The article introduced advances of pharmacokinetic studies of topiramate, a new antiepileptic agent, in recent years. Topiramate pharmacokinetic parameters were determined after the administrations of single dose, multiple dose and concomitant therapy. The changes of its pharmacokinetic parameters were determined in the influence of the factors, for example, age, disease, and so on. These results have revealed the regulations of metabolism and excretion of topiramate in the healthy volunteers and patients. The data provide a basis of clinical rational medication for the patiens with epilepsy.

As a technique which can assess both the micro-vascularization and macro-vascularization of the tumor,contrast-enhanced ultrasound have been developed rapidly,and its researches in thyroid nodules check and differentiation has became more and more widely.Different infusion modes in the diagnostic of thyroid nodules are really meaningful.The development of CEUS and identification of thyroid nodules will be reviewed in this article.

Objective To evaluate the clinical effect of Liyanjiedu decoction for the prophylaxis and treatment of acute radiotherapy-induced oral mucositis of nasopharyngeal carcinoma(NPC)and the influence to the effect of the radiotherapy to NPC.Methods A total of 96 patients with NPC were randomly divided into treatment group and control group,48 cases for each group.The two groups were given radical radiotherapy.The treatment group was given Liyanjiedu decoction for buccal.The control group were given western medicine for mouthwash.The course of two groups was all from the beginning of radiotherapy to the end of it.Results The occurring time of radiotherapy-induced mucositis in treatment group and control group were(21?4.2)d and(16?3.6)d,and radiotherapeutic dose were(40.252?11.758)Gy and(29.625? 11.632)Gy,with significant difference between the tow groups(P

Objective: To develop parental punishment style the questionnaire. Methods: Based upon previous literature about parental punishment style and expert interview, data were collected for the parental punishment style questionnaire. A sample of 1028 junior high school students were asked to complete the questionnaire and 158 of them was given retest after a month. Results: Taken from the questionnaire by exploratory factor analysis four factors were compatible. The results of confirmatory factor analysis showed a good fit to the data. The internal consistency reliability of father and mother questionnaire was satisfactory, with Cronbach ? coefficient 0.91; and the test-retest reliability was also satisfactory, with test-retest correlation coefficient 0.88 and 0.89, which showed good content validity and high construct validity. Conclusion: The questionnaire has good reliability and validity, and meets the need of psychometrics.

Objective To study the influence of carbon dioxide pneumoperitoneum on BIS and oxygen metabolism in patients underwent laparoscopic hysterectomy in propofol and sevoflurane anesthesia. Methods 100 cases undergoing laparoscopic hysterectomy were selected in the second hospital of Shandong university and were divided into group A and group B, 50 cases in each group. Group A were received propofol and group B were received sevoflurane anesthesia . The oxygen metabolism index in the two groups were compared before and after pneumoperitoneum. Results The PETCO2 of two groups at the time points after pneumoperitoneum were significantly higher than those before pneumoperitoneum (P<0.05). There was no significant difference of the SpO2 in two groups at the different time points during pneumoperitoneum, The HR and MAP of the group A were significantly lower than that of group B (P<0.05). There were no significant difference of the PETCO2、SpO2 between two groups. Bis in 2 groups maintained a stationary state before and after pneumoperitoneum. There was no significant difference in the period between the two groups. The CjvO2、Lac of two groups were significantly higher than that before pneumoperitoneum (all P<0.05).The CjvO2、Lac of two groups were significantly lower than that before pneumoperitoneum (all P<0.05). The CjvO2 of group A at 40 minutes after pneumoperitoneum were higher than that of group B (P<0.05), and the level of CERO2、Da-jvO2 were lower than that of group B (P<0.05). But there were no difference of the BIS、CaO2 and Lac between two groups. Conclusion Carbon dioxide pneumoperitoneum can affect the BIS and oxygen metabolism in patients underwent laparoscopic hysterectomy. The effect in propofol anesthesia was more significant than that in sevoflurane anesthesia.

Objective To explore the methods of the hemorrhage prevention and the measures of hemostasis by CT guided after renal cancer cryoablation.Methods Retrospective analysis of 8 patients of renal cell carcinoma patienthave been done,all the patients were underwent cryoablation.The basic model included 10 min frozen,3 min thawed and 1 cycle were repeated.Before the cryoprobe puncture,a CT scan was taken to observe the blood supply of the tumor and the relationship between the border of the tumor and renal cortex,renal pelvis.Besides,the path of reducing the injury of normal renal cortex and renal pelvis was chosen,and the decreased number of probes was adopted by taking conformal cryoablation to reduce the damage to the renal capsule,in theensurance of the treatment efficacy.Intraoperative CT scan was performed discontinuously,to observe the covering status of the range of ice ball on the lesion and to monitor the perirenal bleeding.Postoperative ECG and blood pressure changes was observed 24 h after operation.Besides,CT scan or blood routine examination is necessary to monitor whether active bleeding happened.Results According enhanced CT image positioning puncture path,the path of probes were selected in the shortest path between the tumor margins and the renal cortical which avoid the renal pelvis.Probes were CT-guided conformal puncture into the lesion successfully for 8 patients,according to freezing basic mode to complete cryoablation.Timely intraoperative CT scan can clearly observe that a low-density ice ball wrapped lesion completely without involving the renal pelvis and normal tissue surrounding the kidney.There was no bleeding in the procedure of cryoablation.After the probe was pulled,CT scan showed:3 of the 8 patients didn't show any sign of henorrhage,in which 1 patient had heavily bleeding,about 150 ml due to the biopsy after cryoablation.The bleeding was stopped by interventional embolization.A little hemorrhage was found in two patients,about 10 ml outside renal capsule.Medium hemorrhage took place in two patients,30 nl in one patient which underwent several cycles of thawing and 60 ml in another.The patients of mild and medium hemorrhage was treated with intravenous injection of Reptilase and strict bed rest.There was a great hemorrhage in one patient,about 200 ml.The bleeding was stopped by interventional embolization.A small and moderate bleeding,it necessary to execute intravenous infusion 2 IU reptilase and strict bed rest.There was no significant active bleeding from the CT scan after 24 h operation and no change in the blood routine examination of blood hemoglobin and red blood cell count.Conclusions Before the puncture,it is necessary to perform an enhanced CT scan to understand the position,which can determine the path of the puncture.It can reduce the damage of renal cortex,renal capsule and surrounding tissue and prevent and reduce the risk of bleeding.For larger amounts of intraoperative and postoperative bleeding subjects,the embolization should be given immediately,as for the small or moderate amount of bleeding,the conservative treatment may be given firstly.

Objective To evaluate the clinical efficacy and safety of methotrexate(MTX) plus low dose glucocorticoid in the treatment of rheumatoid arthritis (RA) from thetarget control point of view.Methods Patients diagnosed as RA according to American College of Rheumatology(ACR)/European League against Rheumatism (EULAR) 2010 classification criteria were enrolled.All of the patients were prescribed with 15 mg/week MTX,5 mg/week folic acid and prednisone (not exceeding 10 mg/day) orally.At week 0,4,12,disease activity and clinical efficacy were recorded.Co-primary assessment criterion was disease activityscore (DAS28)-based on C-reactive protein (CRP).Secondary assessment criteria included EULAR response criteria,ACR response criteria,simplified disease activity index(SDAI),clinical disease activity index(CDAI).The tolerability and toxicity of MTX was recorded at week 4,12.All patients were evaluated for the occurrence of adverse drug reactions associated with prednisone at week 12.Results A total of 76 patients were enrolled in the study.At week 4 and 12,68 and 65 patients completed regular follow-up respectively.At week 12,there were 30(46.2％),9(13.8％),26(40.0％) patients who met DAS28-CRP remission,low disease activity,middle and high disease activity criterion respectively.Three of nine patients who grouped in low disease activity after therapy were early or intermediate patients and didn't reach the target.Thus 36 (55.4％) patients met the standard of target control.The percentage of patients who met the criteria of EULAR good response,the ACR criteria for 20％ improvement (ACR20),the ACR criteria for 50％ improvement (ACR50),the ACR criteria for 70％ improvement (ACR70) were 29.2％,75.4％,69.2％,64.6％,respectively.The proportion of patients meeting the standard of treat to target using SDAI and CDAI were 76.9％,58.5％ respectively.The rate of liver injury,abdominal pain,abdominal distention and acid reflux,nausea were 11.8％,4.4％,4.4％,2.9％ respectively at week 4.At week 12,4.6％ of patients reported abdominal distention.There was only one patient (1.5％) each who complained of abdominal pain,nausea,loss of hair,varicella zoster virus infection and pulmonary infection at week 12.No serious adverse event was observed during the study.Conclusions Based on the view of target control,drug efficacy and safety,MTX plus low dose prednisone is still a useful therapeutic regimen for RA at present.

The normative research on safeguarding intangible cultural heritage of traditional Chinese medicine is the important measure after building list and filing work of Convention of the protection of intangible cultural heritage of UNESCO, and also a strategy in accordance with the principle of the protection of traditional knowledge of traditional Chinese medicine.This article discussed the arrangement and standardization in the academic level of folk medicine technology teaching orally from generation to generation, to provide protection for the living inheritance of intangible cultural heritage of traditional Chinese medicine, and a pilot measure for the construction of intangible cultural heritage protection system.

Objective To investigate the current situation in construction of WeChat public platform in 9 class A hospitals affiliated to Sichuan Province in Chengdu. Methods The problems and the reasons why they occurred in construction of WeChat public platform in these 9 hospitals were analyzed by literature analysis, interview, Topsis and RSR analysis, and their combination. Results The problems found in hospital WeChat public platform included imperfect management, unmatched construction level and hospital scale, insufficient government policy support and effective supervising mechanisms. Conclusion Hospitals should strengthen the construction and management of their WeChat public platform, innovatively construct their WeChat public platform, win over sufficient government policy support, and improve their supervising mechanisms.

Objective To investigate the effect of different forbidden drink schemes on anesthesia induction and postoperative nausea and vomiting during pediatric interventional heart surgery.Methods One hundred and twenty pediatric patients underwent cardiac interventional procedures under general anesthesia were randomized into group A,B and C,with 40 patients in each group.Patients in cach group were fasted for 8 h preoperatively.Water was prohibited for patients in group A for 6 h preoperatively.Patients in groups B and C orally took 10％ glucose solution and a multivitamin drink (Outfast) at 2 h preoperatively,respectively.Nausea and vomiting after anesthesia induction were recorded for 24 h postoperatively.Results The sedation and mask acceptance scores were significantly higher in group B and C than those in group A,and were significantly higher in group C than those in group B (P ＜ 0.05,resoectively).Following anesthesia induction,MAP was significantly higher in group B and C than that in group A (P ＜ 0.05,resoectively).Both the severity and incidence of postoperative nausea and vomiting were higher in group B and C than those in group A,and was lower in group C than that in group B (P ＜ 0.05,resoectively).Conclusions Taking clear water orally 2 hours before surgery can decrease the restlessness of pediatric interventional heart surgery during anesthesia induction period,with stable smooth hemodynamics,reducing the degree of PONV.