Compound traditional Chinese medicine database was established by collecting 176 compound formulas for dysmenorrhea in the last twenty years. The proportion and frequency of herbal medicine were analyzed and the main herbs with mono-target or multi-target in the compound formulas were selected with simple and multiple linear regression. The linear regression equations were listed and the clinical effects of the compound formulas were evaluated. Of 173 herbs used in the compound formulas, the proportion and frequency of the herbs for activating blood and transforming stasis and regulating qi flow were high in the application. The dosage interval for 20 herbs in common use was estimated. Main herbs with mono-target or multi-target used in the compound formulas were selected with simple and multiple linear regression. The total effectiveness rate of the 176 compound formulas was tested with simple linear regression, and 167 compound formulas (94.84 % of the total) had the absolute error less than 4%. Herbs for activating blood and transforming stasis and regulating qi flow are most commonly used in treatment of dysmenorrhea. Clinical effects of the compound formulas could be forecast with stepwise regression equation.

Objective To evaluate free or pedicled perforator flaps for repairing chronic osteemylitis with soft-tissue defect in the distal lower extremity. Methods From May of 2006 to October of 2007, 28 consecutive patients of chronic osteomylitis with soft-tissue defect in the distal lower extremity underwent surgical debridement and reconstruction with free or pedicled perforator flaps. There were 13 free flaps. The free anterolateral thigh flaps were used in 2 cases to repair the soft defects in the front of leg, 3 cases in the front of the malleolus, 2 cases in the dorsum of foot, 2 cases in the heel. The free lateral crural flaps nourished by perone al artery were used in 4 cases to repair the soft defects in the dorsum of foot. There were 15 pedicled flaps. Posterior tibial artery perforator flaps were used in 4 cases to repair the soft defects in the front of leg, and 2 cases in the medial malleolus. Lateral retromalleolar perforator flaps nourished by peroneal artery were used in 6 cases to repair the soft-defects in the heel, 1 case in the lateral malleolus and 1 case in the dorsum of foot, the first dorsal metatarsal artery perforator flap was used to repair the proximal dorsum of hallux. The wound was closed with irrigation-suction in 7 cases and with vancomycin-impregnated gelatin in 8 cases. Results All 27 flaps were successfully survived except insuffcient vein refluence in 1 posterior tibial artery perforator flap, which resulted in a superficial necrosis and healed spontaneously. The follow-up period from 6 months to 2 years revealed that recurrence developed in two diffuse type patients and both were treated once and twice with success, respectively. The others healed without any signs of recurrences. No debulking procedure was necessary in any case. Secondary bone graft was performed in 3 cases. All patients were ambulatory and fully weight-bearing with normal clinical parameters at the time of last review. According to the evaluating criteria for the treatment of foot disease, the mean score was 84.5. Conclusion Free or pedicled perforator flap has been shown to be well vascularised, and it is feasible for the treatment of chronic osteomyelitis with soft-tissue defect in the distal lower extremity.

Immunological alterations and changes in neurotransmission are considered to be crucial in the pathological process of depression. An immune activation including increased production of proinflammatory cytokines has repeatedly been described in depression, which shines a clue for new anti-depression therapy. Immune activation will lead to depression through serotonin and glutamate systems. This paper is attempted to review the immune mediated alterations on serotonin and glutamate systems.

Objective To compare the efficacy of three solutions used in the patients who suffered chronic obstructive pulmonary diseases (COPD ) when combined with oral fungal infection,and to find the most suitable one. Methods Using randomized controlled trial method, 98 patients who suffered COPD complicated with fungal infection were randomly divided into three groups. Method 1, using 0.5% povidone for the oral care. Method 2, making 200 million U of nystatin powder dissolved in 2.5% NaHCO3 for the oral care.Method 3, gave oral care with 2.5% NaHCO3 first, then put 200 million U of nystatin powder into 20 ml glycerol and covered the oral spots with them. Three groups were observed in the effect of oral fungal infection and the feedback from patients and nurses. Results In the analysis of the white spots sharply disappeared or pharyngeal swab smear turned negative, method 1 and method 3 had no statistical difference, P>0.05, but method 2 and method 3 had statistical significance, t=3.892, P <0.01; the three groups had no significant difference of feedback from the patients’ oral comfort, P >0.05. The time made solution of method 1 occupied 41.7% of method 3, and the time made solution of method 2 occupied 54.4%of method 3, while there was no statistical significance in total time of three groups (P>0.05). Conclusions The oral care with 0.5% povidone had good effect on the patients who suffered COPD complicated with oral fungal infection,with good comfort,and most nurses saving time. Nystatin powder dissolved in 2.5% NaHCO3 worked later than nystatin powder dissolved in glycerol.

Objective To investigate the application and clinical outcomes of anterolateral thigh perforator flap bridging different superficial circumflex iliac artery flaps for the treatment of complex limb wound.Methods Data of 10 patients,who had undergone free tissue transfer of anterolateral thigh perforator flap bridging different superficial circumflex iliac artery flaps (iliac osteocutaneous flap,iliac crest flap and ilioinguinal flap) for the complex limb wound from March 2009 to January 2011,were retrospectively analyzed.There were 9 males and 1 female,aged from 21 to 57 years (average,39.7 years).Iliac osteocutaneous flap was used in 7 patients,iliac crest flap in 2 patients and ilioinguinal flap in 1 patient.The free tissue transfer was performed for hand reconstruction in 3 cases,foot reconstruction in 4 cases and leg reconstruction in 3 cases.The mean size of soft tissue defect was 20 cm × 9.7 cm.Results The mean size of the anterolateral thigh flap and the ilioinguinal flap was 17.8 cm×9.4 cm and 8.4 cm×4.5 cm,respectively.The mean volume of iliac crest was 5.4 cm×2.1 cm×0.8 cm,and the mean length of flow-through conduit was 10.5 cm.Except for the distal necrosis of iliac osteocutaneous flap in 1 case,which were treated by dressing change and skin grafting,the other flaps survived without complications.All patients were followed up for 6 to 36 months (average,12 months).The average bone union time was 3 months in the hand group,4 months in the foot group,and 4.5 months in the leg group.The disabilities of the arm,shoulder,and hand questionnaire score averaged 43,the mean Japanese Orthopaedic Association's foot rating scale was 71.3,and the mean Puno's functional score was 91.Donor site scars were mostly flat,pale and soft but widened in the thigh in 6 patients and in the ilioinguinal region in 3 patients,and numbness was reported in 2 patients.Conclusion In clinical situation that requires for coverage of complex and extensive limb defects,the free tissue transfer of anterolateral thigh perforator flap bridging superficial circumflex iliac artery flap is a better method,which can meet specific reconstructive demands with minimal donor site morbidity.However,a relative high risk has to be considered.

Objective To study and discuss the methods for repairation and reconstruction of foot defects in order to reduce the deformity and insufficiency of foot and to restorat its functional and cosmetic aspects. Mehtods Soft tissue recovery was enough for digital absence, dorsal, submalleolus and calcaneous defect; Delects in plantar should be repaired with pre flap; Abstence of metatarsats head should be reconstructed by using vascularized bone incorporation with free flap transplantation. Results Total 247 cases with bone and soft tissue defects of foot were recpaired by using managements mentioned above aehived satisfactory clinical result. All patiants were assed according to AOFAS of USA fool malleolus scores, excellent 84 cases; good 107; fair 42; poor 14. Conclusion Being flat in shape and abundant blood supply, the iliac bone is a valuable supply bone lor foot defects espesial for muti-matatarsal and ealeaneus. Absence of malleous should be reconstructed by free iliac bone or free febular head with fascial strip. Vascular bone incorporating with vascular flaps provided an ideal method of reconstruction foot conpound defeets.

Objective To prepare the lipid ultrasound microbubbles carrying gene and transactivating transc"ptional activator(Tat)peptide and to study the efficiency of carrying gene and Tat as well as to study their ability as an ultrasound contrast agent.Methods The lipid ultrasound microbubbles were prepared using mechanical vibration method.The appearance,distribution,concentration,diameter and zeta potential were measured.The efficiencies of carrying gene and Tat were studyed by a confocal laser scanning microscopy and a fluorospectrophotometer.For the in vivo experiment,contrast-enhanced ultrasonography was performed on six rabbits to observe the duration and intensity of enhancement in the heart chambers and myocardium after the injection of the microbubbles.Results The diameter of the self-made lipid microbubbles carrying gene and Tat was(2.27±0.38)μm,the concentration was(3.07±0.42)×109/ml and zeta potential was(1.95±0.13)mV.The gene encapsulation efficiency for the lipid ultrasound microbubbles was 32%,and the Tat encapsulation efficiency was 35%.The in vivo experiment showed that the lipid ultrasound microbubbles could significantly enhance the echo intensity of myocardium.Conclusions The efficiency of carrying gene and Tat for the prepared lipid microbubbles is high,which can be used as a new vehicle carrying genes or drugs for therapy as well as an ultrasound contrast agent.

Objective:The epidemiological characteristics of PICU deaths in 2017 in the Affiliated Hospital of Guizhou Medical University, Guizhou Provincial People′s Hospital, and Guiyang Children′s Hospital were summarized and analyzed to provide a basis for formulating intervention measures to effectively reduce the mortality rate of children.Methods:The clinical datas of PICU deaths in three tertiary hospitals in 2017 were collected retrospectively.The cases were divided according to different ages and lengths of hospitalization.And gender, age, length of death, length of hospitalization, and death diseases were summarized and analyzed.Results:In 2017, the PICU of the three tertiary hospitals admitted 2 092 children, of which 139 (6.64%) died, including 84 males and 55 females.The months with the highest case fatality rates were January, February, July and August.The fatality rates were 9.14% (18/197), 9.04% (15/166), 13.25% (20/151), 7.93% (13/164), respectively.There was statistically significant difference in the mortality of children admitted in each month ( P=0.038). Among the death cases, the infant group (29 days to 1 year old) accounted for the largest proportion with 58 cases (41.73%), followed by the preschool group (3 to 7 years old) with 37 cases (26.62%), the infant group (1 to 3 years old) with 24 cases(17.27%), and the school-age group (7 to 14 years old) with 20 cases(14.38%). The top three death diseases were: 39 cases (28.06%) of bronchial pneumonia (severe), 28 cases (20.14%) of hematological tumors and solid tumors, and 23 cases (16.55%) of trauma.The difference of its distribution in different age groups was statistically significant( P<0.05). The patients were divided into four groups according to the length of hospital stay.The time ≤1 d group had the highest mortality of 54 cases (38.85%), -3 d group and -7 d group both had 32 cases (23.02%), the >7 d group had the lowest mortality of 21 cases (15.11%). Conclusion:In 2017, January, February and July, August are the peak months of deaths in PICUs in Guizhou, with the highest number of infant deaths.Bronchial pneumonia(severe), hematological tumors and solid tumors, and trauma are the top three death diseases.

OBJECTIVE:To provide reference for the strategic shift of the producing areas of"8 famous medicines in Zheji-ang"and other genuine medicinal materials. METHODS:The current situation of"8 famous medicines in Zhejiang"and other genu-ine medicinal materials was analyzed,the changes and principles of producing areas were discussed,and the feasibility of shifting to Anhui Chizhou area was evaluated. RESULTS&CONCLUSIONS:The"8 famous medicines in Zhejiang"and other genuine me-dicinal materials were in a relatively disordered state of development. Reduced planting area,disordered introduction and cultiva-tion,decreased quality of original herbs and impacts from other producing areas had seriously affected the sustainable development of"8 famous medicines in Zhejiang"and other genuine medicinal materials. However,the similarity of Anhui Chizhou area with original producing areas in geographical environment,land resources and environmental resources and its own advantages make a feasibility of the strategic shift of the producing areas to Anhui Chizhou area.

Objective: To investigate the impact of bladder filling status on the movement of uterine and on the volume of organs at risk(OAR), so as to provide theoretical basis for individualized internal target volume (ITV) and planning target volume (PTV). Methods: Simulation CT images for a total of 27 patients with locally advanced cervical cancer were acquired with empty bladder, 1.0 h after bladder filling, 1.5 h after bladder filling, respectively. The volumes of uterine corpus, cervix, OARs, CTV and PTV 1.0 h after bladder filling were delineated. The impact of bladder filling status on the displacements of cervix and corpus, volumetric changes of rectum, small intestine, and the volumes of small intestine, bladder and rectum within PTV were analyzed. The correlation between bladder filling status and uterine displacement and volume of OAR was also investigated, as well as the volume of cervix and corpus in the PTV with empty bladder and 1.5 h after bladder filling. Results: Bladder filling status is different for individual cases. The maximum movement range of cervix and uterine body with bladder filling state was 0-3.04 cm and 0-4.31 cm respectively. The anterior displacements of corpus (F=7.818, P<0.05), the volumetric changes of blander, as well the volume of bladder and small intestine in the PTV (F=46.197, 44.609, 29.546, P<0.05) were significantly different between different bladder filling status. The bladder filling status was correlated with the displacements of the anterior of corpus, volumetric changes of small intestine, and the volumes of bladder and small intestine within the PTV (r=-0.232, -0.298, 0.915, -0.336, P<0.05). The volumes of cervix and corpus out of the PTV were significantly different between the empty bladder and 1.5 h after bladder filling (t=-1.326, -1.559, P<0.05). Conclusions Bladder filling status was different for individual patients. The displacements of the anterior of the corpus were significantly affected by the bladder filling status. Increasing the anterior margin of PTV was recommended. The consistency of bladder filling status was critical for the precise cervical cancer IMRT.