Objective To study the relationship between the plasma levels of C-reactive protein (CRP) and the severity of disease as well as outcome in patients with cerebral hemorrhage at early stage. Methods The CRP plasma levels were measured by scatter turbidimetry in 89 patients with cerebral hemorrhage within 24 hrs after onset of the disease. The control group included 30 healthy people who received medical examinations. We analyzed the relationship between CRP levels and the severity of disease as well as outcome.Results CRP levels were less than 8 mg/L (4.21?1.78 mg/L) in control group, and increased in 51 patients with cerebral hemorrhage (30.33?2.53 mg/L), with an abnormal rate of 57.30%. CRP levels and abnormal rate differed significantly (all P

Objective To understand the ‘ problem behavior' and influencing factors during job haunting of medical students and to provide guidance for students.Methods Totally 409 medical students who had graduated or were going to graduate but all having the experiences of applying for jobs were surveyed with self-made questionnaire.Likert 5 points scoring method was employed to evaluate the job hunting and SPSS 17.0 seftware was used to do statistical analysis.Results The ‘ problem behaviors' with the highest scores were conformism and comparison [(3.93 ± 0.628) and (3.80 ± 0.847) respectively)].Self factors influencing students' behavior in career choice included the capacity for self-definition (3.62 ± 0.855),personal values (3.55 ± 0.893) and legal awareness (3.51 ± 1.039).Meanwhile,the factor with the highest score was education cost (3.93 ± 0.887).Besides,influences of family expectation (3.43 ± 0.945),employment environment (3.40 ± 0.940) and college educational system (3.28 ± 1.038) were also outstanding.Conclusions Medical students'‘ problem behaviors' during job hunting are diverse and are influenced by many factors.So,we are supposed to strengthen the education and guidance from the self factors,combining the actions of school,family and society to promote medical students' employment.

OBJECTIVE:To explore the assessment indicators of the accessibility of essential medicines to comprehensively evaluate the accessibility of essential medicinesand its coverage of medicine supply security and service quality and the improve-ment of the implementation of the new Healthcare reform. METHODS:Retrieved from Chinese and English Literature and the World Health Organization(WHO),theoretical analysis was conducted for the covering the core elements of essential medicines to explore construction ideas and content of essential medicines evaluation index system with international suitability,index appropri-ateness and operability. RESULTS&CONCLUSIONS:A series of medicine policy evaluation guide established by WHO is current-ly the main basis of the accessibility of essential medicines evaluation around the world,however,there are certain limitations for these indicators.According to the concept put forward by WHO and the related organizations,the core elements of the accessibility of essential medicines include:availability,affordability,supply system,sustainable financing,medicine quality and appropriate use.

Objective To evaluate the efficacy of mid-axillary approach to transversus abdominis plane (TAP) block in each abdoninal and back region.Methods Twenty patients of both sexes,aged 18-64 yr,with body mass index of 20-27 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic cholecystectomy,who had expected operation time ＜1 h,were enrolled in the study.Ultrasound-guided TAP block was performed on the left side via the mid-axillary line with 0.25％ levobupivacaine 0.5 ml/kg.TAP block was assessed by cold stimulation (75％ alcohol) and acupuncture in each abdominal and back region (the left side of the body was divided into 19 regions using the anatomical landmarks on the body surface).The positive condition in each region at 20 min after administration was recorded.Results The regions in which the positive rate ≤5％ were 11,14,17 and 18 regions.The regions in which the positive rate ＞5％-20％ were 8,15 and 19 regions.The regions in which the positive rate ＞20％-50％ were 12,13 and 16 regions.The regions in which the positive rate ＞50％-70％ were 1 and 4 regions.The regions in which 70％ ＜ the positive rate ＜ 95％ were 7,9 and 10 regions.The regions in which the positive rate ≥ 95％ were 2,3,5 and 6 regions.Conclusion Mid-axillary approach to TAP block is effective in the left middle-lower regions of the anterior abdominal wall,however,it is ineffective in the left upper region between mid-axillary and posterior axillary lines and in the low back region.

AIM The proofs of evidence-based medicine of Qingkailing Injection's effect on viral hepatitis are lack in spite of the wide use of Qingkailing Injection in medical practice.This study aims to use Meta-analysis to evaluate its clinical effect and safety.METHODS Such databases as CNKI,VIP and Wanfang were searched for randomized controlled trials related to Qingkailing Injection in treatment of viral hepatitis,which were published officially between 1996--2016.Revman 5.3 software was used to conduct Meta-analysis for the effective rate,rate of adverse reaction,the decrease rate of ALT,AST and TBIL of Qingkailing Injection.Meanwhile,subgroup analysis was conducted to the clinical effect of doses [＜ 0.5 mL/(kg · d),0.5-0.67 mL/(kg · d),＞0.67 mL/(kg · d)],treatment courses (≤ 14 d,＞ 14 d),manufacturers (Beijing University of Chinese Medicine Pharmaceutical Factory,Shenwei Pharmaceutical Company,Shanxi Taihang Pharmaceutical Company),year (1996 to 2002,2003 to 2009,2010 to 2016).RESULTS Fourteen studies were included according to the criterion.The results of Meta-analysis showed that the total effective rate,the decrease rate of ALT,AST and TBIL in Qingkailing Injection group were significantly higher than those in the control group (P ＜ 0.05).Whereas,no significiant differences were found between Qingkailing Injection group and the control group of its rate of adverse reaction (P ＞ 0.05).Subgroup-analysis showed that the effective rate of Qingkailing in doses subgroup,treatment courses subgroup,manufacturers subgroup and year subgroup were significantly higher than those of the control group.CONCLUSION Qingkailing Injection has obvious benefit in the treatment of viral hepatitis,which can reduce the activity of ALT and AST,also can reduce the content of TBIL.But we should pay attention to the prevention of allergic reaction in the clinical use.

OBJECTIVE:To establish the quality standard for the leaves of Nauclea officinalis. METHODS:Microscopic identi-fication and TLC methods were used for qualitative identification of N. officinalis. The moisture and ash of medicinal materials were determined. HPLC method was adopted to determine the content of strictosamide in medicinal materials. The determination was per-formed on Lichrospher C18 column with mobile phase consisted of acetonitrile-0.1% phosphoric acid solution(gradient elution)at the flow rate of 1 mL/min,injection volume was 10 μL. The detection wavelength was set at 226 nm,and the column temperature was 30 ℃. RESULTS:Microscopic identification of the leaves of N. officinalis had strong characteristics,and TLC sports were clear and well-separated without interference from negative control. The linear range of strictosamide were 0.0105-0.21 mg/mL(r=0.9995);RSDs of precision,stability and reproducibility tests were all lower than 2.0%. Average recoveries were 96.25-101.82%(RSD=1.86%,n=9). Total ash of medicinal materials was 5.27%-6.44%,acid insoluble ash was 0.23%-0.36%,water content was 9.48%-11.46%,strictosamide was 0.124%-1.003%. CONCLUSIONS:Established standard can be used for quality evaluation of N. officinalis.

To establish the quality standard for Xiaobai capsules. Methods: Paeoniae Radix Alba and Angelicae Sinensis Radix were identified by TLC. The contents of psoralen and isopsoralen were determined by HPLC. Results:The qualitative i-dentification was with high resolution and without interference from the negative substances. The linear range of psoralen was 1. 082-108. 200 μg·ml-1 . The average recovery was 99. 82% with RSD of 1. 16%. The linear range of isopsoralen was 0. 818-81. 800μg· ml-1 . The average recovery was 99. 85% with RSD of 1. 81%. Conclusion:The method can be used in the quality control of Xiaobai capsules.

Objective: By the bibliometrical analysis and evaluation of acupuncture theses on auricular acupoint sticking from 2005 to 2014, the analysis was processed from multiple aspects including the types and numbers of diseases and effective rates of various diseases, in order to objectively reflect the general situation of clinical application of ear point embedding method in the recent years. Methods: By the bibliometrical analysis, the literature on auricular acupoint sticking in the recent ten years was counted up, analyzed and categorized. Results and Conclusion: Auricular acupoint sticking is used clinically for diseases of 16 systems, including 130 diseases. 74 diseases were singularly treated with auricular acupoint sticking, including the advantageous disease category like insomnia, constipation and obesity, and secondary advantageous disease category like dysmenorrhea, myopia, allergic rhinitis, post-operative pain and acne vulgaris.

Objective To discuss the clinical significance of vancomycin plasma concentration monitoring and its relationship with adverse reactions in treatment of elderly patients. Methods The clinical records of 32 patients aged over 70 years admitted in the Emergency Medical Department of Sichuan Provincial People's Hospital were collected. Based on the diagnosis and laboratory examinations on admission, the patients were treated with cefoperazone+sulbactam or moxifloxacin, while in patients with severe infections, intravenous drip of carbapenem antibacterial drugs were given. After treatment for 3-5 days, when no effective results were obtained, according to the pathogenic results achieved from cultures of blood, sputum, secretions, catheter, etc, the corresponding treatment was given. If the infection was caused by positive bacteria mainly methicillin-resistant Staphylococcus aureus (MRSA) sensitive to vancomycin, the original antibiotic was replaced by vancomycin or vancomycin combined with other antibiotic; intravenous drip of vancomycin 1 g in 250 mL normal saline was given, once in 12 hours, with a speed of 10 mg/min or not over 15 mg/min. The function of liver and kidney, and auditory impairment were observed, and the correlation between vancomycin plasma concentration and adverse reactions was analyzed. Results The total incidence of adverse reactions in elderly patients with different serum vancomycin trough concentrations was 37.50%(12/32) in which the highest incidence was kidney damage 18.75%(6/32) followed by the hearing loss 9.38%(3/32) and liver damage 9.38%(3/32). There were no statistical significant differences in the rates of adverse reactions among the different vancomycin trough concentrations (<10, 10-20,>20 mg/L) and [37.50%(6/16), 38.46%(5/13), 33.33%(1/3), all P>0.05], that meant along with the increase of vancomycin concentration, no tendency of increment of adverse reactions was seen. Of the 32 cases, there were 13 treated by vancomycin combined with other antibiotic, the combination rate being 40.63%. There were 2 cases of hepatic impairment (11.83%), 1 case of renal impairment (7.69%) and none hearing damage in patients treated with combination of antibiotic therapy. Therefore no correlation was concluded between the occurrence of adverse reactions and the combination therapy ( r=0.15, P>0.05). Conclusions In elderly patients over the age of 70 years, there is a higher incidence of kidney damage in the application of vancomycin. Thus, the monitoring of vancomycin plasma concentration in elderly patients has instructive significance in its clinical use.

The traditional experimental teaching of pathology has defect in training the students' operating ability and mobilizing the initiative of students to observe.Pathology Department of North Sichuan Medical College has developed pathology specimens-making competition for undergraduate students.The students observed,chose and made specimens by themselves after sufficient review of the relevant pathology knowledge.The competition has mobilized the enthusiasm of students effectively and developed their operating ability.This form of teaching should become beneficial supplement to the experimental teaching of pathology.