Nutritional anemia is mainly including the iron deficiency anemia and the megaloblastic anemia.The highlights of the two kinds of nutritional anemia on the differential diagnosis are compared associated with the clinical practice,and the commonly used treatment protocol at present are briefly expounded.

Objective To observe the curative effects of metformin combined with cyproterone therapy on polycystic ovary syndrome(PCOS). Methods Ninety diagnosed PCOS patients were treated. The serum luteinizing hormone(LH), luteinizing hormone and follicule stimulating hormone(LH/FSH) ratio and T, waist hip ratio(WHR) of the patients before therapy were compared with using merformin combined with- cyproterone three cycles. Results A significant reduction(P<0.05 or P<0.01) in LH,LH/FSH,T and WHR of patients after the therapy was observed. Menses became regular after the therapy, and ache and hirsutism mitigated. Conclusion Metformin com- bined with cyproterone is a perfect means to treat polycystic ovary syndrome(PCOS).

Objective To investigate the effect of batroxobin on the plasma levels of endothelin (ET) and calcitonin gene-related peptide(CGRP) in patients with acute cerebral infarction(ACI). Methods 60 patients with ACI were randomly divided into therapy group(n = 30) and control group(n = 30),500 ml of 5% GS plus 1.0g ramme of Troxerutin was intravenously dripped par day and ticlopidine 250mg/day in the control group. Based on the control group therapy,Batroxobin was intravenously dripped with 10U on the 1st day and 5U on the 3rd and 5th day for seven days. The plasma levels of ET and CGRP were detected pre and post treatment by radioimmunoassay. Results Plasma levels of ET and CGRP in batroxobin therapy group post treatment ( 81.25±27.38 ) ; ( 44. 13±13.30) ng/L were significantly different from those pre treatment(109. 83±38.24) ; (24. 73±13.59) ng/L (all P＜0. 01 ) ,and were also significantly different from those post treatment in the control group(98.07±30. 39) ; (37.02±12. 41 )ng/L (all P＜0. 01 ). Conclusion Batroxobin can accommodate the equilibration between ET and CGRP, and protect brain cell and blood vessel endothelial cell.

Objective To understand the work content of community nurses in general practitioners team model in Chongqing.Methods A questionnaire was carried out among 210 community nurses from 12 communityhealth service centers in Chongqing city.Results The work content of community nurses most often did in general practitioners team model were health management,health care of elderly people,health education,chronic disease management and basic medical service.However,the work content of women's health care and inquiry of death cause were relatively done less.Conclusions There are both basic medical service and public health service in the work content of community nurses in Chongqing.The “Six in One” function of community nursing is gradually improved.

ObjectiveTo analyze the results of implementing the tutorial system for medical interns, and to put forward some suggestions. MethodsThe medical interns and the doetors selected as tutors were asked to do questionnaires to study the tutorial system's feasibility and effectiveness. Simultaneously, we adopted the Objective Structured Clinical Examination ( OSCE ) to assess its process and resuits. Results74.3％ of the students and 75.5％ of the doctors think that they need the tutorial system,73.2％of the students think that this system can train better clinical skills,67.9％ of the doetors think that they can review the knowledge learned through teaching. Implemented after one year, students' OSCE scores are improved. ConclusionTutorial system for medical interns has achieved preliminary success, and the preparatory work and related-system building need to be further improved.

Objective To analyse the effect of hedyotisdiffusa on expressions of apoptosis related protein Fas , caspase3 and caspase7 in Renca renal cell carcinoma of model mice.Methods One hundred and twenty BALB/C male mice were randomly divided into normal control group, model control group, interleukin group, hedyotisdiffusa group, 30 mice in each group, half male and female.Excepted for normal control group , renal cell carcinoma models were established in the other groups , and were given corresponding drug treatment.The tumor size and weight , and the tumor inhibition rate of all mice were observed, and the expression levels of Fas,FasL,caspase3 and caspase7 were detected.Results Compared with model control group, the tumor size and weight were lower , the tumor inhibition rate were higher , the positive expression rates and protein levels of Fas were higher , the positive expression rates and protein levels of FasL were lower, the positive expression rates and expression levels of Caspase3,Caspase7 protein were higher in the mice of interleukin group and hedyotisdiffusa group, all with significant differences ( P<0.05 ).The above indicators in hedyotisdiffusa group were significant improved compared with interleukin group (P<0.05).Conclusion The hedyotisdiffusa can effectively promote the expressions of apoptosis related protein Fas,caspase3 and caspase7 in renal cell carcinoma of model mice, inhibit the expression of FasL protein, improve the tumor suppression rate.

Objective To compare the results of emergency clinical training for medical students and to put forward some suggestions.Methods Toatlly 207 medical students of Grade 4 studied in the first people' s hospital of Shanghai Jiaotong university from 2009 to 2011 were divided into the traditional group (n =90 ) and the experimental group (n =117 ).The students in the experimental group participated in emergency clinical training in summer vacation while those in the traditional group did not.Questionnaires about their self-learning ability,clinical communicating ability and critical thinking ability after training the were conducted and the data were analyzed by descriptive statistical analysis.Results One hundred and five effective questionnaires were recovered from the experimental group,with the recovery rate 89.7％ and 62 effective questionnaires were recovered from the traditional group,with the recovery rate 68.9％.The scores about clinical communicating ability and critical thinking ability of the experimental group were significantly highcr than those of the traditional group [ (79.45 ± 9.354)vs.(75.87 ± 9.926),(263.38 ± 30.925 ) vs.(251.36 ± 23.679),P ＜ 0.05 ].However,there was no significant difference in scores about self-learning ability between the two groups [ ( 153.97 ± 23.725 ) vs.( 149.83 ± 13.891 ),P ＞ 0.05].Conclusion Emergency clinical training is helpful to improve medical students' clinical communicating ability and critical thinking ability.It is worth popularizing.

Lymphoid malignancies represent a heterogeneous group of malignancies with differing patterns of behaviour and response to treatment.Anaemia is common in patients with lymphoid malignancies and negatively impacts on quality of life and treatment outcomes and survival.We discuss the diagnosis and management of anaemia in patients with lymphoid malignancies.

Objective:To optimize the preparation technology of ketoconazole and miconazole nitrateβ-cyclodextrin inclusion com-pound. Methods: The weight ratio of β-cyclodextrin to ketoconazole, inclusion temperature and inclusion time as the testing factors, the optimal inclusion technology was screened by orthogonal experiments. Results:The optimum inclusion conditions were as follows:the weight ratio of β-cyclodextrin to ketoconazole was 8 ∶1, the inclusion temperature was 50℃, and the ultrasonic time was 50 min. Conclusion:The optimized β-cyclodextrin inclusion process is simple and convenient to carry out.