Objective To establish the determination of Dehydroandrographolide in Ganmaoqing Capsule. MethodsThe determination was carried out by HPLC with a KromasilC-18 column(250 mm ×4.6 mm,5μm),methanol-water(65:35)severed as the mobile phase,the speed was 1mL/min and the detection wavelength was at 254 nm. ResultsDehydroandrographolide showed a good linear relationship at the range of 0.04872 μg ～0.38976 μg(r2 =0.9995,n= 8);The average recovery of Dehydroandrographolide was 100.1%(RSD= 2.92%). ConclusionHPLC method was sensitive,accurate,reproducible,specific and could be used for quality control of Ganmaoqing Capsule efficiently.

Objective To observe the effect of cyanin on the expression of L-glutamate/ L-aspartate transporter (GLAST) in high glucose cultured retina Müller cells. Methods The retinal tissue of SpragueDawley (SD) rats was collected at postnatal 10 day, and Müller cells were isolated and cultured according to literature. The Müller ceils (2nd-4th generations) were treated with five different medium as normal group (group A), high glucose control group (group B), high glucose+30 μmol/L cyanin group (group C), high glucose+60 μmol/L cyanin group (group D) and high glucose+100 μmol/L cyanin group (group E). Cell relative survival rates (A value) were measured by MTT assay at 570 nm. The GLAST protein expression in M011er cells was observed by Western blot. Results MTT assay showed that the A value of the five group were 0. 450 8±0. 020 4, 0. 270 1±0. 031 4, 0. 332 0±0. 023 2, 0. 428 3±0. 017 2, 0. 361 9±0. 027 0,the cell relative survival rate were 100. 0%, 59. 9%, 73.6%, 95%, 80.3% respectively. The A value of group C, D, E were significantly higher than that of group B (F=32.25, P<0.05), the A value of group D were significantly higher than that of group C and E (F=21.07, P<0. 05). Western blot showed that the GLAST protein expression of group B was lower than that of group A (t=5.25, P<0. 05) ; there was no obvious changes of GLAST protein expression in group A, C, D and E (F= 2. 979, P>0.05).Conclusion Cyanin can rescue high glucose-induced GLAST reduction.

This study compared the efficacy of non-penetrating trabecular surgery and trabeculectomy for the treatment of open angle glaucoma. We searched the Cochrane Library, PUBMED (1966 to 2009), Embase (1980 to 2009) and CMB-disk (1979 to 2009) for the randomized clinical trials (RCT) concerning the two treatment strategies. The reports, including the papers listed in bibliographies, were evaluated against a set of quality criteria and the RCTs that satisfied the criteria were selected and subjected to Meta analysis by employing the Cochrane Collaboration's RevMan 4.5 software package. A total of nine RCTs were included in the study. The analyses of the reports showed that, 12 months after surgery, there was significant difference in the reduction of interocular pressure (IOP) between non-penetrating trabecular surgery and trabeculectomy (Z=6.05 P<0.00001). There also existed statistically significant difference in the reduction of IOP at the censored time between the two procedures (Z=4.92, P<0.00001). Difference in the success rate was also found between the two surgeries (Z=3.82, P=0.0001). It is concluded that, compared with the non-penetrating trabeculectomy, the traditional trabeculectomy could reduce IOP more and had higher success rate while the non-penetrating trabecular surgery is associated with lower postoperative complications.

The community rotation is an important stage of standardized residency training for general practitioners (GPs).However, the community rotation is also considered as a most difficult part of the GP residency training because of the problems in training management and evaluation .Based on our experiences of 7-months community training , we expanded the duration of community training to 1 year, and implemented a new segmentation and multipoint practice plan in Zhongshan hospital .This is a new attempt for GP residency training , which would hopefully meet the international standards of GP residency training .

Objective To study the curative effect of continuous positive airway pressure (CPAP) on elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) complicated with diabetes mellitus. Methods Eighty patients with OSAHS and diabetes mellitus were included and randomly divided into treatment group (n=40) and control group (n=40). The control group was given conventional treatment including diabetes diet and hypoglycemic drugs. The treatment group was given Futong ST-25 continuous positive airway pressure (CPAP) ventilation besides the conventional treatment. The serum levels of fasting blood glucose (FBG), two-hour postprandial blood glucose (2 hPG), insulin, sleep apnea hypop-nea index (AHI), low oxygen saturation (LSpO2) and the longest apnea time were monitored before and after treatment in two groups. Results After four-week treatment, values of FPG, 2 hPG, AHI and the longest apnea time were significantly lower in treatment group than those in control group (P < 0.01), but values of insulin, two-hour postprandial insulin and LSpO2 were significantly higher in treatment group than those in control group (P<0.01). Conclusion CPAP therapy can effec-tively decrease blood sugar level and improve AHI, LSpO2 and the longest apnea time in elderly patients with OSAHS compli-cated with type 2 diabetes.

Objective To explore the relationship between learning and memory ability and antioxidant enzyme (SOD, CAT, GSH-Px)activities in specific brain areas of D-galactose model rats. Methods The aging models were induced by D-galactose in 3-month old rats, and the learning and memory ability of aging model was detected in model MG-2 maze. The activity of SOD, CAT and GSH-Px in brain cortex, cerebellum,hippocampus, striatum and hypothalamus were detected immediately after rats were executed. Results The learning and memory ability of D-ga-lactose aging model was lower than that of control group. The difference of antioxidant enzyme activity among different rat brain areas was significant. The correct response rate of D-galactose aging model was( 58.9 ± 5.4 ) %, which is significantly lower than that of the control group (66.8 ±8.9) %, P ＜ 0.05. The times of response required reaching the standard after 24h of aging model rats was significantly higher than that of the control( Aging group :29.5 ± 12.8, Control group 16.6 ± 6.2; P＜ 0.01 ). Correct response rate after 24h was significantly lower than that of the control ( Aging group :67.3 ± 10.3 , Control group: 79.1 ± 6.9; P＜ 0.01 ). The SOD activity in cortex, hippocampus and striatum( Aging group :66.12 ±5.89,80.46 ± 6.57,87.82 ± 6.87; Control group :57.63 ± 4.21,67.46 ± 6.80,68.37 ± 6.52) significantly reduced ( P ＜ 0.05 and P ＜ 0.01 ).The CAT activity in cortex, hippocampus, striatum and hypothalamus( Aging group :6.45 ± 0.55,5.86 ±0.35,6.93 ± 0.63,8.89 ± 0.38; Control group :5.32 ± 0.56,4.76 ± 0.38,4.37 ± 043,6.11 ± 0.37) significantly reduced ( P ＜ 0.05 and P ＜ 0.01 ). GSH-Px activity was similar in each brain area without significance ( P ＞ 0.05 ). Conclusions The learning and memory ability of aging mode rats decreased. The change of antioxidant enzyme activities in hippocampus, cortex, striatum and hypothalamus is closely related to learning and memory ability.

Objective To study the risk factors of pulmonary embolism and comparison of the effect of different therapy.Methods Risk factors of 182 patients with pulmonary embolism were analyzed retrospectively.The patients were randomly divided into simple drug group and drug joint intervention group.Simple drug group was given heparin and warfarin,or jiont urokinase fibrinolytic therapy.The drug joint intervention group was given the same drug therapy joint vena cava filter implantation and/or catheter broken bolt therapy.After different treatment,the clinical prognosis was compared between the two groups.Results Of 182 patients with pulmonary embolism,the elderly and smoking prevalence rate increased significantly,deep vein thrombosis,cardiovascular disease,cancer,blood system diseases,trauma and surgery,chronic lung disease,fracture and orthopaedic surgery were the main risk factors.The effective rate and mortality between the pure drug therapy group and drug joint intervention group had no significant differences(x2 =0.145,P ＞ 0.05).Conclusion The incidence of pulmonary embolism is closely related to the risk factors.Cancer is one of the important diseases caused by pulmonary embolism.In a timely manner to give the antithrombotic drug treatment has great significance to the prognosis of pulmonary thromboembolism,there was no significant difference compared with the antithrombotic joint intervention.

Objective To review the standardized training of General practitioners (GPs) in Zhongshan Hospital since 2010.Methods Sixty seven GP trainees were recruited by Zhongshan Hospital since 2010.A retrospective analysis was carried out about the training methods,training content,assessment methods and training management.Results The pass rate of hospital examination was 100.0％.Sixteen out of nineteen GP residents of grade 2010 passed both the final examination and medical licensing examination,and completed the training plan; the remaining 3 trainees did not pass the licensing examination,among whom 2 extended the training and passed the exam eventually,and 1 dropped off.Sixteen out of seventeen in grade 2011 passed the medical licensing examination and were preparing for 2014 graduation examination.The training mode of human-centered and competency-based assessment system was established.Conclusion Zhongshan Hospital has accumulated rich experience in standardized training of GPs,established a system of training and assessment,and it will be continuously improved in the future.

ObjectiveTo assess the left ventricular systolic and diastolic function in patients with type 2 diabetes mellitus(DM) using quantitative tissue velocity imaging(QTVI) ,and to provide reliable evidence for early diagnosis and prevention in diabetic cardiomyopathy.MethodsOne hundred and twenty one type 2 DM patients were divided into two DM 1 groups (61 patients without microangiopathy) and DM2 group (60 patientswith microangiopathy).Fifty normal subjects were enrolled as control group.The index of echocardiography,including the LVEF, FS and mitral peak flow velocity during early and late diastole (E/A) were measured by conventional echocardiography,and the ratio of E/A was calculated.The average peak velocities of six LV wall sites at mitral annuluses during systole, early and late diastole(MEm, MEm, MAm) were measured by QTVI, and the ratio of MEm/MAm was calculated.Results Compared with the normal group, MSm ([7.13 ± 1.42])cm/s vs.([6.49 ± 1.29]cm/s), MEm ([6.22 ± 1.39]cm/s) vs.([4.53 ± 0.94]cm/s) and MEm/MAm ([0.79 ±0.17]vs.[0.59 ± 0.19]) in DM patients were significantly decreased(F = 5.32,8.01 ,4.89 ; Ps ＜0.05).There was no significant differences among three groups in the comparisons of LVEF ([67.45 ±5.47]％),([65.91 ±4.83]％),([68.01 ±6.16]％) and FS([38.84±4.23]％,[37.82±5.43]％),([40.17 ± 4.53]％)(F = 1.89 and 2.46 respectively, P ＞ 0.05) .In addition, E/A of DM2 group (0.71 ±0.21)decreased more dramatically than DM1 and normal (0.91 ± 0.18,1.02 ± 0.24)(F = 4.71, P ＜ 0.05)ConclusionCompared with EF,FS and E/A obtained by conventional echocardiography,QTVI-derived MSm,MEm and MEm/MAm are more sensitive indexes to defect early LV dysfunction.The functional disorder appears early than microangiopathy, and the left ventricular systolic and diastolic function gets worse along with the microangiopathy.

Objective To identify the prognosis factors of the patients with high-degree carotid artery stenosis and evaluate the effect of different therapy prospectively.Methods A hundred and three patients with spoke or tansient ischemic attack(TIA)suffering from severe carotid artery stenosis were included into this study consectively.They were given intra-artery intervention or antiplatelet therapy based on clinical factors and the intension of the patients or their Legally Autllorized Representative (LAR)and thus divided into 2 groups.Forty patients were transplanted with stent,63 were given only with antiplatelet drugs.The major outcome of end-point was the 2-year functional prognosis evaluated by modified Rankin score(mRS),while the minor one was the cardiovascular events in 1 year.2 year or longer after the index stroke or TIA,which was defined as stroke,TIA,acute myocardic infarction(AMI)and sudden death in this study.Results There were no statistical significances of sex,years,medical histories,blood pressure, total cholesterol,triglyceide in two groups at baseline.For the major outcome,intra-artery intervention was an independent protective factor for impaired function(mRS 3-6)with the method of binary Logistic(RR= 0.13,P=0.001,95%CI 0.036-0.460).For the minor outcome,the incidence of the cardiovascular events in 1 year and 2 year after the index stroke or TIA was lower in the intra-artery intervention group than in the antiplatelet therapy(For 1 year follow up,intervention group:antiplatelet therapy group= 12.5%:42.9%,OR=0.19,95%CI 0.07-0.55,P=0.001;For 2 year follow up,17.5%:47.6%,OR =0.23,95%CI 0.09-0.60,P=0.002).The median time of cardiovascular events in the two groups was further investigated in 55 months and 54 months separately. Kaplan-Meier analysis showed no significant difference.Survival analysis with Cox-regression showed that neither therapy of intra-artery intervention nor antiplatelet therapy was an independent factor for the cardiovascular events(RR=1.063,95%CI 0.40- 2.83,P=0.900).Conclusions For the stroke or TIA patients suffering from high-degree carotid artery stenosis,intra-artery intervention is superior pure drug therapy in achieving better theapeutical effect and reducing the incidence of the cardiovascular events after the index stroke or TIA.However,its long term effect needs further study.