Sini Powder is the traditional Chinese medicine compound, which comes from Treatise on Febrile Diseases. It is used to treat the syndrome of yang depression and reversal cold of limbs. Sini Powder has a certain effect on treating insomnia caused by liver depression and spleen deficiency. Lots of researches have shown that Sini Powder has a sedative and hypnotic effect similar to diazepam and plays an important role in improving sleep disorders caused by post-traumatic stress disorder (PTSD). Sini Powder is not included in Chinese Pharmacopoeia (2015 edition). It is probably to develop Sini Powder into a new drug for the clinic. We collated and summarized the literature about the sedative and hypnotic effect and the improvement of sleep disorders caused by PTSD of Sini Powder. Based on the modern research on the sedative and hypnotic effect of Sini Powder, we think the effect of "relieve uneasiness of mind and body tranquilization" adapts the theory of traditional Chinese medicine, so that it can improve the applied range of Sini Powder. Meanwhile, we analyzed the possibility of Sini Powder being selected into the ancient classical prescription and key problem in research and development on drug preparation of Sini Powder according to regulations of traditional Chinese medicine. Then we put forward some suggestions for further research from two aspects which are the development of Sini Powder and new drugs of traditional Chinese medicine, to provide a reference for the development of new Chinese medicine preparation of Sini Powder focus on "expelling pathogen and relieving depression, soothing liver and regulating spleen, tranquilizing mind".

Paeoniflorin is the main effective component of Paeoniae lactiflora and Paeonia suffruticosa. A large number of studies have proven that paeoniflorin has many pharmacological effects, such as anti-depression, anti-inflammation, analgesia, anti-tumor, liver protection, nerve protection, sedation and hypnosis, immunomodulation and so on. It has little toxic and side effects and has been highly concerned by people. At present, paeoniflorin is rarely used in clinical practice in the form of monomers. This article mainly refers to the related research literatures on paeoniflorin pharmacological action in recent three years, combs and summarizes the new progress of its pharmacological action research. The relationship between the drug effect and the prescription of traditional Chinese medicine was discussed, in order to provide a reference for further development and clinical application of paeoniflorin.

Objective To explore the peer assisted learning approach combined with micro-teaching in anesthesia internship for oversea students.Methods 60 international medical students were randomly divided into two groups.Students in the control group have peer guidance before routine theatre observation,while students in experimental group discuss micro-teaching of anesthetic skills with each other by watching real time videos from smart phone.Students' subjective attitudes to new approach were evaluated and their final exam score were analyzed.SPSS 1 1.0 was used for data processing and the data was made descriptive analysis,t test and analysis of variance.Results Students in experimental group did better in both theory exam (46.8 ± 4.03) vs.(35.7 ±6.12) and practice exam (35.2 ± 3.20) vs.(27.6± 4.71) than those in control group,and the total scores of two groups were (80.5 ± 7.40) and (63.1 ± 6.81) respectively.These scores all had significant difference between two groups.More students from experimental group than those from control group feel interested in anesthesiology (P＜0.01) and feel confident about exams (P＜0.05);There was no difference between two groups in understanding clinical guideline (P=0.57).Conclusion Peer assisted learning combined with micro-teaching is proved to enhance the quality of anesthesia teaching during internship for oversea undergraduates.

Objective To evaluate the long-term clinical efficacy and security of levetiracetam (Lev) as add-on therapy in patients with different types of epilepsies from an observational study.Methods Fifty-one patients were evaluated (14 female,37male,age range from 7months to 16 years,mean age 8.7 years) with different types of epilepsies ( 20 complex partial seizure,10 tonic-clonic seizure,1 tonic seizure,6 myoclonic epilepsy,2 Lennox-Gastaut syndrome,4 infantile spasms and 2 unspecified epileptic syndromes).The basis for comparison was defined as the seizure frequency in the 3 months prior to the commencement of treatment.Patients received Lev as add-on therapy.The initial dosage was 20 mg/(kg?d),and it was increased 10 mg/(kg?d) every 2 weeks.The maintenance dosage was 30-40 mg/(kg?d).Seizure frequency changes and adverse events were observed.Follow-up was conducted for a period of 6.8 months after treatment.SPSS 14.0 software was used to compare the difference between the seizure frequency before the Lev treatment and that after the Lev treatment.Results Thirteen (25.5%) out of the 51 patients reduced seizure frequency,16 (31.4%) patients had no reoccurrence;While another 9 (17.6%) patients seizure frequencied were reduced,8 patients' remained the same,and 5 patients' condition was got wor-sened.Six cases ceased treatment because of the worsening of the disease and the intolerance of Lev.The difference and after seizure frequency before in Lev treatment is statistically significant(P

0.05).The period when epileptiform abnormalities appear was obviously different(P

0.05).Of essay group 19 children whose PET were normal or slight abnormal,8 children's VEEG had epileptifrom abnormalities only appear in lucid interval,8 children's VEEG had epileptifrom abnormalities appear in nocturnal sleep period,3 children's VEEG had epileptifrom abnormalities appear in lucid interval and nocturnal sleep period.Of essay group,7 children whose PET were serious abnormal,6 children's VEEG had epileptifrom abnormalities appear in lucid interval and nocturnal sleep period.The PET outcome was relate with the time of VEEG epileptic discharge(r=0.461 P

Objective To investigate the situation of drug resistance and nosocomial infection of multi-drug resistant bacteria (MDR),guidance for clinical rational use of antibiotics.Methods A total of 1521 strains of MDR was isolated from January 2015 to December in Beijing Tongren Hospital,using matrixassisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) identification of bacteria,VITEK-2 Compact and Kirby Bauer (KB) method for drug sensitivity test.Results In 1 521 strains of MDR,Acinetobacter Baumanii were 589 strains (38.7％),nosocomial infection rate were 16.6％;350 strains of Escherichia coli (23.0％),nosocomial infection rate were 9.0％;249 strains of Staphylococcus aureus (16.4％),nosocomial infection rate were 2.7％;171 strains of Klebsiella pneumoniae (11.2％),nosocomial infection rate were 14.3％;150 strains of pseudomonas aeruginosa (9.9％),nosocomial infection rate were 64.7％;12 strains of Enterococcus faecium (0.8％),nosocomial infection rate were 16.7％.MDR Acinetobacter Baumanii,MDR Pseudomonas aeruginosa,extended-spectrumβ-lactamase (ESBL) + Escherichia coli and ESBL + Klebsiella pneumoniae resistance rate to Imipenem were 100％,91.5％,0.6％ and 55.6％.Conclusions MDR pseudomonas aeruginosa (MDR-PAE),MDR acinetobacter baumanii (MDR-AB) and ESBL + Klebsiella pneumoniae were highly resistant,and the nosocomial infection rate were higher.

Objective To investigate the safety and efficiency of large-dose alcohol sclerotherapy in treating simple hepatic cyst. Methods Patients with hepatic cyst were divided into two groups. One group with 49 patients was treated with small-dose (<80 ml) absolute alcohol instillation. The other one with 32 patients was treated with large-dose (≥80 ml) absolute alcohol instillation. Blood alcohol concentration (BAC) was recorded right after and 30 rain, 1 h,2 h,3 h after the treatment. Diameter of cyst as a parameter of efficiency was recorded and compared between two groups during 1 year follow-up visit. Results Large-dose group was significantly more efficient in treating hepatic cyst than small-dose group. All BAC records were within the safe range and below the legal limit after drinking. BAC reached its peak 30 minutes after the treatment began and then decreased gradually. A significant correlation was found between BAC and the alcohol dosage. Conclusions Ultrasound-guided sclerotherapy with repeated large-dose absolute alcohol instillation is a safe and efficient treatment for simple hepatic cyst from the perspective of BAC.

Objective To establish whether Wnt-signaling pathway plays a role in mice β-cell function and/or survival in vitro. Methods Mice NIT-1 beta cells were cultured in media with glucose concentration of 33.3 mmol/L and the cytokines interleukin-1β, interferon-γand tumor necrosis factor-α with or without the addition of purified Wnt3a protein in vitro. Subsequently, β-cell apoptosis by Tunnel and flow cytometry, and β-cell proliferation by BrdU were analyzed. Total RNA was extracted to measure gene expressions by real-time PCR.Results Incubations of NIT-1 cells with high glucose and cytokines resulted in an increase in β-cell apoptosis and decrease in β-cell proliferation (P<0.01). In contrast, treatment with Wnt3a protein protected β-cell from glucose and cytokines-induced apoptosis through up-regulating the expressions of above Pitx2、 TCF7L2. Conclusions Wnt-signaling regulates the proliferation of pancreatic β-cell, and protectes β-cell from glucotoxicity and cytokine toxicity with respect to proliferation and apoptosis.

BACKGROUND:Clavicular hook plates have been used widely to treat acromioclavicular dislocations in recent years. However, it remains controversial whether coracoclavicular ligament should be repaired during the surgery.
OBJECTIVE:To study the clinical effect and MRI manifestations after treatment of type III and V acute acromioclavicular Rockwood dislocation with clavicular hook plate, and to discuss the necessity of repairing coracoclavicular ligament during the surgery.
METHODS:A total of 44 patients with type III and V acute acromioclavicular Rockwood dislocations were treated with clavicular hook plates without repair of coracoclavicular ligaments, and underwent plate removal operations later. At 24 months after the second surgery, X-rays were taken to measure the width of coracoclavicular joints in both normal and affected limbs, Constant-Murley scores were calculated in both sides, and MR images were used to observe the healing of coracoclavicular ligaments.
RESULTS AND CONCLUSION:39 patients (89%) were fol owed up for 36.9±3.1 months (range, 30 to 45 months). The mean duration for retaining clavicular hook plates was 12.9±3.1 months (range, 6 to 21 months). The mean width of coracoclavicular joints was 6.04±1.21 mm (range, 4.3 to 8.8 mm) in normal limb, while 5.09±1.18 mm (range, 3.4 to 7.8 mm) in affected side without significant difference (P>0.05). The mean Constant-Murley score was 98.9±1.2 (range, 96 to 100) in normal limb, while 96.7±3.4 (range, 90 to 100) in affected side without significant difference (P>0.05). MRI showed healing of the coracoclavicular ligaments and the presence of continuous scar tissue in 38 patients, excluding one patient with recurrence of acromioclavicular joint dislocation. The clinical effects after treatment of type III and V acute acromioclavicular Rockwood dislocation with clavicular hook plate are satisfactory, and it is unnecessary to repair coracoclavicular ligament during the surgery. MR images reveal scar healing of the coracoclavicular ligaments without operative repair.