in groups D1,D2,D3 than in group C,and in groups D2 and D3 than in group D1 ( P ＜ 0.05).There was no significant difference in the MAC of sevoflurane between groups D2 and D3 ( P ＞0.05).Conclusion Dexmedetomidine 0.2,0.4,0.6 μg/kg can significantly decrease the MAC of sevoflurane required to inhibit the body movement evoked by skin incision in a dose-dependent manner.

Objective To investigate the disease assessment and prognosis value of serum copeptin level in patients with acute cerebral infarction (ACI). Methods One hundred first diagnosed ACI patients were selected as ACI group. According to the National Institutes of Health stroke score (NIHSS), the ACI patients were divided into mild (NIHSS<7 scores), moderate (NIHSS 7-15 scores) and severe (NIHSS>15 scores). Sixty cases of healthy subjects were selected as control group. The serum copeptin level was measured by double antibody sandwich enzyme linked immunosorbent assay method in control group and ACI group (onset within 24 h). The NIHSS, Alberta stroke program early CT score (ASPECTS) and modified Rankin score (mRS) onset within 24 h and 14 d were evaluated in patients with ACI, and the mRS 90 d and 180 d after ACI were evaluated. The neurological impairment was assessed by mRS 180 d after ACI, mRS ≤ 2 scores was good prognosis, ≥ 3 scores was poor prognosis. The correlation was analyzed. Results Among the 100 patients with ACI, mild was in 52 cases, moderate in 34 cases, and severe in 14 cases; good prognosis was in 79 cases and poor prognosis in 21 cases. The serum copeptin levels within 24 h of ACI in mild, moderate and severe patients of ACI group were significantly higher than that in control group:(4.82 ± 1.25), (6.39 ± 2.21) and (9.28 ± 3.82) pmol/L vs. (1.95 ± 0.28) pmol/L. The serum copeptin level within 24 h of ACI in moderate patients was significantly higher than that in mild patients, in severe patients was significantly higher than that in moderate patients, and there were statistical differences (P<0.05). Within 24 h of ACI , the ASPECTS in moderate and severe patients were significantly lower than that in mild patients:(10.02 ± 2.10) and (6.24 ± 3.05) scores vs. (12.16 ± 0.84) scores, in severe patients was significantly lower than that in moderate patients, and there were statistical differences (P<0.05). The NIHSS in moderate and severe patients were significantly higher than that in mild patients:(10.68 ± 3.14) and (16.20 ± 4.26) scores vs. (4.35 ± 1.52) scores, in severe patients was significantly higher than that in moderate patients, and there were statistical differences (P<0.05). The serum copeptin levels within 24 h of ACI and NIHSS in each time point in good prognosis patients were significantly lower than those in poor prognosis patients:(3.52 ± 1.26) pmol/L vs. (8.68 ± 3.06) pmol/L and (5.68 ± 2.11) scores vs. (15.36 ± 3.25) scores, (4.85 ± 1.86) scores vs. (12.60 ± 3.89) scores, (3.68 ± 1.21) scores vs. (6.35 ± 2.96) scores, (2.16 ± 0.75) scores vs. (5.21 ±1.96) scores, and the ASPECTS within 24 h of ACI was significantly higher than that in poor prognosis patients:(11.38 ± 2.21) scores vs. (7.86 ± 2.49) scores, and there were statistical differences (P<0.05). The single factor Logistic regression analysis results showed that the age, ASPECTS, NIHSS and serum copeptin level were the influencing factors of severity of illness in patients with ACI (OR = 1.21, 5.36, 5.61 and 6.62;95%CI 0.99-1.39, 3.34-9.21, 2.86-7.52 and 1.38-12.64;P=0.04, 0.01, 0.01 and 0.00), and the influencing factors of poor prognosis (OR=1.32, 5.21, 4.86 and 6.82;95%CI 0.84-1.43, 3.52-8.39, 2.62-5.35 and 2.67-11.85;P=0.04, 0.01, 0.01 and 0.00). ROC analysis results showed that the area under curve of NIHSS, serum copeptin level and ASPECTS in predicting poor prognosis in patients with ACI were 0.926, 0.863 and 0.624. In the mild, moderate and severe patients, the serum copeptin level was negative correlated with ASPECTS ( r=-0.682,-0.594 and-0.572;P<0.01), and the serum copeptin level was positively correlated with NIHSS ( r = 0.652, 0.614 and 0.586; P<0.01). Conclusions The serum copeptin level in patients with ACI is significantly elevated. The serum copeptin level is positively correlated with neurologic impairment severity and prognosis in patients with ACI, and it has important significance in evaluating pathogenetic condition and prognosis.

Objective Objective To evaluate the effects and safety of total glucosides of paeony (TGP) in the treatment of patients with Sjogren syndrome.Methods The Cochrane Library,PubMed,EMBASE,CBM,VIP,CNKI,Wanfang databases were searched from their establishments up to September 30,2015.We used the method recommended by the Cochrane collaboration to perform a meta-analysis of randomized controlled trails (RCTs) of total glucosides of peony in the treatment of patients with Sjogren syndrome.Two reviewers analyzed these data independently.The Cochrane Collaboration's software RevMan 5.3 was used for meta-analysis.Results A total of 573 patients in 10 studies were finally included,and were divided into different subgroups.The results of subgroup-analysis showed that:①Schimer test:TGP group had a higher effective rate than the blank control group [MD=2.41,95%CI (0.08,4.74)],lower effective rate than Chinese herbal medicine [MD=-2.55,95%CI (-3.88,-1.22);②Salivary flow:TGP group had a lower effective rate than the control group [SMD=-0.87,95%CI (-1.20,-0.54)].③Rheumatic factors (RF):TGP group had a higher effective rate than Chinese herbal medicine [SMD=0.44,95%CI (0.06,0.82)] and Chinese patent drug [SMD=0.74,95%CI (0.36,1.12)],lower effective rate than the blank control group [SMD=2.23,95%CI (-2.79,-1.67);④ C-reactive protein (CRP):TGP group had a higher effective rate than the control group [MD=4.51,95%CI (1.75,7.26)];⑤IgG:TGP group had a higher effective rate than Chinese patent drug group [MD=2.73,95%CI (1.63,3.84)],lower effective rate than the blank control group [MD=-3.90,95%CI (-5.67,-2.13),but no statistical difference was noted when compared with Chinese herbal medicine and Western medicine groups;⑥ESR:TGP group had a higher effective rate than Chinese herbal medicine group [MD=12.73,95%CI (3.62,21.84)] and Chinese patent drug group [MD=7.82,95%CI (5.39,10.24)],lower effective rate than the blank control group [MD=-7.13,95%CI (-12.70,-1.56) and Western medicine group [MD=-12.19,95%CI (-24.19,-0.19)];⑦Safety:8 studies reported adverse effects in 41 patients.TGP group had a higher adverse reaction rate than the control group [OR=3.23,95%CI (1.60,6.50)].Conclusion Current evidence demonstrates that TGP can effectively improve CRP,but its effects on Salivary flow,Schimer test,IgG,ESR,RF were not significant.However,the heterogeneity and high risk of bias in the reports involved in this study limits the reliability of this conclusion.

Objective To investigate the dynamic changes of serum interleukin(IL)-18,IL-1β and copeptin in acute cerebral infarction(ACI),and analyze the relationship with the serious degree of ACI.Methods The levels of serum IL-18,IL-1β and copeptin were measured by Double-antibody sanduicb enzyme-linked immunosorbent assay(ELISA)in 83 patients with ACI who were admitted to the hospital within 24 h,and neurological impairment were evaluated by European stroke scale(ESS)at the 1st,3rd and 7th day respectively after hospitalization.At the same time,the patients with ACI were compared with 32 normal adults.Results The levels of serum IL-18,IL-1β and copeptin at the 1st,3rd and 7th day after hospitalization were(131.30±31.62),(168.30±28.12),(141.26±24.23)ng/L,(0.35±0.04),(0.82±0.10),(0.52±0.21)μ g/L,and(3.64±0.26),(4.18±0.53),(3.26±2.41)μ g/L respectively.There were significant differences among different times respectively(P＜0.05),furthermore they were higher than those in normal adults[(119.12±27.42)ng/L,(0.21±0.08)μ g/L,(2.63±0.23)μ g/L](P＜0.05).Univariate Logistic regression analysis showed that age,copeptin,IL-18,IL-1β and ESS score was the influencing factor in the serious degree of ACI.There was no significant difference in assessing the serious degree of ACI by receiver operating characteristic(ROC)curve between IL-18 and age,copeptin,IL-1 β,ESS score(P＞0.05).Conclusions The serum levels of IL-18,IL-1β and copeptin are increasing after ACI,indicating that the inflammatory and immune factors may be involved in the development process of ACI.The serum levels of IL-18,IL-1β and copeptin can reflect the serious degree of ACI.

OBJECTIVE:To establish the method for simultaneous determination of tenacissoside A,tenacissoside H and tenacissoside I in Marsdenia tenacissima. METHODS:UPLC-MS/MS method was adopted. The determination was performed on a Phenomenex Kinetex XB-C18column with mobile phase consisted of 0.1% formic acid solution-acetonitrile(gradient elution)at the flow rate of 0.2 mL/min. The column temperature was set at 40 ℃,and sample size was 5 μ L. Multiple reaction monitoring (MRM)mode was adopted with electrospray ion source as ion source,using positive ion scanning. Source jet voltage was 5 500 V,nebulizer pressure was 60 psi,heating pressure was 60 psi,curtain pressure was 20 psi and cone temp was set at 600 ℃. RESULTS:The linear ranges of tenacissoside A,tenacissoside H and tenacissoside I were 0.1-10 ng/mL(r=0.999 7),0.025-10 ng/mL(r=0.999 5),0.025-10 ng/mL(r=0.998 9),respectively;limited of quantation were 0.1,0.025,0.025 ng/mL,limited of detection were 0.05,0.012 5,0.012 5 ng/mL,respectively;RSDs of precision,stability and reproducibility tests were<4.0%. The recoveries were 97.67%-99.00%(RSD=0.47%,n=6),95.00%-101.67%(RSD=2.59%,n=6),96.67%-103.33%(RSD=2.83%, n=6). CONCLUSIONS:The method is simple,precise,stable and reproducible,and can be used for simultaneous determination of tenacissoside A,tenacissoside H and tenacissoside I in M.tenacissima.

Objective Establishing intelligent nursing clinical decision support system to improve the safety, quality and efficiency of clinical nursing work. Methods Guided by the HIMSS EMRAM Analytics stage 7 evaluation standard, the nursing decision support system is continuously improved through the establishment of knowledge bases such as nursing plans and nursing conventions. Results By comparing the writing time of nursing documents, the correct rate of nursing diagnosis, and the incidence of nursing risk events before and after the used of the system, the results showed that after the used of the nursing decision-making support system, whole hospital′s writing time could save 222.5 hours per day, improved accuracy of nursing diagnosis from 68.33％ (205/300)to 90.67％ (272/300), the difference was statistical significace (χ2=45.907, P<0.05). Decreased incidents, hospital-wide, on falls from 0.127‰(80/631702) to 0.071‰(45/638715),and on pressure ulcer form 0.064‰ (41/631702)to 0.028‰(18/638715), the difference was statistical significace (χ2=13.004～15.071, P<0.05). Conclusion Nursing clinical decision support system is the trend of hospital informatization and is worthy of clinical application.

Objective: To understand social anxiety of Tibetan adolescents aged 10-15 years old in high altitude areas and its correlation with sleep duration, so as to provide a reference and support for social anxiety prevention and mental health interventions for Tibetan adolescents in high altitude areas. Methods: A total of 2 426 Tibetan adolescents from the Lhasa, Chamdo, and Nagchu regions of Tibet were surveyed. From April to June 2022, basic demographics, social anxiety, and sleep status were obtained and analyzed using class based, stratified whole group sampling, and the correlations detected between the two were analyzed by logistic regression analysis. Results: The average social anxiety score of Tibetan adolescents aged 10-15 years in high altitude areas was (6.51±4.32), and the detection rate of social anxiety was 5.23%. The mean sleep duration was (7.42±1.18) hours/day. The differences were statistically significant when compared across gender, overweight/obesity status, level of physically activity, and sleep duration ( χ 2=19.44, 14.39, 7.83, 7.21, P <0.05). After adjusting for relevant variables, the Logistic regression analysis showed that sleep deprivation among boys ( OR =2.91, 95% CI =1.82-4.61), sleep deprivation among girls ( OR = 3.51 , 95% CI =2.01-6.04), and overall sleep deprivation among Tibetan adolescents ( OR =3.12, 95% CI =1.91-4.58) were positively associated with social anxiety( P <0.01). Conclusions A positive association was found between social anxiety and sleep deprivation, indicating that social anxiety is an issue among Tibetan adolescents living in high altitude regions. Sufficient sleep duration plays a positive protective role in reducing social anxiety among Tibetan adolescents in high altitude areas, and the findings provide a reference for future mental health interventions.

AIM: To explore the pharmacokinetic interactions between sorafenib and dapagliflozin in rats and to provide some theoretical basis for the rational clinical use of the two drugs. METHODS: An ultra -performance liquid chromatography-tandem mass spectrometry (UPLC / MS / MS) method was developed for the simultaneous determination of sorafenib and dapagliflozin. Male SD rats were randomly divided into 5 groups (6 rats in each group), including 100 mg / kg sorafenib group, 0.5 mg / kg dapagliflozin group, 1 mg / kg dapagliflozin group, and 100 mg/kg sorafenib combined with 0.5 mg/kg dapagliflozin group and 100 mg/kg sorafenib combined with 1 mg / kg dapagliflozin group, for sorafenib and dapagliflozin drug interaction study. All samples were analyzed using a validated UPLC/ MS/MS method, and the main pharmacokinetic parameters were calculated by compartment model. RESULTS: 1 mg/kg dapagliflozin increased the C