The book itself is well known in traditional Chinese culture of literature.It contains five chapters: Introspection,Social Intercourse,Deliberation,Leisure and Conspectus.There are 381 observations that lead us through paths as complex,absurd,and grotesque as life itself.Terse,humorous,witty,and above all,timely,this book offers a provocative and personal mix of Taoist,Buddhist,and Confucian understanding.And it embodies the inclusive cultural awareness of social intercourse,the thought of people-oriented educational management and the idea that harmony is above anything,which will lead the management of morality and ethics in higher medical institutions in China.

Objective To analyze the effect of combined use of povidone iodine and antifungal drugs in the treatment of fungal keratitis.Methods 96 cases of fungal keratitis patients suffering from the disease as the research object from March 2014 to March 2016 in our hospital,according to different treatment methods,they were divided into observation group and control group,48 cases in each group,control group received povidone iodine topical treatment,the observation group used povidone iodine and topical antifungal agents the treatment,the clinical efficacy of the two groups received.Results The total efficiency of the observation group was 97.9％higher than that of the control group 85.4％,the difference was statistically significant(χ2=4.909,P< 0.05);the visual acuity >0.05 share of the observation group was significantly higher than the control group,the difference was statistically significant(χ2=6.042,P< 0.05); There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The combined use of povidone iodine and antifungal drugs in the treatment of fungal keratitis can produce a very significant therapeutic effect,effectively improve the visual acuity of patients,and has high application value.

Objective To investigate the methods of special departments nursing quality control in our hospital. Methods Through the establishment of nursing quality control standards of special departments, set up department quality control group, establish the three level nursing quality control systems and improve nursing care and quality control feedback mechanism,compare and contrast the quality control before and after the method application. Results Nursing quality of all special departments was significantly higher than before,there was significant difference;satisfaction degree of patients and doctors with nursing work significantly improved after the implementation of nursing quality control. Conclusions Nursing work can be scientific and standardized, satisfaction degree of patients and doctors can be improved through modifying nursing quality control methods of the special departments.

Objective To analyze the travoprost and brinzolamide for clinical effect of open-angle glaucoma and ocular hypertension in the treatment of persistent state.MethodsA total of 104 patients with open-angle glaucoma and ocular hypertension who were treated in our hospital from June 2014-2016 in June were randomly divided into control group and study group, each group had 52 cases.The control group were only treated by travoprost therapy, study group with travoprost combined with brinzolamide treatment, to study and analyze the efficacy of two groups.ResultsAfter treatment,the intraocular pressure improved,compared with before treatment,the difference was statistically significant(P<0.05).Visual acuity was significantly improved compared with before treatment,the difference was satistically significant(P<0.05).ConclusionFor open angle glaucoma and ocular hypertension patients combined with travoprost and brinzolamide treatment, patients can improve clinical curative effect, improve the visual acuity, it has practical value.

The myopic population is growing rapidly worldwide,the treatment of myopia become one of the hot spots in ophthalmology.Medicine therapy of myopia is now commonly used to slow down the progression of myopia,and it has already been the most expected one.Among all the drugs,the effect of muscarinic antagonists has been recognized at home and abroad.Muscarinic antagonists,according to their different M receptors,own different interventional approaches and therapeutic effects.Muscarinic antagonists,such include atropine,pirenzepine,tropicamide and cyclopentolate,their pharmacology and adverse effects are analyzed in order to explore their safety and efficacy and evaluate their clinical value.This paper reviewed these aspects of muscarinic antagonists and raise the discussion and prospect of muscarinic antagonists in the treatment of myopia.

Objective: To analyze the risk factors for peri-procedural myocardial infarction (PMI) in patients with percutaneous coronary intervention (PCI) and to study the impact of CYP2C19 genotypes on PMI. Methods: A total of 283 coronary artery disease (CAD) patients received elective PCI were enrolled, the patients were with normal level of cTnI prior PCI, without adverse reaction post PCI and cTnI levels were re-examined at 24 hours after PCI. The patients were divided into 2 groups: PMI group,n=83 and Non-PMI group,n=200. CYP2C19 genotypes were detected by DNA microarray chip method and based on its result, the patients were classiifed into 3 genotypes: Extensive metabolism type, Intermediate metabolism type and Poor metabolism type. The patients with ADP inhibition rate ≤ 20% was deifned as heightened platelet reactivity (HPR) which was measured by thrombelastograph. Baseline clinical condition was compared between 2 groups and the impact of CYP2C19 genotypes with other risk factors for PMI occurrence were studied. Results: The occurrence rate of PMI was 29.3% (83/283); the age, gender, BMI, smoking, blood levels of TG, LDL-C and uric acid, history of hypertension and diabetes were similar between 2 groups,P>0.05. Compared with Non-PMI group, PMI group had more implanted stents (2.1 ± 0.9) vs (1.5 ± 0.6) and longer total length of stents 56 (36-71) mm vs 33 (23-51) mm, bothP<0.05; lower ADP inhibition rate (36.0 ± 29.8) % vs (43.9 ± 26.4) %,P=0.02 and higher HPR occurrence rate 39.8% vs 22.0%,P=0.01. The ratios of CYP2C19 genotypes of Extensive metabolism, Intermediate metabolism and Poor metabolism were 37.5%, 45.2% and 17.3% respectively, while PMI patients in each genotype were 21.7%, 29.7% and 44.9% respectively. Logistic regression analysis indicated that HPR (OR=2.18, 95% CI 1.19-4.01,P=0.02), total length of stents (OR=1.03, 95% CI 1.00-1.06,P=0.007) and CYP2C19 Poor metabolism genotype (OR=2.8, 95% CI 1.24-6.28,P=0.01) were the risk factors for PMI occurrence. Conclusion: HPR, total length of stents and CYP2C19 poor metabolism genotype were the risk factors of PMI occurrence, while poor metabolism genotype might be the most important endogenous reason for PMI occurrence.

Objective To observe the clinical effect of treating refractory ascites by intermittent cycle ascites reinfusion.Methods Having 30 refractory ascites patients of both chronic renal failure and maintenance hemodialysis(MHD),treating them 102 times by intermittent close ascites reinfusion and synchronous hemodialysis,having reinfusion ascites 3000～5000ml each time,checking the change of serum creatinine(Scr),blood urea nitrogen(Bun),and serum albumin before and after hemodialysis(HD) by blood-test,and observing their temperature,weight,belly size,blood pressure,and pulse before and after treatment.Results After treatment,all the patients feel well,have good appetite,and have less swollen belly.The average treatment is 3.2 times.The table shows the patients' weight,belly size,serum albumin,serum creatinie and blood urea nitrogen(Bun) before and after treatment.The difference is obviously distinctive(P

BACKGROUND:Deep venous thrombosis is one of the common and fatal complications of total joint arthroplasty.For our clinical practice,we require duplex ultrasound and venography to evaluate the presence of deep venous thrombosis,but the diagnostic tools have several disadvantages.OBJECTIVE:To explore the appropriate and non-invasive biomarkers in the early diagnosis of deep venous thrombosis.METHODS:With the key words of Thrombosis,DVT,Biomarker,Total Joint Arthroplasty,D-dimer,Factor VIII,Thrombin Generation,Fibrin Monomer,P-selectin,Inflammatory Cytokines,Microparticles,Leukocyte Count,Genetic factors,MicroRNAs,a computer-based search was performed for articles published in PubMed database from January 1995 to March 2015.After the initial screening,the reserved articles were further detailed,summarized and concluded.RESULTS AND CONCLUSION: Totaly 66 articles were colected.This brief review is used to analyze the mechanism of the biomarkers which are classified into three levels as folow: detection of blood coagulation,inflammation markers and molecular biology and genetics-based biomarkers.The review also showed a great need of economic and safer biomarkers for the clinic and provided the theoretical basis to diagnose and predict deep venous thrombosis in an early stage.

Objective To explore the effect of trans-axillary single-port and bilateral breast of ipsilateral axillary approach in endoscopic thyroidectomy on area of skin flap ,complications and the corresponding impact damage .Methods A total of 72 patients who were underwent either BBIAA or TASPET in our hospital from February 2013 to April 2015,were divided into BBIAA group and TASPET group ,each group had 36 cases.The area of skin flap ,complications and the corresponding impact damage between two surgical methods were compared .Results The average separation of the flap area in TASPET group was significantly higher than that in BBIAA group (P<0.01).The VAS score of BBIAA group was (0.24 ±0.39) point,which was lower than (1.85 ±1.37)point of TASPET group,the difference was significant(P<0. 01 ) .The patients of BBIAA group had no complications ,while there were 10 patients suffered complications in TASPET group ,and the differ-ence of postoperative complications was significant (P<0.01).Conclusion Bilateral breast and ipsilateral axillary approach have the advan-tage of less operative time ,smaller separation of the flap area ,lower complication incidence and less damage on parathyroid gland and nerve , which had an ideal safety and cosmetic result .

Objective To observe the clinical significance and variation of plasma B-type brain natriuretic peptide (△BNP) levels before and after treadmill exercise test (TET) in women with coronary heart disease(CHD). Methods Sixty-one women with suspected coronary heart disease were selected (except for heart failure, blood BNP levels were normal). All patients underwent coronary angiography, were divided into two groups, 25 cases in normal group and 36 cases in coronary heart disease group. Plasma BNP levels were measured before and after the TET test, and data were compared between two groups after one week.Furthermore, the levels of△BNP before and after TET in patients with different degrees of coronary artery lesions were compared. The diagnostic value of the levels of△BNP in coronary heart disease was evaluated by the re-ceiver operating characteristic curve (ROC). Results The plasma BNP level was significantly increased after TET (44.20± 14.53) than that before the test (32.82±10.72) in coronary heart disease group (P<0.01). There were significant differences in levels of△BNP before and after TET in patients with different degrees of coronary lesions. The levels of△BNP were sig-nificantly higher in multi-vessel disease group than those of single and double lesion group (P<0.05). The level of△BNP was significantly higher in double lesion group than that of single lesion group (P < 0.05). When the level of △BNP=7.3 ng/L, the sensibility value and specificity value for the diagnosis of CHD was 82.4%and 81.5%. The area under curve (AUC) was 0.900, and 95%confidence interval was 0.796-0.962. Conclusion The detection of△BNP before and after TET has an important clinical significance in the diagnosis and evaluation of coronary heart disease in women patients.