Following the medical discipline’s own developmental pattern,according to the intrinsic requirement of the university’s construction,the edge disciplines which are the medicine and the humanities overlapping,and relatively superior should be developed by high starting point,specialization and the key breakthrough way.Considering the multidisciplinary development on the construction and developmental strategic altitude of the academy by following the development regularity of different subject itself,by consummating the leadership mechanism,transforming management conceptions,concising discipline direction,strengthening construction of the talented person troop and so on,is the inevitable choice of the related disciplines development in the provincial medical academy

Objective To investigate the clinical characteristics and prognosis of acute myocardial infarction (AMI) combined with ventrical septal perforation (VSP).Methods Fifty-seven AMI + VSP patients were retrospectively analyzed their clinical characteristics and outcomes who were treated in the Fourth People' s Hospital of Shenyang and the First Hospital Affiliated to China Medical University from June 2000 to May 2014.Results Of all patients,43 (75.4％) VSP occurred anterior wall AMI,and 14 (24.6％) were not.Echocardiogram show the end diastolic diameter of left ventricle was (53.7 ± 9.5) mm,left ventricle ejection fraction was (48.5 ± 11.8)％,VSP diameter was (9.8 ±7.9) mm,and 37(64.9％) were with near apex.The level of cardiactroponin I,C-reactive protein,and N terminal of B type natriuretic peptide of patients were (16.7 ± 12.9) μg/L,(99.7 ± 31.40 mg/L,(3 051.2 ± 879.7) μg/L.Total mortality was 71.9％ (41/57) in 30 days and 78.9％ (45/57) in 1 year.The mortality of operation group was 73.9％ (17/23) in 30 days and 91.3％ (21/23) in 1 year.The mortality of consecutive therapy was 64.7％ (22/34) in 30 days and 76.5％ (26/34) in 1 year.Conclusion The mortality of AMI + VSP is higher and operation is the most effective therapeutic method.

Objective To compare the cardiorespiratory system effects of propofol-remifentanil and etomidate-remifentanil sedation in older patients undergoing diagnostic gastroscopy.Methods 400 older patients undergoing painless gastroscopy in endoscopy center of our hospital were chosen and randomly received intravenous propofol-remifentanil or etomidate-remifentanil sedation and divided into propofol group (n=200)and etomidate group(n=200).The diagnosis,endoscopic insertion time,operation time,wake up time,hemodynamics,adverse reaction and satisfactory of patients in each group were observed.Results There were no difference between two groups in diagnosis(P＞0.05);the onset time was earlier in the etomidate group (P＜0.05).Systolic pressure and diastolic pressure in propofol group were lower than etomidate group during and after operation(all P＜0.05);the heart rate in propofol group were lower than etomidate group after operation(P＜0.05);meanwhile,the SpO2 in propofol group were lower than etomidate group during operation(P＜0.05).All adverse events in propofol group were higher than etomidate group (P＜0.05).Incidences of hyoxemia and injection pain were higher in the propofol group (all P＜0.05),while those of body quiver and myoclonus were higher in the etomidate group (all P＜0.05).However,Satisfaction of physician and anesthetist in the propofol group were better the etomidate group (all P＜0.05).Conclusion Etomidate-remifentanil administration for sedation undergoing painless gastroscopy resulted in more stable haemodynamic responses and less adverse events in older patients.Etomidate-remifentanil administration was worth to be popularized in older patients.

Objective To investigate the clinical and pathogenic features and other related factors of hospital-acquired bloodstream infections (HABSI) in geriatric wards,in order to provide the scientific basis for clinical diagnosis and therapy.Methods Clinical characteristics and other related factors of HABSI in patients admitted to the Department of Geriatrics of our hospital from June 2010 to October 2015 were retrospectively analyzed.Results Of the 64 elderly patients with HABSI,malignant tumor (39.1％) and type 2 diabetes mellitus (32.8％) were among the main disorders for their admission to the hospital.There were 53 cases of primary bloodstream infections and 11 cases of secondary bloodstream infections,accounting for 82.8％ and 17.2％,respectively.Primary infections involved mostly the respiratory,urinary and hepatobiliary systems.13 patients died,giving a fatality rate of 20.3％.Multiple logistic regression analysis showed that the retention time of central venous catheters or implantable venous access ports was ≥ 7 days (OR =49.51) and the duration of proton pump inhibitor administration was ≥3 days (OR=13.63),and these were independent risk factors for HABSI in elderly patients.A total of 66 strains of pathogenic bacteria were detected from the 64 patients.The most common G+ type was coagulase negative staphylococcus (18.2 ％) and the most common G-bacteria were Escherichia coli (18.2％) and Klebsiella pneumonia (15.2％),with the latter two making up 54.5％ of the extended-spectrum β-lactamase (ESBL)-producing strains.Conclusions HABSI can seriously affect the prognosis of elderly patients.Reduction in invasive procedures,active prevention and treatment of tumors,improvement of the internal environment and protection of vital organ functions are the main measures to reduce the bloodstream infection rate in geriatric wards.

With the fast social and economic development ecosystem has been seriously impacted. Country ecotypic sanitary system based on urine diverting Ecosan toilets and biogas Ecosan toilets can make positive contributions to the protection of ecosystem. This paper makes a review on the conception of ecotypic sanitary system the application of two types of ecotypic utilities the effect of ecotyptic sanitary utility and disease prevention and control comprehensive benefit of country ecotypic sanitary system and construction and operations. The results of researches demonstrate that although some valuable achievements have been gained in those fields mentioned above further improvement should be made and the application should be further widened as soon as possible.

Objective To examine the relationships among measures of gait recovery and community integra-tion index in people with brain injury.Methods 142 brain injured patients were chosen in this study.Community Balance and Mobility Scale,Dynamic Gait Index,Ten-Meter Walk Test for gait speed,and the Community Integration Questionnaire (CIQ) was measured.Results Average walk speed was 0.31-5.30 (1.36 ±0.88)m/s;DGI score was 5-24 (18.6 ±5.44) points;CMBS score was 0 -96 (54.1 ±25.3) points;CIQ subscale 6 -29 (16.2 ± 5.1)points,CIQ family subscale was 0-10 (4.8 ±3.0)points;CIQ society subscale was 4-12(8.2 ±2.1)points;CIQ productivity subscale was 0-7(3.8 ±2.2).The correlation between age and Ten-Meter Walk Test was nega-tive significantly (r=-0.50,P<0.05).All 3 balance/gait measures correlated significantly with the CIQ Productiv-ity subscale (r=0.35-0.58,P<0.05).Conclusion The ability of people with brain injury to engage in work/school/volunteer activity may be reduced by impairments in balance and mobility.

OBJECTIVE: To investigate the drug use involved in outpatient's prescriptions in a hospital in 2007.METHO-DS: With the International Selected Drug Use Indicators and defined daily dose as indexes,the drug use involved in a total of 5 029 outpatient's prescriptions randomly selected from a hospital were analyzed statistically based on Excel sheet.RESULTS: Of the total 5 029 outpatient prescriptions,60.83% paid the expenses at one's own expense,and the average age of the patiens were 46.9 years.The average number of drugs prescribed for patient's each visit was 2.63 kinds,and the percentages of antibacterial agents,ampuls,and prescriptions of drugs prescribed in generic names were 21.79%,10.44%,and 50.47%,respectively.Quinolones,cephalosporins and macrocyclic lactones ranked at the first three places in DDDs and consumption sum.The drug utilization indexes of cephalosporins and penicillins were on the high side.23.72% of antibacterial agents used in combination and 76.28% alone,20.07% in bigeminy.The antibacterial agents used in trigeminy or more than 3 kinds in combination were all for antiuberculotic treatment.Physician's signature rate after prescription revision was 60.19%,and the rate of prescriptions in which medicines for oral administration or for external use were prescribed alone was 32.88%.CONCLUSION: The drug use for the outpatients in the hospital is rational on the whole,but measures should be taken to tighten control on the drug use by strenthening physicians' consiousness on rational drug use so as to reduce the incidence of irrational drug use.

Objective:To study the risk factors and treatment of lymphatic fistulas after the radical operation of gastric cancer.Methods:Observed the clinical data of 631 cases after the radical operation of gastric cancer that had been received in our hospital from February 1998 to February 2008.Multiple factor analysis with logistic regression was performed for the risk factors.Results:The level of post-operative serum albumin on the first day and Ultrasonically activated shears are protective facrors against lymphatic fistulas(P

Objective To compare the influence of blood lipids and angina pectoris using combination therapy in coronary heart diseases(CHD) with unstable angina.Methods 100 patients were randomly divided into the probucol group(A group) 50 cases and probucol combined with atorvastatin treatment group(B group) 50 cases,The treadmill exercise ECG test,lipid and oxidation before and after treatment in two groups were observed.Results The total effective rate was 90.0% in group B significantly higher than 64.0% in group A(χ2 =3.841,P＜0.05);The total effective rate of ECG was 74.0% in group B after treatment which was significantly higher than the 42.0% in group A(χ2 = 3.981,P＜0.05);Treadmill exercise ECG test positive 82.0%,84.0% in two group before treatment,significantly higher than that 48.0%,24.0% in two group after treatment,(χ2 = 3.841,3.791,all P＜0.05);Angina pectoris in A、 B group after treatment [(1.6 ± 0.8) times、(1.0 ± 0.5) times]were significantly lower than [(4.3±1.9) times、(4.6 ±2.8) times]before treatment(χ2 =7.584,7.984,all P＜0.01).Conclusion Probucol was a safe and effective drug for treating hypolipidemic and reducing angina attack.Its combination with atorvastatin was safe,and the efficacy is more visible.

BACKGROUND:The establishment of animal pulmonary hypertension models will promote the improvement of clinical diagnosis and treatment on pulmonary hypertension.OBJECTIVE:To analyze and summarize the establishment of animal pulmonary hypertension models.METHODS:The databases of PubMed and CNKI were retrieved with key words of "pulmonary hypertension and animal model".Studies concerning the following aspects were included:using surgery method to prepare animal pulmonary hypertension models;using drug injection method to prepare animal pulmonary hypertension models;animal severe pulmonary hypertension model;pathophysiological comparison between animal models and pulmonary hypertension patients;and drug intervention on animal pulmonary models.RESULTS AND CONCLUSION:The methods for animal pulmonary hypertension models construction including:Surgical shunt,monoerotatine injection,chronically hypoxic and so on,in addition,the animal several severe pulmonary hypertension models which appeared at distal pulmonary artery neointimal lesion formation was reported.Through continuous improvement,they have provided insights into pathological cellular and molecular signaling pathways.However,how closely any of the models simulate to the cellular and molecular pathobiology of human pulmonary hypertension was poody understood.