In clinical, the common side effects of antipsychotic were extrapyramidal symptoms, drug-induced liver injury, sexual dysfunction, amenorrhea, neutropenia, drug-induced dermatitis, digestive disorders, abnormal increase in body weight, etc. According to patients clinical manifestations of side effects of antipsychotics and chinese medical clinic cognitive model of ‘outer appearance from inside essence’, ‘conjecturing the interior by observing the exterior’, ‘analogy by classifi cation’, ‘identifying etiology by symptoms differentiation’, ‘syndrome determination by drugs’, etc., it can be found that in conventional treatment course, different antipsychotic drugs acted on the different human body may induce different side effects and different toxic reaction, generally including stagnation of heat in spleen-stomach, excessive heat in Yangming, excessive heat generating wind, body fluid deficiency generating wind, internal retention of phlegm and dampness, obstruction of collaterals. TCM differential treatment to antipsychotic-induced disease obtained a more signifi cant effect. Clearing away heat, purgative activity, invigorating qi, nourishing yin, activating blood flow, resolving phlegm were the basic treatment methods, of which nourishing yin, activating blood flow were of particular signifi cance.

Objective To evaluate the safety and efficacy of the general anesthesia for laparoscopy-assisted surgery in aged patients (≥80years). Methods The effects of general anesthesia in 39 patients who underwent laparoscopy-assisted surgery during the period from May 2000 to February 2007 were analyzed retrospectively. All the patients were 80 years old or above, with a mean of 83.3 years old. Among the patients 38 cases had systemic diseases, and some of them had more than one concomitant disease. The systemic diseases included diabetes mellitus in 6 cases, coronary atherosclerotic heart disease in 10 cases, hypertension in 18 cases, arrhythmia in 15 cases, cerebral vascular disease in 8 cases and anemia in 1 case. The laparoscopy-assisted surgery included cholecystectomy in 14 cases, radical resection for rectal cancer in 6 cases, for colon carcinoma in 8 cases, and for kidney cancer in 6 cases, and resection for colonic benign tumor, hernioplasty, gastro-jejunal anastomosis and fenestration of hepatic or renal cysts in 1 patient each. Results During the peri-narcosis period cerebral infarction occurred in 1 patient, and 20 patients were transferred to Intensity Care Unit. After operation 33 patients (84.6%) were cured and 6 patients (15.4%) had the illness condition improved. Conclusions The general anesthesia in laparoscopy-assisted surgery is safe and feasible for the elderly patients over 80 years old. The elderly patients may safely tide over the peri-narcosis period with good prognosis with effective control of complications and concomitant diseases. So the general anesthesia should not be categorically forbidden in laparoscopy-assisted surgery for the elderly patients with complications.

Objective To summarize the experience of anesthesia management of retroperitoneoscopic surgery in aged patients(aged more than 70 years old).Methods The clinical data of 81 aged patients(ranged from 70 to 86 years old,mean:74.2 years old)receiving retroperioneoscopic surgery from October 2002 to January 2007 was reviewed retrospectively in our hospital.Of whom,77 patients had concomitant diseases.81 patients were operated on under general anesthesia.Results Hypercarbia,acidosis and hypertension occurred in 35(43.2%),35(43.2%) and 41(50.6%) cases,respectively,after pneumoperitoneum.Tracheal catheters were pulled out in 66 patients in operation room,with the decannulation time being 5-50 minutes(mean,15.1 minutes).14 patients(17.3%) were transferred to ICU postoperatively.1 patient(1.2%) died from acute myocardial infarction.Sever delirious state was found in 1 patient.Conclusions On the basis of cautious perianesthesia management,aged patients can tolerate hypercapnia,acidosis and elevation of blood pressure induced by pneumoperitoneum,but the management of perianesthesia period should be prudent.

Objective To investigate effects and complications of medline and paramedian approaches for intravertebral anesthesia in knee arthroscopy.Methods A total of 120 ASA I or II patients scheduled for knee arthroscopy were randomly assigned into 2 groups: either receiving midline approach intravertebral block(Medline Group) or paramedian approach block(Paramedian Group).A combined spinal-epidural anesthesia was performed with the single-segment needle-through-needle technique in both groups.The anesthetic response time,successful puncture rate,incidence of paresthesia,incidence of difficult epidural catheterization,incidence of traumatic needle placement,and backache rate and duration of both groups were observed respectively.Values of SBP,DBP,HR,and SpO2 at 1,5,10,30 minutes after anesthesia respectively were recorded.Results There were no significant differences(P

Schizophrenia is roughly equivalent to insanity in TCM.Premorbid personality traits of schizophrenia are similar to the characteristic of stagnation of liver in TCM.The stagnation of liver-qi is a usually cause and main differentiation type of schizophrenia.Early location of this disease is toward to the liver.The stagnant qi of the liver turns into fire,up to brain to interfere the activity of mind,then leads the disease into the acute phase;Stagnation of the liver-qi and the heart-fire affect other organs and lead the disease to its chronic phase:The change of solar term or dramatic disturbances of climate change often leads liver yang to interfere the mind,resulting in recurrence or relapses of schizophrenia.We should pay attention to rule of liver in the treatment,rehabilitation,prevention of recurrence in schizophrenia.When treating schizophrenia,we need pay attention to soothing liver,without inhibiting the sthenic liver-energy;suppressing the hyperactive liver by calming the liver and removing heat from the liver.Soothing liver and strengthening spleen,dispersing liver-qi and regulating stomach are the common treatment.For preventing degeneration,while nourishing liver and kidney,clearing heat and calming the mind should be used at same time;while nourishing liver yin,wind-dispersing,eliminating phlegm,clearing-stasis should be used at same time.Cleaning liver heat,nourishing yin,activating blood and detoxification should be paid attention to when preventing and treating the side effects caused by antipsychotic drugs.

Objective To evaluate the value of Univent tube in the airway management during one-lung ventilation. Methods A total of 40 patients with pneumothorax undergoing video-assisted thoracoscopic surgery (VATS) were randomly divided into Univent (U) and double-lumen tube (Robertshaw) (D) groups (20 in each). In U group, intubation was performed under the guidance of a fibreoptic bronchoscope; while in D group, the position of the tube was confirmed using fibreoptic bronchoscopy after intubation. The time of intubation, number of secondary dislodgements, quality of lung deflation, peak airway pressure during one-lung ventilation, and blood artery gas analysis data in the two groups were recorded 30 minutes after one-lung ventilation. Results The intubation time in U group was significantly longer than that in D group [(6.18?1.26) min vs (3.26?0.82) min, t=8.654, P=0.000]. The number of secondary dislodgements was 7 in U group, and 5 in D group(U=187.500, P=0.663). No significant difference was detected in the quality of lung deflation between the two groups, (U group: 15 excellent, 3 fair, and 2 poor; D group: 17 excellent, 2 fair, and 1 poor;U=179.500, P=0.583). The peak airway pressure during one-lung ventilation in U group was significantly lower than that in D group [(15.3?3.5) cm H2O vs (21.4?6.6) cm H2O, t=-3.649, P=0.001]; and the oxygen pressure in group U was significantly higher than that in group D [(303.8?65.7) mm Hg vs (258.4?72.9) mm Hg, t=2.066, P=0.046]. No significant difference was found in carbon dioxide pressure and oxygen saturation between the two groups. Conclusion During VATS, univent tube showed the same effectiveness and safety as DLT for one-lung ventilation.

Objective To investigate the changes of T cells and dendritic cells (DCs) and their related factors in children with immune thrombocytopenia (ITP) before and after therapy,and to analyze their clinical significance.Methods T-cells and DCs subsets were determined by flow cytometry both in 64 children with ITP (ITP group) before and after therapy and the control group.The serum levels of interleukin (IL)-4,interferon-γ (IFN-γ),transforming growth factor beta 1 (TGF-β1),and IL-27 were detected by enzyme linked immunosorbent assay (ELISA).Results Treatments of glucocorticoid or IVIg were effective in 41 cases of 64 ITP children.Compared to the control group,helper T cells (Th),Th/suppressor T cells (Ts),T regulatory cells (Treg),plasmacytoid DC (pDC),pDC/myeloid DC (mDC),and TGF-β1 in ITP patient group before treatment were significantly lower,while IFN-γ and IFN-γ/IL-4 were significantly higher (P ＜0.05).In ITP group,Th,Th/Ts,Treg,pDC,pDC/mDC,TGF-β1,and IL-27 were significantly increased,while IFN-γ and IFN-γ/IL-4 were decreased in children with ITP after therapy and achieved response (P ＜ 0.05).However,there was no significant difference between before and after therapy in ITP children without treatment response (P ＞ 0.05).Conclusions T cells and DCs subsets disorder and abnormal cytokine levels are observed in children with ITP,which can be corrected by immunosuppressive therapy,indicating that Th1 overactivity and the decrease of Treg and pDC both in quantity and function may be related to the pathogenesis of ITP in children.

Objective:To study the impacts of high power microwave radiation on the testicular germ cell apoptosis in the rats. Methods: Fifty Spraque-Dawley rats were randomly divided into two groups .In the experimental group,the animals were radiated with S wave band 20 mW/cm 2 high power microwave for 5 min, and in the control group,5 rat were not radiated. 5 blank radiation groups served as controls. At the end of process, testicular germ cell apoptosis were detected by in situ terminal deoxymudeotityl transferase mediated dUTP nick end labeling (TUNEL) 6 h , 24 h, 48 h, 72 h and 5d following radiation. Results:In experiment group the amounts of apoptosis cells were more than that of control group 6 h?24 h?48 h following radiation(P0.05). Conclusion: Radiation by HPM for 5 min would result in testicular germ cell apoptosis and damage in the rat.

BACKGROUND:Studies concerning bone marrow mesenchymal stem cells (BMSCs) cultured by umbilical cord serum in vitro were hot topic to avoid the heterogenous serum rejection during BMSC culture and improve culture efficiency of BMSCs.OBJECTIVE:To compare biological feature of BMSCs by the umbilical cord serum and adult autoserum in vitro.DESIGN,TIME AND SETTING:The opening experiment was performed at the Laboratory of Cell Biology,Xiangya Second Hospital,Central South University,China from October 2006 to June 2008.MATERIALS:Sixteen bone marrow samples were provided by Xiangya Second Hospital,Central South University and Xiangtan Central Hospital of Hunan Province.METHODS:BMSCs were obtained from 16 fresh adult bone marrow by gradient centrifugation with Ficoll Paque,cultured with DMEM/F12 with 10% umbilical cord blood serum and 10% adult autoserum.The fourth passage was used in this study.The surface antigens of BMSCs were detected by flow cytometry.BMSCs could differentiate into ostenblasts and adipocytes under culture in conditioned medium for osteogeneais and adipogenesis and the differentiated BMSCs were identified by morphological observation,immunophenotype and immunochemical staining.MAIN OUTCOME MEASURES:The following parameters were measured:morphological observation;cell cycle and cell count;identification of surface antigen;observation of osteoblasts and adipocytea induced from BMSCs by immunochemical staining.RESULTS:The quantity and velocity of BMSCs in umbilical curd blood serum was better than those in adult autoserum (P ＜ 0.05)Only few cells were proliferating in both medium,BMSCs in S phase in umbilical cord blood serum was more than those in adult autoserum (P ＜ 0.05).The positive rate of CD29,CD73 and CD105 on BMSCs in umbilical cord serum (above 90%) was higher than those in adult autoserum (P ＜ 0.05),and the positive rates of CD31,CD34 and CD45 were lower than 2%,and the positive rate of CD31 was lower than those in adult autoserum (P ＜ 0.05).The positive rate of BMSCs differentiated into osteoblasts and adipocytes in umbilical cord blood serum was also higher than these in adult autoserum (P ＜ 0.05).CONCLUSION:Purity and differentiated potency of BMSCs in umbilical cord blood serum are better than those in the adult autoserum in vitro.The umbilical cord serum is more adapt to clinical application.

Objective To study the effect of various methods determining lung volume and fraction dose on the lung dose-volume parameters for lung cancer patients. Methods Twenty patients with lung cancer were rantdomly enrolled into our study and the plan of three dimensional eonformal radiation therapy(3DCRT)was designed by Varian Eclipse TPS.The lung volumes and the dose-volume parameters were measured under CT value of-300- -980, -400- -980 and -500- -980.Under CT value of -400- -980,total lung volumes were confirmed.The dose-volume parameters of V30,V20,V10 and mean lung dose(MLD)were reevaluated after GTV,CTV and PTV were subtracted from the total lung volumes and when the fraction dose was elevated from 2.0 Gy to 10.0 Gy. Results When the CT value ranged from-300--980 to-500--980,the median reduction of the total lung volumes(-9.10%)was significantly higher than that of V30,V20,V10 and MLD(-3.18%,-1.13%,0.82%and-0.79%,respectively).When the total lung volume was fixed at CT value of-400--980,the alterations of V30,V20,V10 and MLD became more apparent as the increase of the subtracted lung volume,among which the alteration of V30 was most significant while V10 the least.Among five cases with a fixed total dose of 60 Gy and PTV less than 140 cm3,the V30,V20,V10 and MLD were increased to a similar extent(about 40%)when the fraction dose was increased from 2.0 Gy to 10.0 Gy.MLD was increased(36%)when the fraction dose was above 6.0 Gy. Conclusions When CT value ranges from-300- -980 to-500- -980,the total lung volume is influenced most.The alteration of V30,being statistically significant,might have some significance but is not enough to determine the plan of radiotherapy clinically.The alteration of V20、V10 and MLD is not statistically significant.When the overlapped target volume is subtracted from the total lung volumes,the alteration of V30 is the most sign:tifhcant while V10 the least.The fraction dose,being the most consuming factor(＞10%)when comparing with the CT valHe and targeted volume,can significantly influence the dose-volume parameter.