Following the medical discipline’s own developmental pattern,according to the intrinsic requirement of the university’s construction,the edge disciplines which are the medicine and the humanities overlapping,and relatively superior should be developed by high starting point,specialization and the key breakthrough way.Considering the multidisciplinary development on the construction and developmental strategic altitude of the academy by following the development regularity of different subject itself,by consummating the leadership mechanism,transforming management conceptions,concising discipline direction,strengthening construction of the talented person troop and so on,is the inevitable choice of the related disciplines development in the provincial medical academy

Objective: To investigate the role of diffusion weighted imaging (DWI) in evaluating prognoses of patients with hyperacute cerebral infarction after thrombolysis. Methods: A total of 112 patients with hyperacute cerebral infarction underwent MR examination (including routine MR and DWI) before thrombolysis. Forty-six patients met the standard of thrombolysis and were treated with rt-PA. Control group included 48 patients who did not meet the thrombolysis standard and were treated routinely. The other 3 patients had a poor MRI quality due to metal denture or other fillers. Fifteen patients had the onset of TIA and received conservative treatment. The measurements included the infarction volume, location, margin and ADC value of the progression area. Correlation analysis was conducted between the above parameters and the related parameters after thrombolysis to assess their roles in evaluating of patients prognoses. Results: There was no significant difference in the ADC values of different areas of DWI between the control group and thrombolysis group (P = 0.07, 0.46, 0.71, and 0.34). Significant correlation was found between the infarction volume with the NIHSS score, length of hospital stay, mRS, and intracerebral hemorrhage(ICH)(P = 0.009, 0.034, 0.048, and 0.015, respectivley). The larger the volume of infarction was, the higher the NIHSS score and the more the possibility of ICH. Conclusion: The determination of cerebral infarction area by DWI may help to evaluate the prognoses of patients with hyperacute cerebral infarction after thrombolysis; the ADC value only play a little role for the evaluation.

Autonomic dysreflexia (AD) is a condition of abnormal sympathetic response,which generally occurs in patients with the spinal cord injury (SCI) at levels of T6 and above.AD usually occurs owing to the excessive reaction of the sympathetic nervous system to the adverse stimulus.Since AD can result in fatal complications,such as epilepsy,apnea,heart infarction,acute intracranial hypertension and cerebral hemorrhage,the diagnosis and treatment of AD is very important.This article simply introduces the morbidity,pathogenesis,causative factor,clinical manifestation and treatment of AD by reviewing recent literatures.

With the fast social and economic development ecosystem has been seriously impacted. Country ecotypic sanitary system based on urine diverting Ecosan toilets and biogas Ecosan toilets can make positive contributions to the protection of ecosystem. This paper makes a review on the conception of ecotypic sanitary system the application of two types of ecotypic utilities the effect of ecotyptic sanitary utility and disease prevention and control comprehensive benefit of country ecotypic sanitary system and construction and operations. The results of researches demonstrate that although some valuable achievements have been gained in those fields mentioned above further improvement should be made and the application should be further widened as soon as possible.

Objective To compare the influence of blood lipids and angina pectoris using combination therapy in coronary heart diseases(CHD) with unstable angina.Methods 100 patients were randomly divided into the probucol group(A group) 50 cases and probucol combined with atorvastatin treatment group(B group) 50 cases,The treadmill exercise ECG test,lipid and oxidation before and after treatment in two groups were observed.Results The total effective rate was 90.0% in group B significantly higher than 64.0% in group A(χ2 =3.841,P＜0.05);The total effective rate of ECG was 74.0% in group B after treatment which was significantly higher than the 42.0% in group A(χ2 = 3.981,P＜0.05);Treadmill exercise ECG test positive 82.0%,84.0% in two group before treatment,significantly higher than that 48.0%,24.0% in two group after treatment,(χ2 = 3.841,3.791,all P＜0.05);Angina pectoris in A、 B group after treatment [(1.6 ± 0.8) times、(1.0 ± 0.5) times]were significantly lower than [(4.3±1.9) times、(4.6 ±2.8) times]before treatment(χ2 =7.584,7.984,all P＜0.01).Conclusion Probucol was a safe and effective drug for treating hypolipidemic and reducing angina attack.Its combination with atorvastatin was safe,and the efficacy is more visible.

Objective:To study the anti-inflammatory and analgesic effects of Jiehuo Dieda ointment. Methods:The anti-inflam-matory activity was observed by rat foot swelling model induced by carrageenan and rat cotton ball granuloma model, and writhing re-sponse in mice induced by acetic acid and hot-plate test were used to explore the analgesic effects. Results:Compared with that of mod-el group, Jiehuo Dieda ointment 28 g·kg-1 ,14 g·kg-1 could significantly decrease rats hind paw swelling rate after 2 hours of ad-ministration. Compared with that of normal control group,Jiehuo Dieda ointment 28 g·kg-1 ,14 g·kg-1 could significantly decrease the weights of rats cotton ball granuloma,could significantly decrease the writhing times ,and increase the pain thresholdr after 60 min of administration(P<0. 05,P<0. 01). Conclusion:Jiehuo Dieda Ointment had obviously anti-inflammatory and analgesia effects.

Objective To compare the cardiorespiratory system effects of propofol-remifentanil and etomidate-remifentanil sedation in older patients undergoing diagnostic gastroscopy.Methods 400 older patients undergoing painless gastroscopy in endoscopy center of our hospital were chosen and randomly received intravenous propofol-remifentanil or etomidate-remifentanil sedation and divided into propofol group (n=200)and etomidate group(n=200).The diagnosis,endoscopic insertion time,operation time,wake up time,hemodynamics,adverse reaction and satisfactory of patients in each group were observed.Results There were no difference between two groups in diagnosis(P＞0.05);the onset time was earlier in the etomidate group (P＜0.05).Systolic pressure and diastolic pressure in propofol group were lower than etomidate group during and after operation(all P＜0.05);the heart rate in propofol group were lower than etomidate group after operation(P＜0.05);meanwhile,the SpO2 in propofol group were lower than etomidate group during operation(P＜0.05).All adverse events in propofol group were higher than etomidate group (P＜0.05).Incidences of hyoxemia and injection pain were higher in the propofol group (all P＜0.05),while those of body quiver and myoclonus were higher in the etomidate group (all P＜0.05).However,Satisfaction of physician and anesthetist in the propofol group were better the etomidate group (all P＜0.05).Conclusion Etomidate-remifentanil administration for sedation undergoing painless gastroscopy resulted in more stable haemodynamic responses and less adverse events in older patients.Etomidate-remifentanil administration was worth to be popularized in older patients.

Objective To investigate the clinical and pathogenic features and other related factors of hospital-acquired bloodstream infections (HABSI) in geriatric wards,in order to provide the scientific basis for clinical diagnosis and therapy.Methods Clinical characteristics and other related factors of HABSI in patients admitted to the Department of Geriatrics of our hospital from June 2010 to October 2015 were retrospectively analyzed.Results Of the 64 elderly patients with HABSI,malignant tumor (39.1％) and type 2 diabetes mellitus (32.8％) were among the main disorders for their admission to the hospital.There were 53 cases of primary bloodstream infections and 11 cases of secondary bloodstream infections,accounting for 82.8％ and 17.2％,respectively.Primary infections involved mostly the respiratory,urinary and hepatobiliary systems.13 patients died,giving a fatality rate of 20.3％.Multiple logistic regression analysis showed that the retention time of central venous catheters or implantable venous access ports was ≥ 7 days (OR =49.51) and the duration of proton pump inhibitor administration was ≥3 days (OR=13.63),and these were independent risk factors for HABSI in elderly patients.A total of 66 strains of pathogenic bacteria were detected from the 64 patients.The most common G+ type was coagulase negative staphylococcus (18.2 ％) and the most common G-bacteria were Escherichia coli (18.2％) and Klebsiella pneumonia (15.2％),with the latter two making up 54.5％ of the extended-spectrum β-lactamase (ESBL)-producing strains.Conclusions HABSI can seriously affect the prognosis of elderly patients.Reduction in invasive procedures,active prevention and treatment of tumors,improvement of the internal environment and protection of vital organ functions are the main measures to reduce the bloodstream infection rate in geriatric wards.

Objective To investigate the clinical characteristics and prognosis of acute myocardial infarction (AMI) combined with ventrical septal perforation (VSP).Methods Fifty-seven AMI + VSP patients were retrospectively analyzed their clinical characteristics and outcomes who were treated in the Fourth People' s Hospital of Shenyang and the First Hospital Affiliated to China Medical University from June 2000 to May 2014.Results Of all patients,43 (75.4％) VSP occurred anterior wall AMI,and 14 (24.6％) were not.Echocardiogram show the end diastolic diameter of left ventricle was (53.7 ± 9.5) mm,left ventricle ejection fraction was (48.5 ± 11.8)％,VSP diameter was (9.8 ±7.9) mm,and 37(64.9％) were with near apex.The level of cardiactroponin I,C-reactive protein,and N terminal of B type natriuretic peptide of patients were (16.7 ± 12.9) μg/L,(99.7 ± 31.40 mg/L,(3 051.2 ± 879.7) μg/L.Total mortality was 71.9％ (41/57) in 30 days and 78.9％ (45/57) in 1 year.The mortality of operation group was 73.9％ (17/23) in 30 days and 91.3％ (21/23) in 1 year.The mortality of consecutive therapy was 64.7％ (22/34) in 30 days and 76.5％ (26/34) in 1 year.Conclusion The mortality of AMI + VSP is higher and operation is the most effective therapeutic method.

Objective To examine the relationships among measures of gait recovery and community integra-tion index in people with brain injury.Methods 142 brain injured patients were chosen in this study.Community Balance and Mobility Scale,Dynamic Gait Index,Ten-Meter Walk Test for gait speed,and the Community Integration Questionnaire (CIQ) was measured.Results Average walk speed was 0.31-5.30 (1.36 ±0.88)m/s;DGI score was 5-24 (18.6 ±5.44) points;CMBS score was 0 -96 (54.1 ±25.3) points;CIQ subscale 6 -29 (16.2 ± 5.1)points,CIQ family subscale was 0-10 (4.8 ±3.0)points;CIQ society subscale was 4-12(8.2 ±2.1)points;CIQ productivity subscale was 0-7(3.8 ±2.2).The correlation between age and Ten-Meter Walk Test was nega-tive significantly (r=-0.50,P<0.05).All 3 balance/gait measures correlated significantly with the CIQ Productiv-ity subscale (r=0.35-0.58,P<0.05).Conclusion The ability of people with brain injury to engage in work/school/volunteer activity may be reduced by impairments in balance and mobility.