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Objective To studythe efficacy of levosimendan in treating refractory heart failure complicating severe renal in sufficiency.Methods Sixty-seven cases of refractory heart failure complicating severe renal insufficiency in the internal medicine department of our hospital were randomly divided into the levosimendan treatment group(L group,n=33)and dopamine treatment group(D group,n=34).The changes of N-terminal pro-B-type natriuretic peptide(NT-pro-BNP),left ventricular ejection fraction (LVEF)and glomerular filtration rate(GFR)before treatment and on 1,3,7,30 d after treatment were compared between the two groups and analyzed.Results Before the treatment,there were no statistically significant differences in the baseline indicators between the two groups(P＞0.05).The group L:the NT-pro-BNP level on 1,3,7 d after treatment was decreased significantly(P＜ 0.05),LVEF on 3,7 d was significantly increased compared with th baseline(P＜0.05)and GFR on 1,3,7,30 d was significantly increased compared with the baseline(P＜0.05).The group D:the NT-pro-BNP level on 7 d of treatment was significantly decreased(P＜0.05),LVEF on 7 d of treatment was significantly increased compared with the baseline(P＜0.05),and no statistically significant changes were observed in GFR on 1,3,7,30 d(P＞0.05).After treatment,NT-pro-BNP,LVEF and GFR significant level values in the group L were better than those in the group D.Conclusion Levosimendan is superior to dopamine in improving heart and renal function for the patients with refractory heart failure complicating severe renal insufficiency.

Objective To compare the effectiveness of CO2 laser treatment and routine scalpel procedure for facial sebaceous cyst (SC),and to compare cosmetic effect of laser welding and routine suture skin incision.Methods Two hundred patients with SC were randomly divided into two groups:CO2 laser operative treatment group (laser group),and routine scalpel operative treatment control group (control group),with 100 patients in each group.For the laser group,skins of SC were incised and cyst were extirpated using CO2 laser beam (power 20 W,diameter of light spot 0.2 cm and power density 637 W/cm2).If cyst wall was broken,then CO2 laser was used to gasify the residual.After cleaning skin incision,both border of incision with anastomat of laser welding skin was performed,next to welding skin incision with CO2 laser (power 1 W,diameter of light spot 0.2 cm and power density 32 W/cm2) scanning radiating 2 mm/s.For the control group,skins of SC were incised and cyst or residual wall were extirpated with single-use scalpel,and skin incisions were sutured with 1-0 silk thread by whole layer interrupted suture.Results For the laser group,97 cases (97 ％) were cured,3 cases (3 ％) improved.For the control group,87 cases (87 ％) were cured,9 cases (9 ％)improved and 2 cases (2 ％) had no improvement.Cure rate of laser group was obviously higher than that of the control group (P＜0.05).The cosmetic effect of the laser group was also better than that of the control group (P＜0.01).For the laser group,successful rate of welding skin incision was 100 ％.Conclusions Surgical removal of SC on face and welding skin incision with CO2 laser is very effective.The chances of recurrence and cicatrisation are greatly reduced.In particular,laser welding skin incision establishes a new non-suture reparable method of skin incision,which has important value for the cosmetic and plastic surgery.

Objective To examine the association between one-hour plasma glucose (1-hPG) level during an oral glucose tolerance test (OGTT) and serum lipid profiles in individuals with NGT. Methods 6 402 individuals with NGT who underwent a 75 g OGTT were screened from four communities of Hefei suburban areas, aged over 40 years. Then 1 291 cases of NGT were randomly selected as the object of this research by random data table method. They were divided into NGT-1 group (1-h PG < 8.6 mmol/L, n = 597)and NGT-2 group(1-h PG≥8.6 mmol/L, n = 694). Pearson correlation analysis and multivariate linear regression analyses were performed to assess correlations between 1-h PG levels and lipid profiles. Results (1) The average values of body mass index were 24.3 kg/m2 in NGT-1 group, and 24.5 kg/m2 in NGT-2 group. (2) Compared with individuals in NGT-1 group , fasting plasma glucose , two-hour plasma glucose during OGTT , HbA1c , triglyceride (TG), and high-density lipoprotein-cholesterol(HDL-c) levels, TG/HDL-c ratios, and total cholesterol(TCH)/HDL-c ratios were significantly higher in individuals than in NGT-2 group. By contranst, body mass index, blood pressure , TCH and low-density lipoprotein-cholesterol levels were not significantly different between NGT-1 group and NGT-2 group. (3) The multiple linear regression analyses showed that 1 h PG levels positively correlated with TG in individuals in both NGT-1 group and NGT-2 group (P < 0.01). In addition, 1-h PG levels negatively correlated with HDL-c ratio in both groups (P < 0.01). Conclusion 1-h PG levels during OGTT in overweight individuals with NGT closely correlate with HDL-c and TG levels.

Objective To observe the effect of treatment and cosmetology in cbildren patients with strawberry hemangioma (SH) on face by three kind of infrared wavelength lasers.Methods In 300 children patients aged from 5 to 12 years with SH on face were randomly divided into a semi con ductor laser group (100 cases),a Nd ∶ YAG laser group (100 cases) and a CO2 laser group (100 cases).The parameters of laser were the same in the three groups,such as 10 W,light spot 0.2 cm in diameter and 318 W/cm2.According to size of area in the semiconductor laser and Nd ∶ YAG laser groups SH were coagulated by semiconductor laser and Nd ∶ YAG laser,and in the CO2 laser group it were gasified by CO2 laser,respectively.Children patients with SH were followed up for observation of cicatrzation and evaluation of the effect of therapeutics and cosmetology at six months after laser treatment.Results The cure rates were 89 ％ in the semiconductor laser group,83 ％ in the Nd ∶ YAG laser group and 69 ％ in the CO2 laser group (P＜0.05).The excellent and faworahle rates of cosmetic effect were 87.0 ％ in the CO2 laser group,86.5 ％ in the semiconductor laser group and 57.8 ％ in the Nd ∶ YAG laser group (P＜0.01).The analysis also showed that average therapeutic time,operative time and quantity of bleeding in the semiconductor laser group were less than that of in the Nd ∶ YAG laser and CO2 laser groups (P＜0.01).Conclusions The semiconductor laser (wave length 830 nm and power 318 W/cm2) for the treatmet of children patients with SH on face has many advantages,such as higher cure rate,shorter operative time,less bleeding in operation and better cos metic effects.It might become a first selective therapy for children patients with SH on face.

Objective To compare the effect of treating chronic colonitis diarrhea (CCD) using He-Ne laser irradiation of acupoints with routine drug treatment. Methods Two hundred patients with CCD were randomly divided into a laser irradiation group (laser group) and a routine drug treatment group (control group) with 100 patients in each group. The laser group patients were treated with a He-Ne laser ( power density 478 mW/cm2 )through coupling fiberoptic cable radiating onto the Shenque (REN8) , bilateral Tianshu (ST25) and Dachangshu (BL25) acupoints, each for 10 min daily for 10 days. Control group patients were treated with routine drugs such as antibiotics, astringents, antidiarrheals, antispasmodic analgesics, vitamins and Chinese herbal enemas. Three months after treatment the patients were examined by fibercoloscope to evaluate the therapeutic efficacy in the two groups. Results In the laser group 66 cases (66%) experienced a short-term cure, 27 cases (27%) improved and7 cases (7%) showed no effect. In the control group 33 cases (33%) were short-term cures, 43 cases (43%) improved and 24 cases (24%) had no effect. These differences were statistically significant. In both groups the effects for patients with short histories was better than for those with longer histories. In the laser group the pathological changes in the distal colon were significantly better than in the proximal colon, but this difference wasn't significant in the control group. The average days of total treatment to achieve short-term cure and improvement in the laser group were significantly less than in the control group. In the laser group the average days to the disappearance of abdominal pain and diarrhea in the short-term cure patients of was significantly fewer than in the control group. Conclusions Laser irradiation was more effective than routine drug treatment, especially for stopping diarrhea, spasmolysis and analgia.

OBJECTIVE:To investigate the characteristics of cecum and colon-specific drug delivery system of 4-aminosalicyl-ic acid-maltoside (4-ASA-Mal) in vitro. METHODS:With the cumulative release rate of 4-ASA as the index,HPLC was em-ployed to observe the delivery of 4-ASA-Mal (equivalent to 250 μg/ml 4-ASA) in the buffer solutions of different pH (1.2,6.8 and 7.4)and in the aqueous contents in different parts(stomach,small intestine,cecum and colon)of normal rats and the rat mod-els of ulcerative colitis. RESULTS:4-ASA-Mal was hardly released in the buffer solutions of different pH. 12 h cumulative release rates were less than 8% in the aqueous contents in the stomachs and small intestines of normal rats and rat models,and were 55%and 81% in the aqueous contents in the cecum and colons of normal rats,and 55% and 74% in the aqueous contents in the cecum and colons of model rats with ulcerative colitis. CONCLUSIONS:4-ASA-Mal can release a lot of 4-ASA in aqueous contents in ce-cum and colon,targeting cecum and colon in vitro.

OBJECTIVETo probe into the influences of different granule sizes and to prepare procedures on rational clinical usage of rhubarb based on chemical equivalence.

METHODThe effects of particle size, extract solvent, extract time and repeat times, and pre-extract or pro-extract of rhubarb on the extract amounts of the anthraquinones (AQs) were compared.

RESULTThe different prepare procedures investigated in the paper revealed significant influence on the extract amounts of the AQs and those extracts were not chemical equivalent. Ethanol extracted more AQs than water did, when other conditions were same. When extracted with water, the rhubarb of piece size 0.8-1.2 cm could extract relatively high amount of AQs nearly equal to superfine grinded powders, and the former was cheap. The water extraction of AQs showed an increasing trend with the extraction time extended. And pro-extract manner with water could extract more AQs than pre-extract manner with a extraction time of 30, 60 min. The water extraction of AQs repeated two times exceeded half of the amount of totally six times. When extracted with ethanol, the rhubarb of fine powders could extract relatively high amount of AQs nearly equal to superfine grinded powders. And pre-extract manner with ethanol could extract more AQs than pro-extract manner. The ethanol extraction of AQs increased in 30 min and then increased slower. The ethanol extraction of AQs repeated two times exceeded 70% of the amount of totally six times. So, the optimal conditions for water extraction rhubarb were pro-extract, two times repeated and 30 min per time; and the optimal conditions for ethanol extract were pre-extract, two times repeated and 30 min per time.

CONCLUSIONThe different prepare procedures showed significant influence on the extraction of rhubarb AQs. There is great need to establish a good usage practice (GUP) for Chinese Materia Medica to maintain rational clinical usage.

Early warning of infectious disease outbreak is key to controlling epidemics. Public general hospitals can effectively play their " outpost" role in the early warning and response of infectious diseases, which is directly related to the success of epidemic prevention and control. The authors summarized the current construction and main functions of infectious disease early warning systems at national level, regional level and public general hospitals, analyzed the problems existing in such construction, and put forward targeted suggestions. As found by the authors, some public general hospitals in China have initially built an early warning system for infectious diseases, achieving early recognition, early warning and reporting of infectious diseases to some extent. However, these systems were challenged by such shortcomings as insufficient intelligence, lack of data information exchange, immature practice and application, and lack of attention to the monitoring and early warning of endemic infectious diseases. It is suggested to improve the policy and system support in the future, to expand the types of infectious diseases for monitoring and early warning, to enlarge the sources of monitoring data and to strength hospital informationization construction.

Objective:To analyze the doctor-patient communication ability of medical interns, and to further explore the application value of strengthening doctor-patient communication education.Methods:Questionnaire and simulated doctor-patient communication were used to investigate students' doctor-patient communication ability according to whether they had received doctor-patient communication training (group A) or not (group B) at school. Doctor-patient communication education and skill training for three months were given to those interns, and questionnaires and simulated doctor-patient communication were conducted again to investigate the role in improving interns' doctor-patient communication ability and to analyze the application value of strengthening doctor-patient communication education.Results:Pre-training scores and pass rate in the group B were higher than those in the group A [(110.62±3.98) vs. (101.28±3.56), 88% vs. 58%], with statistical difference ( P<0.001). After the comprehensive training, the score and pass rate in the group A were significantly improved [(143.28±4.32) vs. (145.95±4.12), 97% vs. 100%], without significant difference between group B and group A before and after training ( P>0.05). Conclusion:Strengthening doctor-patient communication education and skill training is of great significance to improve the doctor-patient communication ability of medical students.