Cholesteatoma ; complications ; diagnostic imaging ; Cholesteatoma, Middle Ear ; Humans ; Otitis Media, Suppurative ; complications ; diagnostic imaging ; Radiography ; Temporal Bone ; diagnostic imaging

Clinical thoughts based on symptoms, physical signs and examine outcomes is a process of analysis, judgement and conclusion of disease diagnosis. To cultivate an exact thinking model can avoid taking a part for the whole or a miss in disease analysis, so to cultivate clinical thoughts in clinical practice can elevate medical students'clinical skills.

OBJECTIVE: Comparison of operation of epitympanic/antrum cholesteatoma excised by endoscopy and microscope. METHOD: Eleven patients with epitympanic/antrum cholesteatoma were analysed, 5 cases were excised by endoscopy and 6 cases were excised under microscope. RESULT: No complication occurred after operation and all patients got dried ear. There were no difference in hearing recovery and closure of perforation of tympanic membrane between two group. The operation time, injury degree, length of stay in hospital and hospitalization expense with endoscopy was superior to that of microscope. CONCLUSION Considering financial constraints of patients, resection of epitympanic/antrum cholesteatoma cholesteatoma can be adopted by endoscopy.
Adolescent ; Adult ; Cholesteatoma, Middle Ear ; surgery ; Endoscopy ; Female ; Humans ; Male ; Microscopy ; Middle Aged ; Treatment Outcome ; Young Adult

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Esophagus ; Female ; Foreign Bodies ; complications ; therapy ; Humans ; Infection ; etiology ; therapy ; Male ; Middle Aged ; Neck ; Young Adult

Objective] To observe the clinical efficacy and 5-HT of Shugan Jianpi Tiaoshen acupuncture treatment for senile patients with constipation type of irritable bowel syndrome(IBS-C). [Method] A total of 68 patients with IBS-C were allocated into control group and acupuncture group from June 2015 to June 2014. 34 patients in the control group, who accepted Lactulose oral solution and Citrate Mosapride Citrate, of in 15 males and 19 females, the mean age was 66.8, the average duration of disease was 15.6 months;34 patients in acupuncture group, who accepted acupuncture treatment based on control group, in 17 males and 17 females, the mean age was 65.9, the average duration of disease was 17.1 months. Acupoint selection:Tianshu, Zusanli, Taichong, Xingjian, Qimen, Baihui, Neiguan. Observe constipation symptoms, depressive symptoms, and quality of life and serum 5-HT levels before and after treatment. [Result] The pre-treatment constipation symptoms and depressive symptom scores in two groups were decreased than post-treatment( P<0.05), which showed two methods can improve constipation and depressive symptoms of IBS-C patients. After treatment, constipation symptoms and depressive symptoms score in acupuncture group were lower than that in control group(P<0.05), which showed the effect of acupuncture was better. The eight dimensions of SF-36 were higher than those before treatment in total patients(P<0.05), which showed two methods can improve quality of life of patients; differences of physiological function, physiological function between acupuncture group and control group had no statistical significance( P>0.05), but body pain, vitality, emotional function, mental health, social function, and general health values were higher than that of the control group( P<0.05), which showed acupuncture treatment can reduce physical discomfort and improve the quality of life of patients. After treatment,serum 5-HT in control group was 33.8 pg/ml, in acupuncture group was 27.6 pg/m, which were lower than pre-treatment. 5-HT in acupuncture group was lower than control group( P<0.05), which showed the effect of acupuncture on regulation of 5-HT was more significant. [Conclusion]Shugan Jianpi Tiaoshen acupuncture can modulate 5-HT level of elderly patients with IBS-C, and play its role in modulating gastrointestinal function, improving constipation symptoms, depressive symptoms and quality of life.It is an effective method for the treatment of elderly patients with IBS-C.

Objective:To reflect the training of basic-level medical stuff by investigating the doctor-patient cognition status of patients in a county-level hospital.Methods:The questionnaire of 180 patients collected from a county hospital in Shaanxi province was analyzed by Rank sum test and Descriptive analysis with SPSS17.0.ReSults:There were no statistically significant differences in the evaluation of current doctor-patient relationship from patients of different ages,occupations and degrees of education (P ＞ 0.05).82.2％ of the patients believed that the doctor-patient relationship is harmonious or somewhat harmonious.Moreover although the patient's trust in doctors is not high,there is a certain sense of recognition;and they put forward some expectation and requirements on doctor's professional skills,communication skills and professionalism.Conclusion:Considering the patients' feedback,local medical colleges and universities should reflect medical education ideas,play an active synergy model in the training of students' professional skills.In the meantime,they should strengthen the medical internship management,while paying equal attention to enhance students' responsibility and professionalism to serve the grassroots.

OBJECTIVE:To establish an optimal method for microbial limit test for ciclopirox olamine vaginal suppository.METHODS:The microbial limit test for antibacterial agents was validated by plating method and membrane filtration method,and the optimal method for the test of bacteria and mold were confirmed based on the recovery rate of artificially sprayed bacteria.RESULTS:By plating method,the recovery rate of artificially sprayed E.coli was more than 70%,whereas that of mould was 0%;however,by membrane filtration method,the recovery rates of bacterial and mould were all higher than 70% when flushing doses of bacteria,mold,and control bacteria were 200 mL,300 mL,and 200 mL,respectively.CONCLUSIONS:The membrane filtration method could be used for the microbial limit test of the preparation the drug quality can be kept under effective control,and the established method is accurate and reliable.

Applying the principle of Evidence-Based Medicine to the clinical teaching,we have made the students raise the cognition level on the diagnose of diseases and treating policy and trained their clinical logic thinking ability.

Objective　To investigate the changes and its clinical significance of plasma neuropeptide Y(NPY) concentration in patients with pregnancy induced hypertension (PIH). Methods　Plasma NPY levels were detected by radioimmunoassay in 30 patients with PIH, 20 normal non-pregnant women and 23 normal pregnant women. The PIH group was subdivided into mild, moderate and Severe subgroups, and the NPY concentration was also measured in these subgroups respectively at admission and one week after delivery. Results　The plasma NPY levels in patients with PIH ［(164.16±68.32) ng/L］ were significantly higher than those of normal non-pregnant women and normal pregnancies ［(86.60±20.65) ng/L, (82.42±12.46) ng/L, P<0.01, respectively］. There was significant difference among plasma NPY levels among the patients with mild, moderate, and severe PIH at admission (P<0,01). At one week after delivery the concentrations of plasma NPY were significantly decreased in the moderate and severe subgroups compared with the value measured at admission (P<0.01). Moreover, the NPY levels in patients with severe PIH after delivery were still higher than those of normal non-pregnant women. Conclusions　The results suggested that the level of NPY in plasma is increased in women with PIH. Elevated plasma NPY levels may play a key role in the development of PIH.

Objective To study tannins of Corylus heterophylla from Heilongjiang Province. Methods The constituents were separated and purified repeatedly by macroporons resin chromatography methods and their structures were identified by 1H-NMR, 13C-NMR, FAB-MS, and 1H-1HCOSY spectra, and chemical methods as well. Results Three tannins were obtained from C. heterophylla. They were heterophylliin D (Ⅰ), roxbin A ( Ⅱ ), and rugosin F ( Ⅲ ). Conclusion Heterophylliin D ( Ⅰ ) is isolated from the extract of C. heterophylla leaves as a new dimmer tannin firstly.