OBJECTIVE: To observe the therapeutic effects of the conventional therapy plus Melitracen and Flupentixol in the treatment of functional dyspepsia(FD).METHODS: 320 FD cases were divided into gastrointestinal dyskinesis type(Type A,n=120 cases),ulceration type(Type B,n=100 cases),and nonspecific type(Type C,n=100 cases) based on their clinical symptoms.Patients of different clinical types were randomly assigned to receive conventional therapy alone or in combination with Melitracen and Flupentixol for 4 weeks.The curative effects were observed using gastrointestinal symptom rating scale(GSRS) and the total effective rate were computed.RESULTS: After treatment,the GSRS score of 3 different clinical types of FD in the combination therapy group versus the conventional therapy alone were 1.53?1.68 vs.3.10?1.78,2.02?1.63 vs.3.48?1.80 and 3.46?2.95 vs.5.18?3.21 respectively(P

To explore novel monoamine reuptake inhibitor with antidepressant activity, a series of substituted aryl alkanol piperidine derivatives were designed and synthesized. All of them were new compounds, and their structures were confirmed with 1H NMR and HR-MS. The results showed that compounds 4, 5 and 8 displayed strong 5-HT, NA and DA reuptake inhibiting activities in vitro. Among the tested compounds, 4, 5 and 13 exhibited potent antidepressant activities in the mice forced swimming test. Compounds 4 and 5 have potent antidepressant activities and are worth further development.

Objective Experimental autoimmune anterior uveitis (EAAU) is a useful model for human anterior uveitis. The purpose of this study was to observe whether EAAU development could be prevented by anterior chamber-associated immune deviation (ACAID). Methods Bovine melanin protein (BMP) in phosphate-buffered saline (PBS) was injected into the anterior chamber of the right eye of rats; control animals were injected with PBS alone. Seven days later, all animals were immunized with BMP in complete Freund's adjuvant (CFA) and pertussis toxin. The severity and incidence of uveitis was monitored by clinical examination and histopathology. The delayed-type hypersensitivity (DTH) responses were evaluated by footpad swelling elicited by injection of BMP.Results Rats intraocularly injected with BMP showed a reduced severity and incidence of EAAU, and significantly suppressed DTH response compared to control rats.Conclusion These data suggest that the ACAID procedure can be utilized to prevent the development of EAAU.

AIM:To determine whether the vitreous cavity (VC) is capable of supporting the induction of deviant immune response to retinal soluble (S) antigen and to observe the influence of interleukin-1 (IL-1) on the immunologic properties of the VC. METHODS: Retinal S antigen was inoculated into the anterior chamber (AC) and VC in Wistar rats. Seven days after antigen inoculation, the recipient animals were immunized with S antigen and complete Freund's adjuvant. Delayed-type hypersensitivity (DTH) was then assessed by footpad challenge. To alter systemic immune conditions, IL-1 was administrated by intraperitoneal injection. RESULTS: Antigen-specific DTH did not develop in rats in which S antigen was injected into the AC and the VC. In contrast, strong DTH was elicited by S antigen injected into the AC and VC if IL-1 was administrated systemically for 7 consecutive days after the antigen challenge. CONCLUSION: The VC is capable of supporting immune deviation to soluble antigen by actively suppressing antigen-specific DTH. Systemic administration of exogenous IL-1 eliminates the capacity of the VC to support immune deviation inducing by soluble antigen injected locally.

Objective:To evaluate the prognostic value of post-mastectomy radiation therapy (PMRT) in patients with axillary lymph node-positive breast cancer treated with breast conservation surgery and to establish the candidates for PMRT based on different pN stages and lymph node ratios (LNR). Methods:A retrospective analysis of the clinical data of the patients was conducted. The pa-tients had positive lymph nodes (n=152) between 1998 and 2007 and underwent breast conservation surgery. A comparison of the dis-ease-free survival (DFS) and overall survival (OS) rates was conducted based on LNR and pN staging and with PMRT as a prognostic factor. Results:A total of 152 cases were studied, of which 114 were pN1, 23 were pN2, and 15 were pN3. Among these cases, 114 had an LNR ranging from 0.01 to 0.20, 26 had an LNR from 0.21 to 0.65, and 12 had an LNR>0.65. Univariate analysis showed that the number of dissected lymph nodes, LNR, pN stage, estrogen and progesterone receptor status, and radiotherapy were the prognostic fac-tors for DFS and OS rates (P<0.05). Age and chemotherapy were prognostic factors only for OS rate (P<0.05). Multivariate analysis in-dicated that PMRT and LNR were independent prognostic factors of DFS and OS (P<0.05). The pN staging had no significant effect on DFS or OS (P>0.05). In the subgroup analysis, PMRT had significant effect on DFS and OS (P<0.05) in patients with pN1 and LNR<0.21. Conclusion:LNR is an independent prognostic factor in axillary lymph node-positive breast cancer patients treated with breast conservation surgery, and a candidate for PMRT should be established based on different LNR risks.

Objective:To provide reference for the pharmacy automation construction in outpatient pharmacy of domestic hospitals. Methods:The work process, application effect and patient satisfaction before and after the use of automatic drug dispensing machine were analyzed and compared by the data collection and questionnaire according to the operation practice of automatic drug dispensing machine in the outpatient pharmacy of our hospital. Results:After using the automatic dispensing machine, the work flow could be op-timized, the comprehensive benefit and the satisfaction of patients could be improved, and the investment return rate was promising. Conclusion:Automatic pharmacy is the direction of modern pharmacy construction, which has a good application prospect.

Objective To investigate the dynamic changes of infectious distribution,current resistant situation of Streptococcus pneumoniae(SP) and resistant to penicillin and other 10 kinds of antibiotics for the guidance of clinical therapy of SP.Methods Bacteria were identified by French BioMerieux API identification system,VITEK 2-COMPACT identification system and Optochin test,bile solubility test.In vitro,drug susceptibility test to penicillin,cefotaxime,and other 10 kinds of antibiotics were conducted with K-B disk diffusion method combined with the concentration gradient method.Drug susceptibility results were analyzed from 2001 to 2011.Results In recent 11 years,SP antimicrobial resistance rate had increased year after year,especially rates of penicillin-resistant and penicillin not-sensitive had increased significantly,rising from 8.3％( in 2001 ) to 72.7％ ( in 2011 ) ( meningitis 86.4％,non-meningitis 59.0％ ).Resistance rate of cefotaxime,belonging to third-generation cephalosporin had already accounted for 54.0％ ( meningitis 64.0％,non-meningitis 44.0％ ) ;and the resistance rate of macrolide antimicrobial was 100％ ; vancomycin-resistant strains and linezolid-resistant strains had not been detected.Conclusion Penicillin non-susceptible SP has accounted for a high percentage,antimicrobial resistance of Streptococcus pneumoniae penicillin,cephalosporins,macrolides are in serious condition.Vancomycin and linezolid should be preferred or the right antibiotics be chosen according to vitro susceptibility results of isolates in clinical treatment of severe infections caused by SP.

ObjectiveTo systematically and objectively evaluate the therapeutic efficacy of comprehensive acupuncture treatment in managing wet age-related macular degeneration (ARMD), and to seek a standard acupuncture protocol for this disease, for promoting the application in clinic.MethodTotally 37 patients (67 eyes) were observed to compare the vision, Amsler grid and rating scale of quality of life for visual impairment before and after the 3-month treatment. The clinical efficacy was then evaluated. ResultThe vision and score of quality of life were significantly changed after intervention (P<0.05); according to Amsler grid, the total improved rate was 79.2% and the total effective rate was 77.6%; age and disease duration were negatively correlated with the therapeutic efficacy (P<0.05).ConclusionComprehensive acupuncture treatment can significantly improve the vision and quality of life in patients with wet ARMD, and the younger the patients and the shorter the disease duration, the higher the therapeutic efficacy.

Objective:To retrospectively evaluate the prognostic risk factors of T1-2 stage breast cancer patients with one to three positive node(s) and their effects on the benefits of post-mastectomy radiation therapy (PMRT). Methods:We retrospectively analyzed 457 breast cancer patients with T1-2 stage and one to three positive axillary lymph nodes treated in our hospital between 2000 and 2002. The independent prognostic factors of the patients were calculated by the Cox proportional hazards model. The patients were fur-ther classified into high-risk and low-risk subgroups according to the risk factors to explore the benefit of PMRT on the prognosis of dif-ferent subgroups using survival analysis. Results:PMRT was not an independent beneficial factor of overall survival (OS) (HR=0.949;CI:0.435-2.074;P=0.896) or loco-regional recurrent free survival (LRRFS) (HR=0.611;CI:0.231-1.614;P=0.320) in all patients. Ex-tracapsular extension (ECE) and pathological grades were independent prognostic risk factors, and the benefits of PMRT were signifi-cantly different on the prognosis of high-risk subgroup patients (group ECE+OS:P=0.020, LRRFS:P=0.014;group GradeⅢOS:P=0.002, LRRFS:P<0.001). Meanwhile, PMRT failed to prolong the OS and LRRFS of low-risk subgroup patients (group ECE+OS:P=0.353, LRRFS:P=0.796;group GradeⅠtoⅡOS:P=0.267, LRRFS:P=0.589). Conclusion:ECE and gradeⅢwere the independent risk factors of death and loco-regional recurrence in the T1-2 breast cancer patients with one to three positive lymph node(s). PMRT was an effective adjuvant therapy to improve the prognosis of patients with high-risk factors. However, the benefit of PMRT had no sig-nificance in patients with ECE-or gradeⅠ-Ⅱ.

Objective Through investigating the clinicians’ scientific research level and weakness,we can carry out targeted clinical research training systematically,and then strengthen their utilization of clinical resources and data,and finally promote the transformation of scientific research resuits.Methods Filling and submitting the online questionnaires through WeChat,a popular chatting tool in China,physicians from 13 affiliated hospitals of a university in Shanghai have joined this research.Results 507 valid questionnaires have been received online:In terms of clinical research capacity,there seemed to be more barriers in the following issues:comprehension of the types and applications to design a clinical trial,formulation of the details including PICO elements(Patient-Intervention-Comparison-Outcome),methodological application including the category and principle of randomization,the category and principle of blind method and how to control the confounding elements and probable bias,and statistical problems in scientific research including discrimination of the different definition between FAS(Full Analysis Set) based on the principle of ITT(Intention-To-Treat) and PPS(Per-Protocol Set),how to write a standardized SAP(Statistical Analysis Plan) and how to calculate the sample size of a trial),and various management of clinical trials including data management,follow-up management,adverse event management and so on,and writing a protocol and a CRF (Case Report Form) in a standard and professional way.As for the needs for training,the top three topics were how to design a clinical research in a standardized style,how to practice the methodology and how to utilize the statistical skills into clinical trials.Conclusions Standardized design and writing of clinical trial protocols according to the CONSORT (Consolidated Standards of Reporting Trials) and SPIRIT (Standard Protocol Items:Recommendations for Interventional Trials),and the application of epidemiological and statistical methods are still short boards that most clinicians need to improve urgently,also are what they most concerned about at the same time.So it is necessary for physicians to receive systematic clinical research training to enhance their scientific research capacity.