Objective To analyze the curative effect and safety of the estrogen as an adjunctive treatment of senile vaginitis.Methods 100 patients with senile vaginitis in our hospital from June 2011 to September 2012 were divided into observation group (n =50) and control group (n =50).Observation group was given estrogen plus metronidazole and control group was given metronidazole only.Results 45 cases were cured and 4 cases had effective treatment in observation group,and 21 cases were cured and 17 cases had effective treatment in control group.The efficacy rate was 98.0％ (49 cases)in observation group versus 76.0％(38 cases) in control group (x2=11.50,P＜0.01).After the treatment,the recurrence rate was 6.1％ (3 cases)and 26.3 ％ (10 cases)in observation and control groups respectively (x2 =10.66,P＜0.05).After treatment,vaginal health scores,symptom scores of vaginitis,and vaginal PH were significantly higher in the observation group than in the control group (all P＜0.05).In addition,the improvements of signs and symptoms were significantly better in the observation group than in the control group (all P＜0.05).However,there was no significant difference in adverse reaction rate between the two groups (P＞ 0.05).Conclusions Estrogen as an adjunctive treatment of senile vaginitis has better curative effect and safety.It is worthy of generalization in clinical medicine.

Objective To investigate clinical value of the emergency endoscopic sclerotherapy and tissue adhesives embolization on patients with gastroesophageal varices bleeding. Methods A retrospective analysis of 52 cases of esophageal variceal bleeding in patients with clinical data was performed. Of which,22 patients were given conservative treatment alone and they were served as conservative treatment group. Another 30 patients were given the emergency endoscopic sclerotherapy and/ or tissue adhesive embolization besides the basis of conservative treatment,and they served as endoscopic treatment group. The data of hospitalization and mortality,rebleeding rates were recorded during hospitalized time and 1 year off hospitalization. Results The indices of hospitalized periods in endoscopic treatment group was( 16. 2 ± 1. 5)d,shorter than that in conservative treatment group((17. 6 ± 2. 1)d,P = 0. 53). The mortality and rebleeding rate in endoscopic treatment group in followed up periods were 3. 3% and 6. 6%,lower than those in conservative treatment group (9. 1%,13. 6%),and the comparison of relative risk RR of two groups of mortality and rebleeding rate were 2. 76 and 2. 06. Conclusion The therapy of emergency endoscopic sclerotherapy and tissue adhesives embolization of bleeding esophageal varices shows a good effect and it is worth recommending.

Objective To investigate the effects of peer education on treatment among patients using 131I with thyroid cancer after surgery.Methods A total of 80 patients using 131I therapy after surgery of thyroid can cerhospitalized from June 2014 to May 2016 were enrolled and randomly divided into two groups.The control group were given routine health care including hospitalized treatment,education,and follow-up examination after discharge from hospital,while the experimental group were given peer education,and the intervention was provided from admission to one month after discharge.Distress level,complication rates and knowledge mastering were compared between two groups.Results The differences of distress level,complication rates and knowledge mastering between two groups were statistically significant(P＜0.05).Conclusion Patients using 131I with thyroid cancer after surgery suffer from significant distress.Peer education can greatly reduce patients' distress,complications after 131I treatment,and improve mastering knowledge.

ObjectiveTo investigate the diagnostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and MB isoenzyme of creatine kinase (CK-MB) for heart failure (HF) in pneumonia children.MethodsThe NT-proBNP and CK-MB were assayed in 132 pneumonia children with HF, 138 pneumonia children without HF and 62 healthy children were recruited into this study. A receiver operating characteristics (ROC) curve and a logistic regression model were employed to assess the diagnostic accuracy of NT-proBNP and CK-MB for HF in pneumonia children.ResultsPneumonia children with HF had higher blood NT-proBNP and CK-MB than those in pneumonia children without HF and healthy controls (P<0.01 for both). Pneumonia children with HF had higher blood NT-proBNP and CK-MB than the pneumonia children without HF. The area under curves (AUCs) of NT-proBNP and CK-MB for HF were 0.85 and 0.72, respectively. The AUC for their combinational usage was 0.87.ConclusionBoth NT-proBNP and CK-MB are effective markers as diagnostic adjuncts for HF in pneumonia children. Combination of NT-proBNP and CK-MB can improve the diagnostic accuracy for HF in pneumonia children.

Objective To explore the experience of thyroid cancer patients about the diagnosis and post-surgical radioactive iodine treatment. Methods A qualitative, descriptive study was used. Thirty-eight patients with thyroid cancer who were undergoing post-surgical radioactive iodine treatment participated in this study. Dairies about the participants′ experience were collected from them. Interpretative phenomenological analysis was used. Results Three superordinate themes emerged: the psychological process from distress to acceptance; the experience about post-surgical radioactive iodine treatment; and personal growth related to the cancer. Conclusions Understanding the psychological process of patients with thyroid cancer after the diagnosis and their experience about post-surgical radioactive iodine treatment can contribute to the clinical staff to improve the care quality for this group.

OBJECTIVE:To study the pharmacokinetic characteristics of triflusal capsule in healthy volunteers. METHODS:In ran-domized test,36 healthy volunteers were randomly divided into 3 groups. They were given low-dose,medium-dose and high-dose of Triflusal capsule(300 mg,600 mg and 900 mg),qd,for one day,and then pharmacokinetic study of single dose of Triflusal capsule was conducted;Triflusal capsule medium-dose group was continuously given medicine for 13 days,and then pharmacokinetic study of multiple dose of Triflusal capsule was conducted. The plasma concentration of triflusal was determined by LC-MS/MS,and Zorbax SB-C18 column was used with methanol-0.2% formic acid (80:20,V/V) at the flow rate of 0.2 ml/min. ESI was adopted in MRM mode,negative ion detection was carried out,quantitative analysis m/z 247.1→161.1(triflusal),m/z 294.0→250.0(internal standard, diclofenac sodium). Pharmacokinetic parameters were calculated by using WinNonlin 6.2 software,and the difference of them were compared. RESULTS:The linear range of triflusal were 0.05-20 μg/ml. The main pharmacokinetic parameters of triflusal capsules high-dose,medium-dose and low-dose groups were as follows:t1/2 were (0.45 ± 0.20),(0.47 ± 0.10),(0.43 ± 0.20) h;tmax were (0.56±0.20),(0.60±0.20),(0.47±0.40)h;cmax were(3.30±0.98),(10.65±3.26),(13.96±4.88)μg/ml;AUC0-8 h were(3.99±0.93), (13.29±1.72),(19.62±6.78)μg·h/ml;within dose of 300-900 mg,linear relationship was found between cmax,AUC0-8 h and dose(R2=0.954,0.986). When reaching stable state of multiple dose,average blood concentration was(0.71±0.20)μg/ml;main pharmacokinetic parameters were as follows:AUCs(17.10±4.82)μg·h/ml,t1/2(0.49±0.10)h,tmax(0.85±0.62)h,cmax(11.58±3.99)μg/ml,AUC0-8 h (16.99±4.84)μg·h/ml,AUC0-∞(17.08±4.81)μg·h/ml;accumulation factor(1.28±0.40). tmax and t1/2 of single dose were similar to those of multiple dose. CONCLUSIONS:LC-MS/MS can determine the content of triflusal in human plasma rapidly and accurately, and accumulation phenomena exist in healthy Chinese volunteers,which shows linear pharmacokinetic characteristics.

Objective To evaluate the clinical efficacy and safety of combination treatment with clofazimine ( Cfz ) and other antituberculosis drugs for patients with multidrug-resistant tuberculosis(MDR-TB).Methods 32 cases of MDR-TB patients were treated with combination regimens that included clofaziminefrom October 2011 to September 2016 in our hospitol,according to the history of drug use and drug susceptibility test results using individualized chemotherapy,the starting dose of clofazimine was 0.1 g/day,oral,some patients with adverse reactions and tolerance adjusted to 0.05 g/day,treatment for the last 12 months for three consecutive sputum mycobacterium tuberculosis culture and sputum smear acid-fast bacilli were cured,observe the clinical efficacy and safety.Results After treatment with the combined regimen,56.2%(18/32) of patients were cured,43.8%(14/32) of patients failed treatment, there was no statistically significant difference in the number of drug-resistant patients before and after CFZ treatment,there was no statistically significant difference between the time of failure and the time of CFZ treatment,after taking CFZ combined with anti-tuberculosis program,the number of drug users was statistically significant of patients cured and failed (P<0.05).The average time of sputum culture inversion was 16w.90.6% (29/32) of patients with adverse reactions,mainly including skin color change,ichthyosis and gastrointestinal tract and other adverse reactions, through dose adjustment and symptomatic treatment to continue treatment.The average duration of treatment with clofazimine was about 13 months.ConclusionClofazimine was welltolerated,combination treatment with Clofazimine and others for patients with MDR-TBhave better efficacy .

Objective To investigate the correlation between HCY (Homocysteine),folate,vitamin B12 and head and neck vascular stenosis in patients with ischemic cerebrovascular disease.Methods 225 patients with ischemic cerebrovascular disease in Tangdu Hospital of the Fourth Military Medical University were enrolled in the study from April 2016 to October 2016.The serum levels of HCY,folate and vitamin B12 were detected.CT angiography (CTA) was uesd for patients with head and neck vascular scanning.According to whether the presence of vascular stenosis,patients were classified as no vessel stenosis group and vascular stenosis group.According to the degree of stenosis,patients were classified as no vascular stenosis group,mild moderate stenosis group and severe stenosis group.Results The HCY levels in the vascular stenosis group were significantly higher than no vessel stenosis group,while the levels of folate and vitamin B12 were significantly lower than no vessel stenosis group,the differences were statistically significant (t=9.656,7.140 and 8.350,all P＜0,01).The HCY levels in mild moderate stenosis group and severe stenosis group were significantly higher than no vessel stenosis group,and the HCY levels in severe stenosis group were significantly higher than mild moderate stenosis group,the differences were statistically significant (t=6.108,9.401 and 5.273,all P＜0.01).The folate levels in mild moderate stenosis group and severe stenosis group were significantly lower than no stenosis group,the differences were statistically significant (t=5.574 and 5.988,all P＜0.01).The vitamin B12 levels in mild moderate stenosis group and severe stenosis group were significantly lower than no stenosis group,the differences were statistically significant (t=4.548 and 7.816,all P＜0.01).The degree of head and neck vascular stenosis and serum levels of HCY were positively correlated (r=0.331,P＜0.01).The degree of head and neck vascular stenosis and levels of vitamin B12 were negatively correlated (r=-0.279,P＜0.05).Conclusion The levels of HCY,folate and vitamin tB12 were closely related to the degree of head and neck vascular stenosis.HCY,folate,vitamin B12 and head and neck CTA play important roles in patients with ischemic cerebrovascular disease clinically.

Problem-based Learning (PBL) is a teaching model originating from the construc-tivism theory, which stressed the meaning construction in problem situation by collaborative learning, conversation and completing knowledge. Based on the times background, development of learning theory, teaching situation, cognitive strategies, ideological connotation about constructivism, PBL's practical significance, its teaching forms, teaching resources, internal motivation, and the teaching evaluation were analyzed deeply, which was beneficial to carrying out PBL normatively in medical education, so as to provide the theoretical support for further exploration and innovation of PBL.

Objective: To determine the rate of lymph node metastases in women with endometrial carci-noma and to compare the pattern of lymphatic spread of endometrial carcinoma with that of cervical carcino-ma. Methods: We retrospectively analyzed the lymphatic spread in 104 patients with endometrial carcinoma and 253 patients with cervical carcinoma. All of the patients underwent a complete pelvic and para-aortic lymphadenectomy from caudal to the median circumflex to the level of renal vessels. Results: The incidence of lymphatic metastases in the endometrial carcinoma group was higher than that in the cervical carcinoma group (22.1% vs 16.2 %). The pathologic grade (G_1: 12.1%; G_2: 21.4%; G_3: 34.5%) and depth of myometrial in-vasion (≤1/2: 11.9%; >1/2: 29%) were correlated with lymph node metastasis. The rates of para-aortic node involvement, pelvic lymph node involvement and involvement of both were 4.3%, 34.8% and 60.9% in the en-dometrial carcinoma group and 0%, 68.3% and 31.7% in the cervical carcinoma group. The rates of obturator node involvement were 73.9% and 70.7%, respectively; the rates of suprainguinal node involvement were 8.7% and 7.3%, respectively. Compared with cervical carcinoma, endometrial carcinoma showed higher rate of para-aortic and sacral node involvement (65.2% vs 31.7%, and 21.7% vs 17.1%) and lower rate of extamal iliac node involvement (17.4% vs 41.5%). Conclusion: Compared with cervical carcinoma, endometrial carcino-ma has a distinct lymphatic spread pattern and can directly metastasize to both pelvic lymph nodes and pa-ra-aortic lymph nodes with pelvic lymph node metastases being dominant. Positive lymph nodes are common-ly seen in cases of all pathological grades.