Addendum was added to designing thought of sleep cognition information module of thought imprint psychotherapy under low resistant state (TIP) in this paper on the basis of past treatment experience.The main added contents included expected treatment information module,and cognitive information module according to the next sleep situation and possible future events.We hoped to provide some help to the psychotherapy of insomnia or better use of TIP.

AIM: To detect the amount of heavy metals and As salt in Dangyao Tablets. METHODS: The method for detecting the heavy metals and As salt in volume 1 of 2000 China Pharmacopoeia. RESULTS: The(amount) of heavy metals in 15 batches of Dangyao Tablets was little less than 20.0 mg/g;As salt was little less than 2.0 mg/g. CONCLUSION: The amount of heavy metals and As salt in Dangyao Tablets is in the limit of the standard.

The Outline-style homework is introduced, which is one of the characteristic diagnostic methods of TCM psychology. The outline-style homework contents include①the painful, sad or aggrieving things.②the person(s) or object(s) or event(s) that your are/were afraid of.③the past events about love relationship and sex that you are reluctant or feel too ashamed to mention.④the most trusted, dependence, unforgettable person, and why.⑤the most relaxed , happy time, and why? It comes from the ancient Chinese emotional theory and modern TCM psychotherapy practice. Nowadays, this method is widely used to help doctors quickly collect the patient's mental condition, growth experience, and convenient for clinical treatment.

ObjectiveTo investigate the early diagnosis value of IMA and D-dimer and cTn Ⅰ in ACS.MethodsAll the 113 blood samples of patients with chest pain in the emergency department of the Third Hospital of Hebei Medical University were selected.Thirty healthy people were selected as the control group.Patients were divided into two groups:one of 52 cases was within 3 hours after onset of chest pain.the other of 61 cases was between 3 to 6 hours.According to the final clinical diagnosis,31 cases were divided into non-ischemic chest pain group (NICP) and 82 cases were divided into the ACS group.The ACS group was divided into the UA group (51 cases),NSTEMI group (18 cases) and STEMI group (13 cases).IMA was measured with albumin-cobalt binding test,and D-dimer was measured with the automated blood coagulation analyzer,and cTn Ⅰ was measured with the automatic biochemical analyzer.Levels of IMA,D-dimer,cTn Ⅰ were compared in the different groups and their sensitivity,specificity and accuracy to the early diagnosis of ACS were evaluated by Four format diagnositic test.ResultsThe levels of IMA in ACS group,which include the UA group,NSTEMI group and STEMI group were (0.722 ± 0.181 ),(0.601 ± 0.122),(0.631 ± 0.153 ) ABSU respectively.The levels of D-dimer were ( 0.485 ± 0.124 ),( 0.571 ± 0.181 ),(0.748 ± 0.094 ) mg/L respectively.The levels of cTn Ⅰ were ( 0.076 ± 0.027 ),( 0.059 ± 0.038 ),(0.065 ± 0.015 )μg/L respectively.Concentrations of IMA,D-dimer and cTn Ⅰ in ACS group were significantly higher than those of the NICP group [IMA (0.338 ± 0.065 ) ABSU,D-dimer (0.368 ± 0.078 )mg/L,cTn Ⅰ (0.022 ±0.007) μg/L] and the controls group [IMA (0.292 ±0.058) ABSU,D-dimer (0.267 ±0.052) mg/L,cTn Ⅰ (0.029 ± 0.016) μg/L].There were significant differences between the ACS group and the NICP group and the control group,F value was 3.613,3.289 and 3.521 respectivily,and P ＜0.05.The levels of IMA in ACS group within 3 hours and between 3 to 6 hours,which is (0.665 ±0.104 ),(0.520 ± 0.073 ) ABSU,were significantly higher than that of the controls (0.292 ± 0.058 ) ABSU ( F value was 3.58,P ＜ 0.05 ).The levels of D-dimer and the cTn Ⅰ in the group between 3 to 6 hours [which were (0.634 ±0.213 ) mg/L and (0.079 ±0.032) μg/L] were significantly higher than those of the controls [(0.267 ±0.052) mg/L and (0.029 ±0.016) μg/L] (q was4.24 and 3.46,P ＜0.05).The sensitivity,specificity and accuracy was 83.36％,70.97％ and 81.42％ of the IMA in a separate diagnosis of ACS,but the sensitivity,specificity and accuracy were 97.56％,58.06％ and 86.73％ of the IMA,D-dimer and cTn Ⅰ with the affiliation diagnosis.ConclusionThe serum IMA is a more sensitive indicator of ACS in early myocardial ischemia than cTn Ⅰ and plasma D-dimer.Serum IMA in combination with D-dimer and cTn Ⅰ could improve the sensitivity and specitivity,and had value to guide cinical diagnosis of ACS in the early stage.

Objective To evaluate the effect of propofol on liver injury in mice with acute liver failure (ALF).Methods Eighty adult male ICR mice,aged 1 months,weighing 20-25 g,were randomly divided into 3 groups (n =20 each) using a random number table:control group (group Ⅰ),ALF group (group Ⅱ),and ALF + propofol group (group Ⅲ).ALF model was established with intra-peritoneal D-galactosamine (D-GaIN) and lipopolysaccharide (LPS).Propofol 5 mg/kg was injected via the tail vein every 1 h within 6 h after injection of DGaIN and LPS in group Ⅲ,while the equal volume of normal saline was given instead in the other groups.Venous blood samples were taken from the tail vein at 1,3 and 6 h after injection of D-GaIN and LPS (T1-3) to detect the activities of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and serum tumor necrosis factor-alpha (TNF-α),interleukin-1β (IL-1β) and IL-10 concentrations (by ILISA).The survival within 12 h after injection of D-GaIN and LPS was observed and the survival rates were calculated.The mice were sacrificed and livers were removed for microscopic examination of pathologic changes.Results Compared with group Ⅰ,the activities of AST and ALT were significantly increased at each time point in Ⅱ and Ⅲ groups and the serum TNF-α concentrations at T1,2 and IL-1β and IL-10 concentrations at each time point were significantly increased in group Ⅱ,and the serum TNF-α concentrations at T1,and IL-1β and IL-10 concentrations at T2,3 were significantly increased in group Ⅲ (P ＜ 0.05).Compared with group Ⅱ,the activities of AST and ALT at each time point,serum TNF-α concentrations at T1,2 and IL-1β and IL-10 concentrations at T2,3 were significantly decreased and the survival rate within 12 h after injection of D-GaIN and LPS was increased in group Ⅲll (P ＜ 0.05).The pathologic changes of liver tissues were gradually attenuated in Ⅱ and Ⅲ groups.Conclusion Propofol can reduce the liver injury in mice with ALF through inhibiting inflammatory responses.

OBJECTIVE To investigate the distribution and resistance of clinical isolates to antimicrobial agents commonly used.Antimicrobial agents should be used rationally based on the results of susceptibility testing.METHODS The clinical isolates were identified with W/A-40 or VITEK-32.The results were analyzed by WHONET 5.3 software according to CLSI 2005.RESULTS A total of 2892 clinical isolates were collected in 2007.Gram-negative bacilli accounted for 68.2% and Gram-positive cocci accounted for 31.8%.The top eight pathogens were Pseudomonas aeruginosa,Escherichia coli,Klebsiella spp,Acinetobacter spp,coagulase-negative Staphylococcus,Enterobacter spp,Serratia spp and S.aureus.About 76.4% of S.aureus isolates were MRSA,81.6% of coagulase-negative Staphylococcus isolates were meticillin-resistant.Under 20.0% of Enterobacteriaceae strains were resistant to cefoperazone/sulbactam,imipenem and piperacillin/tazobactam.About 16.3% and 32.5% of P.aeruginosa isolates were resistant to cefoperazone/sulbactam and imipenem.CONCLUSIONS Gram-negative bacilli were dominant isolates in our hospital during 2007.P.aeruginosa is the most frequent pathogenwith severe antibiotic resistance.Enterobacteriaceae are susceptible to cefoperazone/sulbactam and imipenem.

Objective To investigate the dilating effect of dexmedetomidine (DEX)on isolated vascular smooth muscles and to explore the mechanism.Methods Tension of isolated mesenteric arterial rings of male Sprague-Dawley rats was recorded.The effects of DEX on the rings and the effects of DEX on vascular reaction induced by various drugs were recorded. Results DEX completely relaxed the contraction induced by phenylephrine (PE)and KCl in a concentration-dependent manner in endothelium intact mesenteric arterial rings in rats.The vasodilating effect of DEX was increased by sodium nitroprusside.In phenylephrine (10-5 mol/L)based on pre-vasoconstriction,adding acetylcholine could not suppress DEX’s vasodilating effect.Vasodilation was not related to the endothelial cells.In physiological saline solution without calcium,DEX significantly inhibited the contraction induced by addition of CaCl2 .Conclusion DEX can induce vasodilation in a concentration-dependent manner,which is not dependent on the endothelial cells.

Farnesoid X receptor (FXR) belongs to the nuclear receptor superfamily. It is highly related to the formation of metabolic syndrome and the glucose homeostasis, and therefore represents an important drug target against metabolic diseases and diabetes. In recent years, great progress has been made in the agonists, antagonists, and crystal structures of FXR. The diverse FXR ligands and their structure-activity relationship are reviewed in this article. The advances in the crystal structures of FXR in complex with different ligands are also introduced.

Objective To evaluate how functional endoscopic sinus surgery(FESS)modifies patients symptom profiles and the quality of life and analyze the influential factors.Methods During 2010 to 2012,90 cases were investigated to evaluate the quality of life of different age groups to use SNOT-20.Results The quality of life after the surgery of different age groups were significantly higher than it before the surgery(P<0.05).The juvenile group:first dimension(nasal congestion,70%),the second dimension (memory,30%),the third dimension(worried about the condition,30%)and the fourth dimension(social influence,40%).The young aged group:first dimension(nasal congestion,73.3%),the fourth dimension(social influence,43.3%),second dimension (quality of sleep,20.0%)and the third dimension(irritability,16.7%).The middle and old aged group:first dimension(nasal con-gestion,66.7%),the third dimension(trepidation,20%),the second dimension(quality of sleep,20.0%)and the fourth dimension (financial burden,40.0%).Preoperative QOL related factors:complications,age,gender,disease duration and urban-rural;Postop-erative QOL related factors:complications,disease duration,age,perioperative management,gender and urban-rural.Conclusion The quality of life of different ages after FESS is improved in different aspects.To increase the level of perioperative compliance can improve the quality of life.

Many patients suffering from insomnia,especially chronic insomnia are treated by hypnotics.While taking hypnotics for long time will lead to drug dependence.How to fulfill gradual reduction of hypnotics has become one of the big problems doctor meet clinically.Drug dependence can be classified into two aspects.One is psychological,the other is pathological.Psychological treatment has advantage in the procedure of reducing drug.Thought imprint psychotherapy under lower resistance (TIP) which combines traditional Qigong,relaxation and cognitive-behavioral therapy of modern clinical psychology is a psychotherapy fit for Chinese.TIP techniques used during reduction procedure of hypnotics have been improved.