OBJECTIVE:To compare economical efficiency of 4 therapeutic regimens for pediatric perianal abscess. METH-ODS:By retrospective study method,85 children were divided into group A(18 cases),B(10 cases),C(14 cases)and D(43 cases)according to different therapeutic regimens. They were given amoxicillin-flucloxacillin,flucloxacillin,cefathiamidine and ce-famandole 100 mg/(kg·d) intravenously for 5-7 d,respectively. Clinical efficacies and the occurrence of ADR were compared among 4 groups. The economical efficiency of 4 therapeutic regimens were analyzed by the method of cost-effectiveness analysis. RESULTS:For group A,B,C and D,the cure rates were 77.78%,80.00%,57.14% and 90.70%,that of group C was signifi-cantly lower than those of other 3 groups,with statistical significance(P<0.05). No significant ADR were found in 4 groups. The costs were 3 600.86,2 913.92,3 416.19 and 2 981.97 yuan,and the cost-effectiveness ratios were 46.30,36.42,59.79 and 32.88. The incremental cost-effectiveness ratios of group A,C and D to group B were -309.43,-21.97 and 6.36. The results of cost-ef-fectiveness analysis were supported by sensitivity analysis. CONCLUSIONS:For pediatric perianal abscess,cefamandole shows the best cost-effectiveness;but the therapeutic duration and total cost of flucloxacillin therapeutic regimen is shorter and lower. Thera-peutic regimen should be selected according to children’s condition.

Objective] Research the treatment characteristics of premenstrual abdominal pain and postmenstrual abdominal pain in Fu Qingzhu’s Obstetrics and Gynecology and the clinical medical records.[Method] By reading the relevant documents and medical records to discuss the medication characteristics of premenstrual abdominal pain and postmenstrual abdominal pain in Fu Qingzhu’s Obstetrics and Gynecology along with the medication experience of dysmenorrhea from the traditional Chinese medicine expert Guo Zhenqing. [Results] Fu Qingzhu treated dysmenorrhea by distinguishing between the anterior and posterior with different treatments such as Xuanyu Tongjing decoction and the decoction for regulating liver. Focus on liver qi stagnation and use of white peony root, angelica nourishing blood and liver to relieve pain .Old Guo paid attention to treatment based on syndrome differentiation and modified acupoint prescriptions based on Xuanyu Tongjing Decoction. She treated dysmenorrhea with two prescriptions, two periods of medication and hit the pathogenesis. Achieve satisfactory results in the treatment of this disease. [Conclusion] The clinical dysmenorrhea syndrome is complex, Xuanyu Tongjing Decoction and the decoction for regulating liver should not be confined to the treatment before and after abdominal pain, must have detailed exploration of its thought and use the original prescription flexibly, which can be effective.

Objective To explore the relationship between self-confident and personality of college students' self-confident.Methods 527 college students were investigated with Personal Evaluation Inventory 16.04)than that of girls(141.13±15.76,t=2.558,P＜0.05);the score of students from urban areas was higher(145.14±15.66)than that of students from rural areas(141.54 ±15.99,t=2.394,P＜0.05);the score of students from one-child family was higher(146.50±16.76)than that of students from non-only-child family (141.57±15.61,t=2.910,P＜0.01);the score of students from Different Grades existed significant differences students(r=0.548,P＜0.01),and it was significantly negative correlation with neuroticism(r=-0.207,P＜0.01)and psychoticism(r=-0.476,P＜0.01).Conclusion There are significant difference of gender,family locus,only-child whether or not and grade in self-confident of college students;and self-confident of college students also significantly correlated with personality characteristics.

Objective To investigate the therapeutic effect of bundle treatments for critically ill patients with pulmonary tuberculosis and respiratory failure (RF).Methods A prospective study was conducted, including 56 patients with pulmonary tuberculosis and RF necessary for invasive mechanical ventilation admitted into Department of Critical Care Medicine of the Fourth People's Hospital of Nanning City from January 2013 to December 2014 as the observation group to be treated by bundle treatments. A series of treatments and cares were given to the critically ill patients, such as invasive mechanical ventilation, application of antibiotics by experience within the first hour, supportive treatment targeted to hemodynamics in early stage, correction of brain dysfunction, effective therapy for tuberculosis, establishment of enteral nutrition in early stage and prevention of ventilator-associated pneumonia (VAP), etc. All the above treatments were completed one by one in 6 hours to 12 hours. Meanwhile, 42 patients who hospitalized from January 2011 to December 2012 and treated with conventional targeted therapy were designed as the control group. The changes of vital signs, blood routine test, respiration, liver, kidney, etc organ functions, the improvement of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, expected mortality and sequential organ failure assessment (SOFA) score, the incidence of VAP, cure and improvement rate, mortality, duration of invasive mechanical ventilation, the length of stay in intensive care unit (ICU) were compared between the two groups after treatments.Results There were no statistically significant differences in the comparisons between the two groups before and after treatments in temperature, white blood cell count (WBC), blood glucose, total bilirubin (TBil), alanine transaminase (ALT), albumin (Alb) and cholesterol level (allP > 0.05), except the platelet (PLT) count in observation group was higher than that in control group before treatments. After treatments for 72 hours, in the two groups, the heart rate (HR), respiration rate (RR), APACHE Ⅱ score and expected mortality were lower than those before treatments, while the arterial partial pressure of oxygen (PaO2) and oxygenation index were higher than those before treatments. There were no statistically significant differences in pH value, PLT, arterial partial pressure of carbon dioxide (PaCO2) and SOFA score before and after treatments in the control group (allP > 0.05). In the observation group, after treatments, the pH value was increased compared with that before treatments, while PLT, PaCO2 and SOFA score were decreased compared with those before treatments (allP < 0.05). The degrees of improvement of PaCO2 and oxygenation index in the observation group were superior to those in the control group [PaCO2 (mmHg, 1 mmHg = 0.133 kPa): 43.32±9.10 vs. 56.10±9.39, oxygenation index (mmHg): 330.60±100.98 vs. 245.65±83.20, bothP < 0.05]. After bundle treatments, compared with control group, the incidence of VAP was decreased [16.07% (9/56) vs. 33.33% (14/42),P < 0.05], improvement and cure rate was increased [78.57% (44/56) vs. 59.52% (25/42),P < 0.05] and mortality was decreased significantly in observation group [10.71% (6/56) vs. 28.57% (12/42),P < 0.05]. The duration of invasive mechanical ventilation (days: 9.15±3.59 vs. 16.96±13.44) and the length of stay in ICU (days: 13.30±4.24 vs. 23.00±15.03) in the observation group were shorter than those in the control group, but no statistically significant differences were found (bothP > 0.05).Conclusion The bundle treatments can effectively reduce the incidence of VAP and elevate the improvement and cure rate in patients with pulmonary tuberculosis complicated with RF.

Rhabdomyosarcoma is a kind of skeletal muscle ifferentiation tendency of primitive mesenchymal malignant tumor. It is common in pediatric malignant pleomorphic rhabdomyosarcoma, and its prognosis is poor. It is easy to relapse, and its predilection sites in head and face were around the eyes, the external auditory meatus, nasal cavity and paranasal sinuses. We should take comprehensive treatment including surgical operation, radiotherapy and chemotherapy drug combination for embryonal rhabdomyosarcoma.
Child ; Ear Canal ; pathology ; Humans ; Infant ; Nasal Cavity ; pathology ; Orbit ; pathology ; Paranasal Sinuses ; pathology ; Prognosis ; Rhabdomyosarcoma, Embryonal ; diagnosis ; therapy

Through the comparative analysis of traditional medical dispute handling methods and the concept of the third party mediation in medical dispute,this paper discussed that the third party mediation method in medical dispute obtain the recognition of both doctor and patient with its advantages such as neutrality,impartiality,convenience,and it had good running effect in the practice from place to place.But there still remain Some Problems,in cluding the intervention lacks initiative;the amount of indemnity lacks scientificity;the conciliation agreementlacks coercive enforcement;the privacy lacks protection;the institution development is limited.So we must improve the third party mediation work mechanism,identification process,operation mechanism and the relevant insurance system.

The effectiveness and efficiency of university educational management would have a direct impact on universities' teaching performance.Moreover,it is important to undertake a further reformation for the educational management system of university and college and establish such a standardized,high efficient educational management system.Since they would be the milestones that improve universities'teaching performance constantly and ensure there is a persistent evolution in universities as well.

Physiology is one of the most important elementary subjects for medical students.Associated with physiological teaching practice,some experience is shared here to further improve teaching effect.

To investigate the cell proliferation inhibition and apoptosis induced by berberine a-hydroxy f-decanoylethyl sulfonate (HB) on MDA-MB-231 cells in vitro, and the inhibitory effect of HB on the expression of poly adenosine diphosphate RNA polymerase (PARP), MTT assay was used to detect the viability of MDA-MB-231 cells and cell cycle was examined by flow cytometry. The results showed that HB could significantly inhibit the proliferation of MDA-MB-231 cells, and mildly arrested cell cycle progression at S phase. The IC50S for 24, 48 and 72 h treatment were 4.65, 1.46 and 0.75 mg.L-1 (7.55, 2.37 and 1.22 micromol.L-1), respectively. Annexin V-FITC/PI double staining assay showed that HB increased apoptotic ratio of MDA-MB-231 cells. Western blotting analysis showed the expressions of procaspase-3, procaspase-9 and PARP were decreased after HB treatment, while their fragment increased. The results suggest that HB can inhibit the growth and induce apoptosis of MDA-MB-231 cells, which may be associated with inhibition of the expression of procaspase-3, procaspase-9 and PARP.

Synergistic antitumor effects of HB (berberine alpha-hydroxy-beta-decanoylethyl sulfonate, houttuyn berberine) with HCPT (hydroxycamptothecine), and its correlative mechanism were studied in vitro. MTT assay was employed to determine the cytotoxicity of HB combined with HCPT in tumor cells culture in vitro, IC50 and combination index (CI value) were used to evaluate the synergistic effects. The supercoiled DNA relaxation mediated by topoisomerase I & II was measured by agarose gel electrophoresis assay, and influence of HB was detected. The results showed that HB could inhibit the proliferation of tumor cells (SGC-7901, SW1116 and SW480) in vitro, and the inhibition ratio was increased, IC50 was reduced when combining with HCPT. CI value of the two drugs was less than 1 in HepG2, SW480, SGC-7901 and SW1116 cells. The lowest value was 0.447, 0.626, 0.161 and 0.178 in these tumor cells, respectively, further indicating HB has synergistic action with HCPT on suppressing tumor proliferation. The agarose gel electrophoresis assay showed HB can inhibit topoisomerase I & II activity of SW480 cells at the concentration of 2.0-8.0 mg x L(-1). HCPT is a typical inhibitor of topoisomerase I , the synergistic action between HCPT and HB on suppressing tumor proliferation is perhaps related to the congenerous inhibition of topoisomerase.