HC is very common in international classification of diseases. ICD-9 and ICD- 10 differ in their hypothesis. HC refers to the way of coding according to the occurrence of the most frequent clinical cases. Since the most frequent clinical cases are determined in accordance with the clinical cases in Western countries, they may often be contradictory to the diagnoses by clinicians in China. Thus it is imperative to understand and grasp the definition, identification and evolution of HC in intemational classification of diseases so as to arrive at more exact coding.

Anemia, Hemolytic ; complications ; Child ; Humans ; Pneumonia ; complications

Objective To investigate the application value of combination of ambroxol and fluidmicronized ipratropium bromide in full dose and frequency in treating senile refractory pneumonia.Methods From January 2010 to November 2013,84 cases of elderly patients with refractory pneumonia were divided into 3 groups.On the basis of anti-inflammatory and symptomatic treatment,the control group (n=28) received routine sputum suction and normal saline irrigation;the routine dose group (n=28) received the intravenous ambroxol 15 mg twice daily and the inhalation of 2.5 ml of nebulized ipratropium bromide once daily plus treatment in control group while full dose group (n=28) received intravenous ambroxol hydrochloride 30 mg three times a day and the inhalation of 2.5 ml of nebulized ipratropium bromide four times a day.The severity of pulmonary infection was described by clinical pulmonary infection score (CPIS) and C reactive protein (CRP),and therapeutic efficiency was evaluated by clinical symptom remission time,average hospitalization days and effective rate.Results At the 5 day and 10 days after treatment,the CPIS in full dose group was (4.82 ± 1.21) scores and (4.39± 1.03),respectively,C-reactive protein (CRP) was (58.11 ± 11.12) mg/L and (57.57±12.69) mg/L respectively,and these CPIS and CRP values at the 5 day and 10 days were significantly lower than those in the control group (6.10 ± 1.10) scores and (5.36 ± 0.95) scores,(74.50± 12.79)mg/L and (68.46± 13.77) mg/L (all P＜0.05).The above Values were lower as compared with those [(5.43±0.84) and (5.21 ±0.83),(65.11 ±834) mg/L and (59.11± 13.77) mg/L (P＜ 0.05)] in routine dose group.The CPIS and CRP concentration in full dose group and routine dose group were lower at the 10 days than at the 5 days (P＜0.05).Besides,clinical symptom remission time (4.43 ± 1.75) days,average hospitalization duration(26.32 ± 4.92) days in full dose group,clinical symptom remission time (5.68 ± 2.29) day,average hospitalization (32.21 ± 5.63) days in conventional dose group were significantly lower than in the control group (7.79±2.74) and (36.71 ± 11.78) days (P ＜ 0.05).Clinical manifestation,time of remission,and average hospitalization days of the full dose group were also reduced as compared with the conventional dose group (P＜0.05).The efficiency rates in the three groups of control,conventional dose and full dose were 42.9％ (12/28),71.4％ (20/28),92.9％ (26/28),among which the efficiency of full dose group was significantly higher than those of the control group and the conventional dose group,(x2 =16.047,6.788,P＜0.01).The conventional dose group showed a higher efficiency than the control group (x2 =4.667,P ＜ 0.01).Conclusions Combination of ambroxol and fluid-micronized ipratropium bromidet in full dose and frequency for treating senile refractory pneumonia is a useful managemen in the elderly patients.

SF-36 scale has been widely accepted because of its objectivity and scientificity. However, until now its application in TCM treatment for rheumatoid arthritis is not common. This article discussed the significance of SF-36 scale as the main content of life quality assessment in the efficacy evaluation system of TCM treatment for rheumatoid arthritis, which can provide certain references for the promotion of the application in this field.

Clinical teaching mode based on the theory of empowerment is a combination of the theory of em -powerment and clinical teaching activities .It emphasizes a student -centered philosophy .By empowering students in clinical teaching , the teachers can continuously stimulate the students 'initiative and thereby give full play to the students'potential.Starting from a discussion on of cases in clinical teaching , this thesis builds an effective student -leading mode of clinical teaching based on the theory of empowerment , tries to construct a clinical teaching theoretical system based on the theory of empowerment and explores strategies for practice , in order to improve clinical teaching effectiveness and promote reform in clinical teaching education .

Objective To assess whether 5-HTR1A C( - 1019) G and GNβ3 C825T gene polymorphisms are associated with post-stroke depression (PSD) and explore the genetic mechanism of the pathogenesis of post-stroke depression. Methods All 159 patients with first stroke were divided into the PSD group and the control group according to HAMD scores. Their genotypes were determined with polymerase chain reaction and allele-specific restriction enzyme analysis. Results The frequency of 5-HTR1A (-1019) GG genotype(8/53,15. 1% ), G allele (44/106,41.5%)and GNβ3 825T allele(68/106,64. 2% ) were significantly higher in the post-stroke depression group than in the controls (5/106,4.7% ;35/212, 16. 5%; 113/212, 53.3%; ×2 = 23.204, 23. 655, 3. 392, all P ＜ 0. 05 ). Combined genotype analysis showed that individuals with both 5-HTR1A ( - 1019) G and GNβ3 825T allele ( OR =4. 980,95% CI 2. 429-10. 210,P =0. 000) had a higher risk than those with 5-HTR1 A (-1019) G allele ( OR = 3. 589,95% CI 2. 113-6. 096, P = 0. 000) or GNβ3 825T allele ( OR = 0. 638,95% CI 0.395-1. 031 ,P =0. 042) only for post-stroke depression. Conclusion The 5-HTR1A C( - 1019)G and GNβ3 C825T polymorphisms are predisposing genes of post-stroke depression. Our data also suggest a significant interaction between the 5-HTR1A ( - 1019)G allele and GNβ3 825T allele in post-stroke depression.

[Objective]To report the polyaxial locking plate and its primary clinical results in the treatment of the tibial plateau fractures.[Method]From July 2006 to August 2007,38 patients with tibial plateau fractures,including 26 males and 12 females,were treated with surgical reduction and internal fixation with polyaxial locking plate.The mean age of the patients was 30.6 years(18-65 years).According to Schatzker classification,there were 3 of type Ⅰ,5 of type Ⅱ,5 of type Ⅲ,6 of type Ⅳ,16 of type Ⅴ,3 of type Ⅵ,of which 34 were closed fractures and 4 open fractures.The follow-up period ranged from 7 to 18 months with a mean of 13.7 months.Function of the knees were assessed according to HSS system and radiological examination.[Result]Solid arthrodesis were obtained in all patients at 3-6 months after operation.Skin flap necrosis and incision infection happened respectively in 2 cases of type Ⅴ and type Ⅵ fractures.The score of HSS system was 92.8(range 78-98) averagely half year after operation and no reduction loss was observed.[Conclusion]The polyaxial locking plate is an effective fixation technique for the surgical treatment of the tibial plateau fractures because of its convenience and stability.The locking screws can be implanted in various directions and reduction loss is avoided post-operation.

Currently, about 300 million people worldwide are affected by asthma. Most of these sufferers inhale immunosuppressants (ie corticosteroids) and beta-adrenergic receptor agonists for their asthma treatment. However, about 5%-10% of patients of asthma have poor response to such treatment. Investigation of kinase signaling pathway and nuclear transcription factor as a target molecule in the treatment of allergic asthma has been the concern of scholars home and abroad. This paper reviewed inhibitors of kinase signaling pathway and nuclear transcription factors for the treatment of asthma.

MOS 36-Item Short-Form Health Survey has been widely recognized, but the application in the field of traditional Chinese medicine rheumatism was less. This article aimed to summarize the application of MOS 36-Item Short-Form Health Survey in Chinese medicine for rheumatism. This may provide certain reference for the future application.

As for the ? opioid receptor, there are some disputes about the domains involved in the selective recognition of ligands, the relative spatial orientation of the amino acids within the TM affect the affinities of selective ligands. Regulation of opioid receptor activities does not appear to involve in their ability to promote the association of GTP onto the G proteins and the subsequent dissociation of heterotrimers. It is not very clear if phosphorylation correlates with agonist induced receptor desensitization. The celluar processing of ? opioid receptors requires the formation of multiple protein complexes, it is clear that interactions of ubiquitous transcriptional factors determine gene transcription.