Objective:To establish the quality control method for Tribulus terrestris L. by colorimetry and HPLC. Methods:The HPLC method was with a Welch Ultimate LP-C18 column(250 mm × 4. 6 mm,5μm),the mobile phase was methanol-water(80:20) and the detection wavelength was 203 nm. The colorimetry was with a perchloric acid method. The saponins of Tribulus terrestrist as the index,the determination method for total saponins and saponins of Tribulus terrestris L. was established. Results:The results of the HPLC and colorimetry methods showed saponins of Tribulus terrestris had good linear relationship within the range of 0. 820-7. 380 μg and 24. 600-86. 100 μg with the average recovery of 99. 3% and 99. 5%,respectively. Total saponins and saponins of Tribulus terres-tris in Tribulus terrestris from 18 habitats were measured by the methods. Conclusion:The methods are sensitive,accurate and repro-ducible,and can be used as the quality control methods for Tribulus terrestris.

Objective To optimize the microemulsion preparation of Fufang Zicao Oil(FZO).Methods The extraction conditions of microemulsion preparation of FZO were optimized by orthogonal experiment;the kinds and contents of surfactants and cosurfactants determined by pseudo-ternary phase diagram were used for the optimization of the prescription of FZO;centrifugation method was used for detecting the stability of FZO.Results The optimum extract conditions were as follows:10-mesh coarse powder of medicinal material,four times amount of solvent(sesame oil),extraction for 25 minutes.With Tween 80 and propylene glycol(7:3)as the surfactant and cosurfactant,and mixing with the oils in the proportion of 20:10,a steady microemulsion of FZO can be obtained after centrifugation by 13000 r? min-1 for 30 min.Conclusion Under the above achieved conditions,the obtained microemulsion of FZO is clear,transparent and steady.

Objective:To observe the clinical application of flexible endoscope assisted by general versus pillow-under-shoulder supine position in nasotracheal intubation of the patients with difficult airway, and to explore the influence of intubation position in the intubation effect.Methods: A total of 168 patients with difficult airway who underwent nasotracheal intubation and oromaxillofacial surgery under general anesthesia were randomly divided into general supine position (control group) and pillow-under-shoulder supine position (experimental group) with 84 cases in each group.The first-time and the total success rate of intubation, the intubation time, and the rate of direct glottis exposure of the patients in two groups were recorded.The mean arterial pressure(MAP), heart rate (HR), and complications of intubation of the patients in two groups before induction, before tracheal intubation, during intubation, 1 and 5 min after intubation, were also recorded.Results:The first-time success rate of intubation in experimental group (94.0 %, 79/84) was significantly higher than that in control group (71.4%, 60/84) (P<0.01);the total success rate of intubation (98.8%, 83/84) had no difference compared with control group (97.6 %, 82/84) (P>0.05);the intubation time (57 s±12 s) was significantly shorter than that in control group (146 s±29 s) (P<0.01);the rate of direct glottis exposure (47.6%, 40/84) when the flexible endoscope passed through the posterior nasal apertures was obviously higher than that in control group (15.5 %, 13/84) (P<0.01).The values of MAP and HR of the patients in two groups before and during intubation were decreased significantly compared with the baselines (P<0.01), and came back to the baselines 1 and 5 min after intubation (P>0.05).There were no significant differences in the MAP and HR between different time points (P>0.05).The incidence rates of complications including pharyngalgia, hoarseness and epistaxis had no differences between two groups (P>0.05).Conclusion: Flexible endoscope assisted by pillow-under-shoulder in nasotracheal intubation has a higher intubation success rate, shorter intubation time and it is a superior procedure for the patients with difficult airway.

Objective To study the correlation between the electrophysiological features and mechanical ventilation and long?term outcome in Guil?lain?Barré syndrome(GBS)patients. Methods Electrophysiological and clinical data were retrospectively collected,and compared between venti?lated and not ventilated patients,as well as among each subtype of GBS. Results Totally 38 GBS patients were included in the study,among which 12(32%)were ventilated. The p/d CMAP ratio of the common peroneal nerve was significantly lower in ventilated group compared to not ventilated group(48.7±15.3 vs 80.8±24.0,P=0.005). AIDP was the most common subtype in ventilated patients compared with AMAN and undetermined (46%vs 0%and 9%,P=0.027). The long?term outcome score of AMAN was significantly lower than AIDP(4.3±1.3 vs 2.5±0.9,P=0.028). Conclusion Electrophysiological testing was predictive for mechanical ventilation and long?term outcome:low p/d CMAP ratio of the common pero?neal nerve was helpful for predicting mechanical ventilation,AIDP was prone to develop respiratory failure and had a worse outcome compared to AMAN.

Objective To retrospectively study the clinical and electrodiagnostic features in subacute combined degeneration of spinal cord (SCD)patients. Methods The clinical and electrodiagnostic recordings of all SCD patients conformed in our Neurology Department from Janu?ary 2013 to July 2015 were retrospectively reviewed. Totally 29 patients diagnosed as SCD,whom received no treatment before admitted in our hos?pital,were recruited for the study. Correlation analysis between serum level of vitamin B12(VB12),course of disease and degree of neural lesion was performed,and the electrodiagnostic features were summarized and analyzed. Results The course of disease had significant correlation with the degree of neural lesion(P=0.001),but there was no significant relevance between serum VB12 level and neural damage(P>0.05). Electrodi?agnostic examination revealed:The abnormal rate of motor nerve(15.20%)was lower than that of sensory nerve(42.75%,P<0.001)and the up?per limb nerve(27.1%)was lower than that of lower limb nerve(30.87%,P=0.578). There was no remarkable difference of abnormal rate in all kinds of nerves of motor and sensory nerve(P1=0.320,P2=0.755). In the analysis of the parameters of electromyograph,there was statistical signif?icance of the abnormal rates of compound muscle action potential(CAMP)between each motor nerve(P=0.005). There was statistical signifi?cance of the abnormal rates of CAMP and no function between each sensory nerve(all P<0.001). Conclusion The course of disease has signifi?cant correlation with the degree of neural lesion. Sensory nerve is tended to be betreffend than motor nerve. Phil.always nervous are more likely to be affected than others in motor nerve at CAMP. Tibial nerve is easier to be influenced at CAMP in sensory nerve ,and the lesion is more serious.

Currently,the toxicity study of traditional Chinese medicine is faced with the following problems. Firstly,the evaluation in vitro cannot fully reflect the true state of the body. Secondly,the traditional method is not sensitive enough to the early toxicity. Lastly,the toxicity evaluation indexes cannot determine whether the compatibility of traditional Chinese medicine produces toxicity or increases toxicity systematically. The paper proposed a synthesized early evaluation research method for target organ toxicity induced by traditional Chinese medicine:screening,validation,optimization and application. This method mainly inoolves early target organ toxicity biomarkers in screening,optimi?zation,validation,biological significance explanation,and application to the traditional Chinese medicine incompatibility based on the metabolic dynamic fingerprint spectrum in order to obtain biomarkers of target organ toxicity that are sensitive and precede conventional biochemical indices for early evaluation . We attempted to analyze the pattern of chang of the biomarkers for animals acted by″18 incompatible medicaments″compatibility combination. We found that Radix Aconiti Lateralis Preparata with cardiotoxicity were compatible with Rhizoma Pinelliae,and that Trichosanthes kirilowii Maxim,Fritillaria,Ampelopsis Radix and Bletilla striata without non-cardiotoxicity produced and increased cardiotoxicity systematically.

The Algerian medical health system provides free medical care. The incidence of non-communicable diseases, such as ischemic heart disease, stroke and Alzheimer’s disease, are high. Acupuncture has become a popular treatment recognized by the public with certain influence. However, some problems restrict the development of Traditional Chinese Medicine (TCM) in Algeria, like insufficient training of TCM talents; lack of TCM related knowledge, and medical insurance policy uncoving TCM. Based on the status quo of TCM, we suggested promotion and dissemination of TCM development in Algeria, including breaking through education limitation to expand the talent team, carrying out targeted publicity to expand the influence of TCM, promoting the inclusion of TCM in medical insurance and government legislative protection. Only in these ways, could we increase and expand the strength and scope of TCM influence, and promote the development of TCM in Algeria.

American medical insurance is mainly composed of public medical insurance borne by the government and private medical insurance. The main cause of death in this country are ischemic heart disease, Alzheimer’s disease, and lung cancer. The motality rate mainly caused by drug use disorders, chronic kidney disease and Alzheimer’s disease. The development of Chinese herbal medicine is relatively slow and difficult. The education system has covered Traditional Chinese Medicine (TCM). However, there still exist certain challenges of the development of TCM acupuncture faces the challenge of localization; Chinese herbal medicine still lacks standardization and TCM education needs to be standardized. Based on the current situation, it is suggested to focus on the development of acupuncture and moxibustion, to promote the registration and declaration of Chinese herbal medicine products for treating difficult diseases, and to strengthen the international exchange of TCM education, so as to promote the development and spread of TCM in the United States.

Egypt’s medical insurance is mainly covered by government and commercial insurance. The low coverage of commercial insurance and the quality of medical services needs more improvement in Egypt. Recently, the incidence rate of diabetes, chronic kidney disease, hypertensive heart disease, COPD and liver cancer is rising. Traditional Egyptian medicine is similar to Traditional Chinese Medicine (TCM), and its modern traditional medicine is mainly Arabian medicine. Acupuncture, as the main form of TCM, was introduced into Egypt in the 1970s, but it has not been covered by the medical insurance system. The development of TCM in Egypt needs improvement. It is suggested that further explorated fields should be focused on the acupuncture therapy, TCM education and TCM treatment of keeping health in Egypt.

The popularization of medical insurance in Panama has been basically completed. The coverage of health insurance is high, but with the problem of polarization. The major causes of death in Panama are is chemic heart disease, stroke, AD and diabetes. In recent years, the chronic kidney disease and COPD are increasing significantly. Panamanian native medicine, considered as complementary and alternative medicine, is recognized by local laws and usedby most of indigenous groups and rural people. Traditional Chinese Medicine (TCM) in Panama is at the starting stage, and there is no relevant legislation. However, this country attaches great importance to indigenous traditional medicine, and more and more people gradually accept it. TCM has great development potential in this country. It is suggested to promote the development of TCM in Panama. By culture as the pathway, exploring various forms of cooperation and exchange, taking the research and development of traditional herbal medicine as the breakthrough point, and increasing the spead of acupuncture usage, etc.