The emergent and severe diseases always shows the characteristics of acute course, severe condition, rapid changes, and many complications. The common treatments based on syndrome differentiation usually lacked dynamics and promptness. The treatment of emergent and severe diseases emphasized the importance of early interventions, which can reverse the acute trend of the diseases and improve the outcomes. This article discuessed in five parts, including the meaning and significance of trend identification, the physiological and pathological trend of the human body, the influence factors of diseases' trend, how to carry out a trend identification and intervention strategies of trend identification. It elaborated the theory about the trend identification in the emergent and severe diseases.

Objective To observe the clinical efficacy of Chuankezhi acupoint injection combined with nursing health care education for treatment of patients with chronic obstructive pulmonary disease (COPD) at stable stage complicated with spleen kidney deficiency syndrome.Methods A prospective study was conducted. 118 patients with stable COPD and spleen kidney yang deficiency syndrome admitted to Hangzhou Third People's Hospital and Zhejiang Xinhua Hospital from February to April 2014 were enrolled, and they were divided into an experimental group (60 cases) and a control group (58 cases) according to the random number table. Both groups were given conventional treatment [including oxygen therapy, bronchodilators, corticosteroids, rehabilitation therapy in accord with the Global Initiative COPD (GOLD)]. Simultaneously, in the experimental group, Chuankezhi acupoint injection was additionally given, once daily for 12 weeks, and appropriate corresponding health education was mentioned. The lung function, quality of life and prognoses of the patients were regularly followed up for 9 months and compared between the two groups.Results After 12 weeks, one second forced expiratory volume (FEV1), FEV1/forced vital capacity (FVC) and maximum voluntary ventilation (MVV) per minute in the experimental group were significantly higher than those in control group [FEV1 (L): 1.57±0.42 vs. 1.35±0.35, FEV1/FVC: (58.62±4.56)% vs. (50.36±4.35)%, MVV (L/min): 60.62±7.56 vs. 56.95±6.33, allP < 0.05]. The quality of life evaluation form for COPD (QLICD-COPD) was used to evaluate the physical function, psychological function, social function and specific modules scores, showing that the above items in the experimental group were significantly higher than those in control group (total score: 74.69±8.92 vs. 68.62±8.95, physical function score: 74.16±8.55 vs. 66.31±7.15, mental function score: 78.69±9.79 vs. 72.64±8.45, social function score: 75.45±6.75 vs. 70.36±6.12, specific modules score: 67.52±6.33 vs. 61.36±6.17, allP < 0.05); Barthel index score was also significantly higher than that in the control group (75.41±9.24 vs. 68.43±7.95,P < 0.05). Within 9 months of follow-up, the incidence of acute exacerbation of COPD in the experimental group was significantly lower than that in the control group [5.00% (3/60) vs. 17.24% (10/58),P < 0.05]. The re-admission rate was also significantly less in patients in experimental group compared with that of control group [1.67% (1/60) vs. 12.07% (7/58),P < 0.05]. Conclusion Chuankezhi acupoint injection with health education for treatment of patients with COPD at stable stage and spleen kidney yang deficiency syndrome has good clinical efficacy, worthy to be applied more widely.

Objective To explore the characteristics of uhrasonography of hepatobiliary cystadenoma. Methods The ultrasonographic characteristics of 5 cases with hepatobiliary cystadenoma were retrospectively analysed, and compared with the operation and pathology. Results The ultrasonography of 5 cases was multilocular cystic mass,which seems to be,but not indeed communicating with the biliary tree,in which irregular septation was demonstrated in two-dimensional structure and also with perforator vessels along in color Doppler flow imagineg. And in some cases small papillary tuft and small loci of calcification was noted on the septation. Conclusions Muhilocular cystic mass,locating along the biliary tree, however not communicating with the the biliary tree, is an important diagnostic basis of biliary cystadenoma. And it should be distinguished with other cystic tumor in the liver.

Objective To build a scientific,rational and practical evaluation index system for medical tutors.Methods Evaluation framework was initially constructed on the basis of literature analysis.Two rounds questionnaires investigation were conducted soon using Delphi method and the data were analyzed using descriptive analysis,independent samples of non-parametric test (Kreskas-Wallis test),expert reliability analysis,analytic hierarchy process and other methods.Results The results of two rounds of expert questionnaires showed that both recovery rate and acceptance rate of the questionnaires were more than 90％ and overall expert coefficient was 0.8957.The coordinate coefficient of the second-class index was 0.181,x2 =27.148,P ＜ 0.001,and that of the third-class index was 0.157,x2 =127.03,P ＜ 0.001.Experts' opinions were highly consistent.Conclusions Evaluation index system including three first-class indexes,seven second-class indexes and twenty-eight third-class indexes was established for medical tutors.The evaluation index system is of great importance in safeguarding postgraduate culturing quality and strengthening teaching staff construction.

By equality in the healthcare retorm we mean equal access to healthcare protection.Future reiorm should establish a fair value concept and make great efforts to solve the serious lack of fairness in the current healthcare system.Efficiency in the healthcare refers to not only higher revenue income of medical institutes but also to utmostly meet the citizens" needs for medical service.For the sake of the most cost - effective distribution of the insufficient budgets and medical resources,medical services have to be diversified for an improved efficiency. In the framework of the healthcare reform,relations between equality and efficiency is the unity of opposites,and top priority shall be given to equality while maintain efficiency.

Around the features of low power and high integration of portable electronic medical equipment design, the primary low power MCU series from the current semiconductor manufacturers were compared. The analysis results showed that the 32-bit MCUs based on the low cost and high energy efficient ARM Cortex-M architectures, have comprehensive advantages on power level, operational performance and integrated peripherals obviously.
Electronics, Medical ; instrumentation ; Equipment Design

Background and purpose:Ca2+plays a very important role in the maintenance of cell biological functions. The storage, release and uptake capacity of Ca2+ is controlled by endoplasmic reticulum (ER). Ca2+ homeo-stasis is essential for cellular energy metabolism and proper protein folding. This study aimed to investigate the effect of cytoplasmic Ca2+ on cisplatin induced ER stress-mediated autophagy in ovarian carcinoma SKOV3 and its underlying mechanism.Methods:The ovarian cancer SKOV3 was used as a study object. The experiment consisted of three parts:① To explore the possible relationship between cisplatin-induced ER stress and autophagy, SKOV3 cells were treated with cisplatin for 0, 6, 12 and 24 h, respectively;② To explore the possible relationship between ER stress induced Ca2+ effux and autophagy, SKOV3 cells were treated with cisplatin for 0, 9 and 12 h, respectively, and TG was used as a positive control;③ To explore the effects of blocking calcium effux on autophagy, SKOV3 cells were divided into control group, cisplatin group, TG group, BAPTA-AM group, cisplatin combined with BAPTA-AM group and TG com-bined with BAPTA-AM group. Western blot was used to detect the protein levels of GRP78 and LC3. Fluo-4 calcium lfuorescent probe was used to examine cytoplasmic Ca2+ levels. Confocal microscopy was used to detect LC3 level by immunolfurescence staining.Results:Compared to control group (0.679±0.011), GRP78 was signiifcantly accumulated at 6, 12 and 24 h after cisplatin treatment and reached the maximum value at 6 h (1.393±0.004,P=0.000). Similarly, compared to control group (0.038±0.000), LC3 puncta were clearly seen after cisplatin treatment and reached the maxi-mum value at 12 h (0.072±0.002,P=0.000). Using confocal microscopy, we found that cisplatin and TG increased LC3 punctate accumulation and cytoplasmic Ca2+ levels in a time-dependent manner. Immunolfuorescent method showed that treatment with cisplatin combined with BAPTA-AM or TG combined with BAPTA-AM increased LC3 punctate accumulation induced by cisplatin or TG. The results of Western blot showed that cisplatin combined with BAPTA-AM (0.071±0.001) or TG combined with BAPTA-AM (0.065±0.001) signiifcantly increased LC3Ⅱ/LC3Ⅰ ratio induced by cisplatin (0.039±0.000,P=0.000) or TG (0.035±0.001,P=0.000).Conclusion:Cisplatin induces intracellular ER stress and autophagy in SKOV3 cells, accompanied by increased cytoplasmic Ca2+ levels. Chelating cytoplasmic Ca2+enhanc-es cisplatin-induced autophagy.

OBJECTIVE:To observe the therapeutic effect of Shenfu Injection in combination of rougui for oxaliplatin-induced neurotoxicity.METHODS:A total of 73 cases with malignant tumor were randomly divided into control group and treatment group:the control group was treated with chemotherapy alone,in which oxaliplatin was included;the treatment group was treated intravenously with Shenfu Injection 40～60ml for 7～10d plus orally with 3g Rougui decoction prior to chemothera_py.RESULTS:Incidences of neurotoxicity for the treatment group and the control group were 13.5% and 55.6%,respectively.Significant differences were noted between 2 groups(P

OBJECTIVE:To explore the therapeutic effect of early use of alprostadil and the effects on PTX-3,renal function and stability of carotid plaque in patients with acute cerebral infarction. METHODS:93 patients with acute cerebral infarction in our hospital from Aug. 2011 to Aug. 2015 were selected,and divided into observation group(47 cases,2 case withdrew from the test and 45 cases completed the test)and control group(46 cases,1 case withdrew from the test and 45 cases completed the test) by odd and even number of registration order. Control group was given Citicoline sodium injection 0.5 g + Extract of ginkgo biloba leaves injection 20 ml added into Sodium chloride injection(NS)250 ml,ivgtt,qd;observation group was additionally given Al-prostadil injection 20 μg added to NS 250 ml,ivgtt,qd. They were treated for 2 weeks. Clinical efficacy,and the differences of PTX-3,blood urea nitrogen(BUN),serum creatinine(SCr),24 h urinary protein(Upro),stability of carotid plaque before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group(91.1%)was higher than control group(73.3%),the difference was statistically significant(P<0.05). There was no statisti-cal significance in PTX-3,BUN,SCr,24 h Upro between 2 groups before treatment (P>0.05). After treatment,PTX-3,BUN, SCr,24 h Upro in 2 groups decreased,and observation group was lower than control group;stability of carotid plaque in observa-tion group(100.0%)was higher than control group(64.0%),the differences were no statistically significant(P<0.05). The ad-verse reactions in 2 groups relieved themselves with no special treatment,and with no statistical significant(P>0.05). CONCLU-SIONS:The early use of alprostadil is effective for acate cerebral in farction,and can obviously reduce PTX-3 and improve renal functions,increase stability of carotid plaque with good safety.

A gas chromatography-triple quadrupole mass spectrometry coupled with solid phase microextraction method ( SPME-GC/QQQ) was developed for the determination of chlorinated anilines ( CAs) residues in soil. The multi-reaction monitoring ( MRM ) parameters were optimized. The SPME conditions such as amount of soil sample, volume of added water, extraction temperature and absorption time were investigated. Optimum SPME conditions including 8 g of soil sample, 4 mL of water, 80℃ of extraction temperature and 40 min of absorption time were employed in the experiment. Method detection limits were within the range of 1-10 pg/g, while linearities were within the range of 5-1000 pg/g. Under the optimized conditions, the soil samples spiked with 200 pg/g targets were determined with recoveries of 96. 8%-144. 2%and relative standard deviations of 13 . 4%-27 . 8% ( n=5 ) . The proposed method combines simplicity and rapidity of SPME and high selectivity of MRM. It is especially suitable for the quick screening and determination of trace amounts of chlorinated anilines residues in soil.