Objective:To investigate the efficacy of compound carbidopa tablets combined with Bunao Xifeng Zhijing soup in the treatment of Parkinson’s disease(PD)and the influence on the levels of IL-6,IL-1β,MDA,SOD and serum cystatin C. Methods:Totally 68 patients with PD were divided into the observation group and the control group with 34 cases in each. The course of treatment was 3 months. The control group was treated with compound carbidopa tablets,and the observation group was treated with Bunao Xifeng Zhijing soup additionally. The Parkinson's disease quantitation table(UPDRS),quality of life,TCM symptoms,self-rating depression scale(SDS),self-rating anxiety scale(SAS)and changes of inflammatory factors before and after the treatment were compared between the two groups. Results:After the treatment,UPDRS-1,UPDRS-2,UPDRS-3, UPDRS-4,PDQ-39 SI,SDS,SAS and TCM symptom scores were all decreased in both groups(P < 0. 05),and the decrease was more notable in the observation group(P < 0. 05). Observation group UPDRS-4 score also significantly lower than the control group(P < 0. 05). After treatment,two groups of patients of interleukin(IL)6,IL-1 beta,malondialdehyde(MDA),serum(C level was a significant reduction in the inhibition(P < 0. 05),superoxide dismutase(SOD)levels,compared with the previous significantly increased(P < 0. 05). And the observation group of patients with IL-6,IL-1 beta,MDA,urinary inhibition C level significantly lower than the control group,serum SOD levels are significantly higher than control group(P < 0. 05). Observation group total effectiveness 91. 18% ,significantly higher than that of control group 64. 70%(P < 0. 05). Conclusion:compound carbidopa tablets combined with Bunao Xifeng Zhijing soup in the treatment of PD can significantly improve the movements and non-motor symptoms of the patients with high safety and good clinical efficacy.

Objective To evaluate the teaching effectiveness of applying article structure analysis to improve medical graduate students' ability to read research articles.Methods 48 medical graduate students from basic medicine school of the Fourth Military Medical University were randomly and equally divided into the experimental group and control group.In the reading ability training of scientific research papers,the experimental group used the teaching of the structure analysis,while the control group used the collective self study.Before and after the training,the two groups of students were implemented a unified reading ability test and self reading ability evaluation survey,and after the training,the teaching satisfaction survey was conducted among the experimental group only.SPSS 16 was used to analyze the correlation data and Wilcoxon for signed-rank t est.Results After training the reading ability test results showed that reading ability score (P=0.013),consumed reading time score (P=0.003) and reading efficiency (P=0.004) of the experimental group were significantly higher than those of control group.The two groups of students' self-evaluation of the reading ability showed that after training,the scores of the students in the experimental group were higher than those in the control group,and the differences were statistically significant (P values were less than 0.05).The experimental group students' teaching satisfaction survey to article structure analysis showed students' score in 6 survey contents were greater than 3,namely degree of evaluation was more than general,among which,the score of four survey contents was more than 4,that is to achieve satisfied or very satisfied.Conclttsion Applying article structure analysis can significantly improve medical graduate students' ability to read research articles.

Objective To investigate the acoustic characteristics of snoring sound in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and with simple snoring. Methods 22 patients with OSAHS and 15 with simple snoring were included in this study. Natural overnight snoring was digitally recorded and portable sleep mo-nitoring was performed simultaneously. 10 snores, which were the 1st snores after 10 cycles of obstructive apnea, from each patient in OSAHS group, and 10 snores from each patient in simple snoring group were analyzed in the time and frequency domains. Results The sound waves of snoring in the two groups exhibited different patterns both in the time and frequency domains. The snoring spectrum of patients with simple snoring showed distinct fun-damental- harmonic structures which were not clear in patients with OSAHS. The central frequency of the patients with OSAHS was higher, and 800 Hz power ratio was lower than those of the patients with simple snoring. In the OSAHS group, the central frequency of the patients with moderate-to-severe OSAHS was higher, and 800 Hz power ratio was lower than those of the patients with mild OSAHS. The differences of the two parameters were of statistical significance. Conclusion The snoring sounds in patients with OSAHS and with simple snoring have dif-ferent characteristics in time and frequency domains, indicating that it is feasible to research the OSAHS by way of snore monitoring and analyzing technique.

Objective To investigate the relationship between sound pressure level parameters of snoring sound and obstructive sites in patients with media or severe obstructive sleep apnea hypopnea syndrome(OSAHS). Methods Forty-six patients with media or severe OSAHS were included in this study.All underwent continuous upper airway pressure measurements and snoring sound pressure level recording simultaneously.The correlations between obstructive site,AHI,BMI and sound pressure level parameterssuch as equivalent continuous sound level (LAeq )and maximum sound pressure level (L10 )were analyzed.Results Both LAeq and L10 were affected only by AHI,whereas unrelated to obstructive site and BMI.Conclusion There is no definite relationship between the site of obstruction and sound pressure level parameters of snoring sound.It appears that LAeqand L10may be helpful to e-valuate the severity of OSAHS,but may have no clinical value on distinguishing obstructive sites.

Objective To investigta e the efficayc of bedside plasma exchange( PE) combined con-tinuous veno-venous hemodiafiltration ( CVVHDF ) in childer n with critical hemo lty ic uremic syndrome ( HUS) .Method s Eight patients with HUS from Pediatric Intensive Care Unit of Shanghai Ch ildren′s Hos-pitalw ere included in the present stuyd .The seveir ty of children was gar ded accordni g to peid atric critiac l ill-ness soc re and pediatric riks ofs core mortalityⅢ.Four of them received continuuo s blood purification treat-me nt.Meanwhile,the clinical manifestation and outcom e of HUS weer analyzed.Results Eight children with HUS weer ni itially trae ted with diuretic and blood transfusion for 12-24 hours.Four ac ses who deteriora-ted aggressively were ep rofr med PE and CVVHDF.Plasauto iQ21 and Prisma flex wereu sed with Pir sma TPE 2000 membrna e plasma separator and AN69 M60 membrane filter respectively.All the 4 patients with critical HUS survived after bedside continuous blood purification treatment.Clinical symptoms and serum bio-chemistry were improved sing ificantly as follows.The average levels of serum creatinine and lactate dehydro-genase decreased obviously(318μmol/L vs.162μmol/L;1 963 U/L vs.407 U/L,respectively).In addi-tion,platelet count increased significantly(40 ×109/L vs.97 ×109/L) .Eventually,symptoms disappeared in these 4 patients.Conclusion The combined therapy of PE and CVVHDF in HUS could stabilize fluid acid-base equilibrium,prevent hemolysis and improve the renal function.

ObjectiveTo evaluate the treatment efifcacy of the treatment promotion of standardized management for chil-dren with asthma.MethodsMedical records of 150 children with asthma were reviewed and divided into management group or control group according to whether standardized management was accepted. Comprehensive asthma education for asthma pa-tients and their parents including asthma associated basic knowledge education, health education as well as follow-ups at deifned intervals was conducted in 78 cases. In the meantime, standardized asthma therapies were performed. Control group involved 72 cases who did not receive asthma education managements and only accepted regular clinical therapies. After 1-year observational follow-up, , clinical efifcacy of children with asthma, changes of knowledge-attitude-practice of parents, and compliance of med-ication were compared between the two groups.ResultsAfter promotion of standardized managements treatment, asthma con-trol rates in the management group were signiifcantly higher than that of the control group(χ2=54.68,P<0.01); In addition, the rate of asthma attacks, emergency visits as well as hospitalizations were obviously reduced in the management group than control group (both withP<0.01). Knowledge associated with asthma, therapy and management executions as well as knowledge-atti-tude-practice of parents also demonstrated apparent elevations in the management group (P<0.01); At the same time, management group has illustrated superior medication compliance over the control group (χ2=66.27,P<0.01).ConclusionPromotion of standardized treatment management among children with asthma can help to achieve effective control by raising levels of knowl-edge-attitude-practice of the parents as well as the patient’s compliance to the treatment.

Objective To investigate whether TG2 plays an important role in the osteoblast differentiation and mineralization.Methods TG2 mRNA of SaOS-2 cells was knocked down using a lentivirus stably expressing short-hairpin ( sh) RNA targeting TG2.Then the cells were cultured in osteo-inductive medium for 14 d to measure mineralization and for 7 d to measure the levels of osteoblastic differentiation markers including ALP activity and mRNA of collagen I, osteocalcin ( OCN) and BMP-2.The wild-type SaOS-2 cells and scrambled shRNA-transducted SaOS-2 cells served as the controls. Results The controls displayed an increasing trend of the level of ALP activity and mRNA of collagen I, osteocalcin and BMP-2,and notable mineralization at 14 d.When TG2 was knocked down, ALP activity, mRNA of collagen I, osteocalcin and BMP-2 at 7d,and mineralization at 14 d were all significantly lower in comparison with the corresponding values in the controls.Conclusion TG2 is involved in the differentiation and mineralization of osteoblasts in vitro.

OBJECTIVE:To investigate the new management model of the hospital pharmacy established by application of vender managed inventory (VMI) model. METHODS:Concerned about the implementation of VMI model,its effects and prob-lems,new management model of hospital pharmacy were described after the hospital cooperated with two suppliers. The hospital is mainly in charge of the management and application of pharmaceutical staff and equipment,drug capital flow,and the selection and optimization of drug use list;focus on the training of pharmaceutical talents;improve drug quality management,pharmaceuti-cal administration,pharmaceutical care and rational drug use. Two suppliers are mainly in charge of drug logistics,and the alloca-tion of servicer,software and hardware(as automatic medicine dispensing machine);share logistic cost of supply chain. Drug in-formation flow was established by both hospital and supplier. RESULTS:After cooperation,pharmaceutical staff,related equip-ment and inventory cost(floating capital decreased by 10 million yuan each month)were decreased,and the efficiency of distribu-tion improved;the error rate of drug dispensing in outpatient pharmacy were decreased (decreasing from 0.39‰ to 0.12‰) after the establishment of automatic pharmacy. The establishment of early warning system for abnormal patients flowrate in pharmacy window shortened the time of getting medicine,and improved service level and satisfactory degree of patients (increasing from 84.91% to 93.62%). CONCLUSIONS:New management model of hospital pharmacy based on VMI model provides reference for public hospital reform and hospital-enterprise cooperation under New Medical Reform.

BACKGROUND:Coronary stent implantation can cause blood vessel damage and wal reconstruction, leading to vascular stent restenosis. Studies have found that visfatin is associated with inflammatory reaction, and exhibits an increased expression at the site of plaque rupture in acute myocardial infarction. OBJECTIVE:To investigate the influence of percutaneous coronary intervention on the levels of visfatin in patients with coronary heart disease. METHODS:Thirty patients with acute myocardial infarction within 12 hours after the onset of the chest pain, 30 patients with unstable pectoris and 30 patients with stable angina pectoris were included. Al patients were successfuly treated by percutaneous coronary intervention. Meanwhile, 30 patients only undergoing coronary angiography but not stenting treatment were selected, and another 30 patients without any treatment served as normal control group. RESULTS AND CONCLUSION:According to enzyme-linked immunosorbent method, the visfatin levels of acute myocardial infarction, unstable angina, stable angina and coronary angiography groups continue to rise at pre-operation, 30 minutes, 6 hours, 12 hours, 24 hours after operation, al of which were higher than that in the normal control group (P < 0.05). The results confirmed that within 24 hours after coronary stent implantation the visfatin levels continue to rise.

Objective To investigate the effects of electroacupuncture (EA) on the implementation of blind nasojejunal (NJ) tube placement and enteral nutrition (EN) in neurosurgical severe coma patients in intensive care unit (ICU).Methods Seventy-nine neurosurgical severe coma patients admitted to ICU were randomly divided into conventional group (blind NJ tube placement,n =40) and EA group (NJ placement and EA,n =39).EA was performed after NJ tube placement at bilateral acupoints Zusanli (ST36) and Hegu (L14) points using EA treatment instrument.The impelling distance of NJ tube were measured and the success rate of NJ tube placement were calculated.The postoperative complications were observed.Results The difference of NJ tube impelling distances at the 24th,48th,and 72th hours after surgery in EA group were significant longer than that in conventional group (P ＜ 0.05).The success rates of NJ tube placement at the 24th and 72nd hours after surgery in EA group were significantly better than that in conventional group (P ＜ 0.05).Their EN calories qualifiedness rate in 72 hours also increased significantly compared with conventional group and the proportion of patients assisted with parenteral nutrition decreased (P ＜0.05).The postoperative complications including alimentary tract hemorrhage,vomiting,and abdominal distension decreased remarkably in EA group compared with conventional group (P ＜ 0.05).Conclusions EA stimulation at acupoints could promote the gastrointestinal peristalsis of neurosurgical severe coma patients and elevate the success rate of blind NJ tube placement,so it is beneficial for the implementation of early enteral nutrition (EEN).