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.

Objective To observe the effect of octreotide combined with percutaneous catheter drainage on pancreatic pseudocyst ( PPC ) .Methods 89 patients choosen with PPC were randomly divided into the octreotide combined with percutaneous catheter drainage group(observation group,n=43) and octreotide group (control group, n=46).The control group were subcutaneous injected octreotide 0.1mg q 8 h.The observation group were subcutane-ous injected octreotide 0.1mg q 8 h with ultrasound or CT-guided percutaneous drainage for 4 weeks to place more drainage tubes when there were multiple cysts,drainage not free when washing drainage tube and drainage tube posi-tion adjustment.After 4 weeks rechecked the pancreas CT and curative effect was analyzed.Results The observation group cure rate and total effective rate were 65%,100%,the average hospitalization time was (16.8 ±12.1) d.The control group were 39%,85%,(26.8 ±19.4) d,the differences between the two groups were statistically significant(χ2 =6.01,χ2 =7.10,t=2.89,P<0.05,P<0.01).Conclusion Octreotide combined percutaneous catheter drainage on PPC has good curative effect,small trauma,high success rate,less complications,shorter hospitalization time.It is the preferred method for the treatment of PPC.

OBJECTIVE:To establish phenol-sulfuric acid method for the determination of the content of total polysaccharides in Weile granules.METHODS:The samples were deproteinized by Sevag method,colored by phenol-sulfuric acid method(water bath at 60 ℃ for 30 min),and the content of total polysaccharides in Weile granules was determined with Glucose as control.RESULTS:The linear range of Glucose was 20.47～102.36 ?g?mL-1(r=0.999 4),with an average recovery of 99.09%(RSD=0.92%,n=6).The content of total polysaccharides in Weile granules was 41.63%.CONCLUSION:This method was simple,accurate and reproducible,and suitable for quality control of Weile granules.

Objective To explore the methods and effects of the general resident nurse on duty system,and thereby to play an effective role of skilled nurses to ensure the quality and safety of nursing.Methods Using the management experience of general resident doctors for reference,a general resident nurse on duty system was established.The general resident nurses were strictly selected,trained and examined.At the same time,the management regulations were formulated.Results This practice cultivated a general resident nurse team with well-prepared nursing knowledge,skilled techniques,good capacity to cope with emergency,which could play important roles in the guidance and quality control of clinical nursing.Conclusion The implementation of general resident nurse on duty system can help train the backbone of specialized care,reserve the force of handling emergency and improve the quality of nursing.

A systematic review is based on randomized controlled trials (RCTs), and the reliability of its conclusion is closely related to the quality of original literature. The low quality of existing RCTs in China leads to the failure of conclusive findings in systematic reviews when evaluating the effectiveness of interventions. It is almost universal for systematic reviews to draw the conclusion that "further well-designed multicenter and large-scale RCTs are still required to confirm the beneficial effects of interventions". This paper analyzed the current status of RCTs in China, discussed the influence of including trials of low quality in a systematic review and assessed how a systematic review should be carried out under such circumstances. Furthermore, the methods to evaluate the quality of RCTs were introduced and evaluated. Finally, several strategies were proposed to improve the quality of RCTs in China: foster an honest academic and social environment, enhance the training of doctors on clinical research methodology, promote the implementation of clinical registration systems and strengthen the quality control of clinical research and the medical journals regulations on the quality of submitted papers.

Case based learning(CBL)is one of the teaching modes in clinic education and it is important to explore its teaching methods and qualities.This article discussed on how to use debate in CBL in neurology teaching for seven-year-program students including its organization,topic choosing,rules and specific process in order to provide references for teaching reform.

Objective: To investigate the effects of alcohol, chitosan、 101 juice clarifying agent and ZTC natural clarifying agent on content of active components and the solid compositions in zhonglizhikang decoction. Methods: The solid compositions of different samples were determined by the methods adopted in pharmacopeia, and the chrysophanol content was determined by HPLC. Results: Chitosan has no effect on the content of chrysophanol, and solid compositions decreased by 30.8%. But alcohol、 101 juice clarifying agent and ZTC natural clayifying agent can decrease solid compositions and the content of chrysophanol. Conclusion: Chitosan can decrease solid compositions but has no effect on the content of active components.

Objective To evaluate the clinical value of highfrequency ultrasonography in diagnosis of the complications in mammoplasty.Methods One hundred and one cases of mammoplasty with complications were examined.They were divided into implanted group and injected group,and the prosthetic position,shape,internal echo and capsula were observed.Results Among the cases,91 breasts were capsular contraction and hardening,24 were asymmetry,38 were rupture,4 were infection and 1 was bleed.All cases were proved by operation.Conclusion High-frequency ultrasonography was easy and effective to diagnose the complications of mammoplasty.

The evaluation on clinical efficacy of traditional Tibetan medicine (TTM) is an important scientific subject during the development of TTM. Firstly, the authors introduced the current situations and problems in evaluation on clinical efficacy of traditional Tibetan medicine both at home and abroad in this study. Secondly, they compared the similarities and differences between TTM and traditional Chinese medicine (TCM) in evaluation on clinical efficacy, define their differences in details but not in nature, and proposed that TTM could selectively learn TCM's experiences in clinical research and build a specific methodology system for evaluation on clinical efficacy according to its own characteristics. Thirdly, they discussed the methodological challenges in evaluation on clinical efficacy of TTM, including the pending clinical research guidelines and disease diagnosis standards according to its own characteristics. Finally, they propound some suggestions for promoting the evaluation on clinical efficacy of TTM, including the comprehensive application of multiple research methods, overall research-based evaluation on efficacy of TTM complex intervention and selection of accepted and objective outcome indexes for efficacy evaluation.
Biomedical Research ; Clinical Trials as Topic ; Drug Evaluation ; methods ; standards ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Tibetan Traditional ; Treatment Outcome

Objective Carry out the reform of the online learning mode of prehospital training for refresher doctors , and evaluate the effect of reform in Peking Union Medical College Hospital .Methods An exploration was carried out on the refresher doctors prehospital training mode from traditional classroom teaching to online learning , Estab-lished the online learning system .Evaluated the effect of online learning by the way of questionnaire investigation andreexaminationamong289refresherdoctors.Results 289refresherdoctorshavecompletedthestructuredon-line courses of prehospital training , and the average pass rate of the first test was 42.2%.The questionnaire and retest was conducted , A total of 262 doctors completed the work , The recovery rate was 90.7%, and the average pass rate of retest was 74.9%, showing improvement by 32.7%.Conclusions Online learning mode is an effec-tive tool for knowledge dissemination , and has a better learning effect .