Objective To investigate the effect of thyroxine on elder patients with chronic heart insufficiency. Methods 82 elder patients with chronic heart insufficiency were divided into 2 groups randomly . 46 cases of observation group and 36 cases of control group. All of them were received routine treatment, including vasodilators, diuresis and cardiotonic etc anti-heart failure ways.The group of observation plus thyroxine (20mg/d oral,for 2 weeks ).Cardiac function degree,heart/lung ratio and change of cardiac ejection fraction(F) were observed before and after treatment. Results The value of EF,increased heart/lung ratio reduced,and function of heart were notably improved,as compared with those of the control group (P

Asthma is one of the most chronic airway inflammatory disease,threating the children's health.Bronchiolitis significantly increased the risk of childhood asthma,and many studies have focused on looking for the related factors between bronchiolitis and asthma in recent years.It may be helpful to understand the pathogenesis of the asthma,so as to find new measures for asthma's prevention and treatment.In present studies,bronchiolitis influenced the development of asthma in genetics,immunity,environmental factors and so on.So far,whether bronchiolitis directly causes the development of the childhood asthma,the prevention of bronchiolitis could reduce the asthma morbidity or not,both need more evidences yet.

Obesity and obesity-related diseases have become the main threat to human health .Acid secreted proteins that are rich in cysteine mainly derived from fat tissue , and are associated with insulin resistance , diabetes and diabetic nephropathy .This re-view summaries molecular biology features such as resistance of cell adhesion , regulating cell proliferation , tissue differentiation and embryonic development and the latest research progress of its role in the obesity and obesity related diseases .

Bronchial asthma (also called asthma) is the most common chronic respiratory inflammatory disease in childhood.With the increased incidence of asthma in recent years,the guidelines for diagnosis and treatment of asthma have been also updated quickly at both domestic and overseas.Acute exacerbations of asthma will result in unscheduled medical attendances in emergency department or hospitalizations,and the severe one may be life-threatening,which brings a heavy burden to the families and society.Several guidelines,Meta analysis,and studies in treatment of childhood asthma exacerbations are reviewed in this article,so as to provide recommendations in the treatment of childhood asthma exacerbations for physicians.

Objective To evaluate the early diagnosis value of blood neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) in patients with sepsis-induced acute kidney injury (AKI). Methods A prospective case controlled study was conducted. Fifty-six patients with sepsis but without renal disease admitted to intensive care unit (ICU) of Shanxi People's Hospital from April 2014 to April 2015 were enrolled. Blood lactic acid and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score at ICU admission were recorded. The urine output, blood urea nitrogen (BUN), serum creatinine (SCr), NGAL, IL-18 and tumor necrosis factor-α (TNF-α) were continuously monitored for 48 hours. The patients were divided into AKI group and non-AKI group according to the diagnostic criteria of Kidney Disease: Improving Global Outcomes (KDIGO). The changes trend in above parameters between the two groups at different time points were compared. The early diagnostic value of NGAL, IL-18, and SCr for sepsis-induced AKI was evaluated by receiver operating characteristic curve (ROC). Results Compared with non-AKI group, with the time prolongation after ICU admission, the traditional parameters reflecting AKI urine output in sepsis-induced AKI group was decreased gradually, BUN and SCr were gradually increased, and a statistically significant difference was found at 12 hours between the two groups [BUN (mmol/L): 11.8±3.5 vs. 8.2±3.5, SCr (μmol/L): 88.6±11.3 vs. 74.0±11.0, both P < 0.01]; but the new indicators NGAL and IL-18 reflecting AKI had a statistically significant difference at 6 hours [NGAL (μg/L): 426.7±90.7 vs. 382.3±67.9, IL-18 (ng/L): 75.7±9.3 vs. 70.9±7.3, both P < 0.05]. It was shown that in AKI group, NGAL and IL-18 compared with BUN and SCr increased at least 6 hours ahead of schedule. The area under ROC curve (AUC) of 6-hour NGAL and IL-18 in patients with sepsis-induced AKI were 0.821 [95% confidence interval (95%CI) = 0.713-0.931] and 0.719 (95%CI = 0.584-0.853) respectively, superior to SCr (AUC = 0.677, 95%CI = 0.528-0.825). The cutoff value of NGAL was 363.58 μg/L, and the sensitivity and specificity were 88.0% and 86.7% respectively. Conclusions NGAL and IL-18 in the early prediction of sepsis patients with AKI are better than SCr, and NGAL was most sensitive. Therefore, NGAL can be used as an early biomarker for the diagnosis of AKI in patients with sepsis.

Logistics supplies are essential for normal operations of hospitals,while effective management of hospital suppliers is key to optimizing the materials supplies.An evaluation system is built for both key suppliers and standby suppliers respectively.Based on such a system,a dynamic management mechanism is built to provide long-lasting supplier incentives,for competitive selection and elimination of the suppliers.These efforts enable the hospitals to pick the best suppliers by means of systems and regulations.

As the global economic integration, the trend of internationalization of medical education, social demand for foreign talents is more and more big, the English teaching, especially the doctor-patient communication in English teaching has become a major focus on the teaching content.Learning is the study of doctor-patient communication be-tween medical workers and patients how to mutual understanding, trust and cooperation, common a discipline, to conquer the disease and emphasize ability oriented ESP teaching concept, closely integrated with professional, promotes the student as the center, apply English teaching as means and tools to study, the two organically unifies in together.Practice shows that guided by the ESP teaching concept, improve medical students English power of expression of doctor-patient commu-nication attempt made substantial results.

By analyzing the problems existing in the practice of doctor -patient communication , respectively discusses the speech act theory before the implementation of the implementation of doctor -patient communication oral English training , implementation , and after implementation of the positive role: instant help medical students to master a large number of medical English vocabulary;In view of the students come from different areas , instant help correct the pronunciation and intonation;Benefit based on speech act theory to guide the student to carry on the different roles played in English oral practice helps students to adopt direct and indirect speech act theory and the method of the oral English practice for communication;To improve medical students′professional recognition;To strengthen the medical students′sense of mission .

Objective: To observe the therapeutic effect of acupuncture in the treatment of chloasma.Methods: Ninety patients were randomly divided into treatment group and control group, with 45 cases in each group, then patients in the treatment group were classified into three types according to the syndrome differentiation and were treated with acupuncture, while patients in control group were treated with Vitamin C and Vitamin E. Results: The effective rates in treatment group and control group were 93.3% and 73.3% respectively, and no remarkable difference was found in therapeutic effect among three syndrome-types in treatment group (P＞0.05). Conclusions: Acupuncture therapy has a marked therapeutic effect in the treatment of chloasma of different syndrome types.

Seventy-three patients with bed sores were treated by warming moxibustion. Of the 73 cases, 58 cases were cured, 12 cases improved and 3 cases ineffective, with an effective rate of 95.9%.