ObjectiveTo study the effects of health education on quality of life in patients with osteoporotic fracture.MethodsFrom March 2006 to July 2011,240 patients with osteoporotic fracture admitted into our hospital were randomly divided into the intervention group (130 cases)and the control group( 110 cases).The control group only received routine nursing.The intervention group was applied with health education intervention based upon routine nursing.Bone mineral density were measured with dual energy X ray absorptiometry (DXA,DMS)in L2-4,neck of femur and total hip.MMSE.NIHSS,HAMD,FMA,Barthel index (BI)and WHOQOL-BREF were adopted for effect evaluation before and after three years of follow-up.ResultsAfter 3 years of follow-up,NIHSS and HAMD scores in the intervention group were lower than the control group,MMSE,FMA and BI scores were higher than those in the control group,physical,psychological,social and environmental scores in the intervention group were higher than those in the control group.ConclusionsHealth education for patients with osteopomtic fracture is conducive to patients′ rehabilitation and improvement of quality of life.

Objective:To explore the content and model for clinical pharmacists to carry out pharmaceutical care on elderly pa-tients with atrial fibrillation combined with other diseases treated by warfarin. Methods:One case of an elderly atrial fibrillation patient complicated with coronary artery disease and urinary tract infection suffering elevated INR after the use of warfarin was applied as the example. The pharmaceutical care was carried out by clinical pharmacists including analyzing the causes of elevated INR and assisting the doctor to develop the individualized pharmaceutical care plan. Results: After the adjustment of warfarin dose and the other drugs combined with medical education, bleeding and thromboembolic events did not occur during the hospitalization, and finally, satisfactory effect of anticoagulation therapy was achieved. Conclusion: The implementation of pharmaceutical care on anticoagulation in atrial fi-brillation patients with various diseases is helpful to improve the compliance in patients, avoid the occurrence of adverse drug reactions and guarantee the effectiveness and safety of warfarin.

BACKGROUND:Chitosan (CS) holding a good biocompatibility, biodegradability, antibacterial property and hemostasis effect cannot only promote wound healing and tissue repair, but also exhibit sustained-control release when carrying berberine hydrochloride (Bh). Therefore it functions as an excellent antibacterial and hemostatic material. OBJECTIVE:To prepare the porous CS/Bh composite xerogel and observe its antibacterial and hemostatic properties. METHODS:The porous CS/Bh composite xerogel was prepared using freeze-drying method, and its microstructure was characterized by scanning electron microscope and Fourier transform infrared spectrometer. The biocompatibility was detected through MTT assay and the in vitro antibacterial and hemostatic properties were observed through antibacterial test and blood clotting index. RESULTS AND COCNLUSION:The porosity of the CS/Bh composite xerogel was 83.1%-90.5%and almost degraded after 72 hours of immersion in PBS. The in vitro antibacterial and hemostatic properties of the composite xerogel were significantly better than those of CS, which were enhanced with the Bh content increasing. Additionally, the CS/Bh (10%) composite xerogel showed the best hemostatic and antibacterial abilities in vitro. To conclude, the CS/Bh composite xerogel possesses a good biocompatibility and strong hemostatic and antibacterial abilities, which is a promising postoperative antibacterial and hemostatic material.

OBJECTIVE:To promote the normative management of clinical off-label drug use. METHODS:The degree of devi-ation from the drug instructions and the risk degree were comprehensively considered,and the off-label drug use were classified in-to three different situations for classifying approval and informed consent classifying;situation and effects after classifying were evaluated. RESULTS:The classifying included occasional or small amount off-label use on dosage and drugs solvent (the first), regular off-label use on route or administration(the second)and super-indications drug use with contraindications(the third). The approval was classified as follows as confirmed with signature by doctor,approved by medical department,approved by pharmaceu-tical committee and ethics committee accordingly;informed consent classifying were signing informed consent,informing and re-cording in medical record,informing orally. Off-label drug use approval process was officially initiated from Feb. 2014 to Jun. 2016 in our hospital,51 off-label drug use applications from 13 clinical departments were received,with 16 items belonging to the second situation,35 items belonging to the third. Finally 42 applications were approved and 9 were not. No relevant new/serious ad-verse drug reactions/ events occurred in process of the approved off-label drug use. And no off-label drug use not approved was found to continue to be used in our hospital. CONCLUSIONS:Classification management methods for off-label drug use in our hos-pital have shown high operability,improved the off-label drug use behavior of physicians.

Objective To understand HIV/AIDS related knowledge and attitude among different population groups in Rizhao.Method Self-designed questionnaires were used to investigate HIV/AIDS related knowledge and attitude among rural and urban residents,hotel attendants and government officers.Results The rates of right answers on HIV/AIDS related questions among the government officers,the urban residents,the hotel attendants and the rural residents were 83.38%,72.45%,72.33% and 66.36%,respectively.Conclusion Although different population groups in Rizhao city have relatively high awareness of HIV/AIDS,there still exist some deficiencies,and consequently education and publicity in this respect should be further strengthened.

Objective To evaluate the therapeutic effect of endothelin antagonist on ultraviolet B (UVB)-induced pigmentation in guinea pigs.Methods A skin pigmentation model was established by UVB irradiation in guinea pigs.The modeled animals were divided into 3 groups to be treated with sodium chloride physiological solution (blank control group),an endothelin antagonist (endothelin antagonist group) and arbutin (positive control group),respectively.Before the UVB irradiation,as well as after 15-and 30-day UVB irradiation,Mexameter(R) MX 18 was used to detect the melanin index in the dorsal skin of guinea pigs.After 30-day consecutive treatment,melanin index,the number of melanocytes in the epidermis and melanin content were compared among the above 3 groups.Results After 30-day UVB irradiation,the melanin index in the 9 UVB-irradiated areas on the dorsal skin of guinea pigs significantly increased compared with that before the radiation (P ＜ 0.0001).After 30-day treatment with the 1‰ endothelin antagonist,the melanin index in the UVB-irradiated areas significantly decreased compared with that in the positive control group (P ＜ 0.0001).Melanin content index-1 (MCI-1) was significantly lower in the endothelin antagonist group than in the blank control group (P ＜ 0.05),while no significant difference in MCI-2 was observed among the 3 groups (P ＞ 0.05).Conclusion Topical application of the endothelin antagonist has a certain therapeutic effect on UVB-induced pigmentation in guinea pigs.

The hospital spirit is not only the spiritual support and vital source for staff, but also the concentrat-ed expression of ideology and faith, value orientation, moral trait, psychology tendencies, culture stereotypes, the unified will and code of conduct for all kinds of personnel.The party organizations are the best helmsmen to culti-vate and carry forward the hospital spirit, which reveals distinctive and profound medical ethical principles and norms.In this paper, taking X hospital as an example, we describe the core function of the party committee′s lead-ership and results in the process of breeding, inheritance and innovation of hospital spirit and reflect ethically so as to provide good references for the current hospital spirit cultivation and promotion.

Objective To analyze the safety and tolerability of endoscopic retrograde cholangiopancreatography ( ERCP) for elderly pa-tients in diagnose and therapy. Methods From Jan. 2010 to Dec. 2013, 1 560 patients were collected in our hospital for diagnosis and treatment, 1 116 cases were 60~69 years old, and the other 444 cases were over 70 years old. Retrospective data including clinical and bio-chemical characteristics, ERCP diagnosis and complications were analyzed. Results Using Logistic regression, the potential factors of com-plex multivariable were analyzed, and there was no statistical difference between the two groups (P=0. 039). The successful intubation, in-tubation difficulties and failed intubation in the examination and the treatment were of significantly difference between the two groups (P<0. 05). There were no significant difference between the two groups in common bile duct stones of bile duct obstruction and clinical di-agnosis (P>0. 05), but the ERCP diagnosis, postoperative complications and complications of acute pancreatitis were of certain difference (P<0. 05). Patients over 70 years old were of better tolerance, but their bile duct stones was about two times than that in patients of 60~69 years old (P=0. 004). Conclusion The results show that ERCP for elderly patients in diagnose and therapy is safe and well tolerated, and there were relatively less complications in patients over 70 years old.

Objective To investigate the clinical effect of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in treating senile intertrochanteric fractures.Methods From February 2006 to December 2014,111 cases of senile intertrochanteric fractures treated with PFNA and DHS at our institution were retrospectively analyzed.Fifty-nine cases were treated with PFNA (average age 77.4 years);and fifty-two cases were treated with DHS (average age 76.1 years).The outcome measures collected for statistical analysis on following aspect:surgical time,blood loss in operation,blood transfused,rate of patients transfused,time to partial weight beating,hospital stay,healing time of fracture,orthopedic complications,reoperation rate and post-operation hip function.The Harris Hip Score was used for functional evaluation.Results One hundred and eleven patients were followed up for 10 to 24 months (average 17.2 months).There were no significant differences between two groups with regard to the functional outcome at 1 year,hospital stay,orthopedic complications and reoperation rate (P ＞ 0.05).There were significant differences between the PFNA group and DHS group with regard to the surgical time [(60.7 ±9.9)min vs (97.5 ± 20.5) min],the blood loss in operation [(169.2 ± 82.1) ml vs (428.8 ± 126.O) ml],per patient concentrated red blood cells transfused [(0.7 ± 0.9) U vs (1.2 ± 1.3) U],blood transfusion rate (35.6％ vs 55.8％) and time to partial weight bearing [(12.9 ± 10.3)d vs (47.0 ± 15.5)d] (P ＜0.01).Conclusions PFNA is an effective method for the treatment of senile intertrochanteric fracture with the advantages of simple operative procedure,minimally invasion,stable fixation and fewer complications.

Objective To com pare and explore the application value of diatom nitric acid digestion method and plankton 16S rDNA PCR method for drow ning identification. Methods Forty drow ning cases from 2010 to 2011 were collected from Department of Forensic Medicine of Wenzhou Medical University. Sam ples including lung, kidney, liver and field water fromeach case were tested with diatom nitric acid digestion method and plankton 16S rDNAPCR method, respectively. The Diatom nitric acid digestion method and plankton 16S rDNAPCR method required 20 gand 2g of each organ,and 15 mL and 1.5 mL of field water, respectively. The inspection time and detection rate were com pared between the two methods. Results Diatom nitric acid digestion method m ainly detected two species of diatom s, Centriae and Pennatae, while plankton 16S rDNA PCR method am plified a length of 162 bp band. The average inspection time of each case of the Diatom nitric acid digestion method was (95.30±2.78) min less than (325.33±14.18)min of plankton 16S rDNA PCR method (P<0.05).The detection rates of two methods for field water and lung were both 100% . For liver and kidney, the detection rate of plankton 16S rDNA PCR method was both 80% , higher than 40% and 30% of diatom nitric acid digestion method (P<0.05), respectively. Conclusion The laboratory testing method needs to be appropriately selected according to the specific circum stances in the forensic appraisal of drow ning. Com pared with diatom nitric acid digestion method, plankton 16S rDNA PCR method has practice values with such advantages as less quantity of sam ples, huge inform ation and high specificity.