Objective To investigate the clinical efficacy of acupoint application in treating senile hypertension of yin deficiency and yang excess type.Methods Sixty-six old patients with hypertension of yin deficiency and yang excess type were randomly allocated to treatment and control groups, 33 cases each. The control group took nifedipine controlled release tablets and the treatment group received acupoint application in addition. The quality of life score was recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results The total efficacy rate in reducing blood pressure was 90.0% in the treatment group and 84.8% in the control group; there was no statistically significant difference between the two groups (P>0.05). The total efficacy rate in improving the symptoms was 90.9% in the treatment group and 69.7% in the control group; there was a statistically significant difference between the two groups (P<0.05). There was a statistically significant pre-/post-treatment difference in the quality of life score in the two groups (P<0.05). There was a statistically significant post-treatment difference in the quality of life score between the treatment and control groups (P<0.05).Conclusions Acupoint application is an effective way to treat senile hypertension of yin deficiency and yang excess type. It can improve the quality of life in the patients.

Objective To investigate the changes in auditory evoked potential index(AAI)value and bispectral index(BIS)value produced by treatment of hypotension with ephedrine or phenylephrine during induction of general anesthesia.Methods Seventy-five ASA Ⅰ or Ⅱ patients of both sexes aged 30-50 yr with body mass index ＜ 30 kg/m2 underwent elective abdominal surgery under general anesthesia.Anesthesia was induced with 8%sevoflurane,midazolam 0.1 mg/kg and fentanyl 3 μg/kg.Tracheal intubation was facilitated with succinylcholine 2 mg/kg.Anesthesia was maintained with sevoflurane inhalation.BIS value was maintained at 40-50 and AAI value at 20-30 by adjusting the concentration of sevoflurane.When the desired level of BIS value and AAI value was reached during induction of anesthesia,hypotension(MAP ＜ 80 % of the baseline)was treated with intravenous ephedrine 0.1 mg/kg(group E,n = 25)or phenylephrine 2 mg/kg(group P,n = 25)or 6% HES(130/0.4)10 ml/kg(group C,n = 25)at random.MAP,HR,BIS value and AAI value value were recorded before(T0)and at 2,5,7,10 min after fluid or vasoactive agent administration(T1-4).Results MAP significantly increased after treatment at T1-4 as compared with MAP at To in all 3 groups.BIS and AAI values were significantly increased after administration of ephedrine at T3,4 as compared with MAP at To in group E.There were no significant differences in BIS and AAI values before and after administration of phenylephrine and 6% HES in group P and C.Con-clusion Treatment of hypotension with ephedrine during induction of general anesthesia can increase BIS and AAI and decrease the depth of anesthesia but phenylephrine cannot.

Objective To compare the effects of sedation induced with dexmedetomidine and propofol on intracranial pressure and cerebral oxygen metabolism in patients with permissive hypercapnia. Methods Twentyfour patients with acute respiratory distress syndrome (ARDS) were randomly divided into 2 groups ( n = 12 each) :dexmedetomidine group (group D) and propofol group (group P) . Their APACHE Ⅱ scores were 11-18. The patients were mechanically ventilated (VT 5-7 ml/kg, RR 12-17 bpm, PEEP 6-10 cm H2O, FiO2 40-60%). PaCO2 was maintained at 50-65 mm Hg. Radial artery was cannulated for direct BP monitoring and blood sampling. Right internal jugular vein was cannulated and the catheter was advanced cephalad until jugular bulb. Continuous infusion of dexmedetomidine was started at 0.5 μg· kg-1· h-1 and TCI of propofol was started at target plasma concentration (Cp) of 0.4 μg/ml. The infusion of both drugs was gradually increased until Ramsay score (1= fully awake, 6 =asleep, unresponsive to loud verbal stimulus) reached 3,4,5. Transcranial Doppler monitoring was used to determine cerebral blood flow velocity (CBFV), pulsatility index (PI) and resistance index (RI) before administration of dexmedetomidine and propofol (T0 ) and at 30 min after the 3 levels of sedation were reached (T1-3) . Meanwhile blood samples were taken from radial artery and jugular bulb for blood gas analyses. Cerebral O2 metabolic rate (CMRO2), cerebral A-V O2 content differences (Da-jvO2) and cerebral O2 extraction rate (CERO2) were calculated .ResultsCBFV, PI, RI and CMRO2 were significantly decreased at T1-3 as compared with the baseline values at T0 in both groups. CBFV was positively correlated with CMRO2 in both group D (r = 0.80) and group P ( r = 0.76) . CBFV, PI and RI were significantly lower at T1-3 in group D than in group P. There was no significant change in Da-jvO2 and CERO2 at T1-3 as compared with the baseline values at T0 in both groups. Conclusion At different sedation levels, dexmedetomidine results in lower intracranial pressure than propofol and maintains the balance between cerebral O2 supply and demand in patients with permissive hypercapnia.

Vasovagal syncope (VVS) is the most common cause of transient loss of consciousness ( TLOC ),mainly with head-up tilt test (HUTT) for diagnosis and treatment evaluation.Beacause of potential risks in the process of HUTT,it is necessary to explore an early,accurate,safe,effective,inexpensive and convenient means of diagnosis and evaluation for VVS.The means of quantitative history are now in practice of clinical trials.The means commonly used are Calgary Presyncope Form (CPF)and three questionaires about point scores in the Calgary syncope symptom studies.Due to its stable,simple and easy to apply features,CPF has some advantages on assessing the effectiveness of different treatment methods for VVS.The three questionnaires have some application potential in diagnosis for VVS.

Objective　To investigate the changes and its clinical significance of plasma neuropeptide Y(NPY) concentration in patients with pregnancy induced hypertension (PIH). Methods　Plasma NPY levels were detected by radioimmunoassay in 30 patients with PIH, 20 normal non-pregnant women and 23 normal pregnant women. The PIH group was subdivided into mild, moderate and Severe subgroups, and the NPY concentration was also measured in these subgroups respectively at admission and one week after delivery. Results　The plasma NPY levels in patients with PIH ［(164.16±68.32) ng/L］ were significantly higher than those of normal non-pregnant women and normal pregnancies ［(86.60±20.65) ng/L, (82.42±12.46) ng/L, P<0.01, respectively］. There was significant difference among plasma NPY levels among the patients with mild, moderate, and severe PIH at admission (P<0,01). At one week after delivery the concentrations of plasma NPY were significantly decreased in the moderate and severe subgroups compared with the value measured at admission (P<0.01). Moreover, the NPY levels in patients with severe PIH after delivery were still higher than those of normal non-pregnant women. Conclusions　The results suggested that the level of NPY in plasma is increased in women with PIH. Elevated plasma NPY levels may play a key role in the development of PIH.

Objective To investigate the efficacy of dexmedetomidine in reduce of hyperalgesia in patien with remifentanil anesthesia.Methods 84 patients scheduled for laparoscopic hysterectomy from December 2014 to April 2016 were selected and randomly divided into two groups: the observation group and the control group,42 cases in each group,two groups were intravenous infusion of remifentanil,propofol and inhaled sevoflurane to maintain anesthesia.In the observation group,0.6μg/kg of dexmedetomidine was given 40minutes before the end of the operation(adding to 100mL 0.9％sodium chloride solution,infusion within 10minutes),the control group was given the same volume of 0.9％sodium chloride solution.The visual analogue scale(VAS)and the bruggrmann comfort scale(BCS)were used to evaluate the postoperative pain and comfort of the two groups of patients at different time points,and compare the incidence of adverse events between the two groups.Results The VAS scores of the two groups were significantly different at 1h(T1),4h(T2)and 24h(T3),and the VAS score of the observation group was significant better than that of the control group,the difference was statistically significant(P<0.05),the BCS scores of two group were compared at T1 and T2,the difference was statistically significant(P<0.05),but there was no significant difference between the two groups at T3.The incidence of adverse reactions in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine can relieve and prevent the incidence of hyperalgesia and adverse reactions in patients with remifentanil anesthesia,and improve the analgesic effect of postoperative patients.

Objective:To evaluate the quality condition and problems of acetylspiramycin at present. Methods:According to the standard described in Chinese Pharmacopoeia (2015 edition), acetylspiramycin and its preparations were determined, and the overall quality level of domestic acetylspiramycin was evaluated. The related substances, components and dissolution were analyzed to further explore the quality status. Results:In 258 batches of samples, the dissolution of only one batch did not meet the standard with the passing rate of 99. 6%. The results of exploratory research showed that the content of impurities in raw material was determined by the synthesis process, and the impurity profile of domestic and foreign formula was different. The dissolution behavior of domestic and for-eign formula in four kinds of media was not similar as well. Conclusion: The quality of domestic acetylspiramycin is promising. The research of related substances provides the reference for controlling the target impurities. The consistency assessment of dissolution pro-vides the reference for the formula process improvement and clinical application of acetylspiramycin tablets.

In recent years, the incidence of the allergic skin diseases is increasing as the growing of the pressure, the changes of the environment and other factors. The clinical features of the allergic skin diseases are easily repeated and in long course. It is found that the incidence of clinical allergic skin diseases, in addition to the season, diet and emotional relevant, is also closely linked to the physical deterioration of patients. Therefore, in addition to the emphasis on the treatment of the current symptoms of patients, adjustment and treatment of phsical constitution of patients and improvement of the adaptability of patients to environmental changes should attract attention, thereby reducing the frequency of incidence and alleviating the symptoms. The application of the abdominal acupuncture combined with body acupuncture for the improvement of the symptoms and physical constitution of allergic skin disease patients has obvious efficacy, which should be applied and promoted in clinic.

OBJECTIVE:To probe into the situation of drug use that goes beyond the scope of package inserts in pediatrics of our hospital and to promote clinical rational drug use.METHODS:A total of 3 142 prescriptions between Mar.and Apr.2006 collected from the pediatric out-patient department of our hospital were analyzed in accordance with the contents of the related drug package inserts.RESULTS:Of the total 3 142 prescriptions,345(11.0%) involved drug use that goes beyond the scope of package inserts,leading the list were prescriptions of infants,accounting for 71.3% of the total.The problems such as age(52.2%) and indication(36.5%) were the main type;respiration system drugs(48.4%) and the antibiotics(40.6%) were the main drug kinds involved.CONCLUSIONS:It's widespread for drug use that goes beyond the package inserts in the pe-diatrics,which conforms to evidence-based medicine and the spirit of philosophy and ethics,but against the principle of law,which thus should be given fully attention in the clinic.

This article described the importance of mechanism refonil in the graduate student training and presented its contents.Also,It summarized the characteristics of the reforill proposals in some universities,and analyzed the problems required to attend and solve ia the refogln.The characteristics of the proposals included to set up innovative fund by university,to perform the student awarded police of tutor leading,to establish the scientific system in recruiting students.By analyzing the problems developed during the reform four measures were lannched,which included to establish evaluating system in assessing students,to create a good relationship between students and tutors,to improve the ability and morality of tutors,and to adjust the management method of research funding.It would be possible to reach the objective of perfecting the reform proposal during the implementation of the measures.