Objective To investigate the clinical efficacy of sertraline combined with famciclovir in treatment of herpes zoster neuralgia . Methods Ninety -four patients with herpes zoster neuralgia were randomly divided into treatment group and control group , 47 cases in each group. Two groups of patients were performed conventional nutritional and physical therapy . Control group was treated with oral administration of famciclovir 0.25 g, tid, treatment group added sertraline 50 mg? d-1 on the basis of control group . The course of treatment was 4 weeks. The visual analogues scale ( VAS ) , clinical efficacy , quality of life and the adverse drug reactions were compared between the two groups.Results In the treatment group , the VAS in 1 and 4 weeks were ( 5.13 ±1.26 ), (3.27 ±1.02), significantly decreased than before treatment ( P<0.05 ) , and significantly lower than control group, which were(6.17 ±1.57) and (4.87 ±1.13).The total effective rate in treatment group ( 93.62%) was higher than control group ( 74.47%, P <0.05 ) .The quality of life in two groups were significantly increased after treatment ( P<0.05 ) , and treatment group significantly higher control group (P<0.05).No serious adverse drug reaction was found in two groups.Conclusion The clinical efficacy of seculin combined with famciclovir in the treatment of herpes zoster neuralgia is significant.

Objective To study the effect ofdifferent doses of dexmedeto-midine to pain , stress and immune function in elderly patients with lapa-roscopic surgery Methods One hundred twenty -six patients of laparo-scopic surgery were randomly divided into low -dose group ( 42 cases ) , middle dose group (42 cases), and high-dose group (42 cases).Be-fore anesthesia 15 min, the low dose group , middle dose group and high dose groups were intravenouslygiven 0.2 , 0.4 , 0.6 μg · kg -1 · h-1 of dexmedetomidine ,respectively.Diastolic bllod pressure ( DBP) , systolic blood pressure ( SBP) , blood sugar ( Glu) , heart rate ( HR) to the hori-zontal and CD4, CD8, CD4/CD8 levels of before and after surgery 3, 8, 24 h were compared.Results The pain scores ,DBP, SBP, Glu and HR levels of before and after surgery 24 h between three groups were not sig-nificant differences ( P>0.05 ).After surgery 3 h and 8 h, pain scores of middle high dose groups were significantly higher than that of low -dose group ( P <0.05 ) and their DBP, SBP, Glu, HR were significantly better than that of low-dose group(P<0.05).Before and after surgery, CD4 levels in three groups of patients did not change significantly.Before and 3 h after surgery, CD8, CD4/CD8 levels in the three groups were not significant difference ( P>0.05 ).After surgery 8 h and 24 h, CD8 levels of high-dose group was significantly lower than of the low -dose group , and the CD4/CD8 ratio was significantly better than low -dose group(P<0.05).Conclusion The use of 0.4, 0.6 μg· kg -1 · h-1 dexmedetomidine scheduled for laparo-scopic surgery in elderly patients have a more significant analgesic effect , can reduce stress and improve immune func-tion in patients , it is worth widely used.

Objective To evaluate the effect for stroke(cerebral infarction)at acute stage intervened by traditional Chinese medicine(TCM) clinical pathway. Methods A retrospective analysis was carried out in the patients before and after intervention by TCM clinical pathway during the year of 2013-2016. The outcomes included the entrance rate,completion percentage,aberration rate,severity,hospitalization time,and hospitalization fee as well as functional prognosis 30 d after discharge. Results A total of 792 cases was included,241 cases admitted in the year of 2013, 191 in the year of 2014, 135 in the year of 2015, and 225 in the year of 2016. In the year of 2014-2016,the entrance rate,completion percentage,hospitalization time,hospitalization fee,critical case percentage,and gender constituent ratio were steadily(P > 0.05). Modified Rankin Scale(mRS)for short-term functional prognosis mRS 0 ~ 2 percentage and aberration rate in the year of 2016 were superior to those in the year of 2014 and 2015(P < 0.05). Functional improvement on discharge day 30 in the year of 2014-2016 was superior to that in the year of 2013(P < 0.05). The hospitalization time and hospitalization fee in the year of 2014-2016 were a liffle higher than those in the year of 2013(P < 0.05), showing no obvious increase. Conclusion The application of TCM clinical pathway can make the diagnosis and treatment procedure of stroke at acute stage standardized,enhance the therapeutic effect,achieve or even exceed the goal of manage scheme.