OBJECTIVE:To observe clinical efficacy and safety of Shuxuening injection in the adjunctive treatment of traumat-ic subarachnoid hemorrhage. METHODS:96 patients with traumatic subarachnoid hemorrhage were randomly divided into control group and observation group with 48 patients in each group. Control group was given Tranexamic acid injection,Nimodipine injec-tion and Citicoline injection,daily lumbar punctrive and determined intracranial pressure and drained cerebrospinal fluid via lumbar puncture;observation group was additionally given Shuxuening injection 20 ml added into 5% Glucose injection 250 ml,ivgtt,qd. Both group were treated for consecutive 2 weeks. Clinical efficacy of 2 groups were observed,and GCS and MCA were also ob-served before and after treatment;ADR of 2 groups were recorded. RESULTS:Excellent rate of observation group(60.42%)was significantly higher than that of control group(31.25%),with statistical significance(P<0.05). Before treatment,3 and 5 days af-ter treatment,there was no statistical significance in GCS and MCA between 2 groups(P>0.05);7 and 14 days after treatment, GCS of 2 groups increased significantly while MCA decreased significantly,and the observation group was better than the control group,with statistical significance (P<0.05). The incidence of cerebral vasospasm,cerebral infarction and cerebral hemorrhage were 8.33%,4.17%and 4.17%in observation group,and those of control group were 16.67%,12.50%and 16.67%;the observa-tion group was significantly lower than the control group,with statistical significance(P<0.05). CONCLUSIONS:Shuxuening in-jection shows significant therapeutic efficacy in the adjunctive treatment of traumatic subarachnoid hemorrhage,with low incidence of ADR.

County hospitals function as comerstones in China's health system,as their sustainable development plays a key role for the ongoing health reform.Disciplines are the most primary functional units of a hospital,and their disciplinary culture characteristic of the county hospital' s disciplines and fitting their current development status are definitely the most important and fundamental factor for sustainable development of the discipline.Based on extensive research,authors identified no less than eight cultural elements,namely values of life,self-confidence,a comprehensive model of talent development,safety first,teamwork,communication,scientific pursuit and health management.This study aimed at providing thoughts for the current county hospital development.

Objective To investigate the relationship of Vaneomycin serum concentration and drug adverse reactions (ADRs) in neonates.Methods Two hundred and thirteen neonates who were treated by Vancomycin and had their serum concentration monitored were recruited.The number of cases which had liver,kidney and hearing damage after treatment was calculated.The correlation between 3 different serum concentrations (＜5 mg/L,5-10 mg/L,＞ 10 mg/L) and ADRs were analyzed.Results The mean level of Vancomycin in serum was (4.36 ± 4.99) mg/L The total incidence of ADRs was 17.8％ (38/213 cases).The main ADRs were liver damage and hearing impairment,whose incidences were 9.9％ (21/213 cases) and 7.5％ (16/213 cases),respectively,and they were were significantly higher than kidney danage (0.5％,1/213 cases) (x2 =19.172,P =0.000;x2 =13.785,P =0.000).There was no significant difference be-tween the inidence ratio of liver damage and that of the hearing impairment (x2 =0.330,P =0.566).The ADRs ratio among 3 different serum concentrations was 17.0％ (24/141 cases),17.6％ (9/51 cases) and 23.8％ (5/21 cases).There was no significant difference between the ADRs ratios and distribution of different serum concentrations (x2 =0.576,P =0.750).Moreover,the ADRs rates didn't increase along with the serum concentrations (Z =0.648,P =0.517).Except for aspartate transaminase,the indicators of liver and kidney function varied significantly after vancomycin treatment (P ＜0.05).But there was no clinical significance because the mean value was in normal range.By Bivariate Correlation analysis,Vancomyein serum concentration had no significant influence on liver and kidney function (P ＞ 0.05).Conclusions Neonates treated by Vancomycin had reatively high ratio of the liver damage and the hearing impairment.There is no significant correlation between Vancomyein serum concentration and ADRs in neonates.

Objective To investigate the in vitro anti-inflammatory effects of Sophora davidii Hance leaves total alkaloids(SDLTAs)and possible molecular mechanisms.Methods The lipopolysaccharide(LPS)-induced inflammation model of RAW264.7 cells was used,and different concentrations of SDLTAs(50,100 and 200 μg/mL)were administered,and the effect of SDLTAs on cellular NO expression was detected by the Griess method;ELISA method was used to detect the effect of SDLTAs on the expression of IL-6,TNF-α and IL-1β;The expression of iNOS,NF-κB p65 and IκBα mRNA was detected by RT-qPCR;Western blotting was used to detecte the expres-sion of p-p38,p-p65 and p-JNK in the cells and NF-κB p65 in the nucleus.Results SDLTAs could significantly inhibit the LPS-induced inflammatory response in RAW264.7 cells.SDLTAs significantly decreased the secretion of NO,IL-6,TNF-α and IL-1β in cells(P<0.01),and significantly decreased the mRNA expressions of iNOS,NF-κB p65 and IκBα in cells(P<0.01).Significantly decreased the protein expression of p-p38,p-p65 and p-JNK in cells and NF-κB p65 in nucleus(P<0.01).Conclusion SDLTAs can exert anti-inflammatory effects by regulating the MAPK/NF-κB signalling pathway.

Objective BAG3-related myopathy is a rare condition so far reported in twenty patients worldwide.The purpose of this study was to draw attention to this rare disease and to the fact that BAG3-related myopathy should be considered as a rare differential diagnosis of hypercapnia.Methods We report a sporadic case of a 14-year-old Chinese girl with a de novo p.Pro209Leu mutation in BAG3 and reviewed the literatures for reported cases related to this mutation.Results We described a 14-year-old Chinese girl who presented with gradually appearing symptoms of hypercapnia that required assisted ventilation.The muscle biopsy and the blood whole-exome sequencing results confirmed the diagnosis of myofibrillar myopathy with a de novo p.Pro209Leu mutation in BAG3.Totally twenty-one patients from twenty families with a confirmed diagnosis of BAG3-related myopathy were reported to date,including this patient and literature review.The male to female ratio was 11 :10 and most showed initial symptoms in the first decade of life.Most patients presented toe/clumsy walking or running as the onset symptom,followed by muscle weakness or atrophy.Creatine kinase levels were elevated in fourteen patients and were normal in three.Eighteen patients developed respiratory insufficiency during the disease course and thirteen (one could not tolerate non-invasive assisted ventilation) required non-invasive assisted ventilation for treatment.Except for one not reported,heart involvement was found in seventeen patients during the disease course and seven underwent heart transplantation.Z-disk streaming and aggregation could be observed in most of the patients' muscle histology.In the long-term follow-up,five patients died of cardiac or respiratory failure.Conclusion BAG3-associated myopathy is a rare type of myofibrillar myopathy.It should be considered as a rare differential diagnosis of hypercapnia.