Objective To evaluate the clinical curative effect and safety of Shenqifuzheng injection in the treatment of elderly patients with chronic heart failure.Methods 58 cases of elderly patients with chronic heart failure were selected from September 2014 to September 2015 in our hospital and randomly divided into the control group and treatment group,29 cases in each group.The control group was given conventional therapy,on the basis of the control group,the experimental group was treated with Shenqifuzheng injection,250mL,one time a day,intravenous drip;Before and after treatment,compared between the two groups of patients with serum tumor necrosis factorα(TNF-α),interleukin 1β levels,efficiency of treatment and safety.Results After treatment,compared with the control group,the serum levels of TNF-α and IL-1β were lower in the experimental group(P<0.05); the treatment efficiency of the experimental group(93.11％)was significantly higher than that of the control group(65.52％,P<0.05).Conclusion The Shenqifuzheng injection can significantly reduce the serum levels of TNF-α and IL-1βin elderly patients with chronic heart failure,reduce inflammatory reaction,improve clinical efficacy,and safety was high.

Objective To analyze the clinical features of elderly patients with acute cerebral infarction with early seizures and pathogenesis mechanisms,clinical therapy and prognosis.Methods The clinical data of 66 cases of elderly patients with acute cerebral infarction complicated with seizures were retrospectively analyzed.Results The analysis found that 66 patients had 2 weeks after the onset of acute cerebral infarction,focal motor seizures in which patients were 37 cases,accounting for 56.1%;generalized tonic-clonic seizures in patients of 21 cases,accounting for 31.8%;bureau focal status epilepticus patients 8 cases,accounting for 12.1%.All patients were 2 to 6 months after treatment withdrawal,and followed up for 5 months,64 patients with no recurrence,2 patients needed long-term medi-cation to control the disease.Conclusion Elderly patients with acute cerebral infarction after seizures need aggres-sive treatment and control of cerebral disease,but patients need to control seizures,which can reduce brain injury,help to improve the prognosis of patients.

Objective To investigate the effect of Atorvastatin Combined Naoxintong Capsule treats to cerebral infarction and carotid atherosclerosis.Methods 134 patients with cerebral infarction and carotid atherosclerosis were diagnosed by MRI or CT scan.They were randomly divided into two groups.67 cases were given atorvastatin versus aspirin received routine treatment in the control group and 67 cases were used Naoxintong capsule in observation group on the basis of routine treatment in the observation group.The blood lipid,serum high sensitive C-reactive protein (hs-CRP) level,neural function defect score (NIHSS),carotid artery intima-media thickness (IMT) were comperred before and after treatment in two groups for treated with 1 courses (6 months).Results The blood lipid had no significant difference between two groups before and after treatment (P ＜ 0.05).The IMT,NIHSS score of high sensitivity C-reactive protein levels had no significant difference in two groups before and after treatment (P ＜ 0.05).The scores of NIHSS,IMT,high sensitive C-reactive protein level respectively (10.08 ± 1.82) ％,(1.06 ± 0.13)mm,(3.89 ± 1.41) mg/L of observation group were more decreased significantly than the control group (respectively (13.92 ±2.01)％,(1.24 ±0.15)mm,(5.02 ± 1.52) mg/L after treatment.Conclusion Atorvastatin Combined Naoxintong Capsule in treatment of cerebral infarction and carotid artery gruel kind hardening shows good therapeutic effect,it is worth for clinical use.

In China, medical system reforms have made an obvious achievement in recent years .However, lots of urgent problems still exist.Doctors are not satisfied with their working environment.The high-pressure job with low remuneration reduces doctors'enthusiasm for work.Meanwhile, both the threat to personal safety and disrespect from patients bring negative effects to doctor's physical and mental health .The main factors causing this situation include the leaky health care system , the incomplete health -care legislation, the misleading reports and the poor medical knowledge of patients .Therefore, some countermeasures should be taken to solve problems mentioned above and the construction of medical ethics should be strengthened at the same time .

Objective:To compare the differences between Workshop teaching and PowerPoint teaching being used in resident doctor/advanced doctor training,and to investigate effectiveness of Workshop teaching.Method:Over the limit of teacher on the stage and students off the stage,teacher demonstrated to students hand by hand during Workshop teaching;Over the limit of the students being accepted knowledge passively,teacher encouraged them to take part in mutually;Over the limit of theories lesson separating with practical one,teacher supply more opportunity to operate for students practically.Results:The effectiveness of Workshop teaching mode in practicability and performance ability was better than PowerPoint teaching mode'(P

Objective To investigate the pharmacokinetic characteristics of PSD-007 in BN rats.Methods Blood of the BN rats was collected from the inner canthus after iv administration of PSD-007,and the plasma drug concentrations at different times were determined by fluorescent spectrometry.The best compartment model and the pharmacolinetic were calculated by the software of DNS 2.0.Results The elimination process of PSD-007 fitted three-compartment open model after iv administration.The principal pharmacokinetic parameters were t1/2α=0.096 h,t1/2β=1.299 h,t12γ=19.387 h,V1=0.259 L/kg,A UC=15.263 mg/(L ·h).Conclusions The sensitivity of fluorescent spectrometry was high and the operation is sinple and the progress is short.PSD-007 has fast absorption,quick effect and elimination without accumulation phenomenon.

This paper reports a cases of cervical root chylous cyst and reviews related literatures.This disease is rare in the root of neck. Clinical and imaging diagnosis of the disease is very important for treatment.Surgical excision is the main treatment,conservative treatment can be used as a aductive therapy.

Objective:To explore the value of improved sequential organ failure assessment (ISOFA) in predicting the prognosis of Klebsiella pneumoniae sepsis. Methods:The clinical data of 379 patients with Klebsiella pneumoniae sepsis admitted to the First Hospital of Jilin University from January 1, 2018 to June 30, 2019 were retrospectively analyzed.They were divided into survival group and death group according to the 28-day prognosis, and the age, gender, C-reactive protein, procalcitonin, grade of bacterial resistance, and the occurrence of septic shock of the two groups were compared.Statistical analysis was conducted by using independent sample t test, Mann-Whitney U test and chi-square test. Risk factors for the prognosis of the disease was analyzed by logistic regression analysis.The correlation between ISOFA and other scoring system including Charlson′s weighted index of comorbidities (WIC), national early warning system (NEWS), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), simplified acute physiology scoreⅡ (SAPSⅡ), mortality in emergency department sepsis score (MEDS), sequential organ failure assessment (SOFA), acute gastrointestinal injury (AGI) was determined by Spearman correlation coefficient.The area under the receiver operating characteristic curve (AUROC) was used to compare the evaluation value of each scoring system for the prognosis of Klebsiella pneumoniae sepsis. The clinical significance of ISOFA risk stratification was evaluated by Kaplan-Meier survival curve. Results:Among the 379 patients with Klebsiella pneumoniae sepsis, 278 were in the survival group and 101 were in the death group.The differences of age, gender, the occurrence of septic shock, grade of bacterial resistance, C-reactive protein, procalcitonin, WIC, NEWS, APACHEⅡ, SAPSⅡ, MEDS, SOFA, AGI and ISOFA score between the two groups were all statistically significant ( t=-3.218; χ2=6.781, 24.374 and 27.208, respectively; Z=-3.689, -5.022, -4.396, -4.697, -7.438, -6.348, -6.358, -8.676, -6.680 and -11.658, respectively; all P<0.01). The calculation method of ISOFA was obtained by single factor analysis: ISOFA=SOFA+ 1.5×AGI.Multivariate logistic regression suggested that ISOFA, gender, SOFA, procalcitonin, C-reactive protein, and bacterial resistance were independent risk factors for the prognosis of the disease. The Spearman correlation coefficients of ISOFA and WIC, NEWS, APACHEⅡ, SAPSⅡ, MEDS and SOFA were 0.327, 0.371, 0.614, 0.564, 0.578 and 0.847, respectively. The AUROC and its 95% confidence interval for WIC, NEWS, MEDS, SAPSⅡ, APACHEⅡ, SOFA alone, SOFA plus AGI, and ISOFA to predict the prognosis of Klebsiella pneumoniae sepsis were 0.646 (0.584-0.708), 0.657 (0.597-0.716), 0.712 (0.654-0.771), 0.713 (0.653-0.773), 0.749 (0.693-0.806), 0.788 (0.737-0.838), 0.872 (0.826-0.917) and 0.891 (0.845-0.937), respectively.The results showed that ISOFA had the best predictive effect.The Kaplan-Meier survival curve suggested that there were statistical differences in survival rate among ISOFA low-risk level, medium-risk level, and high-risk level (all P<0.01). Conclusion:ISOFA has important clinical significance in predicting the prognosis of Klebsiella pneumoniae sepsis.

Objective:To study the characteristics of chromogranin(CgA),synaptophysin(SYN) and neuron-specific enolase(NSE) in the cortex of adrenal gland.Methods:Immunohistochemical technique was used to detect the expressions of CgA,SYN and NSE in 56 routinely processed tissue specimens from human adrenal cortical neoplasm and hyperplasia.Results: CgA immunoreactivity was regularly detected in the cortex of adrenal neoplasm,but not in the hyperplasia and normal adrenal gland.The immunoreactive materials appeared in the cytoplasm and in the form of vacuole or grains.Adrenal cortical neoplasm and hyperplasia showed NSE positive cells in the cortex,but not in the normal adrenal gland.SYN positive materials were shown in the cortex of hyperplasia and adrenocorticoadenoma,but not in the adrenocorticoadenocarcinoma and normal adrenal gland.Conclusion: The distributive characteristics of CgA,SYN and NSE in the adrenal cortex help the differential diagnosis of adrenal hyperplasia.The adrenal cortex is closely connected with medulla.Besides the classical hypothalamus-pituitary-adrenal axis(HPAA) and rennin-angiotensin-aldosterone system(RAAS),the adrenal cortex and medulla are mutually regulated on the basis of anatomy and endocrinology.

Objective To study the characteristic of chromogranin A(CgA),synaptophysin(SYN) and neuron-specific enolase(NSE) in cortex and medulla of adrenal.Methods Immunohistochemical method was used to detect the expression of CgA,SYN and NSE in routinely processed tissue specimens from human adrenal neoplasm and hyperplasia.Results The expression of CgA was detected in cortex of adrenocortical adenoma,adrenal neoplasm and chromophile tumor,but not in that of hyperplasia and normal adrenal.The expression of NSE was detected in cortex of adrenal cortical hyperplasia,cortical adenomas and pheochromocyte carcinoma,but not in that of pheochromocytoma and normal adrenal.The expression of SYN was detected in cortex of corticohyperplassia,cortical adenomas,medull neoplasm,chromophile tumor and pheochromocyte carcinoma,but not in that of cortical adenocarcinoma and normal adrenal.The expressions of CgA,NSE and SYN were detected in the medulla of all cases.Conclusion The characteristic of CgA,SYN and NSE in cortex and medulla of adrenal are useful in the differential diagnosis of tumor and hyperplasia in the adrenal.The relationship between the adrenal cortex and medulla is close.Besides the classical hypothalamus-pituitary-adrenal axis(HPAA) and rennin-angiotensin-aldosterone system(RAAS),the adrenal cortex and medulla have the basis of anatomy and endocrinology.