Because of the disunity use of the outcome measures in traditional Chinese medicinal clinical trials, we explain the application of outcome measures in clinical trials on insomnia, provide the international criteria and guideline on outcome reporting. According to analysis of the concrete cases, we in order to improve the misuse of outcome measures of insomnia, to make the selection and reporting of outcome measures follow with the international practices and, to accelerate the development of traditional Chinese medicine.

Neuroblastoma (NB) is a common malignant solid tumor that occurs during childhood;it has a significant heterogene-ity in clinical symptoms and outcome. NB diagnosis is complicated, and various clinical techniques are often involved in examining im-agery, cellular morphology, immunohistochemical staining, gene and molecule biology, and operation excision scope. Diagnoses are graded based on danger extent, which is indicated by clinical stages and unfavorable prognosis factors. These characteristics are the ba-sis for formulating the corresponding synthetic treatment plan. Limited studies are available on treatment norms for adult cases of NB;such cases are currently diagnosed and treated in accordance with child NB diagnosis and treatment norms. An adult patient diagnosed with NB stage 4 is presented. This patient experienced obvious relief from the symptoms after whole body chemotherapy, with further surgery operation indications. This successful case of multi-disciplinary joint diagnosis and cooperative treatment may provide potential treatment techniques for similar patients.

Visual analogue scales(VAS) is extensively applied on evaluating symptomatic outcome data,such as the pain intensity,but currently most of the management of relevant data can't conform to the statistical standard.This article categories the data measured with VAS and the eligible statistical methods,give a specific explanation about analysis of repeated measures data which may commonly misused in practice.It provides a reference criterion for statistical analysis with VAS in clinical research.

Mild cognitive impairment (MCI) is considered as an intermediate clinical state between normal aging and Alzheimer’s disease (AD). The cognitive function and life ability of patients are normal, which have not met the criteria of AD. MCI is considered to be an earlier stage of AD. The clinical effects of AD in the middle or late stage are unsatisfactory. Therefore, studies on MCI have become the hot research areas both at home and abroad. The therapy of MCI is similar to AD. The treatment effect is uncertain. Hence, the understanding and treatment of MCI by TCM reflected TCM features. This article reviewed on TCM understanding of MCI, TCM syndrome differentiation criteria and TCM treatment methods of MCJ. Thus, it was aimed to further understand the dynamic of MCI in order to provide references for improving TCM clinical effects and reducing the incidence of AD.

Objective To evaluate the effectiveness of Tai chi on quality of life of breast cancer patients. Methods Articles from 10 English and Chinese Databases from inception to March 2012 were recalled. 2 researchers independently screened titles and abstracts for eligible trials, methodological quality was assessed according to risk of bias items. Meta-analysis would be used if data available. Results 4 randomized trials with 169 participants were included. All trials had high risk of bias. 2 studies demonstrated significant improvement in Tai chi group for improving shoulder functional capacity which caused by breast cancer. The meta-analysis failed to demonstrate significant effects of Tai chi compared with control interventions (psychological support therapy, standard health care, routine rehabilitation training) in improving quality of life (SMD 0.03, 95%CI: -0.85, 0.91, P=0.94). Conclusion Tai chi is effective on shoulder functional capacity of breast cancer, but not significantly on quality of life.

Objective To investigate the effect of penehyclidine hydrochloride on brain injury induced by cardiopulmonary bypass (CPB) in rats. Methods Thirty adult male SD rats were randomly divided into 5 groups ( n = 6 each): sham operation group (group S), CPB group, and low, median and high dose penehyclidine hydrochloride groups (group PL, PM , PH). Penehyclidine hydrochloride 0.2, 0.6 and 2.0 mg/kg were added to the priming solution in group PL, PM and PH respectively, while the equal volume of normal saline was added instead in group S. Blood samples were obtained at 2 h after termination of CPB to determine the plasma concentrations of neuron specific enolase (NSE) and S-100β protein. The brain tissues were taken to observe the ultrastructure of hippocampal neurons with electron microscope. Results The concentrations of NSE and S-100β protein were significantly higher in the other groups than in group S, while lower in group PM and PH than in group CPB and PL( P＜ 0.05). The S-100β protein concentration was significantly lower in group PH than in group PM( P ＜ 0.05). The damage to hippocampal neurons was significantly attenuated in group PM and Ps. Conclusion Penehyclidine hydrochloride 0.6 or 2.0 mg/kg can reduce the CPB-induced brain injury in a dose-dependent manner in rats.

The animal models of hypoxic-ischemic brain injury have been established inmany animals, such as monkeys, dogs, rats, mice, rabbits, and pigs. These models have provideda great deal of important information for neonatal hypoxic-ischemic brain injury. Howerver, thedifferent species vary in their susceptibility to the various types of ischemic insults. This articlereviews the animal models of hypoxic-ischemic brain injury in different species.

Objective To investigate the effect of probiotics preconditioning on intestinal mucosal barrier function in a rat model of cardiopulmonary bypass (CPB) . Methods Twenty-four adult male SD rats weighing 350-450 g were randomly divided into 3 groups ( n = 8 each) : group Ⅰ sham operation ( group S); group Ⅱ CPB and group Ⅲ probiotics + CPB. CPB was established between left carotid artery and right jugular vein and maintained for 60 min. Croup Ⅲ received intragastric instillation of probiotics 2 ml once a day for 7 consecutive days before CPB. Blood samples were collected at 2 h after CPB was terminated for determination of plasma D-lactate, TNF-and IL-6 concentrations and diamine oxidase (DAO) activity. Venous blood was obtained from portal vein for determination of LPS concentration and cultured. Liver, pancreas, spleen, kidney and mesenteric lymphnode (MLN) specimens were obtained under sterile condition and cultured for bacterial growth. The mucous membrane of small intestine was examined with electron microscope. Results CPB significantly increased plasma DAO activity, and D-lactate, IPS, TNF-α and IL-6 concentrations and the rate of bacteria-positive culture of portal venous blood, liver, MLN, lung and kidney in group Ⅱ as compared with group S. Probiotics preconditioning significantly attenuated the above-mentioned CPB-induced changes. Microscopic examination showed that probiotics preconditioning significantly ameliorated CPB-induced damage to the epithelium of the small intestine. Conclusion Probiotics preconditioning can significantly attenuate CPB-induced inflammatory response and protect the intestinal mucosal barrier function.

Objective To investigate the effects of cardiopulmonary bypass (CPB) on the expression of tight junction protein occludin in rat lung tissues.Methods Twenty adult male Sprague-Dawley rats were randomly divided into 2 groups (n=10 each): sham operation group (group S) and CPBgroup.The rats underwent 1 h of CPB and were observed 2 h later in group CPB.The lung water content,neutrophil percentage and protein concentration in bronchoalveolar lavage fluid (BALF) were measured.The expression of occludin in lung tissues was detected by immunohistochemistry and Western-blot analysis.The ultrastructure of alveolar epithelial barrier was observed with transmission electron microscope.Results Compared with group S,the lung water content,protein concentration in BALF and neutrophil percentage were significantly increased (P ＜ 0.05),the expression of occludin in lung tissues was significantly down-regulated (P ＜ 0.05) and the damage to alveolar epithelial barrier was aggravated in group CPB.Conclusion The expression of occludin in lung tissues is down-regulated and the damage to alveolar epithelial barrier is induced after CPB,which may be one of the important factors in acute lung injury induced by CPB.

Objective To investigate the effects of penehyclidine hydrochloride on blood-brain barrier in a rat model of cardiopulmonary bypass ( CPB) . Methods Sixty adult male SD rats, aged 4-6 months, weighing 320- 370 g, were randomly divided into 5 groups ( n = 12 each) : sham operation group (group S), CPB group, and low-, median- and high-dose penehyclidine hydrochloride groups (groups LP, MP and HP). The animals were anesthetized with intraperitoneal 10% chloral hydrate 350 mg/kg, intubated and mechanically ventilated. The femoral and jugular arteries and jugular vein were cannulated. CPB was performed for 60 min. Penehyclidine hydrochloride 0.2, 0.6 and 2.0 mg/kg were added to the priming solution in groups LP, MP and HP respectively, while the equal volume of normal saline was added in group CPB. Evans blue was injected via femoral vein at 1 h before the animals were sacrificed. Six rats in each group were sacrificed, their brains immediately removed and the hippocampi isolated for determination of Evans blue content. The other rats were sacrificed and the hippocampi isolated to determine the water content and observe the ultrastructure of blood-brain barrier. Results Compared with group S, the Evans blue content and water content were significantly increased in the other groups ( P ＜ 0.05) . Compared with groups CPB and LP, the Evans blue content and water content were significantly decreased in groups MP and HP ( P ＜ 0.05) . The Evans blue content was significantly lower in group HP than in group MP ( P ＜ 0.05). The CPB-induced changes were significantly attenuated in groups MP and HP compared with groups CPB and LP. Conclusion Penehyclidine hydrochloride can protect blood-brain barrier against the CPB-induced injury and the effect is related to the dose.