Objective To investigate the therapeutic effect and safety of albumin combination furosemide in treatment of eld cerebral hemorrhage patients,and provide evidence for clinical treatment of eld cerebral hemorrhage patients.Methods Two hundred eld cerebral hemorrhage patients were divided into control group (110 cases) and observation group (90 cases) by systematic sampling method.The two groups were given the monitor of vital signs,support of organ function,reduce of intracranial pressure and other conventional treatment,on the basis of which albumin (10 g,2 times/day) and furosemide (20 mg,intravenous injection) were given to observation group for 10 days.The levels of arterial blood lactate and vein serum C reactive protein (CRP) of 2 groups were compared at admission,treatment for 7 and 14 days.Moreover,the mortality rate of 2 groups at 14th day of treatment was also compared.Results There were no statistical differences in the condition of patients between the 2 groups at admission (P ＞ 0.05).The levels of arterial blood lactate of control group at treatment for 7 and 14 days were significantly higher than those of observation group [(2.56 ± 0.63) and (1.98 ± 0.65) mmol/L vs.(1.91 ± 0.70) and (1.28 ± 0.68) mmol/L],there were statistical differences between the 2 groups (P＜0.05).The levels of vein serum CRP of control group at treatment for 7 and 14 days were significantly higher than those of observation group [(120.02 ± 40.65) and (48.75 ± 30.11) mg/L vs.(60.52 ± 30.83) and (13.45 ± 6.02) mg/L],there were statistical differences between the 2 groups (P ＜ 0.05).The mortality rate at 14th day of treatment of control group was significantly higher than that of observation group [22.73％ (25/110) vs.13.33％ (12/90)],there was statistical differences between the 2 groups (P ＜ 0.05).Conclusion Albumin combination furosemide in treatment of eld cerebral hemorrhage patients can relieve the inflammatory reaction and decrease the mortality rate,it is expected to become the routine treatment in eld cerebral hemorrhage patients.

Objective To compare the clinical effect of small bone flap craniotony and skull drill drainage in treatment of hypertensive cerebral hemorrhage.Methods Ninety -eight patients with hypertensive cerebral hemorrhage were classified into group A and group B by random number table with 49 cases in each.Group A was used small bone flap craniotony,and group B was used skull drill drainage.The clinical effects between two groups were compared.Results The short-term total effective rate in group A was 83.7％(41/49 ),which was significantly higher than that in group B with 65.3％(32/49 )(P ＜ 0.05 ).The long-term good rate in group A was 55.1％(27/49),which was significantly higher than that in group B with 26.5％ (13/49) (P ＜ 0.05 ).Conclusion Both the short-term and long-term effective rate of small bone flap craniotony for hypertensive cerebral hemorrhage are better than skull drill drainage.

OBJECTIVE: To summarize the classification, property of skull repair material and the processing of related complications in the application of repairing and remodeling the skull.METHODS: The PubMed database (http://www.ncbi.nlm.nih.gov/PubMed) and CNKI Database (www.cnki.net/index.htm) was searched by the first author using key words of "codubix, synmesh, and bone cement" both in English and Chinese. Articles whose content is related to the types, property, biocompatibility and its application effect of skull repairing materials were selected. In the same field, the articles published by authoritative journals or different races were preferred. The repetitive or obsolete literatures were excluded. After that 26 documents were included in this paper.RESULTS: The bone cement exhibited good histocompatibility, however, it is difficult to be absorbed, thus, it only be used for repairing part of skull defects. The study found that titanium had good biocompatibility and could combine with the skull. Its application had a promising prospect, but there are many inadequacies. With the continuous deepening of bio-engineering, bone tissue engineering, and cartilage tissue engineering, it will provide a broader perspective for the study of skull repair materials.CONCLUSION: There are many kinds of materials for skull repairing, and this paper only introduces some of the widely used ones. Actually, the selection of repairing materials should consider the pathogenetic condition, economic condition, local equipment and technical levels. If possible, titanium mesh and titanium screw are preferred, which is characterized by easy operation, few complication and beautiful appearance: When using autogenous bone or bone cements, if related complications can be reduced and handled effectively, the results will be satisfactory.

OBJECTIVE:To study the inhibition effect of spinosin on 7 subtypes (CYP2B6,CYP2C8,CYP2C9,CYP2D6, CYP1A1,CYP2C19 and CYP3A4)of cytochrome P450(CYP450)enzymes from human liver microsomes in vitro. METHODS:Tak-ing 200.00,100.00,50.00,25.00,12.50,6.25,3.13,1.56,0.78,0.39 μmol/L spinosin and human liver microsomes for incuba-tion,using daktarin,bupropion,amodiaquine hydrochloride,diclofenac sodium,mephenytoin,dextromethorphan hydrobromide and midazolam as the specific probe drugs for above-mentioned 7 subtypes of CYP450 enzymes. UPLC-Q-TOF-MS was conducted to detect generation amount of 7 probe drug metabolites,and the half inhibitory concentration (IC50) of spinosin on 7 subtypes of CYP450 enzymes from human liver microsomes was calculated. RESULTS:IC50 of spinosin on 7 subtypes of CYP450 enzymes from human liver microsomes were 1714,1158,226.1,2288,80.59,101.1,1119 μmol/L,respectively,which were higher than 50μmol/L. CONCLUSIONS:Spinosin has no inhibition effect on above-mentioned 7 subtypes of CYP450 enzymes from human liver microsomes,with very low probability of inducing metabolic drug interactions.

OBJECTIVE:To establish a method for simultaneous determination of 4 psoralen compounds in Buwu tincture. METHODS:HPLC was performed on the column of Dikma Diamonsil C18 with mobile phase of acetonitrile-0.2% Acetic acid by gradient elution at flow rate of 1 ml/min,detection wavelength was 246 nm,column temperature was 30 ℃,and the injection vol-ume was 15 μl. RESULTS:The linear range was 13.00-208 μg/ml for angelicin,26.00-416 μg/ml for bavachin,24.50-392 μg/ml for psoralidin and 37.88-606 μg/ml for isobavachalcone,respectively(r≥0.999 6);RSDs of precision,stability and reproducibility tests were less than 2.00%;recoveries were 95.22%-97.23%(RSD=0.87%,n=6),100.24%-104.64%(RSD=1.62%,n=6), 102.28%-104.39%(RSD=1.47%,n=6)and 97.68%-100.17%(RSD=0.97%,n=6),respectively. CONCLUSIONS:The method is simple and reproducible,and can be used for the quality control of Buwu tincture.

The 2019 novel coronavirus (2019-nCoV) outbreak in Wuhan, Hubei Province, China in 2019 led to large numbers of peoplebeing infected and developing atypical pneumonia (coronavirus disease 2019, COVID-19). Typical imaging manifestations ofpatients infected with 2019-nCoV has been reported, but we encountered an atypical radiological manifestation on baselinecomputed tomography (CT) images in three patients from Wuhan, China infected with the 2019-nCoV. Surprisingly, the onlysimilar CT finding was a solitary sub-centimeter ground-glass nodule adjacent to bronchovascular bundles, which could beeasily overlooked. In addition, the follow-up images in these patients showed how COVID-19 pneumonia evolved from thesesmall nodules. The radiologic manifestation of the three cases will expand contemporary understanding of COVID-19.

Objective To get well-informed of the practical skills examination of residents' standardized training in order to detect problems and improve the quality of training. Methods A total of 4484 clinical medical examinees from 2010, 2013 and 2017 in Liaoning province were investigated by questionnaire, from which 4412 valid questionnaires were collected and the total survey efficiency was 98.39％. The survey included the standardized patient (SP) examination, the small station test, the computer simulated case (CCS) examination and the clinical skill operation test station with parts 20 projects. Excel was used to sort and record the data. SPSS 10.0 software was used for statistical analysis. Results All parts of the practical skill assessment was reasonable. The examinees' satisfaction with the test is showing an upward trend year by year, up to 73.93％in 2017. In the standardized patients examination, the key points of the role play (including the fidelity and simulated authenticity of the physical signs) need be strengthened (14.84％ in 2010). Examinees thought the difficulty of computer simulation case examination is increasing year by year. More than 2/3 examinees evaluated the clinical skill operation test station set was reasonable and the difficulty was moderately. Conclusions We should further deepen the exploration of standardized patients assessment model; strengthen the medical humanities in training; improve the residents' clinical thinking;take examination as the guidance and standardize clinical training.

Objective To establish a quality control standard for Qingre Baidu granules .Methods Isatidis Radix ,Fruc-tus Forsythiae ,Herba Violae ,and Glycyrrhizae were identified by TLC ,and the concentration of chlorogenic acid was deter-minedbyHPLC.ThismethodwasemployedonanAgilentZORBAXSB-C18column(4.6mm×250mm,5μm)at30℃ witha mobile phase of acetonitrile (A) and 0 .2% formic acid (B) using the gradient elution program shown as follows :0-12 min , 11%-12% A run at the flow rate of 1 .0 ml/min .The injection volume was 20 μl and the detection wavelength was 327 nm . Results Characteristic spots could be detected by TLC and the specificity of the method was satisfactory .As for chlorogenic acid ,the equation of linear regression of chlorogenic acid was Y=60 .239 4X+9 .096 3 (r=0 .999 9) with the linear range of 6.19-396 .00 μg/ml .The average recovery was 99 .66% (RSD=2 .82% ) .Conclusion The established method is simple ,reli-able ,reproducible ,and can be used for the quantitative determination and quality control of Qingre Baidu granules .

Antiangiogenic target therapy has been a hot topic in cancer treatment recently.Apatinib is a category 1.1 new medication developed domestically.It effectively inhibits angiogenic and exhibits promising anti-tumor activity in preclinical studies.Apatinib has been successfully applied in clinical trials of multiple malignancies,such as gastric cancer,lung cancer and breast cancer with satisfactory safety and efficacy profile.However,its mechanism of action is still not fully understood. Further researches should be carried on to improve its safety,effectiveness and marketability.This review summarized the mechanism of action,pharmacokinetics,clinical efficacy,safety and biomarkers,discussed the recent progress,hot issues and clinical prospects of apatinib,

Objective To explore microRNAs that play key regulatory roles in the pathophysiology of acute transverse myelitis in children,and to find therapeutic targets.Methods Twelve patients with acute transverse myelitis were enrolled as ATM group and three children with normal cerebrospinal fluid as the control group.MicroRNA in cerebrospinal fluid of children with acute transverse myelitis was detected by using microarray4.0 chip.Bioinformatics was used to demonstrate microRNA,which plays a key regulatory role,and to predict target genes.Real-time quantitative polymerase chain reaction (qPCR) technique was adopted for in biology and technology duplication.Enzyme-linked immunosorbent assay (ELISA) and Western blot technique were used to detect the expression of key miRNA target protein.The key candidate microRNA was inhibited/overexpressed in dorsal root ganglion neurons,and the function was verified in vitro.Flavopiridol was used to inhibit the activity of CDKs to verify that miR-92b worked through p57-CDKs-GAP-43 pathway.Results The characteristic elevation of miR-92b in cerebrospinal fluid samples of acute transverse myelitis was significant.Bioinformatics analysis showed that p57 was the target gene of miR-92b.The expression of miR-92b was contrary to the p57 protein.In vitro experiments showed that the length of axons in miR-92bmimics group was significantly shorter than that in the blank group.The axons of neurons in antimiR-92b group were obviously prolonged.In the miR-92b mimics + Flavopiridol groups,the axons of neurons were still significantly prolonged compared with that in the blank group.Western blot showed that p57 and GAP-43 protein expression in miR-92b mimics group was lower than that in blank group.The expression of p57 and GAP-43 protein in antimiR-92b group was significantly higher than that in blank group.But in miR-92b mimics + Flavopiridol group,the expression of p57 was lower compared with that in blank group,and the expression of GAP-43 protein was higher compared with that in blank group.Conclusions Up-regulation of miR-92b in children with acute transverse myelitis leads to a down-regulation of p57.The activity of CDKs is enhanced,which inhibits the expression of GAP-43 protein and the regeneration of axons in spinal cord injury region.MiR-92b is one of the key targets in the treatment of children with acute transverse myelitis.