Objective To investigate the therapeutic effect and safety of glucocorticoid combined with compoundα-keto acids therapy in primary nephrotic syndrome. Methods A prospective randomized controlled trial was carried out.Seventy-two cases of primary nephrotic syndrome were equally divided into treatment group and control group. Two groups of patients were both treated with glucocorticoids , and combined with compoundα-keto acid tablets in the treatment group. The level of BUN ,Scr,CRP,IL-6,PA、Alb,TG,TC,Ca in blood and eGFR、MTP were detected before treatment and the 2nd,4th,6th,8th month after treatment to evaluate the efficacy and safety respectively. Results After 8 months of treatment, the total effective rate in treatment group was significantly higher than that in the control group (P < 0.05); Compared with before treatment, the Alb level was significantly increased in both groups, the level of MTP,TC,TG,PA,CRP,IL-6 were significantly declined in both groups (P < 0.05),while no significant difference was found in the level of BUN,Scr,eGFR,serum calcium in both groups(P > 0.05); the level of MTP,TC,TG,CRP、IL-6 in the treatment group were significantly lower and the Alb level in the treatment group was significantly higher (P < 0.05)compared with the control group, while no significant difference was found in the level of PA、BUN、Scr、eGFR、serum calcium (P > 0.05) between two groups;All of patients with no serious adverse reactions occurred during the investigation. Conclusion The curative effect of glucocorticoid combined with compoundα-keto acids therapy in primary nephrotic syndrome is sure and without significant sideeffect.

Bugbane rhizome is a traditional Chinese herb as a common used in clinic. It has the function of dispersing evils from the superficies and promoting eruption, dispelling evil heat and expelling the virulent factors, ascending Yang-Qi or the vital energy of the spleen. Black cohosh is called Cimicifuga racemosa. It is used for the treatment of the symptoms of perimenopausal female. The origin and function of bugbane rhizome and black cohosh are different and should pay attention to the use.

OBJECTIVE:To study the incidence,the etiological factor and the harm of metoclopramide-induced children poisoning.METHODS:We reviewed 30 reports published in Chinese Pharmaceutical Abstracts(2003～2006)and domestic pediatric journals and gave a comprehensive evaluation on the confirmed 56 metoclopramide-induced children poisoning cases.RESULTS:All of the 56 poisoning cases were induced by oral administration and all had high daily dose.The condition was predominantly characterized by posterior tilt of head,stiffing of root of tongue,ataxia,upward staring or side-glance etc.Metoclopramide has inhibition effect on leucocytes,and it can result in cumulative poisoning,especially for children with hepatorenal inadequacy.CONCLUSION:Great attention should be attached to the dose and course of treatment of metoclopramide to enhance drug efficacy while reducing incidence of adverse drug reactions.

The extracted liquid of Xiaoermagan Granules with water was managed with EtOH,chitosan, 101 juice clarifying agent and ITC natural clarifying agent,respectively. And ephdrine and d-Pseudo-ephedrine contents in them after management were determined by HPLC. As a result,the two components in sample managed with chitosan are lower than that in unmanaged samples,little lower than that of managed sample with EtOH,and higher than that of managed samples with 101 juice clarifying agent and ITC natural clarifying agent. The orthogonal test-variance analysis indicated that there was no significant difference observed in effects of adding amount of chitosan,liquid concentration, PH value on the two component contents in samples on 3 selected levels.

Objective To compare the effects of general anesthesia and epidural anesthesia on short -term cognitive function in elderly patients after orthopedic surgery.Methods According to the digital table,90 elderly orthopedic patients were divided into the control group and observation group,45 cases in each group.The control group was given general anesthesia,and the observation group was given epidural anesthesia.Before anesthesia and 6h,12h,12h,72h after anesthesia,cognitive function was detected according to MMSE,and before anesthesia and operation,30min after operation,postoperation heart rate (HR)and blood pressure (BP)were measured.Results Before anesthesia,before operation,30 min intraoperation and after operation,the HR between the two groups had no significant differences(t =0.094,0.113,0.188,0.348,all P >0.05),and BP between the two groups also had no significant differences (t =0.190,0.179,0.181,0.271,all P >0.05).Compared with the scores of MMSE in the control group at postoperative 24h,the scores of MMSE in the observation group was significantly higher (t =37.947, P <0.01).Compared with pre -induction of anesthesia,the scores of MMSE in the observation group at postoperative 6h and 12h were relatively lower(t =37.210,65.118,all P <0.01),but there was no significant difference at 24h and 72h(t =1.861,P >0.05).Compared with pre -induction,the scores of MMSE in the control group at postopera-tive 6h,12h and 24h were significantly lower(t =29.912,41.000,39.528,all P <0.01),while the score of MMSE in the control group at postoperative 72h had no significant difference compared with before anesthesia(t =1.861,P >0.05).Conclusion Compared with general anesthesia,epidural anesthesia has less impact on short -term cognitive function.and the anesthetic effect is better.

Comorbidity, which can affect the treatment and prognosis of its disease, has gradually caught attention from both at home and abroad. Although chronic obstructive pulmonary disease (COPD) mainly involved lung tissues, it may also cause the systemic (or extra-pulmonary) adverse effects. Many types of comorbidities existed in COPD. This article summarized the prevalence, risk factors and pathogenesis of comorbidities such as cardiovascular disease, osteoporosis, anxiety and depression, lung cancer, infection, metabolic syndrome and diabetes mellitus. It also con-ducted related studies on the diagnosis and treatment status and current problems of COPD comorbidities, which may provide evidences for COPD outcome evaluation.

Objective To evaluate the clinical value of high thoracic washing in leakage of thoracic esophageal anastomosis.Methods 16 cases of anastomosis leakage after esophageaoctomy were treated with high thoracic washing.Results 13 of 16 patients were cured,with a cure rate of 81.25% and the average hospital time of 46 days.One patient died of bleeding and one died of lung infection and respiratory failure.The other one gave up therapy and discharged selfishly.Conclusion High thoracic washing in treating leakage of thoracic esophageal anastomosis is a reliable way with effect,simple procedure and less complication

Objective To summarize the experience in diagnosis and treatment of primary splenic neoplasm (PSN). Methods The clinical data of 31 patients with PSN treated in our hospital were retrospectively analyzed. Results Amongst the patients, 25 were diagnosed as PSN postoperatively. Fifteen out of the 19 patients with benignancy were treated with splenectomy, and the others underwent partial splenectomy or tumor excision. Eleven out of the 12 patients with malignancy received splenectomy (including two by excision of pancreatic body and tail), and the other one underwent biopsy alone. The pathological types were as follows: varieties of cyst in 11, angiocavemoma in 4, inflammatory pseudotumor in 2, cavernous lymphangioma in 1, cystic degeratin of liomyoma in 1, malignant lymphoma and lymphsarcoma in 6, hemangiosarcoma in 3, fibrosarcoma in 1, liomyosarcoma in 1 and malignant fibrous histiocytoma in 1. Three patients with malignancy survived for 5 years. The reason was that they received radical splenectomy in combination with chemotherapy or radiotherapy and immunotherapy. Conclusions PSN should be diagnosed mainly according to clinical manifestations and image examination. The differentiation between benignancy and malignancy depends on CT, hemangiography and determination of seros AKP and ? GT levels. Early diagnosis, radical operation and comprehensive treatment are important for improving the prognosis of PSN.

Objective To evaluate the reliability,validity and responsibility of the efficacy satisfaction scale for COPD patients at stable stage.Methods One hundred and fifty-five COPD patients at stable stage were selected from January to October of 2008.All subjects came from The First Affiliated Hospital of Hean College of TCM.The Cronbach' ? coefficient,Guttman split-half coefficient and re-test reliability were used as the indexes to reflect the reliability of the scale.The content validity and the construct validity were used to evaluate the validity of the sacle.The average score between pre-treatment and post-treatment was compared to evaluate the feasibility.Results The Cronbach'? coefficinent and Guttman split-half coefficinent of the efficacy satisfaction scale for COPD at stable stage respective was 0.906 and 0.758.The Cronbach'? coefficinent of the four domains respective were 0.905(working and life ability),0.645(clinical symptoms),0.788(efficacy) and 0.793(therapy convenience) for the efficacy satisfaction scale.The correlation coefficient between the four domains and it's items were within 0.70～0.87.The factor analysis of the scale extracted three common factors.The scores improvement with four domains was of great effect size change.The effective response rate was 91.2%.Conclusion The efficacy satisfaction scale for COPD patients at stable stage has better reliability,good content validity and common construct validity which could better distinguish therapeutic efficacy.