OBJECTIVE:To establish an optimal method for microbial limit test for ciclopirox olamine vaginal suppository.METHODS:The microbial limit test for antibacterial agents was validated by plating method and membrane filtration method,and the optimal method for the test of bacteria and mold were confirmed based on the recovery rate of artificially sprayed bacteria.RESULTS:By plating method,the recovery rate of artificially sprayed E.coli was more than 70%,whereas that of mould was 0%;however,by membrane filtration method,the recovery rates of bacterial and mould were all higher than 70% when flushing doses of bacteria,mold,and control bacteria were 200 mL,300 mL,and 200 mL,respectively.CONCLUSIONS:The membrane filtration method could be used for the microbial limit test of the preparation the drug quality can be kept under effective control,and the established method is accurate and reliable.

Objective] To observe the clinical efficacy and 5-HT of Shugan Jianpi Tiaoshen acupuncture treatment for senile patients with constipation type of irritable bowel syndrome(IBS-C). [Method] A total of 68 patients with IBS-C were allocated into control group and acupuncture group from June 2015 to June 2014. 34 patients in the control group, who accepted Lactulose oral solution and Citrate Mosapride Citrate, of in 15 males and 19 females, the mean age was 66.8, the average duration of disease was 15.6 months;34 patients in acupuncture group, who accepted acupuncture treatment based on control group, in 17 males and 17 females, the mean age was 65.9, the average duration of disease was 17.1 months. Acupoint selection:Tianshu, Zusanli, Taichong, Xingjian, Qimen, Baihui, Neiguan. Observe constipation symptoms, depressive symptoms, and quality of life and serum 5-HT levels before and after treatment. [Result] The pre-treatment constipation symptoms and depressive symptom scores in two groups were decreased than post-treatment( P<0.05), which showed two methods can improve constipation and depressive symptoms of IBS-C patients. After treatment, constipation symptoms and depressive symptoms score in acupuncture group were lower than that in control group(P<0.05), which showed the effect of acupuncture was better. The eight dimensions of SF-36 were higher than those before treatment in total patients(P<0.05), which showed two methods can improve quality of life of patients; differences of physiological function, physiological function between acupuncture group and control group had no statistical significance( P>0.05), but body pain, vitality, emotional function, mental health, social function, and general health values were higher than that of the control group( P<0.05), which showed acupuncture treatment can reduce physical discomfort and improve the quality of life of patients. After treatment,serum 5-HT in control group was 33.8 pg/ml, in acupuncture group was 27.6 pg/m, which were lower than pre-treatment. 5-HT in acupuncture group was lower than control group( P<0.05), which showed the effect of acupuncture on regulation of 5-HT was more significant. [Conclusion]Shugan Jianpi Tiaoshen acupuncture can modulate 5-HT level of elderly patients with IBS-C, and play its role in modulating gastrointestinal function, improving constipation symptoms, depressive symptoms and quality of life.It is an effective method for the treatment of elderly patients with IBS-C.

Clinical thoughts based on symptoms, physical signs and examine outcomes is a process of analysis, judgement and conclusion of disease diagnosis. To cultivate an exact thinking model can avoid taking a part for the whole or a miss in disease analysis, so to cultivate clinical thoughts in clinical practice can elevate medical students'clinical skills.

Objective:To reflect the training of basic-level medical stuff by investigating the doctor-patient cognition status of patients in a county-level hospital.Methods:The questionnaire of 180 patients collected from a county hospital in Shaanxi province was analyzed by Rank sum test and Descriptive analysis with SPSS17.0.ReSults:There were no statistically significant differences in the evaluation of current doctor-patient relationship from patients of different ages,occupations and degrees of education (P ＞ 0.05).82.2％ of the patients believed that the doctor-patient relationship is harmonious or somewhat harmonious.Moreover although the patient's trust in doctors is not high,there is a certain sense of recognition;and they put forward some expectation and requirements on doctor's professional skills,communication skills and professionalism.Conclusion:Considering the patients' feedback,local medical colleges and universities should reflect medical education ideas,play an active synergy model in the training of students' professional skills.In the meantime,they should strengthen the medical internship management,while paying equal attention to enhance students' responsibility and professionalism to serve the grassroots.

OBJECTIVE: Comparison of operation of epitympanic/antrum cholesteatoma excised by endoscopy and microscope. METHOD: Eleven patients with epitympanic/antrum cholesteatoma were analysed, 5 cases were excised by endoscopy and 6 cases were excised under microscope. RESULT: No complication occurred after operation and all patients got dried ear. There were no difference in hearing recovery and closure of perforation of tympanic membrane between two group. The operation time, injury degree, length of stay in hospital and hospitalization expense with endoscopy was superior to that of microscope. CONCLUSION Considering financial constraints of patients, resection of epitympanic/antrum cholesteatoma cholesteatoma can be adopted by endoscopy.
Adolescent ; Adult ; Cholesteatoma, Middle Ear ; surgery ; Endoscopy ; Female ; Humans ; Male ; Microscopy ; Middle Aged ; Treatment Outcome ; Young Adult

Applying the principle of Evidence-Based Medicine to the clinical teaching,we have made the students raise the cognition level on the diagnose of diseases and treating policy and trained their clinical logic thinking ability.

Sagittal spinal deformity is one of the common reasons of sagittal disequilibrium which can cause torso forward,cardiopulmonary dysfunction,fiat back syndrome,intractable low back pain and a series of cases,affecting the patients' life quality and increasing huge economic burden on society.The treatment of sagittal spinal deformity has been a hot spot in the field of clinical spinal surgery and its main purpose is to reconstruct the overall balance of the body,which would relieve pain and improve life quality.Pedicle subtraction osteotomy is considered to be one of the most effective and safe method for correcting spinal deformity with excellent reconstruction of sagittal plane balance.However,the calculation of the angle required during surgery is still a problem,because insufficient or excessive correction will lead to the secondary sagittal disequilibrium.Therefore,an accurate calculation of the angle required during pedicle subtraction osteotomy is particularly important.In recent years,scholars believe that the sagittal equilibrium depends on a fragile balance among spinal curvature,pelvic shape and position of the lower limbs.Scholars have developed a standard of sagittal equilibrium based on their own research,and proposed a variety of quantitative analysis methods to calculate the angle required during pedicle subtraction osteotomy:trigonometric method,exact angle calculation method,overall balance method,spine femoral angle measurement method,digital virtual method,graphic method,acoustic meati to hip axis method and hilus pulmonis to hip axis method,which provide important theoretical bases for the treatment of sagittal spinal deformity.

According to the medical history,imaging and pathological diagnosis,the advanced gastric cancer patients able to tolerate radiotherapy can be divided into the following three groups:(1) unresectable locally advanced or locally recurrent disease;(2) metastatic disease at primary diagnosis with stage Ⅳ;(3) patients experiencing severe tumor-related clinical symptoms.The role of palliative radiotherapy in patients with advanced gastric cancer would be discussed by reviewing 33 articles (8 in last five years,13 in ten years).

Objective To observe the effect of strengthen rosuvastatin in the treatment of patients with paroxysmal atrial fibrillation in coronary artery disease and the influence on serum inflammatory factor, to provide reference for clinical treatment.Methods 176 coronary artery disease patients with paroxysmal atrial fibrillation were randomly divided into observation group and control group, 88 cases in each group.The control group was given rosuvastatin,10mg/d,qd.The observation group was given rosuvastatin,20mg/d,qd.The LAD and LVEF were detected by color-Doppler before treatment and after 6 months treatment.The fasting blood was exsanguinated for testing BNP,hs-CRP,TNF-α,IL-6.The incidence rates of sinus rhythm maintenance and embolic events were recorded. Results After treatment,the LAD of the observation group and control group were (41.50 ±4.61)mm and (42.21 ± 5.20)mm respectively,which were significantly lower than before treatment (t=3.959,3.863,all P<0.05),the LVEF were (76 ±6)% and (73 ±5)% respectively,which were significantly higher than before treatment (t =7.744,6.837,all P<0.01),there were no statistically significant differences between the two groups after treatment (t=1.140,0.579,all P>0.05).The BNP,hs-CRP,TNF-α,IL-6 levels of the observation group and control group after treatment were (173.44 ±32.45)ng/L and (203.33 ±42.16)ng/L,(4.54 ±1.34)mg/L and (5.44 ± 1.35)mg/L,(15.34 ±3.26) ng/L and (19.45 ±2.23) ng/L,(10.85 ±0.77) ng/L and (13.27 ±1.23) ng/L respectively,which were significantly lower than before treatment (t=5.855 and 3.533,3.857 and 3.534,6.436 and 4.545,5.743 and 3.925,all P<0.05),the BNP,hs-CRP,TNF-α,IL-6 levels of the observation group after treatment were significantly lower than the control group(t=3.546,3.214,3.176,3.414,all P<0.05).The total effective rate,sinus rhythm maintenance rate,embolic events incidence rate of the observation group and the control group were 93.18%(82/88) vs 79.55% (70/88),68.18% (60/88) vs 43.18% (38 /88),2.27%(2/88) vs 18.18%(16/88).The total effective rate,sinus rhythm maintenance rate of the observation group were significantly higher than the control group (χ2 =11.965,11.144,all P<0.01),the embolic event incidence rate was significantly lower than the control group (χ2 =12.129,P<0.01).Conclusion Strengthen rosuvastatin can effectively reduce the serum inflammatory factors and BNP,improve left atrial remodeling and left atrial function,the clinical efficacy and prognosis are significantly improved, it is worthy of clinical use in the treatment of patients with paroxysmal atrial fibrillation in coronary artery disease.

Objective To investigate the characteristics of risk factors and coronary angiography (CAG)in young patients with acute myocardial infarction(AMI).Methods A total of 36 consecutive AMI female patients (age≤44 years)who underwent coronary angiography were retrospectively retrieved from the database,and 90 AMI patients whose age >44 years who also underwent coronary angiography were enrolled as a control (elderly)group.Characteristics of risk factors and coronary angiography were com-pared between the two groups.Results The risk factors:BMI,family history of coronary heart disease and high triglycerides(TG)were major in the youth group.The percentage of single-branch lesion was lower in the young patients.The prevalence of left anterior descending (LAD)was higher in the young patients(P <0.05).Conclusions The main risk factors in young and elderly patients are significantly different.The out-comes of CAG in the young patients show the coronary lesion are mostly single vessel lesion,and early inter-vention may improve prognosis.