To discuss the relationship between Chinese medicine processing and medicine usage.After being processed,characteristics of Chinese medicine can be changed,the performance be mitigated,and some side effects be reduced or eliminated,which makes its clinical usage more rational and effective.besides,medicine processing can also change the taste and reduce bad smell of medicines.

Fetal hydrocephalus is a kind of congenital malformation,which is characterized by the enlargement of the ventricular system and the obstruction of cerebrospinal fluid.It is not accompanied by a primary brain atrophy,with or without the increase of head circumference.Early diagnosis and early treatment is very important.Without the timely inter-vention,most of the patients will die during the perinatal and infant period,and even the survivors often suffer from cere-bral palsy and mental retardation.However,the long -term prognosis and clinical course of patients with hydrocephalus is not yet fully understood.There is controversy on the factors which influence the long -term outcome,such as the timing of diagnosis of hydrocephalus,the severity of ventricular dilatation,the basic disease and accompanying anomalies.So,should establish comprehensive protocols to avoid and decrease fetal hydrocephalus,as well as pay attention to the clinicopatho-logical research,prenatal diagnosis,perinatal management and early treatment of fetal hydrocephalus.

Although the percentage of preterm infants developing intraventricular haemorrhage (IVH) has been greatly re-duced in the past three decades, increased survival of extremely preterms has meant that severe IVH with subsequent posthae-morrhagic hydrocephalus is still one of the serious unsolved problems for managements of preterms. Therapeutic interventions for posthaemorrhagic hydrocephalus include serial lumbar punctures, repeated aspiration through a ventricular access device, ventriculoperitoneal shunting, drainage, irrigation and fibrinolytic therapy, diuretic therapy treatment to reduce cerebrospinal fluid production, intraventricular fibrinolytic therapy, etc. This review summarizes the current concepts on the pathophysiology, inter-vention indications, and the effectiveness and safety of different interventions of subsequent posthaemorrhagic hydrocephalus.

Objective To explore cephalosporinase from nosocomial Klebsiella pneumoniae infection and their drug-resistant characteristics among the ICU patients so as to provide an instruction for rational clinical medication.Methods 67 samples were identified with VITEK-60 automated system.The strains producing AmpC β-lactamases were screened with cefoxitin disk diffusion method recommended by the CLSI,and confirmed by cefoxitin three-dimensional test.AmpC β-lactamase genotype was differentiated by PCR-sequencing and susceptibility tests which were done with the Kirby-Bauer method recommended by the CLSI.Results In the 67 isolates of Klebsiella pneumoniae,11 strains(16.4％) were found to produce AmpC β-lactamases.The drug-resistant genotype for all the 11 AmpC-positive strains was DHA-1.AmpC-producing strains developed multi-drug resistance,especially for broadspectrum β-lactam antibiotics and enzyme inhibitors.β-lactamases-producing strains were more resistant than non-producing ones.Conclusion Klebsiella pneumoniae in ICU patients has a higher proportion of producing AmpC β-lactamase strains,which are all of DHA-1 genotype and have multi-drug resistance.

Various of long-lasting and persistent bradyarrhythmia can induce cardiomyopathy.The pathogenesis of bradycardia-induced cardiomyopathy(BIC) is not clear,which is possibly related to significantly prolonged ventricular diastole,overloaded volume,changes of atrioventricular activation sequence,changes of atrioventricular sequence contraction,myocardial hypoperfusion,effect of neuroendocrine,etc.Diagnosis of disease includes a medical history of persistent bradycardia;relevant clinical symptoms (fatigue,dizziness,black Meng even syncope);the signs and symptoms of right or left heart failure in serious cases;electrocardiogram prompt bradycardia;echocardiography shows dilation of heart,less obvious reduction left ventricular ejection fraction (compensatory),but the left ventricle index can be decreased.Treatment is mainly to early identify the causes of bradycardia and remove it and pharmacotherapy,cardiac pacemaker therapy.Heart function can be back to normal after therapy(cardiac pacemaker).

BACKGROUND:In the past, the surgical treatment of patients with hemophilia B was difficult, the bleeding was difficult to estimate, and the wound healing was difficult. In the perioperative period, the control of coagulation factor IX activity in a safe range can ensure the safety of the operation, resulting in wel wound healing, good recovery, and no significant complications appeared in the long term. OBJECTIVE:To study essentials of perioperative diagnosis and treatment in omarthritis patients with hemophilia B undergoing humeral head replacement, and to analyze the importance on prognosis and rehabilitation. METHODS:The significance of surgical treatment for hemophilia B patients with arthritis, the prevention and treatment of perioperative complications were summarized through literature review. Humeral head replacement was conducted in a patient with hemophilia omarthritis by monitoring coagulation factor activity and infusing human prothrombin complex and frozen plasma. RESULTS AND CONCLUSION:(1) According to the monitoring, patients, whose coagulation factor IX activity increased from 7%to 50%, underwent humeral head replacement. (2) Within three days after replacement, coagulation factor IX activity was control ed>30%, 3 days-2 weeks>20%. No obvious complication was found after surgery. (3) These results suggested that hemophilia B arthritis was commonly treated by surgical treatment, which plays an important role in assessing patient’s condition and treatment. During perioperative period, replacement therapy of human prothrombin complex and control of coagulation factor activity in a appropriate range can effectively prevent postoperative complications.

Objective:To investigate high sensitivity-C reactive protein (Hs-CRP) as a prognostic factor in non-Hodgkin lympho-ma (NHL). Methods:Data for 85 consecutive non-Hodgkin lymphoma patients were followed up and reviewed to determine the value of Hs-CRP relative to known prognostic parameters. Results:The progression-free survival (PFS) and overall survival (OS) times of pa-tients with pre-therapeutic baseline serum Hs-CRP levels of≥4 mg/L were shorter than those of patients with basal serum Hs-CRP lev-els of<4 mg/L (P>0.05). However, the post-therapeutic, early-to-mid serum Hs-CRP level was not significantly correlated with the OS and PFS times (P>0.05). Multivariate Cox regression analysis showed that the pre-therapeutic baseline serum Hs-CRP level may be an important prognostic parameter for the relapse and survival of NHL patients (P<0.05). Conclusion:The baseline Hs-CRP level can be a major indicator of prognosis in NHL patients.

Based on binocular disparity, three-dimensional (3D) display technology makes the right and left eyes see different images in a certain way, which generates a stereo image after the processing of the brain's visual cortex.Due to its high-definition stereoscopic surgical field of vision and accurate spatial positioning ability, 3D display technology has been widely used in surgery.Ophthalmic microsurgery is performed with the help of microscope because of the complex intraocular operation and small operating space, especially minimally invasive vitreoretinal surgery, which is the most difficult surgery with the longest learning curve in ophthalmology.The 3D display viewing system can improve surgical accuracy, reduce retinal phototoxicity, relieve the pressure on the neck and back of the surgeon as well as promote communication and cooperation between medical staff and so on.At present, the major 3D display systems applied in ophthalmology include the NGENUITY 3D Visualization System and TrueVision 3D Visualization System, both of which require wearing 3D glasses.The naked eye 3D display system is the main direction of future development.The combination of 3D display system and ophthalmic surgical robot system provides a new idea for the development of remote ophthalmic surgery.At the same time, broader application of 3D display system requires continuous improvement.In this article, the research and application of 3D display system in anterior segment surgery and vitreoretinal surgery were reviewed.

ObjectiveTo valuate the three-dimensional CT angiography(3DCTA) in diagnosing blood vessel diseases.MethodsCTA findings of 284 patients confirmed with blood vessel diseases were retrospectively analyzed.They were divided into two groups:141 cases of head and neck and 143 cases of trunk and extremities.Scan was performed with the beam collimation of 0.625 ～ 3.0mm,increment of 0.3 ～ 1.4mm,pitch of 1.0 ～ 1.5,with the gross contrast medium of 1.5 ～ 2.0ml/kg.3D imaging methods included volume rendering(VR),multi-planar reformatting (MPR),curved planar reformatting(CPR),surface shade display(SSD),maximum intensity project(MIP) and virtual endoscopy(VE).The diagnostic results of CTA were compared with those of DSA and/or surgery.ResultsIn this study,3D images of vasculature met the diagnostic criterion.The diagnostic sensitivity,specificity and accuracy of CTA was 97.28％,82.35％ and 96.48％,respectively.The size of artery aneurysm shown with CTA and DSA had no significant difference( P ＞0.05 ),both smaller than that in surgery( P ＜ 0.05 ).Conclusion3DCTA could be used in diagnosing the cardiovascular diseases and compensate the limitation of conventional CT.It had the characteristics of non-invasion,high accuracy and could partly substitute DSA.

Objective To evaluate the implementation of the early goal-directed therapy after cardiopulmonary resuscitation in Suzhou area,in order to provide clinical data for standardized post resuscitation care.Methods This retrospective study included comatose survivors of CA,admitted into intensive care units (ICU) of 10 hospitals in Suzhou area between January 2009 and December 2010.the parameters,mean arterial pressure (MAP),peripheral oxygen saturation (SpO2),partial pressure of carbon dioxide (PaCO2),blood glucose (Glu) and body temperature (T),were collected for 48 h after CA.The percentage of parameters achieving recommended goals was compared.Results A total of 101 CA patients were enrolled in this study.Among the parameters of GDT,the percentage of achieving recommended goals for SpO2 and MAP was 90.1％ and 81.4％ ; the percentage of achieving recommended goals for Glu and PaCO2 was 55.4％ and 32.8％ ; however,mild therapeutic hypothermia (MTH) reached the lowest percentage,only 10％ ; there were significant differences in the percentage of achieving recommended goals for these parameters,P ＜0.01.Conclusions The quality of early goal-directed therapy in the CA patients should be improved,especially in the management of body temperature and partial pressure of carbon dioxide.