Vasovagal syncope (VVS) was a neurally-mediated functional disease, a transient disturbance of consciousness triggered by transient cerebral ischemia due to peripheral vasodilation resulting from a variety of incentives, accompanied by the loss of muscle tone and even fainting. Children with VVS are characterized by recurrent syncopal attacks induced by prolonged standing, postural changes and muggy environment, etc. Currently treatments of VVS include non-pharmacological therapy and pharmacological therapy.

Objective To investigate the feasibility and safety of transumbilical laparoscopic single-port choledocholithotomy in the treatment of common bile duct stones. Methods The clinical data of four patients who underwent transumbilical laparoscopic single-port choledocholithotomy at Shengjing Hospital of China Medical University from January to June, 2010 were retrospectively analyzed. The operation method and postoperative effects were reviewed. Results All the operations were successfully carried out. The mean operation time was 100 minutes and the mean blood loss was 62. 5 ml. All patients were cured without the occurrence ofcomplications except for one patient who had a peritoneal infection and was cured after surgical drainage. Conclusion Transumbilical laparoscopic single-port choledocholithotomy is safe and feasible, but indications should be strictly followed.

Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive ability in patients suffering from mild cognitive impairment (MCI) after ischemic stroke.Methods Forty five ischemic stroke survivors with MCI but not meeting the criterion for diagnosis as dementia were recruited, and were randomly assigned into an rTMS group (32 patients) and a control group (30 patients) according to a random number table.Both groups received the routine drug therapy of medicine and cognitive function training, and the rTMS group was additionally given rTMS over the left dorsolateral prefrontal cortex at 5 Hz and 80％ motor threshold.The treatments lasted for 4 weeks.The Montreal Cognitive Assessment (MoCA) and auditory event related potential (ERP) were tested for both group before and after the treatment.Results After the treatment, two groups showed significant improvements in the average score of MoCA compared to that before the treatment, and that of the rTMS group was significantly higher than that of the control group.For both groups, the P300 latency shortened and the amplitude increased after the treatment.Moreover, the latency and amplitude of the rTMS group increased to 355.67 ± 16.43 ms and 8.69 ± 1.65 μV, respectively, after the treatment, significantly shortened and lengthened than that of the control group [(372.76 ± 23.35 ms and 7.03 ± 3.04 μV), respectively].Conclusions rTMS can significantly improve the cognitive ability of ischemic stroke survivors in a relatively safe way.

OBJECTIVE:To provide reference for the realization of normalization and standardization of quality control and management of Pharmacy intravenous admixture service(PIVAS). METHODS:The management and effectiveness of PIVAS quali-ty control in our hospital were introduced from aspects of the establishment of internal quality control system,the key indicators and effects of quality control. RESULTS:According to checking items from aspects of examining once in a month,on prescription checking,preparation,infection control,equipments,drugs,consumable materials,sanitation;holding 1 monthly quality control reviews;and analyzing unqualified indexes and existing security risks,the quality control of PIVAS had achieved good results. The qualified percentage of quality control index was increased from 84%(Jan. 2016)to 90%(Jun. 2016),error rate in the same peri-od was decreased from 0.579‰ to 0.099‰. CONCLUSIONS:Developing quality control of the implementation of detailed quality control key indexes for the whole process of intravenous infusion in PIVAS can effectively regulate the position working process,re-duce preparation error and ensure the quality of infusion preparation.

Objective To supply evidence for quality control of Herba Ephedra by determining content limit in different batches of medicinal material of Herba Ephedra.Methods A RP-HPLC method was used for the determination of ephedrine and pseudo-ephedrine. The chromatographic conditions were: Kromasil RP-C18(250?4.6 mm,5 ?m) column, a mixture of 0.3 %phosphoric acid-methanol (10∶90) as mobile phase and 213nm as detected wavelengths.Results The contents of the above two alkaloids showed great difference among the 14 patches of tested samples. The content of ephedrine ranged 0.361 %～1.538 %and that of pseudo-ephedrine 0.332～2.087 %. The suggested content limitation of ephedrine should be 1.082 %, and that of psedoephedrine be 1.008 %in the crude Herba Ephedra.Conclusion The established method has been proven to be simple, stable and repeatable, and can be applied for quality control of the crude crude Herba Ephedra and compound prescriptions containing crude Herba Ephedra.

Objective To establish a HPLC method for the assay of psoralen and isopsoralen in different effective extracts of Fructus Psoraleae. Methods HPLC was carried out on the column of Kromasil RP-C18. The mobile phase was methanol -water(65 ∶35). The flow rate was 1.0 mL/min and the UV detection wavelength was 245 nm. Results Good linearity of psoralen was showed within the range of 10.5 ng～525 ng(r= 0.999 3)and isopsoralen within the range of 9 ng～450 ng (r= 0. 999 9). The content of psoralen and isopsoralen differed in different extractions of Fructus Psoraleae. Among them,the extract C (extracted by ethyl acetate ) contained the highest contents of psoralen and isopsoralen,while the contents of psoralen and isopsoralen were very low in the extract D (extracted by n-butyl alcohol) and E (supernatant of water extract). Conclusion The method is simple,accurate and reproducible. The anti-asthma effect and the dose-effect relationship of the different effective extracts of Fructus Psoralea need further pharmacodynamics study.

It has long been one significant focus in the field of surgery to reduce postoperative incisional complications.Recently,incisional negative pressure wound therapy (iNPWT),which was designed to reduce the incidence of incisional complications,has gradually been applied for primary incision closure.This article reviews the relevant basic and clinical studies to elucidate the mechanism of iNPWT and its clinical safety and efficacy,and answers some fundamental questions regarding clinical application of iNPWT.

ObjectiveTo investigate the popularity of the sedated gastrointestinal endoscopy in mainland China.MethodsThe survey on the popularity of the sedated gastrointestinal endoscopy was conducted with questionnaires sent by e-mails or telephones to the GI endoscopy units of three levels of hospitals.ResultsFrom May,2010 to November,2010,169 units from 28 provinces (90.3％ ) were enrolled,including 46 hospitals of grade Ⅲ,91 of grade Ⅱ and 32 of grade Ⅰ.Sedated gastrointestinal endoscopy were performed in 110 (65.1％,110/169) hospitals,i.e.93.5％ (43/46) grade Ⅲ hospitals,68.1％(62/91) grade Ⅱ hospitals and 15.6％ (5/32) grade Ⅰ hospitals.Significant difference was observed between the grade Ⅲ and the grade Ⅱ hospitals (P ＜ 0.05 ),so was between the grade Ⅱ and the grade Ⅰ hospitals ( P ＜ 0.05 ).Propofol was frequently used in sedation in 98 hospitals ( 89.1％ ).The only 9.1％( 10/110)hospitals,which had full-time anesthetists or anesthetic nurses,were all grade Ⅲ hospitals.ConclusionThere has been great progress in the popularity of sedated gastrointestinal endoscopy in mainland China during the past decade.However,it is less frequently pefformed in grade Ⅰ and Ⅱ hospitals.Shortage of full-time anesthetists is still a problem.

Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive ability of patients after ischemic stroke. Methods 45 patients with mild cognitive impairment (MCI) after ischemic stroke were randomly assigned into control group (n=22) and observation group (n=23). Both groups received routine drugs and cognitive training. The observation group received rTMS over the left dorsolateral prefrontal cortex (DLPFC) (5 Hz, 80% motor threshold) in addition for 4 weeks. Results The score of Montreal Cognitive Assessment (MoCA), P300 latencies and amplitudes improved after treatment in both groups (P<0.001), and were better in the observation group than in the control group (P<0.05). The MoCA score was negatively related with P300 latency (r=-0.851, P<0.05). There was no severe adverse effect during the treatment. Conclusion rTMS could improve the cognitive ability of patients with MCI after stroke, with little side effect.

Objective To explore the changes in plasma nitric oxide (NO) and nitric oxide synthase (NOS) activity in children with orthostatic hypertension(OHT) and the relationship with blood pressure changes.Methods The OHT group included 51 children who were diagnosed OHT in in-patient and out-patient departments of Peking University First Hospital from Jun.2012 to Jun.2013.Their age range was (12 ± 2) years.At the same time,control group consisted of 28 normal children who received physical examination with their age range of(12 ± 1) years.The diagnosis of OHT was based on the clinical manifestation and head-up tests.Plasma NO was determined by using a nitrate reductase method and plasma NOS activity by a chemical colorimetric method.Results 1.There were no significant differences between OHT group and control group in age,sex ratio,height,weight and body mass index (all P ＞0.05).2.In OHT children,the upright systolic blood pressure was higher than that of the supine [(114 ± 10) mmHg vs (104 ± 9) mmHg,t =-12.853,P ＜ 0.001],and the upright diastolic blood pressure was higher than that of the supine[(73 ±7) mmHg vs(59 ± 8) mmHg,t =-21.859,P ＜0.001].3.Plasma NO level and NOS activity,however,were significantly lower in OHT group than those in the control group [NO:(28.947 ± 6.031) μmol/L vs (35.216 ±6.662) μmol/L,t =4.257,P ＜ 0.001 ; NOS activity:(14.753 ± 3.060) U/mL vs (17.560 ± 4.253) U/mL,t =3.026,P =0.006].4.There was significantly negative correlation between plasma NO and the upright systolic blood pressure(r =-0.276,P ＜ 0.05) and the systolic blood pressure change (r =-0.280,P ＜ 0.05).Conclusions Plasma NO level and NOS activity were significantly lower in OHT children than those in control group.The abnormal vascular endothelial function may play an important role in OHT in children.