Intracoronary effects of calcitonin gene related peptide (CGRP) on coro-nary hemodynamics were observed in the normal and following different extent of coro-nary stenosis using graded coropary- stenosis modl in dogs. The results showed that CGRPincreased the coronary artery blood flow (CBF) and distant coronary blood prepsure (DCP),but decreased mean artery pressure (MAP), coronary vessels total resistance (R_T),large co-ronary vessels, resistance (R_L) and small coronary vessels resistance (R_s). Thirty minutesafter. coronary middle. stenosis, CGRP was given intracoronary, MAP had no significantchange, but CBF insreased and R_T R_L, R_s decreased, and which maintained for 30 min. 30min after coronary severe stenosis, CGRP increased CBF and MAP, but decreased DCP,R_T, R_L, R_S continuously. These results suggested that CGRP could ameliorate myocardialischemia through enlargement of coronary vessels and by increasing CBF.

Objective To investigate the clinical effect of standard large bone flap decompression for severe craniocerebral injury.Methods This study was performed in 58 patients with severe traumatic brain injury,according to different surgical methods,the patients were divided into control group and study group,29 cases in each group.The control group was treated with conventional bone flap craniotomy,and the study group was treated with large bone flap decompression surgery.The clinical effect and complications were compared between the two groups.Results After operation,the patients were followed up for 5 months.The mortality of the study group (10.34%)was significantly lower than that of the control group (27.59%),and the difference was statistically significant (χ2 =3.98,P <0.05).In addition,the good rate of the study group (55.17%)was significantly higher than that of the control group (27.59%),and the difference was significant (χ2 =4.55,P <0.05).The preoperative intracranial pressure had no significant difference between the two groups.While at postoperative 1d,3d and 5d,the intracranial pressure of the study group was significantly lower than that of the control group,and the difference was statistically significant (t =3.55,4.02,6.12,all P <0.05).The scores of GOS and BAI in the study group were significantly higher than those in the control group (t =5.02,4.21,P <0.05 ).The incidence rates of complications such as cerebrospinal fluid leakage,trauma of cerebral infarction,trauma of epilepsy,hydrocephalus,wound infection of the study group were sig-nificantly lower than those of the control group,and the differences were statistically significant (χ2 =4.00,5.02, 456,4.22,3.99,all P <0.05).Conclusion Compared with conventional craniotomy,open standard big bone flap decompression can significantly reduce the mortality rate,decrease intracranial pressure,and improve the quality of life of patients,it has better curative effect and prognosis for patients with severe craniocerebral injury,and is worthy of clinical application.

OBJECTIVE:To establish a method for simultaneous contents determination of schizandrin,schizandrin B and cin-namaldehyde in Xiaoqinglong granule. METHODS:HPLC was performed on the column of Wondasil-C18 with the mobile phase of acetonitrile-0.1% phosphoric acid solution(gradient elution)at the flow rate of 1.0 ml/min,the detection wavelength was 245 nm, temperature was 25 ℃ and volume was 20 μl. RESULTS:The linear range was 1.008-20.16 μg/ml(r=0.999 8) for schizandrin, 0.496-9.92μg/ml(r=0.999 7)for schizandrin B,and 1.012-20.24μg/ml(r=0.999 6)for cinnamaldehyde;RSDs of precision,sta-bility and reproducibility tests were no more than 1.33%;the average recoveries were respectively 98.9%(RSD=1.71%,n=6), 99.9%(RSD=1.50%,n=6) and 98.7%(RSD=2.10%,n=6). CONCLUSIONS:The method is simple,accurate and reproduc-ible,and can be used for the quality control of Xiaoqinglong granule.

Monoclonal gammopathy of undetermined significances (MGUS) is a premalignant clonal disorder occurring in 4.2 ％ of adults ＞50 years old,and is associated with a 1％ risk every year of progression to multiple myeloma (MM),light-chain amyloidosis and related conditions.Differential diagnosis of asymptomatic and symptomatic monoclonal gammopathies is the determinant for starting therapy.Most patients with MGUS need frequent assessment and follow-up.A few patients with MGUS might progress into smoldering MM and symptomatic MM,or develop into light chain diseases such as AL amyloidosis and light chain deposition disease caused by M-protein,who should be followed with effective therapy.The above were in detail reviewed in the 54th American Society of Hematology (ASH) annual meetina.

Objective: To study the efficacy and safety of microscope assisted nasal transsphenoidal pituitary tumor resection. Methods: pituitary tumor patients in our hospital from March 2011 to May 2013 were enrolled and divided into observation group given microscope assisted nasal transsphenoidal pituitary tumor resection and control group given oral-nasal septum-sphenoid sinus pituitary tumor resection according to different operation mode. Then stress level, curative effect related index and complications were observed and compared with existing research. Results: (1) Adrenaline, noradrenaline, rennin, angiotensin Ⅱlevel and operation time, intraoperative bleeding volume, postoperative hospitalization time of observation group were lower than control group, cases of hormone levels return to normal and improve were more than control group, complication cases were less than control group. (2)compared with the existing research on nerve endoscopic surgery, operation time, intraoperative bleeding volume, postoperative hospitalization time and cases of hormone levels return to normal, improve and complications of observation group had no statistical difference. Conclusion:microscope assisted nasal transsphenoidal pituitary tumor resection is helpful to reduce surgery trauma, relieve stress condition and can achieve equal operation effect and complications.

Objective To discuss the way of treatment of bile duct stone with laparoscope and choledochoscope. Methods Forty six patients with bile duct stones admitted in our hospital from July 2001. to July 2008 were selected in this study. The 46 cases were divided into two groups:the control and observation group.The control group included 22 patients who were performed cholecystectomy and choledochotomy with T tube drainage. The obeservation group included 24 patients who were performed laparoscope and choledochoscope operation.We used the Mann-Whites statistics and compared the incidence of complications, the amount of bleeding and hospitalized days in patients between two groups. When P<0.05, the difference between the two groups was considered statistically significant. Results The incidence of complications after operation, amount of bleeding and hospitalized days in patients had no statistically significant difference between two groups. The time of operation in observation group was longer than control group. The bile stones eradication rate in observation group was higher than control gourp. and the bile stones recurring rate in observation group was lower than control gourp. Conclusion It is better to treat the bile duct stones by using laparoscope with choledochoscope than the way of traditional cholecystectomy and choledochotomy with T tube drainage, the former has advantages such as higher bile duct stones edarication rate, lower recurring rate, safer and more reliable operation and fewer complications.

Defibrillators, Implantable ; Electric Countershock

BACKGROUND: Severe acute respiratory syndrome (SARS) is a kind of very strong infective respiratory system diseases. Due to rapid development of disease course, severe symptoms, forced isolation, being away the supports from relatives and friends, many patients with SARS presented extremely anxiety and panic, even depression and despair, and they are in the crisis state and need mental support and help.OBJECTIVE: To evaluate the therapeutic effect of mental crisis intervention in patients with SARS.DESIGN: Controlled observation.SETTING: Xiaotangshan Hospital of Chinese PLA.PARTICIPANTS: Totally 680 patients with SARS who received the mental intervention in the Psychological Counseling Center, Xiaotangshan Hospital of Chinese PLA in May 2003. The patients, 379 male (55.74%)and 301 female (44.26%), were aged (35±7) years. Degree of education:34.5% of patients received education below junior high school, 31.5% senior high school and 34.0% college. 100% of the patients had family member or colleague-infected life events, and 14.4% of the patients lost their family members. Degree of disease: 6.9% of patients were in the severe period, 67.5% in the stable period and 25.6% in the rehabilitation period.METHODS: ① Totally 489 patients who received telephone counseling,and attended telephone mutual-help group, group debugging, individual counseling and group counseling were chosen, serving as intervention group, and the other 191 patients served as control group. ②The mental health state of patients in the 2 groups was evaluated at admission with symptom checklist 90 (SCL-90), which consisted of somatization, obsessive compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism 9 factors. The grading scoring was used. The higher grades, the more severe symptoms. ③ The patients of intervention group were given comprehensive mental intervention, which included handing out materials(self-debugging propagandist manual), care from staff, mental counseling by telephone, group debugging, individual counseling, guidance by mental doctor, etc. Patients in the control group only received handed materials (self-debugging propagandist manual) and the care from staff. SCL-90 was used to re-evaluate the patients of intervention group and control group before discharge. ④Intervention therapeutic effect of patients in 2 groups were evaluated with comprehensive mental intervention questionnaires, which were mainly about self and social cognition, feeling and emotion, life behavior styles, physiological and body symptoms 4 dimensions. Grading scoring was used. The higher points, the better intervention effect. Self-rating and rating by others were used in each question. If the results in self-rating are the same as those in rating by others, questionnaire is valid, otherwise, it is invalid). ⑤ The scoring of all the patients at admission was compared with that of Beijing norm by using SCL-90.The mental health of patients of 2 groups after intervention was measured, evaluated and compared with SCL-90.MAIN OUTCOME MEASURES: Difference in scoring of SCL-90 between all the patients and Beijing norm; Changes in the scoring of SCL-90 between intervention group and control group at admission and after intervention.RESULTS: Totally 680 comprehensive mental intervention questionnaires were handed out, and 669 of them were retrieved, among which 483 from intervention group and 186 from control group. Altogether 669 patients participated in the result analysis. ① Points of each factor in SCL-90 of patients at admission were significantly higher than norm, especially in anxiety and phobic anxiety. 45.5% and 50.1% of the investigated patients had more than 3 points in anxiety and phobic anxiety respectively. 86.5% of the investigated patients had mental problems to different degrees. ②There was no significant difference in the points of various factors in SCL-90 at admission between intervention group and control group (P＞0.05).In the various factors of SCL-90, no significant difference in the points of various factors in SCL-90 at admission between intervention group and control group (P＞0.05).In the various factors of SCL-90,no significant difference exists in phobic anxiety and paranoid ideation and psychoticism between two groups (P＞0.05),but the points of the other factors of intervention group were significantly lower than those of control group (P＜0.05-0.01).CONCLUSION: Mental crisis intervention can remarkably lighten the somatization, obsessive-compulsive, anxiety and depression, lower interpersonal sensitivity and improve hostility.