Based on the analysis of the problems of traditional medical literature retrieval teaching,taking North Sichuan Medical College as an example,the paper discusses the reform practice of medical literature retrieval course teaching from the aspects of enriching teaching contents,constructing literature retrieval excellent resource shared course,online practice and examination platform and controlling teaching quality strictly,etc.

OBJECTIVE: To investigate the clinical features and medication of unilateral idiopathic vocal fold paralysis. METHOD: Thirty-nine of medical treated patients with unilateral idiopathic vocal fold paralysis were retrospectively studied, and relevant literatures were reviewed. RESULT: After 4 to 19 days of medical therapy, 9 patients were cured, the vocal fold movement of 18 sufferers were improved, and 12 pantients were not healed. CONCLUSION Unilateral idiopathic vocal fold paralysis is common, and the treatment efficacy of medicine is almost the same with others. Unilateral idiopathic vocal fold paralysis is a disease with spontaneous recovery, which should be followed up.
Humans ; Retrospective Studies ; Treatment Outcome ; Vocal Cord Paralysis ; drug therapy ; Vocal Cords ; physiopathology

BACKGROUND: After reviewing the literature, the author found that most of the epidemiological data related to cancer pain was reported by physicians from the point of view of treatment, or of patients' response to the treatment. Although the nurses in oncology department are most direct participants in the cancer pain management, there is less investigation about the nurses' knowledge, attitudes to and skills of cancer pain management.OBJECTIVE: The purpose of this investigation was to provide information so as to suggest the nursing managers and educators in specifically propagating and disseminating the knowledge of cancer pain management.DESIGN: A sampled investigation.SETTING: Integrated Medicine Ward, College of Clinical Oncology,Peking University.PARTICIPANTS: The participants of this investigation were 128 nurses who took part in the National Tumor Care Academic Exchanges and Seminar Conference held in June 1998.METHODS: This investigation was carried out through a survey questionnaire and the questionnaire was designed on the basis of the Cancer Analgesics Questionnaire (for nurses use only) established by the Oncology Profession Committee of Chinese Nursing Association in 1993, furthermore,suggestions from experts were adopted.MAIN OUTCOME MEASURES:①The perception about "three-step analgesic ladder";②currently most commonly used analgesics in clinical;③assessment methods for cancer pain④knowledge of being addicted to analgesics⑤attitude of nursing staff to cancer pain management.RESULTS: The number of those who could correctly designate the relationship of three steps and pain intensity was 82(64.0% ). Only one person could correctly write down the contents of three steps analgesic ladder (0.7%) . Physician's orders for analgesics for cancer pain in the responders' hospitals were classified into the following types: temporary order:54.0%; when necessary, 38.0%; long-term order, 24.0%. But none of the nurses could mark correctly the range of mild, moderate and severe grade on the scale. Only 49.2% (63/128) of the nurses considered that "The pain scale should be determined according to the cancer patients' self-perception to the pain intensity(chief complaint)" . Among the responders, only 12.5% (16/128) of them accepted that "the incidence of addiction occurred as a result of analgesics used for pain control is less than 1% ". Only 26. 5% (34/128) of the responders could distinguish the concepts of tolerance, physical dependence, and addiction.CONCLUSION: From the results of the investigation, we can see that, the nursing professionals do not have sufficient knowledge about "three-step analgesic ladder". The popularization of related knowledge among nurses has been delayed severely. Nurses will obtain the knowledge of cancer pain management by clinical experience instead of in regular ways. The attitude of nursing personnel to cancer pain treatment is one of the important factors that affect the pain management. The frontline nurses should master the pharmacological characteristics of opioids so as to explain it to the patients and their relations distinctly. Nurses should bring into play a more powerful action in reducing the "addiction-phobia" due to their professional characteristics. We suggest that the latest new progress in cancer pain treatment should be incorporated into the normal textbooks on the management of cancer pain. We also propose that the methods of cancer pain treatment,contents of the principle of drug prescription be included in the training of a medical care personnel of oncology professional before entering into clinic.

Objective To explore the relationship between quality items of chest compression for resuscitation of cardiac arrest and to identify the key points in chest compression training and practice.Method The training project was offered to 219 healthcare workers by using Laerdal ACLS advanced life support resuscitation model, and the quality issues of chest compression were monitored including compression hands placement,compression rate,compression depth,and chest wall recoil,as well as selfreported fatigue time by Laerdal Computer Skills and Reporting System.Results The quality of chest compression was related to the geuder of the practitioner.The items in males including self-reported fatigue time,the accuracy of compression depth and the compression rate,the accuracy of compression rate were higher than those in females.However,the chest recoil rate was higher in females than that in males.The quality items of chest compression were correlated with one another. The self-reported fatigue time was related to all the items except the compression rate.Conclusions It is necessary to offer cardiopulmonary resuscitation (CPR) training courses regularly. In clinical practice,it might be better to change the practitioner before fatigue,especially for female or weak practitioners.In training projects,more attention should be paid to the control of compression rate, in order to delay the fatigue, guarantee enough compression depth and improve the quality of chest compression.

OBJECTIVE:To compare the efficacy and safety of ferrous succinate or Shengxuening in the adjuvant treatment of renal anemia in patients with diabetic nephropathy peritoneal dialysis (CAPD). METHODS:64 diatetic nephropathy CAPD pa-tients with renal anemia were randomly divided into observation group (32 cases) and control group (32 cases). All patients re-ceived subcutaneous injection of insulin for blood glucose control (adjusted the insulin dosage based on fasting blood glucose lev-els),hypertension patients actively controlled blood pressure,corrected acid-base and electrolyte balance disorders,orally received fo-lic acid and vitamin B12,ambulant CAPD,then rhEPO was subcutaneously injected with initial dose of 100-150 U/(kg·week) for 2-3 times and other conventional treatment. Based on it,observation group received 1 g of Shengxuening tablet,3 times a day;control group received 0.2 g Ferrous succinate tablet,3 times a day. The treatment course for both groups was 16 weeks. The rhEPO dose was monthly adjusted to make Hb 100-120 g/L. Clinical efficacy,serum iron,serum ferritin,total iron binding capacity,transfer-rin saturation before and after treatment,Hb,Hct,hs-CRP,rhEPO dose before treatment and after 4,8,12 and 16 weeks of treat-ment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:There was no significant difference in the total effective rate between 2 groups (P>0.05). After treatment,serumiron,total iron binding capacity,transferrin saturation,Hb and Hct in 2 groups were significantly higher than before,and it gradually increased by treatment time,serum ferritin,hs-CRP was sig-nificantly lower than before,and it gradually decreased by treatment time,the differences were statistically significant(P<0.05);but there was no significant difference between 2 groups(P>0.05). The rhRPO dose in observation group 8,16 and 16 weeks af-ter treatment and in control group 8 weeks after treatment were significantly lower than 4 weeks after treatment,and 12 and 16 weeks after treatment in observation group were lower than control group,the differences were statistically significant (P<0.05). The incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). CONCLUSIONS:Based on conventional treatment,both ferrous succinate and Shengxuening show good ef-ficacy in the adjuvant treatment of renal anemia with diabetic nephropathy CAPD,both can improve anemia and iron metabolism, while Shengxuening is superior to ferrous succinate in terms of improving microinflammatory state and reducing rhEPO dose,with better safety.

Objective To understand information on cognitive and demand of chronic kidney disease(CKD) patient to contin‐uing nursing .Methods Adopting stratified random sampling method took samples 200 CKD patiens who were treated at kidney disease of internal of general hospital form March to June 2014 .Self‐made questionnaire was used to survey cognitive and demand of chronic kidney disease patient to continuing nursing .Results Totally 200 questionnaires were gave out and 184 of them were taken back ,efficient rate is 92% .First ,cognition :10 .32% CKD patiens knew the meaning of continuing nursing ,9 .24% CKD patiens knew the content of continuing nursing ,12 .50% CKD patiens knew the role of continuing nursing .Second ,demand :65 .76% -95 .11% CKD patiens had demand on disease treatment knowledge ,individual diet guidance ,regular telephone follow‐up ,and regular follow‐up nurse ;38 .04% - 53 .26% CKD patiens had urgent demand on individual diet guidance ,free health consultation ,and regu‐lar follow‐up nurse ;28 .89% CKD patiens had demand on electronic health record .Conclusion The cognitive of CKD patiens to continuing nursing is low and the demand is high .Hospital should to actively develop the continuation of local nursing service .

OBJECTIVE: To analyze the clinical features and treatment of tuberculous otitis media and mastoiditis. METHOD: Thirteen patients with tuberculous otitis media and mastoiditis were retrospectively analyzed and the related literatures were reviewed. One case was treated by surgery only, and anti-tuberculosis treatment was given to another one patient, and surgical removal of disease lesions in combination with anti-tuberculosis treatment were given to 12 patients. RESULT: One patient received surgery only was found to recur after follow-up for seven months. The patient did not recur after seven months' follow-up after antituberculosis therapy,and other patients did not recur. CONCLUSION Although the regular anti-tuberculosis chemotherapy treatment was the main treatment for tuberculous otitis and mastoiditis, surgical treatment was helpful to achieved more rapid healing of the ear.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Mastoiditis ; microbiology ; Middle Aged ; Mycobacterium tuberculosis ; Otitis Media ; microbiology ; Retrospective Studies ; Tuberculosis ; Young Adult

OBJECTIVE:To investigate the compatible stability of Levetiracetam(Lev)injection with 3 injections. METHODS:Each Lev injection 1000 mg mixed with 0.9% Sodium chloride injection 100 mL,5% Glucose injection 100 mL or Sodium lactate Ringer's injection 100 mL respectively. Under the light condition,at 25 ℃,the color and clarification degree of mixtures were ob-served at different time points within 24 h after mixing;pH value and the number of insoluble particles were determined. The contents of related impurities(impurity A,B,C,D,2-hydroxypyridine)and Lev in mixtures were determined by HPLC. RESULTS:Under above condition,all mixtures were colorless clear liquid within 24 h;pH value had no significant change (RSD<1%,n=7);the number of insoluble particles was no more than the range stated in Chinese Pharmacopeia(2015 edition). Impurity B and C were not detected;the contents of other impurities were in line with the requirements of foreign pharmacopeia. No marked change was noted for relative content of Lev(RSD<1%,n=7). CONCLUSIONS:After mixing with 0.9% Sodium chloride injection,5% Glucose injec-tion or Sodium lactate Ringer's injection,Lev injection keep stable at 25℃within 24 h under the light condition.

Objective To investigate the changes of fractalkine (FKN) in rat model of acute liver failure (ALF) and the role of FKN in liver inflammatory injury.Methods SD rats were divided into tWO groups:6 in normal group and 36 in model group.D-galactosamine(D-Gal) was used to induce ALF in model group.The sera and hepatic tissue samples were collected at 12,24,48,72,120 andl68 h.After D-Gal injection.FKN mRNA and nuclear factor(NF)-kB mRNA in hepatic tissue samples were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) at 12 h were(208.3±43.5)U/L and (375.2±117.3)lJ/L,respectively,which were both significantly higher than those in normal group[(31.8±2.9)U/L and (90.8±3.1)U/L](t=-9.912 and-5.935,respectively,both P<0.01);the levels of ALT and AST peaked at 72 h after D-Gal injection.The levels of FKN mRNA(O.086±0.009)in model group at 12 h were significantly higher than those (O.044±0.009) in normal group(t=-7.999.P<0.01),and peaked at 72 h (O.333±0.033),then decreased obviously at 120 h. The levels of NF-KB mRNA in the liver of normal rats were very little;and the levels in model group were increased gradually over time,then peaked at 72 h (O.583±0.i01,t=-12.607,P<0.01).FKN mRNA and NF0kB mRNA were positively correlated (r=0.760,P<0.01).Conclusion The FKN expression may play all important role in liver inflammatory injury in rat model of acute liver failure, which could provide a new approach for ALF therapy.

Objective To detect the expression of CK19 in sentinel lymph node for breast cancer and to evaluate its clinical significance.Methods SLNs of 30 patients with breast cancer were successfully detected with methylene blue,both SLN and ALN were examined by hematoxylin and eosin staining ( HK staining). The expression level of CK19 in SLNs were assessed by RT-PCR and Western Blot for mRNA and Protein respectively. Results Detection positive rate of SLN melastases was 26. 67% (8/30) by HE staining,and 1 case of false negative. Through RT-PCR,12 cases,including all the positive cases detected by routine pathological examination,were detected to be positive in the expression of CK19mRNA, with a positive rate of 40. 0% ( 12/30) , and a positive rate of 36. 67% (11/30) for CK19 was observed by Western Blot There was a significant difference between RT-PCR or Western Blot methods and routine pathological examination ( P < 0.05 ) for the detection efficiency of SI.Ns melastases. Conclusions CK19rnRNA may be a potential tumor marker for detecting micrometastasis in SLNs of breast cancer. The combined utilization of locating SLNs and detecting CK19 mRNA expression by RT-PCR instead of histopathological examination can greatly enhance the detection efficiency of SLN micrometastasis of breast cancer.