OBJECTIVE:To explore the standardized package of Metformin tablets to meet clinical needs. METHODS:Statis-tics was conducted for the utilization data of Metformin tablets in medical and health institutions from 6 cities of China;question-naires were designed to investigate and analyze the evaluation for the suitability of physicians,pharmacists and patients in the pre-scription,deployment and use links to Metformin tablets with different packaging loaded amount in Beijing and Haikou. RE-SULTS:For 0.5 g/tablet,the daily dose of 1.5 g accounted for the largest proportion (32.23%-69.91%) in 5 cities except for Chengdu. Totally 490 questionnaires about package suitability of Metformin tablets in outpatient department were sent out,includ-ing 478 valid questionnaires with effective rate of 97.5%. Results showed that packaging quantity with 4 weeks was considered as appropriate by physicians,pharmacists and patients in Beijing;however,packaging quantity with 1-2 week(s) was considered as appropriate by physicians,pharmacists and patients in Haikou;300-500 tablets of packaging quantity were preferred to be appropri-ate with the matching degree of automatic dispensing machines in both places. CONCLUSIONS:Considering the results in 2 plac-es,for 0.5 g/tablet,2 weeks is appropriate for the packaging loaded amount in outpatient department,that is 0.5 g×45 tablets/box;and 300-500 tablets/box is appropriate for inpatient pharmacies.

Objective To investigate the clinical manifestations, immunological features and prognosis of primary Sj(o)gren's syndrome(pSS) with anticentromere antibodies(ACA). Methods Sixty pSS patients with ACA in our hospital between 1985 and 2006 were screened retrospectively and compared with those without ACA. Results The mean age at the onset of pSS with ACA was higher than that of those without ACA[(48±11)yr vs(41±12)yr,P=0.000].There was no difference in sex ratio,dry mouth.dry eyes and positive salivary gland biopsy between the two groups(P＞0.05).Compared with those without ACA,patients with ACA presented a higher prevalence of liver involvement(68.3%vs 37.0%,P=0.000),while a lower prevalence of renal involvement(13.3%vs 30.9%,P=0.009), neuropathy(1.7% vs 11.5%,P=0.025)and hypergammaglobulinemia(20.8%vs 45.7%,P=0.002). The difference was not significant between the two groups in Raynaud's phenomenon,articular involvement,myositis,hematologic involvement,lung involvement,and thyroiditis. While both groups showed the same prevalence of antinuclear antibody(ANA),the patterns of ANA-IF were different and the discrete speckled pattern was the most freqent in patients with ACA and occurred in 61.7%. Different from those without ACA,patients with ACA presented a lower prevalence of anti-SSA,anti-SSB, rheumatoid factor, and antiU1 RNP,while showed a higher prevalence of antimitochondrial antibodies(AMA) and AMA-M2. The most frequent cause of death was the complications associated with cirrhosis,notably bleeding varices(3/5 cases). Conclusion Patients with ACA present a high risk of liver involvement. Because of the remarkable difference in the mean age of disease onset and also differences in systemic damage, immunological and antibody features, pSS with ACA may be a special subtype of pSS.

Objective To systematically compare propofol and isoflurane for myocardial protection in patients undergoing coronary artery bypass grafting (CABG).Methods Electronic databases were searched for randomized controlled clinical trials comparing propofol and isoflurane for myocardial protection in patients undergoing CABG.Data which were extracted independently by two reviewers included the general data of patients,premedication,induction of anesthesia and anesthetics applied during maintenance of anesthesia,level of cardiac troponin I (cTnI) before operation and at 6,12,24 and 48 h after operation,requirement for positive inotropic agents during operation,and development of myocardial infarction within 24 h after operation.Meta-analysis was conducted using Review Manager 5.0.2.Results Sixteen randomized controlled clinical trials involving 794 patients were included in this meta-analysis.The patients were divided into 2 groups:propofol group (n =405) and isoflurane group (n =389).There were no significant differences between the two groups in the plasma concentration of cTnI after operation,incidence of myocardial infarction within 24 h after operation,and requirement for positive inotropic agents during operation (P ＞ 0.05).Conclusion There is no significant difference between propofol and isoflurane for myocardial protection in the patients undergoing CABG.

Objective To investigate the multi-phase dynamic spiral CT findings of small hepatic hemangioma with arterioportal shunts,and to discuss its mechanism and influencing factors.Methods Multi-phase dynamic contrast-enhancement CT findings of 52 small hepatic hemangiomas in 33 cases were analyzed retrospectively.The criteria for diagnosing arterioportal shunts were as follow:①Transient wedge-shape or irregularly shape homogenous enhancement in the liver parenchyma adjacent to the tumor on hepatic arterial phase and slight hyper-or iso-attenuation in the area on portal venous phase and delayed phase;②Some branches of portal vein showed early appearance within the wedge-shaped homogenously hyper-attenuating area on the arterial phase.The correlation between the enhancement patterns of homangiomas and the prevalence of arterioportal shunts in small hepatic homangiomas were analyzed.Results Arterioportal shunts were found in 13(25%)of 52 small hepatic hemangiomas,all of them showed transient wedge-shaped enhancement peripheral to the tumor and in 7 of 13 hemangiomas showed early enhancement of branches of the portal veins on the arterial phase.Eleven(52.4%)of the 21 small hepatic hemangiomas with rapid enhancement had arterioportal shunt shunts,whereas only 2(6.5%)of the 31 hemangiomas with slow enhancement had arterioportal shunt shunts(P

0.05),there was not statistically different before and after HIFU. However,the normal myometrium after HIFU enhanced obviously just as that before treatment. Conclusion MRI was useful for the evaluation of the intensity, volume changes and the blood supply in leimyomas before and after HIFU.

OBJECTIVE: To optimize the prescription of traditional Chinese medicine for motion sickness (MS).METHODS: Zingiber officinale,Herba pogostemonis,Aucklandia lappa were extracted respectively,and rotating-inducing MS mice were enrolled in uniform design.The prescription was optimized with MS index as the parameters.RESULTS: The optimal prescription was as follows:60 g Z.officinale,45 g Herba pogostemonis,5 g A.lappa.The extractive of prescription was significantly better than dimenhydrinate in the treatment of MS.CONCLUSION: MS index is a stable and sensitive parameters and it is suitable for screening and evaluation of anti-MS drugs.R.zingiberis,H.pogostemonis,A.lappq are potential drug for MS.

Breaking through the traditional teaching model of medical microbiology,establishing the teaching philosophy of the subject to professional features and the core of combination with form as a breakthrough,promoting the intrest in active learning and the improvement of comprehensive ability of nursing profession students.

Objective To improve the understanding of drug-induced lupus (DIL) and the differences from systemic lupus erythematosus (SLE).Methods Clinical manifestation and treatment of patients with definite DIL were retrospectively analyzed.Results Six patients with DIL were enrolled in this study,including 4 females and 2 males.Two patients were diagnosed after receiving interferon,one after soluble tumor necrosis factor receptor fusion protein,one after propylthiouracil,one after penicillamine,and one after levofloxacin.High titer of antinuclear antibody was identified in all six patients,including 3 with positive anti-dsDNA antibody.One patient had positive anti-Sm antibody.One patient had positive anti-RNP antibody.One patient had anti-nucleosome antibody.One patient had anti-histone antibody.One patient had antimitochondrial antibodies-M2,and one patient had anticardiolipin antibodies.Conclusion Patients with DIL are not as severe as those with SLE.After cessation of suspected drugs and administration of standard treatment,the clinical outcome of DIL is satisfying.

Objective To explore the role of type Ⅶ collagen (COL7A1) gene in the pathogenesis of pretibial dominant dystrophic epidermolysis bullosa (DDEB-Pt).Methods Peripheral blood samples were obtained from a sporadic Chinese patient of Han nationality with DDEB-Pt,his parents and 100 healthy human controls.A modified salting-out method was used to extract genomic DNA from the blood samples,and PCR was performed to amplify 118 exons of the COL7A1 gene followed by DNA sequencing.Results A G→A mutation was identified at position 6109 (G6109A) in exon 78 of the COL7A1 gene in this patient,which caused a change from GCT to ACT at codon 2037 in the triple helix region,and resulted in the substitution of glycine (Gly) by arginine (Arg) (p.Gly2037Arg).Conclusion A novel glycine substitution mutation was identified in the COL7A1 gene in the patient with DDEB-Pt,which may be a pathogenic mutation.

Objective To evaluate the efficacy of case management care practice on the self-care ability of the elderly patients with prostate cancer during the endocrine therapy. Methods About 84 patients were divided into two groups by drawing lots. About 41 cases in the control group continued their treatment after discharge and consulted the nurses or doctors by phone call in case of problems. The 43 cases in the observation group was treated with case management for 3 months. The self-care ability was compared between the groups before and after the intervention. Result After the intervention, the ESCA total score of the observation group, self-care skills, self protection responsibility and health knowledge level were significantly higher than that of the observation group before intervention and that of the control group (P<0.05). Conclusion Implementation of the case management can improve the self-care ability, health knowledge level, self-care skill and sense of responsibility of the elderly patients with prostate cancer during the endocrine therapy, eventually improving the patient's ability in self care.