Causative factors of multi-drug resistance tuberculosis (MDR-TB) were analyzed from iatrogenic angles, patients themselves, and society. Reviewed was the development of treatment strategies for MDR-TB from directly observed treatment short-course (DOTS) to DOTS-Plus. The history of Chinese medicine (CM) fighting TB and characteristics at the present stage were also analyzed. Authors pointed out that CM pays attention not only to killing pathogens and confirms the necessity of getting rid of pathogens, but also to cascade response caused by pathogens. It also regards the occurrence and development of MDR-TB as a whole by combining patients' conditions, climatic, geographic, psychological, and social factors. Authors believed that therapeutic principles under guidance of CM holistic view are of positive significance and inspiration in treating MDR-TB, and emphasized holistic view as basic strategies for treating MDR-TB, but not a single countermeasure.
Antitubercular Agents ; therapeutic use ; Holistic Health ; Humans ; Medicine, Chinese Traditional ; Tuberculosis, Multidrug-Resistant ; therapy

Objective To compare the clinical outcomes of arthroscopy versus mini-incision surgery for the treatment of avulsion fracture of the tibial attachment of the posterior cruciate ligament (PCL).Methods From March 2001 to September 2009,84 patients with acute displaced avulsion fracture of the tibial PCL attachment were treated operatively in our department.Thirty-five patients were treated with arthroscopic reduction and suture fixation (Group 1); 49 patients were treated with open reduction through a mini-incision and internal fixation with cannulated screw(s) and washer(s) (Group 2).There were 27 males and 8 females in group 1,with a mean age of 29.6 ± 5.6 years old,and 40 males and 9 females in group 2,with a mean age of 32.2 ± 7.6 years old.Based on the Meyers & Mckeever classification,there were 24 type Ⅱ fractures and 11 type Ⅲ fractures in group 1,and 31 type Ⅱ fractures and 18 type Ⅲ fractures in group 2.The 2 groups were compared in terms of range of motion,posterior drawer test (PDT),Lysholm score,International Knee Documentation Committee (IKDC) grading,and clinical results.Results All the patients obtained an average follow-up of 21.5 months (range,13 to 34 months).Primary union was achieved in all the fractures 3 months postoperatively.There were no significant differences between group 1 and group 2 regarding the PDT negative rate [82.9％ (29/35) versus 91.8％ (45/49)],the Lysholm score (95.1 ± 5.6 versus 96.1 ±4.7),therate ofIKDC grade A [88.6％ (31/35) versus91.8％ (45/49)],or the rate of normal range of motion [94.3％ (33/35) versus 93.9％ (46/49)] (P ＞ 0.05).On average,group 1 used significantly longer operative time (92.4 ± 15.9 minutes) than group 2 (53.8 ± 14.3 minutes).Conclusions Both arthroscopy and mini-incision surgery can achieve satisfactory clinical outcomes in the treatment of PCL tibial avulsion fracture.Although the 2 methods make no significant differences in stability of the knee joint and clinical scores,mini-incision surgery can result in much shorter operative time and thus permit an early postoperative rehabilitation.

Objective The experiment was designed to observe the effect of inhaled arsenic trioxide(As2O3)and in combination with inhaled moxa leaf oil on eosinophils(EOS)and lung tissue's morphology in asthmatic guinea pigs, and to explore its mechanism of relieving wheezing. Methods The ovalbumin(OVA)-induced asthmatic guinea pig model was established. Sixty guinea pigs were randomly divided into As2O3 atomization inhalation group B1 As2O3 low dose group:2.0 mg/(kg·d), B2 As2O3 high dose group:4.0 mg/(kg·d), combined treatment group C1 low dose group:2.0 mg/(kg·d)+moxa leaf oil 0.05 ml, C2 high dose group: 4.0 mg/(kg·d)+moxa leaf oil 0.10 ml, saline aerosol inhalation group(group A) asthma model group)and normal control group(group D)according to random permutation table method. After 7 days medicated, the EOS in bronchoalveolar lavage fluid(BALF)were compared. Guinea pig lung, heart, liver and kidney pathological specimens were prepared and the change of the lung tissue's inflammation and heart, liver and kidney tissue were investigated. Lung tissue’s electron microscopy specimens were prepared and the apoptosis of acidophilic cells and repair of alveolar epithelial cells were observed. Results Compared with asthma model group's EOS number[(58.08±19.01)×105], the difference in As2O3 low dose group、As2O3 high dose group、combined treatment low dose group、combined treatment high dose group and normal control group[(26.37±1.12)×105, (11.50±1.61)×105, (14.16±4.88)×105, (5.03±1.66)×105 and(0.35±0.16)×105, respectively] were statistically significant(P<0.01); there was statistical difference between As2O3 low dose group and As2O3 high dose group(P<0.01);There was statistical difference between As2O3 low dose group and combined treatment low dose group(P<0.01);There was statistical difference between As2O3 high dose group and combined treatment high dose group(P<0.05). Compared with combined treatment high dose group, difference in As2O3 low dose group、As2O3 high dose group and combined treatment low dose group was statistically significant(P<0.05). The difference in B1, B2, C1, C2 and D group was statistically significant compared with group A (P<0.01). The difference in B1 and B2, B1 and C1 group was statistically significant (P<0.01). The difference between B2 and C2 group was statistically significant(P<0.05). The difference in C2 group was statistically significant compared with group B1, B2 and C1(P<0.05). Conclusion EOS abnormal apoptosis was an important pathogenesis of bronchial asthma. The mechanism of arsenic trioxide anti-asthma was that arsenic trioxide could reduce acidophil infiltration and promote acidophilic cell apoptosis. The mechanism of moxa leaf oil anti-asthma was it could reduce acidophil infiltration. Smaller doses of the combination of inhaled As2O3 and moxa leaf oil was safe and effective to achieve the effect of relieving wheezing and the combined use had synergy.

Objective To describe the arthroscopic reductions and fixation of tibial intercondylar eminence fracture with cannulated screws. Methods During February 2003 to September 2005, 40 patients were treated arthroscopically for fracture of the tibial intercondylar eminence. The average age was 29.5 years (11-58 years), with a mean follow-up time of 20.1 months(6-37 months). Among the 40 patients, there were 4 type Ⅱ fractures (10%), 24 type Ⅲ fractures (60%) and 12 type Ⅳ fractures (30%). The fragments were reduced and fixed with cannulated screws. All-arthroscopic technique was adopted in all cases. The hematoma and the fragment were debrided, and the bony fragment was reduced and temporarily fixed with 2-3 guide wires through the portal superomedial to the patella. Intra-operative X-ray was taken to prove the reduction. One or two cannulated screws were used to fix the fragment as the definite fixation. Results The fracture healed completely in all but 1 patient. Lachman test were negative in all patients postoperatively. The average postoperative KT-1000 manual maximum displacement(MMD) was 0.625 mm(?蛳1-2 mm) and average Lysholm score was 98.3 points(87-100 points). The range of motion was normal in 34 patients. Flexion deficit was found in 5 cases, but within 10?. Knee joint stiffness was found in 1 case with range of extension and flexion 0?-30?-45?. A secondary operation with arthroscopic release was performed. The range of extension and flexion was improved to 0?-10?-80? postoperatively. Mild anterior knee pains were found in 8 patients. For 4 young patients with open epiphysis, the cannulated screws were removed 10-12 weeks post operation. No growth disturbance was detected for these 4 patients at final follow-up. Conclusion Arthroscopic fixation of fracture of the tibial intercondylar eminence with cannulated screw is a simple, safe and effective procedure suitable for both children and adult patients.

Objective To present the preoperative planning protocol and surgical procedures of computerized navigation technique in arthroscopic anterior cruciate ligament (ACL) reconstruction, and the comparative study results of tibial and femoral bone tunnel positions between navigation and arthroscopy technique. Methods The proper placement of femoral and tibial tunnels were planned preoperatively in standard AP and lateral X-ray view. Intraoperative fluoroscopic images were taken and inputed into navigation computer system to form the virtual interactive working fields. After placement and registration, signals from patient trackers being fixed into distal femur and tibia respectively, and tool trackers being attached with ACL tibial and femoral guide, were identified and captured by the optic navigation camera and so, the navigation computer system could pursued the real-time position of the ACL guide tools and the virtual tunnel positions were projeted into the working fields to help precise placement of femoral and tibial tunnels. From December 2005 to April 2006, 46 patients underwent fluoroscopy assisted anterior cruciate ligament reconstruction. Of them, 40 cases were evaluated with the postoperative X-ray lateral view to measure the placement of both femoral and tibial tunnels, and compared with the group of 40 cases of arthroscopy assisted ACL reconstruction in the same study period. Results For the navigation group, the average position of tibial tunnel was 45.35%?3.827% (37% to 53%) and 62.25%?5.610% (52% to 73%) for femoral tunnel. For the arthroscopic group, the average tunnel positions was 41.05%?6.008% (25% to 54%) for the tibia, and 56.62%?7.316% (46% to 77%) for the femur. With reduced SD, the average positions for both of the 2 tunnels in the navigation group were significantly more posterior than the arthroscopic group(P

It is pointed out that nursing personnel at the clinical forefront are a high-risk group for occupational injuries. The risk factors include: lack of knowledge on occupational injuries and their prevention in elementary and continuing education; various factors affecting nursing personnel's physical health, such as drug-dissolving facilities for the special purpose of chemotherapy, imperfect clean work station or relatively hermetical drug-dissolving environment ; increase of diseases that could be easily contracted in the hospital, such as hepatitis B, with the stabbing of nursing personnel by sharp medical instruments infected by blood or saliva being the main route of their occupational infection. The disadvantageous impact of occupation on their health puts nursing personnel under great psychological pressure. In order to safeguard their physical and mental health, it is imperative to put knowledge on hospital infection, occupational injuries and health maintenance on the curriculum of medical colleges and universities, reinforce nursing personnel's training in occupational safety, and take measures to prevent occupational injuries, such as using disposable gloves when dispensing medicines in chemotherapeutic drug centers.

Objective To analyze the frontier and evolution of cognitive neuroscience. Methods CiteSpace Ⅱ was running on Java platform. Results By analyzing the node types,such as the author\institution\country\keyword\cited reference with the tool of Information Visualization, the critical subject for reference and the focuses were quickly defined, and the basic literature and the key literature of cognitive neuroscience were specifically determined and carefully reviewed.Conclusion Keeping track of the evolution trends and significant changes will contribute to development of cognitive neuroscience.

Objective:To research and summarize the characteristics and medication regulars of external medicine for hydrocephalus therapy with TCM. Methods:Retrieved literatures of explicitly recorded external medicine in all ages,input its drugs into the Excel sheet specifing and specified various terms used for drug,adopted spss17.0 frequency analysis,principal factor analysis,cluster analysis, and sought its regulars.Results:Frequency analysis of external medicine from higher to lower in order as Radix Ledebouriellas,Rhizoma Bletillae,Arborvitae seed,Cinnamon bark,Ackinthepulpit tuber,Rhizoma Zingiberis ect. Withdrawed 16 main factors from 50 original targets, used cluster analysis made 16 main factors into 10 types as eliminating phlegm for resuscitation,activating blood and disinhibiting fluid etc. Conclusion: External medicine for hydrocephalus therapy mainly as drugs for activating blood and dissolving stasis, expelling wind with diaphoresis, warming yang,reinforcing kidneys to strengthening bones,regulating qi.Multivariate statistical analysis can objectively and comprehensively reflect the characteristics and regulars of external medicine and provided some exploratory thoughts.

AIM:To sieve the optimal purification of the total flavonoid from Mulberry Leaves by exploring 8 types of macroporous resin's static and dynamic adsoption-desorption.METHODS:The factors affecting separation,such as flow rate concentration,pH and kind of eluting agent were considerated.RESULTS:Experiment results showed that AB-8 resin possesses high absorption capacity.The best craft was:the adsorption and desorption-power was 2 BV/h,the content of the total flavonoid in liquid was 0.613 mg per 1 mL,pH 4,as the desorption solvent,the concentration of ethanol was 70%,regenerate the resin after using three times.CONCLUSION:Flavones content used the method can be up 2-fold.

Objective To establish a HPLC method for the determination of preservative in iron maltose syrup.Methods A Kromasil 100-5 C18 column was used with acetonitrile-sodium acetate buffer solution(40 ︰60) as the mobile phase at the flow rate of 1.0 mL/min and 254 nm as the detection wavelength.The column temperature was set at 30 ℃.Results The calibration curve was linear within the range of 0.62 ~3.72 μg/mL for methyl parahydroxybenzoate, 0.18~1.07μg/mL for propyl parahydroxybenzoate, and the linear equation was Y=228494X-2512.5,Y=203351X-3471.4, respectively.The average recovery of methyl parahydroxybenzoate, propyl parahydroxybenzoate was 100.9%(RSD=1.5%),99.6%(RSD=0.5%), respectively.Conclusion The established method is simple, rapid and accurate, which could be used in the determination of preservative in iron maltose syrup.