Atomoxetine is a noradrenaline transmitter reuptake inhibitor which can selectively inhibit presynaptic noradrenaline transport protein,strengthen noradrenaline's resupination effect,and increases noradrenaline's activity released by synaptic cleft to improve the symptoms of the attention deficit hyperactivity disorder(ADHD)patients.ADHD patients often accompany with other psychological diseases like oppositional defiant disorder,anxiety disorder,which may hinder the diagnosis of ADHD.There is still no accepted effective medicine nowadays.Currently,research on the treatment of the ADHD is more and more popular.Good therapeutic effect of atomoxetine to treat ADHD has been found in resent studies.This article summarized the current management of using atomoxetine to treat ADHD.

Objective To describe the clinical features of convulsive status epileptieus (CSE) in our hospital and to provide a basis for future CSE prevention and treatment. Methods Patients with CSE hospitalized from January 1996 to October 2007 were prospectively observed. Logistic regression was used to identify predictors of prognosis. Results All 220 eases of CSE were prospeetively analyzed, a hundred and two patients(46.4%) originated from rural areas. The primary cause of CSE was central nervous system(CNS)infectian (72cases, 32.7%), followed by discontinuation or reduction of antiepileptie drugs (AEDs, 35 cases,15.5%). The median duration of CSE was 5 hours and median duration of seizures before treatment was 2 hours; both were longer in rural patients (7.0 and3.5 hours respectively) than in urban patients (3.0 and 2.0 hours, Z=-3.433,-1.558,both P<0.05). The fatality rate by the time of discharge was 15.9%. Logistic regression analysis showed that the duration of CSE (χ2=20.941), a history of epilepsy (χ2=4.910), and respiratory depression (χ2=16.086) were independent predictors of CSE prognosis (allP<0.05) . Comparisons between these data of USA and Europe were made. Conclusions CSE occurs mostly in rural population and epilepsy patients. CNS infection and withdrawal or reduction of AEDs in patients with epilepsy were important triggers of CSE. Antiepileptic therapy for status epilepticus in China falls behind that in the European countries.

Objective To investigate the diagnosis and treatment of hepatolithiasis complicated by bronchobiliary fistula.Method The data of 35 patients with hepatolithiasis and bronchobiliary fistula treated in our department in the last 10 years were retrospectively studied.Results The operations were:-repair of fistula in the diaphragm (n=35),hepatic segmentectomy (n=22) biliary stricturoplasty (n=13),T-tube drainage of common bile duct (n=19),hepaticojejunostomy (n=3) and bilateral hepatojejunostomy with a Roux-en-Y loop of jejunum (n=13).Residual stones were left in 4 patients.There was no recurrence of the bronchobiliary fistula on follow-up.Conclusions Expectoration of bitter and purulent yellow sputum was an important clinical feature of bronchobiliary fistula.The key steps in a successful operation were reliefing the obstructed bile duct and re-establishment of adequate biliary drainage.

Objective Degenerative lumbar scoliosis is frequent clinic spine malformation ,and it is complicated by lumbar inter-vertebral disc ,joint of lumbar vertebra cataplasia and lumbar spinal stenosis .The aim of this paper is to study surgical therapeutic regimen for analyzing clinic feature of degenerative lumbar scoliosis .Methods We comprehended symptom and analyzed imageology feature for lumbar spinal stenosis through reviewing 48 cases of operation from August 2003 to August 2010 ,and then approached its therapeutic principle and regimen .Results There were good therapeutic effect on the basis of comprehending degenerative lum-bar scoliosis and designing different treatment plan by different case feature .Conclusion Ii is need to know degenerative lumbar scoliosis again ,in order to work out individual therapeutic regimen based on clinic feather ,process segment ,state of spinal stenosis , angle of lumbar scoliosis ,degree of vertebra rotation and lumbar destabilizing .

AIM:To investigate efficacy of ranibizumab combined with laser treatment for patients with branch retinal vein occlusion (BRVO) and macular edema.METHODS: We selected 67 patients (67 eyes) with BRVO and macular edema in our hospital from March 2013 to June 2016, they were randomly divided into observation group (n=31) and control group (n=36).The observation group was treated with ranibizumab combined with laser treatment.The control group was treated with macular grid photocoagulation.We observed best corrected visual acuity (BCVA), centre macular thickness (CMT) and macular leakage of two groups.RESULTS: The BCVA of observation group at 1, 2 and 3mo after treatment were 0.41±0.07, 0.42±0.05 and 0.48±0.05, significantly higher than those of the control group (P<0.05).The CMT of observation group at 1, 2 and 3mo after treatment were 203.11±59.13μm, 201.41±56.22μm and 204.22±60.13μm, significantly lower than those of the control group (P<0.05).The blood vessel leakage of observation group at 3mo after treatment was significantly better than that of the control group (P<0.05).No leakage ratio in the observation group was 71%.There were no postoperative infection, aseptic endophthalmitis and other complications in the two groups.CONCLUSION: Ranibizumab combined with laser treatment in patients with BRVO and macular edema has better curative effect, can improve the visual acuity of patients, eliminate macular edema, and is safe and reliable.

To evaluate the efficacy of a variety of lacrimal duct obstruction diseases treated by Nd: YAG laser lacrimal duct forming surgery using Meta analysis.
●METHODS: Relevant database in 1995 - 2012 and other network resources were retrieved by computer and manual, using MetaAnalyst software on the Meta analysis. Analysis of indicators: disease prevalence between men and women, the prevalence of various lacrimal duct diseases and the effective rate of Nd: YAG laser lacrimal duct forming surgery to treat a variety of lacrimal duct obstruction diseases.
●RESULTS: According to the inclusion and exclusion criteria, 38 subjects were selected, the cumulative number of patients included 4638 cases, the men combined prevalence was 23%; the women combined prevalence was 77%; lacrimal punctum occlusion combined prevalence was 6. 0%, combined treatment efficiency was 88. 1%; lacrimal canaliculus obstruction combined prevalence of 17. 9%, combined efficiency was 85. 6%;lacrimal common canaliculus obstruction combined prevalence was 14. 0%, 92. 7% of the combined effective rate; nasolacrimal duct obstruction combined prevalence of was 43. 6%, 93. 3% of the combined effective rate;chronic dacryocystitis combined prevalence was 18. 4%, 76. 6% of the combined efficiency. All study has heterogeneity. Selection of random effects model combined effect size. Model was statistically significant (P<0. 001).
●CONCLUSlON: The prevalence of lacrimal duct obstruction diseases of women are higher than men, lacrimal canaliculus obstruction in the lacrimal duct obstruction is in the lowest prevalence, nasolacrimal duct obstruction is the main type of lacrimal duct obstruction disease, Nd: YAG laser lacrimal forming surgery has slightly efficacy different in various lacrimal duct obstruction diseases.

Objective:To optimize the extraction technology of Fufang Jinsha Lidan granule. Methods:According to the properties of traditional Chinese medicines in the formula, orthogonal experiments were used to optimize the extraction process of Fufang Jinsha Li-dan granule. The volume of water, boiling time and boiling frequency were used as the three influencing factors with three different lev-els in the orthogonal experiments. Moreover, the content of paeoniflorin and the yield of extract were chosen as the evaluation indices. The orthogonal experiments were carried out according to the L9 (34 ) orthogonal table. Results:The optimal extraction process of Fu-fang Jinsha Lidan granule was as follows:boiled twice, and one hour per time with 12-fold amount of water ( soaked for 30 min with 14-fold amount of water for the first extraction process) . Conclusion:The extraction process has such properties as high extraction rate, stability, simple operation, high yield of extract and controllable quality, which is worthy of wide application.

Adult ; Antibodies, Monoclonal ; metabolism ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lung Neoplasms ; metabolism ; pathology ; surgery ; Male ; MyoD Protein ; metabolism ; Pneumonectomy ; Pulmonary Veins ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism ; Sarcoma, Alveolar Soft Part ; metabolism ; pathology ; surgery ; Vascular Neoplasms ; metabolism ; pathology ; surgery

OBJECTIVETo study the clinical effects of Müller method for reconstruction of posterolateral corner (PLS) of knee joint.

METHODSFrom June 2005 to June 2007, 13 patients with PLS injured were treated with Müller method. Four patients complicated with injuries in anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), 7 patients complicated with injuries in PCL, 4 patient also had injuries in ACL, 1 patient complicated with ACL injury, and 1 patient complicated with avulsions fractures of the tibial ACL insertion. Among the patients, 5 patients had chronic injuries with a duration of 2 to 7 months. After the cruciate ligament was reconstructed, the popliteus tendon was reconstructed with iliotibial band and lateral collateral ligament (LCL) reconstructed with biceps femoris tendon. All the ligaments were fixed with interface screws. The patients were encouraged to do strength and motion exercise on bed immediately after operation and permit toe-touch weight-bearing till two months after operation. The brace was used till six months after operation.

RESULTSThe average follow-up period was 13 months (ranged from 6 to 27 months). There was no restriction of range of motion. External rotation range were good compared to the normal side. One year after operation, one-grade varus instability at 30 degrees flexion was found only in 2 patients. The postoperative Lysholm scores were from 77 to 94 (average 86).

CONCLUSIONThe method is easier to perform, easier to get the materiar for reconstruction and promised satisfactory clinical results.

Adult ; Female ; Humans ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; methods

OBJECTIVETo study therapeutic effects of lateral ankle ligaments reconstruction for the treatment of chronic lateral instability of the ankle joint.

METHODSFrom July 2005 to January 2008, among 13 patients with chronic lateral instability of the ankle joint, 10 patients were male and 3 patients were female, ranging in age from 24 to 45 years,with an average of 33 years. Anterior talo-fibular ligament (ATFL) and calcanea-fibular ligament (CFL) were anatomy reconstructed with a split peroneus brevis tendon graft for all patients. The ankle scoring system was used to evaluate ankle joint function before and after operation, which including stability, pain, locomotor activity and X-ray films.

RESULTSAll the patients were followed up ranged from 6 to 32 months, averaged 16.4 months. The postoperative scores of the ankles increased in respect to stability, pain and locomotor activity. The total average score increased from preoperative (43.54+/-7.04) to postoperative (73.38+/-4.17). There was significant difference between preoperative scores and postoperative scores (P<0.01). All the patients were satisfied with the results.

CONCLUSIONAnatomy reconstruct of the ATFL and CFL with a split peroneus brevis tendon graft (Sammarco method) is a practical method for lateral ankle instability and promise good results especially for patients complained of instability.

Adult ; Ankle Joint ; anatomy & histology ; pathology ; surgery ; Female ; Humans ; Joint Instability ; pathology ; surgery ; Lateral Ligament, Ankle ; anatomy & histology ; pathology ; surgery ; Male ; Middle Aged ; Models, Biological ; Reconstructive Surgical Procedures ; methods ; Young Adult