Sepsis is a common complication in critically ill patients. The incidence rate was significantly higher in recent years, and it has been as the main cause of death in critically ill patients. The traditional treatment measures failed to significantly improve mortality. In recent years, the treatment of sepsis by traditional Chinese medicine are getting far more attention, the combination of Chinese traditional and western medicine treatment of sepsis bring out new treatment ideas and thoughts,and has achieved good results. This paper reviews the TCM recognition of sepsis from the etiology and pathogenesis, syndrome differentiation, treatments, signgle traditional Chinese medicine and compound preparations and so on,following a brief analysis of existing problems and solutions.

Objective To study the diagnostic value of mammography and high-frequency ultrasound in diagnosis of early breast carcinoma.Methods Sixty-five female patients with breast carcinoma were all confirmed by surgery and pathological examinations. All the patients were examined by the high-frequency ultrasound as well as mammography.Results The positive diagnostic rate,the display of tumor shadow and malignant microcalcification with high-frequency ultrasound and mammography were as follows :64.6%(42/65)and 46%(30/ 65),62%(40/65)and 20%(13/65),40%(26/65)and 20%(13/65)respectively. The difference was considered statistically significant(P

Objective:To investigate the correlation between positive rate of thyroid autoantibodies in healthy people and thy -roid dysfunction.Methods:Fasting blood from 3218 healthy examined people in Cangzhou were collected and the serum was separa -ted.Automatic electrochemiluminescence immunoassay systems and reagents were used to determine the concentration of thyroid stimu -lating hormone(TSH),free triiodothyroninthyroid(FT3),free thyroxine(FT4),peroxidase antibody(TPOAb)and thyroglobulin antibody ( TgAb ) .TPOAb>34 U/ml and TgAb>115 U/ml was positives.Statistical analysis of test results .statistica analysis of test reults.Results:The positive rate of thyroid autoantibodies of tested population was 16.19%.The positive rates of TPOAb and TgAb were 14.57%,12.74%separately.The detection rate of TPOAb and TgAb was 11.12%in tested population.The positive rate of TPO-Ab and TgAb and TPOAb+TgAb were 6.92%,5.68%,5.03%separately in 1532 male subjects and were 21.53%,19.16 ,16.67%separately in 1686 female subjects,which were significantly higher in female group than that in male group (P<0.001).They gradually increased with age and reached a peak above 70 years old in female group and in 50-59 in male group.The positive rate and OR of thy-roid autoantibodies in hyperthyroidism and subclinical hyperthyroidism and in hypothyroidism and subclinical hypothyroidism and in hy -pothyroidism and subclinical hypothyroidism were statistically significant .Conclusion:The positive incidence of thyroid autoantibodies is higher in healthy people of Cangzhou .It is essential to follow-up these people of normal thyroid function with positive autoantibodies in order to facilitate prevention and early diagnosis and treatment of thyroid disease .

OBJECTIVE To study the clinical value of superficial layer coagulation of trigeminal sensory root in the treatment of trigeminal neuralgia. METHODS The clinical data of 5 cases with trigeminal neuralgia were studied. Head MRI (B-FFE) examinations were made before surgery and operations were performed via retrosigmoidal approach. One case with left facial pain showed 3 arteries with offsets crossing and compressing the left trigeminal nerve. Among 4 cases with right facial pain,3 cases had an artery compressing the right trigeminal and the nerve were distorted and moved from its original site,one case with an artery going with trigeminal nerve sensory root branchlets. All cases were no indications for microvascular decompression and thus were treated with surface coagulation of trigeminal nerve sensory root. RESULTS Pain disappeared instantly after operation and facial sensory were retained. All cases were followed up for 2.4 to 5 years and no recurrences were found. CONCLUSION Superficial layer coagulation of trigeminal sensory root is a safe and effective method for the treatment of trigeminal neuralgia.

Objective To investigate the effects of target-controlled infusion (TCI)of dexme-detomidine on the median effective concentration of effect-site (Ce50 )of propofol at loss of conscious-ness (LOC)in patients.Methods Sixty-four patients,28 males and 36 females,aged 20-60 years, ASA physical status Ⅰ or Ⅱ,scheduled for elective surgery,were randomly allocated to receive dexmedetomidine of 0 ng/ml (group P),dexmedetomidine of 0.4 ng/ml (group D1),dexmedetomi-dine of 0.6 ng/ml (group D2)and dexmedetomidine of 0.8 ng/ml (group D3)for 1 5 min before TCI of propofol,n =1 6 in each group.The propofol infusion was started to provide an effect-site concen-tration of 1.0 μg/ml,and increased by 0.2 μg/ml when propofol effect-site concentration and target concentration were equilibrium until LOC.Results The Ce50 (95%CI )at loss of consciousness in groups P,D1,D2 and D3 were 2.30 (2.24-2.36)μg/ml,1.92 (1.87-1.96 )μg/ml,1.60 (1.55-1.65)μg/ml and 1.41 (1.35-1.45 )μg/ml,respectively.There was a negative correlation between the effect-site concentration of propofol-induced LOC and target concentration of dexmedetomidine (r=-0.84,P <0.01).Compared with groups P,D1 and D2,the incidence of bradycardia was higher in group D3 (P <0.05).Conclusion The Ce50 of propofol-induced LOC gradually decreases with in-creasing target concentration of dexmedetomidine.Combining propofol with dexmedetomidine of 0.4 or 0.6 ng/ml that can reduce the Ce50 of propofol-induced LOC,which is suitable for induction of an-esthesia with a lower incidence of bradycardia.

Objective To evaluate the sedative interaction between dexmedetomidine and propofol.Methods Sixty-four American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 20-60 yr,with body mass index of 19.0-25.0 kg/m2,scheduled for elective surgery under general anesthesia,were allocated into 4 groups (n =16 each) using a random number table:different target concentrations of dexmedetomidine groups (D1-4 groups).Dexmedetomidine was administered by target-controlled infusion (TCI) with the Markku model.The target plasma concentrations of dexmedetomidine were 0,0.4,0.6 and 0.8 ng/ml in D1-4 groups,respectively.At 15 min of dexmedetomidine TCI,propofol was given by TCI with Schnider model,and the initial target effect-site concentration was set at 1.0 μg/ml.After the target effect-site and plasma concentrations were balanced,the target effect-site concentration of propofol was gradually increased in increments of 0.2 μg/ml until loss of consciousness (Observer's Assessment of Alertness/Sedation Scale score was 1).The model of pharmacodynamic interaction was used to analyze the sedative interaction between the two drugs.Results There was no statistically significant difference in residual sums of squares fitted by using the model of pharmacodynamic interaction between the target effect-site concentration of propofol and target plasma concentration of dexmedetomidine at loss of consciousness (P＞0.05).The linear dimensionless parameter of pharmacodynamic interaction was 0.The median effective effect-site concentration of propofol was 2.38 μg/ml at loss of consciousness,and the median effective plasma concentration of dexmedetomidine was 2.03 ng/ml at loss of consciousness.Conclusion Dexmedetomidine and propofol interact additively in terms of sedation.

Objective To evaluate the examination of non-small-cell lung (NSCLC) vein formation and the dynamic characteristics of blood stream through enforced SCT scanning for the research on and clinical diagnosis of tumor.Methods Double period enhanced SCT scanning was done to 152 NSCLC cases identified pathologically.Makes the color coding the tumour blood stream irrigation chart,the analysis blood stream irrigation characteristic.Compare the enforced morphologic manifestation of cancer focus with histology and analyze their pertinence.Results The enforced CT peak value (PV) of the low differentiation is bigger than that of the medium differentiation,which is bigger than the high differentiation.63 cases are 45-70 HU,78 cases are 20-45 HU and 11 cases are 10-20 HU.67 case are of abnormal arteriola; 23 cases are of abnormal hemal sinus development; 35 cases are pistil-like.Conclusion Accurately examining and quantifying cancer focus vein formation according to SCT double period enforced scanning is of high guiding value in the enactment of the plan for treating NSCLC and the comprehensive treatment of tumors.

Objective To assess and analyze the current status of clinical guidelines for hypertension in the world by using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument.Methods The clinical guidelines for hypertension were identified and approved by searching China hownet,WANFANG database,PUBMED database,MEDLINE,Embase and related institutions and authorization web site from 1995 to January 2012,and relevant Web sites of agencies and organizations that produce and/or endorse guidelines.Names of the guidelines,published years and organizations,methodology of development and reference number were descriptively analyzed.AGREE instrument was used to evaluate the qualities of latest edited clinical guidelines for hypertension in countries all over the world.Results Nine guidelines were enrolled.The results showed that the hypertension guidelines scored the highest average of 88.4％ for clarity of presentation and reliability field; for applicability fields,scored an average of 86.1％; the scope and goal field scored an average of 83.8％; participants field scored an average of 71.7％; editorial independence field scored an average of 64.1％ ; rigor of development field scored the lowest average of 62.9％.The overall assessment showed that NICE 2011,Canada 2012,ESC 2009,Australia 2010 editions were the positively recommended guidelines,JNC7,Japan 2009,China Taiwan 2010,China 2010,South Africa 2011 editions were the recommended guidelines (still need to supplement and improve).No recommend or uncertain guide was found.Conclusions The quality of the hypertension guidelines is higher in general,but some common deficiency in the rigor of development and editorial independence in Asian and African guidelines formulated by the states still exists.There still exist certain gaps in evidence-based medical requirement.And the contents and quality are needed for further regulating and enhancing.A set of scientific systemic hypertension clinical guidelines evaluation system should be established.

Reduced responsiveness to reward stimuli is a central feature of major depressive disorder (MDD). Study on the changes of neural substrates and behavior contributes to understand the mechanism of MDD. Functional magnetic resonance imaging (fMRI) has the unique advantage of investigating reward processing, which is of importance in the brain imaging study. The progresses of event-related fMRI (ER-fMRI) in field of rewarding stimuli in major depressive disorder were reviewed in this article.

Objective: To investigate the effects of oral Lactobacillus Plantarum supplementation on apoptosis of liver and tight junction of hepatocytes in an experimental model of obstructive jaundice.Methods: Wistar rats were randomly divided into five groups: sham-operated;bile duct ligation;bile duct ligation +LP(0.2 g/5 mL/day);bile internal drainage;bile internal drainage+LP.Hepatocyte apoptosis was quantitated using TUNEL assay.Transmission electron microscopy,RT-PCR and Western blot were used to observe tight junction associated proteins.Results: Compared to the sham-operated,a significant increase in apoptosis(P