Objective] To explore the clinical experience of Ma Weiming in the treatment of insomnia.[Method] By following the teacher clinic, the author summarizes chief physician Ma Weiming’s academic experience of treatment of insomnia with classical prescriptions. [Results] In Ma Weiming's opinion, everything harasses the heart, mind vacillation, inducing liver ’s function of storing soul abnormal, the spirit restless is due to insomnia with much dream. So teacher Ma pays attention to “dream diagnosis”.The treatment of insomnia must be combined with heart and liver, making the mind quiet and the liver comfortable. He likes using flowers to balance Qi. In Ma Weiming's opinion, collaterals are invaded by prolonged illness, due to blood stasis. The treatment should use insect drugs to dispell wind and remove obstruction in the meridians, purifying orifices, promoting sleep. [Conclusion] According to the etiology of insomnia to distinguish among different dreams, teacher Ma uses classical prescriptions and combines with his own unique clinical experience on treating insomnia, which has significant effect and worth generalizing.

Objective To evaluate the treatment effect of PFNA clinical analysis in patients with intertro-chanteric fracture application.Methods 40 cases of intertrochanteric fractures PFNA internal fixation treatment were selected,the operation time,intraoperative blood loss and fractures healing time,degree of hip joint function recovery after operation and the postoperative complications were observed.Results Operating time was 60 -120minutes,with an average of (90.0 ±12.5)minutes.Intraoperative blood loss volume was 200 -600mL,and the average volume was 380.8 plus or minus 58 ml.Fracture clinical healing time was 8 to 15 weeks,with an average of (10.5 ±2.5)weeks. According to Harris hip joint function score,the overall good rate was 85.5%.There were no postoperative complica-tions occurred.Conclusion PFNA applies to all types of intertrochanteric fractures,especially for the old type osteo-porosis bone fracture,which with simple operation,small trauma,fixed firmly,fracture healing fast and less complica-tions.It is worthy of clinical use.

OBJECTIVE: To discuss the correlation between the consumption of antibacterials and the antibiotic resistance of Pseudomonas aeruginosa(PA) in our hospital.METHODS: The total antibacterial consumption expressed as defined daily doses(DDDs/day/100 persons) as well as the synchronous antibiotic resistance rate of PA were computed and the correlation beween the them was analyzed.RESULTS: The resistance rates of PA to cefepime,gentamycin and ciprofloxacin were positively correlated with the consumption of ciprofloxacin.A significant positive correlation was noted between the resistance rates of PA to gentamycin and imipenem cilastatin and the consumption of imipenem.The resistance rates of PA to ceftazidime and ceftriaxone were positively correlated with the consumption of piperacillin/tazobactam.The resistance rates of PA to amikacin and gentamycin were positively correlated with the consumption of amikacin and gentamycin respectively.CONCLUSION: A positive correlation was noted between antimicrobial consumption and antibiotic resistance of PA.

Objective To investigate the surgical treatment of gastrointestinal stromal tumor (GIST) based on the clinical characteristics of GIST in different locations.Methods The clinical data of 486 GIST patients who received surgical treatment at the Peking Union Hospital from January 2003 to December 2012 were retrospectively analyzed.There were 461 patients with primary GIST and 25 with secondary GIST.The clinical characteristics and surgical treatment methods were analyzed.All data were analyzed using the chi-square test.Results Of the 461 patients with esophageal stromal tumors,6 received partial esophagectomy.Of the 234 patients with gastric stromal tumors,183 received partial gastrectomy,23 received proximal gastrectomy + cardiectomy,23 received distal gastrectomy,2 received total gastrectomy and 3 received exploratory laparotomy.Of the 51 patients with duodenal stromal tumors,34 received partial duodenectomy,9 received pancreatico-duodenectomy,5 received pylorus-preserving pancreaticoduodenectomy,3 received palliative surgery.Of the 116 patients with small intestinal stromal tumors,110 received partial small intestinal resection and 6 received palliative surgery.Of the 29 patients with rectal stromal tumors,13 received posterial transsphincteric surgery of the rectum,12 received transanal local resection of rectal tumors and 4 received abdominoperineal resection; laparotomy was performed on 25 patients with GIST in other positions.Of the 25 patients with secondary GIST,10 patients with liver metastasis of GIST received hepatic segmentectomy,1 received hepatobiopsy; 6 received abdominopelvic tumor resection; 5 received portial resection of the small intestine or colon; 1 received sigmoid colostomy; 1 received splenectomy and 1 received intracranial tumor resection.Of the 461 patients with primary GIST,patients who received combined devisceration accounted for 12.58％ (58/461),and the ratio of combined cholecystectomy was the highest,which was 34.5％ (20/58).Combined devisceration was considered for patients with duodenal stromal tumors,gastric stromal tumors and small intestinal tumors.Laparoscopic surgery accounted for 20.39％ (94/461) of all the surgery,and the ratio of laparoscopic surgery which carried out in recent 5 years was 28.52％ (77/270),which was significantly higher than 8.90％ (17/191) of the earlier 5 years (x2=36.67,P ＜ 0.05).Conclusion Different surgical treatment methods including minimally invasive surgery could be adopted according to different clinical characteristics of GIST in different locations,and radical resection of GIST is the main objective.

Objective To investigate the value of the interhospital transportation and the advantage of the cooperative network to the critically ill children.Methods The clinical data of 232 critically ill chil-dren transported from other hospitals in long distances to PICU of Fudan University Affiliated Children Hos-pital cooperated with Shanghai 120 interprovincial transport Department,between Oct 2010 and Oct 2013, were analyzed retrospectively.Results At otal of 232 critically ill childrne were transported from 31 hospi-tals of Eastern China region including five provinces and the city of Shanghai.Among thse e critically ill chil-dren 141 casse were male and 91 cases were femla e,with age from 29 days ot 13 years( median age was 12 months) and weight from 2.5 to 66 kg ( median weight was 10 kg ) .The average pediatric clinical illness score was 80.4 ±7.7,155 cases(66.8%) were single organ dysfunction,55 cases(23.7%) were multiple organs dysfunction,105 cases(45.3%) were mechanical ventilation required fort ransportait on.Referral radi-us was 50-1 000 km(median).Among these patients,87 cases(37.3%) weret ransported over 200 km radius and73 cases(36%) were transop rted 101-200 km,62 cases(26.7%) were transported 100 km or less.D ur-ing the transportation,0 case died,3 cases(1.3%) received cardiopulmonary resuscitation treatment,2 cases (0.9%) received electrical conversion treatment,2 cases(0.9%) were replaced endotracheal intuab tion,the success rate of transportation was 100%.The top 4 disae ses were respiratro y id seases(90 cases,38.8%), neural diseases(43 cases,18.5%) ,cardiovascular diseases(36 cases,15.5%) and acute pediatric trauma(28 cases,12.1%) .Al l 232 cir tically ill children were admitted to our PICU for further treatment through the Green Channel.In the end, 178 cases ( 76.7%) discharged, 24 cases ( 10.3%) gave up and 32 cases (13.8%) died.Among thse e 232 rc itically ill children,30 cases(12.9%) received special organ replacement treatment,4 casse ( 1.7%) of whom were treated with extracorporeal membrane oxyg enation, 26 cases (11.1%) received blood purification therapy.Conclusion Establishing the system of transportation between PICU of hospitals will be propitious to treat the critically ill children energetically and effectively.It is worth pro-moting to master the transportation indication of children with critical illness,which is safe and reliable.

Objective To investigate the effect of sleeve gastrectomy on the intestinal barrier of obesity rats fed with high-fat diet.Methods Thirty obesity rats fed with high-fat diet were randomly divided into three groups including common diet group (CD,n=10),sham operation group (SO,n=10) and sleeve gastrectomy group (SG,n=10).The lactulose/mannitol ratios (L/M) in 24-hour urine and endotoxin in portal vein were evaluated four weeks after surgery.The levels of tight junction proteins including claudin-1 and occludin in intestinal mucosa were analyzed by western blot.Results The body weight of SG group was significantly decreased than those of CD group (P<0.001) and SO group (P<0.001) four weeks after surgery.The L/M ratio in 24-hour urine of SG group was significantly lower than those of CD group (P<0.001) and SO group (P<0.01).The endotoxin level in portal vein of SG group was significantly lower than those of CD group (P<0.01) and SO group (P<0.05).The claudin-1 level in intestinal mucosa of SG group was significantly higher than those of CD group (P<0.001) and SO group (P<0.01) four weeks after surgery.The occludin level in intestinal mucosa of SG group was significantly higherthan those of CD group (P<0.001) and SO group (P<0.001).Conclusions Sleeve gastrectomy can reduce body weight,L/M ratio in 24-hour urine and endotoxin level in portal vein of obesity rat fed with high-fat diet and increase the levels of claudin-1 and occludin in intestinal mucosa.

ObjectiveTo test the expression of epidermal growth factor-like domain 7 (EGFL7),microvessel density (MVD) and foeal adhesion kinase pY397 (FAKpY397) in human glioma tissues,and to evaluate their relationship.MethodsThe expression of EGFL7 and FAKpY397 in 56 cases of human glioma and 8 cases of normal brain tissues were detected by immunohistochemistry test,and MVD was detected by CD34 staining.ResultsThere was a significant difference of the positive rates of EGFL7 between normal brain tissue (0) and gliomas (75％),χ2 =17.45,P ＜0.01.With the increased pathological grade,the expression level of EGFL7 increased (χ2 =26.24,P ＜ 0.01 ).There was a significant difference of the positive rates of FAKpY397 between normal brain tissue ( 12.5％ ) and gliomas (73.2％),χ2 =6.23,P ＜ 0.05.With the increased pathological grade,the expression level of FAKpY397 increased (χ2 =6.71,P ＜ 0.01 ). MVD on normal brain was( 15 ± 4 )/HP,on Ⅰ - Ⅱ grade and Ⅲ -Ⅳ grade gliomas was ( 27 ± 3 )/HPand ( 60 ± 4 )/HP respectively,there was a significant difference on MVD between normal brain tissue and gliomas (P ＜ 0.01 ).Higher level of MVD was found in gliomas with higher grade ( P ＜ 0.01 ).There was a positive correlation between EGFL7 and FAKpY397 expressions in gliomas (r =0.314,P ＜0.01 ).There was a significant difference on MVD between positive and negative expression of EGFL7 ( t =26.55,P ＜ 0.01 ). MVD was (56 ± 4 )/HP and (25 ± 3 )/HP respectively.ConclusionThe expression of EGFL7 of human gliomas has a favorable positive correlation with the degree of malignancy,MVD and FAKpY397.It is indicated that EGFL7not only palys an important regulative role in glioma neovascularization,but also it may participate directly in glioma occurrence and invasion.

OBJECTIVE: To prepare clomipramine hydrochloride sustained release tablet and study its in vitro release rate.METHODS: Orthogonal experiment was carried out to optimize the formulation and the preparation was prepared taking by the formula dosage of HPMC,lactose and amylum pregelatinisatum as factors and the in vitro release rate as index.The in vitro drug release rate was investigated as well.RESULTS: The optimal formulation was as follows: HPMC 45 mg,lactose 35 mg,and amylum pregelatinisatum 40 mg.The preparation prepared in the optimal formulation had a sustained release of 24 h and the release behavior of the tablets followed the zero order equation.CONCLUSION: The formula of the sustained release tablets is reasonable and which had satisfactory sustained release efficacy.

Objective To find out a PPM-based transcutaneous wireless bidirectional communication system for implantable medical device.Methods The wireless communication system included device implanted in the body,controller and PDA outside the body.Pulse position modulation(PPM) was used for the wireless bidirectional communication between device implanted in the body and controller outside the body.Results A PPM-based transcutaneous wireless communication system was realized.Its wireless bidirectional communication distance between device implanted in the body with titanium container and controller outside the body was over two inches.This system was with good position availability.Conclusion Pulse position modulation is successfully used for transcutaneous wireless communication system,and average power consumption for communication device implanted in the body is lowered greatly compared with ASK modulation method.At the same time,the volume of communication device implanted in the body is decreased for antenna common-using idea.

Objective To investigate the multidisciplinary modality for obesity treatment and evaluate the safety and long-term efficacy of laparoscopic adjustable gastric banding(LAGB) on weight loss and obesity related metabolic diseases in obesity patients.Methods The clinical and follow-up data of 28 consecutive morbid obesity patients receiving LAGB in Dept.General Surgery of PUMC hospital in a multidisciplinary modality from Oct 2009 to May 2012 were retrospectively analyzed.The strategy of perioperative and follow-up management was summarized and the safety and long-term efficacy of LAGB on weight loss and comorbidity were evaluated.Results Mean body weight of the subjects was 129.1kg and mean body mass index(BMI)44.9 kg/m2.All patients underwent LAGB successfully without perioperative mortality.Early postoperative complications included 1 case (3.6％) of pulmonary infection and long-term complications included 2 cases (7.1％)of port infection.Mean body weight and BMI decreased gradually after LAGB.The mean percentage of excess weight loss(％ EWL)at postoperative 24 months was 41.3％.％ EWL of the group with regular follow-up and good compliance was significantly better than the other group.Complete or partial remission was observed in obesity related metabolic diseases at the last follow-up.Conclusions LAGB is safe and has good long-term efficacy on weight loss and comorbidity improvement of obesity patients.Better services can be provided for obesity patients in a multidisciplinary modality,It is important for the patients to follow up regularly after surgery in order to maintain long-term weight loss.