AIM:To establish quality standard for Compound Shenyi Granule(Fructus Jujubae,Radix et Rhizoma Glycyrrhizae,Radix et Rhizoma Salviae miltiorrhizae,Radix Rehmanniae).METHODS:Ziziphus jujuba Mill、Glycyrrhiza uralensis Fisch、Salvia miltiorrhiza Bge、Rehmannia glutinosa Libosch.were identified by TLC.Glycy-rrhizic acid and glycyrrhetinic acid were determined by HPLC.The chromatographic separation was performed on an Agilent ZORBAX Eclipse?DB-C_ 18(4.6 mm?250 mm,5 ?m)column by a gradient elution with methanol and 2.5 % acetic acid at a flow-rate of 1.0 mL/min;the detection wavelength was set at 254 nm.RESULTS:TLC spots developed were fairly clear and the blank test showed no interference.The linear rangers were 1.135-9.08 ?g(r=0.999 3) for glycyrrhizic acid,0.71-5.68 ?g(r=0.999 7) for glycyrrhetinic acid,respectively.CONCLUSION:The methods is effective for the quality control of Compound Shenyi Granule.

The reflective behaviors of teachers are a primary factor affecting teaching quality.However,the reflective behaviors of teachers can be propelled only by enhancing stimulus to teaching work,completing training system of continuing education on teaching theory and techniques to increase the teaching theory of teachers and performing teaching summarization of courses and assessment system.Only in this way can the teaching level and teaching quality of teachers be enhanced.

Objective To investigate the risk factors of pancreatic fistula after pancreaticoduodenectomy (PD).Methods The clinical data of 186 patients who received PD at the Second Affiliated Hospital of Kunming Medical College from May 2000 to May 2010 were retrospectively analyzed.All patients were divided into pancreatic fistula group (39 patients) and non-pancreatic fistula group ( 147 patients).Risk factors of pancreatic fistula after PD were screened out from 20 factors by univariate and multivariate analysis.The univariate analysis was carried out by chi-square test or Fisher exact test,and the muhivariate analysis was done by Logistic regression.Results Thirty-nine patients were complicated with pancreatic fistula,including 26 in grade A,10 in grade B and 3 in grade C.The results of univariate analysis showed that duration of preoperative jaundicc,loss of body weight at 6 months before operation,preoperative total bilirubin level,preoperative albumin level,postoperative albumin level,length of pancreas dissected,pancreatic tube diameter,pancreatic texture and time of abdominal drainage tube pull out were high risk factors of pancreatic fistula ( x2 =34.990,20.480,8.212,10.890,13.561,11.505,13.820,4.539,36.590,P ＜ 0.05).The results of multivariate analysis showed that duration of preoperative jaundice ＞ 8 weeks,loss of body weight at 6 months before operation ≥ 10％,pancreatic tube diameter ＜ 3 mm,soft pancreatic texture and time of abdominal drainage tube pull out ＞ 5 days were the independent risk factors of pancreatic fistula ( OR =2.229,3.383,1.437,1.273,11.939,P ＜ 0.05).Conclusion Duration of preoperative jaundice ＞ 8 weeks,unconscious loss of body weight ≥ 10％ within 6 months before operation,pancreatic tube diameter ＜ 3 mm,soft pancreatic texture,time of abdominal drainage tube pull out ＞ 5 days would increase the risk of pancreatic fistula after PD.

Objective To investigate the utility of bedside electromyography (EMG) in diagnosis and management of critical illness patients with suspected neuromuscular diseases.Methods Bedside EMG was performed in 34 critical illness patients with weakness and respiratory involvement,including segmental motor nerve conduction studies,sensory nerve conduction studies,F waves,concentric needle EMG and repetitive nerve stimulation.The clinical manifestations and clinical utility of bedside EMG in critical illness patients with suspected neuromuscular diseases were analyzed. Results EMG was normal in 5 patients.Low-frequency repetitive nerve stimulation showed decrement response of compound muscle action potential (CMAP) in 4 of 8 patients.Motor nerve conduction studies showed CMAP amplitude decreased in 73.3％(22/30) patients,and demyelinating changes was detected in 20.0％ (6/30)patients.F-wave persistence was 0 in 55.0％ (11/20) patients.Amplitude of sensory nerve action potential decreased in 28.6％ (6/21)patients.Bedside EMG could help to confirm or exclude diagnoses and guide the management in 82.4％(28/34) patients,confirm the diagnoses of peripheral neuropathy but have no effect on management in 11.8％ (4/34) patients,and bedside EMG was inconclusive in 2 patients.Conclusions Bedside EMG is useful for the diagnosis and management of critical ill with suspected neuromuscular diseases,while motor nerve conduction studies and repetitive nerve stimulation are more valuable.Individualized protocol for EMG studies should be made on the basis of clinical problem.

Objective To evaluate the physical dependence of total Ervatamia yunnansis alkaloid .Methods The physi-cal dependence of total Ervatamia yunnansis alkaloid was observed by jump test in mice and spontaneous withdrawal test in rats .Results In the jump test ,after injecting total Ervatamia yunnansis alkaloid (total dosage of 140 and 430 mg/kg) for 7 days continuously ,the mice didn't show any withdrawal symptom and the loss of body weight .In the spontaneous withdrawal test ,two dosages of total Ervatamia yunnansis alkaloid (total dosage of 210 and 775 mg/kg) were continuously given for 30 days .The withdrawal response and the loss of body weight were not found in rats after drug withdrawal .Conclusion Total Ervatamia yunnansis alkaloid showed no obvious withdrawal symptoms in mice and rats ,which suggests that it has no physical dependence .

ObjectiveTo explore the effect of early rehabilitation on patients with severe traumatic brain injury.Methods89 patients with severe traumatic brain injury were divided randomly into the treatment group (49 cases) and control group (40 cases). All patients of two groups were treated with routine nursing, dehydrated drug, brain protective therapy and alimental therapy, and measures of preventing complications. While, the patients of the treatment group were added with motor and cognitive rehabilitation, mainly physical therapy, combined with occupational therapy, psychotherapy and speech therapy. All patients of two groups were evaluated with scores of activities of daily living (ADL), Disability Rating Scale (DRS), Fugl-Mayer Assessment (FMA), Mini-mental status examination (MMSE), three class balance scale before and after treatment.ResultsThe scores of ADL, DRS, FMA and balance function of the patients in the treatment group were significantly different from that of the control group after treatment ( P<0.05).The MMSE scores of two groups had no significantly difference after treatment ( P>0.05).ConclusionEarly rehabilitation can improve the brain function of the patients with severe traumatic brain injury, patients' living quality and ADL.

Objective To establish the reference ranges of the spatial angles among cardiac chambers and great vessels in second and third trimester fetuses measured by spatiotemporal image correlation (STIC).Methods Volume images of 352 normal fetuses from 20 to 38 weeks of gestation were recruited in the study.An off-line analysis of acquired volume datasets was carried out with multiplanar mode.Parameters measured included angles between:(1) the 4-chamber view and the left ventricular long axis view; (2) the left ventricular long axis view and main pulmonary artery; and (3) the ductal arch and aortic arch.The relationships between above-mentioned angles and gestational age were assessed by correlation and regression analysis.Results The angle between the 4-chamber view and the left ventricular long axis view (range:55.7° - 35.7°,mean:45.7° ± 5.12°) was uncorrelated with gestational age (r = 0.03,P = 0.51).In contrast,the angle between the left ventricular long axis view and main pulmonary artery,and the angle between the ductal arch and aortic arch were correlated with gestational age (P ＜ 0.001),and the correlation coefficient was - 0.53 and 0.57 respectively.The best-fit exponential curve regression equations of the angle between the left ventricular long axis view and main pulmonary artery was:Y = 154- 4.24X +0.05X2 ,and the angle between the ductal arch and aortic arch was:Y = - 20.8 + 2.65X - 0.37X2.Conclusions The angles among cardiac chambers and great arteries of fetuses from 20 to 38 weeks of gestation can be quantitatively measured by STIC.The reference ranges provide a reliable quantitative standard to estimate the spatial relationships of the cardiac large arteries of fetuses,which may be clinically useful in prenatal screening congenital heart disease.

Objective To evaluate the feasibility,safety and clinical value of CT-guided localization with a Hook-wire system for nodular pulmonary lesions before video-assisted thoracoscopic resection (VATS). Methods The records of all patients undergoing VATS resection for solitary pulmonary nodules preoperatively localized by CT-guided a Hook-wire system were assessed with respect to failure to localize the lesion by the Hook-wire system, conversion thoracotomy rate, duration of operation, postoperative complications, and histology of nodular pulmonary lesions. Results Sixty-eight patients with seventy four nodules underwent VATS resections. Preoperative CT-guided Hook-wire localization succeeded in all patients ( 100. 0% ). Conversion thoracotomy was necessary in 2 patients. The average operative time was ( 15 ±6)min. Asymptomatic complication rate was 70.6% (48/68), asymptomatic pneumothorax rate, asymptomatic hemorrhage rate and simultaneous pneumothorax and bleeding rate were 45.6% (31/68),25.0% ( 17/68 ) and 4. 4% ( 3/68 ), respectively. The mean hospitalization was ( 15 ± 6 ) days.Histological assessment revealed primary lung cancer (NSCLC) in 30, metastasis in 18, and nonmalignant disease in 26 nodules. Conclusions Video-assisted thoracoscopic resection of nodular pulmonary lesions previously localized by a CT-guided Hook-wire system is related to a low conversion thoracotomy rate, short operation time, and high safety. It for differential diagnosis and treatment.

Objective: To determine the association between physical health fitness with Chinese reading ability of schoolaged children, so as to provide evidence for improving children s reading ability. Methods: A questionnaire survey was conducted among 1 923 school aged children in grades 2-6 in a primary school in Wuhan, Hubei Province, China. The questionnaire included basic demographic information and Dyslexia Checklist for Chinese Children and the Pupil Rating Scale Revised Screening. At the same time, participants underwent physical fitness tests which included an assessment of height, weight, and lung capacity, as well as a 50 meter run, sit forward bend, one minute skipping rope task, sit ups, and a 50 × 8 round trip. Results: A total of 59 children were identified with dyslexia. Normal children achieved higher scores than children with dyslexia in the total physical health score, as well as the one minute skipping rope score, one minute sit up score, and sitting forward score ( P <0.05). Multiple linear regression analyses showed that the reading ability of girls was higher than that of boys ( β =-3.04, P <0.01), and the children who regularly participated in more intense physical activity and who had higher fitness scores had a higher reading ability ( β =-1.68, -0.08, P <0.01). Children s reading ability increased significantly with parental educational level( P <0.05). Conclusion Gender, parents education level, physical exercise intensity, and children s physical fitness were identified as influencing factors of school age children s reading ability. A positive correlation was found between children s physical health level and reading ability.

Objective To investigate the effect of rhynchophylline on mRNA expression of excitatory amino acid transporter 2 (EAAT2 ) and N-methyl-D-aspartic acid receptor 2B (NR2B) after astrocyte oxygen-glucose deprivation. Methods The subcultured third generation astrocytes from the hippocampus were inoculated into 6-well plates, and they were divided into blank control group, hypoxia-ischemia group,low-dose rhynchophylline group (0. 02 mg/ml) and high-dose rhynchophylline group (0. 2 mg/ml) after the cells were attached to the wall and grew out protrusion. The total RNAs in each group were extracted.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression levels of EAAT2 and NR2B mRNA in astrocytes of each group. Results Compared with the blank control group, the expression levels of NR2B and EAAT2 mRNA in astrocytes of the ischemia-hypoxia group were significantly higher (all P < 0. 05 ). The expression levels of NR2B and EAAT2 mRNA in the low-dose rhynchophylline group were lower than those in ischemia-hypoxia group, but there was no significant difference. The expression levels of NR2B and EAAT2 mRNA in the high-dose rhynchophylline group were significantly lower than the ischemia-hypoxia group and the low-dose rhynchophylline group (all P < 0. 05).Conclusion The expression of EAAT2 and NR2B mRNA in astrocytes of hippocampus cultured in vitro was significantly increased after ischemia and hypoxia, and rhynchophylline intervention could significantly reduce its expression in a concentration dependent manner.