Objective:To standardize the bacterial endotoxin testing criteria for zoledronic acid injection and estab-lish a detection method using recombinant factor C(rFC).Methods:The gel-clot method(BET)was utilized to test 13 batches of zoledronic acid injection from national supervision and random inspection.Interference tests were conducted on zoledronic acid injections from three manufacturers at different concentrations(500,100,50,25 μg·mL-1)using rFC test kits from two manufacturers.Results:Detection was performed for the specification of 100 mL∶5 mg and other specifications according to＜0.50 EU per 1 mL and＜5.0 EU per 1 mg,respectively,and all results met the criteria.The recovery rate for 25 μg·mL-1 using rFC kits from both manufacturers ranged between 50％and 200％.Validation of rFC.Methods:Eight batches of zoledronic acid injection were validated at 25 μg·mL-1,five batches of zoledronic acid injection(100 mL∶5 mg)were validated at 0.5 EU·mL-1,and all recovery rates were between 50％and 200％.Conclusion:The bacterial endotoxin testing method for zoledronic acid injection can be established as follows:for large volume injection products with 100 mL or more,each 1 mL should contain less than 0.50 EU of endotoxin(following the Chinese Pharmacopoeia 2020,general chapter 1143).For other specifications,each 1 mg of zoledronic acid should contain less than 10.0 EU of endotoxin.The rFC test kit method for bacterial endotoxins involved diluting the sample with water for bacterial endotoxin testing to contain 25 μg of zoledronic acid per 1 mL,or performing 1∶1 dilution for large volume injections(100 mL∶5.0 mg specifi-cation),with recovery rate between 50％and 200％as per the kit instructions.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

OBJECTIVE： To investigate the effects of different doses of total alkaloids from Aconitum racemulosum （ARTA） on serum inflammation factors and FOS protein expression in synovial tissue of joint in collagen-induced arthritis （CIA） model rats， and to investigate its potential mechanism of anti-rheumatoid arthritis （RA）. METHODS： Male SD rats were randomly divided into blank group， model group， positive group （Compound dexamethasone acetate ointment， 0.2 g/kg）， ARTA low-dose， medium-dose and high-dose groups （56.26， 112.50， 225.00 mg/kg， by the weight of ARTA in the extract）， with 10 rats in each group. Except for blank group， other groups were given subcutaneous injection of Bovine collagen Ⅱ emulsified with incomplete Freund’s adjuvant into the left foot to establish CIA model； the left foot were smeared with relevant medicine from the day of modeling. Blank group and model group were smeared with constant volume of 65％ ethanol， 3 times a day， for consecutive 28 days. On the 7th， 14th， 21st and 28th day of administration， the thickness of left hind toe was measured with vernier caliper， and the degree of foot swelling was calculated. The serum contents of IL-1β， IL-6 and TNF-α in rats were measured by ELISA after last administration. The expression of FOS protein in synovial tissue was determined by immunohistochemical method [expressed by HIS]. The comprehensive score was conculated by entropy weight method. Effects of each dosage on above indexes of CIA model rats were evaluated with the comprehensive score. RESULTS： Compared with blank group， the degree of foot swelling， serum content of inflammatory factors and HIS value were increased significantly in model group （P＜0.05）. Compared with model group， the degree of foot swelling in each administration group， serum contents of IL-1β， IL-6 and TNF-α， HIS in positive group and ARTA high-dose group， serum contents of IL-6 and TNF-α in ARTA medium-dose group as well as serum content of TNF-α in ARTA low-dose group were decreased significantly（P＜0.05）. Comprehensive score of above indicators were 0.37（positive group）， 0.31（ARTA high-dose group）， 0.23（ARTA medium-dose group） and 0.09（ARTA low-dose group）. CONCLUSIONS： ARTA can improve CIA model rats， and the effect tends to increase with the increase of dose. Above effect may be associated with reducing serum content of inflammatory factors and inhibiting the expression of FOS protein in synovial tissue.

Objective To explore the effects of motivational interviewing health education on the self-management behavior and lung function of the community-elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods Totally 215 elderly patients with stable COPD from Xi'an community were enrolled by convenience sampling,and the patients were randomly divided into control (n=108) and experimental group (n=107) using the random number table.The patients in the experimental group received motivational interviewing health education for 6 months in addition to usual health education for both groups.The two groups were examed by self-management behavior (smoking,respiratory function exercises,muscle exercises,home oxygen therapy,medication adherence and inhaled drugs method) and lung function before and after intervention.Results In the experimental group,smoking cessation rate [72.9％ (78 cases) vs.84.1％ (90 cases),x2 =7.40],respiratory-function exercises (often) [16.8％ (18 cases) vs.84.1％ (90 cases),x2 =99.35],muscle exercises (often) [30.8 ％ (33 cases) vs.87.0％ (93 cases),x2 =69.49],frequent home-oxygen therapy [9.3％(10 cases) vs.35.5％(38 cases),x2 =30.50],medication following the doctor's advice [36.5％(39 cases) vs.86.9％ (93 cases),x2 =57.67]and right inhaled-drugs method [44.9％ (48 cases) vs.95.3％(102 cases),x2 =65.00]were much greater than those before intervention (all P＜0.05).Lung function including vital capacity (VC) [(2.53±0.41) L vs.(2.66±0.58)L,t =-2.62],forced vital capacity (FVC) [(2.51 ± 0.45) L vs.(2.64 ± 0.60) L,t =-2.56],forced expiratory volume in one second (FEV1) [(1.59±0.23)L vs.(1.74±0.47)L,t =-2.75],FEV1％ [(63.6±22.8) ％ vs.(73.5±20.9)％,t =-3.38]were significantly improved after 6 months as compared with those before intervention (all P ＜0.05).However,only right inhaled-drugs method was significantly greater than that before intervention in the control group [41.7 ％ (45 cases) vs.61.1％ (66 cases),x2 =8.17,P＜0.05].Conclusions Motivational interviewing health education may improve the self-management behavior and lung function of elderly patients with stable COPD,and it serves as an effective disease-management strategy.

Objective To study epidemic of schistosomiasis in the Qiandao Lake reservoir area,and to provide a reference for prevention and control of schistosomiasis in the construction of large water conservancy projects in the epidemic area of schistosomiasis.Methods The data over the years of snail condition and monitoring of schistosomiasis before and after building the dam,and water conservancy project reconstruction related information were collected.Based on the survey results of the river channel,the lake beach and the dissipation zone in the reservoir area,the influence of Xin'an River water conservancy project on epidemic of schistosomiasis in the Qiandao Lake reservoir area was analyzed,and the epidemic factors of the schistosomiasis in the Three Gorges reservoir were compared and analyzed.Results Before the dam was built,an area of 38 144 000 m2 was examined but Oncomelania was undetected.The Qiandao Lake reservoir area belonged to a non epidemic area of schistosomiasis.After the dam was built,557 cases of schistosomiasis were found in 6 232 immigrants during 1962-1965,resulting in an imported epidemic.In 1970-1980,an area of 379 654 m2 in which Oncomelania was found was examined and snails were mainly distributed in some rice fields and ditches in the end of the reservoir.949 cases of local schistosomiasis were found in the snails.The condition and condition of the snail are gradually controlled through several decades of comprehensive prevention and control.Compared with the epidemic factors of schistosomiasis in Qiandao Lake and the Three Gorges reservoir,the environment of elevation beach and ecologically fragile fluctuation zone coexist in the two reservoir areas.Conclusion From the long-term longitudinal monitoring data of the Qiandao Lake reservoir area and the epidemic regularity of schistosomiasis and the comparison with the ecology of the Three Gorges reservoir,it is concluded that the two reservoir areas will not cause a large range of schistosomiasis epidemic in general,but it does not exclude the possibility of the breeding of the inputting Oncomelania.

Objective To determine whether the cross-sectional area (CSA)of the calf measured with MRI could stage lower ex-tremity lymphedema (LEL)secondary to gynecological cancer treatments.Methods 148 patients were enrolled in this research.116 females with unilateral LEL and 32 without LEL after gynecological cancer treatments underwent calf MRI and water displacement. Total soft tissue CSA (T),muscle CSA (M)and subcutaneous tissue CSA (S)of affected calf,and difference of T (DT),M (DM) and S (DS)between calves were obtained on MRI at mid-calf level.Volume of affected calf and difference of volume (DV)between calves were obtained by water displacement.Statistical analysis was performed to determine feasibility of MRI measurements for ac-cessing LEL.Results There were close correlations between volume and T or S of affected calf,and between DV and DT or DS of calves.The correlations of stages of LEL with T and S of affected calf as well as DT and DS were stronger than the volume of affect-ed calf and DV (P< 0.01).Multivariate analysis showed more significant differences in T and S than in volume of affected calf,and in DS than in DV between LEL stages (P< 0.05).No difference was found in volume of affected calf and in DV between stage 0 andⅠ. For staging LEL,DS showed the most profound discrimination ability among all measurable parameters.Conclusion DS of calves could be the most reliable parameter recommended for staging and early diagnosis of LEL.

Objective To evaluate the MR lymphangiography (MRL)in diagnosis of limb lymphedema.Methods A total of 582 patients with lymphedemtous limbs were enrolled in the study,MRL was performed at 3.0T MR.The morphology and enhancement of the lymph nodes,the number of lymphatic vessels and the lymph flow were evaluated.Results No matter in primary or secondary lymphedema,there were patients showed only lymph nodes affected,or only lymph vessels affected,and some patients showed both affected.Lymphatic aplasia,hypoplasia or hyperplasia were showed in primary lymphedema.Obstruction lymphatic vessels,and lym-phangiectasia were showed in secondary lymphedema.The velocity of lymph flow was (1.0±0.62)cm/min in affected limb of pa-tients with primary lymphedema,which was significantly slower than that of affected limb of patients with secondary lymphedema (2.22±1.64)cm/min(P<0.01)in dynamic contrast-enhanced MRL.In both type of lymphedema,the contrast enhanced lymph nodes showed less nodes with delayed enhancement and lower signal intensity,compared to that of lymph nodes in the contralateral normal side.Conclusion Dynamic contrast-enhanced MRL is helpful for assessing the anatomical and functional status of lymphatic system in lymphedematous limb.This new imaging techniques provides a powerful tool for the diagnosis of lymphedema.

Objective To explore the influence of singing therapy on anxiety and depression of patients with stable COPD.Methods Toally 56 COPD patients were divided into intervention group and control group according to random digit table.The control group was provided health education and mental nursing.On the base of treatment for the control group,the intervention group received singing therapy for 24 weeks.The anxiety and depression scale was to measure the anxiety and depression before and 24 weeks after intervention.Results There were no differences in HAD score and HAD-A score and HAD-D score between the groups before intervention (P＞0.05),but after intervention,the differences were significant in terms of the HAD score and HAD-A score and HAD-D score (P＜0.01).The scores of intervention group were significantly lower than those of the control group.For the scores,there was no difference in the control group between pre-and post-intervention (P＞0.05),but the scores after intervention were significantly lower than those before intervention in the intervention group (P＜0.001).Conclusion Singing therapy can effectively alleviate anxiety and depression of COPD patients at the stable state.

Objective To investigate the expression and significance of YB -1 in serum and endometrial tis-sues in patients with endometriosis ( EMs ) for taking YB -1 EMs as an index of early diagnosis and treatment . Methods ELISAwas adopted to detect YB -1 expressions in serum of EMs group and control group .The expression of YB-1 in endometrial tissue in the EMs group and control group was detected by immunohistochemistry SP method . Results The average concentration of YB -1 in serum of EMs group (14.65 ±3.91 ug/L) was higherthan thatin the control group (9.64 ±2.37 ug/L), with statistically significant differences (p<0.05).The results of immuno-histochemistry showed that the expression of YB -1 was moderately positive in endometria of patients with EMs . Weakly positive expressions of YB -1 were detected in a fewcases of the control group .There are significant differ-ences in the positive expression rates of YB -1 between two groups ( p <0.05).Conclusion The expression of YB-1 in serum and endometria of patients with EMs is higher .YB-1 can not only be an intracellular marker , but also expected to become an ideal serological marker .

OBJECTIVETo describe the incidence and related risk factors of fatty liver disease in the general population of Northwest China.

METHODSThe study was a cross-sectional survey with multiplestage stratified cluster and random sampling. All participants were 18 years or older and resided in northwest provinces of China.Demographic and behavioral data was gathered by questionnaire.Clinical data such as height, body weight, waist circumference, biochemical function (standard tests) and liver status (ultrasonographic examination) were also collected.

RESULTSAmong the 2 300 total study participants, 1 523 were habitual drinkers (total drinking rate: 66.2%). This population of drinkers was composed almost exclusively of males. There were 201 cases of alcoholic liver disease (total prevalence:8.7%), represented by mild alcoholic injury (prevalence: 4.2%), alcoholic fatty liver (3.8%), alcoholic hepatitis (0.5%), and alcoholic cirrhosis (0.3%).When examined according to provinces of residence, the prevalence of alcoholic liver disease followed this pattern: Shaanxi (14.0%), Gansu (8.6%), and Xinjiang autonomous region (5.0%). Of the total 337 cases of nonalcoholic fatty liver disease (total prevalence: 14.7%), the prevalence by province was: Shaanxi (18.5%), Gansu (10.3%), and Xinjiang autonomous region (16.6%). Individuals with alcoholic liver disease had significantly higher mean age (years), body weight, body mass index (BMI), waist circumference, average daily alcohol intake, and level of aspartate aminotransferase (AST), and alanine aminotraasferase (ALT) (vs. Those with no liver disease, P less than 0.05). Individuals with nonalcoholic fatty liver disease had significantly higher mean age (years), height, body weight, BMI, waist circumference, level of AST and ALT, and presence of obesity, abdominal obesity, hyperlipidemia, diabetes mellitus and hypertension (vs. Those with no liver disease, P less than 0.05). Multiple logistic regression demonstrated that alcoholic liver disease was closely related to age, sex, and average daily alcohol intake. The prevalence of nonalcoholic fatty liver disease was positively correlated to age, female sex, hyperlipidemia, diabetes mellitus, and BMI.

CONCLUSIONThe drinking-rate and prevalence of fatty liver disease is high in Northwest China, but the most prevalent type is nonalcoholic fatty liver disease.Fatty liver disease is closely related to age, sex, average daily alcohol intake, hyperlipidemia, diabetes mellitus, and BMI.

Aspartate Aminotransferases ; Body Mass Index ; Body Weight ; China ; Cross-Sectional Studies ; Diabetes Mellitus ; Fatty Liver ; Female ; Humans ; Hyperlipidemias ; Hypertension ; Logistic Models ; Male ; Obesity ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Waist Circumference