Objective:To explore the therapeutic effect on blood glucose, lipid, and renal function of Bailing capsules combined with calcium dobesilate dispersible tablets in the treatment of diabetic nephropathy. Methods: Totally 216 patients with diabetic ne-phropathy in phase Ⅳ were randomly divided into the control group (108 cases) and the treatment group (108 cases). The control group was given the conventional therapy, and the treatment group was treated with Bailing capsules combined with calcium dobesilate dispersible tablets additionally. The levels of serum creatine (Scr), urean ntrogen (BUN), endothelin (ET-1), β2-microglobulin (β2-MG) ,cystatin C ( CYC) and urinary albumin excretion rate ( UAER) were detected for all the patients before and after the treat-ment. The adverse drug reactions were observed as well. Results:After the treatment, all the indices in the two groups were all obvi-ously decreased (P<0. 05), and those in the treatment group were significantly lower than those in the control group (P<0. 05). There were no significant changes in blood glucose, blood lipid and glycosylated hemoglobin before and after the treatment in the two groups (P>0. 05). The adverse drug reactions showed no significant differences between the two groups (P>0. 05). Conclusion:The effect of Bailing capsules combined with calcium dobesilate dispersible tablets is better than that of calcium dobesilate dispersible tablets in the treatment of diabetic nephropathy in phase IV, which can improve the renal function indices with high safety and without notable influence on blood glucose and lipid.

Objective To compare radiation dose and image quality between prospective electrocardiograph(ECG)-triggered axial seau and retrospective ECG-gated helical scan in coronary 64-slice CT angiography(CTA).Methods Seventy-seven consecutive patients[group A.Average body mass index (BMI):24.6,heart rate＜70 bpm]underwent 64-slice CTA using prospective ECG-triggered axial scan protocol(120 kV,mA tailored to BMI).For each patient,the simulated radiation dose using retrospective ECG-gated scan protocol without ECG-driven X-ray current modulation technology was calculated and recorded at sanle kV and mA.Retrospective ECG-gated scan protocol was performed on 30 consecutive patients in another group(group B.Average BMI:23.9,heart rate＜70 bpm).The image quality was blindly evaluated between group A and B(paired t-test was used and P＜0.05 as a significant difference).Results There Was a significant difference(t=18.50,P＜0.01)between radiation dose of group A (3.37 mSv)and that of group B(18.13 mSv),decreased by 81.4%.The image quality of group A could fulfill clinical diagnostic needs.The average radiation dose of using simulated helical scan without optimization was 17.29 mSv,which wag similar to that of group B(18.13 mSv)(t=0.87,P＞0.05).Condusion Prospective ECG-triggered axial scan in 64-slice coronary CTA Call significantly reduce radiation exposure and the image quality can fulfill clinical diagnostic needs.

Objective:To explore the effects of Bailing capsules combined with salvianolate on inflammatory cytokines, renal vas-cular endothelia and renal function in diabetic nephropathy inⅣphase. Methods:Totally 60 patients with diabetic nephropathy in IV phase were randomly divided into the control group (30 cases) and the treatment group (30 cases). The control group was given the conventional and salvianolate therapy, and the treatment group was treated with Bailing capsules additionally. The treatment course was 3 months. The changes of serum creatine(SCr), urean itrogen (BUN), creatinine clearance rate (Ccr), ethelin (ET-1), interleukin-6 (IL-6), tumor necrosis factor (TNF-a) and C-reactive protein (CRP) were detected before and after the treatment. Results:After the 3-month treatment, SCr, BUN, IL-6, TNF-a, CRP and ET-1 were significantly decreased in the two groups with statistical signifi-cance, and Ccr was significantly increased in the treatment group (P<0. 05), and the changes in the treatment group were significant-ly better than those in the control group (P<0. 05). After the treatment, the blood glucose, blood lipids, glycosylated hemoglobin and the other indicators had no significant changes in the two groups (P>0. 05). There was no significant difference in the incidence of adverse drug reactions between the two groups (P>0. 05). Conclusion:The combination of Bailing capsules and salvianolate can re-duce the inflammatory reaction and improve renal vascular endothelial function and renal function in the patients with diabetic nephrop-athy in Ⅳ phase with promising safety and few adverse reactions.

OBJECTIVE:To provide reference for improving pharmaceutical care in the construction of medical union. METH-ODS:Based on the work practice of the author,the status of the pharmaceutical care in the construction of medical union was ana-lyzed,and the reasonable suggestions were put forward from the aspects of clinical pathway,drug purchasing,information con-struction,pharmacist training and residents'awareness of durg use,etc. RESULTS:There were some problems in pharmaceutical care of medical union,such as the level of knowledge and guidance ability in pharmaceutical staff were different;catalogue of drugs supplied by medical institutions of different levels were inconsistent;patient information could not be shared and exchanged;prescription automatic screening system was seriously inadequate. In view of these problems,it was suggested to solve these prob-lems in five aspects,such as implementing clinical pathway,promoting standard disease diagnosis and treatment;realizing unified procurement of drugs in medical union,guaranteeing homogenization of drug supply;establishing information platform for medical union,realizing information integration;establishing pharmaceutical alliance in medical union,updating pharmaceutical knowl-edge;building WeChat public service platform,improving awareness of medication safety among residents. CONCLUSIONS:With the rapid development of social economy and the continuous reform of the medical system,the demand for medical quality and pharmaceutical service has gradually improved.The capacity improvement of pharmaceutical care can help promote the development of medical union,and ensure that residents receive equal,homogenized and integrated health care services.

This study started with the comprehensive experimental research and practice of pre-ventive medicine. Taking the school of public health of China Medical University as an example, this paper introduced the ideas, principles, and experience of reform and implementation of comprehensive experimen-tal teaching. The methods of comprehensive experiments construction and implementation were introduced, such as subjects, application, basic training, implementation, writing, replying and score. In addition, the comprehensive experimental topics (such as classic experiment, new technology experiment, interesting ex-periment and fund project experiment et al), and basic training (such as literature searching, epidemiology and statistical analysis, laboratory safety and quality of experimental data, network sharing et al) were pre-sented in detail. It gave the evaluation that the comprehensive experimental teaching played an important role in the process of improving the quality of teaching and formed a unique preventive medicine experi-mental teaching system and talent training mode.

Objective To explore the diagnostic value of artificial intelligence (AI) cytology combined with DNA-image cytometry (DNA-ICM) auxiliary diagnostic system for the identification of benign and malignant pleural effusion and ascites. Methods Liquid-based cytology technology (LCT), DNA-ICM, AI, and AI combined with DNA-ICM were used to identify benign and malignant pleural effusion and ascites specimens in 360 cases, and their sensitivity, specificity, accuracy, Kappa value, Youden index and AUC were statistically analyzed. Results The sensitivity, specificity, and accuracy of AI combined with DNA-ICM in detecting benign and malignant pleural effusion and ascites were 95.23%, 94.12%, and 94.44%, respectively, which were higher than those of the three other separate detection methods (all P < 0.05). The kappa values of LCT, DNA-ICM, and AI were 0.646, 0.642, and 0.586; their Youden index values were 0.693, 0.687, and 0.676, and their AUC values were 0.846, 0.843, and 0.838, respectively. The Kappa value of AI combined with DNA-ICM was 0.869, the Youden index was 0.893, and AUC was 0.947, which were all higher than those of the three detection methods alone. Conclusion Among the three separate detection methods, LCT has the highest reliability, authenticity, and diagnostic value, and it can be used as a common method for the clinical identification of benign and malignant pleural effusion and ascites. The diagnostic performance of AI combined with DNA-ICM auxiliary diagnosis system in identifying benign and malignant pleural effusion and ascites is better than those of the three separate detection methods and can be used as a reliable method for the clinical identification of benign and malignant pleural effusion and ascites.

OBJECTIVEThis work explores the diurnal variation of Solar ultraviolet radiation (UVR) and total solar radiation (TSR) in northeast China, using daily observations of UVR and TSR in Shenyang.

METHODSUVR and TSR measurements were carried out from March 1st, 2006 to December 31st, 2009 in Shenyang, Liaoning province, China (41°51' N, 123°27' E).

RESULTSBoth TSR and UVR showed seasonal variation, reaching the highest levels in summer and the lowest in winter. They showed the greatest fluctuation in summer and autumn. The irradiance of TSR and UVR on clear days around the equinoxes and solstices increased substantially compared with the mean seasonal irradiance, especially in autumn. The whole day accumulated dose of UVR in winter was far less than that during the middle part of a summer day (i.e. between 10:00 and 14:00). It was also less than the accumulated summer dose of morning and afternoon (i.e. between 8:00 and 10:00 and 14:00 and 16:00).

CONCLUSIONThe instant irradiance and daily accumulated amount of UVR are low in Shenyang, especially in autumn and winter. Thus concern about the health effects arising because shortage of UVR in northeast China is warranted.

The management of healthcare services for the suspected cases in non-designated hospitalsis a serious concern in controlling coronavirus disease 2019 (COVID-19) epidemic. Owing to the complexity of care providers, large requirement of medical supplies as well as the possible needs off frequent transfers, the major difficulty is preventing the coronavirus from spreading while caring the suspected critical cases before the 2019 novel coronavirus ribonucleic acid test results are reported. For the purpose of enhancing the prevention of the propagation of COVID-19, this article puts emphasis on the following aspects in non-designated hospital Peking University Third Hospital: preparatory procedures of receiving critical suspected patients, the management of medical personnel during the waiting session of RNA test results, the delivering procedures of testing samples, the management of referred medical wastes, daily operations including the cleaning and sanitizing of caring units and the management of related patients after the testing session.

Objective To evaluate the impact of customized rehabilitation exercise plans based on the results of cardiopulmonary exercise test(CPET)on cardiac function and prognosis in patients with chronic heart failure(CHF).Methods A total of 52 CHF patients admitted to Chengde Central Hospital from February 2020 to September 2021 were selected as the study subjects,and the patients were divided into observation group and control group according to the principle of randomized controlled study,with 26 cases in each group.The control group received rehabilitation treatment excluding exercise.The observation group was given routine rehabilitation treatment and high-intensity rehabilitation exercise plans based on CPET guidance.Above anaerobic threshold Δ50%power was exercise intensity,exercise time was 30 minutes/day,4 days/week,and intervention period was 12 weeks.Before and 12 weeks after intervention,CPET functional indicators,serum brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),and 6-minute walking distance(6MWD)were measured.The Minnesota CHF quality of life questionnaire(LiHFe)was used to evaluate patient's quality of life,readmission rate and cardiogenic mortality within 1 year of follow-up,and univariate and multivariate Logistic regression analysis was used to analyze factors affecting readmission of CHF patients.Results ① Cardiopulmonary function indicators:there was no statistically significant difference in the anaerobic threshold,peak oxygen uptake,and peak oxygen pulse of CPET functional indicators before and after intervention in the control group,after intervention,the CPET functional indicators in the observation group were significantly higher than those before intervention,and the above indexes in the observation group were significantly higher than those of the control group[anaerobic threshold(mL·min-1·kg-1):10.77±1.40 vs.9.59±1.11,anaerobic threshold(%ped):78.95±11.39 vs.70.09±6.48,peak oxygen uptake(mL·min-1·kg-1):15.63±1.36 vs.14.27±1.72,peak oxygen uptake(%ped):72.42±6.91 vs.63.41±7.31,peak oxygen pulse(mL/order):11.38±1.29 vs.9.05±1.64,peak oxygen pulse(%ped):90.23±10.16 vs.80.53±6.73,all P＜0.05].②Serum indicators,cardiac function indicators,exercise ability indicators,and quality of life evaluation:there was no statistically significant difference in serum indicators BNP,cardiac function indicators LVEDD,LVEF,exercise ability indicators 6MWD,and quality of life LiHFe scores between the two groups before intervention.After intervention,BNP and LiHFe scores were significantly reduced compared with before intervention,while LVEF and 6MWD were both increased compared with before intervention,and the changes of the above indexes in the observation group were more significant than those in the control group[BNP(ng/L):313.25±77.91 vs.445.89±110.67,LVEF:0.41±0.08 vs.0.37±0.06,6MWD(m):495.62±91.35 vs.416.04±65.29,LiHFe score:23.27±6.02 vs.29.50±4.61,all P＜0.05].③ Prognostic follow-up:the readmission rate within 1 year in the observation group was significantly lower than that in the control group(23.08%vs.53.85%),and there was no statistically significant difference in the mortality rate of cardiogenic diseases between the two groups.④Logistic univariate analysis showed that hyperlipidemia,New York Heart Association(NYHA)grading,BNP,and rehabilitation exercise were factors that affect the prognosis of CHF patients[odds ratio(OR)and 95%confidence interval(95%CI)were 0.098(0.019-0.494),0.069(0.016-0.294),1.018(1.007-1.029),and 3.889(1.178-12.841),respectively,all P＜0.05].Multivariate analysis showed that after adjusting for other factors,hyperlipidemia,NYHA grading,and BNP were risk factors affecting the prognosis of CHF patients(OR and 95%CI were 0.068(0.007-0.687),0.048(0.005-0.415),1.016(1.002-1.030),respectively,with P＜0.05],the use of rehabilitation exercise therapy was a protective factor affecting the prognosis of CHF patients[OR and 95%CI were 11.179(1.135-10.124),P＜0.05].Receiver operator characteristic curve(ROC curve)analysis showed that hyperlipidemia,NYHA grading,BNP,rehabilitation exercise therapy,and combined testing all had predictive value for the patient's prognosis(all P＜0.05),and the prediction value of joint detection was the highest,with the area under the ROC curve(AUC)=0.984 and P = 0.000.Conclusion Developing a high-intensity individualized cardiac exercise rehabilitation plan under the guidance of CPET can help improve the cardiopulmonary function,cardiac function,and quality of life of CHF patients,which is of great benefit for improving the long-term prognosis of CHF patients and has high safety.

Discipline evaluation is an important measure to promote the virtuous circle of discipline construction, and is an indispensable link in the process of discipline development in public hospitals. After becoming a directly affiliated hospital of a " double first-class" university, in order to improve the comprehensive strength and influence, a hospital built and applied a disciplinary evaluation system in four directions: talent construction, clinical medicine, scientific research ability, and teaching work. According to the evaluation results, the hospital′s disciplines were divided into three categories, namely, advantageous disciplines, cultivating disciplines and potential disciplines, and development strategies were established at different levels, providing policy support and financial support, especially in the field of scientific research and teaching, to accelerate to make up for shortcomings. Through exploration and practice, the talent team, scientific research and teaching level, discipline reputation, and comprehensive strength of the hospital had been significantly improved, providing effective support for the high-quality development of the hospital.