Nutritional anemia is mainly including the iron deficiency anemia and the megaloblastic anemia.The highlights of the two kinds of nutritional anemia on the differential diagnosis are compared associated with the clinical practice,and the commonly used treatment protocol at present are briefly expounded.

Inhibition of tumor neovascularization (angiogenesis) has become one of the novel therapeutic strategies for tumor, and natural inhibitor of angiogenesis has been highlighted in this field. Thrombospondin-1 (TSP-1), as an important extracellular matrix component which can influence endothelial cell adhesion, migration, and proliferation, is reported to be a potent inhibitor of angiogenesis in vivo. It will be valuable to use its active peptides or small fragments from TSP-1 in antiangiogenesis therapy.

Objective To evaluate the clinical efficacy of Yixin Bardiranjibuya Keli combined with escitalopram in the treatment of somatoform disorders.Methods 90 patients with somatoform disorders from March 2014 to March 2015,were recruited in our hospital as the subjects of this study.According to the random number method,the observation group and the control group were divided into observation group(45 cases)and control group(45 cases).The control group was treated with escitalopram,and the observation group was treated with Yixin Bardiranjibuya Keli on the basis of the control group.(SCL-90),Hamilton Depression Rating Scale(HAMD),Hamilton Anxiety Scale(HAMA),Health Status Questionnaire(SF-36PCS),Mental Health Overall Evaluation(SF-36PCS)before and after treatment,MCS score,adverse reaction,and curative effect.Results After treatment,the scores of SCL-90,HAMD and HAMA in the observation group were significantly lower than those in the control group [(2.40±0.53)vs.(2.47±0.56),(7.32±1.08)vs.(13.69±2.81),(4.82±1.21)vs.(9.93±2.02)],respectively(P<0.05),and the scores of SF-36PCS and MCS were significantly higher than those of the control group(P<0.05).The total effective rate was 95.55(48.38±11.02)points(P<0.05),and the adverse reactions were significantly lower than those in the control group [8.88％(4/45)vs 24.44％(11/45)％,Significantly higher than the control group 73.33％(P<0.05).Conclusion Yixin Bardiranjibuya Keli combined with escitalopram for the treatment of somatosensory disorder is significant and effective in relieving anxiety and depression of the patients and improving the physical symptoms of the patients,which can be used as the first choice of treatment.

[Summary] With the rapid development of endoscopic thyroidectomy for its advantages of hidden incision and good cosmetic effects, it becomes a significant issue to reduce surgical adverse effects.Recurrent laryngeal nerve ( RLN) injury is among the most important complications and is paid much attention to by clinical researchers.Reasons leading to RLN injury include accidental injury, ligation and intraoperative blood loss. An appropriate way to expose RLN, skilled operation performance, precise anatomy, individualized operation scheme and intraoperative neuromonitoring can prevent RLN injury.

Objective:To study the effect of caprylic/capric acid glycerides (Lab), propylene glycol (PG) and Azone on the transdermal behavior of ketoconazole and miconazole nitrate in compound ketoconazole gel, to screen appropriate penetration enhanc-ers. Methods:Using a RYJ-6A-type transdermal drug diffusion tester, the effects of Lab, PG and Azone at different concentrations on the transdermal behavior of ketoconazole and miconazole nitrate in compound ketoconazole gel were studied. Results:3% PG showed the most obvious penetration enhancement, which could increase the permeation of ketoconazole by 2. 004 times, and increase the pen-etration of miconazole nitrate by 1. 795 times, and the differences were statistically significant (P<0. 05). Conclusion:The penetra-tion effect of 3% PG is obvious, which can be applied in compound ketoconazole gel.

AIM:To investigate the effect of small incision non-phacoemulsification cataract surgery on corneal endothelial cell.METHODS:Totally 140 cataract patients (152 eyes) treated in our hospital from August 2013 to March 2016 were selected.All of the patients underwent small incision non-phacoemulsification cataract surgery.Before surgery and at 1wk, 1mo and 3mo after surgery, we measured the corneal endothelium of upper cornea, the central cornea and the lower part of cornea.The proportion and density of hexagonal cells, loss rate and cell area in corneal endothelial cells were calculated and compared.RESULTS:Postoperatively 36 eyes had posterior elastic layer folds, aqueous flare, which disappeared after treatment.After surgery, corneal incision was found to have mild corneal edema.No other complications were found.A total of 128 patients (137 eyes) were followed up for a total of up to 3mo, with a loss of follow-up in 12 patients (15 eyes).After surgery, corneal endothelial cell density of the upper part of the cornea, the central cornea and the lower part of cornea, was statistically significantly different with each other (F=3.526, P=0.031), the difference in different time points was statistically significant (F=4.111, P=0.018).The postoperative corneal endothelial cell loss rate was statistically significant different between the three groups (F=3.526, P=0.031), at different time pionts (F=4.111, P=0.018).There was statistical significance of percentage of hexagonal cells between the three groups (F=4.348, P=0.014), the difference was significantly different between different time points (F=4.964, P=0.008).There was statistical significance of corneal endothelial cell area between the three groups (F=3.180, P=0.044), the difference was significantly different between the time points (F=3.511, P=0.032).CONCLUSION:After small incision non-phacoemulsification cataract surgery, corneal endothelial cell density decreased, hexagonal cell proportion decreased, corneal cell area expanded.

Objective To compare the results of emergency clinical training for medical students and to put forward some suggestions.Methods Toatlly 207 medical students of Grade 4 studied in the first people' s hospital of Shanghai Jiaotong university from 2009 to 2011 were divided into the traditional group (n =90 ) and the experimental group (n =117 ).The students in the experimental group participated in emergency clinical training in summer vacation while those in the traditional group did not.Questionnaires about their self-learning ability,clinical communicating ability and critical thinking ability after training the were conducted and the data were analyzed by descriptive statistical analysis.Results One hundred and five effective questionnaires were recovered from the experimental group,with the recovery rate 89.7％ and 62 effective questionnaires were recovered from the traditional group,with the recovery rate 68.9％.The scores about clinical communicating ability and critical thinking ability of the experimental group were significantly highcr than those of the traditional group [ (79.45 ± 9.354)vs.(75.87 ± 9.926),(263.38 ± 30.925 ) vs.(251.36 ± 23.679),P ＜ 0.05 ].However,there was no significant difference in scores about self-learning ability between the two groups [ ( 153.97 ± 23.725 ) vs.( 149.83 ± 13.891 ),P ＞ 0.05].Conclusion Emergency clinical training is helpful to improve medical students' clinical communicating ability and critical thinking ability.It is worth popularizing.

Objective To observe the curative effects of metformin combined with cyproterone therapy on polycystic ovary syndrome(PCOS). Methods Ninety diagnosed PCOS patients were treated. The serum luteinizing hormone(LH), luteinizing hormone and follicule stimulating hormone(LH/FSH) ratio and T, waist hip ratio(WHR) of the patients before therapy were compared with using merformin combined with- cyproterone three cycles. Results A significant reduction(P<0.05 or P<0.01) in LH,LH/FSH,T and WHR of patients after the therapy was observed. Menses became regular after the therapy, and ache and hirsutism mitigated. Conclusion Metformin com- bined with cyproterone is a perfect means to treat polycystic ovary syndrome(PCOS).

ObjectiveTo analyze the results of implementing the tutorial system for medical interns, and to put forward some suggestions. MethodsThe medical interns and the doetors selected as tutors were asked to do questionnaires to study the tutorial system's feasibility and effectiveness. Simultaneously, we adopted the Objective Structured Clinical Examination ( OSCE ) to assess its process and resuits. Results74.3％ of the students and 75.5％ of the doctors think that they need the tutorial system,73.2％of the students think that this system can train better clinical skills,67.9％ of the doetors think that they can review the knowledge learned through teaching. Implemented after one year, students' OSCE scores are improved. ConclusionTutorial system for medical interns has achieved preliminary success, and the preparatory work and related-system building need to be further improved.

Objective To understand the work content of community nurses in general practitioners team model in Chongqing.Methods A questionnaire was carried out among 210 community nurses from 12 communityhealth service centers in Chongqing city.Results The work content of community nurses most often did in general practitioners team model were health management,health care of elderly people,health education,chronic disease management and basic medical service.However,the work content of women's health care and inquiry of death cause were relatively done less.Conclusions There are both basic medical service and public health service in the work content of community nurses in Chongqing.The “Six in One” function of community nursing is gradually improved.