By analyzing the present condition of communication courses in some medical colleges and universi -ties and the clinical practice situation , this paper emphasized the significance of the clinical professional courses :it is beneficial to promote the reform of medical education , is advantageous to the medical students′humanistic spirit , to improve clinical teachers′humanistic quality , is helpful to reduce medical disputes .And on the future develop-ment of clinical communication course put forward the following suggestions: extended content , the integration of related courses , reform teaching methods , intensify communication course value .

OBJECTIVE:To optimize the extraction technology of Bushen huoxue capsules. METHODS:Central composite de-sign-response surface method was used to optimize the extraction technology with the amount of water and boiling time as main fac-tors using normalized value of the contents of icariin and salvianolic acid B,the yield of dry extract as index. Validation test was al-so conducted. RESULTS:The optimal extraction technology was as follows as 15-fold water,reflux extracting for 75 min,extract-ing for 2 times. The deviation of measured value and predicted value was 0.000 3% in validation test. CONCLUSIONS:The cen-tral composite design-response surface method can be used to optimize the extraction technology of Bushen huoxue capsules with good prediction,and the technology is simple and stable.

Objective To understand the species,clinical distribution features and drug susceptibility situation of bloodstream infection pathogenic bacteria in this hospital to provide reference for clinical empirical treatment.Methods The retrospective analysis was performed on 1 938 strains of pathogenic bacteria isolated from blood culture in our hospital from January 2012 to August 2016,their species distribution,department distribution and drug sensitivity were analyzed.Results A total of 1 938 strain of bacteria were comprised of 56 kinds of bacteria and 8 kinds of fungi.Gram-negative bacteria had 1 216 strains,accounting for 64.2%,Gram-positive bacteria had 677 strains,accounting for 34.9%,Fungi had 45 strains,accounting for 2.4%.The top 5 of isolation rates were Escherichia coli(628 strains,32.4%),Klebsiella pneumoniae(230 strains,11.9%),Salmonella(143 strains,7.4%),Staphylococcus epidermidis(142 strains,7.3%) and Staphylococcus hominis (130 strains,6.7%).Enterobacteriaceae bacteria had 1 098 strains(58.0%),which was dominated by Escherichia coli and Klebsiella pneumoniae,in which 363 strains(57.8%) were Escherichia coli and 85 strains(37.0%) were extended spectrum β lactamases (ESBLs) producing Klebsiella pneumoniae.Nonfermenters had 118 strains(6.1%),Acinetobacter baumannii and Pseudomonas aeruginosa were predominant.Staphylococcus aureus had 75 strains (3.9%),the MRSA occurrence rate was 25.3%,coagulase-negative staphylococci (CoNS) had 401 strains (20.7%),the methicillin-resistant CoNS occurrence rate was 72.8%.Enterococcus had 85 strains(4.5%).The top 5 departments in positive rates were respiratory department,ICU,hepatobiliary department,gastroenterology department and hematology department.The other departments were consistent to the overall distribution except for ICU and pediatrics.The majority of Acinetobacter baumannii showed multi-drug resistant.Vancomycin-resistant Staphylococcus and Enterococcus did not be detected,Candida maintained good sensitivity to commonly used antifungal agents.Conclusion Bloodstream infection pathogenic bacteria in this hospital are widely distributed.Commonly used drug have different sensitivities,the overall drug resistance rate is higher,clinic may conduct early medication according to the pathogenic bacterial department distribution and drug sensitivity.

OBJECTIVETo evaluate the clinical efficacy and safety of Qiangji Recipe (QR) in ad- junctive treatment of axial undifferentiated spondyloarthritis (axuSpA) through a four-week open study.

METHODSFifty-four axuSpA patients of Shen-deficiency Du-channel cold syndrome (SDDCS) in line with inclusive criteria were recruited and assigned to the treatment group and the control group according to random digit table, 27 in each group. Patients in the control group took Celecoxib Capsule (0.2 g each time, twice per day). Patients in the treatment group additionally took QR (consisting of Herba Epimedii 15 g, antler glue 15 g, Cibotium Barometz 15 g, eucommia bark 20 g, dipsacus asper 10 g, two toothed achyranthes root 15 g, drynaria 15 g, Taxillus Chinensis 20 g, ground beetle 10 g, scorpion 5 g, wild celery 10 g, notopterygium incisium 10 g, cow-fat seed 10 g, white mustard seed 6 g, and licorice root 6 g, one dose per day, twice daily). The therapeutic course for all was 4 weeks. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath AS Metrology Index (BASMI), total body pain and spinal pain, patient and physician global assessment on a four-point scale, the Ankylosing Spondylitis Quality of Life (ASQoL), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured before and after 4 weeks of treatment. The primary end point in this study was the proportion of patients with a 20%improvement response accord- ing to the ASAS International Working Group Criteria (ASAS 20 responders) at week 4.

RESULTSTotally 50 patients completed this trial, 26 in the treatment group and 24 in the control group. Improvement of BASDAI, BASFI, BASMI, ASQoL, ESR, and CRP was shown in both groups after treatment. Better effect was shown in the treatment group in all indices except ESR and BASMI after treatment (P < 0.05, P < 0.01). Twenty cases (accounting for 76.92%) in the treatment group achieved ASAS 20 response at week 4, while 12 cases (accounting for 50.00%) in the control group achieved ASAS 20 response at week 4 (P < 0.05). No obvious adverse reaction occurred in the two groups.

CONCLUSIONQR combined Celecoxib Capsule showed better effect in treating axuSpA patients than using Celecoxib Capsule alone.

Blood Sedimentation ; C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Pain ; Quality of Life ; Spondylitis, Ankylosing ; drug therapy

Objective To study the mechanism of calcium oxalate monohydrate and calcium oxalate dihydrate stone formation. Methods 258 urinary stones were examined by infrared spectrophotometry, from which, 20 patients with calcium oxalate monohydrate stones (COM) and 10 patients with calcium oxlate dihydrate stones (COD) were selected for the study of some urinary parameters. The statistical study was carried out with SPSS t test . Results The urinary excretions of both calcium and phosphate varied obviously between the two groups of patients.In the COM group,the urinary calcium was (4.83?1.98)mmol/24h whereas in COD group it was (9.88?4.28)mmol/24h,( P

0.05); ② Significant correlation was found between natural head posture and angle SNA, SNB, SN/MP, N S PNS, NSU, NSGn, ANS PNS Gn, NSH( P

Objective: To develop a grinding intrument for removing the remaining bonding material and polishing the dental enamel after orthodontic treatment. Methods: A dental griding instrument was made based on ultrasonic principle with the frequency of 25～45 kHz. 60 premolars extracted for orthodontic purpose were used in the experiment, before treatment the surface roughness was measured and recorded as Ra 1. Brackets were adhered to the premolars, and then debonded. The surface enamel of 30 teeth were polished by the ultrasonic grinding instrument (group of GI), that of another 30 by conventional technique(group of CT) , the roughness was measured and recorded as Ra 2. Results: In group GI Ra 1 and Ra 2 were 0.846 6?0.428 2 and 0.740 5?0.372 1(P0.05), respectively. After treatment Ra 2 in group GI was smaller than that in group CT(P

Objective To evaluate the completion of a goal in elimination of iodine deficiency disorders IDD) in the 12th five-year plan for prevention and control of endemic diseases,to analyze the present situation of IDD in prevention and to improve sustainable control strategies in the city of Wuhai in Inner Mongolia.Methods In 2015,using the specific sampling method,5 units were selected from 3 counties of Wuhai according to their subarea positions of east,south,west,north and center,and then 1 township was randomly selected from each unit,40 school children (half males and half females) aged 8-10 and 20 pregnant women were investigated in each township.Goiter of children aged 8-10 was examined by B ultrasonic,the urinary iodine levels were detected by acid digestion arsenic-cerium contact method and the salt iodine levels were measured with the method of direct titrimetric method.Results Totally 900 edible salt samples of local residents had been examined and the median iodized salt iodine was 24.2 mg/kg,the consumption rate of iodized salt was 99.56％ (896/900),the coverage rate of iodized salt was 99.78％ (896/900),and the rate of qualified iodized salt was 99.78％ (898/898).The goiter rate of children was 0.33％ (2/600),urinary iodine level (UI) median was 221.6 μg/L in 600 children aged 8-10,the ratio of urinary iodine levels between 100-199 μg/L was 31.7％ and the median of urinary iodine was 122.15 μg/L in 300 pregnant women,the ratio of urinary iodine between 150-250 μg/L was 26.7％ (80/300).Conclusion Wuhai has achieved the goal of prevention and control of endemic disease prevention andcontrol of the 12th five-year plan,and reached the continuous state of elimination of IDD.

Objective To explore the effect of preserving intercostobrachial nerve (ICBN) in axillary lymph node dissection on sensory disturbance for breast cancer.Methods Clinical data of 146 cases of stage Ⅰ,Ⅱ and Ⅲa breast cancer patients treated by modified radical mastectomy was analyzed.The patients were randomly divided into two groups.Retention group included 67 patients who were performed axillary lymph node dissection preserving ICBN,and 79 cases undergoing axillary lymph node dissection were taken as control group.Data of the two groups were assessed to compare the operation time,nunber of lymph nodes dissection and sensory abnormalities of upper arms.Results In the follow-up of 1,3 and 6 months,the incidence rate of the lateral upper ann sensory disturbance were 17.9％ and 74.9％,11.9％ and 60.7％,7.4％ and 59.5％ respectively in the retention and control group,and the difference was statistically significant (x2=46.78,P＜0.001;x2=36.54,P＜0.001;x2=42.80,P＜0.001).Meanwhile,there was no obvious difference between the retention and control group in operation time and number of lymph nodes(P＞0.05).No local recurrence after operation occurred in the follow-up of 8 months to 5 years.Conclusions For stage Ⅰ,Ⅱ and Ⅲ a breast cancer patients undergoing axillary lymph node dissection,retaining ICBN can significantly reduce the chance of the postoperative medial upper arm sensory disturbance,improve the quality of life with no increase of local recurrence rate.

[Objective]To investigate the manner and the key of reoperation for failed back surgery syndrome(FBSS).[Method]Twenty reoperated FBSS cases were investigated retrospectively.The data about the history,physical sign,image and exploration were analyzed.The treatment protocols were made correspondingly.Twenty cases were all operated with decompression of nerve root and dura assisted with fusion of auto-bone kraft between posterior arches of vertebra.In them,12 cases who were suffered from spinal instability were treated with pedicle screw fixation supplementarily.All patients were rehabilitated after operation.[Result]The complications included neural root injury in 1 case and tear of dural cyst in 3 cases.The outcome was evaluated according to the standard of Ragab's,10 cases were excellent,5 cases good,2 cases fair and 1 case poor.The rate of excellent and good was 85%.[Conclusion]FBSS is a complication of back surgery manifesting as a syndrome with multi-factor and multi-present.We should analyze the clinical present of patient integratively to find out the cause before operation,and map out appropriate operational protocol.