AIM:To evaluate the therapeutic effects of treating chronic schizophrenia with ginkgo leaf capsule combined with comprehensive rehabilitation training. METHODS:110 chronic schizophrenia patients who had been treated with systemic antipsychotic for more than 12 weeks with unsatisfactory therapeutic effects and a long history of hospitalization were enrolled in this study. Ginkgo leaf capsule combined with comprehensive rehabilitation training was applied for 12 weeks and the therapeutic effects were evaluated. The positive and negative syndrome scale (PANSS) and treatment emergent symptom scale(TESS) for the side effects that needed to be treated during treating were used to evaluate the therapeutic effects and side effects. RESULTS:The treatment of ginkgo leaf capsule combined with comprehensive rehabilitation training was effective for the chronic schizophrenia patients with a long history of hospitalization,the total clinical effective rate was 96.36% and the cure rate together with the apparent rate was 67.27%,which were significantly better. CONCLUSION:Ginkgo leaf capsule improves the therapeutic effects of antipsychotic in the treatment of chronic schizophrenia and reduces the side effects,so it is a safe and effective drug for treating the chronic schizophrenia patients with a long history of hospitalization.

OBJECTIVE:To discuss the preparation methods of polyaspartate derivatives as drug delivery systems. DATA SOURCES:An online search of Elselvier,ACS publications and Springerlink between January 1990 and January 2006 was undertaken by using the keywords of "polyaspart*,hydrogels,micelles,complexes" to identify the relevant articles published in English.Meanwhile,Chinese journals full-text database were scanned with computer to search relevant articles published from January 1995 to October 2005,and the keywords were"asparmide,complexes,hydrogels,release" with language limited to Chinese.STUDY SELECTION:All the related data were analyzed to select those were aimed directly at the criteria.As for the arti cles in the same field,those published recently or published in the authority journals were preferred. DATA EXTRACTION:A total of 56 articles about the preparation methods of polyaspartate derivatives as drug delivery systems were collected, and 29 of them were in accordance with the inclusion criteria. DATA SYNTHESIS:Polyaspartate derivatives are new biodegradable and biocompatible materials.Covalent complexes, hydrogels and micelles,three main drug delivery systems of polyaspartate derivatives,exhibit good biocompatibility and conspicuous effect of control-release.CONCLUSION:With the help of the short synthesis route,simple manipulation,high production rate, the excellent biocompatibility as well as the better hydrophile,the polyaspartate derivatives are prone to reacting with other compounds for the modification.It is noted that the controllability of the control-release systems will be well improved through the researches of the influence factors of the degrading velocity and the new modifying method,additionally,the polyaspartate derivatives will be applied in the drug delivery field widely.

Objective To investigate the efficacy and safety of percutaneous induced thrombosis closure on small patent ductus arteriosus (PDA) solely under echocardiography guidance.Methods From June 2013 to September 2016,276 PDA patients were treated by femoral artery retrograde approach under echocardiography guidance.Twenty-five patients (14 boys,11 girls) among them with small PDA received percutaneous induced thrombosis closure because the delivery sheath could not pass PDA,with mean age (3.7 ± 1.6) years,mean body weight (16.6 ±5.4) kg and the mean diameter of the most narrow PDA was (1.3 ± 0.4) mm.All patients were assessed by transthoracic echocardiography,chest radiography and electrocardiography preoperatively.The intraoperative and postoperative effects were evaluated by echocardiography.Outpatient assessment was performed at 1,3,6 and 12 months after operation with electrocardiography and echocardiography,and yearly thereafter.Results Twenty-five patients were successfully treated with percutaneous induced thrombosis closure solely under echocardiography guidance.The mean operation time was (35.2 ± 6.1) minutes.The immediate residual shunt rates and 24 hours after operation were 28.0％ (7/25 cases) and 16.0％ (4/25 cases),respectively.All patients recovered and were discharged from hospital.The average hospitalization stay was (3.0 ± 0.6) days.The mean follow-up was (16.8 ± 12.3) months,residual shunt was observed in 2 patients (8.0％),and it decreased from 1.5 mm and 2.0 mm preoperatively to 0.8 mm and 1.0 mm postoperatively,respectively.All patients survived without peripheral vascular injury,cardiac perforation,PDA rupture or thrombembolia.Conclusions Percutaneous induced thrombosis closure of small PDA solely under echocardiography guidance is safe and effective.It can avoid occluder implantation and radiation injury.However,the residual shunt after operation needs following up closely.

Objective: To investigate the safety and efficacy of percutaneous intervention of children with combined congenital heart abnormality solely guided by transthoracic echocardiography (TTE) . Methods: From September 2015 to June 2017, 21 children with combined congenital heart abnormality undergoing percutaneous interventional guided by TTE in Fuwai hospital were enrolled in our study, and the clinical data were retrospective analyzed. The atrial septal defect(ASD) closure, ventricular septal defect(VSD) closure, patent ductus arteriosus(PDA) closure or balloon pulmonary valvuloplasty were performed under the guidance of TTE. The procedural effect was evaluated by TTE after operation. The patients were followed up after discharged from the hospital. Results: The age was (37.3±11.6) months, and there were 9 male and 12 female patients. There were 4 cases with ASD and VSD, 6 cases with VSD and PDA, 6 cases with ASD and PDA, 2 cases with VSD and pulmonary stenosis, 3 cases with ASD and pulmonary stenosis. The operations were successfully performed in all patients. No one required extra X ray guidance or open heart surgery. The operation time was (44.6±7.5)min. All patients did not require blood transfusion, inotropic support, and analgesia. There were no complications such as peripheral vascular injury and pericardialeffusion after the operation. The length of hospital stay time was (3.5±0.6) days. All patients were recovered well. The follow-up was (17.6±5.2) months, and post-procedural conduction disturbances, residual shunts, occlude fall off, thrombosis, and new onset of valvular regurgitation were not observed in these patients. Conclusion Percutaneous interventional of children with combined congenital heart abnormality solely guided by TTE is safe and effective, and the procedure can avoid the potential injuries of X ray and contrast agent.

Objective To analyze the midterm outcome of patients with congenital aortic stenosis undergoing percutaneous balloon aortic valvuloplasty (PBAV) by single echocardiographic guidance. Methods The clinical data of 12 patients with congenital aortic stenosis who underwent PBAV by single echocardiographic guidance at Fuwai Hospital from January 2016 to November 2017 were retrospectively analyzed. There were 7 males and 5 females with an average age of 18.27±15.30 years. The preoperative peak pressure gradient was 61.8–110.0 (80.30±24.50) mm Hg, and 50% of patients had aortic regurgitation. Results All patients successfully underwent PBAV. Aortic annulus diameter was 18.65±3.17 mm and balloon diameter was 17.62±3.77 mm, with balloon diameter to annulus diameter ratio of 0.92±0.07. The peak transaortic gradient was 16-51 (36.72±12.33) mm Hg immediately after procedure, which was significantly different from the preoperation (P=0.000). During the follow-up period, the peak transaortic gradient was 21-58 (37.06±13.52) mm Hg, and there was no significant difference between the follow-up and immediate postoperation (P=0.310). Immediately after procedure and during follow-up, 58% of patients had aortic regurgitation, which was not statistically different from the preoperation (P=0.682). Conclusion Systematic use of Doppler echocardiographic guidance for PBAV is feasible, and that it is associated with a high success rate and a very low complication rate.

ObjectiveTo observe the effect of Dahuang Xiezhuo prescription on the clinical symptoms， blood uric acid， and renal tubular function of patients with immunoglobulin A （IgA） nephropathy in stages 1-2 of chronic kidney disease （CKD） complicated with hyperuricemia （HUA）. MethodSixty patients with IgA nephropathy in stages 1-2 of CKD complicated with HUA of spleen and kidney deficiency and combined turbidity and blood stasis syndromes were randomly divided into an observation group and a control group， with 30 cases in each group. The patients in the control group received basic treatment， i.e.， losartan potassium tablets 50-100 mg/time， once per day， and sodium bicarbonate tablets 0.5 g/time， three times per day by oral administration， combined with low-salt， low-fat， and low-purine diet. The patients in the observation group received Dahuang Xiezhuo prescription on the basis of basic treatment， one dose per day， twice a day in the morning and evening with warm water. Both groups were treated for two months. The total scores of traditional Chinese medicine（TCM）syndrome， blood pressure， 24 h urinary protein （24 h UTP）， blood urea nitrogen （BUN）， serum creatinine （SCr） ［glomerular filtration rate （eGFR） was calculated by CKD-epidemiology collaboration （CKD-EPI） formula］， serum uric acid （SUA）， and renal tubular function indexes ［urinary α₁-microglobulin （α₁-MG）， urinary β₂-microglobulin （β₂-MG）， urinary kidney injury molecule-1 （KIM-1）， and neutrophil gelatinase-associated lipocalin （NGAL）］ of the two groups before treatment and two months after treatment were recorded. The clinical efficacy of the two groups was evaluated two months after treatment. ResultAfter 2 months of treatment，the total effective rate in the observation group was 81.48%（22/27），higher than 50.00%（14/28） in the control group（χ² =6.661，P<0.05）. The total scores of TCM syndrome， 24 h UTP， and SUA in the observation group and the observation group were lower than those before treatment （P<0.05）， and compared with the control group after treatment， the observation group decreased more significantly （P<0.05）. After treatment， the blood pressure in the observation group and the observation group was lower than that before treatment （P<0.05）， and there was no significant difference in blood pressure between the two groups after treatment. After treatment， the levels of urinary α₁-MG， β₂-MG， KIM-1， and NGAL in the two groups were lower than those before treatment （P<0.05）， and the observation group was lower than the control group after treatment （P<0.05）. There were no significant inter-group and intra-group differences in BUN， SCr， and eGFR levels before and after treatment. There were no obvious abnormalities in blood routine， liver function， and electrolytes before and after treatment in the two groups， and no adverse reactions such as allergies occurred. ConclusionDahuang Xiezhuo prescription can effectively improve the clinical symptoms of IgA nephropathy with HUA （CKD1-2） patients with spleen and kidney deficiency and combined turbidity and blood stasis syndromes， reduce blood uric acid level， alleviate renal tubular injury， and protect the kidney. The curative effect is better than that of basic treatment.

Objective     To analyze the safety and effectiveness of ultrasound-guided thoracoscopic atrial septal defect (ASD) closure. Methods     We prospectively collected the clinical data of 12 patients with ASD treated by ultrasound-guided thoracoscopic ASD closure in Fuwai Hospital from January to September 2017. The characteristics of the patients' ASD and operation, operation safety and effectiveness, postoperative complications and follow-up results were analyzed. Results     Among the 12 patients, 10 were successfully treated with ultrasound-guided thoracoscopic ASD closure. Two patients switched to ASD repair under thoracoscopy-assisted cardiopulmonary bypass. The size of the ASD was 17-40 (27.22±8.97) mm and the size of the occluder was 36 (30-42) mm. The average postoperative length of hospital stay was 6 days. There were no complications such as arrhythmia, bleeding and pericardial effusion after operation. The average follow-up was 6 (3-10) months after the operation. During the follow-up, no Ⅲ-degree conduction block, occluder dislocation, residual shunt or cardiac pericardial effusion was found. Conclusion     Ultrasound-guided thoracoscopic ASD closure is a minimally invasive, safe and effective treatment. This technique provides a new minimally invasive surgical option for patients with large defect diameter and poor edge condition.

Objective    To assess the efficacy and safety of percutaneous closure of patent ductus arteriosus (PDA) solely under echocardiography guidance. Methods    We retrospectively analyzed the clinical data of 200 patients who received the percutaneous closure of PDA under echocardiography guidance in Fuwai Hospital from August 2013 to April 2016. According the different approach, they were divided into 2 groups: a femoral artery approach group (n=143) and a femoral vein approach group (n=57). In the femoral artery approach group, there were 42 males and 101 females aged 3.20±5.63 years. In the femoral vein group, there were 10 males and 47 females aged 7.30±11.36 years. All Patients were treated by percutaneous PDA closure solely under echocardiography guidance. The follow-up was performed at one month after the operation by echocardiography, chest radiograph and electrocardiogram. Results    All 200 patients were successfully treated with percutaneous closure of PDA. The patients’ gender, in-hospital stay, rates of occluder  detachment were similar between the two groups (P>0.05). Compared with the femoral vein approach group, the femoral artery approach group had a younger age (3.20±5.63 years vs. 7.30±11.36 years, P<0.001), less body weight (14.25±11.54 kg vs. 24.25±19.14 kg, P<0.001) and shorter diameter of PDA (3.06±0.79 mm vs. 5.93±0.68 mm, P<0.001) and PDA occluders (5.43±1.00 mm vs. 12.14±0.54 mm, P<0.001), but had higher hospitalization expenses (32 108.2±3 100.2 yuan vs. 25 120.7±3 534.1 yuan, P<0.001). In the femoral vein approach group, one patient was closed under radiation guidance because guide wires could not pass through PDA. One patient in the femoral artery approach group suffered from occluder detachment at one day after operation and was cured by transthoracic minimally invasive PDA occlusion. There were no complications of occluder detachment, residual shunt, pericardial effusion or left pulmonary stenosis during the follow-up. Conclusion    Echocardiography-guided percutaneous PDA closure is safe and effective, while the proper interventional approach should be chosen by the anatomical features of PDA.