No abstract

ABSTRACT-Paeoniflorin, a monoterpene glycoside, is the principal bioactive component of Paeoniae Radix. The traditional prescription Shao-yao Gan-chao Tang (SGT; Kampo: Shakuyaku-Kanzo-To), which is composed of Paeoniae Radix and Glycyrrhizae Radix, has been widely used in China and Japan. Quantification of paeoniflorin in mouse plasma after oral administration of SGT (at a dose containing 10 mg /kg paeoniflorin) was achieved using a simple and rapid high-performance liquid chromatography method. The plasma concentration-time curves were fitted with mean terminal half-lives (t 1 /2 ) of 116.17 min. The maximum plasma concentration (C max ) of paeoniflorin was 111.56 ng /ml, time to reach maximum concentration (t max ) was 17.00 min, the area under the plasma concentration-time curve (AUC) 0-t was 12293.42 ng · min /ml, clearance / bioavailability (CL /F) value was 644.74 ml /min · kg, apparent volume of distribution / bioavailability (V d /F) value was 103.05 l /kg, and the mean residence time (MRT) was 169.64 min. These results, together with the previously reported kinetic data of paeoniflorin after oral administration of Paeoniae Radix extract alone, indicated that absorption of paeoniflorin after oral administration of SGT was significantly greater than that after oral administration of Paeoniae Radix alone.

The aim of this study is to evaluate the medication knowledge achieved by conventional verbal education and the influence of drug information leaflets in patients with epilepsy. Drug compliance and sources of information of the patients were also examined. Fifty-one adults in an epilepsy outpatient clinic participated this survey. These patients were asked to complete a questionnaire and to specify sources of drug information. Serum drug levels were checked and compared with the self-reported compliance. Then, drug information leaflets were given to patients. In the next follow-up visit, patients were asked to fill out the same questionnaire again. In the baseline assessment, 36 patients (70.6%) could accurately list their medications. However, half of patients were not knowledgeable about side effects and did not keep a seizure diary. After provision of drug leaflets, the epilepsy medication assessment score increased from 3.9 +/- 1.9 to 5.1 +/- 1.7 (P<0.001). In addition, patients reported being compliant most of the time and this matched drug levels. On average, each patient had 2.8 sources of information and 5 patients used Internet as a tool. Despite achieving good compliance, conventional verbal education did not sufficiently cover drug-related issues. Providing patients with written information apparently increase their medication knowledge and probably enhance seizure control.

Despite advances in medical science, the causes of death can sometimes only be determined by pathologists after a complete autopsy. Few studies have investigated the importance of forensic autopsy in medically disputed cases among different levels of institutional settings. Our study aimed to analyze forensic autopsy in 120 cases of medical disputes among five levels of institutional settings between 2001 and 2012 in Wenzhou, China. The results showed an overall concordance rate of 55%. Of the 39% of clinically missed diagnosis, cardiovascular pathology comprises 55.32%, while respiratory pathology accounts for the remaining 44. 68%. Factors that increase the likelihood of missed diagnoses were private clinics, community settings, and county hospitals. These results support that autopsy remains an important tool in establishing causes of death in medically disputed case, which may directly determine or exclude the fault of medical care and therefore in helping in resolving these cases.