Objective To evaluate the treatment of acute cerebral infarction of 4 kinds of drug cost-effective-ness.Methods A retrospective analysis was performed on 207 patients with acute cerebral infarction,according to the drug formulation of patients treatment,they were divided into four groups: group A (alprostadil),group B(Oza-grel),group C(Dan red injection),group D(Xuesaitong),the curative effects and adverse reactions were observed and analyzed by using pharmacoeconomic cost-effectiveness method.Results The costs of groups A,B,C and D were 5 248.6,4 253.7,4 475.8,3 501.2 yuan,respectively;The effective rates were 92.2%,83.7%,87.5%,76.9%, respectively;The cost effectiveness ratio(C/E) were 56.93,50.82,51.15,45.53,respectively;A,B,C group compared with the incremental cost-D group,the effect of ratio(△C/△E) were 107.2,110.7,91.9;The incidence of adverse reactions were 3.9%,6.1%,12.5%,11.5%.Conclusion Alprostadil group scheme was the best treatment scheme.

Objective To describe the feelings,career development needs and the coping styles of stress experience of nurses with master's degree within one year after graduation.Methods The semistructured in-depth interview was conducted in 15 nurses with master's degree individually.The data were analyzed by qualitative content analysis method and the themes were abstractod.Results Three themes were extracted,including feelings,their career development needs and coping styles of stress.The nurses with master's degree reported feelings of heavy work pressure; lack of a sense of accomplishment; strong sense of loss.Their career development needs included improvement of professional knowledge and clinical skills; organizational supports; improvement of professional English and received a doctor' s degree.There were three main coping styles of stress:adjusting attitude and self role orientation; competence improvement; adjusting interpersonal relationship.Conclusions Nursing masters suffer from heavy pressure in clinical practice within one year after graduation.They have some occupation development needs.Nursing managers should explore positive and effective methods to relieve the nurses' stress and ratioually use and actively guide nursing masters,and provide direction and space for achieving their occupation value.

Objective To observe the influence of simulated microgravity on rat islet. Methods Isolated islet were assigned to flask-culture or bioreactor-culture. Gross structure and ultrastructure of islet were observed by transmission electron microscopy (TEM) and scanning electron microscopy (SEM). Results Islets ultrastructure on 7th day in bioreactor closely resembled fresh islets,with well-formed secretory granules and abundant mitochondria. SEM showed under microgravity islets communicating each other with cavity-like areas. Conclusions The ultrastructure of islets cultured under microgravity closely resembled fresh islets.

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Objective To explore the clinical application value of transcatheter arterial chemoembolization (TACE) combined with CT-guided percutaneous acetic acid injection (PAI) in treatment of huge hepatocellular carcinoma (HCC). Methods Forty-three patients with huge HCC were randomly divided into two group. Twenty-one patients in group A underwent routine one course for TACE (three times), and the interval of TACEs was one month. Twenty-two patients in group B underwent TACE combined with PAI, and CT-guided PAI was performed once a week since 2-3 weeks after first TACE, and one course included 6-9 times of PAI. Postoperative follow-up was conducted (including AFP, the size of tumor, etc.). One course of treatment was repeated in case of tumor recurred. Results At the 1st month after treatment, no statistical difference was found of AFP positive rate between two groups. Statistical difference of total effective rate was found between two groups (38.10% vs 77.27%). The 1-, 2- and 3-year survival rate In group A was 47.62%, 23.81% and 9.52%, respectively, while in group B was 81.82%, 54.55% and 36.36%, respectively, and significant differences were found between the two groups for the same period. Conclusion TACE combined with PAI is safe and more effective than TACE alone in the treatment of huge HCC.

Objective:To investigate the effects of sign-contract services on hypertension patient disease control and the satisfaction of medical staff. Methods:a face-to-face questionnaire survey was conducted among hypertension patients selected from 20 primary health centers in 10 provinces in China. Results:This paper collected 1 ,881 valid questionnaires, and the average age of the population was 65. 72 ± 10. 88. Respondents that received sign-contract services accounted for 53. 88%, and there was no difference between patients who signed the service contract and who did not in terms of demographics. In self-reporting of blood pressure controls, respondents who signed the service contract, aged 40~50 years old, enjoyed the free medical care, preferred to seek medical services from primary a-gencies ( i. e. community health centers and township hospitals) for minor illnesses, controlled their blood pressure better ( P<0. 05 ) . Respondents enjoyed the civil resident medical insurance, preferred to seek medical care from community health centers for minor illnesses and signed the service contract were more likely to be satisfied with their medical practitioner (P<0. 05). After adjusting for age, gender, education level, medical insurance style, patient willingness to seek medical care for minor illnesses, signing service contracts was found to be an independent factor both associated with blood pressure self-control and attitudes towards medical service providers, with the odds ratio of 3. 007 (95%CI:2. 572 -3. 517) and 1. 814 (95%CI: 1. 563 -2. 105) respectively. Conclusion: Contracts are correlated with blood pressure control and satisfaction toward medical practitioners, which means that patients who signed the service contract control their blood pressure better and are more satisfied with their medical deliverers.

Objective To understand the status of service contract signing conducted by primary medical and health institutions.Methods A questionnaire survey and in-depth interview methods were used to study the service contract signing at primary health care institutions.Results The contract signing rate of the institutions surveyed was 1 9.1%,and valid contract signing rate was 76%.Senior people above 65 years old accounted for 33.5% of those signers,while hypertension patients accounted for 1 9.5% and diabetes patients for 10.6%.Interviews to the general practitioners team at the primary health institutions found that main factors affecting residents′ intention to sign were drug availability, attraction for signing the services,treatment habits among others.Interviews to the staff the primary health institutions found that contracted services are facing such difficulties as medical staff shortage,lack of motivation,lack of competence among others.Interviews to leaders of the primary health institutions found that the lack of publicity and support of medical insurance also has great influence to service contract signing.Conclusions The enthusiasm of general practitioners and residents to sign up for the service remains to be improved.

Objective To explore the effect of atorvastatin on the proliferation and apoptosis of K562 cells andto investigate its mechanisms.Methods The cells were treated by different concentrations of atorvastatin.The CCK-8 assay was employed to detect the cell proliferation.The cell apoptosis was detected by AnnexinV-FITC/PI dual staining;the flow cytometry was used to detect the cellular cycle;the activities of caspase-3,-8,-9 were detected by the colorimetric method;qRT-PCR was employed to measure the mRNA expression levels of Bcl-2 and PDCD5 in K562 cells.Results Atorvastatin could inhibit the proliferation of K562 cells in a time-and dose-dependent manner(P＜0.05);and induced the apoptosis of K562 cells,the percentage of G0/G1 phase cells was increased after atorvastatin treating k562 cells(P＜0.01),while the percentage of S phase cells was decreased(P＜0.01),moreover which showing the concentration dependence(P＜0.01);atorvastatin activated the caspase-3,-8,-9 (P＜0.01);down-regulated Bcl-2 mRNA expression and up-regulated PDCD5 mRNA expressionin a concentration dependence(P＜0.01).Conclusion Atorvastatin can inhibit the proliferation and induce apoptosis in K562 cells.

Objective To investigate clinical and reflectance confocal microscopy(RCM)features of extragenital lichen sclerosus et atrophicus.Methods Clinical data and RCM images were collected from 11 patients with extragenital lichen sclerosus et atrophicus in Department of Dermatology of Shenyang No.7 People's Hospital and the First Hospital of China Medical University between October 2010 and October 2016,and retrospectively analyzed.Results Of the 11 patients,9 were female,and 6 had lesions on the neck.RCM imaging showed atrophy of the epidermis,disappearance of high reflectivity and circular structures in the basal layer,blurred dermo-epidermal junction,highly reflective quasi-circular big cells and a few mononuclear cells scattering in the superficial dermis,and homogenization and increased density of collagen.Conclusion Extragenital lichen sclerosus et atrophicus has characteristic RCM presentation.

Objective:To explore the effect of integrated application of multi-mode teaching in presentation-assimilation-discussion (PAD) class of medical microbiology.Methods:A total of 102 2017-batch clinical medical students of Hubei University of Medicine were collected, and the quasi-experimental study was adopted. The experimental class (50 students) was established by setting a PAD class, integrating the use of WeChat public account, Rain Classroom and WJX software during the teaching implement. And traditional mode of teaching was carried out in the control class (52 students). Moreover, the questionnaire survey and the test assessment were applied to compare the teaching effects of the two classes.Results:Questionnaire results showed that scores of indicators related to the teaching effectiveness in the experimental group were significantly higher than those in the control group ( P<0.01), and scores of tests in the experimental group were significantly better than those in the control group ( P<0.01). The t test was performed by SPSS 20 in the study. Conclusion:The integrated application of multi-mode teaching enriches the teaching mode of PAD class, which fully describes the student-centered concept, and increases students' initiative, participation, as well as students' knowledge mastery and innovation.