Phytoestrogens (PEs) and estrogen receptorβ(ERβ) have close relationship with breast cancer. PEs preferentially binds to ERβ rather than ERa. Although there are still some arguments, it provides a new though for researching the mechanism of Phytoestrogen-containing herbs on breast cancer and exploring the essence of TCM theory.

Objective To evaluate the effect of antimicrobial management guideline on the daily antimicrobial use rate in a general hospital.Methods An one-day point-prevalence survey on antimicrobial use in hospitalized patients was conducted in 2010,2011,and 2012 by means of cross-sectional investigation method.Results The daily utiliza-tion rate of antimicrobial agents in 2010,2011,and 2012 was 65.40% ,42.09% and 26.74% respectively,the rate of the submission of specimens for bacterial culture was 22.53% ,35.74% and 41.74% respectively(χ2 trend= 266.42, 29.02,respectively,bothP<0.01). The utilization rate of single drug was 83.72% ,80.27% and 93.41% respec-tively. the utilization rate of both two-drug and more than three-drug combination kept a downward tendency. The utilization rate of antimicrobial agents in several departments(digestive internal medicine,cardiovascular,hematolog-ical tumor,neurology,general surgery,orthopedics,obstetrics,pediatrics,and ophthalmology)showed a decreasing tendency(all P<0 .0 1 ).Conclusion The implementation of antimicrobial management guideline has remarkably re-duced the daily antimicrobial use rate,and increased etiological detection rate for therapeutic antimicrobial use.

Through analyzing the academic ideas in Shanghan Zhinan written by Wei-Ju ZHU, a modern famous physician, it is pointed out that ZHU's achievement on integrative medicine has been overlooked. Taking the theory of syndrome differentiation of six channels from Shanghan Lun as an example, ZHU presumed that the essence of therapeutic theory of traditional Chinese medicine was to conform to or strengthen human body's self-healing and self-regulating abilities. Since Yangqi is the major force in the body to help heal disease when it occurred, ZHU often took measures to strengthen Yang first in treating disease and also was good at using hot-natured herbs, such as Radix aconiti lateralis preparata. ZHU's thoughts on integrative medicine were concerned with etiology, pathology and therapeutics. In addition, ZHU generalized the syndrome differentiation into the theory of five phases and eight principles, and made important contributions to the history of integrative medicine. His thinking will provide valuable revelation for clinical practice and modern research on traditional Chinese medicine.

To guarantee the basic quality of nursing service, many countries have carried out the licensure examinations for registered nurses, which are used not only to evaluate the quality of nursing education but also to guide the development of education. This paper reviewed the process of the establishment of the systems, and outlined the features of the examinations in content design, organization and implementation, improvement and development trends in both China and America in order to improve ours.

Objective To investigate effect of tiotropium bromide combined with formoterol on oxidative stress and lipid peroxidation in peripheral blood in elderly patients with chronic obstructive pulmonary disease.Methods 80 elderly patients with chronic obstructive pulmonary disease from our hospital were selected and divided into conventional group and experimental group, conventional group on the basis of conventional therapy was treated with salmeterol xinafoate and fluticasone propionate powder for inhalation with 2 suction per times, 2 -3 times per day for 14d.Experimental group was treated with tiotropium bromide spray combined with formoterol fumarate powder for inhalation with 2 suction per times, 2-3 times per day for 14 d.7 d for a period of treatment, after 2 courses of the treatment, changes of clinical signs, blood gas levels, peripheral blood oxidative stress products and lipid peroxidation and inflammatory factors were compared before and after treatment.Results Compared with conventional group,the recovery time were shorter(P<0.05) ,and blood gas levels, peripheral blood oxidative stress products and lipid peroxidation, inflammatory factors were lower(P<0.05). Conclusion Tiotropium bromide combined with formoterol can significantly reduce airway hyperresponsiveness, inhibit inflammation, relieve clinical symptoms.And the drug resistance is low, the side effect is small, the clinical curative effect is ideal, may be the clinical treatment effective plan, and has the vital significance.

The incidence of invasive fungal infection in critically ill patients is increasing year by year. Its clinical manifestation lacks specificity which is difficult for early diagnosis. It′s hard to identify inva-sive fungal infection with fungal colonization in clinical practice. We need to find out the way to distinguish them.

Objective:To determine the location of mycobacterium tuberculosis(MTB) and whether the cellular immunity is induced after intragastric administration of BCG in mice.Methods:Viable MTB were detected in mesenteric lymph nodes?spleen and lungs at day 15,30 and 60 after intragastric administration of BCG to mice.The proliferation of T-lymphocyte with the stimulus of the purified protein derivative(PPD) was measured at day 60 and 90 after intragastric administration of BCG to mice.The expression of interleukin-2(IL-2) of T-lymphocyte in spleen was detected at day 60 and 90 after intragastric administration of BCG.Results:Viable MTB were detected in the mesenteric lymph nodes and spleen at day 15,30 and 60 after intragastric administration.At day 60 and 90 after intragastric administration of BCG to mice,the ratio of T-lymphocyte proliferation was 31.32%,37.94% separately and the production of IL-2 was 37.47?5.60 U/ml,39.41?7.73 U/ml separately.There were no statistically significant differences in the cellular immunity between the mice of the intragastric administration of BCG significant differences in the cellular immunity between the mice of the intragastric administration and the mice of the subcutaneous vaccination of BCG( P 0.05).Conclusion:Intragastric administration of BCG can induce cellular immunity in mice.

Objective: To investigate the effect of cognitive intervention on the therapy to Chronic prostatitis(CP) following Sexually Transmitted Diseases(STD). Methods: 84 patients were divided into two groups, as control group(n=42) in which prostant was locally used and the intervention group(n=42) which received cognitive Intervention therapy based on the locally using prostant. After a month, the therapy effect was evaluated. Results: Compared with control group, the subjective syndrome in intervention group was improved much more apparent receiving therapy one month later(P 0.05). Conclusion: Cognitive intervention is an effective method to improve the subjective syndrome of CP following STD; so a clinical medicine should study psychology.

The main methods examing artery function are measuing pulse wave velocity,augmentation index of reflected wave and the expansibility and compliance of specified artery by ultrasound examination.The methods evaluating artery structure includes the examination of the intima-media thickness,the detection of plaques and the calculation of ankle-brachial BP index.The above methods could be used to stratify the risk of hypertension patients.

The spleen whose size reaches or exceeds third degree should be regarded as massive splenomegaly.Splenectomy for massive splenomegaly demands precise procedures.First,median incision on upper abdomen(or vertical rectus muscle splitting incision)and incision under left costal arch are preferred.Second,the spleen was freed and then 0.33 mg of epinephrine was injected via the splenic artery before splenic artery ligation.During the process,a cell saver helps to minimize blood loss and makes autoinfusion possible for patients with benign lesions.Third,preoperative administration of fibrinogen,platelet and essential styptieum combined with the cooperation between surgeons and anesthesi010gists are the key points of bloodless surgery which is important for the recovery of patients.Four common problems of splenectomy for massive splenomegaly should also be addressed,including operation discontinuance,perioperative hemorrhage,accessory injury and postoperative intractable fever.