Teaching diagnosis is also called analysis of the scene of teaching. By using multimedia teaching in the classroom,teaching monitoring system for remote video,the use of the basic method of Chinese medicine in the diagnosis of the disease"look,smell,ask and feel" to watch video playback,we let the students purposefully observe teachers’ teaching,conduct the "Self-or experts",feeling the pulse diagnosis,and find the inadequate teaching and make recommendations for improvement so as to ultimately enhance the quality of classroom teaching purposes.

Objective:To investigate the relationship of hypertension with osteoporosis(OP)and bone mineral density(BMD) in elderly type 2 diabetic women.Methods: A total of 179 elderly type 2 diabetic women were categorized into hypertension group(n=124)and non-hypertension group(n=55).Lumbar and hip BMD were measured by dual-energy X-ray absorptiometry.Prevalences of osteoporosis were compared between the two groups using Chi-square test,and BMD was compared using covariance analysis.The correlation between the osteoporosis and risk factors was analyzed using binary logistic regression method.Results: The prevalences of osteoporosis(total OP,lumber OP and hip OP) in non-hypertension group were higher than that of the hypertension group(Pt=0.037,Pl=0.042 and Ph=0.051,respectively).Lumbar and hip BMD in the hypertension group was higher than that in the non-hypertension group,and there were significant differences in L3 and L4 BMDs between the two groups(P3=0.040,P4=0.021);however,the difference disappeared after adjustment for body mass index(BMD).After adjustment for C peptide,the P value also increased,but not as obvious as after adjustment for BMI.Binary logistic regression analysis showed that OP was associated with age,BMI and osteocalcin,but not with hypertension.Conclusion: OP is associated with the age,BMI,and osteocalcin,but not with hypertension in elderly type 2 diabetic women.

A survey was conducted on a sample of 67 general practitioners ( GPs ) receiving in-service training in Beijing in 2012.Hypertension knowledge mastering and training status were investigated through a self-administered questionnaire .Results showed that the accuracy rates of the 4 domainitems (basic knowledge and skill, lifestyle modification, drug therapy, health management ) were 42.3%(340/804), 48.0%(225/469), 27.8%(96/335) and 70.6%(473/670), respectively with an overall accuracy rate of 49.8%(1 134/2 278).Trainees from urban scored higher than those from rural areas (P<0.01).About one third of trainees indicated that the 3 main teaching sessions they took part in did not cover the content of hypertension management .The hypertension guideline ( primary care version 2009) was most frequently used for training GPs , but only 33.9%(21/62) accessed such training .The results indicate that hypertension knowledge level seems to be generally low among GPs on in-service training in Beijing and the current training situation need to be further improved , particularly for those from rural areas .

Objective To analyze the correlative factors of anemia in patients with non-small-cell lung cancer (NSCLC), and to explore the impact of anemia on prognosis.Methods The clinical data of 473 patients with NSCLC treated at the first time from January 2008 to November 2012 in the Fourth Hospital of Hebei Medical University were analyzed retrospectively.Results There were 273 patients (57.72 ％) with anemia.Anemia occurred in different age (x2 =3.459, P =3.459), different albumin level (x2 =70.648, P =70.648), different PS score (x2 =10.222, P =10.222), whether recent surgery (x2 =4.956, P =4.956), whether recent chemotherapy (x2 =3.627, P =0.037), and other factors.By multiple factors analysis, hypoalbuminemia was an independent risk factor for anemia (P ＜ 0.05).The median OS of the anemia patients was shorter than that of the patients without anemia (15 months vs 17 months, P ＜ 0.05).Conclusions Hypoalbuminemia is the independent risk factor for emergence of anemia.Anemia is the prognosis indicator of shorten survival period, which is an independent factor of prognosis in the NSCLC.

Objective:To explore the pharmacodynamic differences of india madder root before and after charcoal in antiinflammatory,ease pain,promoting blood circulation for removing blood stasis and hemostasis function.Methods: The india madder root and india madder root charcoal decoction pieces were processed by the same one operation,then the water decoction of them were given to the mouse by intragastric administration in different dosages.The method of auricle tumefaction was adopted to compare the antiinflammatory function,body wrings was adopted to compare the ease pain function,to compare the hemostasis function of india madder root before and after charcoal by snipping off the mouse’s tail and capillary method.Blood stasis model was made by injecting Dexamethasone Sodium Phosphate,then to compare the promoting blood circulation for removing blood stasis function of india madder root before and after charcoal of india madder root before and after charcoal.Results: India madder root decoction pieces is more effective than india madder root charcoal decoction pieces in antiinflammatory,ease pain,promoting blood circulation for removing blood stasis,but less effective in hemostasis.Conclusion: The function of antiinflammatory,ease pain,promoting blood circulation for removing blood stasis of india madder root were less effective after charcoal,but the fuction of hemostasis was more effective.

Background and objective hTe activation of coagulation and ifbrinolysis is frequently encountered among cancer patients. Such tumors are associated with high risk of invasion, metastases, and negative ifnal outcomes. Non-small cell lung cancer (NSCLC) accounts for approximately 80%to 85%of all lung malignancies. hTis study aims to investigate the prognostic value of blood coagulation tests for NSCLC and provide a reference to patients on the prevention and treatment of thrombophilia. Methods Data were collected from 604 cases of hospitalized patients with histologically conifrmed NSCLC from January 2009 to December 2012 at the Fourth Hospital of Hebei Medical University. Data included the related indexes of coagulation function in patients before treatment [(i.e., prothrombin time (PT), prothrombin time activity (PTA), interna-tional normalized ratio (INR), activated partial thromboplastin time (APTT), ifbrinogen (Fib), D-dimer, and platelet count)], as well as sex, age, pathological type, TNM stage, and lymph node status. Fitfy control subjects without cancer were included in the analysis. Statistical analysis was conducted by using SPSS 13.0 sotfware. Results hTe plasma level of all coagulation tests including D-dimer, Fib, PT, APTT, INR, and platelet counts revealed statistically signiifcant differences between the patient and control group (P<0.001 for all variables;P=0.001,5 and P=0.004,5 for Fib and platelet counts, respectively). hTe squamous subtype exhibited high plasma Fib levels (P<0.001) compared with adenocarcinoma cell lung cancer patients. Fib and PLT levels increased (P<0.001 and P=0.014, respectively), and aPTT decreased (P<0.001) in patients at stages III and IV compared with those in patients at stages I and II. aPTT decreased signiifcantly (P<0.001), and Fib and D-dimer levels increased (P<0.001 and P=0.048, respectively) in N1-3 patients with NSCLC compared with those of N0 patients. Prolonged PT and INR, high plasma Fib levels, and low PTA levels had statistically signiifcant adverse effects on survival (P=0.032, P=0.001, P<0.001, and P=0.005, respectively). Multivariate analyses revealed that only increased INR was associated with a decreased survival rate in the related indexes of coagulation function (P=0.017). Conclusion Patients who have lung adenocarcinoma and/or lymph node metastasis at advanced stages of NSCLC are prone to thrombophilia. Prolonged PT and INR was associated with poor prognosis, and elevated INR was independently associated with a decreased survival rate. PT and INR are promising prognos-tic markers of NSCLC.

Esophageal squamous cell carcinoma is one of the most common cancer in China, and locally advanced stage remains a heterogeneous and complex disease. Its treatments are constantly evolving. To date, radiochemotherapy and surgery are involved in the comprehensive treatment of this disease. However, because of the specifical anatomical location of esophagus, its physiological function will be impaired after surgical resection. If similar survival is obtained in esophageal cancer, an organ preserving strategy without surgery is of great significance for improving the quality of life. As a non-invasive tumor treatment method, neoadjuvant therapy plays an important role in the comprehensive treatment of preserving the esophagus. Recently, there are studies investigating the role of organ preserving strategy in the comprehensive treatment of esophageal cancer with neoadjuvant therapy, and the recognition of these advances will provide reference value for the comprehensive treatment of esophageal cancer.

Objective To compare the clinical efficacy and safety between recombinant human parathyroid hormone ( rhPTH) ( 1 -34) and elcatonin in the treatment of postmenopausal women with osteoporosis in China.Methods This 6 month, multicenter, randomized and controlled study enrolled 205 postmenopausal women with osteoporosis.They were randomized to receive either rhPTH (1 -34) 20 μg (200 U) daily or elcatonin 20 U weekly.Lumbar spine (L1-4 ) and femoral neck bone mineral density (BMD) and biochemical markers of bone turnover were measured. In the meantime adverse events were recorded. Results The results showed that both rhPTH ( 1 -34) and elcatonin increased L1-4 BMD significantly at the endpoint of the study, but femoral neck BMD did not change significantly.From baseline to endpoint, BMD of L1-4 and femoral neck in the rhPTH( 1-34) group increased by 5.51% (P <0.01) and 0.65% (P >0.05), but BMD of L1-4 and femoral neck in elcatonin group increased by 1.55% (P <0.05) and 0.11% (P>0.05).Moreover, the rhPTH(1-34) group had better improvement in L1-4 BMD than the elcatonin group at 3, 6 months, but there was no difference of BMD in these two groups with regard to femoral neck.There were greater mean increases of the bone markers in the rhPTH( 1-34) group than those in the elcatonin group at 3, 6 months [serum bone-specific alkaline phosphatase ( BSAP) 36.79% vs 0.31% ; 92.42% vs -0.17% ; the ratio of urine N-telopeptide of type I collagen and creatinine (NTX/Cr) 48.91% vs -5.32% ; 68.82% vs - 10.86%].Both kinds of treatment were well tolerated and there were no differences between the two groups in the rates of adverse events and serious adverse events.Conclusion It is concluded that rhPTH (1 -34) has more positive effects on bone formation than elcatonin as shown by the greater increments of L1-4 BMD and bone formation markers and the less occurrence of adverse events as well as no significant change in hepatic, renal or hemopoietic function.

Objective:To research the clinical effect of early comprehensive intervention for physical and intelligence development of premature infant (test-tube baby).Methods:One hundred and eleven premature infant in Dalian Municipal Women and Children′s Medical Center from June 2016 to June 2018 were enrolled. Study group (57 cases) received comprehensive intervention including health education, exercise training, nutrition guidance and rehabilitation therapy, and control group (54 cases) received health education. The weight, height, head circumference and CDCC score of two groups were analyzed in 3, 6 and 12 month.Results:Physical development: the weight [3 month: (4.72 ± 0.19) kg vs. (4.34 ± 0.29) kg; 6 month: (6.49 ± 0.37) kg vs. (6.25 ± 0.41) kg; 12 month: (9.58 ± 1.15) kg vs. (8.76 ± 0.92) kg] and height [3 month: (59.63 ± 5.51) cm vs. (56.29 ± 5.86) cm; 6 month: (65.09 ± 5.94) cm vs. (62.36 ± 6.20) cm] in 3, 6 and 12 month, and head circumference in 3 and 6 month [3 month: (37.71 ± 1.77) cm vs. (35.90 ± 1.48) cm; 6 month: (43.18 ± 1.96) cm vs. (41.82 ± 2.61) cm] of study group were higher than those in control group, and all difference had statistical significant ( P<0.05). Intelligence development: the MDI [3 month: (84.49 ± 9.78) scores vs. (80.58 ± 10.40) scores; 6 month: (89.65 ± 13.21) scores vs. (83.24 ± 17.66) scores; 12 month: (96.03 ± 15.43) scores vs. (89.71 ± 17.85) scores] and PDI score of study group was higher than that in control group in 3, 6 and 12 month [3 month: (82.68 ± 5.35) scores vs. (79.43 ± 7.21) scores; 6 month: (86.34 ± 8.33) scores vs. (82.51 ± 9.67) scores; 12 month: (94.86 ± 10.27) scores vs. (90.32 ± 11.65) scores] ( P<0.05). Conclusions:Early comprehensive intervention has a good clinical efficacy for physical and intelligence development of premature infant (test-tube baby) and is worthy of popularizing and applying.

Objective To evaluate the clinical efficacy and feasibility of using the expanding pedicle subtraction osteotomy (E-PSO) technique for the treatment of congenital severe thoracic angular kyphotic deformity.Methods We retrospectively reviewed a cohort of 13patients with congenital severe kyphosis admitted to our hospital from January 2010 to June 2015 including 5 males and 8 females,the average age is (34.9±20.5) years old (ranged 15-55 years old).The vertebral deformity in T7～83 cases,T8～93 cases,T9～102 cases,T10～114 cases,T9～111 case.All cases were treated by E-PSO technique.The multi-malformed vertebrae are considered as a complexus.And the osteotomy was performed within the complexus.The superior and inferior endplate of the complexus were reserved.After the osteotomy was completed,alternately pressed tightly closed the upper and lower parts.Results All cases were followed up for 10-42 months,with an average of 32 months.At the time of preoperation,postoperation andthe last follow-up,the deformity angle was 107.0°±3.5°,23.5°± 1.5° and 23.5°±0.2°;TK was 98.1°±7.6°,28.9°±3.0° and 29.5°±0.1 °,LL was 94.1 °± 1.5°,43.7°± 1.3° and 44.1 °±5.3°;SVA was (-0.6±39) mm,(1.6±7.9) mm and (6±0.7) mm,respectively;PI was 28.9°±1.6°,31.7±12.3°and 31.9°±2.1°;PT was 17.7°±1.9°,13.4°±3.4°and 13.1°±4.2°,SS was 11.3°±0.4°,18.2°±1.1° and 18.7°±2.1°,respectively.The sagittal parameters and spinopelvic parameters except SVA were significantly improved in the post-operation and the last follow-up compared with the pre-operation according to the image data.No significant loss of correction occurred during the follow-up,and there was no statistical difference.The preoperative VAS score was (5.7± 1.4) points,ODI score was (19.8±12.7) points.The last follow-up VAS score was (1.9±0.7) points,the ODI score was (9.2±0.7) points.No case of nerve damage,infection and other complications,and no dissection,displacement and rupture of internal fixation were found during the follow-up.Conclusion The use of E-PSO technique for the treatment of congenital severe thoracic kyphotic kyphosis is feasible and can achieve better curative effect.