Objective To master the status of"Knowledge Attitude Practice"(KAP)methodology used in China by philological research.Methods Choosing the appropriate key words to retrieve the literatures based on CNKI total library,removing the false one by intensive reading,and analyzing the valid literatures in different ways based on which subject.Results①The amount of related literatures rising steadily from the middle of 1990's and remarkably since 2000.②The over 2000 valid literatures were mostly distributed in the healthcare field,and the most common subjects related in which were disease control,nourishment,smoking control,sex,conception control,drug abuse etc.③Not all of the research reported in the literatures performed the 3 core elements of KAP, and most of the literatures did not mention about the special interference on the targets,let alone the result analysis of the interference.④There were few literature whose main topic is KAP methodology.⑤The terms used for representing the KAP concept are not standardized.Conclusion ①The KAP methodology had been introduced into China and had been widely used in many fields.but the Chinese concept and terms of which should be more standardized,and the usage of which in some special application should be more advanced.②The KAP methodology Can be used and should be useful in TCM healthcare monitoring.

Objective To explore the relationships between the expression of PECAM-1 and the degree of ALI in Paraquat induced lung injury model of rabbits. Method Thirty six adult New Zealand rabbits were randomly divided into three groups: 8 mg/kg (Group A), 16 mg/kg (Group B) and 32 mg/kg ( Group C) according to the dose of Paraquat which were infusion into stomach. After poisoned, the animals were monitored for seven days, and then sacrificed. The upper lobe of lung were removed for HE,Masson staining and immunohistochemisty. The ALl score, fibrosis of lung and expression of PECAM-1 were semiquantitative analyzed. Results Each group has 12 animals suffered from poisoning. The survival time of animals in Group C was (6. 47 ± 0. 99 ) days, shorter than (6. 09 + 1.04) days ( P = 0. 031 ) in Group B and (4. 77 + 2. 04) days ( P = 0. 0 07) in Group A. The ALI score were ( 8. 33 ± 1.03) points in Group A, superior to (9. 83 ± 1.17) points ( P = 0. 047 ) in Group B and ( 11.50 + 1.38) points ( P ＜ 0. 01 ) in group C, Group B vs Group C, P=-0.03o The fibrosis degree of lung was (31.09 +2.05)% in Group A,not severe as (34. 37 ±1.62)% (P=0. 002) in Group B and (36. 54 ±0. 44)% (P ＜0. 01 ) in Group C, Group B vs Group C, P = 0. 026. The Pearson correlation analysis showed the expression of PECAM-1 was negative correlated to ALI score (Coe = -0. 732, P =0. 001 ) and fibrosis degree of lung (Coe = -0. 779, P ＜ 0. 001 ) . Conclusions The expressions of PECAM-1 were significantly decreased in New Zealand after Paraquat poisoned, which were dose dependent, correlated to ALI scored and fibrosis degree of lung, so it may play an important role in the development of lung injured induced by Paraquat.

Objective To know the utilization and development trend of TCM decoction pieces for clearing damp and promoting diuresis in our hospital;To provide references for rational medicine use and purchase in clinic. Methods Excel software was used to analyze the utilization of TCM decoction pieces for clearing damp and promoting diuresis in our hospital during 2009-2013 from the aspects of consumption quantity, consumption sum, and annual average growth. Results The consumption quantity of TCM decoction pieces for clearing damp and promoting diuresis in our hospital increased year by year with average growth rate of 10.58%;the consumption sum increased year by year with average growth rate of 20.21%. The consumption quantity of TCM decoction pieces for inducing diuresis to alleviate edema took the lead among all kinds of medicine, followed by medicine for inducing dampness for treating jaundice, and medicine for inducing diuresis for treating stranguria. Conclusion Both the consumption quantity and the consumption sum of TCM decoction pieces for clearing damp and promoting diuresis in our hospital have been increasing year by year. The proportion of which in total quantity and the consumption sum of TCM decoction pieces and the medicine utilization structure have kept stable, and its usages is rational on the whole.

Objective To investigate the distribution of human thyroid stimulation hormone(hTSH) in dried venous blood spots of neonatal screening for congenital hypothyroidism in Guilin ,and establish the hTSH cut‐off value for neonatal screening .Methods We selected 101 817 cases of neonatals with the local household registration from January 2011 to December 2013 ,and collected their venous blood to be made into dried venous blood spots on filter paper ,then the hTSH levels in dried blood spots were deter‐mined for congenital hypothyroidism ,According to screening results ,using the percentile method to calculate the hTSH P50 ,P99 of all the normal neonatals and neonatals that born in different quarters .Results Among 101 817 neonatals who were screened ,101 746 cases of normal neonatals ,71 cases of patients(including 47 cases of patients with CH ,24 cases of patients with high hTSH hy‐perlipidemia) ,the hTSH levels of normal neonatals showing a skewed distribution ,P50 ,P99 were 2 .45 μU/mL ,9 .86 μU/mL .the hTSH levels of the neonatal who were born in different quarters was changed with the change in the quarter ,P50 ,P99 were 2 .15μU/mL ,9 .20 μU/mL in The Spring ;P50 ,P99 were 1 .97 μU/mL ,8 .38 μU/mL in the summer ;P50 ,P99 were 2 .67 μU/mL ,10 .43μU/mL in the autumn ;P50 ,P99 were 2 .90μU/mL ,11 .15μU/mL in the winter .Through the analysis ,although the hTSH cut‐off of capillary blood spots that was used in the local center could be applied to dried venous blood spots ,but not ideal cut‐off value .Even‐tually ,the hTSH P99 9 .20μU /mL in the spring was identified as cut‐off value of dried venous blood spots for routine screening la‐boratory ,which had a sensitivity of 100 .00% ,a specificity of 36 .80% ,the diagnosis rate of 38 .96% ,and no missed phenomena .For the better service ,the hTSH value in the range of 9 .20-20 .00 μU/mL was defined as the boundary region ,and it was the danger region when the hTSH value was higher than 20 .00 μU/mL .Conclusion It is necessary to establish a reasonable hTSH cut‐off value to provide objective evidence for the use of dried venous blood spots of neonatal screening for congenital hypothyroidism ,ac‐cording to the boundary region and the danger region ,the recall chosen a different way ,the development of neonatal screening can be effectively promoted .

Objective To analyze the utilization and the development trend of TCM decoction pieces for relieving exterior syndrome in Affiliated Hospital of Nanjing University of TCM;To provide references for clinical rational medicine use and purchase. Methods Excel software was used to analyze the consumption quantity and consumption sum of TCM decoction pieces for relieving exterior syndrome in our hospital during 2009-2013. Results The consumption quantity of TCM decoction pieces for relieving exterior syndrome in our hospital increased year by year with average growth rate of 11.52%, among which the consumption quantity of medicine for diverging wind-cold was more than medicine for diverging wind-heat. Conclusion Both the consumption quantity and the consumption sum of TCM decoction pieces for relieving exterior syndrome in our hospital have been increasing significantly. The proportion of which in the total TCM decoction pieces for relieving exterior syndrome and the medicine utilization structure were stable, and the use of TCM decoction pieces for relieving exterior syndrome was rational on the whole.

OBJECTIVE:To provide reference for clinical rational use and purchase of TCM decoction pieces for rheumatism. METHODS:Using Excel software,the application of TCM decoction pieces for rheumatism in our hospital during 2010-2014 was analyzed statistically in respects of drug type,consumption quantity and consumption sum,etc. RESULTS:The consumption quan-tity of TCM decoction pieces for rheumatism increased from 46 026 kg to 79 139 kg in our hospital during 2010-2014,and annual growth rate was 14.68%;consumption sum increased from 3 851 300 yuan to 6 403 800 yuan,with annual growth rate was 15.46%;consumption quantity ratio was 2.48%-2.85%. Among antirheumatic drug subtype,the quantity of drugs for antirheumatic and dissipating cold was the largest (accounting for 51.43%-58.42%),followed by drugs for antirheumatic and strengthening the bones and muscles(accounting for 23.05%-28.42%)and drugs for antirheumatic and clearing heat(accounting for 18.53%-21.08%). Top 3 TCM decoction pieces for rheumatism in the list of annual quantity were Viscum coloratum,Cynanchum paniculatum and Clematis chinensis/Chaenomeles sinensis during 2011-2014. Top 3 TCM decoction pieces for rheumatism in the list of consumption sum were Zoacys dhumnades,C. paniculatum and V. coloratum during 2011-2014. CONCLUSIONS:Both consumption quantity and consumption sum of TCM decoction pieces for rheumatism have increased year by year in our hospital,but the ratio of total quantity to total amount and medication structure keep stable,and TCM for expelling wind-damp and dispelling cold is the greatest in consumption quantity which is in line with clinical drug use characteristics. Purchasing staff can purchase drugs predictably ac-cording to the results.

Objective To explore the surgical treatments through anterior and posterior approaches for anterior and posterior compression of cervical spinal cord. Methods The clinical data of 25 cases of anterior and posterior compression of cervical spinal cord from June 1999 to November 2003 were summarized retrospectively. There were 18 males and seven females with age range of 28-56 years (average 36.4 years). Of all,18 cases were with tricolumnae fractures of cervical spine caused by traffic injury,five with cervical herniation and two with malignant macrophage tumor in vertebral body and annex and vertebral lamina. Results All 25 cases underwent internal fixation decompression with I-stage combination operation of anterior and posterior approaches. Of 18 cases with tricolumnae fractures,one died and 17 recovered in various degrees. In five cases with cervical herniation,the positive sign disappeared basically. Two cases of malignant giant-cell tumor appeared metastatic carcinoma in the lungs 10 months after operation. Conclusions The I-stage combination operation of anterior and posterior approaches is an ideal way for the patients suffering from anteropsterospinal compression in cervical spinal cord. It can not only decompress completely the cervical spinal cord,stabilize the wounded cervical vertebra,but also facilitate nursing and function training and be beneficial to the recovery of spinal cord function.

Objective To observe the therapeutic effect of Tianwang Buxin Decoction for delirium after hip joint replacement in senile femoral neck fracture patients. Methods A total of 57 senile patients with femoral neck fracture induced by falling were enrolled from the department of arthropathy of Zhongshan Hospital of Traditional Chinese Medicine admitted from September of 2009 to February of 2014. The patents were aged over 65 years, and had delirium after hip joint replacement. Random number method was used to divide the patients into Chinese medicine group ( 29 cases) and western medicine group ( 28 cases) , which were given oral use of Tianwang Buxin Decoction and Olanzapine separetely. Before and after treatment, we observed the scores of Delirium Rating Scale (DRS), time for delirium disappearing, and incidence of indifferent mind and somnolence.Results (1) After treatment, DRS scores were obviously decreased in both groups (P<0.01 compared with those before treatment), but the difference was insignificant between the two groups (P>0.05). (2) The difference of time for delirium disappearing was insignificant between the two groups after treatment ( P>0.05). ( 3) After treatment, 7 cases of the control group had indifferent mind or somnolence, accounting for 25%. No case of the treatment group had indifferent mind or somnolence. The difference between the two groups was significant ( P<0.01). Conclusion Oral use of Tianwang Buxin Decoction has the same effect as Olanzapine for the treatment of delirium after hip joint replacement in falling-induced senile femoral neck fracture patients, and has the advantages of having no adverse reaction of indifferent mind or somnolence, and can realize comprehensive treatment by modification of the recipe according to the symptoms.

Objective To evaluate the efficacy and survival rate of neoadjuvant chemotherapy with docetaxe and pirarubicin in triple negative breast cancer (TNBC).Methods Total 51 breast cancer patients were divided into TNBC group (n =26,including 16 of stage Ⅱ and 10 of stage Ⅲ patients) and non-TNBC group (n =25,including 14 of stage Ⅱ and 11 of stage Ⅲ patients).All patients received a median of 4 treatment cycles with TAC regimen [docetaxe 75 mg/m2 on day 1,pirarubicin 40 mg/m2 on day 1 and cyclophosphamide (CTX) 500 mg/m2 on day 1 of each 21 day cycle].The efficacy of treatment and survival rate of two groups were evaluated.Results In TNBC group,9 out of 26 (34.62 ％) patients achieved clinical complete response (cCR),and 14 (53.85 ％) had partial response (cPR).Overall,88.46 ％ of TNBC patients had clinical response and 26.92 ％ (7/26) showed pathology complete response (pCR).In non-TNBC group,6 (24.00 ％) patients reached cCR and 8 (32.00 ％) showed cPR.The overall response rate was of 56.00 ％,and 4 (16.00 ％) patients achieved pCR.The overall 3-year survival rates in TNBC and non-TNBC groups were 73.08 ％ and 88.00 ％,respectively,indicating a poorer prognosis of TNBC.The 5-year survival rates of TNBC patients with and without pCR were 88.89 ％ and 47.06 ％,respectively.Conclusion TAC regimen improves the prognosis for locally advanced TNBC,indicating that the neoadjuvant chemotherapy is effective and safe for TNBC patients.

Objective To investigate the clinical efficacy of acupuncture combined with back Shu acupoint catgut embedding therapy in treating allergic rhinitis. Methods Totally 66 allergic rhinitis patients were included. Random number table method was used to divide the 66 patients into observation group and control group, with 33 cases in each group. The control group was given Ketotifen Fumarate Nasal Drops nose drops 2 drops each time, 3 times a day, Loratadine Tablets 10 mg orally, once a day for 4 weeks. The experimental group was treated with acupuncture, once a day, 10 d as a treatment course, three courses in total; at the same time, back Shu acupoint catgut embedding therapy was given, 15 d each time, twice treatment in total. After the end of treatment, clinical efficacy, clinical symptom score, life quality score, serum levels of inflammatory factors, serum immunoglobulin, peripheral blood eosinophil count and the incidence of adverse reactionsof the two groups were observed. Results The total effective rate was 93.94％ (31/33) in observation group and 75.76％ (25/33) in the control group, with statistical significance in the two groups (P<0.05). Compared with before treatment, the TNSS score, TNNSS score and RQLQ score of the two groups were significantly lower than after treatment (P<0.05); the IgE and EOS levels significantly decreased (P<0.05); the serum IL-17 and IL-22 levels were significantly lower (P<0.05). Compared with the control group, the TNSS, TNNSS and RQLQ score and the levels of IgE, EOS, IL-17 and IL-22 in the treatment group were lower after treatment (P<0.05). There was no significant difference in adverse reactions between the two groups (P>0.05). Conclusion Acupuncture combined with catgut embedding therapy in the treatment of allergic rhinitis has a significant clinical efficacy, which can improve the level of inflammatory factors in patients with high safety.