Asthenia in origin and asthenia in superficiality is the pathogenesis of dermatomyositis,deficiency of yang qi is the interior etiopathogenisis and the invasion of exogenous evil is the exterior etiopathogenisis.The treatment principles of dermatomyositis are strengthening healthy qi to eliminate pathogens and treating both manifestation and root cause of disease.The course includes acute stage,paracmasis and recovery stage.Based on syndrome differentiation,different treatment principles are used in clinic and achieve significant therapeutic effect.

With the development of the main tumor gene sequencing projects,driver mutations have been put into the highlight due to its significant meaning on the cancer occurrence,development as well as treatment.In the past decade,based on the finding of new driver mutations,the knowledge of non-small cell lung cancer (NSCLC) have been improved from the traditional pathological classification to the current molecular classification.Meanwhile,NSCLC patients are no longer looked as an assembly of the same type tumor but various individuals with different molecular biology behavior with the different sensitivity to the targeted drugs.This article focuses on the recent discovery advances of driver mutations in lung adenocarcinoma.

Objective To study the diagnosis of chronic lymphocytic thyroiditis (CLT), and the treatment of CLT companied with other thyroid diseases. Methods Clinical data of 63 cases of CLT were analyzed retrospectively. Results 26 cases were diagnosed by non-operative methods (11 cases by fine needle aspiration biopsy, FNAB). The rest of 37 cases were operated on because of misdiagnosis as other thyroid disease and then comfirmed as CLT by pathology. Of them, 2 were companied with nodular goiter, 6 with Graves' disease, 1 with thyroid adenoma and 2 with carcinoma, respectively. 19 cases were treated by thyroixine, 3 were not treated, 4 treated by operation after thyioxine managment and 37 were treated by operation. Non-operation group had rather satisfied effect in short-term period. 29 cases (78.4%) in operation group were followed up for 1 to 6 years, and 5 cases had hypothyroidism. Conclusions It is necessary to have complete serum immunologic examination and FNAB for suspect patients.They have to be examined carefully in order to avoid omitting complications and incsease the rate of diagnosis.Non-operative treatment is the major therapy of CLT. If CLT is companied with other thyroid disease, operation or non- operation should be adopted according to the pathological type.

Objective To investigate the characteristic, diagnosis and treatment of occult breast carcinoma(OBC). Methods The clinical data of 12 cases of OBC were analyzed retrospectively.Results All patients showed axillary node enlargement as the first sign and were operated on. The operation included axillary node excision (ANE) in 1 patient, axillary node excision plus simple mastectomy in another one, radical mastectomy in 6, and modified radical mastectomy in the other 4,respectively. Eleven patients (91.7%) were followed up for 1-15 years. During the follow up, 1 patient who underwent axillary node resection and 1 who received ANE plus simple mastectomy died of systemic metastasis,18 and 22 months after operation respectively;another case who subjected to radical mastectomy had axillary lymph node metastasis 3 years after the operation,and was re operated on,but the patient died of lung metastasis 4 years after the reoperation. And the others still survived, in which 2 have lived for over 3 years, 2 over 5 years, and 4 over 10 years. Conclusions For axillary mass which causes are uncertain, the possibility of OBC should be considered.Meanwhile excision and pathological examination are necessary. The metastatic histological structure of the axillary nodes usually provide important clue for the source of tumor. Radical or modified mastectomy is the best treatment,and post operative chemotherapy and/or radiotherapy should be done.

Objective To explore the morbidity and clinical characteristics of knee osteoarthritis (OA) complicated with metabolic syndrome (MS).Methods Four hundred and ten patients with knee OA were enrolled into this survey.The subjects were divided into two groups:those with knee OA only:those with both OA and MS.Clinical data in the two groups were evaluated.Results The prevalence of MS was 40.2％ in all knee OA patients,there was significant difference between the two groups according to the ratio of male to female (x2=5.853,P=0.001),but no difference between the two groups according to age distribution respectively (P＞0.05).For metabolic parameters,waist circumference,triglyceride (TG),low density lipoprotein cholesterol (LDL-C),systolic blood pressure and glycosylated hemoglobin (HbA1c) were significantly increased in the group with both of the two diseases (OA and MS),comparing with those with knee OA only (t=3.123,4.679,2.818,3.697,2.632,2.907,P＜0.05).However,there was no difference in both group in serum total cholesterol (TC),high density lipoprotein cholesterol (HDL-C) and fasting plasma glucose level (P＞0.05).Incidence of coronary heart disease,diabetes mellitus and hypertension was higher in the group with both OA and MS than that in knee OA only group (x2=6.676 and 104.12,P＜0.05).The incidence of diabetes mellitus was not different between the two groups (P＞0.05).Conclusion The incidence of metabolic syndrome in knee OA patients is relatively high.Effective treatment should be invited to treat knee OA with MS.

The Componential Framework of Creativity,advanced by Amabile,one of significant figures on the social psychology of creativity,comprehensively interpreted the nature and the construct components of creativity.Inspiring by the ideology of Amabile's Componential Framework of Creativity,this study examined whether the science research human resource management practices in today's Chinese science research institutions follow the nature of science research and whether the policy and operation inhibit creativity.It identified the common misconducts happened in human resource selection,development and performance management,and the causes and countermeasures of those misconducts were also explored.The findings will be a source of reference for human resource management practitioners at the science research field of China.

Objective To compare the effect of different general anesthesia method on preoperation cognitive function in elderly patients.Methods According to the digital table,82 elderly patients(non cardiac surgical operation) were selected and divided into the two groups,each group 41 cases.The group A was given to sufentanil combined with propofol intravenous injection anesthesia,and the group B was given to sevoflurane inhalation anesthesia.The cognitive function of patients of two groups in preoperative,postoperative 3h,6h,24h were assessed by simple intelligence scale(MMSE),and the indicators of postoperative recovery were evaluated.Results The postoperative sleep time [(6.9 ± 1.2) min],language ability recovery time [(9.8 ± 2.2) min] in the group A were all higher than those of group B (t =6.687,5.640,all P ＜ 0.01).The MMSE scores in group A after 3h [(17.1 ± 2.2) points],6h [(19.6 ±2.7)points],24h[(22.4 ±2.3) points] were lower than those of group B(t =10.026,6.229,5.082,all P＜0.01).And the PCOD rate in group A after 24h was 36.6％,which was higher than 17.1％ in group B(x2 =3.98,P ＜ 0.05).Conclusion The inhalational anesthetic methods has more quickly postoperative recovery,lower incidence of cognitive dysfunction,better clinical effects.

Effective leadership is crucial for health organizations' performance and numerous western universities thus offer leadership courses or modules to their students.However,such education practice has not started in China.In order to optimize knowledge and skills of health service management practitioners,to content with requirements of health service organizations,to cope with dynamic organization environment,to implement health reform successfully and to realized sustainable development of health organizations,it is necessary to provide leadership course for students of health service management at Chinese universities.

AIM: To investigate the effects of different phacoemulsification incision for tear film stability in cataract patients.
METHODS: From January 2014 to September 2015, 108 patients (144 eyes) who underwent cataract surgery were divided into two groups: group A with clear corneal incision ( 52 cases with 74 eyes), group B with scleral tunnel incision (56 cases with 70 eye). Two groups of patients were taken the same incision width. Symptoms of dry eye and tear film break - up time ( BUT) were observed 1d before and 1d, 1, 3wk, 1 and 3mo postoperatively.
RESULTS:After performing cataract phacoemulsification 1d, 1wk, symptoms score of dry eye of group A was less than that of group B, the difference was statistically significant (t = -6. 199, -2. 871, P<0. 01), while at other times after operation there were no significant differences ( t = - 1. 639, - 0. 829, - 0. 301, P >0. 05); at postoperative 1d, 1 and 3wk, BUT of group B was better than those of group A, there were a statistically significant differences ( t = - 3. 718, -2. 342,-2. 506, P<0. 05), there were no significant differences at other the time after operation (t= -0. 882,1. 225, P>0. 05).CONCLUSION: The difference on effect of two different incision on the tear film stability only last a short time, which disappeared at 1mo after operation. The clear corneal incision has stronger impacts on tear film stability than scleral tunnel incision, while with a lower score on symptoms of dry eye.

Purpose:To investigate the clinical characteristics, diagnosis and treatment of accessory breast tumors.Methods:Clinical and pathological data of 16 cases of accessory breast tumors were analyzed retrospectively. Results:There were 5 cases of accessory breast fibroadenoma, 2 cases of intraductal papilloma, 9 cases of accessory breast carcinoma. Local mass resection and radical resection were carried out respectively. All these patients had post operative chemotherapy and radiotherapy. 13 cases (81.3%0 were followed up for 1—10 year. As to results, 3 cases died of metastasis in 2,2.5 and 4 years respectively after operation;one case, reoperated because of local recurrence, still survives (over 3 years):and the others recovered well.Conclusions:It is possible for benign or malignant tumor to occur in the accessory breast,and the manifestation of the accessory breast tumors is similar to that of the primary breast tumor. Operation is the first choice for all treatment benign tumor with local mass resection including the whole accessory breast while accessory breast carcinoma should be treated by radical dissection.