Objective To discuss the efficacy of fiberoptic ductoscopy(FDS)in the treatment of mammary duct diseases with nipple discharge.Methods Fiberoptic ductoscopy was utilized for diagnosing and treating exudative lesions in the mammary duct in 72 cases(80 sides).After the lesion was detected under ductoscope,repeated irrigation using normal saline was performed until the flocculent discharge disappeared.Intraductal drug administration(dexamethasone 5 mg and gentamycin 40 000 U)was given during the retreat of ductoscope.Results There were 57 sides of galactophoritis and 23 sides of mammary duct ectasia.A complete recovery was achieved in 65 sides(nipple discharge disappeared completely and no relapse occurred in 6 months),in which a follow-up for 1～2 years showed no recurrence.A remarkable improvement was obtained in 15 sides(nipple discharge significantly reduced,or progressively decreased within 6 months,or underwear wetted occasionally).Conclusions Fiberoptic ductoscopy in the treatment of mammary duct lesions with abnormal nipple discharge is effective.

Objective To probe into the usage of statins in the patients with coronary artery disease in elderly patients. Methods From Jun 1,2009 to Mar 31,2009 in our hospital, 323 elderly outpatients with coronary artery disease were included in the investigation. The data were statistically analyzed. Results 62.2% of the patients used statins. The statins usage rates (44. 8% ,61.3% ,71.3% ) among three age groups(60 -69 years old,70- 79 years old, and ＞ 80 years old)were significantly different. The rates of statins usage were significantly different between male and female groups. Conclusion The usage of statins as secondary prevention of coronary artery disease varies and there is urgent need to standardize the usage of statins according to the treatment guideline.

Adult ; Asymptomatic Diseases ; China ; Chondromatosis, Synovial ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Hip Joint ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Hospitals ; Humans ; Male ; Tomography, X-Ray Computed

Objective To investigate the effect of nerve growth factor in the treatment of senile cerebral hemorrhage and its effect on the nerve function.Methods According to the digital table,90 elderly patients with cerebral hemorrhage were randomly divided into observation group and control group,45 patients in each group.The control group was given conventional treatment for cerebral hemorrhage.The observation group was injected mouse nerve growth factor based on the control group.The efficacy of the two groups after treatment,nerve function defect score(NIHSS) before and after treatment changes and simple type Fugl-Meyer motor function score(FMA) were compared.Results The total effective rate of the observation group after treatment was 93.33%,which was higher than 73.33% of the control group,the difference was statistically significant(χ2=6.480,P=0.010).Before treatment,the NIHSS scores of the two groups had no statistically significant difference (t=0.333,P=0.739).After treatment,the NIHSS score of the observation group was (6.49±7.02)points,which was lower than (11.01±8.65)points of the control group,the difference was statistically significant(t=2.721,P=0.007).Before treatment,the FMA scores of the two groups had no statistically significant difference (t=0.198,P=0.198).Compared with the control group,the FMA score of the observation group after treatment was significantly higher,the difference was statistically significant(t=3.222,P=0.001).Conclusion Rat nerve growth factor in the treatment of elderly patients with cerebral hemorrhage can effectively improve the patients' neurological deficits and activities of daily living,the clinical efficacy is significant,it is worthy of clinical application.

To adapt to the character and target of teaching Chinese as a foreign language,the setting of the curricula should follow such principles as enhancing the foundation,tool and link. We should give priority to foundation Chinese assisted with Chinese of traditional Chinese medicine ,supplement Chinese culture,and divide the stage to lay emphasis,make a point of three of organism connection,adopt required,elective subject and lectures as the teaching format.

Objective To study the efficacy and mechanism of sequential therapy of clopidogrel combined with aspirin in the treatment of transient ischemic attack.Methods 150 cases with transient ischemic attack were set as the research subjects.According to the random number table method,they were divided into aspirin group,clopidogrel group and combination group.The clopidogrel group was treated with 75mg clopidogrel,once daily.The aspirin group was treated with 50mg aspirin,twice a day.The combined group was treated with 300mg clopidogrel +300mg aspirin at the first day,75mg clopidogrel +100mg aspirin at the second day.Three groups were treated for a period of 15 days.After 15d treatment,the raw fiber protein (FIB),two D dimer (D-D),activated partial thromboplastin time (APTT) and prothrombin time (PT) of three groups and adverse reactions,curative effect and recurrence rate were analyzed.Results After treatment,the FIB,D-D,APTT and PT of the combined group were (3.14±0.24)g/L,(0.61±0.26)mg/L,(33.58±2.77)s,(15.67±0.72)s,which of the clopidogrel group were (3.32±0.25)g/L,(0.91±0.32)mg/L,(30.19±2.19)s,(15.64±0.78)s,which of the aspirin group were (3.40±0.22)g/L,(1.02±0.39)mg/L,(29.71±2.21)s,(13.21±0.80)s,which were significantly improved than before treatment[the combination group (3.59±0.26)g/L,(2.50±0.35)mg/L,(27.53±2.41)s,(11.23±0.69)s;the clopidogrel group (3.58±0.28)g/L,(2.51±0.40)mg/L,(27.19±2.53)s,(11.73±0.82)s;the aspirin group (3.61±0.27)g/L,(2.46±0.32)mg/L,(27.61±2.13)s,(11.68±0.77)s,the effect of the combined group was better than that of the clopidogrel group and aspirin group (F=8.12,P<0.05).The total effective rate of the combination group (96.00%) was significantly higher than that of clopidogrel group (84.00%) and aspirin group (76.00%),the differences were statistically significant (x2 combination group vs.clopidogrel group=4.00,x2combination group vs.aspirin group=8.31,all P<0.05).The adverse reactions in the three groups had no difference,but the recurrence rate of the combination group (8.00%) was significantly lower than that of the clopidogrel group (24.00%) and the aspirin group (28.00%),the differences were statistically significant (x2combination group vs.clopidogrel group=4.76,x2combination group vs.aspirin group=6.78,all P<0.05).Conclusion The combination of clopidogrel and aspirin in the treatment of transient ischemic attack has significant effect and low recurrence rate,which is worthy of popularizing widely.

Objective To investigate the clinical value of neutrophil-to-lymphocytc ratio(NLR) in identifying blood stream infection caused by different pathogens and for differentiating coagulase negative staphylococcus(CNS)bloodstream infection and contamination.Methods Medical records of 500 patients who underwent blood culture test and routine blood test at the same time were retrospectively analyzed,blood culture negative group 356 patients,blood culture positive group 144 patients,which included Gram-negative group,Gram positive group,fungi group,CNS bloodstream contamination and mingled group.Collected the results and calculated the NLR at the same time.NLR were applied by t test of each group.ROC curve was used to determine the cut off value of NLR.Results ①Mean values of NLR in negative blood culture,blood stream infection group,CNS bloodstream infection and contamination were 6.12,13.15,10.11 and 6.24.NLR had statistical difference between negative blood culture and blood stream infection group,CNS bloodstream infection group and contamination group (P＜0.05).②Mean values of NLR in and fungi group were 15.33,11.63 and 10.58,respectively.NLR had statistical difference between Gram-positive bacteria group and Gram-negative bacteria group (P＜0.05).NLR had no differences among Gram-positive bacteria (15.33) and Gram negative bacteria (11.63) compared with (10.58) fungi respectively (P＞0.05).③The area under the curve of NLR predicting a positive blood culture,distinguishing Gram-positive bacteria and Gram-negative bacteria,differentiating CNS bloodstream infection and contamination were 0.86,0.60 and 0.75,respectively.The optimal cut off values of NLR for predicting a positive blood culture,distinguishing Gram-positive bacteria and Gramnegative bacteria,differentiating CNS bloodstream infection and contamination were 10.45,7.50 and 8.10 respectively.Conclusion NLR is highly effective in distinguishing blood stream infection and differentiating CNS bloodstream infection and contamination.

ObjectiveTo investigate the feasibility and clinical effect of bispectral index (BIS) monitoring target controlled infusion of midazolam and propofol for sedation of mechanically ventilated patients.MethodsEighty cases with severe respiratory failure,sane,the need for endotracheal intubation mechanical ventilation for at least 24 h were divided into 4 groups by random digits table with 20 cases each.Group A and group C patients routinely received propofol and midazolam,group B and group D patients used BIS monitoring target controlled infusion of propofol and midazolam.The correlation of BIS and Ramsay score was analyzed,and the changes of mean arterial pressure (MAP) and heart rate (HR) were compared among 4 groups.ResultsBIS was negatively correlated with Ramsay score in group B and group D (P ＜ 0.05).MAP after 24 h intubation was lower than that at intubation immediately among 4 groups [group A:(63.89 ±4.68) mm Hg (1 mm Hg =0.133 kPa) vs.(92.33 ±3.57) mm Hg,group B:(62.66 ±3.97) mm Hg vs.(93.76 ± 4.02) mm Hg,group C:(64.59 ± 3.29) mm Hg vs. (93.78 ± 4.61 ) mm Hg,group D:(63.18 ±2.51 )mm Hg vs. (93.61 ± 5.36) mm Hg],and there were significant differences (P＜ 0.05).Group A and group B reached the standard after 1 h intubation.HR after 24 h intubation decreased in 4 groups,but there was no significant difference (P ＞ 0.05).ConclusionsBIS monitoring target conmolled infusion of midazolam and propofol for sedation of mechanically ventilated patients can achieve similar sedative effects,in addition,the need for rapid sedation of mechanically ventilated patients with suitable choice of propofol.At the same time,BIS is negatively correlated with Ramsay score.

Objective Probing into a way to reform the assessment indexing of diagnosis and treatment in clinical specialties, to help with objective assessment and ranking among hospitals in terms of the performances of their respective specialties. Methods Treatment outcomes of the diseases pinpointed by heart physicians and urology surgeons of three hospitals in 2005 as the criteria to calculate the adjusted value for fatality rate and cure rate. Results The adjusted value of fatality rate for the heart physicians is CFR≥1, and that of cure rate for the urology surgeons is CFR≤1. A trial assessment is made based on these figures, and a ranking is achieved on the diagnosis and treatment outcomes of the clinical medicine specialties in these three hospitals as a result. Conclusions Diseases as the assessment levels for medical quality of clinical medicine specialties and relative risks as the core computation adjusted factor, may help yield the indexes and methodology for clinical medicine specialties in line with China's specifics.

To improve the solubility of quercetin ( QT) , one of flavonoids that can inhibit the proliferation of vari-ous types of cancer cells, the novel amphiphilic polymer N-( 4-methylimidazole)-hydroxyethyl-chitosan ( MHC) , synthetized by chemical derivatization from chitosan, was used as the self-assembly micelles of QT. The formed polymer was characterized by 1 H NMR, elemental analysis and pyrene fluorescence spectrometry. The formulation of MHC micelles loading quercetin was optimized through single factor experiment. Then the optimized formulation was obtained as follows:the concentration of MHC was 0. 67% and the ratio of drug and carrier was 1 ∶10. The micelles particle size was ( 99. 21 ± 1. 71) nm, Zeta potential was +( 20. 01 ± 0. 72) mV and drug loading was ( 5. 42 ± 0. 32 )%. The in vitro release curve was investigated and was found to conform to Higuchi equation of Q=0. 1101 t1/2 -0. 064. The results of in vivo experiment showed that the mean rentention time and bioavail-ability of the MHC-QT micelles were 21. 42 h and 57. 49 μg h/mL, respectively, compared to 0. 30 h and 2. 50 μg h/mL of the free QT solution. These indicated that the MHC micelles could significantly improve the solubility of QT, the drug sustained-release effect and bioavailability, which would used as carrier for the anti-tumor drugs.