Prospective studies have indicated that the incidence of recurrent stroke in patients with symptomatic intracranial arterial stenosis is approximately 15-20％ per year,and the mortality rate is significantly higher.Although the strict control of the risk factors for atherosclerosis and antithrombotic drugs,especially the use of anti-platelet drugs,is the main basis treatment for these patients,some patients may have drug resistance.These high-riskpatients showed severe stenosis ( ＞ 70％ ) of the recent clinical symptoms of ischemia and theclinical and imaging evidence of distal hemodynamic irnpairment accompanying arterial stenosis.The advances in balloon and stenting have made people begun to consider the possibility ofusing angioplasty and stenting for the treatment of these high-risk patients.However,becausethe relative efficacy of these invasive therapy and drug therapy is not very clear,furtherrandomized clinical trial is still needed.This article reviews the available drug treatment optionsfor symptomatic intracranial arteriosclerotic disease and the current status of endovascudartreatment.

Objective To investigate the effective management approaches for mental retardation plus epilepsy in children.Method Sodium valproat[15～ 60 mg/（ kg· day)] or nitrazepam[0.5～ 1 mg/（ kg· day） ] and guanmaishu containing hyoscyamine(0.0045～ 0.045 mg/（ kg· day)] as adjuvant were administered for 1.5～2 consecutive years.EEG,three dimensional Doppler ultrasonic examination of cerebral vessels were performed.Result Favorable therapeutic effect was obtained in 25 cases(48.1％ ),good effect in 12 cases(23.1％ ).Conclusion Favorable therapeutic effect of hyoscyamine in epilepsy is correlated with improved cerebral microcirculation,cortical choline receptor blocking ,reduced conduction between synapses.These factors all inhibit onset of epilepsy.

During the Ming dynasty,great progress had been made on the theoretical and clinical aspects of diagnosis and treatment of phlegm disease in TCM.It mainly showed that: during this period,unprecedented monographs about phlegm diseases such as 《Tan Huo Zhuan Men》,《Tan Huo Dian Xue》 appeared.The ancient medical scholars all paid attention to the in? uence and harm of the phlegm to the body and accumulated abundant experience in clinical diagnosis and treatment,further made a great summary to provide reference to the posterity.In this article,several physicians’ academic thoughts of phlegm disease were chosen to research.The theories and experience of ancient medical scholars were explained.It has important theoretical and practical values for the health preservation and clinical diagnosis and treatment.

The physicians of Qing Dynasty made deeper knowledge to the formation and harm of the phlegm and systematically summarized the theory of the diagnosis, syndrome differentiation and treatment of the phlegm diseases. In the literatures of such as CHEN Shi-duo, LIN Pei-qin, HE Meng-yao, YOU Zai-jing, the special discussion of the phlegm diseases diagnosis and treatment which contents were theory, principle, prescription and drugs. Next, in the surgery, ophthalmology, gynecology, pediatrics, the physicians paid attention to the diagnosis and treatment from the phlegm and summarized the clinical practical experience. Moreover, in the Chuan Ya Nei Bian, Chuan Ya Wai Bian written by ZHAO Xue-min, the experience of "Zou Fang Yi" on treating the phlegm disease by the method of Ding, Chuan, Jie had its own characteristics.

This paper elucidates the diagnosis and treatment of phlegm syndrome in Jing-Yue Complete Works(Jing Yue Quan Shu from pathogenesis,syndrome differentiation,principle and method of treatment,recipe,medicines,diet and rest,which are used for reference in the modern clinical diagnosis and treatment of traditional Chinese medicine.The diagnosis and treatment of phlegm syndrome in Jing-Yue Complete Works(Jing Yue Quan Shu) is widely used in internal medicine,surgery,gynecology and pediatrics,etc.Based on the point of emphasizing yin-yang in person,Zhang Jingyue supposed that the diagnosis and treatment of phlegm syndrome should focus on spleen and kidney,strengthening the body resistance,treating symptoms in acute condition,choosing recipe and medicines according to the position and character of phlegm,diet and rest.

Objective To summarize the clinical features and the experience in treating of severe craniocerebral injury complicated by shock.Methods The clinical datas of 76 patients with severe craniocerebral injury complicated by shock were analysed retrospectively.Results Among 76 patients with severe craniocerebral injury complicated by shock,there were 25 cases with good recovery,7 cases with moderate disability,5 cases with severe deficts or vegetable,and 39 dead after therapy.The mortality was 51.3%.Conclusion It is very important to give prompt diagnosis and treatment and to find early the causes of shock.The importance of on site rescue and immediate surgical treatment should be emphasized.

Objective To study the clinical features and treatment of traumatic cerebral intraventricular hemorrhage(TIVH).Methods A retrospective analysis was conducted on the clinical manifestations,the changes of CT scan and the respective therapies in the 28 TIVH cases.Results All the cases were evaluated with GOS at discharge:8 cases were good recovery(29%),5 moderate disabled(18%),4 severely disabiled or vegetable(14%) and 11 died(39%).Conclusion Surgical approaches to treat TIVH rely on changes of CT scan.Injection of urokinase into ventricles,if necessary,can produce a good curative effect.

Traditional Chinese Medicine has its own academic thoughts and practical experience on diagnosing and treating phlegm disease,which has sprouted in Qin and Han Dynasties,originated in Jin and Tang Dynasties,developed in Song and Yuan Dynasties,become prosperous in the Ming and Qing Dynasties and made much progress in the recent years.This article shows researches of academic thoughts and clinic experiences on diagnosing and treating phlegm disease,which is based on ancient books and records of Traditional Chinese Medicine from Pre-Qin Period to the Sui and Tang Dynasties.Hope to provide beneficial reference to modern clinic,health preservation,prevention and treatment of phlegm disease.

During the Song、Jin、Yuan dynasties,great progress had been made on the theoretical and clinical aspects of phlegm disease diagnosis and treatment in TCM accompanied with the vigor and prosperity of the TCM learning. It mainly showed that:rich diagnostic and treating experience had been accumulated and summarized to serve as a legacy based on the theoretical innovation of the clinical practice. ZHU Dan-xi、WANG Gui made epoch-making academic achievements on the aspect of the phlegm disease diagnosis and treatment. YANG Shi-ying、SHI Zai-zhi、YAN Yong-he also had made their own contributions. Besides,the medical formularies of the Song、Jin、Yuan dynasties had special summary and discussion to the all kinds of prescriptions for treating the phlegm. A fair number of those prescriptions were used until now for their effects.

Objective To investigate the changes of myocardial systolic and diastolic function and the expression of ryanodine receport 2 (RyR2)during different degree of myocardial dysfunction in septic shock rats.Methods We used random number method to divide 250 to 300g male Wistar rats into septic shock group and the control group which were divided into 4 subgroups at different time intervals of 0h,2h,4h,6h with six rats in each subgroup.The rat model of septic shock was established by intravenous dosing of LPS.When mean arterial pressure reduced by 25% to 30% from the basic value,a model of septic shock was established.We monitored the mean arterial pressure through femoral arterial catheterization and the left ventricular end-diastolic pressure,maximum rate of left ventricular systolic pressure rise(+dp/dt max) and maximum rate of left ventricular diastolic pressure drop(-dp/dt max)through carotid arterial catheterization.The pathological changes of myocardial tissue were observed via the pathological sections.The changes of RyR2 expression and the phosphorylation of RyR2 were detected via immunohistochemistry.The change of RyR2 gene expression was detected via PCR.Results In septic shock group,myocardial structure disturbance was worsen,myocardial tissue was ruptured,and myocardial cells and nucleus was disrupted.Myocardial dysfunction was gradually aggravated with the extension of time.The immunohistochemical results showed that the expression of RyR2 protein in septic shock group was higher than that in the control group(P<0.01), while the expression at 0h in septic shock group was the highest.As the extension of shock time,the myocardial function of rats decreased,the expression of RyR2 gradually declined in protein level,but the phosphorylation of RyR2 rised.The PCR results showed that the mRNA expression of RyR2 in septic shock group was higher than that in the control group(P<0.01), while the mRNA expression in septic shock group at early stage was the highest.As the extension of shock time,the mRNA expression of RyR2 gradually declined.Conclusion As the Ca2+ channel in the heart,the expression of RyR2 and the phosphorylation of RyR2 might be highly associated with the severity level of myocardial dysfunction under septic shock.