OBJECTIVE:To analyze the clinical efficacy of edaravone combined with Xingnaojing in the treatment of acute severe head injury.METHODS:72 patients with acute severe brain injury were collected from Nov.2008 to Nov.2009 and randomly divided into 2 groups.Treatment group were treated with edaravone and Xingnaojing and control group received edaravone alone.14 days after treatment,APACHE-Ⅱ and GCS score were collected.The overall efficacies of 2 groups were evaluated three months after suffering from injury.RESULTS:The GCS score of treatment group was increased while APACHE-Ⅱ score was decreased,there was statistical significance in difference between 2 groups(P

This study was aimed to observe the tongue image characteristics at different renal function stages among 157 chronic kidney disease (CKD) patients. Tongue images of 157 CKD cases and 30 healthy people were recorded with the instrument designed by Shanghai University of Traditional Chinese Medicine. Parameters of the tongue image were compared among different renal function stages. The results showed that compared with the control group, there were obvious decreasing on the R and L indexes in groups of different renal function stages (P < 0.05). Compared with the control group, there were obvious decreasing on the G and B indexes in groups of CKD1, CKD2, CKD3 and CKD4 stages (P < 0.05). Compared to CKD4 stage, there were obvious decreasing on the R, G, B, L indexes from group of CKD1 and CKD2 stage (P< 0.05). Compared with the group of CKD5 stage, there were obvious decreasing in the group of CKD1, CKD2, and CKD3 (P< 0.05). Compared with the control group, the cracking index was obvi-ous increased in 5 stages (P < 0.05). There was obvious difference in the greasy index between the group of CKD5 stage and the control group (P< 0.05). Compared with the control group, there was obvious difference in the peeling index from the group of CKD3, CKD 4, CKD5 stage (P < 0.05). Along the decreasing of renal function, compared with the group of CKD5 stage, there was obvious decreasing on the greasy index and peeling index in the group of CKD1 and CKD2 (P< 0.05). It was concluded that Chinese medicine tongue and face diagnosis instrument can pro-vide certain objective evidence for the clinical diagnosis of CKD.

Objective To evaluate effects and safety of gonadotrophin-releasing hormone agonist (GnRH-a) combined with transdermal estradiol and medroxyprogesterone acetate in the treatment of endometriosis. Methods From January I st, 2007 to July 31 st, 2007, 28 endometriosis patients underwent laparnscopic or transabdominal surgery in Obstetrics and Gynecology Hospital affiliated to Fudan University were randomly divided into group A and group B. 14 patients in group A received 3.6 mg goserelin once every 4 weeks, 12 weeks in all 14 patients in group B received goserelin and added 1/2 piece of half-hydrate estradiol every week and 6 mg oral medroxyprogesterone acetate per day, 12 weeks in all. Serum estradiol (E2 ), follicle stimulating hormone(FSH), bone gla protein levels, visual analogue scale (VAS) of pain, bone mineral density of lumbar spine, vaginal exfoliate cell spurs and the form of Kupperman were compared in patients before and after treatment. Results (1 ) After treatment, the level of FSH and E2levels were (5.0 ± 2. 6 ) U/L and (29 ± 17 ) pmol/L in group A and (3.0 ± 1.5 ) U/L, and (87 ± 53 ) pmol/L in group B, which were significantly lower than those before treatment [FSH (17. 0 ± 12. 2) U/L, and E2 (184 ± 194) pmol/L in group A and FSH :(15.3±13.6)U/L and E2: (281±242) pmol/L in group B, P ＜ 0. 01]. On the seventh day after three-month GnRH-a treatment, it was observed that the level of E2 was higher and FSH was lower in group B than the level of E2 and FSH of group A (P ＜ 0. 01 ). (2 ) After treatment, the basal vaginal exfoliate cell proportion in group A [(66. 2 ± 29. 0) %] was significantly lower than that in group B [(11.8 ± 28. 0) %, P ＜ 0. 01] ; while patients in group A owned a lower proportion of the middle [(29. 1 ± 23.1 ) %], superficial layers [(4. 0 ± 5.5 ) %] and esinophilic cells [(2. 3 ± 2. 6)%]than patients group B [middle layer: (73. 0 ± 25.2)% ; superficial layer: (15. 2 ± 10. 9)% ; esinophilic cells: (10. 8 ± 7.9 ) % ; P ＜ 0. 01]. (3) Before the treatment, patients' VAS scores of total, pelvic pain, dysmenorrheal and dyspareunia were 7.43±3. 20,2. 35 ± 1.82, 4. 93 ± 1.98 and 0. 14±0. 53 in group A and were 7.71±2. 02, 2. 57 ± 1.60, 4. 86 ± 1.56 and 0. 29 ± 1.07 in group B; after treatment, the scores above were changed to 0. 14±0. 36,0. 07±0. 27,0. 07±0. 27and 0 in group A and 0. 36±0. 50, 0. 29±0. 47, 0. 07±0. 27 and 0 in group B, which were all significantly lower than those before treatment separately (P ＜0. 01 ). When menstruation recovered, the scores were 0. 21±0. 43, 0. 07±0. 27, 0. 14 ± 0. 36, and 0 in group A and 0. 50±0. 65, 0. 29±0. 47, 0. 21±0. 43 and 0 in group B, which were also significantly lower than those before treatment (P ＜ 0.01 ), however, no statistical difference was found between groups at any time spot(P ＞ 0. 05). (4) In group A, the bone density after treatment [(0. 96 ± 0. 06 ) g/cm2] was lower than that before treatment [(0. 99 ± 0. 06 ) g/cm2, P ＜ 0.01 )]. In group B, the index was (0. 98 ± 0. 09) g/cm2, which was lower than that before treatment [(0. 99 ± 0. 10 ) g/cm2, P = 0. 201]. No statistical difference was found between groups(P ＞ 0. 05 ). The bone loss rate were (- 2. 77 ± 1.97 ) % in group A and (- 0. 93 ± 2. 86 ) % in group B (P = 0. 058 ). Before treatment, the bone gla protein was (13±3) μg/L in group A and (13±6) μg/L in group B. After treatment, the bone gla protein levels was (17±6)μg/L in group A, which was higher than that before treatment (P ＜ 0. 01 ), the level was (16±6)μg/L in group B, which was higher than that before treatment, however showed no statistical difference(P =0. 053). No difference was found in bone gla protein before and after treatment between two groups (P＞0. 05). (5) The form of Kupperman after treatment were 15±7 in group A and 11±6 in group B, which did not show significant difference (P ＞ 0. 05 ). The incidence of flash and sweat were 93% (13/14)in group A, which was significantly higher than that 57% (8/14) in group B(P ＜0.01 ). Conclusion The add-back therapy that consists of an estradiol patch and oral medroxyprogesterone acetate is effective and safe treatment for endometriosis.

Objective To explore facial characteristics of patients with different organ diseases; To provide some references for objective study on TCM inspection information. Methods Smart TCM-I type Life Information Analysis Systems was used to detect facial characteristics of 510 patients with five zang-organs diseases. 36 specific quantitative parameters including red ?, green (G), blue (B) and hue (H), saturation (S), value (V) of the face, forehead, eyes, cheeks, nose and chin were collected, and the Kruskal M-Wallis H and Nemenyi test were used for statistical analysis. Results Among the 510 patients with five zang-organs diseases, 96 patients belonged to lung system diseases, 105 heart system diseases, 101 liver system diseases, 107 spleen and stomach system diseases and 101 kidney system diseases. There was statistical significance in R, G, B, H, S, and V in forehead, eyes, cheeks and nose. Conclusion Facial characteristics can provide objective references for the facial division of five zang-organs diseases.

Objective To explore the relationship between posttraumatic stress disorder and nurses′ psychological capital. Methods By convenient sampling, totally 550 nurses in 5 first-class upper level general hospitals in Zhejiang province were investigated by the posttraumatic stress disorder (PTSD)Cheeklist-Civilan Version (PCL-C) and Nurses Psychological Capital Questionnaire Revision (NPCQR), and the results were analyzed. Results 18.35%investigated nurses showed a certain degree of PTSD symptoms and 13.71% showed obvious PTSD symptoms. The positive rate was 32.06%.The overall score of nurses′psychological capital was 78.81 ± 16.54, which was in the middle level, and the dimension scores from high to low were self-efficacy (23.80±5.35), hope (23.36±5.24), resilience (19.66 ±4.29), and optimism (11.99 ± 3.21). The nurses′psychological capital had a negative effect on posttraumatic stress disorder (P<0.01). Conclusions Psychological capital of nurses is a negative predictor of PTSD symptoms, which suggested that managers should pay more attention to the development of nurses′psychological capital to reduce and prevent the occurrence of posttraumatic stress disorder,then to improve nursing service quality.

This study was aimed to observe bronchial asthma patients in remission after treatment of traditional Chi-nese medicine(TCM) with four diagnostic information, syndrome differentiation and changes oflung function indicators, in order to explore the efficacy evaluation with TCM characteristics. TCM tongue manifestation instrument, TCM in-quiry scale, pulse-taking instrument, acoustic diagnostic information collection system, and spirometer were used in thecollection of 33 bronchial asthma cases in remission before and after treatment (1~5 months) basedon four diagnos-tic information and lung function indexes. Single-factor analysis of variance and other methods were used in the analysis of four diagnostic parameters and lung function indexes before and after treatment. The results showed that after TCM treatment, there were significant changes on indexes such as facial complexion, tongue sub-region color, color of tongue coating and other parameters. There was significant difference in the acoustic parameters before and after treatment. After TCM treatment, the frequency of lung system symptom such as nasal obstruction was decreased. There was no significant difference on changes of pulse-taking indexes among asthma patients before and after treat-ment. After treatment, the FEV1.0% of asthma patients was increased,whichindicated that asthma ventilatory function had been improved to some extent. It was concluded that TCM objective test provide an effective basis for the diag-nosis of bronchial asthma on aspects such as TCM syndrome, disease change observation and clinical evaluation.

This study mainly explored the pulse parameters in children with RRTI with different TCM syndromes,aiming at providing therapeutic indexes and objective basis for its diagnosis and treatment.Three hundred and forty-eight cases of RRTI were divided into five groups,including the group of qi deficiency in the lung (or Fei Qi Xu,FQX),the group of invasion of the lung by wind-heat (or Feng Re Fan Fei,FRFF),the group of invasion of lung by wind-cold (or Feng Han Fan Fei,FHFF),the group of obstruction of phlegm-damp in the lung (or Tan Shi Zu Fei,TSZF) and the group of obstruction of phlegm-heat in the lung (or Tan Re Yong Fei,TRYF).65 children of good health were involved in the control group.Z-BOX pulsemeter apparatus was applied to the paraticipants for analyzing their pulse parameters.As a result,it was found that values of h1,h3,h4,h5,t and h4/h1 of RRTI children decreased,compared with the children of good health (P ＜ 0.01);while h1,h3,h4 and h5 of children in FQX group declined (P ＜ 0.01);and the values of h4,h5,t,w,h3/h1,h4/h1 and h5/h1 of children in FRFF group went down (P ＜ 0.01);while the values of h1,h3,h4,h5,t,w,h3/h1 and h4/h1 of TRYF group fell (P ＜ 0.01);and those of h5,t and h5/h1 of children in FHFF group decreased (P ＜ 0.01).Compared with FQX group,h1 value of FRFF group increased (P ＜ 0.01),while the values of w,h3/h1,hs/h1 and w/t of FRFF group declined (P ＜ 0.01);and the h1 value of TSZF group boosted (P ＜ 0.01),while the value of w and h3/h1 of TRYF group decreased (P ＜ 0.01);and the h5/h1 value of FHFF group fell (P ＜ 0.01).In comparison with FRFF group,the values of t,w and h5/h1 of TSZF group went up (P ＜ 0.01),while the values of h1 and h3 of TRYF group declined (P ＜ 0.01).In comparison with TSZF group,the values of h3,h4,t and w of TRYF group went down (P ＜ 0.01),and the t value of FHFF group decreased (P ＜ 0.01).In conclusion,the pulse parameters of RRTI children can be recognized as objective indicators for TCM syndrome differentiations.

Objective To investigate the associated protein markers in urine of patients with chronic renal failure (CRF) based on surface enhanced laser desorption and ionization time of flight mass spectrometry (SELDI-TOF MS)technique.Methods Urine samples were taken from 150 CRF patients and 50 healthy people,and investigated by proteomic techniques with H4 gene chip.Results Compared to healthy group,141 different protein peaks were identified within the range of 1000 to 20 000 M/Z in the protein map of CRF group,whose differences were all significant (all P＜0.01).The decision tree model for CRF urine was constructed after bioinformation analysis to significantly differentiate between CRF and healthy group.The accuracy rate,sensitivity and specificity of the decision tree model were 96.0％,100.0％ and 94.7％ respectively.In CRF group and healthy group,the different protein peaks in urine were identified to probably be 17 proteins with reference to SwissProt database.Conclusions Candidate protein markers in urine are screened and prediction model of CRF urine is established.The markers are identified with the database which provides a more accurate prediction and solid evidence for early diagnosis of CRF.

Objective To Screen serum protein markers related to CRF and establish a diagnosis model,exploring and discussing its significance in serodiagnosis by comparing differences of serum protein spectrum expression between patients with chronic renal failure (CRF) and control group.Methods The trial included 62 CRF patients and 28 control ones.Serum samples were tested by surface enhanced laser desorption/ionization-time of flight-mass spectrometry (SELDI-TOF-MS).The data were analyzed to screen serum proteomic biomarkers.By bioinformatics analysis,decision classification tree models were to be established and tested.Results A total of 19 effective protein peaks were significantly different between CRF and normal control (P＜0.001) at m/z range of 1 500 to 30 000,among which 18 showed low expression and 1 showed high expression in CRF.CRF and normal control were obviously different in the clustering;By bioinformatics analysis,a CRF-normal controls of the diagnostic decision tree model was developed,which was 87.8% in with prediction accuracy rate of 87.8% sensitivity of 87.1% and a specificity of 89.3%.Condusion Diagnostic decision tree model provides a more accurate prediction and solid experimental evidence for early clinical diagnosis.

By combing the development of tongue image,this paper analyzes the image features,advantages and disadvantages of different stages,and makes it clear that tongue image is an important carrier of clinical information of tongue diagnosis.It has been regarded as an important way to understand tongue image since the first monograph on tongue diagnosis.The article also analyzes the formation and development of modern digital and standardized tongue image,and explains the role and value of tongue image in the development of TCM tongue diagnosis terminology,providing reference for the formulation of international standards of TCM diagnosis terminology and the consensus reached by international experts.