OBJECTIVE:To promote the rational use of Chinese patent drugs(CPD).METHODS:The efficacy of several groups of CPD which share the similar formulation were compared and the components in each formulation were further analyzed in detail.RESULTS:The origins and pathogenesis of diseases treated with different CPD of the similar formulation varied,so did their indications.CONCLUSION:Only by following the principle of"Syndrome Differentiation Treatment"can the efficacy of CPD be maximized.

Bipolar disorder is a common, highly disabling psychiatric disorder characterized by early onset, frequent episodes, high suicide risk, and chronic outcomes, and is associated with severe social dysfunction. The pathogenesis of bipolar disorder is still unclear, and current studies mainly focus on circadian rhythm abnormalities, including rhythm gene mutation, polymorphism, abnormal kinase expression, and rhythm abnormalities in neurotransmitter secretion and transport. It has been found that at any stage of bipolar disorder, whether prodrome, episode, or remission, patients exhibit circadian rhythm disruptions, including disrupted sleep-wake cycles, hormonal phase abnormalities, and irregular social rhythms. Based on this mechanism, the time therapy, such as light therapy, dark therapy, sleep deprivation and behavioral intervention, can rapidly improve the circadian rhythm of patients with bipolar disorder, achieve the goal of rapid relief of symptoms, with fewer side effects, low risk of switching to manic. In this paper, circadian rhythm mechanism, clinical manifestations and chronotherapy of bipolar disorder are reviewed to provide a basis for clinical diagnosis and treatment.

Objective To discuss the value of hysteroseope in the diagnosis and treatment of infertility.Methods Retrospectively 60 cases of hysteroscope examimtiom on infertility patients.Results Uterine lesions had been found in 70%(42/60)cases.The most common type was endometrial polyps followed by endometrisitis.Conclusion Hysteroscope isone of the most effective examinations for diseases of uterine cavity.It has great value in the infertility diagnosis.

Objective To investigate the efficacy of adhesive negative pressure suction apparatus in treatment of wound infection after colorectal surgery.Methods From January 2010 to November 2011,consecutive patients with wound infection after colorectal surgery were randomized to the experimental group (n =24 ) and the control group (n =24).The patients in experimental group were treated with the adhesive negative pressure suction apparatus.The patients in the control group were treated with traditional wound therapy.The results of treatment were evaluated.Results Time from debriding the wound infection to secondary suture was significantly shorter in patients of the experimental group ( P ＜ 0.05 ).The total number of dressing changes was very significantly less in patients of the experimental group ( P ＜ 0.01 ).The total cost of dressing in experimental group was significantly less than the control group (P ＜ 0.05 ).Conclusions The application of adhesive negative pressure suction apparatus in treatment of the wound infection after colorectal surgery can shorten the wound processing time,reduce the number of dressing changes and the total cost of dressing,thus has a high clinical value.

BACKGROUND: Anterior cervical discectomy and fusion has been considered the gold standard for treatment of symptomatic degenerative disc disease within the cervical spine.However,fusion may result in progressive degeneration of the adjacent segments.Artificial disc replacement seems to be promising,segmental motion and stability are preserved while the spinal canal has been enlarged,and the intervertebral disc biological mechanics has been preserved,but not leads to progressive degeneration of the adjacent segments.OBJECTIVE: To observe the functional outcome and kinematics after the Prodisc artificial neck intervertebral disc replacement.METHODS: A total of 55 cases (69 intervertebral discs),29 males and 26 females,aged 48 (31-76) years were selected,including14 with bi-segmental injury.There were 32 cases of cervical spondylotic myelopathy,9 of cervical spondylotic radiculopathy,and 14 of mixed type cervical spondylosis.Prodisc artificial neck intervertebral disc replacement was performed using anterior or oblique incision.Prospective data JOA score and kinematic measures were collected before surgery and at 3,6,12,and 24 months after surgery.Range of motion was determined by independent radiologic assessment of flexion-extension radiographs.RESULTS AND CONCLUSION: The 55 patients were followed-up,including 41 undergoing single segmental disc replacement and 14 undergoing bi-segmental disc replacement.They were followed up for 22(56-48)months postoperatively.JOA scores displayed improved cervical function by 56%.Range of motion of sagittal and coronal planes were similar to those prior to operation compared with preoperatively(P = 0.45,0.74),and the range of motion and stability were maintained as adjacent segments.Results showed that the artificial disc replacement maintained range of motion of original intervertebral disc,accelerated patient recovery,and slightly affected adjacent intervertebral disc.

?AlM: To evaluate the relationship of early-life and childhood exposures and age-related cataract ( ARC ) , and provide a scientific evidence for early preventing, treating and detecting ARC.
?METHODS: A hospital-based case control study was conducted from April 2011 to October 2012. A total of 360 cases ( 360 eyes ) aged 41 ~ 60 years old for cataract extraction and 360 frequency-matched controls in the same hospital for various not related to ARC were included in the study. A structured interviewer -administrated questionnaire that included information on sociodemographic characteristics, early - life and childhood exposures was used. The risk factors of ARC were estimated with unconditioned logistic regression models.
?RESULTS:Early gestational age at birth sooner and lower birth weight was significantly associated with the risk of ARC(OR=1. 152,95%CI:1. 029~2. 235,P=0. 024;OR=1. 374, 95%CI:1. 156 ~2. 581,P=0. 037,respectively). The maternal pre-pregnancy diabetes ( OR=1. 587, 95%CI:1. 177~2. 915,P=0. 019),gestational diabetes (OR=1. 763, 95%CI:1. 375 ~ 2. 367,P= 0. 004), preeclampsia(OR=1. 581, 95%CI: 1. 139 ~1. 996,P=0. 021), and pregnancy induced hypertension (OR=1. 517, 95%CI:1. 032~1. 963,P=0. 024) could make the risk of ARC increased. Of the factors affecting the period of children, only shorter height relative to peers and overweight at age 10 were significantly associated with the risk of ARC( OR=1. 329, 95%CI:1. 072~2. 351,P=0. 038;OR=2. 302, 95%CI:1. 323~3. 196,P=0. 011, respectively).
?CONCLUSlON:Early gestational age at birth, low birth weight, the maternal pre - pregnancy diabetes, gestational diabetes, preeclampsia, and gestational hypertension, and shorter height and overweight relative to peers, at age 10 were risk factors of ARC. But lasted long large and prospective studies are needed to insure early risk factors for ARC in the Chinese population.

ObjectiveTo observe the changes of artery diameters, cerebral blood flow and glutamate level in the early stage (2 h after the stimulus finished) of acute mechanical middle cerebral artery (MCA) vasospasm in cats. MethodsThe right MCA was persistently mechanically stimulated using a small smooth stainless steel nail in the field across the olfactory tract for 30 min. The diameter of MCA was recorded with metrical ocular of microscope. The changes of the perfusion index of brain tissue were observed through the Laser Doppler flowmetry monitor fixed on the skull. The level of glutamate were investigated through high performance liquid chromatography. ResultsThe diameter of MCA decreased to 68.8% of normal. 2 h later, the diameter of MCA recovered. The perfusion index of the cortex surface decreased to 42.6% of normal and up to 63.8% 2 h later. The level of glutamate raised about 40 times of normal and maintained a high level 2 h after the mechanical stimulus. ConclusionThe persistent mechanical stimulus can cause acute cerebral vasospasm. Reduce of cerebral blood flow and raise of excitatory amino acids were observed in the early stage of acute mechanical vasospasm.

BACKGROUND:Cerebrovascular drag, occlusion and other mechanical stimulations inevitably occur during some craniocerebral operations, which cause acute mechanical cerebrovascular vasospasm. At present, the mechanism underlying the patho-physiology as well as the pathological prognosis of this acute mechanical vasospasm remains unclear.OBJECTIVE: To observe changes in the vascular diameter of the middle cerebral artery, cerebral blood flow (CBF), and ultrastructure of vascular wall and vascular endothelial cells, during the early stage (2 hours) of mechanical cerebral vasospasm in cats.DESIGN: Open experiment.SETTING: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University; Beijing Institute of Neurosurgery.MATERIALS: Six healthy adult hybrid cats, of either gender, weighing from 2.5 to 3.5 kg, were provided by the China Medical Science Institute of Experimental Animals. Laser Doppler flowmetry (Periflux 5010, Sweden Perimed Company)was used.METHODS: This study was carried out in the Beijing Institute of Neurosurgery between August 2005 and March 2006. For all experimental surgical procedures, the cats were anesthetized by intraperitoneal injection of 200 g/L chloral hydrate, at 2 mL/kg, and then placed in a prone position. A median incision was made in the scalp and a square bone window, 8×10 mm, was opened at 1.5 cm posterior and 1.5 lateral to the anterior fontanel, after which the dura mater was pricked out. The fine detecting head of the Laser Doppler flowmetry was fixed to a region of the cerebral surfacewith no vessels or with only a few vessels. Subsequently, the cats were placed in lateral position. Under the surgical microscope, the right middle cerebral artery was exposed through a suborbital approach. Blunt apparatus was used to stimulate middle the middle cerebral artery repeatedly, at a frequency of 100 time/min within 30 minutes.The diameter of the middle cerebral artery was measured and a perfusion index of cortical brain tissue was monitored, separately, before and then at 0, 0.5, 1.0, 1.5, 2.0 hours after stimulation. Ultrastructural changes in the vascular wall and the vascular endothelial cells were observed during the early stage (2 hours) of mechanical cerebral vasospasm in cats.MAIN OUTCOME MEASURES: Diameter of the middle cerebral artery and the perfusion index of cortical brain tissue before and then at 0, 0.5, 1.0, 1.5, 2.0 hours after stimulation, as well as any ultrastructural changes in the vascular wall and endothelial cells 2 hours after stimulation.RESULTS: The results from six cats were were analyzed. ①The diameter of the middle cerebral artery was (0.617±0.129), (0.723±0.082), (0.840±0.084) mm 0, 0.5 and 1.0 hours after stimulation, respectively, which was significantly smaller than that before stimulation [(0.897±0.066) mm,t =4.74, 4.017, 1.299,P ＜ 0.01]. ② The perfusion index of cortical brain tissue was 67.8±18.5, 82.5±17.5, 89.8±24.0, 94.0±22.2 and 98.5±21.0 at 0, 0.5, 1.0,1.5 and 2.0 hours after stimulation, which was significantly lower than that before stimulation (159.2±23.5, t =4.716-7.469, P ＜ 0.01 ). ③ At the early stage of acute mechanical stimulation (2 hours) to middle cerebral artery, endothelial cell chromatin aggregated at the edge of the cells and achromocyte formed, but mitochondrial crista was unclear.CONCLUSION: Mechanical stimulation to the middle cerebral artery in cats can lead to cerebral vasospasm. Apoptosis of endothelial cells appears at the early stage of stimulation (2 hours). These results indicate that, in order to prevent against cerebral vasospasm, cerebrovascular mechanical stimulation should be as minimal as possible and that as few as possible craniocerebral operations should be performed.

Objective To study and design a fluid resuscitation control system which is suitable for the treatment of hemorrhagic shock in the battlefield and prehospital settings. Methods The physiological parameters of the wounded were set as the system input and fuzzy control technology was used to identify the hemorrhagic shock (HS) severity and made a decision. At last, fluid resuscitation was finished with the use of the efficient blood transfusion and infusion pump. Results High-speed resuscitation could be carried out when the wounded was in severe condition, while low-speed resuscitation could be conducted when the wound was in mild condition. Conclusions Compared with the traditional resuscitation method, the designed fluid resuscitation control system can improve the efficiency of fluid resuscitation and the treatment success rate.

Objective To investigate the application effects of ultrasonic scalpel combined with bipolar coag-ulation tweezers on open thyroid surgery.Methods 80 cases of thyroidectomy patients were randomly selected.These patients were divided into two groups by random cluster sampling method,whch were the study group (n =40)and control group (n =40).The control group of patients were given ultracision ligature methods combined with traditional therapy,while the study group of patients were given ultrasonic scalpel combined with bipolar coagulation tweezers treatment.And then the surgical related indicators and complications of the two groups of patients were statistically an-alyzed.Results Compared with the control group of (90.5 ±3.6)min,(6.5 ±0.6)d,(40.5 ±2.0)mL,(50.3 ± 1.4)mL and (6.6 ±0.5)cm,the operative time and length of stay of the study group of patients[(58.5 ±5.4)min and (3.4 ±0.2)d]were significantly shorter (t =6.965,3.143,all P <0.05);the blood loss and postoperative drainage of (5.0 ±1.4)mL and (1.0 ±0.6)mL were significantly less (t =4.541,3.747,all P <0.05);the cut diameter of (3.8 ±0.3)cm was significantly shorter (t =3.365,P <0.05);the complication rate of 2.5% (1 /40) was significantly lower than the control group 10.0%(4 /40)(χ2 =9.35,P <0.05).Conclusion The application effects of ultrasonic scalpel combined with bipolar coagulation tweezers on open thyroid surgery are obvious.