Objective To investigate the change of homocysteine level,vascular endothelial growth factor (VEGF) and adiponectin levels in type 2 diabetic patients with diabetic retinopathy and its signicance.Methods 60 patients with diabetic retinopathy ( DR group) and 40 patients with normal fundus ( NDR goup) were selected.30 healthy subjects were used as control group.The serum levels of Hcy,VEGF and adiponectin were detected.Results The serum levels of Hcy and VEGF of DR group and NDR goup patients were higher than that of control group and had statistical significance(all P ＜0.05) ;The serum levels of Hcy and VEGF of DR group were higher than that of NDR group( all P ＜ 0.05 ).The serum level of adiponectin of DR group and NDR goup patients was lower than that of control group ( all P ＜ 0.05 ) ; The serum level of adiponectin of DR group was lower than that of NDR group ( all P ＜ 0.05 ).Hcy and VEGF had a positive correlation with adiponectin( all P ＜ 0.05 ).Conclusion Hcy,VEGF and adiponectin may play important roles in the initiation and sustainment of DR.

While the development and application of gene technology are benefiting human beings widely and deeply, it also arouses people's special attention towards the sustaining of human value and dignity. Ethic problems caused by gene diagnosis, gene treatment and the interpretation of human genome code allow no ignorance. It is an important researching subject in the 21th century to conduct scientific ethical education to personnel of gene technology and medical students according to correct ethic education principles, so as to avoid or reduce the damage caused by it as much as possible.

Background:As a minimally invasive treatment of early gastric cancer,endoscopic submucosal dissection(ESD) proves it could reduce postoperative complications and improve the quality of patients’life. However,ESD-induced gastric ulcer remains a problem. Aims:To evaluate the effect of teprenone combined with rabeprazole on post-ESD ulcer healing and prevention of bleeding after gastric ESD. Methods:One hundred and twenty cases of early gastric cancer or precancerous lesion treated by gastric ESD were divided randomly into group A and group B. Patients in group A were given teprenone combined with rabeprazole,while patients in group B were given rabeprazole alone. The treatment course was 8 weeks. Delayed bleeding rate after ESD and ulcer healing in the two groups were compared. Results:No significant difference was found in rate of delayed bleeding after ESD between the two groups(P = 0. 679). The stage of ulcer had no differences after 7 days of ESD(P > 0. 05),while showed a better healing stage in group A after 30 days and 60 days of ESD(P < 0. 05). The rates of decreased size and area of ulcer were higher in group A after 30 days of ESD(P < 0. 05), while had no statistical differences after 60 days of ESD(P > 0. 05). Conclusions:Teprenone can effectively promote post ESD ulcer healing,especially in the early stage of healing,thus reducing the rate of bleeding after gastric ESD.

Objective:To discuss the relevant factors between occurrence rate of ventilator associated pneumonia (VAP) and sedative therapy of patients adopted mechanical ventilation in intensive care unit (ICU) so as to improve strategy of sedation and reduce occurrence rate of VAP.Methods: The clinical data of 218 patients of ICU who were implemented mechanical ventilation combined with sedative were retrospectively analyzed. All of patients were divided into observation group (61cases) and control group(157cases) according to whether happened VAP. And the differences of sedative time, score of sedation, time of mechanical ventilation and stayed time in ICU between the two groups were analyzed and compared.Results: In observation group, the total sedative time was (7.51±7.86)d, score of sedation was (-2.69±1.09), time of mechanical ventilation was (8.52±17.11)d and stayed time in ICU was (24.44±21.93)d. In control group, all of these indicators were (3.83±2.91)d, (-1.22±1.52), (6.47±5.70)d, and (11.63±7.49)d, respectively. And the differences of them between the two groups were statistically significant (t=6.8850,t=5.0334,t=7.8012,t=6.4368,P<0.05).Conclusion: The sedative time, sedative depth of patient adopted mechanical ventilation are positively relevant with the occurrence rate of VAP, and the occurrence rate can be reduced through improving the strategy of sedation.

Objective To explore the therapeutic effect of drug combined with psychological intervention on the patients with chronic urticaria.Methods 119 patients who were diagnosed and diagnosed in our hospital from October 2015 to November 2016 were randomly divided into experimental group and control group according to the time of hospitalization.example.The experimental group for drug and psychological intervention in the double treatment;the control group for simple drug treatment.Results There were different degrees of mental health problems in patients with chronic urticaria, and there were many significant differences in mental health problems, such as tension, insomnia, anxiety and mood, muscle system symptoms.In the experimental group and the control group, there was no significant difference between the experimental group and the control group.However, the data of the experimental group and the control group were statistically significant (P<0.05), but there was no significant difference between the experimental group and the control group.In addition, after 4 weeks of treatment, the experimental group and the control group of patients with significant differences in treatment, respectively, 91.53% and 79.66%.There was significant difference between the two groups (P<0.05).Conclusion Compared with the single drug treatment, the effect is more significant which drug combined with psychological intervention was used on the treatment of the patients with chronic urticaria, and has certain positive significance.It can be popularized in clinical practice according to the actual situation.

Objective:To analyze the pharmaceutical care performed by clinical pharmacist for one patient with biliary tract infec -tion to investigate the role of clinical pharmacists in clinical treatment .Methods:The clinical pharmacist supervised the whole process of treatment for the patient and optimized the treatment regimen together with the clinical doctors to achieve good efficacy .Results:With the cooperation of clinical pharmacist , the clinical doctors changed the treatment drugs to avoid the potential adverse drug reac -tions until the patient was cured .Conclusion:The participation of clinical pharmacist in the pharmaceutical care for the patients with biliary tract infection can provide a new thought of working mode .

OBJECTIVE:To provide reference for promoting rational drug use and formulating medication policy by health ad-ministrative department. METHODS:The utilization of top 20 adjuvant drugs in the list of consumption sum in 11 tertiary hospitals from Xi’an area during 2013-2015 was analyzed statistically in respects of total consumption sum and constituent ratio,the con-sumption sum of single type,DDDs,DDC,ADR,etc. RESULTS:The total consumption sum and the proportion of adjuvant drugs in 11 tertiary hospitals from Xi’an area increased year by year from 2013 to 2015,accounting for 8.43%,10.25% and 12.20%,respectively. 13 kinds of adjuvant drugs were included in top 20 in the list of total consumption sum from more than 3 hospitals. Deproteinised calf blood serum injection,Alprostadil injection and Danhong injection took up the first 4 places in the list of consumption sum,and Salvianolate for injection took up the first 3 place during 2014-2015. Alprostadil injection,Xueshuantong injection and Spleen peptide oral lyophilized powder took up the first 3 places in the list of DDDs. Spleen polypeptides injection, Yiqi fumai for injection and Cattle encephalon glycoside and ignotin injection took up the first 3 places in the list of DDC,and their DDC were 885.24,372.34 and 349.37 yuan. The incidence of adjuvant drugs-induced ADR increased year by year,increasing from 9.13% of 2013 to 13.49% of 2015. CONCLUSIONS:At present,adjuvant drugs become the important part of clinical drug use in Xi’an area. The consumption sum and amount is increasing rapidly. Great importance should be attached to the rational use and safety of adjuvant drugs so as to control the unreasonable increase of drug expenses.

The demands for Traditional Chinese Medicine(TCM)standardization are rising internationally,but the development for TCM intemational standards is confronted with competence.In this context,the authors analyzed the competing status of intemationalized TCM standardization from 3 aspects:1.It is the key point for competition that obtaining leadership in the international organization and dominant position in developing important intemational standards:2.Integrating technical development and intellectual property with intemational standards has been gradually formed;3.Striving to make breakthrough in the development of TCM international standards on the basis of TCM Chinese national standards.The authors recommend that international standards be initiated from TCM service standards.TCM products quality standards and TCM process standards.

Objective To understand the clinical significance of serum immunoglobulins and C3 at the initial episode on the treat-ment and prognosis of childhood primary nephrotic syndrome(PNS) .Methods 426 children patients with first episode of PNS ad-mitted to the nephrology department of our hospital from January 1 ,2003 to December 30 ,2012 were retrospectively analyzed .The clinical data were collected for conducting the analysis on the immuneglobulins and C 3 levels in different age groups ,clinical classifi-cation ,hormone response ,recurrence ,prognosis and correlation among various pathological types .Results (1)Compared with the healthy children ,the peripheral blood IgG level in childhood PNS was significantly decreased ,while the IgM and IgE level were sig-nificantly increased .(2)The IgE level in steroid-sensitive nephrotic syndrome(SSNS) was higher than that in steroid-resistant ne-phrotic syndrome(SRNS);which in frequent recurrence nephrotic syndrome was higher than that in non-recurrence nephrotic syn-drome .(3) The C3 level in the PNS children patients aged over 1 years and nephritis nephrotic syndrome(NNS) was lower than that in simple nephrotic syndrome(SNS) .Conclusion PNS is correlated with the immune dysfunction .Serum IgE level increase clinically manifests by the steroid sensitivity and frequent relapse ;the lower the C3 level ,the poorer the prognosis .

Objective To explore the characteristics of T wave alternans (TWA) in aortic stenosis (AS) in school-aged children. Methods TWA was analyzed in 15 AS patients and 60 age-matched normal children using Microvolt T-Wave Alternans and the incidence of sustained TWA was compared between two groups. Myocardial ischemia during treadmill test was studied in sustained TWA and non-sustained TWA in AS patients. Results Compared with normal children, the incidence of sustained TWA was signiifcantly increased in AS group (P<0.01). In AS school-aged patients, the incidence of myocardial ischemia is higher in sustained TWA than in non-sustained TWA during treadmill test (P<0.05). Conclusions AS school-aged children have electrophysiologic basis for sunstained TWA. TWA is closely related to myocardial ischemia during treadmill test. Sustained TWA could be used as an important electrophysiologic index to assess the cardiac function in children with AS.