As an anti-epilepsy drug,gabapentin plays an important role in the treatment of neuropathic pain through a variety of central and peripheral mechanisms.Studies have shown that gabapentin has better efficacy for post-stroke pain,spinal cord injury-related pain,postherpetic neuralgia,and pain in diabetic peripheral neuropathy.For mild adverse effects,good tolerance and lack of interactions,gabapentin is an ideal drug for the treatment of neuropathic pain.

Objective To observe the clinical effect of Sangao Decoction combined with Azithromycin in the treatment of mycoplasmal pneumonia in children.MethodsFrom August 2013 to August 2014, 76 children with mycoplasma pneumonia were enrolled in this study.The patients were randomly divided into observation group and control group.The control group was treated with azithromycin alone, and the observation group was given the treatment of Sanao Decoction on the basis of the control group.Comparison of the two groups of clinical efficacy, fever time, cough time, tonsil disappearance time, lung rales disappear time, length of stay and the incidence of adverse reactions.ResultsThe effective rate was 94.37% in the observation group and 76.32% in the control group, which was statistically significant (P<0.05).(2.45±0.90) d, duration of coughing (5.37±1.67) d, duration of disappearance of tonsil (6.23±2.47) d, disappearance of rales (7.18±1.58) d, duration of hospital stay (10.26±1.65) d were shorter than the control group, which was statistically significant (P<0.05).The incidence of adverse reactions was not statistically significant.ConclusionThe effect of Sangao Decoction combined with azithromycin in the treatment of mycoplasma pneumonia in children can significantly shorten the symptoms and signs of the patients, the time of disappearance of the signs and the length of hospital stay, promote the rapid recovery of children, high safety, and have good clinical application value.

Objective To investigate the effect of gamma globulin combined with glucocorticoid pulse therapy in the treatment of children with refractory mycoplasma pneumonia in CRP and safety.Methods 46 cases of children with refractory mycoplasma pneumonia from February 2012 to February 2016 were selected and randomly divided into the control group and experimental group,23 cases in each group.On the basis of the regular treatment,the control group was given azithromycin,10mg/kg,qd,intravenous drip,on the basis of the control group treatment,the experimental group was treated with methylprednisolone 2mg/kg+human immunoglobulin 400mg/kg,qd,intravenous drip.The levels of serum C-reactive protein(CRP),white blood cell count(WBC),lymphocyte count(LC),therapeutic efficiency and safety were measured before and after treatment.Results After treatment,compared with the control group,the serum levels of CRP、WBC、LC were lower in the experimental group,the difference was statistically significant(P<0.05).The treatment efficiency of the experimental group(91.31％)was significantly higher than that of the control group(65.22％),the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The gamma globulin combined with glucocorticoid pulse therapy can significantly reduce the serum levels of CRP,WBC and LC in children with refractory mycoplasma pneumonia,improve clinical efficacy and the safety were good.

With the growing prevalence of obesity,diagnosis and treatment of obesity has drawn great attention.On the basis of previous guidelines on obesity,May 2016,American Association of Clinical Endocrinologists (AACE)and American College of Endocrinology (ACE)announced the clinical practice guidelines for comprehensive medical care of patients with obesity.The guidelines give advice and guidance in obesity diagnosis,assessment,treatment goals and treatment strategies around obesity-related complications as center.This article interprets the key content of the guideline in order to acquire enlightenment for clinical work.

AIM: To investigate the effect of platycodin D on Candida albicans infection in oral epithelial cells.METHODS:The viability of the oral squamous carcinoma KB cells was detected by MTT assay after treated with different concentrations of platycodin D .The KB cells were infected with Candida albicans, and then were incubated with platycodin D at different concentrations .Adherent numbers of the Candida albicans were counted by Gram staining , and the bacterial activity and conversion were measured by Trypan blue staining .Furthermore , the protein levels of IL-18 and hu-man β-defensin 2 ( HBD-2) were analyzed by ELISA , and the expression of HBD-2 at mRNA and protein levels was deter-mined by RT-qPCR and Western blot , respectively .RESULTS:The viability of the KB cells was not affected by platycod-in D at the concentrations used .The adherent numbers , bacterial activity and conversion were decreased by treatment with platycodin D in a dose-dependent manner .In addition, the protein level of IL-18 in the culture supernatant and the mRNA expression of HBD-2 in the KB cells were also reduced after platycodin D treatment .CONCLUSION:Platycodin D has a bacteriostasis effect and prevents oral epithelial cells from Candida albicans infection.

Discussion on the construction of medical dispute prevention and control mechanism from the per -spective of crisis management and the ethical thinking are conducive to the effective prevention , control and solution of medical disputes .This can promote the healthy development of the doctor -patient relationship and has the im-portant value of ethics .At present , should strengthen the crisis management from the aspect of ethics to control medical disputes in the following aspects: establishing the medical dispute crisis -prevention mechanism by strengthening the training of medical staff′s medical ethics and medical skill;establishing the medical dispute crisis-resolution mechanism under the principle of respect for life and the patient first;establishing the medical dispute crisis assessment and post -processing mechanism around the idea of love , gratitude , and excellence development .

OBJECTIVE:To evaluate the environmental quality of planting bases of Artemisia argyi in Qichun county of Hubei province so as to provide scientific foundation for the construction of the planting bases of A. argyi which conforms to the require-ments of Good Agriculturing Practice (GAP). METHODS:By reference to national Ambient Air Quality Standards (GB 3095-1996),Water Quality Standards for Farm Irrigation(GB 5084-2005)and Soil Environment Quality Standards(GB 15618-1995), the ambient air,irrigation water and soil quality at 3 major producing areas of A. argyi,including Hongmenlou,Zhulinhu and Tongxin,were tested respectively. RESULTS:At the 3 major producing areas,the ambient air(including sulfur dioxide,nitrogen dioxide,total suspended particulates,fluoride,etc.)was up to primary standards in Ambient Air Quality Standards,irrigation wa-ter quality(including pH,chloride,sulfide,total arsenic,total mercury,lead,cadmium,fecal coligroup count,number of ascaris eggs,etc.)met the basic dry farming requirements in Water Quality Standards for Farm Irrigation,and soil quality(including pH, cadmium,mercury,lead,arsenic,chromium,copper,DDT,hexachlorocyclohexane,etc.) reached secondary standards in Soil Environment Quality Standards. CONCLUSIONS:The aforesaid results show that the planting bases meet GAP requirements in am-bient air,irrigation water and soil quality and are applicable producing areas of medicinal material A. argyi.

OBJECTIVE:To study the inhibitory effects of emodin on the proliferation of human hepatocellular carcinoma SMMC7721 cells. METHODS:SMMC7721 cells were treated with 0(negative control),25,37.5,50,62.5,75,87.5,100μmol/L emodin solution and 100 μmol/L 5-FU for 24 h,48 h,72 h. The optical density value of cells was detected,and inhibition rate was calculated. SMMC7721 cells were treated with 0 (negative control),25,50,75 μmol/L emodin solution and 100 μmol/L 5-FU for 48 h,and cell apoptosis rate,cell cycle and the expression of Bax and Bcl-2 gene were detected. RESULTS:Compared with negative control,the rate of cell proliferation inhibition increased after treated with 25,37.5,50,62.5,75,87.5,100 μmol/L emodin and 100 μmol/L 5-FU,which was positively associated with the concentration and duration. Compared with negative con-trol,the rate of cell apoptosis increased after treated with 25,50,75 μmol/L emodin solution and 100 μmol/L 5-FU;the expres-sion of Bax increased and that of Bcl-2 dereased;50,75 μmol/L emodin solution and 100 μmol/L 5-FU could arrested cells at G0/G1 phase(P<0.05 or P<0.01). CONCLUSIONS:Emodin can inhibit the proliferation of SMMC7721,promote cell apoptosis and in-hibit cell growth.

Objective To evaluate the effect of progressive problem-based learning (PBL) in teach-ing of neurology and study its impact factors. Methods A total of 110 5-year undergraduate students were randomly divided into LBL and progressive PBL groups, with 55 students in each group. Both groups ac-cepted basic knowledge, clinical skills, case analysis and document retrieval teaching. Progressive PBL were given by three steps including introduction phase, transition phase and PBL stage. At the end of the internship, theoretical knowledg,practical skill scores and questionnaires were used to evaluate the effects of different teaching methods. Pearsonχ2 test was used to analyze the effects of gender, urban-rural character, mastery of relevant based knowledge and intra-group contribution on examination results of progressive PBL. Results Theoretical knowledge score of progressive PBL group was significantly lower than LBL group [(78.49 ±3.15) vs. (81.94 ±5.37), t=-4.11, P=0.000], while clinical skill score [(86.34 ±9.16) vs. (80.96±7.85), t=1.63, P=0.003] and clinical analysis score [(82.25±5.17) vs. (70.54±3.85), t=13.47, P=
0.000] of progressive PBL group were significantly higher than LBL group. Teaching satisfaction scales of learning interest ( χ2=7.21, P=0.007), self-learning ability ( χ2=6.70, P=0.010), knowledge use ability ( χ2=7.92, P=0.005), analytical thinking ability (χ2=4.36, P=0.037) and expression ability (χ2=9.17, P=0.003) in progressive PBL group were significantly higher than LBL group. Gender( χ2=0.0109,P=0.917) and urban-rural character (χ2=0.045, P=0.831) showed no significant impact on examination results of progressive PBL. While relevant based knowledge (χ2=6.82, P=0.009) and intra-group contribution (χ2=4.91, P=0.027) showed significant impact on examination results of progressive PBL. Conclusion Progressive PBL can improve the clinical skill and case analysis ability of students. Relevant based knowledge and intra-group contribution have significant impact on the effect of progressive PBL.