Objective To discuss the effect of the application of anti-reflux venous indwelling needle after gastrointestinal polyps endoscopic resection.Methods 400 cases of patients after gastrointestinal polyps endoscopic resection were selected in our department.200 cases of patients using ordinary venous indwelling needle were set as the control group.In addition,200 cases of patients chose anti-reflux indwelling needles which were produced by a certain medical instrument Co.,Ltd were set as the experimental group.The incidence rate of phlebitis,tube blocking,blood return and indwelling time in the process of using anti-reflux indwelling needle were observed in two groups.Results During the indwelling time of two kinds of indwelling needles,the incidence rates of phlebitis,tube blocking and blood return of anti-reflux indwelling needle in the experimental group were significantly lower than those of the control group.The average indwelling time of the experimental group was 1.2 days,longer than that of the control group.Conclusions Anti-reflux indwelling needle can effectively protect the blood vessels,ensure the patients to use drugs in time,improve the work efficiency of nurses,reduce the damage to patients and effectively reduce the burden of patients.

Objective To investigate diagnosis and treatment of venous cerebral infarction.Methods The reasons, clinical findings, imaging characters, treatment methods and prognosis of 19 patients diagnosed venous cerebral infarction were analyzed.Results The most frequent symptoms were headache, focal deficits, epilepsy, increased CSF pressure.Among 19 cases, multiple cerebral lesions were found in 12 cases, lobes lesions in18 cases, cerebral infarction with hemorrhage in 3 cases. After various treatments, 16 patients were discharged and one patient died and 2 patients gave up treatment. Conclusions Venous cerebral infarction has complicated causes, non-specific chinical manifestations and characteristic MR images. Anticoagulation and thrombolysis treatment in early stage may have good therapeutic effect.

Objective: To optimize the extraction process of total flavonoids from Oxytropis falcata bunge.Methods: With the content of total flavonoids as the index,and based on the results of single factor tests, central composite design-response surface methodology was adopted to optimize the extraction technology with the solvent amount, ethanol concentration and extraction time as the factors.Results: The optimal extraction conditions were as follows: extracted twice with 20-fold amount of 66% ethanol, and 84 minute per time.Under the above conditions, the extraction rate of total flavonoids was up to 23.21 mg·g-1.Conclusion: The central composite design-response surface methodology is convenient and highly predictive for the extraction optimization of total flavonoids from oxytropis falcata bunge.

Objective To evaluate the possible factors that may influence the resting energy expenditure (REE) in patients with newly diagnosed esophageal cancer. Methods Totally, 40 patients with newly diagnosed esophageal cancer were prospectively collected from November 2008 to June 2009 in Xinhua Hospital. Nutritional risk screening 2002 (NRS 2002) was performed. REE and body composition were measured using indirect calorimetry and bioeletrical impedence method, respectively. Results Twenty-seven (67.5%) patients were found with nutrition risk, and NRS score was negatively correlated with prealbumin ( r = - 0.444, P = 0.004) and albumin levels (r = - 0.386, P = 0.014). Measured REE and predicted REE values were ( 6770 ± 1360) and (6021 ± 841 ) kJ/d, respectively (P ＜ 0.001 ). Among all 40 patients, 57.5% of them were hypermetabolic,30.0% were normal, and 12.5% were hypometabolic. Stepwise linear regression analysis showed that fat free mass was the only significant determinant variable for REE (P ＜ 0.001 ). Conclusion Fat free mass is a factor than can influence the energy metabolism in patients with newly diagnosed esophageal cancer.

OBJECTIVE:To compare the cost-effectiveness among four different antiemetic schemes for prevention vomiting induced by chemotherapy in patients with lung cancer.METHODS:120 patients receiving cisplatin chemotherapy were divided into 4 groups:Ondansetron(Group A),Tropisetron(Group B),Ramosetron(Group C),and Metoclopramide(Group D).The therapeutic effects were monitored and the cost-effectiveness analysis was performed on the four treatment schemes.RESULTS:The effective rates of the four groups were 87.3%,92.7%,90.7% and 61.3% respectively;the cost-effectiveness ratios were 684.77,906.37,222.33 and 45.02,respectively;and the incremental cost-effectiveness ratios of A,B and C group were 2 193.08,2 587.90 and 592.01 respectively as against Group D.CONCLUSION:Ramosetron is the most rational one among the 4 schemes.

Objective:In investigate the status quo of current physician-patient relationship.Method:A self-designed questionnaire is conducted among the medical staff and patients in 40 hospitals(20 grade 3 hospitals and 20 grade 2 hospitals) located in 10 cities of China.Result:9.3% of the total patient responders consider the current physician-patient relationship dissatisfying,with a counterpart ratio of 31.2% in responders of medical staff.Conclusion:Currently in China,main-stream of physician-patient relationship is harmonious,but it can not be denied that medical staff are suffering tremendous stress from the ever tenser physician-patient contradictions.

Objective To gather observational data on resting energy expenditure(REE)of children with newly diagnosed malignant solid tumor, and to examine factors that might be relevant to their energy expenditure change. Methods It is a retrospective study. Data from sixty-one patients with newly diagnosed malignant tumor admitted to department of pediatric surgery in Xinhua Hospital were reviewed in this study. Resting energy expenditure was measured by indirect calorimetry. Patients with benign tumor admitted during the same period were used as the control group. Results The difference of percentage of patients with normal, decreased, or increased REE between benign and malignant groups was not significant(χ2 = 0.466, P = 0.792). Patients with one or more gastrointestinal symptoms had higher percent of Pre-REE compared with patients without any gastrointestinal symptoms, but no significant difference existed(119.8±80.4 vs 91.1±27.2, Z = 0.746, P = 0.456). Different tumor types were associated with different effects on REE. There was no significant difference in REE levels between patients with decreased diet intake and those without(Z = 0.528, P = 0.598). Conclusions It is confirmed that not all patients with malignant tumor have an increased REE. Moreover, the tumor site might be an independent factor affecting patients' REE level.

Cultivation of medical students' clinical practice is an important part of higher medical education.At present,the imbalance of teachers structure and the old and single teaching mode and method etc,have had a great impact on the clinical practice of medical students.Only by strengthening the construction of clinical teachers,establishing access and assessment system of clinical teachers,carring out diverse clinical education reform,such as Problem-Based Learning ( PBL )and Case-Based Learning ( CBL ),etc,and fully mobilizing the initiative of students and enthusiasm for learning to reach teaching and learning complement in virtuous circle.can we truly improve the quality of clinical practice.

Objective To study the effect of homocysteine(Hcy)on the formation of atherosclerotic and acceleration of ApoE-/-mice liver lipid metabolism disorder .Methods 12 normal 5 weeks old C57BL/6J mice served as control group ,and 36 5 weeks old C57BL/6J A poE-/- mice were randomly divided into 3 groups(n=12 for each group) ,the model control group ,the hyperhomocys-teinemia(HHcy)group and the intervention group(intervened by folate and vitamin B12 ) .18 weeks later ,the blood of the mice was gotten using a Unilateral enucleation method ,and the Serum Hcy and lipid changes were detected by Biochemical analyzer .And the changes of plaque size were measured by HE staining .The liver tissues of the 4 groups mice were taken and the changes in hepato-cyte lipid were detected by oil red O staining ,and the hepatic lipid levels were measured by enzymatic determination(by Semi-quan-titative image analysis) .Results The results showed that ,when compared with the control group ,the serum Hcy ,LDL ,TG and CHOL levels of the HHcy group significantly increased by 2 .3 ,2 .8 ,5 .0 ,10 .7 fold(P<0 .01)and the content of HDL decreased by 64% (P<0 .01) ,and the result showed that ,conpared with the HHcy group ,the seram Hcy ,LDL and CHOL levels of the interven-tion group were significantly decreased by 43% ,34% ,21% (P<0 .05) .Atherosclerotic fatty plaque could be seen in the hyperlipi-demic ,model and intervention group .Meanwhile ,there was a large number of scattered fat in A poE-/-mice liver by oil red O staining in the HHcy group ,and the CHOL and TG levels were 2 .2 fold and 2 .8 fold higher in the HHcy than that in the normal control group respectively(P<0 .01) .And compared with the HHcy group ,the serum CHOL and TG levels of the intervention group sig-nificantly decreased by 34% ,33% (P<0 .01) .Conclusion It is found that Hcy can induce the formation of As and accelerate liver lipid metabolism disorder .

OBJECTIVE:To evaluate the availability and equipment of antidiabetic drugs in public hospitals from Shaanxi prov-ince. METHODS:Using a standardized methodology developed by WHO and Health Action International,the availability and equipping rate of the most common oral antidiabitic drugs were investigated and evaluated in public hospitals of Shaanxi province. RESULTS:The availability and equipping rate of tertiary hospitals and secondary hospitals were all higher than those of community health service centers. Among generic drugs,the availability of metformin was the highest (94.4%),and those of glibenclamide and repaglinide were the lowest(5.6%). Among original drugs,the availability of acarbose was the highest(68.1%). The equip-ping rate of original drugs was higher than that of generic drugs. The equipping rate of generic drugs(25.0%)was higher than that of original drugs(12.5%)in community health service center,but the equipping rates of generic drugs and original drugs were in low level. CONCLUSIONS:General hospitals (especially tertiary hospitals) have high equipping rate of original antidiabetic drugs,the community health services have low availability and equipping rate. Comprehensive measures should be taken to im-prove the availability of drugs in primary medical institutions and ensure drug use of chronic disease patients in primary hospitals.