Objective To investigate the effect and safety of Compound codeine phosphate syrup with Ambroxol treatment in the stable phase of chronic obstructive pulmonary disease. Methods 100 patients with stable COPD were divided into Compound codeine phosphate syrup with Ambroxolt treatment group (Group A) 50 cases and Compound codeine phosphate syrup treatment group( Group B) 50 cases,drug were given for 3 ～ 7d. The symptom score and efficacy of two groups before treatment and after treatment were compared. Results The symptom score of cough,sputum volume,sputum viscosity ,wheeze,sleep after treatment 8th day were improved significantly ( χ2 = 3. 891 ,χ2 =3. 992, χ2 = 4. 198, χ2 = 3.981, χ2 = 3. 879, allP < 0. 05; Total effective rate of cough, sputum volume, sputum viscosity,wheeze in group A(92. 0% ,94. 0% ,90. 0% ,90. 0% ) higher than that in group B(80.0% ,86.0% ,80. 0%,78.0% ) ( χ2 = 3.991, χ2 = 4. 012, χ2 = 3. 998, χ2 = 3.971, allP < 0. 05); The adverse reactions of A、 B group were 12.0% and 14.0%(χ2 =1.971,P>0.05). Conclusion Compound codeine phosphate syrup with Ambroxol is an effective and safe antitussive in the stable phase of chronic obstructive pulmonary disease.

OBJECTIVE:To provide reference for the establishment of clinical skills evaluation system in students majored in clinical pharmacy and pharmacy of China. METHODS:Retrieved from pharmacy OSCE literatures and the related websites,phar-macy OSCE contents and evaluation in the United States,the United Kingdom,Canada,Japan,Malaysia and other countries were introduced to provide suggestions for clinical skills evaluation system in students majored in clinical pharmacy and pharmacy of Chi-na. RESULTS & CONCLUSIONS:OSCE had widely applied in medicine,nursing and other professional clinical skills,the United States,the United Kingdom and other countries had applied OSCE into pharmacy,and confirmed its important role in assessment of clinical competence in pharmacy students. There was no uniform standard in OSCE,and OSCE examinations were slightly different in different countries and different schools. Pharmacy OSCE usually based on school courses such as pharmacotherapy,clinical pharmacokinetics,medicine information,pharmaceutical care,doctor-patient communication,identification and solving ability of clinical drug-related issues. Numerous college of pharmacy in domestic colleges and universities has added the practice-based cours-es,but evaluation system and assessment methods are poor. Almost no OSCE is applied for the assessment of pharmacy students. OSCE has short application time in pharmacy education and relatively less study,therefore,pharmacy OSCE in foreign countries should be learnt to assess clinical skills of pharmacy students,establish and improve the pharmacy OSCE that is suitable for China by combining with the pharmacy education status.

Objective To evaluate the MRI and clinic types of oxfordshire community stroke project(OCSP)in the diagnosis of acute young ischemic stroke patients.Methods 1 64 young patients (18-45 years)and 228 old patients (>60 years)with acute ischemic stroke were analyzed retrospectively.There are four groups according to MR and clinic types of OCSP:total anterior circulation infarct (TACI),partial anterior circulation infarction (PACI),posterior circulation infarction(POCI)and lacunar infarction (LACI).Results Cerebral infarction showed a mild hypo-signal on T1 WI,hyper-signal on T2 WI,FLAIR and DWI.Among the 164 young patients,8 (4.88%)were classified as TACI,72 (43.90%)as PACI,30 (18.29%)as POCI and 54 (32.93%)as LACI.Young and old group image types comparison,χ2 = 1.221,P >0.05.Young stroke patients image and clinical types comparison,Kappa =0.525,P <0.05.Conclusion OCSP imaging types has a good consistency with clinical types,which helps to evaluate ischemic stroke objectively in youth.

Objective To explore the clinical features, imaging and their diagnosis vaule of Baló's concentric sclerosis (BCS). Methods The clinical manifestation, laboratory examination, neuroimaging characteristics, pathology and follow-up of 12 (2 outpatients and 10 inpatients) cases of BCS were analyzed retrospectively. Results The onset age of 12 patients (male 4, female 8) ranged from 8 to 54 years old (mean 36.8 years). Unconcerned and slowness response were common in the disease onset (7 cases).Other symptoms and signs such as hypophrenia ( 10 cases), limitation of limb or hand movement (8 cases),urinary and fecal incontinence (7 cases), hypo-myodynamia (7 cases), positive pyramidal sign (6 cases)were not rare in course of disease. Eight cases underwent the examination of cerebrospinal fluid myelin basic protein, which increased in 7 cases. Demyelinating change and perivascular inflammatory infiltration were shown in 6 brain biopsies. The involvements of multi-lesions were found in 11 cases. Four patients underwent CT scanning and all the cases showed with hypodense lesions and couldn' t be enhanced. On MRI, all cases appeared round or round-like in shape. Enhanced lesions showed ring-like or half-ting-like shape (8 cases) and concentric ring (3 cases). It's easy to be misdiagnosed as brain tumor (8 cases).Conclusions BCS is a kind of demyelinating disease of subacute or chronic onset accompanied with cognitive disorder being the most common initiating symptoms. It's prone to be misdiagnosed. Diagnosis depends on MRI and corticosteroid treatment is effective. BCS has a good prognosis and presents with benign clinical course.

Teaching ability is the comprehensive embodiment of expertise and personal cultivation,and it is closely related to teaching results.The teaching ability of teachers in the field of traumatology and orthopedics of TCM is developed in their practice of clinical work and teaching practice,which reflects the efficiency and quality of their classroom teaching and clinical teaching.The elements of teaching ability in the field of traumatology and orthopedics of TCM should be strengthened by approaches such as professionalism,the ability of teaching design,the expertise of modem educational technology and professional dedication.

Objective To evaluate the efficacy of nimodipine combined with cerebrospinal fluid exchange in treating subarachnoid hemorrhage (SAH) .Methods The electronic databases and manual retrieval ,and the meta-analytic method were used to conduct the systematic evaluation on the efficacies of nimodipine combined with cerebrospinal fluid exchange versus routine internal medicine therapy for treating SAH in all the included randomized controlled trials (RCTs) .Results 16 RCTs(n=1 076) were included .The methodological quality of all included trials was poor .Compared with the routine internal medicine therapy ,nimodipine combined with cerebrospinal fluid exchange could reduce the occurrence of cerebral vasospasm (RR 0 .33 ,95% CI 0 .25-0 .43 ,P<0 .01) ,hy-drocephalus(RR 0 .28 ,95% CI 0 .18-0 .44 ,P<0 .01) and mortality after SAH (RR 0 .41 ,95% CI 0 .24-0 .70 ,P=0 .001) ,while no difference was found in the occurrence of re-bleeding between two groups(RR 0 .89 ,95% CI 0 .53-1 .50 ,P=0 .67) .Conclusion The current clinical research evidences demonstrate that the combination of nimodipine and cerebrospinal fluid exchange can re-duce the occurrence of cerebral vasospasm and hydrocephalus ,decrease the mortality after SAH But further well-designed multi-center RCTs with larger sample should be carried out to confirm our findings due to the influence of the poor quality of included tri-als .

With the widely development of psychiatric clinical researches,the ethical issue has been concerned gradually.Although the ethical review has strict rules on informed consent,there are many problems and challenges on informed consent implementation because of the special mental illness population.According to the relevant laws and regulations,combined with the characteristics of clinical psychiatric researches,this paper discussed the protection of subjects' fights and interests during the implementation of informed consent in psychiatric clinical researches,from the following aspects:providing a quiet,comfortable,and relatively independent environment for the participants to ensure informed consent,guaranteeing full informed consent time,choosing qualified researchers for informed consent,ensuring the effective process of informed consent,and guiding the subjects to correctly sign their names and the date.

Objective To summarize the clinical features, neuroimaging findings and pathological characteristics of 26 patients with tumor-like inflammatory demyelinating diseases (TIDD) confirmed by histopathology for better diagnosis and differential diagnosis. Methods The clinical features, neuroimaging findings and pathological characteristics of 26 patients (14 male, 12 female) with pathologically proven TIDD(24 brain-type and 2 spinal cord-type ) were retrospectively analysed. Results The mean onset age was 6-69 (36.7±13.8) years. Twenty-one patients had good prognosis with a median followed-up duration of 51.0 months. Two patients were died of post-operative complication and pulmonary infection respectively and the remaining 3 patients were lost to followed up. The TIDD patients almost showed monophasic clinical setting. Headache, indifference accompanied with hypomnesis were the commonest initial symptoms. The positive or abnormol rates of cerebrospinal fluid oligoclonal bands (OCB) and myelin basic protein (MBP)in TIDD patients were high. The involvements of bilateral and multi-lesions were commonest in TIDD (61.5%, 65.4% respectively). Twenty-two patients with CT unenhanced scanning showed hypodense lesions. Long T1 and long T2 signal intensity was showed on MRI and most cases apeared round-like lesion in shape. Acccording to the shape of enhancement of the 23 patients performed with contrast agents, 11 were shown with open-ring enhancement, 4 cases (including 2 accompanied with open-ring enhancement) with complete ring enhancement, 3 with asymmetrical dotted enhancement, 2 with diffused even enhancement,and no enhancement was seen in the other 6. Furthermore, 14 cases with DWI and 12 with FLAIR all appeared hyperdensity. The typical pathological changes were demyelinating, perivascular inflammatory cells infiltration and reactive gliosis. Occationally, the Creutzfeuldt cells were also found in brain tissue of some patients. Conclusions TIDD is a distinct demyelinating disease entity. In spite of being apt to be confused with the neoplasm in brain and spinal cord. TIDD has its own-features, for example, OCB is frequently positive in patients with TIDD and the level of MBP may be significantly increased. Furthermore, the involvements of bilateral and multi-lesions are the common in TIDD, and most cases showed open-ring enhancement or complete rim enhancement on MRI. In addition, all cases present hypodense lesions on unenhanced CT and patients with hyperdense seemed not to be considered as TIDD.

Objective To compare the expression of mIFN-γ, replicative activities and anti-tumor activities of CNHK300-mIFN-γand Ad-mIFN-γin normal and gastric cancer cells. Methods The replicative activities of viruses in cells were measured by viral replication assay. CPE assay was used to detect the antitumor effect of viruses. The expression level of mIFN-γ in cancer cells was detected by ELISA. Results The infection of CNHK300-mIFN-γled to an obvious expression of mIFN-γin gastric cancer cells. The vector system CNHK300-mIFN-γpossessed more replicated potential than Ad-mIFN-γ, and could specifically kill most of BGC-823 cells at MOI value of 0.1, which was much better than that by the traditional adenoviral vector. Conclusion CNHK300-mIFN-γcan selectively replicate and effectively express mIFN-γ in tumor cells, and specifically kill gastric cancer cells, suggesting a splendid future as a new anticancer agent.

Objective To observe the electrophysiological changes, especially in the examination of external anal sphincter electromyography ( EAS-EMG), with those patients diagnosed as multiple system atrophy ( MSA), Parkinson's disease (PD) and late-onset spinocerebellar ataxia (LOSCA) and explore its clinical diagnostic value as well as differential diagnostic value for the three diseases. Methods The clinical data, cranial magnetic resonance imaging (MRI) data as well as results of EAS-EMG for 3 groups patients, including 88-cases MSA, 69-cases PD and 18-cases LOSCA, were analyzed retrospectively.Results EAS-EMG showed that 84 cases (95.5%) in MSA group had varying degrees of neurogenic injury. Meanwhile, mean motor unit potentials (MUPs) duration (( 12.92 ± 2.59)ms), mean MUPs amplitude ( ( 648.6 ± 251.0 ) μV ), and MUPs polyphasicity ( percentage of polyphasic MUPs; 42. 6% ±21.2% ) in MSA group were significantly different from those in PD ( ( 8. 99 ± 0. 47 ) ms, (470. 0 ±91.9) μV, 24.2% ±11.0%) and LOSCA groups ((9.04 ±0.62)ms, (493.1 ± 113.7)μV,22.0% ±12. 1%; Welch:94. 240,18. 093,26. 710,all P =0. 000). The spontaneous potentials and satellite potentials showed more common in MSA group, but not in other groups. Conclusions MSA and PD and LOSCA are easily mutually misdiagnosed because of some similar syndromes, but the method of EAS-EMG could be effective and helpful to enhance accurate diagnostic rate of MSA and its differential diagnosis with PD and LOSCA.