Objective To evaluate clinical importance of high ligation combined with endovenous laser treat-ment(EVLT)for great sapenous varicose veins patients with diabetes,to provide a reference for clinical treatment. Methods 65 great sapenous varicose veins patients with diabetes were selected,and they were set as the observation group with treatment of high ligation combined with EVLT;while 50 great sapenous varicose veins patients without diabetes were selected during the same period,they were set as the control group under the same treatment.Clinical effect and complication were compared between the two groups.Results The wound cure rate of the observation group was 96.92%,surgery time was (42.94 ±7.93)min,hospital stay time was (6.87 ±1.74)d,there were no statistical differences compared with the control group (χ2 =1.003,P =0.174;t =0.994,P =0.254;t =0.883,P =0.317);The complication rate of the observation group was 18.46%,that of control group was 18.00%,there was no statistical difference between the two groups(χ2 =1.114,P =0.097).Conclusion With control of blood sugar,high ligation combined with endovenous laser treatment can get a good result and safety performance for great sapenous varicose veins patients with diabetes.

Objective:To investigate the intervention effect of vitamin C for the treatment to diabetes patients with diabetes and gastric ulcer.Methods: 53 cases of patients with diabetes combined with gastric ulcer were selected as the research subjects, and were divided into a control group(23) and a intervention group(30). The patients in two groups were given the treatment of reducing blood sugar and anti-HP triple therapy. The intervention group was given additionally diet intervention via eating vitamin C. The blood sugar, blood lipid levels, gastric ulcer index and inflammatory markers of the two groups were reviewed six months later by helicobacter pylori type detector. And the statistical analysis was performed.Results: After treatment, the blood sugar, blood lipid levels, gastric ulcer index and inflammatory markers of the two groups were significantly improved (t=1.23,t=1.35,t=2.63,t=1.07,t=0.77,P<0.05), except for the HP cure rate (P>0.05). Other indexes of the intervention group are significantly better than the control group (t=1.45,t=1.67,t=2.33, t=1.55,P<0.05).Conclusion:Vitamin C play a very good role in the treatment and prevention for the blood sugar, the blood lipids, gastric function and inflammation of patients with diabetes and gastric ulcer, and helicobacter pylori type detector can simplify the detection of helicobacter pylori.

Health education is not only the first step to health management,but also an important health intervention.It has an important significance for promoting the development of health management because it runs through the whole process of health management.However,because the health management has just started in our country,it faces many challenges when putting the health education into effect in the health management process.From the organizational structure,management system,resources,education content and method of the implementing body,this paper summarized eight problems existing in the implementation.This paper tried putting forward corresponding countermeasures,and hoped to be helpful to the further development of health education.

Objective To explore the effectiveness of bilevel positive airway pressure(Bipap)ventilation via nasal/ mouth mask in patients with respiratory failure secondary to the acute exacerbation of chronic obstructive pulmonary diseases(COPD).Methods 40 patients were randomly submitted either to standard therapy(consisting of medical,oxygen and physical therapy)plus BiPAP or to standard therapy.Clinical manifestation were comparatively analyzed before and after 4 hours and 7 days of treatment in each group.Results After 4 hours and 7 days of treatment by BiPAP,patients showed a significant improvement in PaCO_2,and clinical manifestation,and there was a significant difference between the two groups.Conclusion Bipap ventilation is effective in patients with respiratory failure during acute exacerbation of COPD.

Objective To investigate the diagnostic value for rheumatoid arthritis(RA) by using combined detection of anti‐cy‐clic citrullinated peptide antibody (anti CCP ) ,anti keratin antibody (AKA ) and the antiperinuclear factor (APF ) in serum . Methods A total of 110 RA patients(RA group) ,50 patients with other autoimmune diseases(non RA group) and 110 healthy subjects (control group) were enrolled in the study .The concentrations of AKA ,APF were detected by using indirect immunofluo‐rescence assay and anti CCP by using ELISA .Results The positive rates of anti‐CCP ,AKA ,APF in RA group were higher than those in non RA group and control group(P<0 .05) .In the series detection of the three indicators ,the sensibility and specificity were 44 .55% and 99 .38% respectively ;in the parallel detection of the three indicators the sensibility and specificity were 93 .64%and 85 .63% respectively .Conclusion Anti CCP detection exhibits relatively higher sensitivity and specificity in the diagnosis of RA .Series detection of the 3 indicators can improve the specificity ,reduce the rate of misdiagnosis;parallel detection of the 3 indica‐tors can improve the sensitivity ,reduce the rate of misdiagnosis .The Combined detection of anti CCP ,AKA and APF has better di‐agnostic efficiency than single detection .

Objective To investigate the histological injury as well as the risk factors for the course of HBeAg-negative chronic hep-atitis B virus( HBV)-infected patients with persistently normal alanine aminotransferase ( ALT) levels ( PNAL) . Methods Ninty four patients of HBeAg-negative chronic HBV-infected with PNAL were performed liver puncturing. The ALT, HBV markers, and liver histo-logical changes were detected. The gender, age, family history, HBV-DNA and HBsAg levels were compared between different patients with liver inflammation and fibrosis. And the Logistic model was used during the analysis of independent risk factor. Results Among 94 cases, patients with inflammatory necrosis classification≥G2 accounted for 74. 5%, fibrosis grading≥S2 accounted for 27. 7%. Patients in the group of inflammatory necrosis classification≥G2 was older than the group of < G2, and the ALT level of≥G2 group was higher, as well as a higher HBV-DNA. What is more,Patients in the group of inflammatory necrosis classification ≥G2 were mainly male, and were associated with a family history of hepatitis B. Patients in the group of fibrosis stage ≥S2 was older than < S2 group, and the ALT level of fibrosis stage ≥S2 group was higher. And those patients were often associated with a family history of hepatitis B, but there was no significant difference among the HBV-DNA level and gender constitution. HBV-DNA and family history were the independent risk fac-tors of liver inflammation necrosis≥G2, and family history was the only independent risk factor of fibrosis stage≥S2. Conclusion The patients of HBeAg-negative chronic HBV-infected with PNAL, regardless of the ALT and HBV-DNA, must have a liver biopsy. The pa-tients with high level of HBV-DNA and with a family history of hepatitis B should be performed liver puncturing accordingly.

Objective To evaluate the diagnostic values of enzyme‐linked immunosorbent assay (ELISA ) and colloidal gold im‐munochromatographic assay in detecting serum anti‐cyclic citrullinated peptide(anti‐CCP) antibody .Methods Colloidal gold immu‐nochromatographic assay and ELISA were used to detect serum anti‐CCP antibody in 110 RA patients and 110 healthy cases . Results The data were analysed with the paired Chi‐Square Test (χ2 = 174 .354 ,P < 0 .01) ,the difference was significant .The K ap pa value was 0 .890(P< 0 .01) ,indicating that the coincidence between the two kinds of methods was good .The sensitivity , speciality of ELISA were 83 .64% and 92 .73% respectively .Conclusion In detecting serum anti‐CCP Antibody ,there was dife‐rence between colloidal gold immunochromatographic assay and ELISA according to statistics analysis .The sensitivity and speciality of ELISA were higher than those of colloidal gold immunochromatographic assay .

OBJECTIVE:To provide a reference for promoting and strengthening pharmaceutical services by retail pharmacies in rural area in Yongzhou of Hunan. METHODS:Investigation was conducted on 13 aspects including the service concept,service mode,service process,service contents,hardwares and softwares and professional quality of practitioners of 357 retail pharmacies in rural area in Yongzhou of Hunan to know about current pharmaceutical services. RESULTS & CONCLUSIONS:In this area, 78.9% of pharmacies operated in the name of a licensed pharmacist or pharmacist who did not work in that pharmacy;only 53.3%of practitioners were pharmacy graduates;the proportion of the practitioners who takes part in training every year was less than 30.0%,average training time was not more than 8 hours;65.3% of practitioners in the pharmacies were not aware of the concept of pharmaceutical services;the pharmacies which were not equipped with basic hardwares and softwares for pharmaceutical servic-es accounted for 47.0%,those which had not established a pharmaceutical service management process accounted for 87.4%;and less than 10.0% of retail pharmacies provided door-to-door pharmaceutical services. Safe,effective and rational drug use should be achieved by intensifying the management and training for retail pharmacy practitioners,standardizing the contents of pharmaceutical services,establishing standard pharmaceutical service process,defining basic hardwares and softwares for pharmaceutical services, strengthening performance appraisal and evaluation for pharmaceutical services and urging the pharmacy to serve society.

Objective To evaluate the clinical results and the value of usefulness with the operation methods of posterolateral transpedicular approach in treating thoracic disc herniation. Methods Selecting the patient who treated in our hospital from November 1999 to November 2003. In all the 45 patients who suffered from thoracic disc herniation, we had got 43 patients followed up, the following-up times were from 1.2 to 3.5 years. 38 patients were treated with posterolateral unilateral transpedicular approach operation method. There were 26 males and other 19 females. The patients were from 30.5 years old to 67.5 years old, and the mean age was 46.5 years old. The interval between onset of symptoms and operation ranged from 5 to 12 months, and 9 months for average. In this group, 45% patients were involved in T9-10 and T10-11 disc herniation, 4 cases(11%) in T8-9, 4 cases(11%) in T11-12, and 4 cases(11%) in T12L1. All patients underwent X-ray and MR examination. 22 patients underwent myelography, 25 patients underwent CT or CTM examination. Using Otanni scored system to evaluate the clinical results. Selecting the SPSS 11.5 to do the statistics works. Results A perfect result was found in 16 patients, a good result was found in a further 18 patients, and a fair result was found in 2 patients the outcome was unchanged with no effect in 2 cases. No clinical or radiographic features of instability, nervous symptoms and wound infection were found. The clinical satisfaction rate was 89.74%, the results showed that it was a good result of posterolateral entrance operation. Conclusion The posterolateral transpedicular entrance operation shows a good result in treating patients who suffered from thoracic disc herniation.

[Objective]To study the clinical manifestation,early diagnosis and surgical outcomes of traumatic thoracic disc herniation.[Method]Eleven patients of traumatic thoracic disc herniation were selected from June 2000 to June 2005.There were 8 males and 3 females with an average age of 23.96 years old(ranged,15-38 years old).The average time from traumatism to diagnosis were 4.1 months(range,2 days to 8 months).After early clinical diagnosis,discectomy through posterolateral transpedicular approach were carried out for all 11 patients.[Result]All 11 patients were followed up for an average time of 2.6 years(range,1.1～3.8 years).According to Otani's classification criterion,the results were excellent in 7cases,good in 3 cases,fair in I cases,no poor case and failure case.The excellent and good results were obtained in 90.91% of the patients.[Conclusion]The incidence of traumatic thoracic disc herniation is rather low,and this disease has no representative symptom and sign.Early diagnosis and operative treatment is a very effective guarantee to curative effect for traumatic thoracic disc herniation.