OBJECTIVE:To establish a microbial limit test method for Akafen powder and validate the methodology.METHODS:The three methods for microbial limit test in appendices volume Ⅱ of Chinese Pharmacopoeia(2005 Edition)were adopted to study Akafen powder.The optimal test method was obtained by comparing the recovery rates of test organisms.RESULTS:According to the results,the recoveries of five test bacteria of Akafen powder by plating method were less than 70% versus above 85% by membrane-filter procedure.The the test organisms were successfully detected in the control bacteria test by media dilution method.CONCLUSION:Membrane-filter procedure is advisable for the test of bacteria,mould and yeast fungus,while media dilution method is advisable for the control bacteria test.

Objective:To develop a method for the determination of natural benzoic acid in Mesona chinensis Benth. with different production places and storage time. Methods:HPLC was adopted, the column was an Agilent ZORBAX SB-C18 (250 mm × 4. 6 mm, 5 μm) column, the mobile phase was methanol-0. 02 mol·L-1 ammonium acetate (5∶95) at the flow rate of 1. 0 ml·min-1 , the col-umn temperature was 35℃, the detection wavelength was 230 nm, and the injection vocume was 10μl. Results:Benzoic acid showed good linearity over the concentration range of 0. 1-10. 0 μg·ml-1(r=0. 999 9). The average recovery was 99. 59%(RSD=1. 57%, n=9). Natural benzoic acid in powered Mesona chinensis Benth. was different because of various production places. The maximum content of natural benzoic acid in Mesona chinensis Benth. was 141. 8 mg·kg-1, while the minimum content was 73. 8 mg·kg-1. The content of natural benzoic acid in Mesona chinensis Benth. stored for two years was declined obviously. Conclusion: The method with simple operation is accurate and reproducible. It can provide a basis for the further study of Mesona chinensis Benth. resources, and provide a reference for the content determination of natural benzoic acid in other plants.

Objective To investigate the potential of the Clock Drawing Test (CTD) in differentiating the mild cognitive impairment (MCI) and Alzheimer's disease (AD). Methods Cognitive impaired patients admitted to the outpatient and inpatient of neurological department of our hospital from October 2011 to October 2013 were reviewed. There were 65 cases with MCI and 63 cases with AD. The scores of CDT were compared between them, and the sensitivity and specificity were evaluated with Receiver Operating Characteristic Curve. Results The MCI group and AD group matched in age, gender and education. The scores of Chinese version of the Mini-Mental State Examination and CDT were significantly defferent between the two groups. The sensitivity of 3-point CDT was 54.0% and the specificity was 80.9% in differentiating MCI and AD. Conclusion CDT is helpful to differentiate MCI from AD only in a set of assessment.

Objective To observe the results of free medialis pedis mini-flap pedicled on medial branch of deep branch of the medial plantar artery to repair a soft tissue defect of finger. Methods The mini-flap designed on the medial side of the foot pedicled on the medial branch of deep branch of medial plantar artery was used to repair the soft tissue defect of finger or the degloved injury of the finger combined with second toe flap, furthermore, the vascular pedicle of flap was anastomosed with the digital artery and dorsal vein respectively. 13 fingers of 11 cases, which included 10 fingers of 8 cases of male and 3 fingers of 3 cases of female with an average of 32 years ranging from 18 to 58 years, were performed 13 free medialis pedis mini-flaps transplantation. Eight free medialis pedis mini-flaps were used to repair the soft tissue defect of the finger, and 5 free medialis pedis mini-flaps combined with the second toe composite flap were used to reconstruct the degloved finger. Results All the patients were followed up on an average of 21 months ranging from 3 months to 5.5 years. The maximal area of flaps was 5 cm?4 cm, and the minimal was 2.5 cm?3 cm. 12 of the 13 free medialis pedis mini-flaps were survived completely, however, 1 healed but partly necrosis. The color, character and thickness of this flap after transplantation were similar to the skin of the finger; and the appearance of the reconstructed finger by mini-medialis pedis flap and second toe composite flap was perfect. The transplanted skin of donated areas survived well, and the appearance and functions of donated feet were not affected significantly. Conclusion The free medialis pedis flap pedicled on medial branch of the deep branch of the medial plantar artery was one of the optimal flaps to repair soft tissue defect of the finger especially on the palmer side.

Objective To observe the outcome of healthy C7 nerve root transfer through the anterior spinal approach to repair the brachial plexus avulsion. Methods The healthy C7 nerve root was sectioned at the junction site of trunk and division, the proximal side was dissected to the foramina and transfered behind the posterior aspect of anterior scalenus to the space between the esophagus and cervical vertebrae, then the 4-6 bands of cutaneous nerves were used for bridging the defect between the healthy C7 and recipient nerve to repair the upper trunk or dorsal division of the upper trunk of the injured brachial plexus. From March 2002 to August 2003, 21 patients with brachial plexus avulsion were repaired using this procedure, among which 14 patients (12 males, 2 females) were followed up for more than 12 months. The average age was 31 years with a range of 17 to 41 years. The interval from injury to operation ranged from 2 to 6 months with a mean of 4 months. 14 patients included 5 cases with total brachial plexus avulsion, 8 cases with upper and middle trunk avulsion associated with partial injury of the lower trunk and 1 case with cutting injury of upper and middle trunk. Results The average follow-up duration was 16 months ranging from 12 to 19 months. 9 of the 10 cases who underwent the healthy C7 transfer through the anterior spinal approach to repair the upper trunk, the C5 and C6 nerve roots or the anterior and posterior division of upper trunk achieved at least the MRC grade 3 motor recovery of shoulder abduction and elbow flexion and 1 case failed. 3 cases underwent the healthy C7 transfer to repair the dorsal division of the upper trunk achieved at least the MRC grade 3 motor recovery of shoulder abduction. 1 case who underwent the healthy C7 transfer to repair the C6 nerve root didnt get recovery. Conclusion The result of healthy C7 transfer througth the anterior spinal approach to repair the upper trunk of brachial plexus for restoration of the shoulder abduction and elbow flexion or the function of shoulder abduction in repairing the dorsal division of upper trunk is satisfactory.

Objective To compare sleep electroencephalogram-modulated repetitive transcranial magnetic stimulation (SEM-rTMS) with routine repetitive transcranial magnetic stimulation (R-rTMS) in the treatment of primary insomnia. Methods One hundred and twenty six patients with insomnia were divided randomly into a SEM-rTMS group (44 cases) , a R-rTMS group (42 cases) and a sham rTMS group (40 cases). Each case was treated with rTMS for 30 min once a day for 10 d under double blinding of the patient and therapist. The clinical effect was observed along with Krakow sleep scores, electroencephalograms and blood pressure before and after a 10-day course of therapy and 30 days later. Results During rTMS treatment, some patients reported feeling sleepy, and this was confirmed by their EEGs at the time. After the entire course of therapy, 80% of the SEM-rTMS group and 45% of the R-rTMS group showed improvements, a significant difference. At the 30th day after therapy, the effect in the SEM-rTMS group was still significantly better than in the R-rTMS group. There were no obvious side effects in any group throughout the whole observation period. Conclusions SEM-rTMS is more effective and more reliable than R-rTMS. SEM-rTMS is safe to use with primary insomnia patients.

Objective To investigate the efficacy of ultrasound-guided fascia iliaca compartment block (FICB) on postoperative analgesia in patients undergoing total hip arthroplasty.Methods Thirty-six ASA Ⅰ-Ⅲ patients aged 54-82 yr weighing 48-72 kg undergoing total hip arthroplasty were randomly divided into 2 groups (n =18 each): normal saline group(group NS)and ropivacaine group (group R).Ultrasound-guided FICB was performed within 30 min after operation.Group R received 0.25 ％ ropivacaine 30 ml,while the equal volume of normal saline was used instead of ropivacaine in group NS.All patients received PCIA with 0.01 mg/ml fentanyl after FICB.PCIA included a bolus dose of 2 ml with a 15 min lockout interval and no background infusion.Pain at rest was evaluated using VAS (RVAS) score before FICB (T0 ）and at 3 h(T1 ),6 h(T2 ),8 h(T3 ),12 h(T4 ),24 h(T5 ),48 h(T6 )and 72 h(T7 )after FICB.The passive exercise VAS (PVAS) score at T4-6,T7 and active exercise VAS (AVAS) score at T5-7 were recorded.The consumption of fentanyl at 0-12 h,12-24 h、24-48 h and 48-72 h after FICB and the adverse effects were also recorded.Results Compared with group NS,RVAS score,PVAS score,AVAS score and the consumption of fentanyl were significantly decreased in group R.There was no significant difference in the adverse effects between the two groups.Conclusion Ultrasound-guided FICB can provide better postoperative analgesia with little adverse effects in patients undergoing total hip arthroplasty.

Objective To observe the rehabilitation of “Six Healing Sounds” on mild anxiety disorders of the old and middle-aged persons.Methods All patients were randomly divided into “Six Healing Sounds” exercise group and control group using random number table.Self-Rating Anxiety Scale (SAS),Hamilton Anxiety Scale (HAMD) were adopted for evaluating the efficacy of the subjects before and three months after the practice.“Nerve-physiology information workstation” was setup to record the changes of cerebral electric powder of both groups before and 3 months after the treatment.The data was further analyzed by “intelligent cerebral powder analyzing system”.Results ①After three months practice,clinical efficacy shwoed significant difference between the two groups (exercise group 66.67％,control group 26.19％.HAMA(12.440±4.104) and SAS (36.355±15.085) score decreased significantly after the treatment in the exercise group.HAMA score,the SAS score and HAMA reduction rate (26.3±23.8)％ had significant difference between the two group.②)Frequancy changes:the change of β1 (0.1005±0.0132) μν2 before and after the exercise in the exercise group showed significant difference than that in the control group.③Space changes:in the exercise group after 3 months:F3(3.7449±3.0739),F4(3.9948±3.5865),P4(2.6442±1.7867),O1 (2.5845 ± 1.7883),T4(2.7916 ± 2.0327)were increased than before; Fpl (5.4771 ± 3.9768),Fp2 (5.8682 ± 3.8109),O2 (4168 ± 2.9227 ) were increased than before; comparison between the exercise group and control group:Fp1、Fp2、F3、F4、P4)、O1、T4Fp1 (3.8686±3.2034),Fp2(3.9419±3.4709),F3(2.5632±2.0258),F4(2.6763±2.2542),P4(1.7535± 1.7334),O1(1.6426± 1.5885),T4(1.8626± 1.7103) in the exercise group were obviously increased; O2 (1.8942± 1.8346)was significantly increased in the exercise group.Conclusion “Six Healing Sounds” had rehabilitation effects on anxiety disorders of the middle-aged persons.

Objective To investigate the efficacy of continuous fascia iliaca compartment block withdifferent concentrations of ropivacaine for postoperative analgesia in patients undergoing total hip arthroplasty.Methods One hundred and sixty ASA physical status Ⅰ or Ⅲ patients,aged 52-84 yr,body mass index 18-26 kg/m2,scheduled for total hip arthroplasty,were randomly divided into 4 groups (n =40 each) using a random number table:0.20％ ropivacaine group (group A),0.25％ ropivacaine group (group B),0.30％ ropivacaine group (group C) and 0.35％ ropivacaine group (group D).A catheter was inserted into the fascia iliaca compartment on the affected side within 30 min after operation.The corresponding concentrations of ropivacaine 20 ml were given in each group.The catheter was then connected to a patient-controlled analgesia pump programmed to deliver 10 ml with a lockout interval of 60 rin for postoperative analgesia (72 h).When VAS score at rest≥4,parecoxib sodium 40 mg was injected intravenously.At 12,24,48 and 72 h of blockade,the passive and active exercise VAS scores were recorded.The consumption of ropivacaine within 72 h after the end of blockade,and requirement for parecoxib sodium and development of adverse reactions during blockade were recorded.Results Compared with group A,the passive and active exercise VAS scores were significantly decreased in C and D groups (P ＜ 0.05),and no significant change was found in group B (P ＞ 0.05),and the consumption of ropivacaine within 72 h after the end of blockade was significantly decreased in B,C and D groups (P ＜ 0.05).There was no significant difference in the passive and active exercise VAS scores between group C and group D (P ＞ 0.05).There was no significant difference in consumption of ropivacaine within 72 h after the end of blockade between B,C and D groups (P ＞ 0.05).There were no significant differences in the requirement for parecoxib sodium and incidence of vomiting among the four groups (P ＞ 0.05).Conclusion The optimum concentration of ropivacaine is 0.30％ when used for continuous fascia iliaca compartment block in patients undergoing total hip arthroplasty.

Objective At present , there is only a small amount of survey scale of caregivers′cognitive level on continuous nursing care for premature infants , which had not been subject to stringent testing of reliability and validity .This paper aims at developing a suitable survey scale of caregivers′cognitive level oncontinuous nursing care for 0-1 year premature infants , and testing its reliability and validity. Methods Convenience sampling method was used and totally 495 caregivers of premature infants of Army General Hospi-tal affiliated BaYi Children hospital from April to August 2016 has been investigated .After we had preliminary content of the question-naire, two-round Delphi consultations were used to identify the draft of the scale , and the reliability and validity were tested . Results Totally 419 valid questionnaires from 495.Questionnaires effective recovery was 84.65%.Critical ratio for each entry was 9.355-23.179 ( P<0.05) , which suggested that entries had good distinction .Coeffi-cient of correlation between scale items and total score was 0.500-0.775(P<0.05), whichindicated highly homogeneity between entries and table.By exploratory factor analysis , 5 entries were removed and 77 entries remained .The final scale of caregivers′cognitive level on continuous nursing care for premature infants included 4 indicators in level one , 15 indicators in level two and 77 indicators in level three .The Cronbach′s alpha was 0.985 for overall questionnaire and 0.848-0.939 for each dimension .The split-half reliability was 0.895 for overall questionnaire and 0.814-0.939 for each dimension .The content validity index was 0.963.The cumulative contribution rate of each dimension was 64.645%-83.236%. Conclusion The scale content was scientific and comprehensive .It can be used to investigate the caregivers′cognitive level on continuous nursing care for 0-1 year pre-mature infants, direct nurses to provide continuous care for premature infants , and evaluate the continuous nursing effect .