Objective To study the effect of anti anxiety treatment in residual dizziness after successful canalith repositioning procedure in benign paroxysmal positional vertigo.Methods 68 cases of benign paroxysmal position vertigo patients with residual dizziness after successful canalith repositioning procedure were collected,who visit department of Neurology..They were randomly assigned to anti anxiety group and the control group according to randomized controlled method.Deanxit (0.5mg/10mg,1times/day)combined with betahistine mesilate tablets (6mg, 3 times/day)were taken by patients in the anti anxiety group;take betahistine mesilate tablets (6mg,3 times/day) were taken in the control group.Follow up 3 months,the duration of residual dizziness and the changes of symptoms between the two groups were compared.The symptoms of all patients were evaluated before and after treatment by dizziness handicap inventory.Results The duration of residual dizziness in the control group was (16.38 ±8.83)days, and that in the anti anxiety group was (10.13 ±5.10)days.The duration of residual dizziness in the anti anxiety group was significantly shorter than that in the control group (t =3.440,P <0.05).In the control group,the scores of first week,s econd week and third week were (26.60 ±13.54)points,(20.80 ±10.97)points and (6.27 ±5.88)points.In the anti anxiety group,the scores of first week,second week and third week were (23.10 ±11.02)points,(13.33 ± 5.83)points and (0.67 ±2.50)points.There was not significant difference between the two groups (t =1.122,P >0.05)in the treatment of first week.In second week and third week,the scores of the anti anxiety group were lower than those of the control group,the differences were statistically significant (t =3.378,4.935,all P <0.05).After 3 weeks of treatment,the scores of the anti anxiety group were significantly decreased in the functional,emotional and physical scores (t =5.297,4.537,4.451,all P <0.01 ).Conclusion Deanxit can shorten residual dizziness duration of benign paroxysmal position vertigo patients after successful canalith repositioning procedure,and can reduce the degree of residual dizziness.

With the quick development of information network,a new disease-Internet Addiction has been paid more and more attention,and how to prevent and cure it has become one important problem that need to be resolved.At present,the rate of Internet Addiction among medical students is rising year by year,so we should make a united effort to prevent and control Internet Addiction among medical students.This article tries to explore how to prevent and control medical students'Internet Addiction from the point of view of law and ethics and expect to prevent them form being patients of Internet Addiction and help them thrive promptly.

OBJECTIVE:To discuss the feasibility of the development of pharmaceutical care by clinical pharmacist based on micro letter public platform. METHODS:The content and method of pharmaceutical care based on micro letter public platform were introduced by registering micro letter public platform public number,building reasonable medication guidance team,releasing reasonable medication information regularly. RESULTS:40 pieces of reasonable medication information had been pushed by micro letter public platform of our department during Aug.-Nov. 2014,and 350 users added our public platform. The pushed information was mainly about reasonable drug use(57.5%),read by 18 585 persons,and read by 465 person per time in average. Reposted or collected 2 190 times in total,reposted or collected 55 times in average,each piece of information was read by 4 219 person per time at the most. CONCLUSIONS:The pharmaceutical care by pharmacists depending on micro letter public platform contribute to put pharmacist team together,build professional image and provide pharmaceutical care for the public in the information age.

Objective:To develop the intelligent management system for diabetes medication knowledge base with the help of community hospital information platform.Methods:Based on the China Type 2 Diabetes Prevention Guide (2013 edition),National Essential Drugs (2012 edition) and the relevant package inserts,the knowledge base of diabetes medication was established.Results:The information platform could make interception beforehand,warning in the process of medication and provide attentions for physicians after treatment to determine rational medication.Conclusion:The intelligent management system for diabetes medication knowledge base can promote physicians to firmly grasp the principles of drug treatment,simplify treatment regimen,select effective drugs with reasonable prices and provide individualized treatment.

Objective:To discuss the management norms for the rational use of potassium chloride injection in neurosurgery department of a hospital.Methods:A special review of the medical advice including potassium chloride injection from January to June in 2016 in neurosurgery department was carried out.Results:In the 2 596 prescriptions including potassium chloride injection,the irrational drug use rate was 17.87%,and among them,92.67% were irrational compatibility,which showed serious risk of drug use.Conclusion:Some defects still exist in the application management of potassium chloride injection in neurosurgery department of this hospital.In order to avoid the risk of clinical medication,it is necessary to establish standardized management norms for the use of potassium chloride injection in this hospital to further promote the management of high-risk drugs with intravenous administration commonly used in clinics.

Objective To study the compatible stability of the carbohydrate-electrolyte injection and commonly used vitamin-electrolyte injections. Methods By simulating clinical use of medicines,the carbohydrate-electrolyte injection and various vitamin-electrolyte injections were mixed respectively.The content of sodium acetate was measured by HPLC,and changes in appearance,pH value and insoluble particles of the injections were observed. Results At room temperature,the compatibility solutions showed no significant changes in appearance,pH value,the number of insoluble particles and the content of sodium acetate within 8 h. Conclusion The carbohydrate-electrolyte injection is compatible with commonly used vitamin-electrolyte injections,and the admixtures are stable within 8 h at room temperature.

Objective To investigate the promoter methylation status,mRNA expression and clinical significance of insulin-like growth factors 2 (IGF2)/H19 genes in term infants smaller than gestational age (SGA) infants whose mothers had gestational diabetes mellitus (GDM).Methods The clinical data of 20 full-term infants whose mothers had GDM (group 1),23 cases of full-term SGA infants whose mothers did not have GDM (group 2) and 21 full-term health infants whose mothers did not have any diseases during pregnancy(group 3) were collected,and all infants were delivered in Changsha Hospital for Maternal and Child Health Care between January 2015 and January 2018.The promoter methylation levels of IGF2/H19 gene from peripheral blood of 3 groups were detected by the method of Bisulfite sequencing polymerase chain reaction (PCR) (BSP),and IGF2/H19 mRNA was detected by real-time transcription RT-PCR method.Results The promoter methylation rates of IGF2/H19 in peripheral blood of infants were (22.51 ±5.29)％,(28.94 ±2.51)％ in group 1,(27.84 ±4.63)％,(34.58 ±6.97)％ in group 2,(37.47 ±7.84) ％,and (40.26 ±5.33) ％ in group 3.The promoter methylation rate of IGF2 and H19 in group 1 were significantly lower than those in group 2 and group 3,and the differences were statistically significant(all P ＜ 0.05).The relative expression of IGF2/H19 mRNA in peripheral blood of group 3 (1.04 ±0.12,1.01 ±0.13) were significantly higher than those in the group 1,and the differences were statistically significant (all P ＜ 0.05),and there were no significant differences in relative expression of IGF2/H19 between the group 1 and the group 2 (1.30 ±0.10,1.29 ±0.11) (all P ＞ 0.05).Conclusions The abnormal promoter methylation status and mRNA expression levels of IGF2/H19 gene methylation frequency and mRNA abnormalities may occur in infants less than gestational age infants if exposed to hyperglycemia during pregnancy,which may be one of the causes of intrauterine growth retardation and may affect its later growth and development.

Objective:To analyze the bubble dynamic characteristics of shock wave enhanced emission photoacoustic streaming(SWEEPS)technique in free water region under different temporay delays.Methods:The Er∶YAG laser tip was activated in free water model with SWEEPS mode at 150-600 μs pulse delay.The bubble dynamic process during irrigation was recorded by a high-speed camera(200 000 Hz).Matlab was used to analyze the interaction between bubble made by the dual pulses frame by frame.The distance between bubble remnants and laser tip was measured before the bubble disappeared.The experimental data were statisti-cally analyzed by SPSS 19.0.Results:In free water region,different temporal delays caused different interaction between the bub-bles activated by the SWEEPS technique with a dual pulse modality.The interactions include bubble fusion,bubble collision and bubble separation.When the temporal delay between 360-440 μs,bubble collision was the most violent,and the farthest distance between bubble remnants and laser tip was reached.Conclusion:In free water region,the dual pulse of SWEEPS technique can lead to bubble interaction which may enhance the cavitation effect of Er∶YAG laser irrigation,and improve the debridement in clinic ap-plication.

Objective To analyze the clinical characteristics of IgG4-related disease (IgG4-RD)so as to improve the understanding of IgG4-RD in China.Methods IgG4-RD patients were recruited from Peking Union Medical College Hospital between January 2011 and January 2016.All patients were followedup for more than 6 months.The demographic characteristics,symptoms,organ involvements,laboratory examinations and treatment efficacy were evaluated and analyzed.Results A total of 346 patients were finally enrolled,including 230 males (66.5％) and 116 females (33.5％).The mean age of disease onset was (53.8 ± 14.2) years old.The mostly common involved organs were lymph nodes (56.4％) and submandibular glands (52.6％).Other affected organs and manifestations included:swelling of the lacrimal glands (46.5％),autoimmune pancreatitis (38.4％),pulmonary involvement (28.0％),sclerosing cholangitis (25.4％),naso-sinusitis (23.4％),parotid gland swelling (21.7％),retroperitoneal fibrosis (19.9％),large arteries involvement (9.5％),kidney involvement (obstructive nephropathy caused by retroperitoneal fibrosis was excluded) (6.9％),skin lesions (6.4％).Rare features consisted of thyroid glands,pituitary glands,gastrointestinal tract,pachymeningitis,pericardium,sclerosing mediastinitis and orchitis.The majority of patients had multi-organ involvement,such as 74.3％ patients with 3 and more,18.2％ and 7.5％ patients with 2 and single organ involvement respectively.The average IgG4-RD responder index (IgG4-RD RI) was 13.21 ±5.70.History of allergy was found in 172 (49.7％) patients.As to the laboratory tests,elevated serum IgG4 levels were confirmed in 285 (94.1％) patients,which was positively correlated with IgG4-RD RI.There were 33.5％ patients receiving monotherapy of glucocorticoid,52.6％ treated with glucocorticoids combined with immunosuppressive agents,4.9％ patients with immunosuppressant only,and 9.0％ patients with mild disease not receiving medication.The majority (336,97.1％) patients improved the above regimens.Conclusion IgG4-RD is a systemic fibro-inflammatory disease with multiple organ involvement.The mostly common involved organs include lymph node,submandibular glands,and pancreas.Glucocorticoids and immunosuppressive agents were effective for IgG4-RD.

A 50-year-old female presented with bilateral cervical arteriosclerosis and right-sided plaque formation,after 25 d of treatment with rosuvastatin calcium tablets(20 mg,po,qn),the patient developed temporomandibular joint dislocation,the adverse reactions occurred again after giving manipulative repositioning.The patients were healthy,had no history of trauma and related diseases in stomatology,no history of drug allergy,patients did not open their mouth loudly at the onset of the disease,no external factors affecting the use of drugs during the combined use of other drugs.It was considered"very likely"that the dislocation of the jaw joint was caused by rosuvastatin calcium tablets.The patients were followed up for 3 months after the treatment of manipulative repositioning and other treatments,did not have any further dislocation of the temporomandibular joint dislocation.It is suggested that when using rosuvastatin calcium in clinical practice,attention should be paid to strengthening drug observation to ensure drug safety.