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.

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.

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 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.

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: 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

Objective To evaluate the impact of warmed and humidified CO2 on the gynecological laparoscopic operation. Methods We searched keywords related to gynecological laparoscopic and CO2 pneumoperitoneum temperature and humidity on Pubmed and Wanfang database, then analyze the postoperative pain, analgesic consumption, core temperature, operation time, length of hospital stay. Results 17 publications included into the meta analysis after screening. Compared with the standard laparoscopy, warmed and humidified CO2 can reduce postoperative pain and prevent intraoperative hypothermia. No significant difference in postoperative analgesic consumption, postoperative core temperature, duration of recovery and hospital stay, endoscope lens fog and operation time. Conclusions Only few beneficial effects on postoperative pain and core temperature have been identified in this meta-analysis, though more studies are probably needed to study the real impact of warmed and humidified CO2 for laparoscopic procedures.

Objective The rapid latex scattering immune turbidimetric method detecting urine retinol binding protein, and evaluate methodology.MethodsIn accordance with the commission of American clinical laboratory standards (NCCLS) requirements, evaluation of the research methods of reagent sensitivity, precision, accuracy, stability, linear range, interference analysis, specific degrees.ResultsWith rapid latex scattering immune turbidity method to detect the urine retinol binding protein, for instance, the minimum detection limit of 0.0381 mg/L;Repeatability precision is 1.198%, intermediate precision is 5.541%, reproducibility precision is 6.662%;The linear range is within 0~10 mg/L;Recovery rate were 99.00% and 104.00% respectively;When TBIL<100mg/L and Hb<10mg/L, the detection of Tbil, Hb, RBP interference;With the urine RBP than kit in automatic analyzer compared the test results of analysis showed that r2=0.9720, correlation can be;50 cases of clinical specimens using two methods showed no statistically significant difference positive rate (χ2=0.948, P=0.948).ConclusionRapid latex scattering immune turbidimetric method were used to detect the urine retinol binding protein, has high precision, high accuracy, the advantages of high sensitivity, stability and anti-jamming is strong, good.

Objective To investigate the role of the plan-do-check-action(PDCA) cycle in the quality management of intravenous infusion devices.Methods Based on the self-controlled design and cross-sectional study, the application of intravenous infusion devices before and after the implementation of PDCA cycle was investigated and compared, and the role of PDCA cycle in intravenous infusion device was evaluated.ResultsThe patients treated with intravenous infusion of 38 departments were investigated (1 152 cases in stage P and 1 140 cases in stage C).After the application of PDCA cycle,the accuracy rate of intravenous infusion device use increased from 93.2％ to 97.4％ (χ2=13.030, P<0.001).The accuracy rate of needle indwelling (98.6％ vs.95.7％, χ2=8.894, P=0.003) and central venous catheter use (87.5％ vs.38.9％, χ2=12.963, P<0.001) significantly increased after the application of PDCA cycle.Conclusion The PDCA cycle can remarkably improve the management quality of intravenous infusion devices.

Objective To study the gene mutation of the spinocerebellar ataxia(SCA) types 1～3 in the patients with primary dystonia.Methods The CAG triplet repeat expansion of SCA1～3 were detected with the polymerase chain reaction(PCR) in two patients with primary dystonia(father and son) and their 21 health family members.Results The two patients with primary dystonia were found to have the gene mutation of SCA3,the CAG repeat were 80 and 75 respectively.The gene mutations of SCA1,2 were not found in the two patients.The gene mutation of SCA1～3 were not found in the 21 family members.Conclusions The patients with primary dystonia have the gene mutation of SCA3.The gene mutations of SCA3 may be relatived to the incidence of primary dystonia.