Objective To study the effect of integrated tradition and western medicine on unstable angina.Methods Sixty-six patients with unstable angina were randomized into two groups:control group treated only with routine therapy(n=33) and experiment group treated with routine and jia jian luang gan jian therapy(n=33).The difference of EKG,symptoms and clinic comprehensive evaluation between before treatment and after-3-week-treatment were compared.Results The rate of symptoms and ECG improvement was higher in experiment group than control group(94% vs 73%;73% vs 45%).The difference of clinic comprehensive score between before treatment and after 3 weeks treatment was significantly higher in experiment group.Conclusion The treatment of integrated tradition and western medicine on patients with unstable angina is more effective.

Objective To investigate the features of female sexual dysfunction (FSD) in type 2 diabetic patients (T2DM)and to analyze its risk factors. Methods According to FSFI indexes in the sexual function questionnaire,227 female T2DM patients were divided into DM group without FSD [n=144,FSFI≥25] and DM+FSD group[n=83,FSFI<25]. 80 healthy women served as normal controls. The risk factors for FSD were analyzed using logistic regression analysis. Results The occurrence of FSD was 36.6%(83/227) in female T2DM patients. The levels of FSH,TSTO and LH were higher,and E2 was lower in DM+FSD group and DM group than those in NC group(P<0.01),but there was no statistical significance between DM+FSD group and DM group(P>0.05). The score of sexual desire[(2.54±0.58) vs (3.76±0.90) vs (4.59±1.22) score],sexual arousal[(2.30±0.42) vs (3.57±0.85) vs (4.81±1.00) score],vaginal lubricate[(3.35±0.29) vs (4.46±1.32) vs (5.14±0.83) score],orgasm[(2.75±0.68) vs (3.40±1.86) vs (4.02±1.25)score] and total score [(17.94±4.15) vs (24.71±6.33) vs (28.13±5.78) score] were lower in DM+FSD group and DM group than those in NC group. The score of sexual satisfaction[(3.45±1.68) vs (4.94±0.93),(4.99±0.86)score] and pain[(3.55±0.50) vs (4.58±0.47),(4.58±0.62)score] were lower in DM+FSD group than those in DM group and NC group(P<0.05),but there was no statistical significance between DM group and NC group(P>0.05). Logistic regression analysis showed that age,BMI and HbA1c were risk factors for FSD in T2DM patients (P=0.029,0.001,0.022,respectively). Conclusion The occurrence of FSD is common in female type 2 diabetic patients. BMI and HbA1c are the main risk factors for FSD.

Objective To explore the effect of swimming training on the microcirculations of cochlea in guinea pigs with tertram ethylpyrazine(TMP) treatment after chronic hypoxia.Methods 28 guinea pigs were divided into normal control group outside of cabin (A) and chronic hypoxia model group (B). After four weeks the model group were divided into the model control group (B 1),TMP treatment group (B 2),swimming training group(B 3) and swimming training with TMP treatment group (B 4).Until the given time,LDF was used to investigate the blood flow of every guinea pig's cochlea.The spiral ligament spreaded-slice optical lens was used to observe guinea pig's vascular veins, capillary appearance and RBC counts.Results There was significant difference in cochlear blood flow(CBF) and RBC counts between B 2,B 4 groups and B 1 group.CBF and RBC counts of B 3 group was improved comparing with B 1 gorup,so did that of B 4 group comparing with B 2.But no significant difference was found.Conclusion Swimming training can relieve the swelling on the thin blood vessel and improve the effect of TMP on the microcirculation in cochlea of guinea pigs under chronic hypoxia environment.

Objective To report the clinical experience of extracorporeal membrane oxygenation (ECMO)in the emergency management of fulminant myocarditis.Methods The patient,an 11 year-old boy,had fever for 4 day and abdominal pain,vomiting for 1 day and anuria for 12 hours.Electrocardiogram showed Ⅲ atrial-ventricular block,multifocal ventricular rhythm,bundle branch block,convulsivum multifocal ventricular tachycardia,extensive low voltage,ST-T elevation at lead Ⅰ,AVR,V1,V2,V3;and there were ST-T intrusion,T wave inversion at lead Ⅱ,Ⅲ,AVR,AVF,V4～5.Blood creatine kinase was 2 161 U/L,reatine kinase isoenzyme 109 U/L,α-hydroxybutyrate dehydrogenase 612 U/L,lactate dehydrogenase 696 U/L,troponin Ⅰ 22.1 U/L.Echocardiogram showed right atrium 4.4 mm,right ventricular 2.3 mm,severe tricuspid valve regurgitation,left ejection fraction 33％,left ventricular fractional shortening 15％,ventricular wall motion dyssynchrony.Blood lactate was 4.0 mmol/L.The patient's condition was still unstable after using dobutamin,dopamine,milrinone,furosemide,large dose methylprednisolone,intravenous human immunoglobin,phosphocreatine and so on.ECMO was used for cardio-pulmonary support.It is necessary to monitoring the consciousness,temperature,heart rate,respiration,blood pression,SaO2,urinary volume,ariterial blood gas,blood electrolytes,blood lactate,blood glucose,liver function,renal function,blood routine,activated clotting time(ACT),lower extremity blood supply and so on.ACT was maintained at 160～200 s.Heparin was used persistently[5～10 U/(kg·min)].Results ECMO system had been successfully used for 7 days.The cardiac function of the patient was improved significantly.There was no complication,such as hemorrhage,infection,and embolism.Heart arrest in the patient occurred three times,ventricular fibrillation and ventricular flutter occurred one time respectively during ECMO.The rhythm was recovered by electric defibrillation and antiarrhythmic drugs.On day 20,the patient was discharged.At the time of hospital discharge,the patient demonstrated good activity,with normal myocardial enzymes.The echocardiogram showed the size of the cardiac chambers and the contractile function of the myocardia were normal.Electrocardiogram showed Ⅰ degree atrial-ventricular block,complete right bundle branch block.Two weeks later,the electrocardiogram demonstrated complete right bundle branch block.Echocardiogram showed septal thickening(0.9 cm).Two months later,the electrocardiogram was just as that of two weeks before.Echocardiogram showed septal thickening(0.7 cm).The children had no symptom after he was discharged and acted without limitation.Conclusion ECMO is a kind of effective treatment for fulminant myocarditis.The key to desirable therapeutic effect is the timing of its application.

Objective: Little has been reported on the utilization of the preoperative preparing room before anesthesia.This article aimed to investigate how to improve work efficiency in the operation theatre by utilizing the preoperative preparing room.Methods: Two hundred patients undergoing elective surgery were equally randomized into an operation room group and a preoperative preparing room group,for which the preoperative preparations were made in the operation room and the preoperative preparing room,respectively.Records were made of such parameters as the anxiety score,mean arterial pressure(MAP) and heart rate(HR) of the patients,as well as the surgery rotation time.Results: The anxiety score,MAP and HR were significantly lower(P

AIM:To approach the therapeutic effects of mycophenolate mofetil(MMF)in hormonal resistance nephrotic syndromes.METHODS:Patients were diagnosed as nephrotic syndrome and treated with prednisone at the dose of 1 mg?kg-1?d-1 for over 8 weeks,and 24 patients with unsatisfactory results or were palindromic were selected,and several patients in the 24 patients had been treated with cyclophosphamide or cyclosporine A.All patients were treated with MMF combined with low dose hormone.The initial dose of MMF was 1.0-1.5 g/d for 3 months,later the dose were reduced,and the maintenance dose of MMF was 0.5-1.0 g/d,the dose of prednisone was 5-20 mg/d,the follow-up visit period more than six months.The changes on urine protein,serum albumin,liver function,renal function were compared before and after treatment.RESULTS:Before and after treatment,urine protein decreased from(3.4?1.7)g/d to(0.9?0.2)g/d,serum albumin increased from(19.6?5.4)g/L to(36.1?7.7)g/L.serum creatinine level decreased from(105.7?6.4)?mol/L to(90.1?5.8)g/L.20 patients(83.3%)pathogenetic condition were relieved,15 patients(65.2%)were with complete remission.5 patients(20.8%)were partially recovered,and 4 patients(16.6%)had no response.The adverse effects were observed,including gastrointestinal events(n=8,33.3%),bacterial pneumonia(n=4,16.6%),herpes zoster(n=1,4.1%),hepatic function mild damage(n=3,12.5%).CONCLUSION:It is safe and effective to combine MMF with low dose hormone in treatment of hormonal resistance nephrotic syndrome,which could become a therapeutic option for refractory nephrotic syndrome(RNS).

Objective To observe and analyze clinical characteristics of diabetes patients suffering from pancreatic cancer . Methods We recruited 107 cases of pancreatic cancer(66 without diabetes and 41 with diabetes) and 100 diabetes patients without pancreatic pancreas as control .Patients′ demographic information ,degree of tumor differentiation ,serum markers etc .were com‐pared in order to find out the relevant clinical features of diabetes patients suffering from pancreatic cancer .Results (1)Patients with pancreatic cancer mostly were middle‐aged males .55 .1% of them suffering from dysglycemia ,18(16 .8% ) and 41(38 .3% ) of whom had impaired fasting glucose and diabetes ,respectively .(2)Compared with their without diabetes counterparts ,pancreatic cancer with diabetes were more prone to be asymptomatic and weight loss(P< 0 .05) .(3)Compared with their without diabetes counterparts ,pancreatic cancer with diabetes had significantly higher levels of fasting blood glucose(FBG) andγ‐glutamyltranspep‐tidase(γ‐GT)(P<0 .05) .(4)When compared with diabetes control ,pancreatic cancer with diabetes were older and shorter duration and lower body mass index(BMI)(P<0 .05) .They were more prone to weight loss(P<0 .05) .Moreover ,serum CA19‐9 and CEA levels in them were significantly higher than those in the diabetes control(P<0 .05) .Conclusion Older age ,shorter duration ,low BMI are all risk factors for diabetes patients to develop pancreatic cancer .Being asymptomatic and weight loss are their clinical characteristics .CA19‐9 and CEA are both sensitive serum markers to detect pancreatic cancer patients with diabetes .

Objective To evaluate the value of 18 F?NaF PET/CT and MRI in the diagnosis of skull?base bone invasion ( SBBI) in patients with nasopharyngeal carcinoma( NPC) . Methods Sixty?three NPC patients (45 males, 18 females;age range 23-72 years) were enrolled in this prospective study. Pa?tients underwent 18 F?NaF PET/CT and MRI to confirm whether the skull base was invaded. The reference standard was based on the follow?up imaging in 6 months. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the two imaging modalities were calculated. χ2 test was used to analyze their difference. The SBBI foci and their distribution detected by the two imaging modalities were compared. Results Thirty?four NPC patients demonstrated SBBI in follow?up imaging. The diagnostic sen?sitivity, specificity, positive predictive value, negative predictive value, and accuracy of 18 F?NaF PET/CT were 97.1%(33/34), 89.7%(26/29), 91.7%(33/36), 96.3%(26/27) and 93.7%(59/63), respective?ly. For MRI, the parameters were 91.2%(31/34), 86.2%(25/29), 88.6%(31/35), 89.3%(25/28) and 88.9%(56/63), respectively. The diagnostic efficiency of the two imaging modalities had no significant difference (χ2=0.162-1.062, all P>0.05) . 18 F?NaF PET/CT detected 133 lesions and MRI detected 97 le? sions, and the clivus was the most common site of SBBI. Conclusions 18 F?NaF PET/CT and MRI have similar diagnostic efficiency in detecting SBBI. 18 F?NaF PET/CT can detect more lesions than MRI do, and has potential advantage for detecting tiny bone lesions in skull base.

The safety of TCM injection triggered attentions and hotspots in recent years in China.The centralized monitoring of TCM injection provided important evidence for analyzing the safety risk of TCM injections,recognizing adverse reactions and contraindications and perfecting the instructions.This study aimed at exploring the ethical problems on centralized monitoring.In this paper,we retrieved and screened the ethical issues of TCM injections over hospital centralized monitoring in China National Knowledge Infrastructure (CNKI,1979-Ju1.,2016).Issues over it were put forward and addressed.It is found that the current ethical issues related to hospital centralized monitoring lacks sufficient attentions,corresponding norms and requirements.Based on the ethical issues reflected from the literatures,suggestions should be pressed ahead with the ethical review of centralized surveillance,signing of informed consents,registration of research programs,data statistics and reporting stages,for the better protection of the rights and interests of subjects and improvement of research quality.

Objective To explore the application and effect of case-based learning(CBL)in vas-cular surgery clinical teaching. Methods Totally 37 resident doctors were randomly divided into 2 groups respectively: CBL teaching group (n=21)and traditional teaching group (n=16). CBL teaching was con-ducted through the following procedures:selecting typical cases-establishing and applying typical case library-autonomous learning-holding regular seminars. Traditional teaching was conducted through the following procedures: basic theory studying-participating in clinical practice-participating in case discus-sion. Evaluation was conducted based on test socre (written test and clinical operational skill test)and res-idents' feedback of teaching effect. Data were statistically described and independent sample t test was performed. Results Theoretical exam score and clinical skill test score were high in CBL group than in traditional group ((thoretical score:(85.53 ±1.75) vs. (79.94 ±2.29);clinical skill test score:(85.10±1.64)vs.(80.31±1.82)). CBL teaching group had advantages in improving learning efficiency, cultivat-ing clinical thinking,promoting mastery and application of knowledge,broadening knowledge, promoting communication and expression ability and improving study enthusiasm ,et al . Conclusion CBL teaching can effectively improve the teaching quality and obtain higher evaluation. Typical case li-brary should be constantly improved and education of vascular surgical basic theory should be strength-ened to promote CBL.