As an anti-epilepsy drug,gabapentin plays an important role in the treatment of neuropathic pain through a variety of central and peripheral mechanisms.Studies have shown that gabapentin has better efficacy for post-stroke pain,spinal cord injury-related pain,postherpetic neuralgia,and pain in diabetic peripheral neuropathy.For mild adverse effects,good tolerance and lack of interactions,gabapentin is an ideal drug for the treatment of neuropathic pain.

Objective To investigate the effect of gamma globulin combined with glucocorticoid pulse therapy in the treatment of children with refractory mycoplasma pneumonia in CRP and safety.Methods 46 cases of children with refractory mycoplasma pneumonia from February 2012 to February 2016 were selected and randomly divided into the control group and experimental group,23 cases in each group.On the basis of the regular treatment,the control group was given azithromycin,10mg/kg,qd,intravenous drip,on the basis of the control group treatment,the experimental group was treated with methylprednisolone 2mg/kg+human immunoglobulin 400mg/kg,qd,intravenous drip.The levels of serum C-reactive protein(CRP),white blood cell count(WBC),lymphocyte count(LC),therapeutic efficiency and safety were measured before and after treatment.Results After treatment,compared with the control group,the serum levels of CRP、WBC、LC were lower in the experimental group,the difference was statistically significant(P<0.05).The treatment efficiency of the experimental group(91.31％)was significantly higher than that of the control group(65.22％),the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The gamma globulin combined with glucocorticoid pulse therapy can significantly reduce the serum levels of CRP,WBC and LC in children with refractory mycoplasma pneumonia,improve clinical efficacy and the safety were good.

Objective To observe the clinical effect of Sangao Decoction combined with Azithromycin in the treatment of mycoplasmal pneumonia in children.MethodsFrom August 2013 to August 2014, 76 children with mycoplasma pneumonia were enrolled in this study.The patients were randomly divided into observation group and control group.The control group was treated with azithromycin alone, and the observation group was given the treatment of Sanao Decoction on the basis of the control group.Comparison of the two groups of clinical efficacy, fever time, cough time, tonsil disappearance time, lung rales disappear time, length of stay and the incidence of adverse reactions.ResultsThe effective rate was 94.37% in the observation group and 76.32% in the control group, which was statistically significant (P<0.05).(2.45±0.90) d, duration of coughing (5.37±1.67) d, duration of disappearance of tonsil (6.23±2.47) d, disappearance of rales (7.18±1.58) d, duration of hospital stay (10.26±1.65) d were shorter than the control group, which was statistically significant (P<0.05).The incidence of adverse reactions was not statistically significant.ConclusionThe effect of Sangao Decoction combined with azithromycin in the treatment of mycoplasma pneumonia in children can significantly shorten the symptoms and signs of the patients, the time of disappearance of the signs and the length of hospital stay, promote the rapid recovery of children, high safety, and have good clinical application value.

Adenocarcinoma ; metabolism ; pathology ; Aged ; Carcinoid Tumor ; metabolism ; pathology ; Chromogranin A ; metabolism ; Humans ; Immunohistochemistry ; Male ; Neoplasms, Multiple Primary ; metabolism ; pathology ; Phosphopyruvate Hydratase ; metabolism ; Rectal Neoplasms ; metabolism ; pathology ; S100 Proteins ; metabolism

Objective To assess training programs from trainees of Shanghai General Practice Teacher Training Center for further improvement.Methods Total 171 trainees attending the GP teacher training program in April,2012 were selected for survey.A self-designed questionnaires were adopted in the survey.The rationality of the curriculum and training contents in the program were analyzed.Results Among 170 trainees who answered the questionnaires,86 of them (51％) considered the training curriculum as very appropriate,76 of them (9％) considered as appropriate; 97 of them (57％) thought the training forms as very vivid,65 of them (38％) thought as vivid.The overall evaluation score for teachers was 4.64.Ninety three of the 170 trainees (55％) expressed a great willingness for training,70 (41％) expressed as willingness.Among 170 trainees 156 (92％) preferred to learn new advances in medicine,111 (65％) preferred to learn teaching skills and theories in general practice.Thirty two trainees (19％) considered that the contents of training met the trainees' needs completely,129 (76％)considered that most contents of training met the trainees' needs.Eighty two (48％) considered that they gained a lot after the training,80 (47％) considered that they gained fairly.The survey showed that 147 (86％) believed the training had broadened their minds,104 (61％) believed the training had increased their capabilities of clinical diagnosis and treatment; 53 (31％) thought the training helped raise their theoretical level.Eighty seven (51％) were very satisfied and 75 (44％) were comparatively satisfied with the training in overall evaluation.Conclusion The training program provided by Shanghai General Practice Teacher Training Center is basically satisfactory and trainees are benefited from the training considerably.

Donation after cardiac death (DCD) means organ harvest and donation cannot be carried on until the requirement of death criteria using cardiopulmonary arrest is reached.Great success has been achieved since DCD was promoted widely in China.However,some problems were encountered during the implementation of DCD and there also exists many ethical controversies.The ethical principles of informed consent and no harm mentioned inDonation after Cardiac Death Work Instructions of China should be strictly adhered to,while justice,fairness and openness must be ensured in organ allocation.Appropriate compensation should be given to DCD donor and his family,and the utilization of DCD should be further improved.All of these ethical principles will help to promote the healthy development of organ donation and transplantation in China.

Objective To investigate the correlative factors for osteoporosis among senile patients with multiple cardiovascular diseases and type 2 diabetes mellitus.Methods 206 patients were divided into osteoporosis (OP) group and non-osteoporosis (non-OP) group according to the diagnosis standards of osteoporosis.The general data were recorded.Clinical history of all kinds of cardiovascular diseases and type 2 diabetes mellitus were detected.Serum levels of hemoglobin (Hb),glucose (Glu),glucosylated hemoglobin (HbA1c),alkaline phosphatase (ALP),total serum protein (TP),albumin (ALB),BUN,creatinine (Cr),calcium (Ca),phosphonium (P),total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C) were detected.Dual-energy Xray absorptiometry was used to detect the bone mineral density (BMD) of bilateral femoral neck and lumbar spine.The related factors of BMD were analyzed.Results The morbidity of osteoporosis was much higher in elderly females than in elderly males (58.7％ vs.38.6％).The osteoporosis patients were older than non-osteoporosis patients in both males and females,although there was no significant difference.The body mass index (BMI) of both gender was much lower in osteoporosis group than in non-osteoporosis group (P＜0.05).In male patients,BMD was positively correlated with BMI significantly (P＜0.01).In female patients,TC and LDL C were higher in OP group than in non-OP group (P＜0.05).In female patients,BMD was positively correlated with BMI,and negatively correlated with TC and LDL-C.Logistic regression analysis showed that the lower BMI was an independent risk factor for osteoporosis in male patients; BMI and TC were independent risk factors for osteoporosis in female patients.Conclusions In both male and female,senile patients with lower BMI,multiple cardiovascular diseases and type 2 diabetes mellitus have higher risks for osteoporosis.In senile female patients,TC may be correlated with BMD.TC should be reduced to decrease the risks of cardiovascular diseases and osteoporosisin senile females.

Tobacco smoking is a global healthcare problem that poses a substantial and costly health burden. Nicotine is the major constituent responsible for the addiction to tobacco. Current strategies helping tobacco smokers have limited utility in increasing rates of smoking cessation, consequently indicating the need for alternative therapies. A novel therapeutic method is vaccination against nicotine. Nicotine vaccine can generate specific antibodies that can sequester nicotine from cigarette smoke in the blood, and prevent its access to the brain and minimize positive reinforcing effects, which may help smokers to stop smoking. The vaccine will have great potential for the treatment of nicotine addiction and for relapse prevention. Here we will review the current status of vaccines against nicotine addiction and discuss the problems associated with the development of nicotine vaccines.

Vasovagal syncope (VVS) is the most common cause of transient loss of consciousness ( TLOC ),mainly with head-up tilt test (HUTT) for diagnosis and treatment evaluation.Beacause of potential risks in the process of HUTT,it is necessary to explore an early,accurate,safe,effective,inexpensive and convenient means of diagnosis and evaluation for VVS.The means of quantitative history are now in practice of clinical trials.The means commonly used are Calgary Presyncope Form (CPF)and three questionaires about point scores in the Calgary syncope symptom studies.Due to its stable,simple and easy to apply features,CPF has some advantages on assessing the effectiveness of different treatment methods for VVS.The three questionnaires have some application potential in diagnosis for VVS.