Objective To investigate the clinical efficacy of acupoint application in treating senile hypertension of yin deficiency and yang excess type.Methods Sixty-six old patients with hypertension of yin deficiency and yang excess type were randomly allocated to treatment and control groups, 33 cases each. The control group took nifedipine controlled release tablets and the treatment group received acupoint application in addition. The quality of life score was recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results The total efficacy rate in reducing blood pressure was 90.0% in the treatment group and 84.8% in the control group; there was no statistically significant difference between the two groups (P>0.05). The total efficacy rate in improving the symptoms was 90.9% in the treatment group and 69.7% in the control group; there was a statistically significant difference between the two groups (P<0.05). There was a statistically significant pre-/post-treatment difference in the quality of life score in the two groups (P<0.05). There was a statistically significant post-treatment difference in the quality of life score between the treatment and control groups (P<0.05).Conclusions Acupoint application is an effective way to treat senile hypertension of yin deficiency and yang excess type. It can improve the quality of life in the patients.

Objective To investigate the changes in auditory evoked potential index(AAI)value and bispectral index(BIS)value produced by treatment of hypotension with ephedrine or phenylephrine during induction of general anesthesia.Methods Seventy-five ASA Ⅰ or Ⅱ patients of both sexes aged 30-50 yr with body mass index ＜ 30 kg/m2 underwent elective abdominal surgery under general anesthesia.Anesthesia was induced with 8%sevoflurane,midazolam 0.1 mg/kg and fentanyl 3 μg/kg.Tracheal intubation was facilitated with succinylcholine 2 mg/kg.Anesthesia was maintained with sevoflurane inhalation.BIS value was maintained at 40-50 and AAI value at 20-30 by adjusting the concentration of sevoflurane.When the desired level of BIS value and AAI value was reached during induction of anesthesia,hypotension(MAP ＜ 80 % of the baseline)was treated with intravenous ephedrine 0.1 mg/kg(group E,n = 25)or phenylephrine 2 mg/kg(group P,n = 25)or 6% HES(130/0.4)10 ml/kg(group C,n = 25)at random.MAP,HR,BIS value and AAI value value were recorded before(T0)and at 2,5,7,10 min after fluid or vasoactive agent administration(T1-4).Results MAP significantly increased after treatment at T1-4 as compared with MAP at To in all 3 groups.BIS and AAI values were significantly increased after administration of ephedrine at T3,4 as compared with MAP at To in group E.There were no significant differences in BIS and AAI values before and after administration of phenylephrine and 6% HES in group P and C.Con-clusion Treatment of hypotension with ephedrine during induction of general anesthesia can increase BIS and AAI and decrease the depth of anesthesia but phenylephrine cannot.

Objective To compare the effects of sedation induced with dexmedetomidine and propofol on intracranial pressure and cerebral oxygen metabolism in patients with permissive hypercapnia. Methods Twentyfour patients with acute respiratory distress syndrome (ARDS) were randomly divided into 2 groups ( n = 12 each) :dexmedetomidine group (group D) and propofol group (group P) . Their APACHE Ⅱ scores were 11-18. The patients were mechanically ventilated (VT 5-7 ml/kg, RR 12-17 bpm, PEEP 6-10 cm H2O, FiO2 40-60%). PaCO2 was maintained at 50-65 mm Hg. Radial artery was cannulated for direct BP monitoring and blood sampling. Right internal jugular vein was cannulated and the catheter was advanced cephalad until jugular bulb. Continuous infusion of dexmedetomidine was started at 0.5 μg· kg-1· h-1 and TCI of propofol was started at target plasma concentration (Cp) of 0.4 μg/ml. The infusion of both drugs was gradually increased until Ramsay score (1= fully awake, 6 =asleep, unresponsive to loud verbal stimulus) reached 3,4,5. Transcranial Doppler monitoring was used to determine cerebral blood flow velocity (CBFV), pulsatility index (PI) and resistance index (RI) before administration of dexmedetomidine and propofol (T0 ) and at 30 min after the 3 levels of sedation were reached (T1-3) . Meanwhile blood samples were taken from radial artery and jugular bulb for blood gas analyses. Cerebral O2 metabolic rate (CMRO2), cerebral A-V O2 content differences (Da-jvO2) and cerebral O2 extraction rate (CERO2) were calculated .ResultsCBFV, PI, RI and CMRO2 were significantly decreased at T1-3 as compared with the baseline values at T0 in both groups. CBFV was positively correlated with CMRO2 in both group D (r = 0.80) and group P ( r = 0.76) . CBFV, PI and RI were significantly lower at T1-3 in group D than in group P. There was no significant change in Da-jvO2 and CERO2 at T1-3 as compared with the baseline values at T0 in both groups. Conclusion At different sedation levels, dexmedetomidine results in lower intracranial pressure than propofol and maintains the balance between cerebral O2 supply and demand in patients with permissive hypercapnia.

Three-dimensional (3D) fluorescence spectra and thin layer fluorescence chromatogram of common Camptotheca fruit (CCF) crude drug, camptothecin (CPT) and 10-hydroxycamptothecin (HCPT) have been studied, and a novel fluorimetric method for determination of CPT in CCF crude drug has been established. In 3D fluorescence spectra, CPT presented 3 fluorescence peaks with excitation wavelengths lambdaex of 215, 255 and 365 nm, separately, and all peaks with emission wavelength lambdaem of 430 nm. HCPT presented 4 fluorescence peaks with lambdaex of 220, 265, 325 and 375 nm, separately, and all peaks with lambdaem of 555 nm. The fluorescence of CPT is much stronger than that of HCPT. Comparison of 3D fluorescence spectra and analysis of thin layer fluorescence chromatogram revealed that the main fluorescent component of CCF is CPT. HCPT and other components basically do not interfere with the fluorescence of CPT. Under the condition of pH 3.0-6.7, CCF aqueous solution can produce strong and steady fluorescence. Using methanol as solvent, the extracting solution of CCF was prepared, and diluted properly with water, then measured fluorescence intensity at lambdaex/lambdaem = 365/430 nm to determine the content of CPT. A linear calibration curve covered the concentration range 0.002 35-0.235 microg x mL(-1). The regression equation was IF = 9 + 30,844 c, with correlation coefficient r = 0.999 (n=9). The method has been applied to the analysis of CPT in a CCF sample, with a result of 0.127% and a spiked recovery rate of 102%. The reliability of the method has been verified by a thin layer chromatography-fluorescence scanning method. Experimental results demonstrated that this method can be used for quality evaluation of CCF crude drug.

Objective　To investigate the changes and its clinical significance of plasma neuropeptide Y(NPY) concentration in patients with pregnancy induced hypertension (PIH). Methods　Plasma NPY levels were detected by radioimmunoassay in 30 patients with PIH, 20 normal non-pregnant women and 23 normal pregnant women. The PIH group was subdivided into mild, moderate and Severe subgroups, and the NPY concentration was also measured in these subgroups respectively at admission and one week after delivery. Results　The plasma NPY levels in patients with PIH ［(164.16±68.32) ng/L］ were significantly higher than those of normal non-pregnant women and normal pregnancies ［(86.60±20.65) ng/L, (82.42±12.46) ng/L, P<0.01, respectively］. There was significant difference among plasma NPY levels among the patients with mild, moderate, and severe PIH at admission (P<0,01). At one week after delivery the concentrations of plasma NPY were significantly decreased in the moderate and severe subgroups compared with the value measured at admission (P<0.01). Moreover, the NPY levels in patients with severe PIH after delivery were still higher than those of normal non-pregnant women. Conclusions　The results suggested that the level of NPY in plasma is increased in women with PIH. Elevated plasma NPY levels may play a key role in the development of PIH.

Objective:To evaluate the quality condition and problems of acetylspiramycin at present. Methods:According to the standard described in Chinese Pharmacopoeia (2015 edition), acetylspiramycin and its preparations were determined, and the overall quality level of domestic acetylspiramycin was evaluated. The related substances, components and dissolution were analyzed to further explore the quality status. Results:In 258 batches of samples, the dissolution of only one batch did not meet the standard with the passing rate of 99. 6%. The results of exploratory research showed that the content of impurities in raw material was determined by the synthesis process, and the impurity profile of domestic and foreign formula was different. The dissolution behavior of domestic and for-eign formula in four kinds of media was not similar as well. Conclusion: The quality of domestic acetylspiramycin is promising. The research of related substances provides the reference for controlling the target impurities. The consistency assessment of dissolution pro-vides the reference for the formula process improvement and clinical application of acetylspiramycin tablets.

In recent years, the incidence of the allergic skin diseases is increasing as the growing of the pressure, the changes of the environment and other factors. The clinical features of the allergic skin diseases are easily repeated and in long course. It is found that the incidence of clinical allergic skin diseases, in addition to the season, diet and emotional relevant, is also closely linked to the physical deterioration of patients. Therefore, in addition to the emphasis on the treatment of the current symptoms of patients, adjustment and treatment of phsical constitution of patients and improvement of the adaptability of patients to environmental changes should attract attention, thereby reducing the frequency of incidence and alleviating the symptoms. The application of the abdominal acupuncture combined with body acupuncture for the improvement of the symptoms and physical constitution of allergic skin disease patients has obvious efficacy, which should be applied and promoted in clinic.

Aim To study the role of nitric oxide by measuring the expression and activity of nitric oxide synthase in hippocampus of rats tolerance and dependence to the anticonvulsant action of flurazepam.Method Animal models of toleran and dependence to flurazepam were established. Nitric oxide synthase in hippocampus was measured using Western blot and immunohistochemistry, and its activity was evaluated using colorimetry. Result Hippocampal nNOS increased in rats tolerance to flurazepam. In rats dependence to flurazepam, hippocampal nNOS increased but without statistical significance. Total NOS activity increased dramatically both in flurazepam tolerane and dependene rats.Conclusion NO may play a role in rats tolerance and dependence to the anticonvulsant action of flurazepam.

OBJECTIVE:To probe into the situation of drug use that goes beyond the scope of package inserts in pediatrics of our hospital and to promote clinical rational drug use.METHODS:A total of 3 142 prescriptions between Mar.and Apr.2006 collected from the pediatric out-patient department of our hospital were analyzed in accordance with the contents of the related drug package inserts.RESULTS:Of the total 3 142 prescriptions,345(11.0%) involved drug use that goes beyond the scope of package inserts,leading the list were prescriptions of infants,accounting for 71.3% of the total.The problems such as age(52.2%) and indication(36.5%) were the main type;respiration system drugs(48.4%) and the antibiotics(40.6%) were the main drug kinds involved.CONCLUSIONS:It's widespread for drug use that goes beyond the package inserts in the pe-diatrics,which conforms to evidence-based medicine and the spirit of philosophy and ethics,but against the principle of law,which thus should be given fully attention in the clinic.

In the present paper,the authors make a summary about the development of acupuncture needles in Chinese ancient times recorded in the literature,and have a discussion on the effect of the thickness of acupuncture needles on clinical the-rapeutic efficacy in accordance with modern medical theories,the development of its clinical application and by combining their own experience in acupuncture practice. They conclude that the thickness of the abdominal needle is a negligible factor influencing the therapeutic efficacy of the reinforcing-reducing manipulations. In the treatment of deficiency pattern disorders,a thinner acupuncture needle is suitable,while for excess syndrome,a thicker acupuncture needle is recommended. In the light of the patient's constitution and different state of clinical conditions,a flexible application of the acupuncture needle with different diameters is highly recommended in clinical practice. In this way,the clinical therapeutic effect would be improved much.