Objective:To explore yhe therapeutic effect of Shenfu injection on patients of hepatic cirrhosis with seroperitoneum(yang de ciency of spleen and kidey synndrome).Methods:The 84 patients were divided into treatment group and control group,the patients in treatment group were treated with western medicine and Shenfu injection,only western medicine were used in control group,they were all treated for twenty-eight days.Results:The curative e ect,extinction time of seroperitoneum,amelioration of hepatic function and blood routine of the treatment group were better than those of control group.And there were statistical signi canc between two groups(P

ObjectiveTo evaluate the clinical effects of surgery using scar flap in situ combined with radiotherapy in 24 hours in the restorative treatment of keloids on the auricula and the preventive effects of the therapy in the recurrence of the keloids.MethodsThe scar flap in situ was designed,its size was large enough for covering the wound of the keloid on the auricula.The keloids along the designed lines were excised using local anesthesia,the flap was clipped into the one with even thickness and suitable size which covered the wound tensionlessly to ensure that the scar flap in situ survived well,and then the wound was bandaged with pressure and drained when necessary.18-24 hours after the surgery the wound was perpendicularly irradiated by the 5 MeV high energy electron beam (beta particle) of the Siemens Primus linear accelerator.After the dressing change was performed and the drain was removed; the wound was exposed to the irradiation,3-4 Gy segmentation dose per time,and the wound was then bandaged with pressure.The radiation was performed every two days and four times altogether with a total irradiation dose of 12-16 Gy.Stitches were removed 8-10 days after the surgery.ResultsThere were no avascular necrosis in the 25 scar flaps in situ and the wounds were all primary healing with normal color and fine appearance.All the patients were satisfied with the surgery.There was no recurrence of the 23 patients during the 8 to 42 months' follow-up,but there was a tendency to recur in 2 patients after 4-6 months,and the recurrence was controlled after the beta methasone was locally injected for 2-4 times.ConclusionsIt is not necessary to harvest the flaps on the other sites applying the sear flap in situ in the restorative treatment of keloids on the auricula,and therefore it prevents the formation of the keloids on the donor sites.Furthermore,the surgery is simple and the appearance of the auricula is fine,and it presents satisfactory clinical effects to irradiate the wound in 24 hours after the surgery.

BACKGROUND: Now, dual-energy X-ray absorptiometry is international y recognized as gold standard for the diagnosis of osteoporosis, but the errors can be found in the measurement results due to the heterotopic ossification and bone hyperplasia exists in the measurement part. OBJECTIVE: To investigate the clinical significance of bone metabolic markers in the diagnosis and treatment of elderly patients with osteoporotic fractures, and to research its correlation with the changes of pathological histology and bone mineral density. METHODS: Four bone biochemical markers in 50 elderly patients with osteoporosic fractures were measured preoperatively. According to the results, 25 patients had significantly increased tartrate-resistant acid phosphatase 5b (considered as the increased tartrate-resistant acid phosphatase 5b group), and 25 patients had increased bone alkaline phosphatase (considered as the increased bone alkaline phosphatase group). During operation, the bone tissues of eight patients in each group were treated with hematoxylin-eosin staining and electron microscopy scanning in order to detect the pathological changes. After operation, the patients in the increased tartrate-resistant acid phosphatase 5b group received salmon calcitonin anti-osteoporosis treatment, and the patients in the increased bone alkaline phosphatase group received the anti-osteoporosis treatment of bone peptide injection. The bone mineral density and the four bone biochemical markers were detected again at 6 months after treatment. RESULTS AND CONCLUSION: There were no significant differences in the preoperative bone mineral density and four biomechanical markers between two groups (P > 0.05). The pathological examination results of bone tissue on the fracture site showed that the number of osteoblasts was reduced and the number of oeteoclasts was increased in the increased tartrate-resistant acid phosphatase 5b group; while in the increased bone alkaline phosphatase group, the pathological examination results showed the number of osteoblasts was reduced; the trabecular bone/bone area ratio was decreased in two groups, and there was a significant difference in the decrease degree between two groups (P < 0.05). The electron microscope scanning showed that the osteoclasts of two groups were more active than that of the normal group. The sloppy of trabecular bone in the increased tartrate-resistant acid phosphatase 5b group was more obvious than that in the increased bone alkaline phosphatase group, and the absorption vacuoles were increased. There were significant differences in the bone mineral density and four biomechanical markers between two groups before and after anti-osteoporosis treatment (P < 0.05). The detection of bone metabolic markers could help us to make it clearly that the main function of osteoblast reduce or osteoclast increase in bone tissue of patients, and guide us to use anti-osteoporosis drugs in target. Pathological histology examination can better reflect the condition of osteoblasts, osteoclasts and trabecular bone in bone tissue on the fracture site. Target application of anti-osteoporosis drugs in the osteoporosis patients can effectively improve the efficacy and reduce the relative complications.

Objective To investigate the characteristic,diagnosis and treatment of the nipple discharge.Methods The clinical data of 174 cases who were diagnosed as nipple dlscharge from January 2001 to December2006 were collected and analyzed retrospectively.Results Among those 174 cases,136 cases were confirmed histopathologieally to be intraduetal papilloma.The confirmed diagnosis rate of intraduetal papilloma by galaetograghy was 85.00%.Carcinoma-charge rate of the intraduetal papilloma was 5.17%.Conclusion Nipple discharge was the most common symptom in the intraductal papillomatesis.The galaetography was a valuable method in the diagnosis of the intraduetal papilloma.There was carcinoma-charge possibility in the intraduetal papilloma.

Objective To observe the clinical effects of Zaobo decoction combined bisoprolol treating premature ventricular contractions.Methods 108 patients of ventricular premature beat were recruited intoa control group and an observation group (n=54) according to the random number table method.The control group was treated with bisoprolol, while the observation group was treated with Zaobo decoction on the basis of the control group, and both groups were treated for 8 weeks.24 h dynamic electrocardiogram (ECG), renin activity plasma (PRA), angiotensin Ⅱ (angiotensionⅡ) and ALD (Ang) were observed before and after treatment.The clinical effects were evaluated.Results The total effective rate showed significant difference between the observation group and the control group (75.9％ vs.57.4％;x2=4.167, P=0.041) after the treatment.After treatment, Ang-Ⅱ (56.22 ± 12.7 pg/ml vs.68.45 ± 12.7 pg/ml, t=5.004) in the observation group was significantly lower than the control group (P＜0.01);24 h sinus RR interval standard deviation (129.16 ± 28.56 ms vs.116.13 ± 17.38 ms, t=2.864), every 5 min sinus RR interval mean standard deviation within 24 h (123.57 ± 25.24 ms vs.112.46 ± 18.23 ms, t=2.622), and within 24 h of sinus RR interval difference rms (31.76 ± 11.42 ms vs.22.64 ± 10.32 ms, t=4.354) in the observation group were significantly higher than the control group (P＜0.01).Conclusion Zaobo decoction combined with bisoprolol can effectively improve heart rate variability, regulate rernin vascular angiotensin system, and improve the clinical efficacy of the patients with ventricular premature beat.

The stereoselective hydrolysis of esmolol in whole blood and in its separated components from rat,rabbit and human was investigated.Blood esterase activities were variable in different species in the order of rat ＞ rabbit ＞ human.Rat plasma showed the high esterase activity and had no stereoselectivity to enantiomers.Rabbit red blood cell (RBC) membrane,RBC cytosol and plasma all hydrolyzed esmolol but with different esterase activity,whereas the hydrolysis in RBC membrane and cytosol showed significant stereoselectivity towards R-(+)-esmolol.Esterase in RBC cytosol from human blood mainly contributed to the esmolol hydrolysis,which was demonstrated with no stereoselctivity.Esterase in human plasma showed a low activity,but a remarkable stereoselectivity with R-(+)-esmolol.In addition,the protein concentration affected the hydrolysis behavior of esmolol in RBC suspension.Protein binding of esmolol enantiomers in human plasma,human serum albumin (HSA) and α1-acid glycoprotein (AGP) revealed that there was a significant difference in bound fractions between two enantiomers,especially for AGP.Our results indicated that the stereoselective protein binding might play a role in the different hydrolysis rates of esmolol enantiomers in human plasma.

Objective To investigate and compare the clinical thinking ability of medical graduate students of different majors and different grades to explore the influencing factors of clinical thinking ability. Methods 180 graduate students in Medical College of Qingdao University were sur-veyed,including 54 nursing and 126 clinical medicine graduates of different grades. We used a self-designed scale of clinical thinking ability which included three main dimensions (critical thinking abil-ity, systematic thinking ability, evidence-based thinking ability) and twenty-four level 2 items. Ap-plying t test, ANOVA, multiple linear regression analysis for data statistical analysis. Results There's no significant difference comparing the scores of nursing graduates to the scores of clinical medical graduates(t=-0.80, P>0.05). However, there is significant difference in the different grade graduates (F=53.43, P<0.05). The multiple linear regression analysis shows that the practice time, reading professional literature quantity, and starting research earlier or later,are signif-icantly related to the clinical thinking ability(P<0.05). Conclusion The clinical thinking level of medical graduate students is generally high, and the higher grade, the higher level of clinical think-ing ability. We must strength-en the training of clinical thinking ability of medical graduates.

Objective According to the analysis on nonconformities which were found from on-site assessmentin medical laboratory ISO15189accreditationcarried on byChina National Accreditation Service for Conformity Assessment(CNAS) during years 2004to 2013,to study current status of quality management in domestic medical laboratory.Methods By means of retrospective analysis, nonconformities found in 171 times of on-site audit of 133 clinical laboratories in ISO15189 accreditation during 2004 to 2013 were collected and then classified according to requirements of ISO 15189.Results Among 1 501 nonconformities involved in 171 times of on-site audit, management and technical requirements accounted for 28.5%(428) and 71.5% ( 1073 ) respectively.The mainly clauses of nonconformity were 4.3 ( 26.2%) and 4.6 (12.6%) in management requirements and 5.3 ( 25.2%), 5.4 ( 13.1%), 5.5 ( 16.0%) and 5.6 (20.2%)in technical requirements.The mainly subclauses of technical requirements were 5.3.2, 5.3.7, 5.4.3, 5.4.9, 5.5.2, 5.5.3, 5.6.1, 5.8.3 and 5.8.10.Conclusion The weakness for the medical laboratory quality management is mainly process control(5.4, 5.5 ,5.6), laboratory equipments (5.3), document control (4.3) and external services and supplies (4.6), which werethe main directions need to be improved in current medical laboratory quality management.

AIM To study the effects of nalox-one on plasma endothelin-1 and nitric oxide during myocardiac ischemia-reperfusion ( I/R ) injury. METHODS Using myocardiac ischemia models and myocardiac ischemia -reperfusion injury models that was made by means of ligating sinistra corona-ria arteria,to investigate the change of plasma ET-1 and NO during I/R injury, and after the protection and treatment with naloxone,an antagonist of opoid receptor. 40 New Zealand rabbits were randomly assigned to 4 groupsCischemia group, nalox-one protection group, naloxone treatment group and ischemia-reperfusion group, 10 in each group). The blood was phlebotomized at different time in each group. The concentration of ET-1 was detected with radioimmunology method and NO with nitrate reductase method. RESULTS The levels of ET-1 had the trend of improvement after ischemia and were at its peak at the end of 4 h, but the levels of NO were significantly decreased. The ET-1 levels were significantly improved after 0. 5-1 h of injury compared with that before ischemia (P 0. 05). The levels of NO decreased after injury , whereas its levels in naloxone protection group increased significantly compared with that before ischemia ( P 0.05). CONCLUSION Naloxone may effectively reduce the level of ET-1 and enhance the level of NO after myocardiac ischemia and during I/R injury; whereby it decreases the injury to vascular and myocardium.

Background and purpose: As the most common tracer used for PET/CT to detect malignant tumors. ~(18)F-fluorodeoxyglucose (~(18)F-FDG) can reflect the metabolism of glucose. However, there exists physiologic uptake in the intestinal tract of healthy people. Because ileocecal foci is predilection site of malignant tumors and inflammatory disease, the purpose of this study was to investigate the discrimination of PET/CT detection of incidental ileocecal high FDG uptake. Methods: We retrospectively analyzed 28 unexpected ileocecal focal uptake of ~(18)F-FDG localized by PET/CT, and then semi-quantitatively analyzed the extent of radioactive uptake in ileocecal foci. After PET/CT, the etiology of the findings was confirmed histologically by surgery, endoscopic or by long-term follow-up. All the data were assessed for statistical significance using one-way ANOVA. Results: In all the ileocecal foci, there were 14(50%) physiologic FDG uptake, 8 (28.6%) benign diseases and 6 (21.4%) malignant tumor. Maximal standardized uptake value was 5.2±1.6 in physiologic uptake, 6.8±4.1 in benign lesions and 12.8±5.5 in malignant lesions. There was statistically significant difference between malignant tumors and the other 2 groups. According to ROC analysis, when SUN_(max) was 6.75, the sensitivity and specificity of ileocecal malignant tumor were 100% and 86.4%, respectively. Conclusion: The significant value of discrimination between benign and malignant lesions of ileocecal focal FDG uptake by PET/CT was affirmative. It is very important to recognize physiologic uptake of ileocecal conjunction in the interpretation of image. Semi-quantitative analyze was not helpful to identify benign lesions from physiologic uptake.