Comparative effectiveness research (CER) is well developed in international medical research. This article analyzes the basic connotations of CER from five aspects, including selection of objective, positioning of target population, comparison of intervention scheme, identification of contrast condition and analysis of therapeutic effects. The inclusiveness and advanced nature of CER were revealed by comparing with modern medical research methods, such as evidence-based medicine, patient-important outcome and randomized controlled trials. Based on the superiority of CER, the feasibility of applying CER in clinical evaluation of traditional Chinese medicine is explored. CER should be combined with the holistic concept, syndrome differentiation and individuality-concerned treatment so as to facilitate its development in research of traditional Chinese medicine in China.

Objective To explore the feasibility of laparoscopic cholecystectomy(LC) in patients over 85 years old.Methods Three-port LC was performed in 79 patients aged over 85 years old from October 1996 to October 2006.Patients' co-morbidities were effectively controlled before operation.The operation was conducted under continuous epidural anesthesia,and the CO2 pneumoperitoneum pressure was set at 8～10 mm Hg.Results The LC was successfully completed in 70 patients,while conversions to open surgery were required in 9 patients(11.4%).Causes of conversions included severe intraperitoneal adhesion in 6 patients,uncontrolled bleeding in 1 patient,and suspicion of gallbladder carcinoma in 2 patients.Postoperative complications occurred in 10 patients(12.7%,10/79).Of them,1 patient died of acute myocardial infarction,and the remaining 9 patients were cured(including left heart failure in 1 patient,pulmonary infection in 2 patients,ileus in 1 patient,wound haematoma in 1 patient,fungal enteritis in 1 patient,and effusion in the gallbladder bed in 3 patients).Conclusions Proper peri-operative management,effective control of co-morbidities,and careful surgical performance are essential for a safe LC in patients over the age of 85.

Objective This experiment aimed to confirm whether man made porous chitosan scaffold is a appropriate scaffold for chondrocyte culutre of tissue engineering Methods Chondrocytes were seeded onto porous chitosan and chitosan collagen complex scaffolds for culture in a three dimensional environment The scaffolds in hydrophilia and adhesion to chondrocytes were observed with light microscope and scanning electron microscope The number of the cells attached to the scaffolds and the function of the cells were detected with MTT automated colormetric microassay Result Chondrocytes can multiple and secrete the matrix on the poros chitosan and chitosan collagensc scaffolds The cell adhesion rates were 81 25% and 87 50% respectively Conclusion Chitosan can be fabricated into a suitable three dimensional porous scaffold Porous chitosan collagen complex scafflold may be a more suitable scaffold for chondrocyte culutre of tissue engineering

Amyotrophic lateral sclerosis (ALS) is a rapid progressive neurodegenerative disease, characterized by the degeneration of both upper and lower motor neurons. The progressive motor unit loss due to lower motor neuron damage is one of the most important pathological process in ALS. However, there are lack of specific biomarkers for early diagnosis and progression monitoring of ALS. The relevant electrophysiologic techniques which quantify the number of motor unit have been developed rapidly in recent years. Among them, the motor unit number estimation (MUNE) and the motor unit number index (MUNIX) have been widely applied to quantify motor unit number loss in ALS. The most recent advances of MUNE and MUNIX in ALS were reviewed.

OBJECTIVE To investigate the methods of promoting nosocomial infection administration in laminar airflow(LAF) operation department,based on the theory of air microbe and object surface microbe. METHODS To begin with the construction standard of LAF operation department,to discuss difficult,complicating,professional and legal characteristics of nosocomial infection administration of LAF operating room. RESULTS It was a solid base of promoting nosocomial infection administrition to specify strictly the standard for the LAF operation department built;it was a vital link of promoting nosocomial infection administrition to take part in inspecting the engineering quality of LAF operation department;it is an effective means of LAF nosocomial infection administrition to carry out the supervision and control to the LAF operation department daily;it was the essense of promoting nosocomial infection administrition to make efforts to innovate the modern administration pattern in LAF operation department. CONCLUSIONS The management of hospital infection in the LAF operation department must emphasize the comprehensive measure of the all-directional germ control,make standard of decontamination of air conditioning guarantee system and carry out the whole process supervision.

Objective To establish a method for determining cinnamaldehyde in Zegui Longshuang Capsules. Methods A C18 column was used with Acetonitrile-Water (30∶70) as the mobile phase,and the detection wavelength was at 290 nm. Results The calibration curve of cinnamaldehyde was linear from 0.010 ?g to 0.507 ?g,and r=0.999 9. The average recovery was 98.55 %with RSD being 2.06 %. Conclusion This method is proved to be accurate and reliable,and can be used to control the quality of Zegui Longshuang Capsules.

Objective To explore clinical characteristics and prognostic risk factors in patients with community ac-quired pneumonia(CAP)complicated with acute kidney injury(AKI).Methods In total, 456 CAP patients were included based on the diagnostic guide.According to whether the patients were accompanied with AKI,the patients were divided in-to two groups(non-AKI group and AKI group). AKI group were further divided into risk group, injury group and failure group by RIFLE criteria using admission creatinine.Severity in CAP patients,clinical indexes and prognostic evaluation in-dexes were compared between different groups. Multiple factors were analyzed using Logistic regression model,survival analysis were examined by Kaplan-Meier, which analyzed the risk factors of poor prognosis in CAP patients and the role of RIFLE criteria in prognostic evaluation. Results Thirty percent(135)of the total 456 CAP patients were accompanied with AKI. Patients in AKI group were further divided into risked group (45.2%, 61 patients), injury group (17%, 23 pa-tients) and failure group (37.8%, 51 patients) according to the RIFLE diagnostic criteria using basal creatinine level. Among the 300 patients with PSI gradeⅠtoⅢ,23.3%(70)of patients developed AKI while among 156 patients who are with PSI gradeⅣor over, 65 patients (41.7%) developed AKI(P<0.01).The 30-day mortality of CAP patients accompanied with AKI were increased compared to Non-AKI group(Non-AKI:6.2%;Risk:14.8%;Injury:21.7%;Failure:45.1%).With de-teriorating in RIFLE criteria,the portion of patients who required mechanical ventilation, inotropic support(MV/IS)and re-nal replacement therapy(RRT)increased too. Logistic analysis revealed that AKI,age of 75 years or older and extra-renal or-gan failure were the risk factors of poor prognosis in patients with CAP. The rate of survivors was decreased in the CAP pa-tients accompanied with AKI compared with those who did not.Conclusion There is certain incidence of AKI to compli-cate CAP patients who will have a poor prognosis.RIFLE diagnostic criteria is a valuable tool to evaluate prognosis of CAP patients complicated with AKI.

Objective To discuss the best method to treat deep perianal abscess and to investigate the clinical efficacy and value of the procedure of percutaneous catheter drainage guided by ultrasound in treatment.Ninteen patients with deep abscess underwent the procedure from Jan.2012 to May.2013.Methods Clinical data of 19 patients were analyzed retrospectively,including 16 male cases and 3 female cases.Results The average age is 39.8.All patients were cured without complications.The average length of stay is 7.8 days,a mean follow-up of 6.6 months after discharge,no patient with recurrence or fistula.Conclusion No specific performance of colorectal carcinoid,surgical resection is the most effective method of the treatment of colorectal carcinoid,the procedure should be individual treatment.However,the long term prognosis need to be explored in the future.

Objective: To optimize the separation and purification of the total poly phenol from Dryopteris crassirhizoma with anion- exchange resin. Methods: The rates of elution and absorption, contents of dryocrassin ABBA, and total ploy phenol were used as makers to optimize the purification conditions of total ploy phenol. Results: The extracting solution of D. crassirhizoma passed through 201×7 hydrogen-oxygen the anion-exchange resin column (column diameter-column height, 1:7) at the rate of 6 BV/h in reverse direction, then the resin column was flushed with water at the rate of 6BV/h to pH value 6-7 in forward direction. At last, the column was eluted at the rate of 6 BV/h to obtain ploy phenol with 9BV 3% salt water in 60% alcohol. The elution ratio of dryocrassin ABBA is 90.1%, and the total ploy phenol is 91.1%. The content of dryocrassin ABBA is 29.4% and the content of the total ploy phenol is 49.2%. Conclusion: The separation and purification of the total ploy phenol from D. crassirhizoma with 201 × 7 hydrogen-oxygen anion-exchange resin can achieve the satisfactory results which have wide application prospects.

To investigate the effect of propofol on the release of glutamate and gamma-aminobutyric acid (GABA) from rat hippocampal synatosomes, synaptosomes was made from hippocampus and incubated with artificial cerebrospinal fluid (aCSF). With the experiment of Ca(2+)-dependent release of glutamate and GABA, dihydrokainic acid (DHK) and nipectic acid were added into aCSF. For the observation of Ca(2+)-independent release of glutamate and GABA, no DHK, nipectic acid and Ca2+ were added from aCSF. The release of glutamate and GABA were evoked by 20 micromol/L veratridine or 30 mmol/L KCI. The concentration of glutamate and GABA in aCSF was measured by using high-performance liquid chromatography (HPLC). 30, 100 and 300 micromol/L propofol significantly inhibited veratridine-evoked Ca(2+)-dependent release of glutamate and GABA (P < 0.01 or P < 0. 05). However, propofol showed no effect on elevated KCl-evoked Ca(2+)-dependent release of glutamate and GABA (P > 0.05). Veratridine or elevated KCI evoked Ca(2+)-independent release of glutamate and GABA was not affected significantly by propofol (P > 0.05). Propofol could inhibit Ca(2+)-dependent release of glutamate and GABA. However, it has no effect on the Ca(2+)-independent release of glutamate and GABA.
Anesthetics, Intravenous/pharmacology ; Calcium/metabolism ; Glutamic Acid/*biosynthesis ; Hippocampus/*metabolism ; Propofol/*pharmacology ; Rats, Sprague-Dawley ; Synaptosomes/*metabolism ; gamma-Aminobutyric Acid/*biosynthesis