Objective:To introduce the use of fluoxetine in neurologic disease,especially in epilepsy.Method:We used fluoxetine as a supplement antiepileptic drug in 25 patients who couldnt be controlled yet by routine antiepileptics. A long term follow-up with these cases was carried out.Results:Most patients got better outcome.Conclusion:Fluoxetine would be an important supplement antiepileptic drug and have value for further clinical and experimental research.

Objective To establish HPLC method for fast, effective, simultaneous determination of Vancomycin and Norvancomycin in serum. Methods The separation was achieved on the Hypersil ODS2(250 mm ×4.6 mm,5μm)with methanol-acetonitrile-a mixture of potassium phosphate (9.5:2.5:88) as the mobile phase.The flow rate was 1.0 mL/min.The UV detecting wavelength was 280 nm.The temperature of the column was 35 ℃. Vancomycin and Norvancomycin were used as the internal standard for each other .Results Vancomycin and Norvancomycin blood concentration were in well linearity in the range of 1.25-100μg/mL,R2 =0.9996.The average method recovery rate of three concentrations were 96.88%,99.50%,105.01%respectively, the average method recovery rate of three concentrations were 94.40%,103.90,103.81%respectively, the intra-day and inter-day RSD were less than 5%.Conclusion The HPLC method is proved to be simple,sensitive, accurate and precise in which little blood sample is taken, thus it is suitable for the therapeutic drug monitoring(TDM) and pharmacokinetic study of Vancomycin and Norvancomycin.

Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.

Objective To analyze the relationship between the varicosity of esophagus and portal hypertensive gastropathy(PHC) in patients with upper gastrointestinal hemorrhage of hepatocirrhosis. Methods The damage degree of esophageal varicosity was divided into four grades and the PHG were divided into three groups according to the McCormack standards by emergency gastric endoscopy. Results Among 200 patients with upper gastrointestinal hemorrhage,100 cases(50. 0%) were caused by esophageal varicosity explosion and 44 cases(22. 2% ) were induced by PHG,38 cases (19. 0%) were due to gastric ulcer, 18 cases (9. 0%) were duo to other causes. Comparison between etiology and liver function of A-class(except for other reasons group) were significantly different(X2 =4. 23 ,X2 =4. 15 ,X2 =4. 18,X2 =4. 07,P＜0. 05 ;X2 =6. 83 ,X2 =7. 01 ,P＜0. 01 ) ;The portal vein diameter＞1.5cm bleeding incidence(32. 5% ) were significantly higher than the diameter＜1. 1cm bleeding incidence( 12. 5% ) (X2 =4. 73 ,P ＜0. 05 ) ;The degree of PHG in severe esophageal varices (55. 6% ) were significantly higher than the mild esophageal varices( 11.1% )( X2 = 7.73, P＜0. 01 ). The correlation between PHG degree and esophagus varicosity were positive related(r=0.455,X2 = 4.01,P＜0.05). Conclusion The esophageal varicosity explosion and PHG are two major factors to cause hepatocirrhosis complicated with upper gastrointestinal hemorrhagein. The more severe the damage degree of esophageal varicosity is,the higher incidence and the more severe the PHG will be.

BACKGROUND: Critical incidents are natural and man-made disasters arising suddenly, which are beyond the ability of the individuals to resist or control. In the situation of stress, individuals feel stuck, and are unable to control the situation.OBJECTIVE: To confirm the assessment model of stress response to critical events and the interventional effect of social support, general self-efficacy and coping efficacy.DESIGN: A randomized sampling, questionnaire-based investigation.PARTICIPANTS: We selected 1016 college students of 17 provinces or cities including Beijing, Guangzhou, Hefei, Jilin, Jiangsu, Jiangxi , Liaoning, Sichuan, Inner Mongolia, Shandong , Shanghai, Hebei, Tianjin,Wuhan, Zhejiang , Chongqing and so on as subjects. Totally 708 college students selected from the above regions received the same survey one year later.METHODS: Depression and anxiety state of the subjects were investigated with Center for Epidemiological Studies Depression Scale (CESD)and Anxiety Inventory (SAS) during SARS. Social support condition was investigated with Social Support Rating Scale, authorized by Xiao Shuiyuan. Related items were amended considering used among college students. The subscale was integrated into 3 subscales including group-support, friend-support and social support utilization. One year later, stress response to SARS was investigated again with self-made coping efficacy scale, self-esteem scale and self-efficacy scale and SARS Stress Response Questionnaire, which included 13 items measuring the students in three aspects: cognitive evaluation to SARS epidemic, such as "I believe human beings can conquer SARS in the end"; panic to SARS, like "worrying about SARS sweats me and makes me feel shiver sometimes"; and defense response to SARS, as "In order to prevent SARS, I have to wear respirator in the public". As far as cognitive, panic emotion and defense behaviors were concerned. The coping efficacy developed by the author covered 18items, such as "I'm afraid that I can not deal with things", "I have enough confidence to conquer any difficulty", and namely as friability, confidence and intelligence.RESULTS: ① The two investigated results were compared through assessment of covariation. There was a significant difference in cognitive condition, panic emotion and defense behavior; that was to say, the stress response to SARS had been obviously relieved . ② Social support and SARS stress response model x2=8.654,df=4,P=0.07;criterion fit index NFI= 1, RFI =0.997 and IFI =1, RMSEA=0.034. ③self-efficacy confirmative factor analysis showed the following: x2=0.536,df=2,P=0.765;x2/df=0.268, NFI=1, RFI=1, IFI=1 and CFI=1, RMSEA=0.000. ④The discriminating and convergent validity of coping efficacy questionnaire was as follows. The coefficient was 0.633 with general efficacy questionnaire, 0.530 with self-respect (SES), 0.481 with CESD, 0.387 with anxiety (SAS), and -0.003 with living events. ⑤ A structural equation model about general self-efficacy, coping efficacy and SARS stress response was established: x2 =2.722 df=3, P=0.437; NFI=1, RFI=0.999,IFI=1, CFI=1, RMSEA=0.068. The model fitted well. According to the data, coping efficacy affected SARS stress response negatively (the coefficient was -0.59)CONCLUSION: ① The three-dimensional assessment model assessed the stress response to critical incidents including cognitive adjustment, emotional response and behavioral tendency. The three-dimensional model stood the test while assessing SARS stress response. Compared with the assessment of emotional disorders, such as depression and anxiety, the model was more sensitive. ②Social support played a vital role in the stress response to critical incidents as a buffer or a regulator. It showed more influence on emotional disorders than on SARS stress response. ③Coping efficacy was a measurable intervening variable, which deserves more attention to in the stress response to critical incidents. Compared with general self-efficacy, coping efficacy had a greater intervening effect on SARS stress response.

To establish a method for the deter mination of dissolution of amiodarone hydrochloride tablets. Methods: Samples from five different factories were tested by the paddle meth od with the dissolving medium of 1% SLS. Results: The resu lts showed that there were very significant differences(P＜0.01) in dissolut ion parameters among the tested samples. Conclusion: It is necessary for testing the dissolution of the amiodarone product to control its quality and ensure clinical efficacy and safety.

To promote the normalization,standardization and systematization of hospital infection control,the Coordination and Advisory Group for Hospital Infection Control of the province carried out an investigation in thirty-five 2nd grade hospitals of fourteen prefectures and cities in regard to the orga- nization and management of hospital infection control,necessary infection monitoring and sterilization devices against highly infectious areas through questionaires,medical theory tests and on-the-spot inves- tigations.Analysis is also made of the present conditions and pending problems in the field of infection control of the 2nd grade hospitals in the province.Relevant solutions are suggested.

Retinal detachment (RD) is one of the most common sight-threatening retinal diseases.Visual acuity is not always restored after successful reattachment of the retina.Photoreceptor cell death has been thought to be the major cause of vision loss after RD through various pathways and their interactions,including caspase-dependent apoptosis,endoplasmic reticulum stress-induced apoptosis and non-apoptotic death forms,such as necroptosis,autophagy,and so on.Based on the understanding of the mechanism of photoreceptor cell death after RD,current efforts on combinatorial inhibition of multiple death pathways,targeting upstream molecules and enhancement of intrinsic neuroprotection would help us to protect photoreceptors effectively and improve visual acuity of RD patients.This review summarized current opinions on mechanisms of photoreceptor cell death and the potential treatment strategies.

For HER-2 positive breast cancer, HER-2-targeted agents combined with agents that target downstream signaling or alternative pathways, and endocrine therapy has been investigated in clinical settings. This paper focuses on studies involving phaseⅡand phaseⅢclinical trials for new targets with enhanced clinical applications, including novel small molecular targeting agents, monoclonal antibody-targeted drugs, monoclonal antibody conjugates, dual target drug combination therapy, drug targeting combined with endocrine and targeted chemotherapies, trastuzumab subcutaneous injection, and HER-2 tumor vaccine.

Taking the Fourth Affiliated Hospital of China Medical University as an example,the information integration platform of the hospital is constructed in accordance with the national data and information interaction standard and HL7 standard.The paper introduces the idea for selecting platform products,and technical route and effect of platform construction,and provides guarantee for sustainable development of the hospital,in order to greatly improve core competitiveness of the hospital.