Objective To evaluate the clinical efficacy and safety of modified anti -tuberculosis scheme in the treatment of tuberculous meningitis.Methods 60 cases with tuberculous meningitis were randomly divided into two groups.We enrolled 30 patients in each group.The traditional anti -tuberculosis group used traditional anti -tuberculosis scheme with isoniazid,rifampicin,pyrazinamide,streptomycin,and the modified anti -tuberculosis group was given isoniazid,rifampicin,pyrazinamide,levofloxacin,the treatment course of tuberculous meningitis was 12 months.The efficacy and safety through clinical manifestations and laboratory examinations,the dynamic changes of cerebrospinal fluid were evaluated by statistical methods.Results The total effective rate of the modified anti -tuberculosis group was significantly higher than the traditional anti -tuberculosis group(86.6% vs.63.3%,χ2 =4.36,P <0.05).The cerebrospinal fluid routine and biochemical index in the modified anti -tuberculosis group were obviously superior to the traditional anti -tuberculosis group after treatment(all P <0.05).There was no significant difference in the incidence of adverse reactions between the two groups(26.6% vs.16.7%,χ2 =0.88,P >0.05).Conclusion Levofloxacin combined with other first -line anti -tuberculosis drugs,glucocorticoids,dehydration and other comprehensive measures improved brain function for the treatment of tuberculous meningitis is recommended.

Diabetic nephropathy ( DN) is one of the complications of diabetes, which is closely related to the pathogenesis of in-flammation. This article summarized the relevant literatures on the correlation between MCP-1 , TNF-α and DN, and the intervention of traditional Chinese medicine with DN. In kidney tissues, oxidative stress and NF-κB-dependent signal pathways induced the increase of monocyte chemoattractant protein-1 (MCP-1) expression, which could induce macrophage accumulation, proteinuria increase, renal fibrosis and renal clearance capacity decrease, and further leading to kidney damage. The clinical and experimental trails showed tumor necrosis factorαmRNA and protein levels in serum, urine and renal tissues were closely related with DN, which could be used as a bio marker to provide clinical guidance. As the therapeutic targets,MCP-1 and TNF-αcould give a novel insight into the clinical treatment of DN. Some traditional Chinese medicines or monomer could ameliorate DN by inhibiting MCP-1 and/or TNF-α. Thus, further verifi-cation or clinical application of those traditional Chinese medicines is worth trying.

Objective To investigate the safety and efficacy of a 3-pulmonary vein (PV) isolation approach in treating paroxysmal atrial fibrillation (AF). Methods Radiofrequency catheter ablation was used to eliminate PV potential in 11 patterns with frequent paroxysmal AF refractory to anti-arrhythmic agents. During sinus rhythm, PV potential was mapped in the left and right superior PVs and left inferior PV. The procedural success was defined as the elimination of PV potential in the 3 PVs. Restults PV potential was identified and abolished in a total of 24 PVs, mostly in the left and right superior PV. There was no pulmonary stenosis or other complications during or after the procedures. AF recurred in one patient after an average of 12 ± 3 month follow-up. Conclusions PV potemials were present mostly in the left or right superior PV. The 3-PVs isolation approach is safe and effective in preventing drug-resistant paroxysmal AF.

With the increment of the workload,high stability is required by hospital information system.When the amount of client exceeds the limit,we must reconstruct the Oracle server in order to meet the needs of workload increment.This article describes the principle of shared server and the reconstructed method from dedicated server to multithreaded server.

Objective:To investigate the therapeutic effect of tannins from pomegranate rind on passive Heymann nephritis ( PHN) in rats. Methods:Rabbits were with intradermal immunization for many times to obtain anti-Fx1A serum, and then PHN model in rats was established by tail intravenous injection of anti-Fx1A serum. The experimental rats were randomly divided into six groups, the nor-mal control group, model group, benazepril group, and tannins from pomegranate rind group respectively at high, medium and low dose. After the success of modeling, each rat was received intragastric administration for five weeks, and then the total of urine was collected once a week for the detection of 24-hour urine protein. At the end of treatment, serum was collected for the detection of serum albumin, blood urea nitrogen, creatinine, total cholesterol and triglyceride. The pathological changes of the renal tissue were observed using hematoxylin-eosin and Masson staining to observe the effect of tannins from pomegranate rind on PHN rats. Results:After the in-tragastric administration for five weeks, tannins from pomegranate rind could obviously reduce the level of 24-hour urine protein in PHN rats(P<0. 01), significantly reduce the levels of serum creatinine (P<0. 01), urea nitrogen (P<0. 01,P<0. 01,P<0. 05), total cholesterol (P<0. 01) and triglyceride (P<0. 01,P<0. 01,P<0. 05) in PHN rats, and increase the level of serum albumin (P<0. 01,P<0. 05,P>0. 05). HE and Masson staining results indicated that tannins from pomegranate rind could improve the pathologi-cal damage in PHN rats. Conclusion:Tannins from pomegranate rind has notable improvement for PHN in rats.

Objective; To explore mechanism of Zhongjiling tablet treats experimental autoimmune myasthenia gravis on rats. Methods:Normal mice, immunosuppressive mice and EAMG rats were used to investigate the mechanism. Results:Zhongjiling tablet enhanced T and B cells proliferation of normal mice and immunosuppressive mice induced by ConA or LPS, and increased the production of IL-2. T cell proliferation of EAMG rats was improvement stimulated by AChR and decline by ConA. Zhongjiling tablet inhibited the improvement by AChR and enhanced the decline by ConA, and reduced the expression of IFN-? and IL-4 mRNA. Zhongjiling tablet also induced the apoptosis of CD4 + T lymphocyte stimulated by AChR. Conclusion: Zhongjiling tablet increased immunity of normal mice, immunosuppressive mice and EAMG rats. But it suppressed specific T lymphocyte proliferation induced by AChR and reduced the expression of IFN-? and IL-4 mRNA. It was probably one of mechanisms Zhongjiling tablet induced the apoptosis AChR specific CD4+T lymphocyte.

Objective: To observe the therapeutic effects of warm-needling technique on peripheral facial paralysis. Methods: Warm-needling technique and electroacupuncture were employed to treat 30 cases of facial paralysis, respectively. The same acupoints, Cuanzhu(BL 2)towards Yuyao(Ex-HN 4), Yingxiang(LI 20) towards Xiaguan(ST 7), Taiyang(Ex-HN 5)towards Xuanlu(GB 5), Dicang(ST 4) towards Jiache(ST 6), and Chengjiang(CV 24) towards Daying(ST 5), were used. Results: After 33 treatments, the warm-needling technique has an effective rate of 83.3%, while the electroacupuncture 67.7%. Conclusion: The therapeutic effect of warm-needling technique was better than that of electroacupuncture method.

Objective To find an internal quality controlling method for 17-OHP determination by time-resolved fluoroimmuno-assay .Methods 20 quality control data were collected .The data were analyzed by using L-J method ,instant method and improved instant method .Results were used for the construction of quality control charts .Result The first three quality control data had a great impact on the following judgments of internal quality controlling when instant method was used .The subsequent results might be false acceptance .Improved instant method could effectively reduce the situations of false run-away and false acceptance ,which was suitable for the internal quality control of 17-OHP determination by time-resolved fluoroimmunoassay in newborn screening . Conclusion There are many steps of manual operations in 17-OHP determination of time-resolved fluoroimmunoassay .The details of these operations have great impacts on the experimental results .Thus ,the operations of 17-OHP test should be specified and exe-cuted strictly according to requirement .

Clinicians monitor the gastric residual volume(GRV) of critical ill patients to minimize or prevent side effect of EN.Nevertheless,recommendations about the threshold GRV in critically ill patients treated with EN are not uniform.Many recent clinical studies had demonstrated that increasing the limit of GRV was associated with the increase in the diet volume ratio of ICU patients receiving EN,and it was not associated with adverse effects in gastrointestinal complications.This review summarizes the influence factors of GRV monitoring to evaluate the feasibility and necessity of increasing the threshold of GRV.

Objective To explore the clinical and coronary angiographic characteristics in acute myocardial infarction (AMI) patients with new-onset atrial ifbrillation in early or later stages. Methods From Jun. 2010 to Jun. 2013, 1358 cases of AMI were hospitalized in which 88 were proved to have AMI complicated with new-onset atrial ifbrillation. Eligible patients were divided into early onset group (group1, n=40 cases) and the later onset group (group2, n=48 cases) according to the occurrence of atrial ifbrillation within or after 24 hours of admission. The clinical characteristics and the pathological changes of coronary arteries of the two groups were compared respectively. Results The incidence of inferior wall AMI was signiifcantly higher in group 1. The incidence of anterior wall AMI was signiifcantly higher in group 2 (P<0.05). The incidence of congestive heart failure, the incidence of three-vessel lesions and the in-hospital mortality in group 2 were higher than which in group 1 (P < 0.05). Conclusions The new-onset atrial ifbrillation in different stages may be regarded as a useful indicator for evaluating the clinical characteristic and the infarct-related coronary artery lesions and prognosis of patients with AMI.