This study aimed at optimizing the extraction process of Bi Xie Fen Qing (BXFQ) drink using ultrasound-microwave cooperation with central composite design-response surface method in comparison with the traditional decoction process.Taking microwave frequency,amount of water,extraction time as the main detection factors,diosgenin,glycyrrhizic acid and the extract yield were tested as the evaluation indexes;and taking an integrated score as response value for response surface and contour,predictive analysis was carried out and the optimum extraction conditions were achieved.It was found that the optimum extraction process of BXFQ drink was identified:the microwave frequency was 434 W,water addition was 18.4 times,extraction time was 9.3 mins and the ultrasonic frequency was fixed at 50 W.Under the optimum process,the diosgenin extraction yield rate was 23.17％ (mg· g-1),extraction yield rate of glycyrrhizic acid was 0.64％ (g·g-1),and the extraction yield rate of extractum was 34.12％ (g·g-1).All the indexes were superior to those of the traditional method.It is concluded that the composite design-response surface method is suitable for the extraction optimization of BXFQ drink with favorable predictability of the mathematical model.The optimized ultrasoundmicrowave cooperation was easy to operate with high extraction efficiency.It is suitable for industrialized production with the provision of a scientific reference for the modern formulation development of BXFQ drink.

OBJECTIVE:To observe the clinical efficacy and ADR of ultrasound debridement combined with Huangma tinc-ture in the treatment of diabetic foot ulcer. METHODS:90 diabetic foot ulcer patients were randomly divided into combination treatment group(ultrasound debridement combined with Huangma tincture wet compress),Huangma tincture group(Huangma tinc-ture wet compress) and control group (vaseline) with 30 cases in each group. 3 months after treatment,Ulcer healing rate,cure time,effective time,recovery time,cure rate and ADR were observed in each group. RESULTS:The ulcer healing rate of combi-nation treatment group was significantly higher than that of Huangma tincture group and control group,with statistical significance (P<0.05);there was statistical significance between Huangma tincture group and control group(P<0.05). Mean cure time,effec-tive time and recovery time of combination treatment group were all significantly lower than Huangma tincture group and control group,with statistical significance(P<0.05);there was statistical significance between Huangma tincture group and control group (P<0.05). Cure rate of combination treatment group was higher than that of Huangma tincture group and control group,with statis-tical significance (P<0.05);there was statistical significance between Huangma tincture group and control group (P<0.05). No ADR was found in combination treatment group and Huangma tincture group. CONCLUSIONS:The ultrasound debridement com-bined with Huangma tincture in the treatment of diabetic foot ulcer improve healing rate and shorten healing time significantly with-out obvious ADR. It has good clinical efficacy.

At present,diagnosis and improvement of teaching quality in higher vocational colleges mainly depends on the internal quality assurance system shaped by "five vertical,five horizontal and one platform".Practical teaching is of great importance to medical education.As its teaching quality is mainly generated from the hospitals which are difficult to be integrated with the existing internal quality assurance system.This article tries to build a diagnosis and improvement system for training interns through a method focusing on "five elements and seven ways of giving feedback" on the basis of the in-depth analysis of factors generating the quality of intern training.This system aims to continuously ensure the quality of interns training via supplementing and perfecting the existing internal quality system of medical colleges.

Practice, an important part of medical teaching happened in hospitals, is difficult to be included in the diagnosis and improvement system of schools. Therefore, Jiangxi medical college has established the "five-point and seven-line" diagnosis and improvement system in practice teaching and promoted its implementation according to the idea of "emphasis on key points, point to string transformation, problem-oriented approach, continuous improvement, comprehensive promotion and stratified diagnosis and reform". Through two years' practice, some achievements have been made in the practice teaching management, the improvement of the basic knowledge of interns, the enhancement of teaching and learning consciousness and so on. The achievements have further promoted the cultivation of the concepts of diagnosis and reform of both schools and hospitals, and facilitated the efficiency of practice management and the quality of practice teaching.

Objective To explore the risk factors of acute kidney injury (AKI) in very low birth weight (VLBW) infants. Method The clinical data of 313 VLBW newborns aged under 3 days from January 2012 to December 2016 were retrospectively analyzed. According to the improved KDIGO standard of neonatal AKI, the difference between AKI (group AKI) and non AKI (group NAKI) newborns was compared, and the risk factors of AKI and mortality of AKI infants were analyzed. Results In the 313 VLBW infants, 126 had AKI and the incidence rate was 40.3％. There were 53 cases at stage 1 (42.1％), 43 cases at stage 2 (34.1％), and 30 cases at stage 3 (23.8％). Compared with NAKI group, patients in AKI group were lower in gestational age, birth weight, 5-minute Apgar score, critical score and mean arterial pressure. Furthermore, AKI group was higher in mother's age, incidence of premature rupture of membranes and respiratory failure. Also, white blood cells number and procalcitonin level were higher; albumin and sodium levels were lower; more cases had invasive mechanical ventilation after birth; time of mechanical ventilation was longer; mortality were higher in AKI group. There were statistically differences (P<0.05). Multivariate logistic regression analysis showed that gestational age, respiratory failure and invasive mechanical ventilation at birth were independent risk factors for AKI in VLBW infants. More severe acidosis and associated pulmonary hemorrhage at admission were the independent risk factors for the death caused by AKI in children. Conclusions Short gestational age, respiratory failure, and invasive mechanical ventilation at birth significantly increased the risk of AKI in VLBW infants. The more severe metabolic acidosis and pulmonary hemorrhage increased the risk of death in AKI children .