Objective To provide data support for safe and accurate lower cervical pedicle screw implantation by observing the lower cervical pedicle and its relationship between the adjacent spinal cord, endorhachis, nerve root and vertebral artery, particularly its relation-ship between the endorhachis and epidural sinus. Methods Measured the C3 ~ C7 cervical sample of 32 adult with vernier caliper and pro-tractor, including the distance between cervical pedicle and its upper and lower nerve root, the distance between cervical pedicle and en-dorhachis, the distance between cervical pedicle and vertebral artery, and the distance between cervical pedicle and epidural sinus. Results The distance betweencervical pedicle and its upper nerve root was 1. 18~1. 40 mm, the distance between cervical pedicle and its lower nerve root was 2. 33~3. 11 mm;the distance between cervical pedicle and endorhachis was 2. 75~3. 33 mm;and there was nearly no distance be-tween cervical pedicle and vertebral artery and epidural sinus. Conclusion Cervical pedicle has a very close relationship with spinal cord, endorhachis, vertebral artery and nerve root, and the cervical pedicle is narrow and small. Therefore, it requires fully assess accroding to in-dividualization so as to prevent injury of important anatomical structures.

OBJECTIVE:To systematically review the procalcitonin(PCT)-guided therapy in patients with sepsis. METHODS:Retrieved from PubMed,Cochrane Library,EMBase,CJFD,Wanfang Datebase,related trails about PCT-guided therapy(test group)versus conventional treatment group(control group)in the treatment of sepsis were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation. RESULTS:Totally 5 studies were enrolled,involving 826 patients. Results of Meta-analysis showed,use time of antibiotics in test group was significantly shorter than control group, with statistical significance [MD=-2.52,95%CI(-3.07,-1.98,P<0.001];there were no significant differences in the mortality rate [OR=1.14,95%CI(0.83,1.56),P=0.42],ICU treatment days [MD=-0.22,95%CI(-1.40,0.96),P=0.72] and total hospi-talization [MD=-1.81,95%CI(-4.37,0.76),P=0.17]. CONCLUSIONS:PCT-guided therapy can effectively reduce the use of antibiotics and shorten treatment time in the treatment of patients with sepsis.It can be considered as inflammatory markers for guid-ing rational use of antibiotics in clinic.

Punicalin is an important ellagic tannin in Pericarpium Granati with the pharmacological effects such as antioxidation,anti-bacteria,antivirus and anti-inflammation.The studies on Pericarpium Granati at home and abroad were reviewed in the paper,and the extraction,separation,content determination,pharmacological activities and metabolism of punicalin were also summarized to provide theoretical basis for the development and application of punicalin.

Objective To investigate the surgical approach of the reasonable radical resection for carcino-mas of pancreatic head. Method 35 of 110 patients with carcinomas of pancreatic head underwent the surgical ap-proach of the posterior aspect of the radical resection for carcinomas of pancreatic head, and histopathological findings and prognosis were analyzed. Results The rate of curative resection rate was 31.82%. 3 patients underwent pancre-atoduodenectomy with partial resection of SMV for 9 patients with macroscopic suspicion of invasion of the SMV. The survival rate of the 5 years was 17.14% and the patients exceed 10 years. Conclusion Surgical approach of the reasonable radical resection for carcinomas of pancreatic head allows the reasonable radical resection,and may lead to increasing the resectability rate and the prognosis in the patients with carcinomas of pancreatic head.

Objective To study the relationship with internet addiction disorder(IAD)of the youth,the degree of IAD and home environment,attachment.To study the relationship with home environment and attachment.Methods 490 students were assessed with Internet Addiction Disorder Test,FES-CV,Attachment Questionnaire.Results 37 subjects can be defined as IAD according to Internet Addition Disorder test;IAD group have a higher score in contradictoriness(P＜0.05)of home environment and lack of maternal love,lack of fatherly love,father's rejection,parent's passive entangle,angry with parent[the average score of IAD group Was 13.16±4.62,14.18±5.42,14.41±5.44,19.10±4.59,18.89±4.42,12.37±4.80,11.35±4.17;the average score of normal group was 11.77±4.06,11.59±4.02,16.56±4.99,15.78±4.91,9.87±4.52,9.65±4.25,P＜0.05,0.01].Home environment were significantly correlated with all factors of attachment except independence(P＜0.05,0.01).There Was a significant negative correlation between the degree of IAD and lack of maternal love(r=-0.360).Conclusion Contradiction in home environment and passive attachment,that played an important role in internet addiction disorder of the youth.

Objective To develop an assay of HPLC for the content determination of dryocrassine in Guanye Jinsitao drop pills. Methods The column was Kromasil-C18 (150 mm×4.6 mm, 5μm);mobile phase was acetonitrile-chloroform-isopropanol-0.1% phosphoric acid (52∶8∶30∶10);flow rate was 1.0 mL/min;UV detection was performed at 285 nm;detected drift tube temperature was set at 25 ℃. Results The calibration curves were linear in the range of 0.236-2.124 μg for dryocrassine (r=0.999 9). The average recovery rate of dryocrassine was 99.64% (RSD=1.90%). Conclusion The method is simple and accurate. It is suitable for the determination of dryocrassine in Guanye Jinsitao drop pills.

The Proposal for the Standardization of Urinary Sediments Examination and the expert consensus have provided effective and timely instruction on urinalysis normalization,but there are still some puzzles about the methods and requirements on quality improvement for urinalysis normalization.This paper is discussing about some issues referring to American and European urinalysis guidelines,which include establishment of examination procedure,specifications and methods of testing system evaluation,specimen stability,the influence of sample centrifugation,the usage of sample staining,confirmation tests,requirements on result reporting,internal quality control and external quality assessment.These discussions will contribute to the quality improvement of urinalysis in clinical laboratories.

With the development of the dialysis technology,the survival time of patients with chronic renal failure is prolonged,while more complications which affect the quality of life or even threat the life of patients are followed.Secondary hyperparathyroidism(SHPT)with a certain incidence and mortality is one of the common complications,and its main characteristic performances ale hyperphosphatemia,hypocalcemia and high level of parathyroid hormone.Most patients Can be cured by the treatment of medicine while surgical treatment is still required by some cases in which the disorder of the parathyroid function can not be well regulated through medicine treatment.The purpose of this paper is to make a review of the recent studies of surgical treatment in patients with SHPT.

BACKGROUND: Some researches report that diffusion-weighted imaging (DWI) can appear abnormal signal in minutes after cerebral ischemia.OBJECTIVE: To investigate the manifestation and regularity of diffusion coefficient in middle cerebral artery occlusion (MCAO) of rats after cerebral ischemia.DESIGN: Randomized controlled study.SETTING: Neurological Department of Clinical College of ChongqingMedical University.MATERIALS: The experiment was conducted at the Radiological Department of the First Affiliated Hospital of Chongqing Medical University from April to July 2004. Totally 18 adult Wistar rats with clean grade were randomly divided into three groups: control group, sham operation group and cerebral ischemia group with 6 rats in each group.METHODS: The origin of right middle cerebral artery was blocked with filament into right internal carotid. In the sham-operated group, the filament was just inserted into the common carotid artery not into the origin of middle cerebral artery, rats in normal control group were not treated with anything after anesthesia. MRI experiments were performed on a 1.5 T GE signa Highspeed NMR spectrometer to obtain DWI and ADC values at the time-point of 7, 15, 30, 60 minutes, 3,6, 12, 24 hours, 3, 7, 15 days, 1 and 2 months after operation.MAIN OUTCOME MEASURES: Changes of ADCs in infarct hemisphere and contralateral hemisphere.RESULTS: There was no significant change in MRI T1-and T2-weighted imaging in rats at 7 minutes post-infarction, but abnormal high intensity was emerged during the period of 1 hour to 3 hours, and enlarged over time. Finally, the infarction area located the right basal ganglia and the frontal-parietal lobes at 12 hours and increased less significantly later.Focal abnormal high signal was noted in DWI 7 minutes after cerebral ischemic insult, and the ADC values was decreased at the same time,reduced gradually after significant recover at 30 minutes, dropped to the lowest level at 12 hours and again increased at 24 hours, since then all the ADC values were remained high throughout follow-up, which increased by 5 times at 2 months than that at 12 hours. Correspondingly,rADC values showed the contrary pattern of evolution.CONCLUSION: It is reflected that ADC is highly sensitive not only to onset of cerebral ischemia but also to chronic cerebral ischemia.

To probe tentatively into the relations of Terminalia chebula Retz., Terminalia billerica (Gaertn.) Roxb, and Phyllanthus emblica L. between TCM and Tibetan medicine. Methods　Textual researches of materia medica were carried out and their history in clinical application were traced. Results　T. chebula, T. billerica, P. emblica were all of foreign origin and were introduced into China with Buddhism. As compared in medical practice, the Tibetan autonomony region has their particular choice and preference. Conclusion　We should apply modern scientific research achievements to carry out deep mutual exchanges to enrich TCM.