The‘prevention and early treatment of diseases’conception as‘Huangdi Neijing’suggested,is the highest academic realm among the Chinese medical theory,it flows through the entire process of Chinese medical theory and diseases prevention.Four aspects of the prevention conception manifested in the process of Chinese medical prevention of diseases are: Taking preventive measures before confirmed diagnosis(health cultivation),impeding diffusion after confirmed diagnosis, deterring diffusion from deterioration,and restraining deterioration from being malignant.The malignant causal chain conversion of the coexistence of asthenia and sthenia is considered as the inducing links of critical illness’occurrence,evolution and transformation.Therefore,to intercept the malignant causal chain conversion comes to the key technique of Chinese medical remedy for critical illness.The‘prevention and early treatment of diseases’conception must impenetrate the versal process of treating critical illness.The overall clue and method of Chinese medical remedy for critical illness is to identify and grasp the vital contradiction and each respect of the malignant causal chain conversion which concurs with the evolution of the critical illness,simultaneously utilize the method which combined the prevention in etiology and pathogenesis with the remedy in etiology and pathogenesis,then actuate the pathologically changed organism to extricate from critical conditions at the first opportunity, finalizing with convalescence and recuperation thereafter.

Objective To compare the efficacy in radical cure of H.Pylori (Hp) by different proton pump inhibitor (PPI)-based treatment regimens.Methods One thousand two hundred and three H.Pyloriinfected patients diagnosed by both endoscopic pathology and a rapid urease test were enrolled in this study.Reviewed 13 C-urea breath test at the end of Hp eradication treatment for more than 4 weeks,and retrospective analyzed the different effect of Hp eradication regimens.All patients were given treatment regimens,which including PPI (esomeprazole azole,bella,esomeprazole,pantoprazole omeprazole,2 times/d) plus antimicrobial for 7,10,14 d.According to antimicrobial,patients were divided into A,B,C,D,E group.Patientss in group A(421 cases) were given amoxicillin 1.0 g,2 times/d,clarithromycin 0.5 g,2 times/d;In group B (49cases) were given amoxicillin 1.0 g,2 times/d,levofloxacin 0.2 g,2 times/d;In group C(69 cases) were given amoxicillin 1.0 g,2 times/d,metronidazole 0.4 g,2 times/d;In group D(559 cases) were given clarithromycin 0.5 g/d,2 times/d,levofloxacin 0.2 g,2 times/d and in group E(105 cases) were clarithromycin 0.5 g,2times/d,metronidazole 0.4 g,2 times/d.Bismuth were colloidal bismuth pectin 200 mg,2 times/d.Results The radical cure rate of Hp was 84.04％ (453/539) in the group treated by regimens with Amoxicillin,and significant higher than that of without Amoxicillin (69.12％ (459/664),x2 =36.104,P =0.000),and the radical cure rate of Hp was 14.92％.The Hp radical cure rate of quadruple therapy was 76.85％ (767/998),while triple therapy was 70.73％ (145/205).However,no significant difference between these two regimens was found(x2 =3.476,P =0.062).The Hp radical cure rates of 14-,10-and 7-day course therapies were 84.28％ (134/159),75.79％ (579/764),71.07％ (199/280) respectively,and there was significant different among the three groups (x2 =9.644,P =0.008).There was significant increases trend in the 14-day therapy group comparing to 10-and 7-day regimen groups (x2 =5.399,11.719,P =0.020,0.001 respectively),while no significant difference was shown between the 10-and 7-day therapy groups(x2 =2.398,P =0.121).The radical cure rates were 84.80％ (357/421),81.63％ (40/49),81.16％ (56/69),69.95％ (391/559),64.76％(68/105) respectively in A,B,C,D and E groups,and there was significant difference among the groups (x2 =37.999,P =0.000).Conclusion Radical cure therapy of Hp should be PPI-based.A 14-day triple or quadruple treatment regimen with combination of Amoxicillin and clarithromycin is suggested as a first-line therapy.It is worth to clinically popularize such regimens in the light of the superior efficacy.

Objective To investigate neurological recovery effect and mechanisms of blood activating and phlegm removing decoction in the treatment of patients with hypertensive cerebral hemorrhage.Methods 68 patients with hypertensive cerebral hemorrhage in our hospital were divided into two groups.34 patients of the control group were given conventional western medicine,and 34 patients of the observation group were taken conventional western medicine combined with blood activating and phlegm removing decoction.The clinical outcomes, hematoma volume change and neurological recovery were compared,and analyzed its mechanism of action.Results The effective rate of the observation group(94.12%) was significantly higher than 73.53%of the control group (χ2 =5.31,P<0.05). After 7d,14d,21d treatment,NIHSS scores of the observation group [(12.87 ±1.43) points,(8.55 ±1.11) points and (5.67 ±0.76) points] were significantly lower than those of the control group [(20.43 ±2.57) points, (17.66 ±2.08)points,(14.54 ±1.44)points],and the differences were statistically significant (t=14.99,22.53, 31.76,all P<0.05).After treatment,hematoma volume of the observation group[(6.44 ±0.54)mL]was significant-ly lower than before treatment[(16.30 ±1.90)mL]and after treatment in the control group [(12.11 ±1.44)mL] (t=29.11,21.50,all P<0.05).After treatment,ALD score of the observation group [(66.34 ±5.22)points] was significantly lower than before treatment[(27.53 ±2.20)points]and after treatment in the control group[(47.55 ± 3.33)points],and the differences were statistically significant(t=39.95,17.70,all P<0.05).Conclusion The effect of blood activating and phlegm removing decoction in the treatment of patients with hypertensive cerebral hemor-rhage is significant,can significantly improve neurologic impairment and daily living skills,has no obvious conflict of interest and high application value,worthy of promotion and application.

ObjectiveTo investigate influence on adults'visual function and fluid intelligence with N-back working memory training based on Gabor signal.MethodsControlling group including 13 adults had no training,training group including 14 adults received an eight-days training,half an hour a day.The stimulus was N-back training which has on improved Gabor signal with adjustable spatial frequency and contrast sensitivity.The contrast sensitivity and fluid intelligence were record using OPTEC 6500 and Raven's Standard Progressive Matrices before and after training,then the data was analyzed and processed by SPSS.ResultsContrast sensitivity:there was a siguificant different of the contrast sensitivity between pretest and posttest ( ( 1.93 ± 0.17 ) log,( 1.76 ±0.20 ) log) in training group ( t =-4.579,P =0.001 ).Fluid intelligence:there was a significant different of fluid intelligence between pretest and posttest( ( 129.9 ± 9.0 ) scores,( 113.7 4-16.0 ) scores ) in training group ( t =-4.373,P =0.001 ),and superior to controlling group,which also had a statistical significance (F =1.353,P =0.004).ConclusionThe method of N-back working memory training based on Gabor signal not only enhances working memory and fluid intelligence,but also improves the visual function effectively,and more various effect is acquired comparing to traditional training method.

Objective To validate the accuracy of the colorectal cancer model of the Association of Coloproctology of Great Britain and Ireland(ACPGBI-CCM),and to find out the relationship between clinical risk factors and the predictive value produced by ACPGBI-CCM.Methods The patients diagnosed definitely as colorectal cancer in the department of anal-colorectal surgery,West China hospital from April 2007 to July 2007 were analyzed retrospectively.And the predictive value of mortality for each patient was calculated by ACPGBI-CCM,then the difference of risk factors was compared by classifying the patients into lower risk group and higher risk group by making the median predictive mortality as a cut point.Results From April 2007 to July 2007,a total of 99 patients diagnosed definitely as colorectal cancer accepted treatment,and among which 67 patients included in this study were admitted whose average age was 60.09 years.And there were 34 male and 33 female patients;15 right hemicolon cancer,9 left hemicolon cancer,43 rectal cancer;Dukes staging:A 0 case,B 37 cases,C 24 cases,D 6 cases.The observed mortality 30 days after operation was 0,whereas the predictive mortality was 0.77%-25.75% with a median value of 3.36%.Then the patients whose predictive mortality were ≤3.36% were grouped as lower risk group(34 cases),the others higher risk group(33 cases),and there was strikingly different predictive mortality between two groups 〔(8.86?4.51)% vs(1.76?0.68)%,P0.05).Furthermore,stratification analysis was made for risk factors,and it came out that there were great differences of predictive mortality for different age groups and ASA grading,having internal medicine complications or not,having chemotherapy or not,and for cancer resected or not,and the differences were statistically significant(P0.05).Conclusion The clinical applicability of the ACPGBI-CCM is ascertained in such a large volume single medical centre,but the ACPGBI-CCM overpredicts the mortality in this study which may be attributed to the different areas,nations,or the different cultures.The complications and the neo-adjuvant or adjuvant therapy are further found out that they may be independent predictive factors of survival,and more research will be needed to prove this.

Objective To investigate clinical value of three-dimensional transvaginal sonography (3D-TVS) in the diagnosis of septate uterus and the relationship between its parameters and adverse pregnancy.Methods From Mar.2010 to Sept.2011,73 patients (aged 23-35 years) with septate uterus who were diagnosed by 3D-TVS in Fujian Province Maternal and Child Health Hospital were enrolled in this retrospective study.The septum width,septum angle,septum length and the length of remaining uterine cavity were measured among the patients with subseptate uterus,and then,the distortion rate was calculated.The hysteroscopic surgery was used as the gold standard,and the diagnostic titer of 3D-TVS in the diagnosis of septate uterus was determined.Receiver operating characteristic curve (ROC) were plotted to evaluate the diagnostic titer of uterine parameters measured by 3D-TVS in predicting the adverse pregnancy outcome among patients with subseptate uterus.Univariate logistic regression was used to analyze the effectiveness of uterine parameters on adverse pregnancy outcome.Results Using hysteroscopic surgery as the gold standard,the coincidence rate of diagnosis of septate uterus by 3D-TVS was 94％ (69/73).Among the patients with septate uterus,25％ (17/69)were complete septate uterus,75％ (52/69) were subseptate uterus.Among patients with subseptate uterus,the septum length [(2.2 ± 0.6) cm] and distortion rate in patients with adverse pregnancy(0.60 ± 0.10)were significantly higher than those without adverse pregnancy [(1.5 ±0.6) cm,0.43 ±0.13,both P ＜0.05].However,no significant difference in the width,angle and length of septum were observed between the two groups (P ＞ 0.05).The area under ROC curve (AUC) of septum length and distortion rate in determining adverse pregnancy were 0.833 (95％ CI:0.721-0.944) and 0.800 (95％ CI:0.671-0.929),respectively.The optimal cutoff point of septum length was 1.94 cm,with the sensitivity was 74.3％ and the specificity was 76.5％ ; the optimal cutoff point of distortion rate was 0.48,with the sensitivity was 77.1％ and the specificity was 76.5％.The expectation morbidity ratio of adverse pregnancy was 2.717,3.067 and 0.514 by every adding level of septum length,distortion rate,and length of remaining uterine cavity,respectively.Conclusions 3D-TVS showed high accuracy in diagnosis of septate uterus.The septum length and distortion rate may predict the risk of adverse pregnancy,and the value of them can be used for screening adverse pregnancy in clinical practice.

OBJECTIVE:To prepare nanostructured lipid carrier of adefovir dipivoxil(ADV-NLC),and optimize the formula-tion. METHODS:Using stearic acid and glycerin monostearate as solid lipid,oleic acid as liquid lipid,Gemini surfactant and poly-sorbate 80 as emulsifier,sodium dodecyl sulfate (SDS) as stabilizer,solvent dispersion ultrasonic method was used to prepare ADV-NLC. And using particle size,polydispersity index,Zeta potential,encapsulation efficiency as indexes,single factor test was conducted to screen Gemini surfactant-polysorbate 80 ratio,emulsifier dosage(ratio of emulsifier to water phase),drug-lipid ratio, solid-liquid lipid ratio. RESULTS:The formula was as follow as 3% emulsifier (Gemini surfactant-polysorbate 80 ratio of 1:2), 4.5% drug-lipid ratio,solid-liquid lipid ratio of 6:5. The average particle size of the prepared ADV-NLC was(48.83±2.65)nm, polydispersity index<0.3,Zeta potential was(-28.7±1.8)mV,encapsulation efficiency was(77.65±0.03)%(n=3). CONCLU-SIONS:ADV-NLC is successfully prepared,and the formulation is reasonable and feasible.

Objective To make a systematic review of pressure ulcers risk factors in critically ill patients. Methods We systematically reviewed all articles related to the pressure ulcers risk factors in critically ill patients. The Cochrane Library, PubMed, EMBASE, Web of Science Core Collection, CNKI, WANFANG and SinoMed were searched to August 2016. Results In total, 13 eligible articles were included. These studies included 18, 184 critically ill patients, six studies were classified as high quality, and seven were classified as moderate quality. Risk factors for the development of pressure ulcers include age, ICU stay, diabetes, mean arterial pressure<60-70 mmHg (1 mmHg=0.133 kPa), mechanical ventilation and mechanical ventilation, drugs, sedation and postural changes. Conclusions There is no single factor that can explain the occurrence of pressure ulcers. So it is in a variety of factors interaction, the occurrence of a significant increase in risk.