According to the analysis of PreQin society and history, it is concluded that influenced by special historical conception and low productivity of that time, ancient doctors were able to know the concept “Brain controls consciousness”. The structure of the Five-Zang Theory of TCM was constructed according to the concept of Five-Element Theory and the similarities between nature and human. So they had to enact “Heart controls consciousness” to complete the function of brain with heart instead. Most details of five-zang theory come from long-term medical practices and daily life, so the structure can guide the medical practices correctly. The concept “Heart controls consciousness” was brought about by many factors. After Qin and Han Dynasties, gradually, people used to keep this routinism. Similar to other historical events, formation of these concepts proposed by ancient physicians and philosophers is inevitable. We should analyze these problems formed in history objectively and completely, but not praise or criticize them blindly.

OBJECTIVE To study the washing effect of different methods to keep the surgical instruments moist. METHODS The instruments which were selected from the routine surgical instruments within a week were washed after three different methods to keep moist. The washing effect was compared by eyes, without equipment and with 5 times magnifying glass. RESULTS The multienzymatic detergent was the best one to keep moist, the next was the water, and the chlorine releasing agent was the worst. CONCLUSIONS Hospitals should select the suitable method to keep moist by considering the actuality.

AIM: To prepare flexible nanoliposomes made from active ingredients,phillyrin and volatile oil,from forsythia suspense and study their transdermal delivery system.METHODS: Flexible nanolipsomes of phill-yrin(WN group) and phillyrin in combination with forsythia volatile oil(OWN group) were prepared by the meth-od of membrane-dispersion.Its appearance and particle sizes were measured.Transdermal experiments were carried out on the modified Franz diffusion pool through in vitro mouse skin.HPLC was applied to determining the phillyrin content to compare transdermal rate and cumulative permeation amount of various flexible nanoliposomes.RESULTS: The particle size of the WN group was(180.7 ? 13.69)nm,the Zata potential was-48.8 mV,the average encapsulation percentage was(82.53 ? 2.68)%;the particle size of the OWN group was(212.3 ? 15.31)nm,Zata potential was-51.2 mV,the average encapsulation percentage was(70.49 ? 1.06)%.The accu-mulated permeation amount of the OWN group in 8 hours was(291.92 ? 23.22) ?g/cm2,its transdermal permea-bility in 8 hours was 36.49 ?g/(cm2.h),which was 6.10 folds that of the WS group and 1.92 folds that of the WN group.This difference had statistical significance(P

Objective Using the effect of microneedle array to investigate the feature and rule of transdermal drug delivery of sinomenine hydrogel patch.Methods The microneedles with different length and sinomenine hydrogel patch were prepared;The isolated rat skin was pretreated by different needle-shapes of microneedle array and different timepoints with the same needle-shape,and then sticked the sinomenine patch.The permeation rates of sinomenine were studied using a Franz diffusion cell and compared with passive diffusion of the rat skin untreated.Sinomenine content was measured by HPLC.Results The permeation rates of sinomenine via the skin pretreated with 100 and 200 ?m microneedles were 40.7 and 52.4 times to those of the untreated.The permeation rates of sinomenine via the skin pretreated 7 min with 200 ?m microneedles is 142.0 times to those of the untreated.When skins were pretreated using 200 ?m microneedles with different force, the drug permeation rates were increased with the force increasing.When the force exceeded 5 N,the drug permeation rates were equilibrium.Conclusion When transdermal drug delivery by using microneedle array-hydrogel patch,the permeation rates increase significantly.The needle-shape,skin pretreating time,and force of the microneedles play the important roles in the transdermal drug delivery.

Objective To investigate the safety of treatment of symptomatic middle cerebral artery stenosis with Gateway-Wingspan system by reviewing the data on complications.Methods Forty-seven patients with symptomatic middle cerebral artery stenosis treated with Wingspan system were respectively analyzed and emphasis was paid to cases with complications.Relevant data was collected such as characteristics of patients and lesions,selection of ballon and stent and radiographic information.Results Complications were found in 4 patients (8.5％),which were due to cerebral vasospasm,heperperfution syndrome,artery branch rupture and subacute stent thrombosis respectively.Two patients experienced symptomatic intracranial hemorrhage (4.3％)and one of them died (2.1％).The morbidity of severe complications was 6.4％.The success rate of stent implantation was 100％.Mean artery stenosis reduced from (83.5 ± 10.0)％ to (19.8 ± 9.2)％ after Wingspan stent implantation.Conclusion Middle cerebral artery stenting angioplsty greatly improved the stenosis with high technical success rate.However,the rates of cerebral vascular complications and symptomatic intracranial hemorrhage were relatively high in this study,which needs to be widely verified in practice.

Objective To investigate the risk factors for nosocomial infections in rehabilitation department of a general hospital. Methods The infection rate, underlying diseases and infection sites were retrospectively reviewed in 1243 patients hospitalized in rehabilitation department of the Second Affiliated Hospital of Wenzhou Medical College from July 1, 2004 to June 30, 2008. Risk factors were determined by multivariate analysis with Logistic regression. Results The infection rate and the frequency of nosocomial infections in rehabilitation department were 18. 34 % (228/1234) and 21. 40 % (266/1243), respectively. Patients with spinal cord injury and those with cerebrovascular diseases accounted for 41.67% (95/228) and 31. 14% (71/228) of the total nosocomial infections, respectively. Urinary tract and lower respiratory tract were the frequent infection sites. The incidence of nosocomial infections was correlated with underlying diseases, age, length of stay, invasive operation, nutrition, sensory or movement disturbance and dysphagia. Conclusions Rehabilitation department has high nosocomial infection rate. Relevant risk factors should be carefully monitored to prevent or reduce the occurrence of the infections.

Objective To explore skeletal‐related events (SREs) clinical factors and analysis prognosis factors on patients with non‐small cell lung cancer(NSCLC) with bone metastases .Methods We collected clinical data of pathology confirmed 383 patients with non‐small cell lung cancer between April 2007 and January 2007 in the third affiliated hospital of the third military medical uni‐versity .It was used to screening for Emission Computed Tomography (ECT ) for bone metastases .And then it was need to con‐firmed for CT ,MRI or PET‐CT or pathology .Statistics in patients between clinical features and the SREs prediction factor with Univariate and Multivariate .And Kaplan‐Meier method analysis of survival in the non‐small cell lung cancer patients with bone me‐tastases .Results Out of 383 patients with bone metastases ,178 patients with SREs .The incidence was 46 .5% .Univariate analysis showed that women ,adenocarcinoma ,never smoking history ,single bone metastases ,bisphosphonate therapy ,targeted therapy in patients with bone metastases are less likely to have SREs ,it was considered statistically significant (P<0 .05) .Multivariate analy‐sis showed multiple bone metastases and no bisphosphonate therapy is independent risk factors for SREs .Median survival time was 14 .5 months in non‐small cell lung cancer patients with bone metastases ,1 year survival rate was 46 .5% ,2 years survival rate was 15 .9% .The survival analysis shows that more bisphosphonate treatment and bisphosphonate with EGFR‐TKI therapy on the prog‐nosis of patients with statistically significance (P<0 .05) .Conclusion It was likely to occur SREs in NSCLC patients with bone metastases .No bisphosphonate and multiple bone metastases are independent risk factors for SREs .Bisphosphonate treatment may prevent or reduce occur SREs for NSCLC patients with bone metastases ,and it may prolong survival ,it speculated that bisphospho‐nate may have resistant NSCLC cell activity .

Objective To investigate the mental health status of students with foreign nursing spe-cialty and analyze its relationship with stress, coping style and perceived social support. Method The cluster sampling was conducted between students with foreign nursing specialty. The Perceived Social Support Scale (PSSS), Symptom Check List-90 (SCL-90), and self-designed demographic questionnaires including demographic information questionnaire, College Students Stress Scale and Coping Style Questionnaire were employed. Results Students with foreign nursing specialty obtained significantly higher scores in all factors of SCL-90 when compared to the national youth norm,and obtained significantly higher scores in factors of somatization, obsession, anxiety, fear and psychotic diseases when compared to the norm of college students. The multifactor analysis of mental health status in students with foreign nursing specialty showed that soma-tization factors contained personal stress, seeking help, family supports and other supports;obsession factors contained personal stress, negative life events, academic stress and solving problem;interpersonal sensitivity factors contained personal stress, academic stress, solving problem, self-blame, fantasy and retreat; depres-sion factors contained personal stress, academic stress, solving problem, self-blame and other supports;anxiety factors contained personal stress, academic stress, fantasy, self-blame, family supports and other supports; hostility factors contained personal stress, seeking help, retreat, fantasy and other supports; fear factors contained personal stress, academic stress, seeking help, retreat and fantasy; crankiness factors con-tained personal stress, academic stress, solving problem, retreat, self-blame, family supports and friend sup-ports; factors of psychotic diseases contained personal stress, academic stress, solving problem, self-blame and friend supports;and factors of other symptoms contained personal stress, negative life events, academic stress, retreat, self-blame, family supports, friend supports and other supports. Conclusion The mental health status of students with foreign nursing specialty was inferior to the norms of national youths and col-lege students. It was negatively correlated with stress, active coping style, friend supports and other supports;while positively correlated with passive coping style (except escape) and family supports. Therefore, mental health education toward students with foreign nursing specialty should be strengthened in order to reduce their stress, improve their coping style, enhance their social supports, and finally promote their mental and physical development.

The purpose of this study is to investigate the transdermal delivery characteristics of Gentiana macrophylla complex components system through different parts of the skin under micro-needles conditions. Two-chamber diffusion cells were used, different parts of isolated skin and micro-needle pretreated isolated mouse skin were applied separately, high performance liquid chromatography (HPLC) similarity evaluation methods were used to evaluate transdermal delivery characteristics of Gentiana macrophylla complex components system on receiving pool and the permeation rate and penetration amount of Gentiopicroside at different parts of mouse skin. In the 24 h, the similarity between receiving fluid which was on passive transdermal delivery and micro-needle transdermal delivery conditions and original fluid were ranged from 83.0% to 98.9%; By the micro-needle pretreatment with different parts of the mouse skin, the time that Gentiana macrophylla complex components system though abdominal skin to the receiving fluid which reached 90% similarity compared with that of original fluid was 4 h, which was 18 h at back skin and 12 h at neck skin separately. Micro-needles can be used as the ideal ingredients for traditional Chinese medicine complex transdermal delivery; transdermal absorption time delay could be greatly reduced and its bioavailability was improved. The permeation rate and similarity to original liquid of Chinese medicine complex components increased significantly in the abdominal skin relative to the neck and back skin under micro-needle conditions.

Objective To study the effects on electroporation of Qingfengteng cataplasma transdermal absorption and describe the characteristics of animal pharmacokinetics of it.Methods Two-chamber diffusion cell was used and the plasma drug concentration was determined by HPLC.The application of AIC theory to analysis of the compartmentally based model of sinomenine transdermal delivery by electroporation.Results The Cmax,Ka,and AUC0→∞ of electroporation was larger than those of passive diffusion;t1/2(Ka)and tmax of electroporation were reduced compared with passive diffusion.The drug concentration-curve equation were C=2.884?(e-0.056 t-e-0.232 t)and C=2.512?(e-0.058 t-e-0.149 t)for electroporation and passive diffusion,respectively.Conclusion The change of in vivo drug concentration of Qingfengteng calaplasma transdermal absorption by electroporation could be analized in accordance with mammillary one-compartment open model.The etrectroporation technology could sharply enhance the bioavalibility compared with the passive diffusion.