In the paper, the optimal self-scaling strategy to the modified symmetric rank one (HSR1) update, which satisfies the modified quasi-Newton equation, is derived to improve the condition number of the updates. The scaling factors are derived from minimizing the estimate of upper bounds on the condition number of the updating matrix. Theoretical analysis, and numerical experiments and comparisons show that introducing the optimal scaling factor into the modified symmetric rank one update preserves the positive definiteness of updates, and greatly improves the stability and numerical performance of the modified symmetric rank one algorithm.

Objective To investigate the status of clinical blood transfusion from 2008 to 2014 in order to standardize clinical transfusion management and improve the clinical rational usage of various blood components .Methods By various blood compo‐nents transfusion ,the average quantity of clinical blood transfusion ,4 common blood types and the usage of red blood cells and platelet in different departments were analyzed and compared .Results The rate of blood component transfusion remained at 100%over the 2008 - 2014 year .The utilization of platelet was the highest ,followed by red blood cells and plasma ,and the amount of cryoprecipitate was the least from 2010 .The total consumption of blood was increasing each year ,but there was a downward trend at the average usage of clinical blood ,and also there were significant differences among 4 common blood types ,and the blood compo‐nent transfusion rate was different in different departments in hospital .Conclusion From 2008 to 2014 ,the blood transfusion is ap‐propriate and reasonable ,but still can be improved by effective means .

Objective To explore effect of vidarabine monophosphate combined with astragalus injection on serum cardiac troponin I ( cTnI), interleukin 1β(IL-1β), interleukin-10 (IL-10) and tumor necrosis factor-α(TNF-α) in children with hand-foot-and-mouth disease.Methods 60 cases with hand-foot-and-mouth disease from March 2013 to March 2015 in the hospital were selected and divided into two groups treated by different therapy, 30 cases in each group.The control group received conventional treatment + ribavirin injection, and experimental group received vidarabine monophosphate combined with astragalus injection on the basis of conventional treatment, one time per day.All patients were treated for a course of 7 days.The serum cTnI,IL-1β,IL-10 and TNF-αlevels were compared before and after treatment.Results After treatment, the serum cTnI, IL-1β, IL-10 and TNF-αlevels in two groups decreased than those of pre-treatment (P<0.05), the above indicators of experimental group were lower than those of control group (P<0.05).Conclusion The combination of vidarabine monophosphate and astragalus injection could significantly decrease serum cTnI, IL-1β, IL-10 and TNF-αlevels in children with hand-foot-and-mouth disease.

OBJECTIVE:To discuss the significance of therapeutic drug monitoring(TDM)for rational administration of anti-epileptic drugs and to probe into the cognition of clinic staff on TDM.METHODS:Access database of antiepileptic drugs was established to analyze the TDM data of antiepileptic drugs used from 2001 to 2006.RESULTS:The TDM cases of anti-epileptic drugs increased year by year.The proportions of effective concentration,high blood drug concentration and low blood drug concentration derived from TDM data showed that it is quite necessary to conduct blood drug concentration monitoring.But the lack of individual medication information has hindered the development of patients' individualized medication of anti-epileptic drugs.CONCLUSION:The application of TDM is increasingly widespread;however,the joint efforts of physicians and pharmacists are still needed to ensure individualized medication of anti-epileptic drugs.

Objective To observe the impact of coal-burning-borne fluorosis on the opening day of vagina,and estrogen cycle and endocrinology of female rat.Methods Ninety weaned two weeks and healthy female SD rats,weighing 60-80 g were selected,and divided into three groups by body weight using random number table:control group,moderate fluoride exposed group,and higher fluoride exposed group,thirty rates in each group.Rats in fluoride exposed groups were fed with baked corn collected from coal-burning-borne fluorosis areas containing different levels of fluorine(fluorine contents were 47.8 and 96.0 mg/kg,respectively) to establish coal-burning-borne fluorosis models.The corn fed to control group rats were collected from non-endemic areas (fluoride content was 5.2 mg/kg).After exposed to fluoride for 60,120 and 180 days,the rats were put to death during estrus in three batches (10 rats in every batche).The situation of female vaginal opening was observed and recorded every morning at 8:00 at the beginning of the experiment.Ten female rats in each group were randomly selected to observe vaginal exfoliated cells for 10 days continuously every morning,and HE staining was selected to discriminate estrogen cycle.Femoral artery blood was collected to observe the impact of estradiol(E2) in estrus.Results The vaginal opening day age of the longer fluoride exposed group [(49.0 ± 4.5)d] was longer than that of the control group[(45.4 ± 2.3)d] and the moderate fluoride exposed group[(46.7 ± 1.9)d,all P ＜ 0.05].Estrogen cycle of the longer fluoride exposed group[(5.8 ± 0.8)d] after fluoride exposure for 120 d was higher than that of the control group [(4.4 + 0.9)d] and the moderate fluoride exposed group [(4.9 ± 0.7)d,all P ＜ 0.05].Estrogen cycle increased with increasing dosage of fluoride after fluoride exposure for 180 d in three groups [control group:(4.3 ± 0.7)d,moderate fluoride exposed group:(5.4 ± 1.1)d,higher fluoride exposed group:(6.7 + 0.9)d,all P ＜ 0.05].Estrogen cycle in higher fluoride exposed group at 180 d[(6.7 ± 0.9)d] was higher than that of 60 d and 120 d[(5.2 ± 1.1),(5.8 ± 0.8)d,all P ＜ 0.05].At 60 d after exposed to fluoride,E2 levels of fluoride exposed groups were increased[control group:(30.125 ± 94.17)ng/L,moderate fluoride exposed group:(438.75 ± 71.80) ng/L],higher fluoride exposed group (456.25 ± 57.80)ng/L with increasing dosage of fluoride (all P ＜ 0.05).E2 level in rats exposed to fluoride for 180 d [(275.00 ± 127.83)ng/L] was lower than that of 60 d and 120 d [(456.25 ± 57.80),(392.50 ± 102.50)ng/L,all P ＜ 0.05] in higher fluoride exposed groups.Conclusions Coal-burning-borne fluorosis has a significant effect on vaginal opening day age,estrogen cycle and endocrinology of female rats.The higher the fluoride dose,and the longer the exposure time,the more severe the impact.

OBJECTIVE:To evaluate the uncertainty of the determination of clopidogrel active metabolite derivative(CAMD) in human plasma by LC-MS/MS. METHODS:The course of CAMD determination in human plasma by LC-MS/MS were analyzed to evaluate the uncertainty caused by evaluate repeatability,weighing,standard solution preparation,biological sample prepara-tion,recovery,instrument precision and calibration curve fitting in CAMD assay;the uncertainty were calculated and expanded. RESULTS:The expanded uncertainty for low(0.107 ng/ml),medium(4.467 ng/ml)and high(155.667 ng/ml)levels of CAMD were 0.010 2 ng/ml,0.188 ng/ml and 6.413 ng/ml,respectively(k=2,P=95%). CONCLUSIONS:The uncertainty of the CAMD determination in human plasma by LC-MS/MS at low concentration is mainly caused by calibration curve fitting;at medium and high concentrations is mainly caused by biological sample preparation,extraction procedure,standard solution preparation and in-strument precision.

This article was aimed to study the immunomodulatory effect of ethanol sediments of the seeds of Descurainia sophia(L.) Webb. ex Prantl. both in vitro and in vivo. The lymphocyte proliferation test in vitro was carried out to explore the effect of the ethanol sediments on the proliferation of T cell and B cell in the spleen of normal mice. And, the carbon clearance test, serum hemolysin test, and delayed-type hypersensitivity test were used to investigate the influence of fraction on non-specific immunity, humoral immunity and cellular immunity in the immunosuppressive mice induced by cyclophosphamide. Besides, the immunosuppressive model was used to evaluate the effect of fraction on immune organs and content of cellular factors in blood serum. The results showed that the ethanol sediments promoted Concanavalin A (Con A) induced T cell and Lipopolysaccharides (LPS) induced B cell (P < 0.01). It increased the carbon clearance index K, phagocytic index α, half value hemolysis (HC50), and swelling degree of auricula (P < 0.05 or P < 0.01). It reduced the body weight and atrophy of thymus and spleen index (P < 0.05 or P < 0.01). It increased the contents of IL-2, IFN-γ and IL-4 in serum in immunosuppressive mice (P < 0.05 or P < 0.01). It was concluded that ethanol sediments of the seeds of D. sophia(L.) Webb. ex Prantl. can boost the lymphocyte proliferation, protect the immune organs, and enhance the non-specific and specific immunity in immunosuppressive mice, which indicated that it had immune-promotion effect.

Objective:To investigate the inhibitory effects produced by combination of carboplatin ( CA) and Tanshinone ( TA) on the growth of B16.Methods:After the mice were injected B16 subcutaneously in the right thigh, the mice were divided into four groups,PBS group,TA group,CA group,and TA+CA group.Normal mice were set up as control.Mice of PBS group were injected 0.2 ml PBS intraperitoneally;mice of CA group were injected 0.5 mg CA intraperitoneally for four consecutive days and followed by four days without administration until the mice were killed;mice of CA+TA group were injected 0.5 mg CA intraperitoneally for four consecutive days and followed by four days without administration,TA (0.5 g/kg body weight) was administered to the mice through gastric injection every day until the mice were killed.Results:The tumor weight and volume of CA+TA mice were significantly smaller than those of CA mice,TA mice and PBS mice ( P<0.05 );the tumor weight and volume of CA mice were significantly smaller than those of TA mice and PBS mice (P<0.05).The body weight grow of TA+CA mice was more significant than that of TA mice and CA mice( P<0.05).Conclusion:Combination of carboplatin (CA) and Tanshinone (TA) will produce a better inhibitory effects on the growth of B16 cells.

This article was aimed to study immunomodulatory effect of chemical split fractions ofMori Cortex, in order to initially explain effective parts that played a role in immunomodulatory effect ofMori Cortex. The carbon clearance test, serum hemolysin test, E-rosette test, and lymphocyte transformation test were carried out to explore influence of these chemical split fractions ofMori Cortex on immune organs, nonspecific immunity, humoral immunity and cellular immunity. The results showed that in the carbon clearance test, 50% ethanol fraction markedly reduced the thymus index (P<0.01) and the correction indexα (P<0.05). In hemolysin test, the half value hemolysis (HC50) was improved by 30% ethanol fraction and fatty oil fraction (P<0.05). Besides, in the E-rosette test, the E-rosette ration was increased in the 30% ethanol fraction group (P<0.05). In the lymphocyte transformation test, the 30% ethanol fraction can promote the thymus and spleen lymphocytes proliferation (P<0.05 orP<0.01), while the 50% ethanol fraction inhibited the proliferation (P<0.05 orP<0.01). It was concluded that the 30% ethanol fraction can boost both the humoral immunity and cellular immunity; the 50% ethanol fraction can induce the growth of thymus with a suppressive effect on nonspecific immunity and cellular immunity; the fatty oil fraction can improve humoral immunity.

Objective: To investigate the safety and efficacy of eltrombopag for adult patients with chronic immune thrombocytopenia (cITP). Methods: It was a randomised, single-centre, 6 weeks, placebo-controlled study. Beginning in January 29^th, 2013, 35 patients were enrolled, and the trial was completed on May 16^th, 2014. 17 patients were assigned to receive eltrombopag (starting dose 25 mg/d) and 18 were assigned to receive placebo. Results: A total of 35 cases of adult cITP, 6 males and 29 females with a median age of 42(22-66) years were enrolled. One patient withdrew from eltrombopag treatment group for the adverse event (AE) and discontinued treatment. In first two weeks, 27.78% (5/18) of placebo-treated compared with 64.71%(11/17) of eltrombopag-treated patients achieved platelet counts ≥ 30×10⁹/L(P=0.031); Treatment 6 weeks, the proportion of platelet counts reached ≥50×10⁹/L and ≥ 30×10⁹/L in eltrombopag-treated were higher than placebo-treated ones with statistically significant differences in both groups [64.71%(11/17) vs 11.11% (2/18), P=0.001; 76.47% (13/17) vs 38.89% (7/18), P=0.028]; The study also indicated a statistically significant difference in favour of eltrombopag compared with placebo in the odds of achieving the outcome of a platelet count ≥ 50×10⁹/L at least once during 6-week treatment (94.11% vs 33.33%, P<0.001), and 70.59%(12/17) of patients with the platelet count continuously ≥ 50×10⁹/L in 50% of treatment time in eltrombopag-treated group was more than placebo-treated one [11.11%(2/18), P<0.001]. Proportions of patients who required rescue treatment were 44.44% in placebo group and none in eltrombopag-treated one, respectively (P=0.002); The odds of bleeding symptoms with the WHO bleeding scale had no difference in both groups after 6 weeks (P=0.066). Adverse events that occurred more frequently due to eltrombopag than placebo included increased transaminase (3/17) and blood bilirubin (5/17), cerebral infarction(1/17). Conclusions The thrombopoietin receptor agonist eltrombopag was a suitable therapeutic option for Chinese adults with cITP.