Rational drug-use is an extremely important component part in morden medical and health work. And irrational drug-use will aggravate drug misadventure, increase overpreseribing, waste medicinal resources and harm the reputation of medical workers. The tendency of polypharmacy just for more hospital income, regardless of drug-related adverse effects, comes to be a serious problem and hard to control in recent years. No perfect management system and lack of information may be the major factors of the problem. In order to overcome the irrational drug-use characterized by polypharmacy, we should learn something from the Diagnosis Related Groups/Prepayment System (DRGS/PPS). Now, under the cooperation of The Chinese Pharmacological Society ,The Chinese Pharmaceutical Association and The Public Health Ministry of PLA, a Diagnosis Related Rational Drug-use Management System and a Computerized/Telecommunication Based Dynamic Knowledge Bank are able to be developed. We consider that it will contribute to the modernization of medical and health work in China in the near future.

Objective To compare the effect of scapula lateral margin approach and standard Judet approach in the operative treatment of scapular fracture. Methods Medical data of 48 patients with scapular fractures from January 2006 to February 2013 were retrospectively analyzed. They were divided into the observation group and the control group according to the surgical approach. 27 patients in the observation group were treated with operative treatment through scapula lateral margin approach and 21 patients in the control group were treated with sur-gical treatment through standard Judet approach. Compared the clinical effects and complications of the patients in two groups. Results To operation time and intraoperative hemorrhage in the observation group were less than that of the control group (P<0. 05),fracture healing time was shorter than that of the control group after operation (P<0. 05). Six months after operation,the excellent rate of the observation group was higher than that of the control group. Scores of daily activities and myodynamia in the observation group were higher than that of the control group,the differences were statistically significant(P<0. 05),and there was no significant difference in the scores of pain and joint motion between the groups(P>0. 05). Conclusion Scapula lateral margin approach in treatment of scapular fracture has the advanta-ges of easy operation,small trauma,definite effect,little complication and it can be used as the preferred scheme of scapular fracture operative treatment.

Objective To explore the methods of early diagnosis of arteriosclerosis obliterans of lower extremity (ASOLE).Methods The related literatures on ASOLE detection means adopted clinically were reviewed,and their advantages and disadvantages were compared.Results Asymptomatic ASOLE could be discovered by determination of ankle brachial index (ABI) and toe brachial index (TBI),which was a good index for arterial function assessment of lower extremity.Pulse wave velocity (PWV) was more vulnerable and less sensitive than ABI,and therefore more suitable for screening of a large sample.ASI was an index to assess arterial structure and function,and it had a good correlation with PWV.Flow-mediated dilation (FMD) was a measurement evaluating the function of endothelial cell;Pulse wave measurement was simple,sensitive,and its result was reliable.Color Doppler ultrasonography could localizate the lesion and determine the degree of stenosis at the same time.Multiple-slice CT angiography (MSCTA) was more accurate than color Doppler ultrasonography,but its inherent shortcomings,such as nephrotoxicity of contrast agent,was still need to be resolved.3D-contrast enhancement magnetic resonance angiography (CE-MRA) had little nephrotoxicity,but a combination of other imaging methods was necessary.Microcirculation detections required high consistency of the measurement environment,but they were simple,sensitive and noninvasive,and therefore could be used for screening of ASO.Conclusion Publicity and education of high-risk groups,and reasonable selection of all kinds of detection means,are helpful to improve the early diagnosis of ASOLE.

Objective To summarize the operative experience of transumbilical single-port laparoscopic cholecystectomy. Method The clinical data of 15 patients underwent transumbilical singleport laparoscopic cholecystectomy between May to October in 2010 was reviewed. Results The operative time was 30-85(45±16) min,hospitalization time was (2.5 ± 1.1 ) d. No surgical complications such as bile leak or uncontrolled hemorrhage occurred postoperatively. All the incision were healed well and the surgical scar was virtually concealed whithin the umbilicus. Conclusions Transumbilical single-port laparoscopic cholecystectomy is feasible and safe when patients are well selected. Comparing with conventional laparoscopic cholecystectomy, it's more manipulatively difficult.

Objective To obtain the lung adenocarcinoma initiating cells from the A 549 cell line based on paclitaxel treatment combination with serum-free cultivation and to validate spared cells can represent tumor initiating cells (TICs) .Methods After dis-sociated by trypsogen ,about 106 /mL cells were suspended in serum-free medium supplemented with 0 .4% bovine serum albumin (BSA) ,insulin ,basic fibroblast growth factor (bFGF) ,human recombinant epidermal growth factor (EGF) and obtained spheroid cells .At the second passage ,paclitaxel was added at a concentration of 100 nmol/L for 48 h and then replaced with completely fresh medium once or twice per week until new spheroids emerged .Results The subpopulation of cells that survived serum-free cultiva-tion and paclitaxel treatment could highly express the cluster of differentiation 133/cluster of differentiation (CD133/CD326) mo-lecular markers and have features of stemness including differentiation ,high expression of cancer stem cells (CSCs)-associated genes and stronger capability of tumorigenesis .Conclusion The survived subpopulation that highly express the CD 133/CD326 molecu-lar markers presenting the characteristics of stemness in vitro and in vivo ,and could be used in future researches of biological functions .

Objective To evaluate the influence of endoscopic sinus surgery on olfactory disorder caused by chronic sinusitis and nasal polyps by testing the olfactory function of fifty-two patients with chronic sinusitis and nasal polyps before and after endoscopic sinus surgery and then confirming the olfactory rehabilitation of the patients.Methods The olfactory function of the fifty-two patients with chronic sinusitis and nasal polyps was tested through the CCCRC olfactory testing method pre-operation and four weeks,twelve weeks,twenty-four weeks post-operation.The results were analyzed by matched t-test.Results All results of olfactory function after treatment were significantly better than that of pre-operation(P0.05).Conclusion Olfactory function of above patients was significantly improved within the first month post-operation.There was no further improvement in the following five months compared with the first month post-operation.

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.

Objective To compare transurethral enucleation of plasma chamber(TUERP)plasma and tran-surethral resection of the prostate(PKRP) treatment efficacy,security and the impact on sexual function.Methods 80 cases of BPH patients were randomly divided into two groups,TUERP and PKRP.Follow-up for 12 months,compared two groups maximum urinary flow rate(Qmax),residual urine volume(PVR),serum prostate-specific antigen(PSA) level,prostate volume(PV),international prostate symptom score(IPSS),quality of life score(QOL),the bladder prostate prominent(IPP)and other indicators and erectile dysfunction and retrograde ejaculation changing circum-stances were compared.Results In the weight of prostate surgery there were significant differences,in which removal of the weight of TUERP group significantly higher than PKRP group.After 12 months,32 cases of TUERP patients and 31 patients of PKRP group completed follow-up.After 1,3,6,12 months,Qmax,PVR,IPSS,QOL improved than that before surgery.Two groups were compared after a month,and there were significant differences in prostate volume,which TU/ERP group was significantly smaller than PKRP group.After3 months in the prostate volume and residual U-rine volume there were significant differences,both TUERP group Was significantly smaller than PKRP group.After 6 months and 12 months in the prostate volume,residual urine volume and there were significant differences in PSA,both TUERP group was significantly smaller than PKRP group.ED,and retrograde ejaculation occured after the rate of two between the two groups was no significant difference.Conclusion Transurethral enueleation of plasma chamber on sexual function in patients,but through the appropriate personalized treatment,sexual function in some patients was recoverable.

Objective To compare the local control and survival rates of hyperfractionated radiotherapy plus concurrent chemotherapy with hyperfractionated radiotherapy alone in the treatment of stage Ⅲ-Ⅳ nasopharyngeal carcinoma (NPC).Methods Between December 1992 and December 1995, 150 NPC patients were randomized into hyperfractionated radiotherapy plus concurrent chemotherapy (R+C) and hyperfractionated radiotherapy alone (R alone) groups. Radiotherapy were similar in the two groups: 1.2 Gy/f, twice a day. Chemotherapy was given to R+C patients before and during the course of radiotherapy. Results The overall 5-year survival (OS), disease-free survival and distant metastasis-free survival rates were 57.3%, 55.9% and 55.9% . The 5-year survival rates of the R+C and R alone groups were 64.0% and 50.7%, with the difference statistically significant (P=0.037). One patient in the R+C group and 5 patients in the R alone group developed nasopharyngeal recurrence and the corresponding 5-year local control rates were 98.7% and 93.4%. The acute mucosal reaction in the R+C patients was severer than that of the R alone, but well tolerated and did not develop any severe complications. Conclusions Hyperfractionated radiotherapy plus concurrent chemotherapy can improve the local control and survival in patients with stage Ⅲ-Ⅳ nasopharyngeal carcinoma with well tolerated mucosal reactions. Chemotherapy gives greater benefit on the survival of stage Ⅳ patients.

Objective To obtain informatization of the mobile medical service units,and gift them with enhanced war preparedness management.Methods Based on previous experience on war preparedness,data sharing & management in the mobile medical service units and war preparedness depots were implemented with Management System for Mobile Medical Service Unit of Military Region,wired LAN technology and VB assembly program.The functional modules were created to satisfy the requirements of war preparedness of mobile medical service units.Results The system,when applied in mobile medical service units,could enhance the efficiency of personnel & material management.Conclusion Management System for Mobile Medical Service Unit of Military Region makes the informatized management of mobile medical units realized.