Autism spectrum disorders have gradually been known and its concept is also changing.It is important that comprehend the changing timely for clinical work.This paper is mainly about the formation and evolution for the term,as well as the change in Diagnostic and Statistical Manual of Mental Disorders 5th ed and the significance.

OBJECTIVE:To provide reference for rational use of polycystic ovary syndrome(PCOS)drugs. METHODS:The utilization of PCOS drugs in our hospital during Jan.-Dec. 2013 were analyzed in respects of consumption sum,DDDs,sorting and so on. The rationality of prescription was analyzed according to guidelines and drug package inserts and so on. RESULTS:There were 1 551 prescriptions,involving 76 kinds of drugs,and their total consumption sum was 181 072.90 yuan. Main types of drugs were hormone related drugs (accounting for 81.37% of prescription frequency,73.51% of consumption sum) and Chinese patent medicine (accounting for 15.41% of prescription frequency,19.43% of consumption sum). Top 5 hormone drugs in the list of DDDs were Ethinylestradiol and Cyproterone acetate tablets,Metformin hydrochloride enteric-coated tablets,Progesterone soft cap-sule,Dydrogesterone tablets and Progesterone soft capsules. Top 5 Chinese patent medicines in the list of DDDs were Kuntai cap-sule,Yougui capsule,Huanshao capsule,Jiawei xiaoyao capsule and Nvjin capsule. Single drug accounted for 72.08% in prescrip-tion. The proportion of irrational drug use was 1.69%. CONCLUSIONS:The application of drug in patients with PCOS is reason-able generally. Some prescriptions are unreasonable,mainly manifesting as incomplete clinical diagnosis,irrational usage and dos-age. Pharmacists should strengthen prescription verification and intervention.

Objective To evaluate the safety and efficacy of fiberoptic bronchoscopy in the diagno-sis of 41 neonates with weaning failure.Methods A retrospective study on the results of fiberoptic broncho-scopy was performed in 41 neonates with weaning failure.Results A total of 41 neonates of throat abnor-malities were examined by fiberoptic bronchoscopy,including 38 cases with laryngomalacia,8 cases with seri-ous hyperemia and swelling of the vocal cords,2 cases with scar stenosis of subglottic,and one case in each of congenital laryngeal web,glottic insufficiency and congenital epiglottis cyst;trachea-bronchial abnormali-ties,including 31 cases with tracheomalacia,2 cases with tracheal stenosis,4 cases with partial bronchial ste-nosis,1 cases with bridging bronchus and 1 cases with tracheoesophageal fistula.Thirty-eight neonates under-went fiberoptic bronchoscopy to obtain bronchoalveolar lavage fluid and culture,bacterial culture positive in 15 cases(39.4%),of which 5 cases of Klebsiella pneumoniae,3 cases in each of Pseudomonas aeruginosa and Acinetobacter baumannii,2 cases of Staphylococcus aureus,1 case in each of Escherichia coli and Strep-tococcus mitis;fungal culture positive for 6 cases(15.7%),of which 3 cases of Aspergillus fumigatus,1 case in each of Candida glabrata,Candida albicans and Candida parapsilosis.The most common complications of fiberoptic bronchoscopy were hypoxia and heart rate transient decline(26 cases,63.4%),3 cases fever af-ter operation.Conclusion Fiberoptic bronchoscopy can not only find congenital tracheal deformity and tra-cheal mucosa lesions,but also complete the etiology from deep discharge.Fiberbronchoscopy is safe and relia-ble given adequate preparation and if it is performed by skilled personnel.

BACKGROUND: Stellate ganglion block (SGB) has become a technique frequently used in the field of pain management for its wide indication spectrum. Its ameliorative effect on cephal-facial pain may be achieved by regulating the cerebrovascular diastolic and systolic functions and intensifying cerebral perfusion.OBJECTIVE: To observe the influence of SGB on the blood velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA) and vertebral artery with three-dimensional transcranial Doppler (TCD) in patients with caphal-facial diseases caused by is chemia or vascular spasm.DESIGN: A before-after control observation.SETTINGS: Department of Pain Management, Guizhou Provincial Orthopaedic Hospital; Department of Anesthesiology, the First Affiliated Hospital of Guangzhou Medical College; Department of Anesthesiology, the Second Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Twenty patients of 18-50 years old were selected from the Department of Pain Management of Guizhou Provincial Orthopaedic Hospital from March 2004 to December 2005, including 6 cases of migraine,3 of cluster headache, 4 of muscle tension-type headache, 2 of nervous tinnitus and earache, and 5 of derangement of temporomandibular joint.METHODS: Unilateral SGB was performed by means of paratracheal anterior technique, with the following compound prescription: lidocaine (20 g/L)2.5 mL and dexamethasone 1 mg in normal saline with a total volume of 10 mL. SGB was performed once a day for 7 consecutive days as one course.MAIN OUTCOME MEASURES: The changes of blood velocity of ACA,MCA, PCA and vertebral artery were observed with three-dimensional TCD before SGB and at 30 minutes after SGB.RESULTS: All the 20 patients finished the treatment and entered the analysis of results. After treatment, the blood velocities of ACA, MCA and PCA of the blocked side were increased remarkably as compared with those before treatment [(76.20±3.83), (61.95±2.50) cm/s; (83.65±2.36),(77.55±2.69) em/s; (65.20±2.99), (58.70±2.2.35) cm/s; P ＜ 0.01], but that of vertebral artery had no significant change before and after treatment [(47.20±2.04), (45.55±2.23) cm/s, P ＞ 0.05]. CONCLUSION: The blood velocities of the blocked side are obviously increased after treatmeut, the increased blood velocities of ACA, MCA and PCA have important clinical significance for the blood supply of cerebral hemisphere, especially the anterior 2/3 part, but had little great influence on vertebral artery, indicating that SGB has great pertinence to the caphalfacial diseases caused by ischemia or vascular spasm, and can ameliorate the cerebral blood perfusion.

Objective To compare the difference in pharmacokinetics characteristics of vancomycin in cerebrospinal fluid between administration by continuous infusion and interim infusion.Methods Twenty postoperative patients in the Department of Neurosurgery of Beijing Tiantan Hospital, Capital Medical University admitted into intensive care unit (ICU) to receive vancomycin for prophylaxis of intracranial infection were enrolled, and they were randomly distributed to a continuous intravenous infusion group and a interim intravenous infusion group, each group 10 cases. In continuous intravenous infusion group, the patients received a loading dose of vancomycin (15 mg/kg) by continuous intravenous pump infusion for 1 - 2 hours followed by 30 mg/kg vancomycin in a constant pump infusion rate for 24 hours; while in interim intravenous infusion group, the patients received 15 mg/kg vancomycin administered by intravenous pump infusion for 1 - 2 hours, once every 12 hours. The concentration of vancomycin in the cerebrospinal fluid at different time points was measured by two-dimensional liquid chromatography (2D-LC) method, the parameters of pharmacokinetics were calculated in the two groups, and the adverse reaction was observed.Results The comparison between the ratio of areas under the concentration-time curves (AUC) and minimum inhibitory concentration (MIC) of the continuous and interim groups showed no significant difference (19.7±14.0 vs. 16.1±6.4,P > 0.05). However, in the continuous intravenous infusion group, the drug concentration reached the peak value (0.96± 0.77)μg/mL at 12 hours, and later revealed a plateau concentration 0.91-0.93μg/mL for 12 hours; while in the intravenous infusion interim group, the drug concentration reached the peak value (0.92±0.47)μg/mL at 16 hours, in the later 2 hours declined to (0.84±0.45)μg/mL, and afterwards still had a tendency of persistent declination. In all the patients, no any adverse reaction related to the drug occurred.Conclusion Continuous intravenous infusion and interim intravenous infusion of vancomycin for the postoperative neurosurgical patients without intracranial infection have the similar efficacy of medication, but the former can achieve the peak concentration faster and later the fluctuation of drug concentration in cerebrospinal fluid is smaller than those in the latter.

Objective:To study the influence of Sinapine on the formation of microvessels in chick embryo chorioallantoic membrane(CAM).Methods: Sinapine was purified by the procedure of pressurized-solvent extraction from Semen Sinapis Albae.The inhibition effect of Sinapine on the chorioallantoic vessel was detected by the chick embryo chorioallantoic membrane model.Results: Compared with physiological saline group,large areas of blood vessels in Sinapine groups(5.0g/L and 10.0g/L) had heavy inhibition of angiogenesis on CAM,accompanied by the decreased density of vessels(P0.05).Conclusions: Sinapine can prevent the formation of microvessels of CAM and the effects depend on the concentration.

Objective To determine the diagnostic accuracy of dual- source computed tomography coronary angiography (DSCT-CA) for detecting various degrees of coronary artery stenosis. Methods A total of 278 patients with coronary atherosclerotic heart disease (CHD) were selected for DSCT-CA examination. The coronary angiography (CAG) examination was carried out within 30 days in these patients. The result of CAG was used as the gold standard. The coronary artery stenosis of 50% and 75% was used as the sector. Based on the data of patients, DSCT-CA was calculated for quantitative assessment of the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of coronary stenosis for the coronary blood vessels and coronary artery segments. Kappa consistence test was used to analyze the results of two methods. Results The 50%and 75%of coronary artery stenosis was used for the sector, based on the patients, the sensitivities of DSCT-CA were 99.6% and 99.1%, specificities were 84.2%, 89.6%, diagnostic accuracies were 98.6%and 97.5%, and the Kappa values were 0.88 and 0.91. Based on coronary vessels, the sensitivities were 92.0%and 96.9%, specificities were 89.9%and 94.8%, diagnostic accuracies were 91.0%and 95.8%, and the Kappa values were 0.88 and 0.92. Based on coronary artery segments, the sensitivities were 97.3%, 96.5%, specificities were 93.3%, 98.1%, diagnostic accuracies were 94.2%and 97.9%, and the Kappa values were 0.84 and 0.91. Conclusion Based on patient’s coronary artery analysis, DSCT-CA can accurately assess the different degrees of coronary stenosis, but based on the analysis of the coronary artery segment, the false-positive results may occur in the diagnosis of DACT-CA, which
suggests that DSCT-CA can partly replace the CAG, still cannot completely replace the CAG.

Objective To assess the value of fiberobronchoscopy in the diagnosis of endobronchial tuberculosis. Methods A total of 67 children suspected of endobronchial tuberculosis in our ward from March 2010 to December 2012 had been tested by chest CT and ifberobronchoscopy, mycobacteria culture, liquid-based interlayer vessel technique and FQ-PCR from bronchoalveolar lavage fluid and biopsy. Results 50 patients were clinically diagnosed as endobronchial tuberculosis. The positive rate of FQ-PCR (60%) and liquid-based interlayer vessel technique (42%) are higher than that of mycobacteria culture (20%), which showed no signiifcant difference with biopsy. The positive rate of the combined detection (FQ-PCR and liquid-based interlayer vessel technique) is significantly higher than that of mycobacteria culture and biopsy. Conclusions Fiberobronchoscopy is effective for the diagnosis of endobronchial tuberculosis.

Objective To investigate the clinical value of high frequency ultrasound in discovering secondary pathological changes in infant with developmental dysplasia of the hip (DDH).Methods Thirtyfour infants with 36 dislocation hips were involved.Among them,32 were with unilateral dislocation of hip joint,2 were with bilateral dislocation of hip joint.High frequency ultrasound were used to observe the morphological changes of hip glenoid labrum,adipose hyperplasia in acetabulum,thickness variation of articular capsule,and development of the ossification center of the femoral head.Besides,the morphological changes of hip glenoid labrum and adipose hyperplasia in acetabul were compared with those from MRI.Results The sensitivity and specificity of ultrasound in diagnosing glenoid labral introversion were 82 ％ and 100％ respectively.The coincidence rate of diagnosing glenoid labral introversion and glenoid labral extroversion were both 83％.Adipose hyperplasias in acetabul were clearly seen in 31 hips using ultrasound.The thickness of articular capsule in the affected hip and in the healthy hip was (2.8 ± 0.6)mm versus (1.7 ± 0.4) mm,and the difference was obviously significant (P ＜0.01).The ossification center of the femoral head in the 34 infants were classified as the following four types:① which was smaller in the affected side than in the healthy side (22/34);②which was shown in the healthy side (7/34) but not in the affected side;③ which in both sides were not shown (4/34);④ which in both sides were small (1/34).Conclusions Ultrasound is a method of simple,rapid,non-invasive in diagnosing DDH,and it can be used to discover secondary pathological changes in infant with DDH,which provide important reference for clinical diagnosis and treatment.