OBJECTIVE: To probe into the utilization characteristics and the consumption of oral traditional Chinese medicinal decoctions in our hospital.METHODS: The department of internal medicine in our hospital was subdivided into 8 special divisions.6 physicians of senior professional title(associated professor or above) from each subdivision were randomly selected for analysis of the prescriptions of oral traditional Chinese medicinal decoctions prescribed by the 48 physicians.The ingredients and their dosages in the prescriptions were recorded to database and analyzed by Weka data mining software.RESULTS: The drug use frequency of no less than 5% was noted in 68 kinds of oral traditional Chinese medicinal decoctions,with the drugs for reinforcing deficiency showing the highest drug use frequency,followed by drug for clearing heat,drugs for blood-activating and stasis-dissolving,drugs for eliminating sputum and relieving cough and asthma etc.The drug use frequency of no less than 1% was noted in 193 kinds,of which,160(83%) whose doses exceeded the specified limit value specified in Chinese Pharmacopeia,and in 52 kinds(27%),the proportion of prescriptions involving overdosing was no less than 50%.CONCLUSION: The concerned departments should attached great importance to the widespread phenomenon that the dosages of oral traditional Chinese medicinal decoctions in our hospital exceed the specified dosages in Chinese Pharmacopeia.

Objective To compare the effects of different levels of controlled low central venous pressure (CVP) on blood loss in patients undergoing hepatic lobectomy. Methods One hundred ASAⅠ -Ⅱ patients, aged 28-78 yr, weighing 39-90 kg, undergoing elective hepatic lobectomy under general anesthesia, were randomly divided into S groups ( n = 20 each) with CVP controlled at 1, 2, 3, 4 and 5 mm Hg during the course of operationrespectively (groups CVP1-5 ) . Anesthesia was induced with midazolam, fentanyl, etomidate and vecuronium. The patients were tracheal intubated and mechanically ventilated. Anesthesia was maintained with iv infusion of propofol and remifentanil, inhalation of isoflurane and intermittent iv boluses of vecuronium. CVP was maintained at the predetermined levels by restricted infusion or by administration of diuretics or vasoactive agents and so on during operation. The blood loss before, during and after removal of the diseased liver parenchyma ( V1-3 ) was recorded.The liver parenchyma transection area ( TA) was determined and the blood loss per transaction area ( VTA ) was calculated. Fluid infusion and blood transfusion were recorded during the three time periods mentioned above. MAP and HR were recorded before operation, at 5 min after removal of the diseased liver parenchyma was started and at the end of operation. Results Compared with group CVP5, the MAP during removal of the diseased liver parenchyma in groups CVP1,2 , V2 and VTA in groups CVP1-3,and the percentage of patients who needed blood transfusion during operation and the amount of fluid infused before completion of removal of the diseased liver parenchyma in groups CVP1-4 were significantly decreased ( P ＜ 0.05) . Compared with group CVP4 , V2 , VTA and MAP during removal of the diseased liver parenchyma were significantly decreased in group CVP2 and the amount of fluid infused was significantly increased before removal of the diseased liver parenchyma was completed in group CVP,( P ＜ 0.05) .Conclusion When CVP is controlled at 3 mm Hg, the hemodynamics is stable and blood loss is less during hepatic lobectomy.

Objective To study the curative effectiveness of Itraconazole in the treatment of invasive pulmonary aspergillosis following bilateral lung transplantation.Methods One patients undergoing bilateral lung transplantation was readmitted at 8-month postoperatively due to cough, sputum, and fever. Sputum culture reported positive Aspergillus flavus. Chest X-ray manifested bilateral lung infiltration. Chest CT scan showed multiple small cavities. Itraconazole (Sporanox) therapy was performed.Results Sputum smear and culture reported negative aspergillus at sixth of Itraconazole therapy. Patient’s symptoms after Itraconazole treatment for 10 days were improved obviously. Chest CT scan showed the lung lesion still existed. After treatment by Itraconazole, FK506 dosage was decreased from 3 mg, twice a day to 0.5 mg, once a day.Conclusion Pulmonary aspergillosis is an important complication following lung transplantation. Itraconazole therapy can effectively treat invasive pulmonary aspergillosis following bilateral lung transplantation. Blood drug concentration monitoring indicated the dosage of FK506 was significantly decreased after Itraconazole therapy.

Objective To explore the value of neutiophil gelatinase-associated lipocalin ( NGAL) taken from blood and urine samples in early diagnosis of acute kidney injury ( AKI) after heart valves replacement surgeries. Meth-ods A total of 56 patients received heart valves replacement surgeries were selected prospectively in this study. NGAL from blood and urine samples and serum creatinine ( Scr) were tested among them at different moments. AKI and non-AKI groups were divided based on Scr levels and the value of NGAL taken from blood and urine sam-ples was estimated in early diagnosis of AKI with receiver operating characteristic curve ( ROC) . Results 16 AKIs were observed among all of them. The peak value of Scr in AKI group was shown between 12 and 24 hours after surgeries, while blood-NGAL was seen high significantly (P<0.05) since 2 hours after surgeries, peak value at 4 hours, for urine-NGAL, peak value was seen at 2 hours. The area of ROC of blood-NGAL 4 hours and urine-NGAL 2 hours after surgeries for AKI diagnosis were 0.891 and 0.934, respectively. The better sensitivity and specificity were shown in both threshold set as 50 μg/L and 110 μg/L. Conclusion Blood-NGAL and urine-NGAL can be used as early diagnostic markers of AKI after heart valves replacement surgeries, whose change is significantly earli-er than that of Scr.

Objective: To observe the clinical effect of puncturing Back-Shu points in treating chronic fatigue syndrome. Methods: Twenty-two subjects were recruited and treated by puncturing corresponding Back-Shu points based on syndrome differentiation. The short-form General Health Survey (MOSSF GHS) and the Chalder Questionnaires for Fatigue were adopted for evaluating the therapeutic effects. Results: Of the 22 patients, 4 cases showed a marked effect, 11 got effect, 7 got failure, and the total effective rate was 68.2%. Conclusion: Puncturing Back-Shu points is effective in relieving the symptoms of chronic fatigue syndrome and enhancing the patients' health standard.

Objective To estimate the biological effects of leptin on human HaCaT keratinocytes and explore their molecular mechanisms.Methods Cell counting kit-8 (CCK-8) was used to evaluate the proliferation of cultured HaCaT cells treated with different concentrations of leptin for 24 and 48 hours.Some HaCaT cells were classified into four groups to remain untreated,be treated with leptin (100 μg/L) and piceatannol (a specific inhibitor of STAT3 phosphorylation) alone or in combination for 24 hours,respectively,followed by the evaluation of cell proliferation using CCK-8 kit.Flow cytometry was performed to assess cell cycle of HaCaT cells treated with leptin of 100 μg/L,Western blot to determine the phosphorylation level of Erk1/2 and STAT3 in HaCaT cells treated with leptin of 100 μg/L for different durations.Statistical analysis was done by Student's t-test for unpaired data using GraphPad Prism 5 software.Results The proliferation of HaCaT cells was accelerated to different degrees after treatment with leptin of 50 and 100 μg/L for 24 and 48 hours,and the accelerating effect was in a dose-dependent manner within 24 hours (r =0.9989,P ＜ 0.05).Piceatannol apparently inhibited the promotive effect of leptin on the proliferation of HaCaT cells.There was an obvious elevation in the percentage of cells at S phase ((57.70 ± 5.88)％ vs.(42.50 ± 7.55)％,P ＞ 0.05),but a significant decrease in that at G0/G1 phase ((39.70 ± 1.57)％ vs.(45.20 ± 1.44)％,P ＜ 0.05),with a significant increase in proliferation index (0.603 ±0.0157 vs.0.564 ± 0.0144,P ＜ 0.05) in HaCaT cells treated with leptin of 100 μg/L for 24 hours compared with the untreated controls.Western blot showed that leptin of 100 μg/L markedly enhanced the phosphorylation level of STAT3 in HaCaT cells.Conclusion Leptin may upregulate the proliferation of HaCaT cells through activation of STAT3 pathway.

Objective To explore the early diagnosis value of C‐reactive protein (CRP) and procalcitonin (PCT ) for bacterial in‐fectious pneumonia of children .Methods A total of 101 children with bacterial infectious pneumonia ,64 children with non‐bacterial infectious pneumonia and 73 children with non‐infectious disease were selected in bacterial infectious pneumonia group ,non‐bacterial infectious pneumonia group and non‐infectious disease group respectively .Serum PCT and CRP levels were measured before treat‐ment in the three groups .With sputum culture results as gold standard for the diagnosis of bacterial infectious pneumonia ,the sensi‐tivity ,specificity ,positive predictive value ,negative predictive value ,Youden index and diagnostic accuracy of PCT ,CRP ,PCT /CRP series test and parallel test were calculated for bacterial infectious pneumonia diagnosis .Results The levels of PCT and CRP of children in bacterial infectious pneumonia group were significant higher than those of children in non‐bacterial infectious pneumonia group and non‐infectious disease group(P < 0 .05) .The sensitivity ,specificity ,positive predictive value ,negative predictive value , Youden index and diagnostic accuracy of PCT ( ≥ 0 .5 ng/mL as the best intercept point) for bacterial infectious pneumonia diagno‐sis were 0 .743 ,0 .719 ,0 .806 ,0 .639 ,0 .461 and 0 .733 .And the same values for PCT /CRP series test were 0 .604 ,0 .875 ,0 .884 , 0 .583 ,0 .479 and 0 .709 respectively .All the values were higher than those of children in non‐bacterial infectious pneumonia group and non‐infectious disease group except sensitivity .Conclusion The combination of PCT and PCT /CRP series test is ideal method for early diagnosis of bacterial infectious pneumonia with high sensitivity and specificity .

Objective To study the value of MRI sequence and MRA in the diagnosis of reversible cerebral vasoconstriction syn-drome (RCVS).Methods MRI and MRA of 5 patients with RCVS were reviewed retrospectively.Abnormal distribution,morpholo-gy,signal intensity of the affected arteries and complication of RCVS on MRI and MRA were analyzed.Results All patients showed multifocal segmental vasoconstriction and dilatation of cerebral arteries on MRA,which sometimes was described as “string and beads”.There were 4 patients with cerebral parenchyma lesions,in which posterior reversible encephalopathy syndrome was showed in one case,cortical subarachnoid hemorrhage in one case,and watershed infarcts in 3 cases.Five patients recovered after 3 months. Conclusion MRI and MRA can clearly show cerebrovascular morphology and observe parenchymal secondary lesions,which have an important guiding significance for clinical treatment and prognosis assessment.

Objective To explore the effect of different controlled hypotension method on the blood flow of the vertebral vein by measuring of blood flow of vertebral vein in rabbits. Methods Eighteen New Zealand rabbits,weighing 2-3 kg,were rando mly divided into three groups (n =6 each).Group S maintained MAP (90±5)mm Hg,group GTN reduced MAP to the base value of (70±10)% by using nitroglycerin 0.5 μg·kg-1 ·min-1 and esmolol 2.5 μg·kg-1 ·min-1 (ni-troglycerin∶esmolol= 1∶5 ),group SNP reduced MAP to the base value of (70 ± 10 )% by using sodium nitroprusside 0.5 μg·kg-1 ·min-1 and esmolol 2.5 μg·kg-1 ·min-1 (sodium nitroprusside∶es-molol=1∶5).The controlled hypotension model was established after intravenous general anesthesia. The blood flow of vertebral vein in rabbits were measured by ultrasonic measurement system (Terason 2 000 system ) before controlled hypotension and 1 hour after controlled hypotension. Results The MAP before controlled hypotension in group S (89.0 ± 5.2 )mm Hg,group GTN (91.5± 9.6 )mm Hg,group SNP (92.0 ± 5.7 )mm Hg had no significant difference.The blood pressure before and after the experiment had no significantly difference in group S.The blood pressure after controlled hypotension had no significant difference in group GTN and group SNP,but lower than that before controlled hypotension (P <0.05).Compared with group S,the blood flow of verte-bral vein in group GTN and group SNP were significantly reduced (P < 0.05 ).The blood flow in group GTN was significantly reduced compared with that in group SNP (P <0.05 ).Conclusion In the experiment,the combination of nitroglycerin and esmolol can better reduce blood flow of vertebral vein than that of nitroprusside and esmolol,that it is suitable for the control of hypotension in spinal surgery.