There has been no consensus on the efficacy of extracranial-intracranial arterial bypass (EIAB) for ischemic cerebrovascular disease. As an important factor in the pathophysiologic mechanisms of ischemic cerebrovascular disease, the changes of cerebral hemodynamics have received attention. The article expounds the clinical significance of EIAB from the point of view of cerebral hemodynamics, particularly presents its preoperative assessment, operative procedures, and efficacy criterion.

OBJECTIVE:To develop an RP-HPLC method to determine the camphor in Bohenao zhangnao nose drops. METHODS:The HPLC separation was carried out on a Supelcosil C18(150 mm?4.6 mm,5 ?m) column.The mobile phase consisted of methanol-water(70∶30) at a flow rate of 1 mL?min-1.The column temperature was 25 ℃ and the detective wa-velength was set at 289 nm. The content was computed using external standard method. RESULTS:The linear range of cam-phor was 0.1～1 mg?mL-1(r=0.999 8) with recovery rate ranged from 100% to 103%(RSD

ObjectiveTo investigate the related risk factors ot the portal vein thrombosis (PVT) in patients with liver cirrhosis.MethodsThirty-seven liver cirrhosis patients with PVT (PVT group) and 100 liver cirrhosis patients without PVT (control group) from Jan.2007 to Dec.2009 were enrolled.The clinical data of these patients were collected and the related risk factors of PVT were analyzed.ResultsThe increase of D-dimer,severe esophageal varices(EV) and portal hypertension gastropathy(PHG) were the risk factors of PVT in liver cirrhosis patients(OR =12.872,3.916 and 2.851).No significant correlation was found between sex,platelets,albumin and PVT.ConclusionsThe increase of D-dimer,severe EV and PHG are the main risk factors of PVT.The above examinations should be used to monitor patients with liver cirrhosis for early prevention and diagnosis of PVT.

In 48 postoperative cases using ear-clinoidal line positioning in radiofrequency thermocoagulation for treatment of trigeminal neuralgia,observing its recurrence and postoperative pain and complications in a five-year review. The successful rate of puncturing one time was 100%. Pain disappeared completely in 46 cases with one therapy. Two cases alleviated pain and decreased outbreak times. No recurrence and postoperative complications were observed. The vertical distance between the needle tip and the ear-clinoidal line were confirmed 8-10 mm in the third branch, 6-7 mm in the twice branch, 4-5 mm in the first branch. In order to avoid the first branch of trigeminal nerve injury, the vertical distance must be less than 6 mm, and the needle tip can not exceed ear-clinoidal line.

Objective To establish the HPLC fingerprint of Xuanbo Shuangsheng Granule for its quality control.Methods The components were separated on an Agilent TC-C18 column (150 mm ×4.6 mm,5 μm) at 25 ℃,with a gradient elution in 0-60 min at the flow rate of 1 mL/min using 0.2％ acetic acid aqueous solution and methanol as the mobile phase.The detection wavelength was 278 nm.By detecting 11 batches of Xuanbo Shuangsheng Granule,the HPLC fingerprint was established using Similarity Evaluation System for Chromatographic Fingerprint of TCMs (Version 2004A)and the common peaks were analyzed and identified in raw herbal material.Results The HPLC fingerprint of Xuanbo Shuangsheng Granule was obtained with similarity all over 0.9.Totally 27 common peaks were confirmed,and each common peak could be found in raw herbal medicines.Based on the reference substances,5 common peaks were identified,including phellodendrine (peak 11),liquiritin (peak 22),angoroside C (peak 25),cinnamic acid (peak 26) and harpagoside (peak 27).Conclusions This method is simple,accurate,repeatable and reliable,which could be applied in the quality control of Xuanbo Shuangsheng Granule.

Objective To investigation the incidence of central venous catheter related bloodstream infection (CRBSI) and the distribution of pathogens in patients in the emergency intensive care unit (EICU),and analyze the risk factors of central venous catheter related bloodstream infection.Methods Clinical materials of the patients with central venous catheters in the emergency intensive care unit in Peking Union Medical College Hospital from April 2015 to March 2016 were collected. The indwelling of central venous catheters and the infection situation were investigated with the self-designed central venous catheter monitoring table. Results From April 2015 to March 2016,108 cases of catheters were indwelled in EICU. The total number of days of central venous catheter indwelling was 688 days. There were 9 cases of CRBSI. The incidence of CRBSI was 13.08‰. There were 66.67% of catheters inspected. The gram-negative bacterium infection was the main pathogen of hospital infection. The main CRBSI risk factors were whether contaminated dressings were changed in time and timely removing unnecessary catheters.Conclusions Long term continuous targeted monitoring, timely understanding of infection related factors,and taking timely appropriate preventive measures can effectively reduce the incidence of catheter related bloodstream infection.

Objective To study the clinical application of intercalated combination of osimertinib and docetaxel in T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the southern Hainan Province. Methods T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the sou-thern Hainan Province treated at the Third People's Hospital of Hainan Province from January 2018 to October 2018 were enrolled,and they were divided into intercalated combination of osimertinib and docetaxel group (n = 32)and osimertinib group (n = 28)according to the treatment. The patients in intercalated combination of osimertinib and docetaxel group received oral osimertinib (80 mg,qd),and received docetaxel (75 mg/ m2 , repeated in three-week intervals)when taking to tumor progression,and oral osimertinib treatment (80 mg, qd)was maintained until tumor partial response or stable disease after chemotherapy. The patients in osimer-tinib group received oral osimertinib (80 mg,qd). The patients in both groups received zoledronic acid. The response rate,disease control rate,overall survival (OS)and the incidence of adverse reactions of both groups were contrastively analyzed. Results The response rate of intercalated combination of osimertinib and doceta-xel group (62. 5％,20 / 32)was higher than that of osimertinib group (35. 7％,10 / 28),and disease control rate (93. 8％,30 / 32)was also higher than that of osimertinib group (67. 9％,19 / 28),with statistically sig-nificant differences (χ2 = 4. 286,P = 0. 038;χ2 = 6. 687,P = 0. 010). The median OS of intercalated combi-nation of osimertinib and docetaxel group was 10. 0 months,which was longer than that of osimertinib group (9. 0 months),with statistically significant difference (χ2 = 5. 917,P = 0. 015). Moreover,the adverse reac-tions in both groups were all grade Ⅰ or Ⅱ,which could be relieved or improved through symptomatic treat-ment. Conclusion Intercalated treatment of osimertinib with docetaxel is safe and effective in T790M muta-tion-positive lung adenocarcinoma patients with bone metastasis in the southern Hainan Province. It can prolong the survival time of patients.

Objective To investigate the construction of outpatient quality care services and the needs of patient for outpatient service,and to explore the relevance of the two projects.Methods A total of 152 cases of outpatient department registered nurse of Beijing Union Hospital and 281 cases of hospitalized patients on May,2017 were selected,and then developed the Content Questionnaire on Quality Nursing Work of Outpatient Nurse and the Questionnaire on Outpatient Needs Status to carry out investigation.Results This kind of hospital patients with college or university in 216 cases(76.9%,216/281),personal monthly income of 5.0-10.0 thousand accounted for 44.8%(126/281);outpatient nurses aged ≥46 in 83 cases(54.6%,83/152),the working time≥20 years in 120 cases(78.9%,120/152),college degree or above in 137 cases(90.1%,137/152),97 nurses(63.8%,97/152)in charge.The clinic nursing work relates to the rate of above 85%for disease treatment and consultation,health education,guidance service,self-service system services,on-site inspection,consulting room environment,and the cost of nurses working hours and the most frequent content for the on-site inspection and diagnosis of diseases,counseling,health education,medical order service.The order of patients' needs from high to low was disease and consultation,health education,guidance service,order service,on-site inspection,self-service system,registration service,waiting environment and consulting room environment.There was no correlation between the patient's needs and the rate of nursing,the length of work,and the frequency of work(P＞0.05).There were significant differences in the demand for health education on each department(F =3.047,P ＜0.05),education level,medical order service and on-site inspections have significant difference on demand(F=3.809,3.409,P＜0.05),family income,sources of patients were not statistically significant in the comparison(P＞0.05).The outpatient quality care services had lower improved demand(≤26%),and the first six item that needed to improve are disease and medical consultation,self-service system,treatment order service,waiting environment,health education,guidance services.Conclusions In view of the characteristics of outpatient medical staff and patients in large general hospitals,we will improve the quality of outpatient service and meet the needs of patient outpatient service,which will help to deepen the medical reform and improve the quality of medical service.

Objective To compare curative effect between lenvatinib combined with locoregional therapy and locoregional therapy on PD-L1-positive hepatocellular carcinoma patients with type Ⅰ-Ⅲ portal vein tumor thrombus according to Cheng's classification. Methods The patients in lenvatinib combined with locoregional therapy group received orally-administered lenvatinib at a dose of 12 mg qd for patients≥60 kg or 8 mg qd for patients < 60 kg. The locoregional therapy group only received locoregional therapy. We retrospectively analyzed the clinical data and prognosis of two groups. Results The CR+PR were 78.1% and 53.6% in the combination group and locoregional therapy group, respectively (P < 0.05). The response rate, disease control rate and overall survival of the combination group were higher than those in the locoregional therapy group (P < 0.05). Conclusion The curative effect and overall survival of lenvatinib combined with locoregional therapy is better than locoregional therapy on PD-L1-positive hepatocellular carcinoma patients with type Ⅰ-Ⅲ portal vein tumor thrombus according to Cheng's classification.

In 2020, two formulations of botulinum toxin type A (BoNT-A)named AbobotulinumtoxinA(Dysport ?) and LetibotulinumtoxinA(Letybo ?) have been officially approved by National Medical Products Administration to come on the market. To compare BoNT-As with different formulations, three BoNT-As[AbobotulinumtoxinA, OnabotulinumtoxinA(Botox ?), IncobotulinumtoxinA(Xeomin ?)] with relatively more clinical evidences internationally and two domestic BoNT-As[LanbotulinumtoxinA(Prosigne ?), LetibotulinumtoxinA] were included. Diffusion scale, conversion ratio, onset, duration and immunogenicity of different BoNT-As were reviewed in detail to provide reference for clinical practice.