Objective To observe the effect of local curettage combined with ointment in fistula applying in refractory apical fistula.Methods 56 cases of patients with refractory apical fistula one month after faultless root cannal therapy divided into group A and B by lottery,with 28 cases in each group.Local curettage combined with ointment in fistula applying in group A,and no processing applying in group B.One year fellow up was given to every patient to compare the effect between the two groups.Results All the 28 cases of patients with refractory apical fistu-la were recovering in three months.The improvement rate was 100%,recovery rate 100%,and the mean time of fistula disappearing was (0.5 ±0.1)months,time of shadow around root tip disappearing (2.5 ±0.7)months.Four cases in group B were improved in three months,three cases in six months and one case in nine months,with two cases recove-ring.The improvement rate was 28.57%,recovery rate was 7.14%,and the mean time of fistula disappearing was (5.0 ±0.7)months,time of shadow around root tip disappearing (9.4 ±1.0)months.The improvement rate in group A was higher than that in group B (χ2 =33.749,P<0.05),recovery rate in group A was higher than that in group B (χ2 =49.727,P<0.05).The mean time of fistula disappearing in group A was shorter than that in group B (t=3.081,P<0.05),mean time of shadow around root tip disappearing in group A was shorter than that in group B (t=5.042,P<0.05).Conclusion It was effective to apply local curettage combined with ointment in fistula applying in refractory apical fistula,and it is worthy of clinical popularization.

Emodin is the main effective monomer of Rhubarb, which has a variety of pharmacological actions and valuable clinical applications.Recently, there are many reports about molecular mechanisms of emodin pharmacological actions,and they givehighly attention on the dephlogisticating and antineoplastic effects. These effects are achieved through affecting the concentration and transportation of ions, resisting of oxidation and free radical, and affecting the secretion of inflammatory factor and the enzyme activity and apoptosis and so on. This article summarizes the reports and hopes to provide theoretical basis for the practical application.

Histone deacetylases (HDACs) catalyze the deacetylation of histone and nonhistone proteins. They play important roles in regulating chromatin remodeling and gene transcription,and that aberrant chromatin remodeling and transcriptional dysregulation are associated with many neurodegenerative diseases. Preclinical studies have suggested that histone deacetylases inhibitors (HDACIs) can target diverse pathophysiologies of ischemic stroke,not only reduce neuronal damage and infarct volume,but also promote the neuronal plasticity and functional recovery after ischemia. This article mainly reviews the neuroprotective mechanisms of HDACIs in ischemic stroke.

No abstract available.
Adenomatous Polyposis Coli*

Rat brain development is a complicated process.There are significant changes of histology, cytology and molecular biology in the process of fetal and postnatal brain development.The basic structure of brain has formed in the prenatal period.While the formation of connections between different parts and the improvement of the function of the brain occur after birth, during which many of the variations are bases of the nervous system diseases, so the postnatal brain development is still very important.Although the concept of brain microenvironment has been proposed more than 150 years ago, the research about the changing extracellular space ( ECS ) during the postnatal brain development has yet to gain significant progress.The author reviewed the anatomical and physiological characteristics of ECS in the process of postnatal development of the rat, stating the important role of ECS in the individual development, which is expected to provide reliable evidences for the explore of mechanisms and effective treatment approaches of pediatric development related nervous system diseases.

Objective To investigate the risk factor profile of pneumonia caused by pandrug-resistant Acinetobacter baumannii (PDRAB)in intensive care unit for better distinction between PDRAB infection and colonization.Methods The clinical data of 99 patients diagnosed as A.baumannii pneumonia between February 2009 and March 2012 in Fangcun Hospital,a branch of Guangdong Provincial Hospital of Traditional Chinese Medicine,were reviewed and analyzed retrospectively.The risk factors associated with pandrug-resistance in A.baumannii were examined with multivariate logistic regression analysis.Results ICU stay,duration of invasive ventilation,longer duration of treatment with carbapenems,beta-lactam/beta-lactamase inhibitor,or quinolone antibiotics,use of ≥3 classes of antimicrobial agents,≥3 invasive procedures (including indwelling gastric canal, catheterization,central venous catheter,arterial sheath),and fiberoptic bronchoscopic treatment were associated with PDRAB pneumonia (P <0.05).Multivariate logistic regression analysis showed that use of ≥3 classes of antibiotics,fiberoptic bron-choscopic treatment,and longer duration of treatment with beta-lactam/beta-lactamase inhibitor were independent risk factors predicting the emergence of PDRAB pneumonia.Conclusions We should pay more attention to these risk factors in clinical prac-tice for better differentiation between PDRAB infection and colonization so that appropriate control measures can be taken pro-actively.

Aim: To establish a method for the determination of pantoprazole sodium and its related substances. Methods: A column packed with octadecylsiance bonded silica gel (250 mm × 4. 6 mm, 5 pjn) was used. The 0. 01 mol/L monopotassium phosphate solution( adjusted with phosphoric acid to pH 7. 0) -acetonitrile were adopted as the mobile phase, a gradient elution was programmed as follows: 0→30 min(90:10-60:40), 30→45 min(60: 40→15: 85); the detection wavelength was 289 nm; the column temperature was 40 ℃; the flow rate was 1. 0 mL/min. Results: Pantoprazole sodium, the intermediates and its related substances could be well separated. A good linear relationship was obtained over the range of 6. 96-48. 72 μg/mL( r =0. 999 9). The limit detection and quantisation of pantoprazole sodium were 8.51 ng and 17.0 ng, respectively. Conclusion: This method can be applied to control the related substances of pantoprazole sodium and determine pantoprazole sodi-um.

Objective To investigate effect of platelet-associated antibody to the platelet transfusion.Methods Platelet-associated antibody in 120 patients who needed repeated platelet transfusion for long-time was determined by enzyme-linked immunosorbent assay (ELISA),and platelet count was assayed before and after blood transfusion,and the effect of platelet transfusion was investigated by corrected platelet count.Crossmatch approcah was used to screen compatible platelet for patients with platelet relative antibody positive.Results The ratio of positive platelet-aasociated antibody in patients who needed repeated platelet transfusion was 65.0％,and the ratio of platelet transfusion resistance was 61.7％.The ratios of platelet transfusion resistance were 84.6％ and 19.0％ respectively in patients with positive platelet-associated antibody and in patients with negative platelet-associated antibody,which were different in statistic in both groups( x2 =,46.914,P ＜0.0l ).The effective ratio of platelet transfusion in patients with positive platelet-associated antibody after crossmatch approach was 85.9％.Conclusion Positive platelet-associated antibody was related to platelet transfusion resistance with high risk,and crossmatch approach could increase the effect of platelet transfusion.

Objective To study the effect of different transfusion measures on the clinical outcome in preterm infants.Methods 100 cases of blood transfusion in preterm infants were chosen.They were divided into restrictive transfusion group and non-restrictive transfusion group.The clinical outcomes of infants were recorded.Results The Hct of children with restrictive transfusion group pre-transfusion was(27.97±4.86) ％,which was significantly lower than pre-transfusion Hct of non-restrictive transfusion group(34.51±6.34) ％.The difference was statistically significant(t =3.78,P ＜ 0.05).The differences of each transfusion value,each blood transfusion and transfusion times for the two groups of infants were not statistically significant(t =0.59,0.37,0.68,all P ＞ 0.05).The invasive ventilator of the non-restrictive transfusion group was(5.73±4.95)d,significantly less than the restrictive transfusion group(7.61±5.72) d.The difference was statistically significant(t =2.36,P ＜ 0.05).The differences for the rest of the clinical outcomes for the two groups of infants were not statistically significant(P ＞ 0.05).Conclusion The reducing of non-restrictive transfusion invasive ventilator time may be more conducive to clinical recovery in preterm infants.The clinical should not blindly adopt conservative restrictive transfusion countermeasures.

After summing up the experience of recent years' clinic teaching, ICU department in Fangcun Branch of Second Clinical Medical College of Guangzhou University of TCM comes to a conclusion that, the clinical teaching of ICU should pay attention to and ensure effective implementation of beginning educationg. And following the PDCA method (Plan, Do, Check & Act) will make the work orderly, normative and controllable and meanwhile raise the students' observing and analysis ability as well as their operation and doctor-patient communication ability. In this way we can mostly enhance the effect of teaching.