[Objective]To summarize the clinical academic experience of Professor HU Guojun,a famous Chinese medicine doctor,in the treatment of ankylosing spondylitis based on the theory of"host and client interaction".[Methods]Professor HU Guojun's experience in the treatment of ankylosing spondylitis based on the theory of"host and client interaction"was summarized from four aspects,including theoretical tracing,etiology,pathogenesis,treatment and medication characteristics,by consulting doctors,collating typical medical records and consulting relevant literature,and a medical case was attached to support it.[Results]Professor HU believes that the etiology and pathogenesis of ankylosing spondylitis are highly consistent with the"interaction between host and client"theory.In clinical practice,he emphasizes the principle of"supporting the vital energy and dispelling pathogenic factors,while differentiating between host and guest."He advocates that tonifying deficiency should involve examining the differences between Yin and Yang,and expelling pathogenic factors should involve distinguishing the characteristics of the pathogenic Qi.He skillfully uses blood-enriching and flesh-tonifying substances,insect-based medicines,vine and stem herbs and warming and tonifying drugs to strengthen the host energy and expel the client energy,resulting in significant therapeutic effects.In the attached case study,Professor HU used the principle of dissolving the entanglement between host and guest as the main treatment approach.By addressing both the root cause and symptoms simultaneously,he ultimately achieved the strengthening of the host energy and the expulsion of the pathogenic factors,leading to the resolution of the chronic condition.[Conclusion]Professor HU has innovatively applied the"host and client interaction"theory in the treatment of ankylosing spondylitis,yielding excellent results.This approach can serve as a new reference for the clinical diagnosis and treatment of ankylosing spondylitis.

[Objective]To summarize the clinical academic experience of Professor HU Guojun,a famous Chinese medicine doctor,in the treatment of ankylosing spondylitis based on the theory of"host and client interaction".[Methods]Professor HU Guojun's experience in the treatment of ankylosing spondylitis based on the theory of"host and client interaction"was summarized from four aspects,including theoretical tracing,etiology,pathogenesis,treatment and medication characteristics,by consulting doctors,collating typical medical records and consulting relevant literature,and a medical case was attached to support it.[Results]Professor HU believes that the etiology and pathogenesis of ankylosing spondylitis are highly consistent with the"interaction between host and client"theory.In clinical practice,he emphasizes the principle of"supporting the vital energy and dispelling pathogenic factors,while differentiating between host and guest."He advocates that tonifying deficiency should involve examining the differences between Yin and Yang,and expelling pathogenic factors should involve distinguishing the characteristics of the pathogenic Qi.He skillfully uses blood-enriching and flesh-tonifying substances,insect-based medicines,vine and stem herbs and warming and tonifying drugs to strengthen the host energy and expel the client energy,resulting in significant therapeutic effects.In the attached case study,Professor HU used the principle of dissolving the entanglement between host and guest as the main treatment approach.By addressing both the root cause and symptoms simultaneously,he ultimately achieved the strengthening of the host energy and the expulsion of the pathogenic factors,leading to the resolution of the chronic condition.[Conclusion]Professor HU has innovatively applied the"host and client interaction"theory in the treatment of ankylosing spondylitis,yielding excellent results.This approach can serve as a new reference for the clinical diagnosis and treatment of ankylosing spondylitis.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.

Objective To preliminarily understand the current status of medication safety management of medical institutions in China. Methods Medication Safety Panel in China Core Group of International Network for the Rational Use of Drugs (INRUD) and Chinese Pharmacological Society Professional Committee of Drug-induced Diseases jointly established a research group. Basing on the voluntary principle,members (medical institutions)of the group did medication safety self-assessment using the questionnaires of "2011 ISMP Medication Safety Self Assessment? for Hospitals (Chinese version)", which included 10 key elements,20 core indicators,and 270 assessment projects. The questionnaires were handed out on August 17,2018 and needed to be completed and submitted within 2 months. Results As of October 19,2018,67 hospitals of 16 provincial administrative regions in total had submitted their questionnaires,including 61 (91. 0％)3A hospitals and 6 (9％)2A hospitals. The average value of total scores of medication safety self-assessment in the 67 hospitals was 58. 9％ (7. 6％ -90. 0％). None of the 67 hospitals evaluated the key element Ⅵ(medication device acquisition,use,and monitoring). The scores of the other 9 key elements from high to low were 67. 6％,66. 2％,65. 1％,64. 8％,64. 1％,58. 2％, 54. 5％,54. 4％,and 52. 5％ respectively for element Ⅶ (environmental factors,workflow and staffing patterns),element Ⅳ(drug labeling,packaging and nomenclature),element Ⅸ (patient education), element Ⅲ(communication of drug orders and other drug information),element Ⅷ (staff competency and education),element Ⅴ(drug standardization,storage and distribution),element Ⅹ (quality processes and risk management),element Ⅰ (patient information),and element Ⅱ (drug information). Conclusion The data of medication safety from 67 hospitals of 16 provincial administrative regions were obtained through the first national self-assessment questionnaire survey in medical institutions,which initially reflected the current status of medication safety in medical institutions in China.

Objective To preliminarily understand the current status of medication safety management of medical institutions in China. Methods Medication Safety Panel in China Core Group of International Network for the Rational Use of Drugs (INRUD) and Chinese Pharmacological Society Professional Committee of Drug-induced Diseases jointly established a research group. Basing on the voluntary principle,members (medical institutions)of the group did medication safety self-assessment using the questionnaires of "2011 ISMP Medication Safety Self Assessment? for Hospitals (Chinese version)", which included 10 key elements,20 core indicators,and 270 assessment projects. The questionnaires were handed out on August 17,2018 and needed to be completed and submitted within 2 months. Results As of October 19,2018,67 hospitals of 16 provincial administrative regions in total had submitted their questionnaires,including 61 (91. 0％)3A hospitals and 6 (9％)2A hospitals. The average value of total scores of medication safety self-assessment in the 67 hospitals was 58. 9％ (7. 6％ -90. 0％). None of the 67 hospitals evaluated the key element Ⅵ(medication device acquisition,use,and monitoring). The scores of the other 9 key elements from high to low were 67. 6％,66. 2％,65. 1％,64. 8％,64. 1％,58. 2％, 54. 5％,54. 4％,and 52. 5％ respectively for element Ⅶ (environmental factors,workflow and staffing patterns),element Ⅳ(drug labeling,packaging and nomenclature),element Ⅸ (patient education), element Ⅲ(communication of drug orders and other drug information),element Ⅷ (staff competency and education),element Ⅴ(drug standardization,storage and distribution),element Ⅹ (quality processes and risk management),element Ⅰ (patient information),and element Ⅱ (drug information). Conclusion The data of medication safety from 67 hospitals of 16 provincial administrative regions were obtained through the first national self-assessment questionnaire survey in medical institutions,which initially reflected the current status of medication safety in medical institutions in China.

Objective To extract hyperoside from the leaves of Acanthopanax sessiliflorus by complex enzyme method, and optimize the extraction process by orthogonal experiment. Methods Hyperoside was determined by HPLC. Effects of temperature,α-amylase, neutral protease and cellulase on extraction rate were detected by the orthogonal tests, and the optimum extraction condition of hyperoside from the leaves of Acanthopanax sessiliflorus was determined by complex enzyme method. Results The main influence factor was temperature,follows byα-amylase, neutral protease and cellulase according to orthogonal analysis.The best condition was as follows: dose of cellulase, neutral protease and α-amylase was 2%, 0. 5% and 3%, respectively, extract at temperature of 30 ℃for 10 min. Under this condition, the extraction rate of hyperoside in the leaves of Acanthopanax senticosus was 0.52%. Conclusion As compared with the traditional technics, compound enzyme increases the productivity of hyperoside.

Objective: To explore current status of antithrombotic therapy in patients with non-valvular atrial ifbrillation (NVAF) at Macau area of china via clinical data analysis.
Methods: A total of 472 NVAF patients treated in Centro Hospitalar Conde de S?o Januário (CHCSJ) from 2014-01 to 2041-12 were enrolled. The patients were at the age of (73.0±10.9) years including 197 (41.7%) female and 244 (51.7%)≥75 years. The baseline condition, clinical characteristics and antithrombotic therapy were analyzed; relevant scores were calculated, CHA2DS2-VASc score≥2 was deifned as high risk of stroke and HAS-BLED score≥3 was deifned as high risk of bleeding.
Results: The average CHA2DS2-VASc score was (3.4±1.8) and 389/472 (82.4%) patients with CHA2DS2-VASc scor≥2; the mean HAS-BLED score was (1.96±1.03) and 132 (28.0%) patients with HAS-BLED score≥3. There were 184 (38.9%) patients received antiplatelet therapy, 101 (21.4%) received warfarin, 156 (33.1%) received new oral anticoagulant drug and 22 patients taken both antiplatelet and anticoagulant treatments simultaneously; 53 (11.2%) patients had no antithrombotic therapy. The patients with high risk of stroke had the higher rate of anticoagulant therapy (215/472, 55.3%) and the application rate of new anticoagulant drug was higher than warfarin.
Conclusion: NVAF patients had the higher risk of stroke as more than 80% with CHA2DS2-VASc score≥2 and most patients received anticoagulant therapy in Macau area. The application rate of new anticoagulant drug was higher than warfarin.

This study was aimed to optimize the extraction process of hyperoside from leaves ofAcanthopanax senticosusby compounding-enzyme method and orthogonal experiment. The hyperoside compound was regarded as standard and determined by HPLC. Based on the experiments of 4 factors including the enzyme amount, temperature, extraction time and PH values, the extraction process of hyperoside was determined by the orthogonal experiments and variance analysis. The results of single-factor experiments showed that different enzymes showed different effects on the enhance yield of hyperoside. The effects of different factors showed that the order of PH, neutral protease, temperature, time, pectinase, xylanase and cellulose was from strong to weak. Through orthogonal analysis, the optimum conditions were 2% pectinase, 2% xylanase, 0.5% neutral protease, and 0.5% cellulose, under the temperature of 30°C, extraction time of 10 min, and pH = 4.5. Under these conditions, the extraction rate was 1.84%. The yield was increased 107% compared with traditional process. It was concluded that the use of compounding enzyme can increase the yield of hyperoside, which possessed a lot of economic benefits.

BACKGROUND: Educative instruction is good for the improvement of learning and behavior disorder in children with learning disorder. If this educative instruction were individualized, i. e. different education is provided for different individual, it would receive even better effects.OBJECTIVE: To explore the method and effect of educative instruction for children with learning disorder to accumulate experiences for the development of their learning potentials.DESIGN: A paired(pairing the subjects with similar age and learning disorder) case analysis based on the suffers .SETTING: A medical college of some university.PARTICIPANTS: Eight children with learning disorder were selected from Zhenjiang City Dongwu Kindergarten or Zhenjiang City Dagang Central Primary School. These 8 cases suffered from 4 types of disorders including clumsiness, seclusive personality, language disorder, and poor learning ability. Eight cases were randomly divided into education group and control group.METHODS: Cases of control group received normal educations without specific interventions. Cases of education group received individual customized educative instructions. The educative effects were observed after 3 months.MAIN OUTCOME MEASURES: The improvement of clumsiness, seclusive personality, language disorder or poor learning ability in children with learning disorder.RESULTS: Cases of education group had better psychological and behavior improvements than that of control group after individual educative instruction.CONCLUSION: Individual educative instruction for children with learning disorder is an effective approach for the development of their learning potentials.