Medical record writing is a basic skill for clinicians. As to traditional Chinese medicine (TCM) record, practice writing for a good record can help young TCM doctors to build up the thinking of diagnosing and treating diseases in the unique way of TCM. Being a TCM resident for six years, I find young TCM doctors do not pay enough attention to the medical record writing, producing many common mistakes in the record, which young doctors do not even realize that they are making mistakes everyday in their inpatient medical records. Main mistakes are as follows:the solar term of disease attack is appointed as the term of the day patients are hospitalized; in order to satisfy the disease and syndrome diagnosis, doctors would rather make up a fictitious symptom rather than using the patient’s real chief compliant; the history of the present illnesses are always written too short and ambiguous, which cannot reflect the whole course of the onset, development and changes of illness from its occurrence to the time that the pa-tient comes to the doctor;the presenting symptom is written as the name of the symptom, without descriptive details, which cannot reflect TCM characteristics;nearly all diseases are written as“illness with unknown cause”according to western medicine, ignoring TCM pathogenesis;patient's personal history is written similar to each other, and pa-tient's emotions, diet preference is missing, which should vary with each individual;the four diagnostic methods and TCM syndrome differentiation of the everyone’s illness are written all the same, generally according to the text-book; TCM treatment plan is not made according to TCM disease / syndrome diagnosis in the medical record. The main cause of these mistakes in the inpatient department of TCM hospital has been westernized too much by western medicine. Young TCM doctors can use as much of western medicine as they want;and they use more western medi-cine than TCM in the inpatient department, which weakens their TCM skills. Many TCM doctors in inpatient depart-ment do not focus on practicing TCM four diagnosis skills, such as tongue and pulse, and they do not know how to use the four diagnostics;and do not exactly know how to make a syndrome differentiation either. Thus, they diagnose and treat diseases with western medical thinking instead of considering TCM thinking. When writing a medical re-cord, they tend to copy TCM diagnosis according to textbooks instead, but do not make an authentic TCM diagnosis by themselves, lacking critical thinking skills for TCM. Furthermore, TCM record writing standards made by the Ministry of Health and TCM are defective in reflecting TCM characteristics, which has misguided many doctors. The last reason is that doctors tend to make false entries in medical records in anticipation of medical audits. There are still other outside pressures such as quick treatment of excess patients and liability, which cause errors above. TCM will bestamped outif attention is not paid to this.

Objective To observe the effect of the compound Qinbudan recipe in treating multi-drug resistant pulmonary tuberculosis (MDR-PTB) of deficiency of both qi and yin. Methods A randomized controlled trial was carried out in 72 MDR-PTB cases, and the patients were divided into treatment group and control group, 36 cases in each group. The treatment group was treated with the compound Qinbudan recipe while the control group was treated with Feitai capsules. After treatment for 3 months, the therapeutic effect, scores of traditional Chinese medical syndromes, and adverse reactions were compared in the two groups. Results ( 1) After treatment for 3 months, the total effective rate of the treatment group was 82.86%, and that of the control group was 25.81%, the difference being significant (P <0.01) . (2) After treatment for 3 months, the total scores of traditional Chinese medical syndromes of the treatment group were lower than those of the control group, and the difference was significant ( P <0.05) . ( 3) At the end of the treatment course, the treatment group showed better effect on relieving shortness of breath, night sweating, spontaneous perspiration, cough with sputum than the control group ( P<0.05 or P <0.01) . The two groups had similar effect on relieving cough, dry throat, tidal fever, and emaciation ( P >0.05) . ( 4) Blood routine examination and hepatorenal function showed no disorders during the treatment. Gastrointestinal disturbance was not found either. Conclusion The compound Qinbudan recipe is effective in treating multi-drug resistant pulmonary tuberculosis of deficiency of both qi and yin, and has better effect on relieving shortness of breath, night sweating, spontaneous perspiration and cough with phlegm than Feitai capsules .

Objective To study general law of typing according to syndrome differentiation of Chronic Obstructive Pulmonary Disease (COPD). Method Based on large sample prospective Clinical Epidemiology investigation, symptoms, conditions of tongue, pulse according to TCM and pulmonary function, quality of life in 616 patients of COPD were collected. By means of Frequencies procedure, factor analysis, cluster analysis and analysis of variance in SPSS11.5, analyze the investigated data and lay difficient types of syndrome of COPD according to TCM. Meanwhile, explored distinct distribution and the relation between types of syndrome and pulmonary function, quality of life in patient5 with COPD. Result There were six types according to syndrome differentiation of COPD, deficiency of lung-qi, pathogenic wind-cold attacking lung, deficiency of pulmonosplenic both vital energy and yin, yin-deficiency of the lung and kidney, stagnation of phlegm and pathogenic fluid-reteneion in lung following splenic asthenia and stagnation of liver-qi, blood stasis-phlegm following deficiency of heart-yang and kidney-yang. There were multiple types of syndrome in COPD patients, the relation was detected between each type of syndrome and lung function, quality of life. Conclusion To draw assistance from clinical epidemiology and mathematical statistics method, the initial standard of differentiation of symptoms and signs to COPD was layed. The regularity of types of syndrome to COPD was detected. The result could be used in diagnosis of COPD, and the method could be communicated in the standardization research of syndrome differentiation.

BACKGROUND:With deep understanding of the concept of biological fixation, more and more physicians choose interlocking intramedulary nail in the repair of femoral shaft fracture. Compared with traditional extramedulary plate, the superiority of the interlocking intramedulary nail has not been reported at present. Randomized controled clinical study is less, and lacks of systematic evaluation.
OBJECTIVE:The results of meta-analysis were used to compare the therapeutic effects of interlocking intramedulary nail and steel plate for femoral shaft fractures.
METHODS: We retrieved the MEDLINE, Embase, PubMed, Cochrane library, CNKI, Wanfang database, and Vip database from 2000 to 2015 by computer to colect randomized controled study on interlocking intramedulary nail and extramedulary plate for treatment of femoral shaft fractures. We screened the literatures that met the inclusion criteria, were strict quality evaluation of the selection. Excelent and good rate, operation time, intraoperative blood loss, hospitalization time, recovery time of knee joint function reaching 135°, knee joint function recovery time of the second operation to remove the internal fixation for reaching 135°, postoperative drainage volume, fracture healing time, nonunion or delayed union, internal fixation loosening, postoperative infection, and osteomyelitis were considered as the evaluation index of meta-analysis. Meta-analysis was performed with RevMan 5.2 software from the Cochrane Colaboration.
RESULTS AND CONCLUSION:Finaly 10 Chinese articles were included, including 915 patients with femoral shaft fractures. The results of meta-analysis showed that compared with extramedulary plate, interlocking intramedulary nails for femoral shaft fractures could effectively reduce the amount of blood loss, postoperative drainage, shorten operation time, hospitalization time, fracture healing time, reduce the incidence of postoperative infection, and obtain recovery of knee joint function. These results suggest that interlocking intramedulary nail for treating femoral shaft fractures has certain advantages. The interlocking intramedulary nail can be firstly selected in the permit of patient’s economic conditions and hospital conditions.

This paper introduces the development and application of health-related quality of life (HRQOL) scales in research on coronary heart disease (CHD). Currently, the scales for CHD patients have been more systematically developed and widely used in foreign countries, while domestically in China, they are developed successfully but problematically; research in this field has started later and the scales introduced are limited and not suitable for the entire range of domestic CHD patients. Thus, this paper introduces 26 HRQOL scales in research on CHD, including five generic scales, ten disease-specific scales from abroad and eleven scales originating from China. With the deficiency of HRQOL scales, especially that in traditional Chinese medicine and specific scales, this paper analyzes and summarizes the problems existing in development of scales. The authors also provide solutions in order to help the development and application of scales in further studies.

The paper was aimed to review the modeling methods of spleen-yang deficiency, which can be classified into imitating traditional Chinese medicine (TCM) etiology methods and modern medicine methods. At present, methods of modeling were not generally accepted and the main presented problems were as follows. Modern medicine methods did not conformed to the rules of TCM etiology and pathogenesis. The evaluation of yang deficiency models was not accurate. Some modeling methods can lead to other diseases at the same time. The names of spleen deficiency model were not unified. It was difficult to distinguish the modeling methods of spleen-yang deficiency and spleen-qi deficiency, and etc. Model evaluation of spleen-yang deficiency was various. However, the domestic standard evaluation system had not been formed. The main model evaluation problems were as follows. Macro symptoms of the model lacked of objective and quantitative evaluation. It lacked of evaluation indexes of pulse and tongue with TCM characteristics. The disproof of prescription selection was not unified. Similar syndromes had not been ruled out. The microscopic indexes were fragmented, and etc. This paper reviewed on animal modeling methods of spleen-yang deficiency.

OBJECTIVE:To study the chemical constitutes of Ligusticum chuanxiong and to establish the method for the content determination of ligustilide. METHODS:The compounds were extracted and percolated by ethanol. Then the samples were separated using silica gel and identified by 1H-NMR,13C-NMR data.HPLC was used to assay the contents of ligustilide. RESULTS:Three compounds were isolated and their structures were identified as Z-ligustilide,Z-6,8',7,3'-diligustilide and Z,Z'-6,6',7,3'a-diligustilide. The contents of ligustilide were no less than 0.70%.CONCLUSION:The separation method can be used to prepare high-purity ligustilide reference substance. And the determination method can be used for quality control of L. chuanxiong.

Objective To analyse the application status of antihyportensive drug among community elderly patients with hypertension in Gaomi city. Methods Based on the investigation data of antihypertensive application in communities, various manifestations and the causes of antihypertensive application in community elderly patients are summarized, and the improvement proposals are put forward. Results A total of 1487 elderly patients with hypertension were investigated, 332 of them were untreated, among 1155 patients who received drug therapy the irrational drug use ratio was 77.4%. The main factors that caused the rational use of antihypertensive drug include: patients paid little attention to hypertension , they usually had little knowledge of this disease, and they lacked of professional guidance, as well as other factors such as economic factors, adverse drug reactions, et al. Conclusions There are many problems consist in community hypertension drug therapy, and it is necessary to strengthen the work of community hypertension control.

OBJECTIVE: To study the general law of typing of bronchiectasis according to syndrome differentiation. METHODS: We collected the symptoms, conditions of tongue and pulse in patients of bronchiectasis, using frequencies procedure, discriminant analysis and K-means cluster analysis in SPSS statistical software as research medium. RESULTS: Five hundred and sixty three patients with bronchiectasis were studied. It suggested that accumulation of phlegm-heat in the lungs (45.65%), liver fire attacking the lungs (24.51%), asthenia of pulmonosplenic qi (22.38%), asthenia of both qi and yin (7.46%) were the main types. CONCLUSION: Clinical epidemiology provided scientific basis for further studying of the typing of bronchiectasis according to syndrome differentiation. Building up differentiation of syndromes through differentiation and analysis of main symptoms can be used in clinical diagnosis.