Objective:To introduce the use of fluoxetine in neurologic disease,especially in epilepsy.Method:We used fluoxetine as a supplement antiepileptic drug in 25 patients who couldnt be controlled yet by routine antiepileptics. A long term follow-up with these cases was carried out.Results:Most patients got better outcome.Conclusion:Fluoxetine would be an important supplement antiepileptic drug and have value for further clinical and experimental research.

Objective To establish HPLC method for fast, effective, simultaneous determination of Vancomycin and Norvancomycin in serum. Methods The separation was achieved on the Hypersil ODS2(250 mm ×4.6 mm,5μm)with methanol-acetonitrile-a mixture of potassium phosphate (9.5:2.5:88) as the mobile phase.The flow rate was 1.0 mL/min.The UV detecting wavelength was 280 nm.The temperature of the column was 35 ℃. Vancomycin and Norvancomycin were used as the internal standard for each other .Results Vancomycin and Norvancomycin blood concentration were in well linearity in the range of 1.25-100μg/mL,R2 =0.9996.The average method recovery rate of three concentrations were 96.88%,99.50%,105.01%respectively, the average method recovery rate of three concentrations were 94.40%,103.90,103.81%respectively, the intra-day and inter-day RSD were less than 5%.Conclusion The HPLC method is proved to be simple,sensitive, accurate and precise in which little blood sample is taken, thus it is suitable for the therapeutic drug monitoring(TDM) and pharmacokinetic study of Vancomycin and Norvancomycin.

Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.

Objective To analyze the relationship between the varicosity of esophagus and portal hypertensive gastropathy(PHC) in patients with upper gastrointestinal hemorrhage of hepatocirrhosis. Methods The damage degree of esophageal varicosity was divided into four grades and the PHG were divided into three groups according to the McCormack standards by emergency gastric endoscopy. Results Among 200 patients with upper gastrointestinal hemorrhage,100 cases(50. 0%) were caused by esophageal varicosity explosion and 44 cases(22. 2% ) were induced by PHG,38 cases (19. 0%) were due to gastric ulcer, 18 cases (9. 0%) were duo to other causes. Comparison between etiology and liver function of A-class(except for other reasons group) were significantly different(X2 =4. 23 ,X2 =4. 15 ,X2 =4. 18,X2 =4. 07,P＜0. 05 ;X2 =6. 83 ,X2 =7. 01 ,P＜0. 01 ) ;The portal vein diameter＞1.5cm bleeding incidence(32. 5% ) were significantly higher than the diameter＜1. 1cm bleeding incidence( 12. 5% ) (X2 =4. 73 ,P ＜0. 05 ) ;The degree of PHG in severe esophageal varices (55. 6% ) were significantly higher than the mild esophageal varices( 11.1% )( X2 = 7.73, P＜0. 01 ). The correlation between PHG degree and esophagus varicosity were positive related(r=0.455,X2 = 4.01,P＜0.05). Conclusion The esophageal varicosity explosion and PHG are two major factors to cause hepatocirrhosis complicated with upper gastrointestinal hemorrhagein. The more severe the damage degree of esophageal varicosity is,the higher incidence and the more severe the PHG will be.

With performance evaluation management as the stepping stone,the hospital joined the DRGs with the attending in-charge method by means of enforcing the attending in charge practice,DRGs knowledge training,and identifying problems with DRGs grouped data of the attending physician group, in an effort to explore new methods of medical quality control.Two years of practice provide tools of quality control to strengthen the hospital’s fine management.At the same time,it should also be noticed that DRGs merely diversify management means,as the content and form of which still need to constantly be improved in the course.

Breakthroughs in the immunotherapy of acute leukemia have been achieved in recent years. The paper summarizes the clinical results, experience, and prospect in this area. One of the most significant advancements is the finding that anti-CD19 chimeric anti-gen receptor T cells (CAR-T) or CD3/CD19 bispecific antibody increases the rate of complete remission in patients with refractory re-lapse acute B lymphocytic leukemia. The disease-free survival of patients with low or intermediate risk was dramatically improved by combining chemotherapy and adoptive cytokine-induced killer or natural killer cells. Many immunotherapy methods, such as those fo-cusing on other targets of CAR-T, T-cell antigen receptor-modified T cell, and other targets of bispecific antibodies, are currently being examined. Combined methods can further increase cure rate and improve patients' quality of life, decreasing application of allogeneic hematopoietic cell transplantation which increases risks and reduces the quality of life.

Objective To study the effect of off-pump coronary artery bypass on heart and lung function of patients.Methods 206 patients were randomly divided into the observation group (n=103 cases)and the control group(n=103 cases).The patients in the observation group were operated through off-pump coronary artery bypass, while the patients in the control group were operated through on-pump coronary artery bypass .Left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),plasma N-terminal B-type natriuretic peptide(NT-proBNP) and pulmonary function were measured in two groups .Results The postoperative LVEDD and NT-proBNP of the two groups significantly increased ,and the control group increased more significantly (t=3.226,2.726,all P<0.05).Postoperative lung function were significantly lower in both groups ,and compared with the observation group , postoperative lung function in control group decreased more significantly (t=2.620,2.094,3.016,all P<0.05). Conclusion Off-pump coronary artery bypass not only was less trauma ,but also affect small for the heart ,lungs.

Based on the practice in laboratory animal monitoring, the following issues are suggested: ( 1 ) The core items and candidate items should be separated in the National Standard;(2) Hantaan virus and Ect virus should be omitted in the core list for mice; LCMV should be monitored as a candidate item for rats; TMEV should be listed as candidate item.

The present paper takes an intensive perspective in analyzing learner autonomy and factors influence autonomy.It reveals the actuality of English learning in China,and also gives some advice on how to promote learner autonomy.

FLT can't simply focus on the teaching of grammar,pronunciation and vocabulary,but on its application in practical life.After all,the objective of it is to improve the students' intercultural communication competence.This paper proposes the importance of cultural input in FLT,and analyzes the causes of pragmatic failure,also puts forward several strategies to cultivate students' intercultural communication competence.