To analyze the EBM present situation of the medical staffs and to discuss the measures to raise the ability of EBM so as to promote the performance of EBM.

Objective To evaluate the efficacy of 0.1% tacrolimus ointment and 0.1% mometasone furoate cream in the treatment of chronic actinic dermatitis (CAD). Methods Forty male patients with CAD were recruited and divided into two groups randomly.Twenty cases were treated with 0.1%tacrolimus ointment (Group A), and the other 20 cases were treated with 0.1% mometasone furoate cream (Group B) . The medications mentioned were applied topically to the lesions on the face twice a day and mizolastine tablet 10 mg per day given orally for 4 weeks. The therapeutic efficacy and side effects of medications were observed. The enzyme linked immunosorbent assay (ELISA) method was used to measure the serum levels of IFN-γ, IL-2 and IL12 in CAD patients before and after treatment with topical tacrolimus ointment and mometasone furoate cream. Results (1) Both groups had overall response rates of 100%, with no statistically significant difference ( > 0.05) . (2) Serum levels of IFN-γ,IL-2 and IL-12 were down-regulated after treatment in both treatment groups respectively ( < 0.01) . No statistically significant difference was found between the two treatment groups ( > 0.05) . Conclusion 0.1%tacrolimus ointment is effective in the treatment of CAD. Its therapeutic efficacy is equivalent to that of 0.1%mometasone furoate cream. It can be used as a possible steroid sparing equivalent.

Objective To investigate expression and significance of matrix metalloproteinase-2(MMP-2),MMP-9 and tissue inhibitor of metalloproteinase-1(TIMP-1) in rats with glomerular sclerosis made by doxorubicin.Methods Forty Wistar male rats(8-week-old) were randomly assigned into 2 groups:sham operated and model groups.Rats in model group were nephrectomized after anesthesia and injected with adriamycin(5 mg/kg) after 1 week.Rats in sham operated group was subjected to sham operation and injected with normal saline after 1 week through the tail vein.All rats were killed in the 12th week.Immuno-histochemistry was performed on renal tissue to detect Collagen Ⅳ(Col-Ⅳ),fibronectin(FN),MMP-2,-9 and TIMP-1.Results Immunohistochemistry staining indicated that expressions of MMP-2,-9 in model group decreased significantly compared to sham operated group(Pa

Objective To study the expression of ?-smooth muscle actin(?-SMA)in glomerulosclerosis rats and its relationship with renal function.Methods Forty healthy Wistar rats were equally divided into 2 groups including sham operated group and model control group.Rats in model groups were uninephrectomized and injected with daunorubicin(5 mg/kg)after 1 week through the tail vein.Twenty-four hours of urinary protein excretion,serum creatinine(Scr),blood urea nitrogen(BUN)were measured at the 12th week.Renal pathology was evaluated.Immunohistochemistry(SupervisionTM)was performed on renal glomeruli tissue to detect the expression of ?-SMA.Reverse transcription polymerase chain reaction(RT-PCR)was used to examine the expression levels of ?-SMA mRNA in glomeruli.SPSS 13.0 software was used to analyze the two variables.Results In model control group,the urinary protein,Scr,BUN significantly increased(Pa

The genotypes of extended spectrum β-laetamases(ESBLs) and AmpC β-lactamases produced by Enterococcus gallinarum isolated from chloebia gouldiae were determined to elucidate the evolution mechanism of the resistant genes.The minimum inhibitory concentrations (MICs) of 18 antibacterial drugs against the Enterococcus gallinarum were detected with two dilution method,and the ESBLs and AmpC β-lactamases from the bacterium were amplified by PCR using the primers of TEM,SHV,CTX-M,ACC,CIT,DHA,EBC,FOX and MOX,respectively.The PCR products were cloned and then the cloned fragments were sequenced to identify their genotypes and subtypes.The bacterium was proved to be a ESBL-producing and AmpC β-lactamase-producing bacterium,showing severe resistant to the other drugs,except the third and forth cephalosporins,carbopenems and fosfomycin.Compared with that of AJ847364 (TEM-116),the sequence of the TEM-type was characterized by two nucleotide mutations (512T→A and 695A→C),which led to two mutations of amino acids(17111e→Lys and 232Lys→Thr),showing that the detected TEM-type was a new genotype,the sequence of the AmpC β-lactamase was similar to that of EF078894 (ACT-like type)with a 97% homology.The genotype of ESBLs of Enterococcus gallinarum was a new TEM-type derived from the TEM-type ESBLs of klebstella pneumoniae isolated from the same avian.The genotype of AmpC lactamase was ACT-type,which probably concerned with β-1actam antibiotics used.

Objective To investigate the characteristic of movement disorders,so as to improve their diagnosis and treatment. Methods The clini?cal data of patients with movement disorders that admitted in the dystonia and Botox outpatient department were analyzed. Results Cases of involun?tary movement were significantly more than the primary dystonia,and case of primary hemifacial spasm was dominant(163 cases,61.05%). Among the 66 cases of primary dystonia,blepharospasm was ranked the first(19 cases),the second was spasmodic torticollis(18 cases),and the third was Meige syndrome(12 cases).There was no statistical significance in the gender distribution among primary hemifacial spasm,blepharospasm,spas?modic torticollis and Meige syndrome. Instead,there was statistical significance in the treatment methods(P<0.05),and there was statistical signifi?cance in the mean treatment and onset age(P<0.05). Of the 163 cases with primary hemifacial spasm,the mean onset age was 44.22±12.22 years, and the ratio of men to women was 1∶2.4. There were statistical significances in the mean onset age and duration among the patients with different severity degrees(all P<0.05). Conclusion Primary hemifacial spasm,blepharospasm,spasmodic torticollis and Meige syndrome are the com?mon disease in outpatient department. The primary hemifacial spasm is dominant,women are more than men,and the onset age and/or duration are proportional to the severity degree.

Objective To investigate the serum homocysteine (HCY)levels of patients with various liver diseases,and discuss the clinical value of combined detection of HCY and other liver function indicators in liver disease diagnosis.Methods Se-lected 123 cases of inpatients with different liver diseases (79 cases of male,44 cases of female),including 39 cases of chronic active hepatitis,52 cases of cirrhosis and 32 cases of primary hepatic cancer from Department of Gastroenterology,and 90 ca-ses of healthy persons as control group from Out-patient Health Examination Center of Shaanxi Provincial People’s Hospi-tal.Detected serum HCY and some indicators of liver function (TBIL,ALT,GGT and TBA)in different liver disease groups and normal control group with Roche MODUALR automatic biochemical analyzer,and did statistic analysis.Results The serum HCY levels of chronic active hepatitis,liver cirrhosis and primary hepatic cancer were 16.25± 3.98μmol/L,20.89± 4.26μmol/L and 22.92 ± 6.08μmol/L respectively,and significantly higher than those in normal control group (8.16 ± 4.03μmol/L,t=5.352~9.021,P<0.01).The serum HCY levels of liver cirrhosis and primary hepatic cancer group were higher than that of chronic active hepatitis group (P<0.05).Serum levels of HCY were obviously lower after treatment than that before treatment (P<0.05)for three groups of liver diseases.The positive rate of HCY was higher than those of other liver function indicators (P<0.05).Conclusion Serum homocysteine may be as one of the most important indexes of liver damage,and the combined detection of other liver function indicators may have important clinical value for liver disease diagnosis,differential diagnosis,treatment and prognosis.

Objective To analyze the morbidity,mortality,and hospitalization of complications in late preterm infants.Meth-ods A total of 389 late preterm infants were retrospectively analyzed.The influence of delivery mode on respiratory complications was compared.And the influence of respiratory complications on length of hospital stay,hospital expenses and mortality were ana-lyzed and compared.Results Our data showed that main complications were diagnosed as respiratory complications(23.65%).Oth-er complications were diagnosed as hypoglycemia (20.57%),feeding intolerance (1 7.48%),hyperbilirubinemia (14.91%),and in-tracranial hemorrhage (8.23%).Respiratory morbidity was significantly higher in preterm infants by caesarean section than by va-ginal delivery (32.34% vs .10.39%,P <0.05).The time and cost of hospitalization and the mortality were higher in late preterm infants accompanied by respiratory complications than those in infants without respiratory complications(P <0.05).Conclusion There were very prone to a variety of complications in late preterm infants.In order to reduce the morbidity of respiratory complica-tions in late preterm infant,indications for caesarean section must be strictly mastered.We should pay more attention to respiratory complications,which might be helpful to short the length of hospital stay,save hospitalization expenses and reduce the mortality.

Objective With awareness, attitudes, and rice-intake behavior of Kaschin-Beck disease (KBD) and the analysis of the factors that influence KBD related rice-intake behaviors among resident's in Aba,this research could provide evidences for KBD-Control, and benefit the policy development related to KBD-Control.Methods Villages were chosen by proportional stratified random sampling from KBD monitoring villages among agriculture areas, pastoral areas, and farming & pastoral areas in Aba, Sichuan, in July 2009. Interview questionnaire of household survey, designed by research associates of this project, was used in this research for residents in endemic area of KBD in Aba. The questionnaire covered demographic and socio-economic characteristics, KBD knowledge and diet habits. Multi-level Variance Component Analysis was used to explore factors which would influence the KBD related rice-intake behaviors. Results A total of 1029 permanent residents were recruited in this research, among which the detection rate of KBD was 48.01％ (482/1004). Most of the patients lived in farming & pastoral areas(84.44％, 407/482). Pastoral residents had the least knowledge of KashinBeck disease, and the composition ratios ofGeneral andGood were 15.87％ (33/208)and 3.36％ (7/208),respectively. Still, people who were willing to have rice as staple food were 93.13％(935/1004). It indicated that only (50.40 ± 23.68)％ on average, of research subjects had the life style of rice intake. Ethnic, work status,language situation and attitudes to rice intake were influencing factors for rice-intake behavior. Conclusions The percentage of rice intake in Aba KBD epidemic areas is low. And to prevent KBD, the advocacy actions should be targeted at ethnic, work status, language situation, and attitudes to rice intake.

Objective To evaluate the blood supply features and effectiveness of arterial chemoembolization for pedunculated hepatocellular carcinoma.Methods Angiography and chemoembolization via supplying blood arteries of tumor were performed in five patients with pedunculated hepatocellular carcinoma.Interventional procedure was carried out with tumor vascular infusion of 350 mg hot elemene emulsion and tumor embolization by cisplantin-lipidol emulsion(cisplantin 60-80 mg+lipidol 8-15 ml)and glutin.Results Ten interventional procedures(TACE)were undertaken in 5 patients.Angiography showed that tumor blood supply mainly coming from collateral circulation adjacent to the tumors,but partially from hepatic artery.Tumor sizes decreased from 30% to 50% in 5 cases,and AFP declined in 4 cases after the treatment. Conclusion Pedunculated hepatocellular carcinoma possessing different blood supply features from intrahepatocellular carcinomas.But transarterial ehemoembolization is still an effective method of choice for this treatment.