The Delphi technique was used in the study. Through consulting the panel experts, indicators and their weights were achieved accordingly. Altogether, thirty experts were invited to reply to two rounds of questionnaires. Evaluating system of the medical continuous education was set up.

Objective:To investigate the clinical efficacy and safety of Reduning injections in the treatment of infantile rotavirus enteritis. Methods:Totally 102 cases of infantile rotavirus enteritis in our hospital from June 2012 to June 2013 were randomly divided into two groups, the control group had 50 patients, and the treatment group had 52 cases. Both groups were given conventional symp-tomatic treatment, the control group was given 10 mg·kg-1 ribavirin injections in 100ml glucose injections for intravenous infusion, qd, and the treatment group was given 0. 5 ml·kg-1 Reduning injections in 100ml glucose injections for intravenous infusion, qd. Ev-ery 3-day was a course of treatment. The clinical curative effect of the two groups was observed, and the clinical symptoms, hospitaliza-tion time and adverse reactions were also studied. Results:After the treatment, the total effective rate in the control group was 70. 0%, while that in the treatment group was 92. 3%, and there was significant difference between the two groups (P<0. 05). The clinical symptom disappearance time and hospitalization time in the treatment group were significantly lower than those in the control group with statistically significant difference (P<0. 05). During the treatment, the control group had 5 cases of leucopenia and 2 cases of skin rash, and the patients all recovered after withdrawal of the drug, while the treatment group showed no obvious adverse reaction. Con-clusion:The curative effect of Reduning injections in the treatment of infantile rotavirus enteritis is promising, which can effectively improve the clinical symptoms, shorten the course of disease and reduce adverse reactions with the value of clinical application.

Objective To explore the effect of aspirin combined with clopidogrel bisulfate in the treatment of patients with acute cerebral infarction.Methods 486 patients with acute cerebral infarction were selected and divided into the two groups in accordance with the random number table,243 cases in each group.The control group were given aspirin and conventional medical treatment.The observational group were given aspirin and clopidogrel bisulfate orally,system hemorrhage and TT,PT,APTT,FIB of both group were monitored.The efficacy was analyzed in accordance with the degree of neurological deficits score.Results The NIHSS of the observational group after treatment [(6.38 ± 1.19) points] was significantly lower than that of before [(15.04 ± 2.53) points] (P ＜ 0.05);The NIHSS of the control group after treatment [(9.45 ± 3.27) points] was significantly lower than before [(16.26 ± 2.71) points] (P ＜ 0.05);The NIHSS after treatment in the observational group [(6.38 ± 1.19) points] was significantly lower than that of the control group [(9.45 ± 3.27) points] (t =8.264,P ＜ 0.05).The total effective rate of the observational group was 94.24％,which was significantly higher than 81.48％ of the control group(x2 =11.485,P ＜ 0.05).No system hemorrhage was found in both groups.The coagulation index after treatment was higher than before but still in relatively safe range.There was no significant difference of coagulation index between observational group and control group (all P ＞ 0.05).Conclusion Using aspirin combined with clopidogrel bisulfate in acute cerebral infarction patients is safe and effective.

Objective To assess the methodological quality of randomized controlled trials (RCTs) of rheumatoid arthritis (RA) treated with preparations of Tripterygium wilfordii to provide a scientific basis for the improvement of clinical trials and systematic review. Methods CBMdisc (1978-2000) and TCMLRS (1984-2000) were searched for RCTs on rheumatoid arthritis treated with preparations of Tripterygium Wilfordii. Jadad scale and the evaluating scale designed by the EBM methodological research group of Guangzhou University of TCM were used to evaluate the methodological quality of the trials. Results Of the 27 randomized trials included in this study, seven described the methods for randomization and only one had randomized concealment. Blindness was used in six of the trials. Twenty-four of the trials were found to be of low methodological quality with Jadad scores below three. Although all of the trials had their diagnostic standards for subject selection, only 37% described the inclusion and (or) exclusion criteria. Information about drug safety was not reported in 21% of the trials. Conclusions In general, the methodological quality of the studies is disappointing. Many shortcomings exist in the methodology of the included literatures, which calls for future attention to the correct use of the principles of randomization, control and blindness in randomized control trials.

Objective To investigate the clinical effect by early mechanical ventilation and perfluorocarbons gasification inhala-tion on patients with severe acute pancreatitis (SAP) complicated with acute respiratory distress syndrome (ARDS) .Methods 34 cases of SAP and ARDS patients accepted early mechanical ventilation and vaporization of perfluorocarbon inhalation therapy (ob-servation group) ,and 34 patients received mechanical ventilation for early treatment alone (control group) ,The efficacy ,oxygenation index(PaO2/FiO2 ) and inflammatory cytokines IL-1 ,6 ,8 ,and TNF-a level of two groups were compared .Results The total effi-ciency of the observation group was 94 .12% ,which was significantly higher than the control group that was 76 .47% (P<0 .05) . After treatment ,the arterial oxygen saturation (SaO2 ) ,arterial oxygen pressure (PaO2 ) ,PaO2/FiO2 of the observation group in-creased significantly ,and higher than the control group(P<0 .05) .After treatment ,IL-1 ,6 ,8 ,TNF-αof the observation group were significantly lower than the control group(P<0 .05) .Conclusion The treatment of early mechanical ventilation with perfluorocar-bon inhalation gasification could control the inflammation in patients with SAP complicated with AROS ,which could improve the cure rate .

ObjectiveTo observe the effect of multidisplinary treatments on stroke-induced dysphagia.Methods168 stroke patients with dysphagia were randomly divided into the treatment group and control group with 84 cases in each group. Patients of the control group were received routine medication. Those of the treatment group were added with acupuncture, Chinese herb and rehabilitation training. The therapeutic effects of two groups were compared.ResultsThe total effective rate of the treatment group was 92.03%, that of the control group was 72.62%. There was a significant difference between two groups ( P<0.05).Conclusion Multidisplinary treatments including acupuncture, Chinese medicine and rehabilitation training can improve the therapeutic effect of stroke-induced dysphagia.

Objective: By sorting and analyzing pertinent modern studies targeting auricular point therapy treating primary insomnia (PI), to summarize the point selection rules and clinical efficacy of using auricular points alone or combining it with other therapies in treating PI. Methods: A search on China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), PubMed, Springer and Ovid were conducted from January 1, 1998 till January 31, 2020. Point selection, diagnostic criteria and Pittsburgh sleep quality index (PSQI) in the eligible studies were analyzed and summarized. Results: The difference in PSQI before and after using auricular point therapy alone was more significant than that of using Chinese medication alone (P<0.05), but less significant than that of combining auricular point therapy and acupuncture-moxibustion and Chinese therapeutic massage (tuina) (P<0.05). In the included studies, Shenmen (TF4) was the most commonly used (370 times), followed by Heart (CO15), which was 344 times, and Subcortex (AT4), which was 325 times. In terms of auricular points distribution, points in the auricular concha were the most commonly used (1500 times), followed by those in the antitragus (474 times) and triangular fossa (387 times). Correlation analysis showed that Shenmen (TF4) and Liver (CO12), Sympathetic (AH6a) and Heart (CO15) were used together more often, followed by Shenmen (TF4), Liver (CO12), Spleen (CO13), Kidney (CO10) and Subcortex (AT4), and then Shenmen (TF4), Liver (CO12), Sympathetic (AH6a), Subcortex (AT4) and Heart (CO15). Cluster analysis showed that the auricular points used for PI can be divided into 6 clusters in 2 major groups. One group was Heart (CO15), Subcortex (AT4), Shenmen (TF4), Sympathetic (AH6a), Spleen (CO13), Kidney (CO10), Liver (CO12) and Endocrine (CO18); the other was Occiput (AT3), Stomach (CO4), Pancrease-gallbladder (CO11), Chuiqian (LO4), Small Intestine (CO6), Central Rim (AT2,3,4i) and Sanjiao (CO17). In terms of patterns in traditional Chinese medicine, the pattern of dual deficiency of heart and spleen accounted for the largest proportion in the studies of using auricular points alone or combining it with other treatments to treatment PI, and then it was the pattern of liver depression transforming into fire. Conclusion: In treatment of PI with auricular points alone or combo therapy involving auricular points, Shenmen (TF4) was commonly used, and the commonly used point group consisted of Shenmen (TF4), Liver (CO12), Sympathetic (AH6a) and Heart (CO15). Auricular point therapy can be taken as a complementary therapy in treating PI.

Objective To investigate the pharmacodynamics of remifentanil required to prevent laryngeal mask airway (LMA) insertion response in patients anesthetized with propofol by TCI. Methods Thirty-six ASA Ⅰor Ⅱ patients aged 18-59 yr with body mass index ＜ 30 kg/m2 undergoing elective breast operation were enrolled in the study. Propofol was administered by TCI at an effect-site concentration of 4.0 μg/ml. When the patients lost conciousness, TCI of remifentanil was started. The initial target plasma concentration of remifentanil was set at 2.9 ng/ml, and the ratio of two consecutive effect-site concentrations was 1.2. LMA was inserted at 3 min after the target effect-site concentration and the plasma concentration achieved the balance. Criteria of successful insertion were defined as Muzi score≤2 and the increase in MAP and HR≤ 15% of the baseline values within 3 min after insertion. EC50 was determined by modified Dixon's up-and-down sequential trial and the 95 % confidence interval was calculated. Results The EC50 of remifentanil was 2.75 ng/ml. The 95% confidence interval was 2.51-3.01 ng/ml. Conclusion The EC50 of remifentanil for suppression of cardiovascular response to LMA insertion is 2.75 ng/ml in patients anesthetized with propofol by TCI.

BACKGROUND:How to control the orderly formation of colage in skin repair and scarring process is worthy of attention. OBJECTIVE: To investigate the effect of basic fibroblast growth factor (bFGF) combined with insulin-like growth factor 1 (IGF-1) on the proliferation and colagen synthesis of rat bone marrow mesenchymal stem celsin vitro. METHODS:Rat bone marrow mesenchymal stem cels were isolated and cultured to induce adipogenic differentiation assessed by oil red O staining and osteogenic differentiation identified by alizarin red stainingin vitro. Passage 3 cels were cultured in the medium containing bFGF, IGF-1, combination of them or the control fluid, respectively. MTT assay was used to detect cel proliferation at 12, 24, 48, 72 and 96 hours of culture. The expression of type I colagen and type III colagen were detected by RT-PCR and western blot after 10 days of incubation. RESULTS AND CONCLUSION:Compared with the control group, bFGF or IGF-1 alone significantly promoted the proliferation of bone marrow mesenchymal stem cels, and inhibited the expression of type I colagen and type III colagen. After combined use of bFGF and IGF-1, the proliferation of bone marrow mesenchymal stem cels was improved more significantly, and the expression of type I colagen and type III colagen returned to normal levels. These findings indicate that the combination of IGF-1 and bFGF can promote proliferation of bone marrow mesenchymal stem cels and restrain the expression of type I colagen and type III colagen, which may be helpful for control and repair of scar formation during wound healing.

Objectives To validate the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) in hospitalized pediatric patients, and to assess the nutritional status and nutritional risk using STAMP. Methods the nutritional status of hospitalized pediatric patients was investigated by adopting STAMP. The STAMP score≥4 was deifned as a high standard of nutritional risk. Results Among 1 506 hospitalized children, children with high nutritional risk accounted for 26.56%. The overall prevalence of malnutrition and stunting was 19.12%and 10.16%, respectively. There was signiifcant diffe-rence in stunting among each department (P<0.05), which was the highest in department of internal pediatrics. The proportion of patients receiving nutritional support was 10.09%. Among them, the rate of parenteral and enteral nutrition support was 7.84%and 2.92%, respectively. The ratio of parenteral nutrition to enteral nutrition was 2.68:1. After intervention to hospitalized pa-tients with high nutritional risk, the overall prevalence of high nutritional risk decreased from 26.56%at admission to 21.71%at discharge (P<0.05). Conclusions STAMP can objectively relfect the possible malnutritional risk in hospitalized pediatric patients. The nutrition condition of the pediatric patients can be improved through nutritional risk management.