BACKGROUND: Attention deficit and hyperkinetic disorder (ADHD) isfrequently treated with psychostimulant medications, which had beenshown to improve both cognitive and behavioral outcomes for most chil dren. OBJECTIVE: To compare the efficacy and adverse effects of olanzapinevs methylphenidate treatment in childhood hyperkinetic syndrome.DESIGN: Clinical comparative study. SETTING: Department of Psychiatry, Beijing Huilongguan Hospital; De partment of Mental Psychiatry, Shangdong Mouping People's Hospital. PARTICIPANT S: Sixty children with hyperkinetic syndrome from theclinics of the Department of Psychiatry,Beijing Huilongguan Hospital andthe Department of Mental Psychiatry of Shandong Mouping People's Hos pital between March 2002 and April 2004 were enrolled into this prospec tive study after obtaining the consents from their guardians.The patientswere randomly divided into 2 group: the olanzapine group (n=30) and themethylphenidate group (n=30). METHODS: In the olanzapine group olanzapine 2.5-7.5 mg per day wasgiven as a single dose in every evening.In the methylphenidate groupmethylphenidate 5-15 mg per day was given in divided dose in everymorning and evening.The dosage ofolanzapine and methylphenidatewere adjusted according to age, body mass and patient's clinical condi tions. And the period of treatment for either drug was 12 weeks. Conners teachers scale was used before and at the end of the 12 weektreatment(①hyperkinetic index consisted of 10 items②hyperkinetic behavior factorconsisted of 7 items. Each item was rated “none=0, a little=1, quite alot=2, and very much=3 ). Side effect scale was used to evaluate the hy perkinetic symptom and adverse reactions which consisted of behavior toxicity, abnormal laboratory tests , symptoms of the nervous system, au tonomic nervous system, cardiovascular system and skin etc with. 0=none; 1 =suspicious or very mild, 2=mild, 3 =moderate, 4=severe. The highestscore was 22,and the lowest was 0 with a score over 2 being positivefinding). MAIN OUTCOME MEASURES:Hyperkinetic syndrom score and ad verse reaction score at the end of the 12 weeks treatment. RESULTS:All 60 children completed the study and their results wereentered into the data analysis① At the end of the 12th week treat ment, the total hyperkinetic index score and total behavior score in boththe olanzapine group and the methylphenidategroup were significantly lower than those before the treatment as shown in Table 1 (t=8.16-15.26, P ＜ 0.05-0.01 )]; The total hyperkinetic behavior score in the olanzap inegroup was significantly lower than that in the methylphenidategroup (t=2.69, P ＜ 0.05 ). ② The adverse reaction score of patients inthe olanzapine group and the methylphenidategroup was 10.3±4.5and 10.9±3.8 respectively ,with no significant difference(P ＞ 0.05)between the two groups. CONCLUSION: Olanzapine produced similar effect as methylphenidatein the treatment of the hyperkinetic symptoms and attention deficits with a better efficacy in treating the behavior disorder than methylphenidate.

ObjectiveTo evaluate the long term effect of extra-trabeculotomy on congenital glaucoma．MethodsThe curative effect in 49 eyes of 29 cases with congenital glaucoma，which underwent extra-trabeculotomy in the same hospital in the last 25 years，were retrospectively studied．The average time of post-operation was 92 months．The intraocular pressure and corneal diameter were recorded．ResultsThe final intraocular pressure in 45 of 49 eyes （91.84％）was less than 21 mmHg．The mean postoperative IOP was （16.84±4.11） mmHg．No serious complications occurred．Conclusion This study showed that treating congenital glaucoma by extra-trabeculotomy can control its progresson and attain a long-term satisfactory effectiveness.

BACKGROUND: Formerly, it was thought that the damaged hair cells could not have the repair ability. Recent studies demonstrate that mammal vestibule hair cells also possess certain repair ability after being destroyed.Then, whether mammalia animal cochlea hair cells possess regenerative ability after being destroyed is disputed.OBJECTIVE: To observe cochlear hair cells condition and threshold value change of auditory brainstem response (ABR) at different time following gentamicin ototoxicity by using scanning electron microscope (SEM) technique combined with ABR test, so as to investigate whether cochlear hair cells of mammals can be regenerated after being injured.DESIGN: A randomized and controlled animal experiment.SETTING: Department of Physiology, Shenyang Medical College.MATERIALS: This experiment was carried out at the Hearing Research Room of China Medical University from November 2001 to May 2002. Totally 60 healthy adult white Guinea pigs, with red eyes and sensitive auricle reflex, of clean degree, were used and randomly divided into gentamicin group and normal control group with 30 guinea pigs in each one.METHODS: 100 mg/kg gentamicin was intraperitoneally daily injected into the guinea pigs, serving as gentamicin group. Same volume of normal saline (2.5 mL/kg) was intraperitoneally daily injected into the guinea pigs,serving as normal control group. All the guinea pigs were given medication for 10 successive days. Threshold value of ABR was detected respectively pre-operatively and at the 1st, 3rd, 30th days postoperatively; after withdrawal and execution, scanning electron microscope was used to observe cochlear hair cells of guinea pigs in each group.MAIN OUTCOME MEASURES: ① Threshold value of ABR. ②Cochlear hair cell change of guinea pigs at different time following gentamicin ototoxicity.RESULTS: All the 60 experimental animals entered the stage of result analysis with no loss in the midway. ①At 1,3 and 30 days after withdrawal of gentamicin, threshold value of ABR was significantly higher as compared with normal control group, with significant difference [(38.00±3.75), (2.22 ±3.63) dB nHL,t=30.651, P ＜ 0.001];[(39.09±4.22), (2.50±3.54) dB nHL, t=29.708, P ＜ 0.001];[(14.50±3.69), (1.50±2.42) dB nHL,t =13.175, P ＜ 0.001]. Threshold value of ABR recovered obviously on day 30, but did not reach the normal level. ②On the first day after withdrawal of gentamicin , stereocilium of hair cells in second turn of cochlea of guinea pigs presented fusion, distortion, lodging, loss or incompetence and other pathological changes , especially severe in the third turn , also cystic form protrutions appeared outside the stereocilium of inner hair cell; On day 3 after withdrawal of gentamicin, stereocilium of outer hair cells in the second turn of cochlea of guinea pigs still presented fusion, loss, lodging and other pathological changes. Stereocilium of inner hair cell still showed lodging,but the outside cystic form protrutions decreased; On day 30 after withdrawal of gentamicin, stereocilium of outer hair cells in the second turn of cochlea presented fusion, loss , lodging and other pathological change ,which were obviously weaker than those on the 1st day and 3rd day after withdrawal of gentamicin , and at the same time , new born stereocilium appeared in the third turn of cochlea.CONCLUSION: Cochlear hair cell morphology recovery appears in those which survive for 30 days after cochlear hair cells of guinea pigs are damaged following gentamicin ototoxicity, and threshold value of ABR also recovers to some extent, suggesting that cochlear hair cells possess regenerative and repair ability following gentamicin ototoxicity. Hair cells after gentamicin-induced cochlear damage possess regenerative ability.

AIM: To evaluate the therapeutic efficacy and safety of heavy silicone oil (HSO), Densiron 68, was used as internal tamponade to treat complex vitreoretinopathy.METHODS: A retrospective study of 30 patients (30 eyes) who underwent vitrectomy and HSO tamponade for complex retinal detachment between January 2015 and January 2016.The best corrected visual acuity (BCVA), intraocular pressure (IOP), retinal reattachment and complications after surgery were observed.RESULTS: There were statistical significances in both the BCVA difference between pre-operation and HSO tamponade, and the BCVA difference between pre-operation and the removal of HSO for 3mo (z=-2.198, P=0.028;z=-2.682, P=0.007).The average intraocular pressure of HSO tamponade group was 20.233±8.007mmHg, and the average intraocular pressure of pre-operation group was 16.067±4.025mmHg, showing significant difference(t=-2.913, P=0.005).Between the pre-operation group and the HSO removed group 14.933±3.423mmHg, there was no significant statistical difference in the analysis of IOP (t=2.635, P=0.430).Anatomical success was achieved in 90% of cases after the removal of HSO.Most common complications were cataract formation and oil emulsification.CONCLUSION: Densiron-68 is a safe and effective tamponade material for the treatment of complex vitreoretinopathy.However, most common complications are cataract formation and oil emulsification.So clinicians should strictly handle indications and usage during the clinical applications.

Objective To study the hemodynamics during closed chest cardiopulmonary resuscitation (CCCPR) in dogs in order to unravel the mechanism. Method Twelve healthy mongrel dogs were selected to make animal model of ventricular fibrillation induced by electric shock on the chest wall. Closed-chest cardiopulmonary resuscitation (CCCPR) was initiated four minutes after ventricular fibrillation appeared according to American Heart Guidelines in 2005 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Rescue. After CPR for 2 minutes, 1mg epinephrine was injected intravenously. The central venous pressure (CVP), the aortic pressure (AOP)and the invasive electrocardiogram (ECG) were used to monitor continuously before ventricular fibrillation and the entire course of CPR. The coronary perfusion pressure (CPP) was calculated. The changes in aortic diastolic pressure (ADP) and CPP produced by chest compression or the injection of epinephrine were analyzed. The aortic pressure and the central venous pressure were recorded simultaneously during CPR. A chart was made and the CPP was calculated with the software Chart5Ch. The hemodynamic changes produced by the administration of epinephrine were studied. Data were analyzed with paired Student t test. P ＜ 0.05 was considered as a significant difference. Results Two kinds of hemodynamic effects of CPR were observed. In 8 dogs (8/12) , the aortic pressure changed synchronously with the CVP, and the CPP was almost zero, and in other 4 dogs (4/12), the aortic pressure increased and the CVP remained unchanged with presence of the CPP. After the administration of epinephrine, the AOP and the CPP increased significantly. The Aortic systolic pressure(ASP) increased from (66± 14) mmHg to(107 ± 28) mmHg, (P = 0. 001). The Aortic diastolic pressure (ADP) increased from (25 ±2.2) mmHg to(45 ± 13) mmHg (P =0.001). And the coronary perfusion pressure (CPP) increased from (2.8± 3.8) mmHg to (29 ± 13) mmHg (P ＜ 0.001). The 95 % confidential interval of the added value of the ASP,ADP and CPPwere (21.1-59.1), (10.2-28.3) and (16.7-35.7), respectively. Conclusions The thoracic pump mechanism is the primary role in the closed chest Cardiopulmonary resuscitation. Epinephrine can increase ADP and CPP and has the capability to break the balance between aortic pressure and central venous pressure, increasing the rate of successful cardiopulmonary resuscitation.

Objective To observe the effect of tetraethylplyrazine(TMP) on outward K~+ channel of outer hair cells in guinea pig cochlea.Methods 60 guinea pigs were divided into 6 groups randomly in the experiment.Auditory brainstem response was used to monitor the change of ABR thresholds and patch clamp techniques to observe the effect of TMP on outward K~+ channel.Results TMP decreased the elevated ABR threshold caused by streptomycin. The TMP increased the amplitudes of calcium sensitive potassium channels (I_ K(Ca) ) and delayed outward potassium channels (IK) of outer hair cells of guinea pig cochlea.Conclusion The study indicates that TMP may act as a protective agent against ototoxicity of streptomycin. The amplitudes of I_ K(Ca) and IK of outer hair cells are increased by the TMP,suggesting the possible mechanisms of reducing ototoxicity.

AIM: To study the changes of K + channels of outer hair cells in guinea pig cochlea with streptomycin ototoxicity. METHODS: Auditory brainstem responses (ABR) and whole-cell patch clamp techniques were used.RESULTS: (1) The body weight of guinea pigs with streptomycin ototoxicity decreased significantly; (2) The ABR threshold markedly increased in streptomycin group (Ⅱ,Ⅲ);(3)The number of dissociated outer hair cells of guinea pigs (Ⅱ,Ⅲ) was lower than that of control (Ⅰ); (4) Streptomycin decreased the Ca 2+ -sensitive K + currents and delayed outward K + currents distinctly; (5) There was no significant difference of K + currents between Ⅰ and Ⅱ/Ⅲ. CONCLUSION: These results suggest that the inhibition of K + channels is the basis of streptomycin ototoxicity, but not the direct reason for cell death.

Objective Investigate the effect of applying clinical pathway on the patients undergoing leiomyoma of uterus. Methods As an experimental group of patients, 50 cases of uterine leiomyoma are treated with clinical pathway. By contrast, another 100 cases are treated with the traditional medical care as control group. Results Waiting time for surgery and hospital stay of the experimental group are less than the control group; and the average hospitalization cost of experimental group is lower than the control group (P< 0.01). Conclusions Application of clinical pathway management will regulate the activities of medical treatment, ensure the quality of health care, improve the feeling of patients, increase efficiency of hospital services, reduce the financial burden of patients, increase the hospital social benefits.

Objective To explore the pathophysiological role of gastric leptin in helicobacter associated gastritis.Methods Patients undergoing gastroscopy were involved in the study.Helicobacter pylori infection was diagnosed by use of Hp-ureA-PCR,~(14)C urea breath test and rapid urease-nessler′s test. The level of leptin in local gastric mucosa and plasma were detected by ELISA. The level of IL-1? and IL-1ra in local gastric mucosa were detected by RIA.Results Total of 31 H pylori positive and 30 H pylori negative patients with chronic gastritis were founded. The level of Leptin and IL-1ra in the gastric mucosa in H pylori positive patients were significantly increased as compared with that in H pylori negative group (P 0.05).Gastric leptin closely related to IL-1? in H pylori positive group(r= -0.78,P

With the introduction of the principle of automatic exposure control system,this paper discusses the relation between ionization chamber and photographic position,and analyzes its effect on X-ray image quality.