Exogenous surfactant replacement has been successfully achieved and become standard therapy in neonatal respiratory distress syndrome,but clinical trials in acute respiratory distress syndrome (ARDS) had mixed results.Early studies show that pulmonary surfactant(PS) administration in ARDS can significantly improve oxygenation and decrease mortality,but in recent years,some clinical trials haven't achieve the most substantial benefits to long-term patient outcomes.The inconsistent results of clinical trials may have related to aspects of drug composition,dosing,delivery,and timing.At this time,surfactant therapy cannot be recommended as routine therapy in pediatric ARDS.

The abnormalities of retinal vessels such as retinal arteriolar narrowing,arteriovenous nicking,micro-aneurysms,retinal hemorrhages,and cotton wool spot are closely related to systemic diseases including hypertension,diabetes mellitus,cardiovascular disorders,stroke and renal diseases.The modern retinal vessels examination technology has features of quick noninvasive,quantitative standardized and intelligent analysis.Taking advantage of these to fully discover the retinal vascular abnormalities and get deeper understanding of the relationship between its' mechanism and systemic vascular diseases is not only helpful to better diagnose and treat retinal vascular diseases,but also contributes to predicting the risk and prognosis of systemic diseases.We suggest emphasizing on the study of correlation between retinal vascular abnormalities and systemic vascular diseases using modern retinal vessels examination technology.It will provide the preventive clue of diseases of circulatory system by finding out the retinopathy.Meanwhile,correctly treating systemic diseases would get a better prognosis of the retinopathy.They exist side by side and play a part together for providing a better prognosis,which would be a new direction for the doctors and scientists in the new era.

The epidermal stem cell was introduced briefly in this review.And then the spacial characteristics of diabetic wound healing were summarized.In this regards,we focus on the important role of epidermal stem cell in diabetic wound healing.At last,we outlook the research direction and clinical application of epidermal stem cell in diabetic wound.

Objective To understand the current situation of neurology nurses′self-efficacy and quality of nursing services in Lanzhou area, and explore the relationship between self-efficacy and the quality of nursing services. Methods Using the method of questionnaire, one hundred and the neurology nurses and hospitalized patients in 5 Grade 3 Level hospitals of Lanzhou city were investigated by using self-efficacy scales and Servqual scales. Results Neurology nurses′ self-efficacy in Lanzhou area was lower than the general population ( U=-9.875,P=0.042);the scores of quality of care from high to low were at reliability, tangibles, assurance, responsiveness, cost acceptability and empathy, which were-(0.12 ± 0.05) points,-(0.23 ± 0.03) points,-(0.24 ± 0.06) points,-(0.25 ± 0.02) points,-(0.26 ± 0.05) points,-(0.66 ± 0.03)points.Satisfaction arranged from high to low were assurance (89.98%), reliability (89.69%), responsiveness (89.12%), tangibles (87.66%), cost acceptability (87.08%), empathy (86.67%).There were positive correlations between satisfaction and expectations and perceived service quality, and the correlation between satisfaction and perceived qualities of service was higher. Moreover, there might exist positive correlation between self-efficacy score and quality of nursing services (reliability, assurance, responsiveness, empathy) (P values were 0.002, 0.001,0.012 and 0.005). Conclusions Neurology nurses in Lanzhou area have lower self-efficacy, and the perceived qualities of care from patients never exceed their expectations. As results, hospital managers should take measures to improve general self-efficacy of nurses, and thus enhance the quality of care.

After the basic contents of MOOC and flipped classroom were introduced, MOOC-based flipped classroom teaching model for Chinese medical literature information retrieval course was described, its design and implementation were elaborated with CBM Database as an example.

OBJECTIVE:To prepare Ankang oral liquid and to establish its quality control method.METHODS:Quali?tation identification of the principal agents like Fructus citri sarcodactylis and Radix Curcumae were performed by TLC,the content of hesperidin was detemined by HPLC.RESULTS:The TLC spots were clear and centralized,the linear range of hesperidin was0.04168?g～0.4168?g,the average recovery was98.11%,RSD=0.25%.CONCLUSION:The preparing technique was simple and its quality is stable,the quality control method is accurate and feasible.

Objective To investigate the effects of Yindan-Xinnaotong combined with aspirin on lipidemia levels and hemorrheology in patients with stroke. Methods A total of 62 patients with stroke were randomized into a treatment group (31 cases) and a control group (31 cases). The patients in the control group were treated with aspirin and those in the treatment group were treated with aspirin and Yindan-Xinnaotong capsule (4 capsules each time, 3 times/d) for 30 days. The lipidemia levels and hemorrheology were evaluated before and after the treatment. Results After the treatment, whole blood viscosity (4.15 ± 0.14 mPa?s vs. 5.25 ± 0.40 mPa?s;t=14.452, P<0.01), plasma viscosity (1.70 ± 0.30 mPa?s vs. 2.70 ± 0.25 mPa?s;t=14.258, P<0.01), fibrinogen (3.71 ± 0.51 g/L vs. 5.80 ± 0.41 g/L;t=17.783, P<0.01) and thrombosis index (0.75 ± 0.31 vs. 1.30 ± 0.21;t=8.178, P<0.01) in the treatment group were significantly lower than those in the control group. After the treatment, the serum levels of total cholesterol (3.31 ± 1.19 mmol/L vs. 5.04 ± 1.30 mmol/L;t=5.465, P<0.01), triacylglycerol (0.63 ± 0.31 mmol/L vs. 1.34 ± 0.05 mmol/L;t=12.589. P<0.01) in the treatment were significantly lower than those in the control group, the serum level of high-density lipoprotein cholesterol in the treatment group was significantly higher than that in the control group (1.83 ± 0.49 mmol/L vs. 1.28 ± 0.45 mmol/L;t=4.603, P<0.01), and there was no significant difference in the serum level of low-density lipoprotein cholesterol between the two groups (2.22 ± 0.61 mmol/L vs. 2.11 ± 0.95 mmol/L; t=0.543, P>0.05). Conclusion Yindan-Xinnaotong combined with aspirin can improve the lipidemia and hemorrheology in stroke patients.

Taking Liaoning University of Traditional Chinese Medicine as an example, a survey of seven-year program students in-formation quality is made.Based on the survey result, it discusses the content, teaching method and approach reform of Traditional Chi-nese medicine literature and information retrieval course for seven-year program students, so as to make better contribution to improving the information literacy of the seven-year program students.

Objective To compare the efficacy and complications of early transabdominal preperitoneal patch (TAPP) implantation and open tension-free repair in the treatment of adult inguinal hernia .Methods 84 adult patients with inguinal hernia were divided into two groups by random number table ,and 42 cases in each group .The control group was given Lichtenstein technique ,while the observation group underwent TAPP .The surgery situation, postoperative visual analogue scale (VAS) scores,postoperative morbidity and recurrence rate were compared between the two groups.Results The operative time,ambulation time,average length staying hospital and postoperative VAS scores of the observation group were (42.21 ±3.13) min,(1.13 ±0.21) d,(4.28 ±0.62) d and (2.28 ±0.22) points,which were significantly less than (65.72 ±3.62)min,(2.03 ±0.30)d,(7.87 ±0.83)d and (4.56 ±0.31) points of the control group(t=7.29,8.02,8.32,9.29,all P<0.05).The incidence rate of postoperative complica-tions and recurrence rate of the observation group were 11.90% and 2.38%,which were significantly lower than 26.19%and 16.66%of the control group(χ2 =12.52,14.39,all P<0.05).Conclusion The effect of TAPP in the treatment of adult inguinal hernia is remarkable ,and it is safe and minimally invasive ,which is easy to operate ,it has low recurrence rate ,rapid postoperative recovery and has better clinical value .

Objective:To explore the significance measuring serum levels of high sensitive C reactive protein (hsCRP),ho-mocysteine (Hcy)and carotid atherosclerosis lesion in patients with coronary heart disease (CHD)complicated atrial fibril-lation (AF).Methods:A total of 84 CHD + AF patients (CHD + AF group),42 CHD patients with sinus rhythm (sinus rhythm CHD group)and 40 healthy subjects (healthy control group)were selected.CHD + AF group was further divided into paroxysmal AF group (n=31),persistent AF group (n=27)and permanent AF group (n=26).Serum levels of hsCRP and Hcy and carotid intima-media thickness (IMT)were measured in all groups,and Crouse integral of atheroscle-rotic plaques was calculated.Results:Compared with healthy control group,there were significant rise in serum levels of hsCRP [(4.97±2.14)mg/L vs.(8.96±3.75)mg/L vs.(6.83±2.91)mg/L],Hcy [(15.48±4.36)μmol/L vs.(23.64 ±7.06)μmol/L vs.(17.76±4.83)μmol/L],IMT [(1.21±0.15)mm vs.(1.71±0.19)mm vs.(1.36±0.17)mm]and plaque Crouse integral [(4.13±1.06)scores vs.(7.89±1.35)scores vs.(4.96±1.21)scores]in CHD + AF group and sinus rhythm CHD group,P <0.05 or <0.01;and those of CHD + AF group were significantly higher than those of sinus rhythm CHD group,P <0.01 all,compared with paroxysmal AF group,there were significant rise in serum levels of hsCRP,Hcy,IMT and plaque Crouse integral in permanent AF group and persistent AF group (P <0.05 or <0.01),and those of permanent AF group were significantly higher than those of persistent AF group (P <0.05 or <0.01);Pearson correlation analysis indicated that in CHD + AF group,serum levels of hsCRP and Hcy were positively correlated with AF duration (r =0.619,0.527,P<0.05 both),and positively correlated with Crouse integral of carotid plaque (r =0.438, 0.561,P<0.05 both),and Crouse integral of carotid plaque was positively correlated with AF duration (r =0.624,P <0.05).Conclusion:Inflammatory reaction,oxidative stress and carotid atherosclerosis are more severe in CHD + AF pa-tients,and they aggravate along with AF duration prolongs.