OBJECTIVE:To search a new concept of marketing for the dog-eat-dog OTC drug market.METHODS:The concept of emotional marketing was explained and the application of which in each link of the OTC drug marketing was ana-lyzed.RESULTS&CONCLUSION:The consumption of OTC drugs has come into to an emotional marketing stage.Adopting emotional marketing strategy,seizing consumer's psychology and moving customers by real affection can consolidate status of OTC drugs in the trade war.

Objective:To study the correlation of the ratio and number of involved lymph nodes and the prognosis of gastric carcinoma.Methods: 174 patients of positive gastric lymph nodes were included.They were treated by radical gastrectomy and lymph nodes dissection(D 2 or D 3)in our department.The ratio and number of metastastic gastric lymph nodes were calculated.Their influence and their interrelation with pathogenic parameters were analyzed.Results: The overall 5-year survival rate was 29.6%,and the five-year survival rate of 1～20 per cent and more than 20% were 70.6%,12.0% respectively.One to five positive lymph nodes and five more were 46.6%,17.4% respectively.The five-year survival rate was decreased as the ratio and number of involved lymph nodes increased.Studies also indicated that with the increase of depth of cancer invasion,the ratio and number of involved lymph node elevated.Conclusion: The results shows that the ratio and number of involved lymph nodes correlated to tumour progression and the five survival rate.Perigastric lymph node status can be considered as a simple and effective prognosis factor.

With the development of new military revolution,the training system of officers has greatly changed.The supplement of professionals in army has begun to depend on the graduates from local universities.Based on status-on-quo investigation of the first new recruits' graduates from local medical universities,the authors established a curricula-system of pre-job training by applying the literature review and Delphi method.

Objective To discuss drug resistance of wound-isolated pseudomonas aeruginosa and its correlation with use of antibiotics in children,for guiding the clinical use of antibiotics.Methods One hundred and forty wounded children admitted from January 2009 and December 2013 were collected in the study.There were 97 males and 43 females,aged (5.4 ± 2.6) years.All were victims of road traffic accidents.Distribution of bacteria isolated from the wound and drug resistance of pseudomonas aeruginosa were detected.Twenty-seven children with pseudomonas aeruginosa infection were divided into imipenem-resistant group (n =7) and non-imipenem resistant group (n =20).Drug resistance and application intensity of antibiotics were compared between the two groups.Results A total of 64 pathogens were isolated from the wound culture.Top five bacteria detected were acinetobacter baumannii,pseudomonas aeruginosa,enterobacter cloacae,escherichia coli and staphylococcus epidermidis.Pseudomonas aeruginosa showed resistance to β-lactam antibiotics,tetracyclines,chloram-phenicol and sulfanilamide.Drug resistance of piperacillin tazobactam (64.7％),meropenem (100％),ceftazidime (64.7％) and piperacillin (76.5％) in imipenem-resistant group were all 40％ higher than that in nonimipenem resistant group (P ＜ 0.05).Imipenem-resistant group versus non-imipenem resistant group revealed no significant differences in drug resistant rate of azactan (76.5％,39.0％),cefepime (70.6％,29.3％) and gentamicin (35.3％,17.1％) (P ＞ 0.05).There was no significant difference in total application intensity of antibiotics between the groups (P ＞ 0.05).Conclusions Wound-isolated pseudomonas aeruginosa in children is multidrug resistant.Thus bacterial monitoring in children with traumatic wounds should be strengthened and antibiotics should be selected rationally to reduce the production of multidrug resistance of pseudomonas aeruginosa.

Clinical practice is an important period to train student's skills in pediatric surgical learning,but it is confronted with difficult condition under the new doctor-patient relationship.How to resolve these difficulties is the key to carry on teaching successfully.Aaccording to the students' interests and the knowledge structure characteristics,teachers should cultivate their professionalism,train their communication skills,extend their thinking ability with appropriate use of teaching aid to increase the teaching interests and develop self-learning ability.

Objective:Reports about impact of lumbar posterolateral fusion on adjacent segment degeneration concentrated on biomechanics and imageology,lack experimental study. This study observes the impact of posterolateral arthrodesis on the adjacent intervertebral disc. To observe the impact of posterolateral arthrodesis on the adjacent intervertebral disc. Methods:Rabbit models of posterolateral arthrodesis were established and the transverse processes of the fourth,fifth and sixth lumbar vertebrae were exposed. Stainless-steel wire0.8 mm in diameter was used to interconnect the three transverse processes in a figure of 8. Methylmethacrylate was then applied to encircle the transverse processes and the wire. Changes in the adjacent disc were observed by light microscopy 3 and 6 months after the operation. Results:Disc degeneration was found at L3-4 at 3 months postoperatively,and further degeneration was noted at this level at 6 months. Conclusion:Posterolateral fusion may accelerate the degeneration of the adjacent intervertebral disc.

Objective To study tea polysaccharides(TP) on glucose metabolism,histopathology,and pancreatic islet ?-cell ultrastructure in diabetic mice.Method The alloxan diabetic mice were randomly divided into 4 groups,and orally given distilled water,TP 0.25,0.50,1.00 g/(kg bw?d).for 5 w,and weighed once every week.In experiment 2 and 4 w,the fasting blood glucose was tested once.The glucose tolerance test was conducted at the end of experiments.Blood serum insulin and liver glycogen were measured.The protein content,hexokinase(HK) and pyruvate kinase(PK) activity of 10% liver homogenate were measured.The histopathology of liver,pancreas,kidney and spleen tissue and the ultra structure of pancreas were observed.Results TP could significantly alleviate the symptoms of diabetic mice.The fasting blood glucose values in three TP groups were significantly decreased(P

Objective To observe the myocardial protective effect of dexmedetomidine in patients undergoing open-heart surgery under cardiopulmonary bypass (CPB).Methods 50 patients of open-heart surgery under CPB were randomly divided into two groups equally, namely observation group and control group.Observation group was treated with injection of dexmedetomidine at 0.5 μg/kg for 15 min, and then maintained at 0.4 μg/kgoh.The control group was given equal volume of normal saline.Concentrations of IMA and cTnI were determined before anaesthesia (t0), after 30 minutes of CPB (t1) and after surgery (t2).Results IMA and cTnI concentrations of t1 and t2 in the observation group were significantly lower than those in the control group (P<0.05).Conclusion Dexmedetomidine has obvious protective effect on myocardium, which can reduce open-heart surgery of patients with myocardial ischemia reperfusion injury (MIRI).

Objective:To evaluate the effects of different position interventions in patients with acute respiratory distress syndrome (ARDS) undergoing mechanical ventilation from the aspects of effectiveness and safety using the method of network Meta-analysis.Methods:Randomized clinical trials (RCTs) related to the therapeutic effect of position interventions in adult ARDS patients undergoing mechanical ventilation were retrieved in PubMed, Embase, Cochrane Library, Web of Science, CINAHL, China Biomedical Literature Database, China National Knowledge Infrastructure, VIP and WanFang Data. The search time limit was from the establishment of the database to January 2021. According to the literature inclusion and exclusion criteria, literature was screened and the quality evaluation and data extraction were carried out. StataSE 15 and Addis 1.16.6 were used for network Meta-analysis.Results:A total of 31 RCTs were included, involving5 positions of prone, semi-recumbent, side-recumbent, supine and sitting, and 3 738 patients. The prone position compared with the semi-recumbent position, the semi-recumbent position compared with the supine position could reduce the 28-day all-cause mortality of the patient, and the difference was statistically significant ( P<0.05) . Compared with the semi-recumbent position and the supine position, the prone position could reduce the length of time the patient stayed in the ICU, and the difference was statistically significant ( P<0.05) . The prone position could increase the oxygenation index of patients compared with the supine position, and the difference was statistically significant ( P<0.05) . For the total incidence of adverse events and adverse reactions, there was no statistically significant difference between any two positions ( P>0.05) . The network Meta probability ranking of all the outcome indicators showed that the prone position and the side-recumbent position had advantages, and the supine position and the semi-recumbent position had no obvious advantages. Conclusions:Current evidence shows that the prone and side-recumbent position interventions are effective and safe for the treatment of ARDS patients undergoing mechanical ventilation, and are good choices among several positions.

OBJECTIVETo investigate difference between the appearance and the bony structure in the polysyndactyly of the fifth toe fused with the fourth toe.

METHODSFrom Jan. 2009 to Jan. 2014, 54 patients (65 feet) with polysyndactyly of the fifth toe fused with the fourth toe were treated. The appearance, X-ray and intraoperative finding were recorded and compared to classify the deformity. Then the extra toe was excised and syndactyly was separated. The malalignment and brachydactyly of the sixth toes were corrected simultaneously.

RESULTSAccording to the bone and joint type, the fifth toes were neoplastic toes without joints in 17 feet, or had poor bony and joint alignment with the sixth toes in 48 feet. So the fifth toes were excised in all the cases. The patients were followed up for 1 month to 4 years. The oblique deformity of sixth toes were corrected completely with improved length.

CONCLUSIONSThe polysyndactyly of the fifth toe fused with the fourth toe should be classified to design the excised toe (usually fifth toe) and correction procedure. The appearance and bony joint recovery are both important.

Humans ; Polydactyly ; pathology ; surgery ; Syndactyly ; pathology ; surgery ; Toe Phalanges ; abnormalities ; surgery ; Toes ; abnormalities ; surgery