OBJECTIVE:To analyse compound pharmaceutical preparations by the signal conversion combined with multicomponent calibration methods METHODS:One-order derivative spectrum data was obtained by one-order derivative conversion On the basis of this,we combined them with the MLR method and PLS method to determine the contents of metrozole and chloromycetin in co metrozole injection RESULTS:The labelling quantity and RSD(n=5) were:metrozole 99 6%,0 11%;chloromycetin 99 3%,0 20% by derivate-MLR;The labelling quantity and RSD(n=5) were:metrozole 97 5%,0 43%;chloromycetin 94 6%,0 89% by derivate-PLS respectively CONCLUSION:One-order derivative spectrum signals aplied to the MLR method is better than the D1 PLS method

3 cm,66.67%,18/27) than those in smaller tumors(

OBJECTIVE:To establish an overall teaching evaluation system for clinical pharmacology with PBL(problem-based learning) mode. METHODS:The teaching evaluation system was established by“Delphi”method,and it has been applied to 270 students at China Medical University in 2013-2014. RESULTS:According to the result of test score,PBL method can improve abil-ity of analyzing medical records,while formative evaluation indicates most of the students are satisfied with class response.And PBL method also can enhance student’s skill of clinical practice,broaden the knowledge an so on. CONCLUSIONS:The evaluation sys-tem was comprehensive with contents,systematic and objective,and it also can provide an effective feedback in teaching,which can accelerate the optimization of the teaching mode and improve the quality of education.

Clinical competence was estimated for grades 2011-2013 general practitioners (GPs)trained by the DxR Clinician software.Clinical cases were solved on computer.And the abilities of diagnosis,thinking and handling were assessed.The average score of all GPs was 61.68 ± 10.69.The average score of diagnostic ability was the highest at 71.82 ± 15.47 (weighted score of 25.1).The average score of thinking ability was 62.36 ± 10.40 (weighted score of 28.1).And the average score of handling ability was the least at 42.27 ± 18.22 (weighted score of 8.5).Significant differences in average scores existed between grades 2011 and 2013 (P ＜ 0.05).Significant differences in score of clinical thinking ability existed between grades 2011,2012 and 2013 (P ＜ 0.01) respectively.None of them passed the part of handling.The longer period of training,the higher scores the residents obtained.Since the ability of clinical handling fared the worst,targeted training should be strengthened.

ObjectiveTo investigate the alteration of Fc gamma receptors expressed on monocytes in childhood acute immune thrombocytopenia (aITP).Methods27 patients with aITP and 25 health controls were enrolled in this study.The expression of FcγR Ⅰ and FcγRⅢ on monocytes surface was determined by flow cytometry.Real-time PCR was performed to detect the levels of FcγR Ⅱ a and FcγR.Ⅱ b mRNA.The plasma concentration of IL-4 and IFN-γwas analyzed by ELISA.ResultsThe expression of FcγR I and FcγRⅢ on monocytes was significantly highet in ITP pationts than thatinhealth control group.Transcription levels of FcγR Ⅱ a mRNA and the ratio of FcγR Ⅱ a/Ⅱ b mRNA on monocytes were significantly elevated,while the inhibitory FcγR Ⅱ b mRNA was significant lower in aITP patients (P＜0.05) ; in comparison with healthy controls. After dexamethasone treatment,the stimulatory FcγR Ⅰ,FcγRⅢ and FcγR Ⅱ a mRNA were significantly decreased while inhibitory FcγR Ⅱ b mRNA was increased.(2)The higher levels of plasma IFN-y and lower IL-4 were to be found in aITP patients compared with healthy controls.Correlation analysis showed that the level of plasma IFN-γwas positively correlated with the elevated expression of FcγR Ⅱ a mRNA on monocytes,while the level of IL-4 was positively correlated with FcγRⅡ b mRNA.Conclusion The over expression of inhibitory FcγRs and the down-regulation of inhibitory FcγR Ⅱb mRNA on monocytes,and the imbalance of stimulatory and inhibitory FcγR might be involve in immunological pathogenesis of the acute ITP.The alteration levels of plasma pro-inflammatory cytokine IFN-γand anti-inflammatory cytokine IL-4 might be involved in imbalance expression of FcγR in acute ITP.Dexamethasone therapy could shift the balance between stimulatory and inhibitory FcγR toward inhibitory FcγR Ⅱ b in aITP patients.

Objective To explore the clinical features of chronic granulomatous diseases and Mcleod syndrome caused by continuous X chromosome deletion. Methods The clinical data of two children diagnosed as chronic granulomatous disease and Mcleod syndrome by gene detection were retrospectively analyzed. Results Two males, 4 year 1 month and 1 year 9 month old, were both hospitalized due to persistent pulmonary infections. Both of them had a history of repeated severe infections and BCG vaccine associated lymphadenitis, and were diagnosed as X-linked chronic granulomatous disease for respiratory burst defects and deletion of all CYBB exons. Both of them had retarded motor development, and were diagnosed as DMD for detection of DMD gene exons and muscle speciifc promoter region and exon 1-2 deletion by MLPA. One case was found with obvious echinocytes, the other case showed whole exons deletion of XK gene. Both of them were diagnosed as Mcleod syndrome. Conclusion Continuous X chromosome deletion could lead to combination of Mcleod syndrome, DMD, and X-CGD, which may complicate the condition. Due to the lack of Kx antigen, repeated common blood transfusion can produce relative antibody, which lead to severe hemolytic crisis.

Objective To examine the relationship between the concentration of 25-hydroxy vitamin D3 [25-(OH) D3] in the serum and the body mass,the severity of obesity,body mass index(BMI),blood lipid,and their predicting role in obesity children.Methods The study recruited 244 subjects,who see the doctor in Wuxi Maternal and Child Health Hospital,Childhood Nutrition Outpatient from Jul.2011 to Feb.2013.The intake dose of vitamin D each day was investigated,and weight,height,BMI,concentration of 25-(OH) D3 in serum,and microelement were also measured.In addition,lipid metabolism of 38 cases with obesity over 3 years old was determined.Results 1.The serum 25-(OH) D3 concentration of obese children was (68.31 ± 23.06) nmol/L.The concentration of 25-(OH) D3 was lowest in the group of obese children over 36 months of age[(55.03 ± 15.18) nmol/L].2.The concentration of 25-(OH) D3 in the group of obese and overweight children was far lower than that of the children in the normal group (F =4.739,P ＜0.05).3.The concentrations of 25-(OH) D3 in the severely obese children was significantly lower than that of the mild and moderate obesity children(F =9.711,P ＜ 0.05).4.There were significantly inverse associations of serum 25-(OH) D3 with weight,weight and height percentage,BMI (r =-0.365,-0.237,-0.175,all P ＜ 0.001).5.There were significantly inverse associations between the concentration of 25-(OH) D3 in serum with weight,triglyceride in obese children more than 3 years old (r =0.476,-0.324,all P ＜ 0.05).Conclusions The decreasing level of 25-hydroxy vitamin D3 in the serum was associated with obesity.The cause of it might be the increase of the obese adipose tissue,vitamin D getting trapped in fat cells,and all these factors can lead to a less serum vitamin D levels.The vitamin D consumption of obese children is higher than that of normal children,and should supply more vitamin D to reach normal 25-(OH) D3 level.

OBJECTIVETo explore the effects of early intervention of acupuncture on urinary function reconstruction of neurogenic bladder after spinal cord injury, so as to find the optimal treatment timing of acupuncture.

METHODSFifty-three patients of neurogenic bladder after spinal cord injury were randomly divided into a prior-to-catheter group (25 cases) and a posterior-to-catheter group (28 cases). For the prior-to-catheter group, one week before the removal of catheter, acupoints on the abdomen and back such as Guanyuan (CV 4), Zhongji (CV 3), Baliao (Shangliao (BL 31), Ciliao (BL 32), Zhongliao (BL 33), Xialiao (BL 34), Jiaji (EX-B 2) and acupoints at distal end such as Zusanli (ST 36) and Sanyinjiao (SP 6) were selected; after the catheter removal, simple method. of water column was used to measure bladder capacity pressure to classify the type of bladder, and then different acupuncture manipulations were given; intermittent catheterization was performed if condition was allowed. The posterior-to-catheter group applied identical treatment after removal of catheter as the prior-to-catheter group. The treatment was given 5 times per week; after one-month treatment, five aspects including the time of first effective urination, time of establishing reflex urination, average residual volume of urine, time of residual urine less than 100 mL and quality of life (QOL) were evaluated.

RESULTSAfter treatment, the time of first effective urination, time of establishing reflex urination, average residual volume of urine and time of residual urineless than 100 mL in the prior-to-catheter group were all superior to those in the posterior-to-catheter group (all P<0. 05) ; the score of QOL was improved in two groups after treatment (both P<0. 01), but the difference between two groups was not statistically significant (P>0. 05); each index of urination function was not significant among patients with different injured segments of spinal cord (all P>0. 05).

CONCLUSIONThe early intervention of acupuncture (prior to catheter) has obvious improving function on establishing balanced bladder in patients with neurogenic bladder after spinal cord injury, which is superior to acupuncture intervention after removal of catheter, however, the effects of different injured segments on establishing balanced bladder are not different.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; complications ; Treatment Outcome ; Urinary Bladder ; physiopathology ; Urinary Bladder, Neurogenic ; etiology ; physiopathology ; therapy ; Urination ; Young Adult

Objective To explore the effect of contract learning on rehabilitation training to patients with stroke . Methods According to the random number table, 120 stroke patients were randomly divided in equal number into control group and observation group. The patients in the control group were treated with conventional nursing during hospitalization and health guidance during follow-up. The patients in the observation group were given rehabilitation training according to contracted learning during the period of hospitalization and follow-up. The time was 6 months. The quality of life was compared between the two groups of patients before and after the intervention, 1 months after discharge, 6 months after discharge. Results After six months of intervention, the 7 dimensions of quality of life, including daily life ability, hand function, mobility, strength, emotion, communication and participation in the intervention group were significantly better than those of the control group (P<0.001). The 6 dimensions of quality of life, including daily life ability, hand function, mobility, strength, emotion, and communication of the control group were significantly better than before the intervention (P<0.001). Conclusion For stroke patients, the rehabilitation training under the learning contract can improve the effect of rehabilitation training so as to improve the quality of life and the prognosis.

With the development of human centered medical nursing model, empowerment as a new and effective nursing intervention model has been widely concerned. In this paper, from the overview of empowerment theory, the influencing factors of the implementation of empowerment theory in patients with chronic heart failure and the strategies to improve the implementation effect of empowerment theory for patients with chronic heart failure. The purpose of this review is to provide reference for the implementation of empowerment theory for patients with chronic heart failure in China.