Objective To investigate the awareness rate of TCM knowledge, the application, and demand situation of Chinese appropriate techniques in health clinics in towns and townships of Hunan Province;To put forward the countermeasures of TCM continuing education. Methods 50%of the training doctors were adopted randomly from 4 training courses in health clinics in towns and townships in Hunan Province. The student number of each course was 49, 51, 53, 53, respectively. Self-designed questionaires were used to investigate 206 training doctors. Results 168 (81.55%) doctors’ degrees were technical secondary school degree and college degree;186 (90.29%) doctors’ professional titles were physician assistant and physician;The awareness rate of TCM knowledge was 63.83%;Different study backgrounds of doctors had different effects on the rate of TCM knowledge (χ2=42.42, P=0.01). The using rates of TCM appropriate techniques were all lower than 30%. 96.60%of doctors in health clinics in towns and townships hope to learn one or more TCM appropriate techniques to help diagnose and treat disease. Conclusion The degree, professional title, mastery of TCM knowledge, and TCM appropriate techniques were not optimistic. The doctors in health clinics in towns and townships showed strong desire for TCM appropriate techniques. The health department should combine the actual situation of doctors in health clinics in towns and townships and develop targeted TCM continuing education.

Chemokine is a small protein which plays an impor-tant role in men's physiological function.It has chemotactic ac-tivity and is often secreted by immune cells and glial cells like microglia or astrocytes.Through the effect of chemokine recep-tors on target cells,various immune cells can achieve directional migration and play an important role in the diseases related with immunity and inflammation.CCL2,also known as monocyte chemotactic protein-1 (MCP-1 ),is one member of chemokine CC subfamily (βsubfamily).It can chemokine monocytes, macrophages and T lymphocytes to affect their phagocytosis func-tion and produce antibodies to combat invading microorganisms. In recent years,it has been found that CCL2 plays a key role in the occurrence and development of the problems concerning cen-tral nervous system and immune system as well as cancer, AIDS,leukemia,diabetes and other diseases.This thesis is to give an elaboration on the latest research on CCL2 and the rele-vant diseases.

AIM: To discuss the complications and prevention of phacoemulification in primary angle-closure glaucoma after trabeculectomy.
METHODS:Retrospective analysis of 33 cases (37 eyes) phacoemulification in primary angle-closure glaucoma after trabeculectomy in our hospital between January 2008 and June 2012, followed up 12-33mo, intraoperative and postoperative complications were observed.
RESULTS: Compared with pre-operation, intraocular pressure hadn't increased in follow-up 6mo. Iris was injured in 5 eyes, corneal edema was in 14 eyes, anterior chamber inflammation was in 16 eyes, all symptoms were improved in 3-7d. And no case with posterior capsule rupture or vitreous loss.
CONCLUSION: Phacoemulification is an effective way for the treatment of cataract after angle-closure glaucoma trabeculectomy, careful preoperative examination, intraoperative prevention can reduce or avoid the occurrence of surgical complications.

Objective To study the diagnosis and treatment of iatrogenic bile duct injury(IBDI).Methods The clinical data of 92 patients with IBDI who had been admitted to our hospital from January 1994 to December 2007 were retrospectively analyzed.Results The diagnosis of IBDI was based on the clinical findings,diagnostic abdominocentesis and imaging examination.Sixteen patients gave up treatment because of economic reasons,and 2 patients who were complicated with sepsis and multiple organ dysfunction syndrome died shortly after being transferred to our hospital.Forty-eight patients were treated by Roux-en-Y choledochojejunostomy,14 by endoscopic treatment.2 by bile duet repair+T tube drainage,3 by percutaneous catheter drainage,1 by choledochoduodenostomy,4 by percutaneous transhepatic cholangiodrainage,and 2 by ultrasound guided percutaneous puncture drainage.Sixty-two patients were followed up for 4 month to 10 years(mean,3.6 years),and satisfactory results were obtained.Conclusions Detection of IBDI during operation and prompt repair yield favorable outcome.Roux-en-Y choledochojejunostomy is the best choice for bile duct injury complicated with biliary stricture.Endoscopic and interventional treatments are important auxiliary measures in the treatment of bile duct injury.

Objective To learn therapeutic effect of the combined treatment of mecobalamin and salvia milti-orrhiza ligustrazine on diabetic peripheral neuropathy.To provide effective and reliable operation method for the treat-ment of disease.Methods 163 cases with diabetic peripheral neuropathy were randomly divided into observation group(86 cases)and control group(77 cases).The observation group was treated with mecobalamin combined salvia miltiorrhiza ligustrazine,the control group was treated with mecobalamin.The sensory conduction velocity (SNCV) and motor conduction velocity (MNCV)were measured in the two groups before and after treatment.The therapeutic effects were evaluated after one course.Results The MNCV and SNCV of the two groups were higher than before treatment,the difference was statistically significant (t =24.298,25.546,18.737,15.733,14.284,14.886,9.337, 9.402,all P <0.05).The SNCV and MNCV in the observation group were significantly higher than those in the con-trol group (t =9.119,11.103,7.429,6.352,all P <0.05).The markedly effective rate of the observation group was 48.8% (42 /86),the total effective rate was 90.7% (78 /86),which were higher than those of the control group,the differences were statistically significant (χ2 =9.010,7.937,all P <0.05).The incidence rate of adverse reaction of the observation group was 5.8% (5 /86),which of the control group was 6.5% (5 /77),the difference was not statis-tically significant (χ2 =0.033,P >0.05).Conclusion In the treatment of diabetic peripheral neuropathy,the com-bined treatment of mecobalamin and salvia miltiorrhiza ligustrazine has better curative effect and low incidence rate of adverse reaction,with good clinical application value.

Objective To compare and evaluate the oncological and functional outcomes between reserving thyroid partial laryngectomy and traditional partial laryngectomy for the treatment of stage T2-3glottic laryngeal carcinoma.Methods One hundred and twenty-eight patients treated from January 1999 to January 2009 were selected from all glottic laryngeal carcinoma patients with stage T2-3,who underwent surgery combined with radiation therapy.A retrospective review was randomized and matched by tumour subsite,TNM stage and age,which were confirmed by pathology and observation without thyroid perichondrium invaded or only local invasion of thyroid cartilage,there was no need to extensively resect laryngeal cartilages.Patients were divided into reserving thyroid partial laryngectomy group(study group) and traditional partial laryngectomy group (control group).Each group included 64 cases,which included T2N0 38 cases,T2N1 6 cases,T2N2 1 case,T3N0 17 cases,T3N1 2 cases.Local control rate,decannulation rate,the 3-year and 5-year accumulative survival rate were compared between two groups.Results The 3-year and 5-year accumulative survival rate were 89.8％ and 84.3％ in study group,91.5％ and 85.4％ in control group,there was no sognificant difference (x2 =1.687,P ＞ 0.05).The local control rate was 91.7 ％ (55/60) in study group and 93.2 ％(55/59) in control group,there was no significant difference (x2 =0.103,P ＞0.05).The decannulation rate was 98.3％ (59/60) in study group and 89.8％(53/59) in control group,there was significant difference (x2 =4.933,P ＜0.05).Conclusions Comparing with traditional partial laryngectomy,reserving thyroid partial laryngectomy is successful for treating properly selected stage T2-3 glottic laryngeal carcinoma.This operation has higher decannulation rate and lower complication,which is effective for reducing surgical invasion and facilitated the resumption of respiratory.

Objective To investigate the effect of electroacupuncture plus early rehabilitation training on the function recovery after surgery for cervical spinal cord injury. Methods Sixty patients with cervical spinal cord injury undergone anterior cervical decompression and internal fixation were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by electroacupuncture plus rehabilitation training, while the control group was by rehabilitation training alone. The Frankel’s grading (FG), Barthel Index (BI), and Functional Independence Measure (FIM) were adopted for evaluation before and after intervention. Results The FG was not significantly changed after intervention in both groups (P>0.05). After intervention, there was no significant difference in comparing FG between the two groups (P>0.05). The BI and FIM scores were significantly changed after intervention in both groups (P＜0.01). There were significant differences in comparing BI and FIM scores between the two groups (P＜0.05). Conclusion Electroacupuncture plus early rehabilitation training can promote the function recovery after surgery for cervical spinal cord injury, and improve the quality of life.

The process of late lung development is disturbed in bronchopulmonary dysplasia (BPD).One of the keys in late lung development is secondary septation, in which secondary septa arise from primary septa, producing plenty of small alveoli, which significantly increase the surface area of gas exchange.Secondary septation,together with architectural changes to the vascular structure of the lung which minimize the distance between the blood and the inspired air, are the targets of late lung development.BPD is a disease of premature infants in which development of the alveoli is stunted caused by many factors including volutrauma,inflammation,and oxygen toxicity.Compared with early lung development, the later development of the immature lung remains unclear.This paper is to emphasize remarkable latest research of arrested late lung development and BPD.

Objective To evaluate the short-term effect of elemene combined with transcatheter hepatic arterial chemoembolization (TACE) interventional therapy for the treatment of moderate and advanced liver cancer.Methods A total of 63 patients with moderate and advanced liver cancer were randomized into test group(31 cases) and control group(32 cases). Both groups were given TACE, and additionally, the test group was given intra-arterial infusion of Elemene Emulsion(400-600 mg/m2)together with MAO(Mitomycin C 4-6 mg/m2 , adriamycin 20-40 mg/m2, Oxaliplatin 50-85 mg /m2), and the control group was given intra-arterial infusion of MAO. Short-term effect was evaluated by the clinical outcomes of tumor size, progression-free survival(PFS), total survival rate and adverse reactio n. Results(1)The overall response rate(ORR) in the test group was superior to that in the control group, and the difference was statistically significant(P<0.05) .(2)PFS in the test group covered 125 days, and that in the control group covered 118 days, the difference being significant (P<0.05); the median survival time(MST) in the test group was 257 days, and that in the control group was 214 days,the difference being insignificant(P>0.05).(3) No severe toxic or side effect was found in t he twogroups, the difference being not significant(P>0.05). The test group tended to have milder adverse reaction. Conclusion Intra-arterial infusion Elemene Emulsion combined with TACE interventional therapy is effective in increasing ORR, prolonging PFS, promoting adverse reaction endure and relieving symptoms of weakness, abdominal distension and pain.

ObjectiveTo analyze the systolic function of subendocardial myocardium of the left ventricle in patients with diabetes mellitus (DM) and DM associated hypertension by speckle tracking imaging (STI).Methods The left ventricular ejection fraction(LVEF) and left ventricular mass index (LVMI) of all subjects including 30 patients with diabetes mellitus(DM group),25 patients with DM associated hypertension (DH group) and 30 healthy volunteers (control group) were normal and near.The common parameters of echocardiogram were measured and the peak systolic longitudinal strain of subendocardial myocardium were analyzed from the long-axis view at the levels of mitral annulus,papillary muscle and apex by STI.All above parameters were compared among three groups.ResultsNo significant difference in all parameters was found between the control group and two patient groups,but the ratio of E/A was significantly lower in the two patient groups than that of control group ( P ＜0.01).The peak systolic longitudinal strain of some segments were significantly lower in the two patient groups than that of control group ( P ＜0.01).The peak systolic longitudinal strain of the subendocardial myocardium of all segments in the two patient groups were different decrease compared with the control group( P ＜0.01 or P ＜ 0.001).The peak systolic longitudinal strain of the subendocardial myocardium of the DH group except some segments were decrease compared with the DM group ( P ＜0.01).ConclusionsSTI may be early used to identify the left ventricular systolic function in patients with diabetes mellitus.