Objective To investigate the application of ear endoscope in the treatment of secretory otitis media in children with ineffective drug therapy.Methods 80 secretory otitis media children with ineffective drug therapy were selected as the research subjects.According to the random number table method,all patients were divided into treatment group and control group,40 cases in each group.The observation group received otoendoscopic tympanic membrane tube surgery treatment,the control group received auripucture with otic endoscope surgery treatment.The complications of the two groups were observed,and the clinical curative effect and postoperative recurrence were compared.Results The recurrence rate of the observation group was 5 .00%,which was significantly lower than 20.00% of the control group (χ2 =4.114,P=0.042).The middle ear effusion time of the observation group was (8.53 ±1.25)d,which was significantly shorter than (10.46 ±1.44)d of the control group (t=5.074,P=0.000). In the observation group,37 patients after treatment had change,the total effective rate was 92.50%.In the control group,28 patients after treatment had change,the total effective rate was 70.00%,the total effective rate of the observation group was significantly higher than the control group,the difference was statistically significant (χ2 =6.646,P=0.009).The incidence rate of complication in the observation group was 7.50%,which was significantly lower than 32.50% in the control group (χ2 =7.812,P=0.005 ).Conclusion Tympanostomy tube under ear endoscope surgery for the treatment of drug refractory secretory otitis media in children has good effect,the recurrence rate is relatively lower,has less complications,high safety,it is worthy of clinical application.

The ZHENG (syndrome of traditional Chinese medicine) oriented effects and the multiple-targets' mechanism are the main challenges encountered by recent researches for Chinese herbal formula. Using methods of bioinformatics and systems biology, we proposed a biological network-based framework for understanding the mechanism of Chinese herbal formula, and reviewed our studies under this framework which aimed to explore the relationship between Chinese herbal formula and corresponding ZHENGs, as well as the synergism of herbal combinations. These studies include the network construction for cold or heat ZHENG and its relationship with herbal formula of hot or cold nature, the biological network construction of angiogenesis, and the network regulation-based emergent property of an herbal combination with anti-angiogenesis synergism extracting from the cold formula. It is shown that the ZHENG-oriented effects and the herbal synergism can be nicely explicated by such network-based approaches. Thus, the network-based drug combination discovery, as well as the "traditional Chinese medicine bioinformatics (TCMB)" and "TCM computational systems biology" combining with computational and experimental approaches, is conceivable and can open a new avenue for understanding Chinese herbal formula.

Objective To evaluate the clinical efficacy of low molecular weight heparin in treatment of patients with severe community-acquired pneumonia (CAP).Methods PubMed, BMA, EMbase, ASP, Cochrane Library, EMCC, CBM, CNKI, CECDB, CQVIP, and VIP databases were searched to identify the relevant randomized clinical trials (RCTs) from the publications during the period from January 1994 to January 2014. The search terms were “low molecular heparin”, “severe community-acquired pneumonia”, “prognosis” in both Chinese and English. The quality of the included studies were strictly evaluated and data were extracted. Stata/SE version 12 software was used for systematic review and meta-analysis.Results Six RCTs were ifnally qualiifed in the analysis, including a total of 208 cases in treatment group and 196 cases in control group. The patients in control group received conventional therapy, while the patients in treatment group received low molecular weight heparin by subcutaneous injection as add-on to conventional therapy. Meta-analysis showed that after treatment with low molecular weight heparin for 7 days, the APACHE II score of severe CAP patients signiifcantly decreased (P = 0.43,I2 = 0%, SMD = -0.70, 95%CI: - 0.90, -0.49) with controllable publication bias (bias_p = 0.93, bias_95CI: -6.79, 6.37). The PaO2 of severe CAP patients signiifcantly increased (P = 0.858,I2 =0%, SMD = 0.51, 95%CI: 0.30, 0.72) with controllable publication bias (bias_p =0.770, bias_95CI: -4.82, 5.90). However, after low molecular weight heparin treatment for 7 days, the PaCO2 of severe CAP patients did not change significantly (SMD = -0.17, 95 %CI: -0.38, 0.04).Conclusion Low molecular
weight heparin is beneifcial in the treatment of severe CAP patients in terms of signiifcantly decreased APACHE II score, increased oxygenation, and improved clinical symptoms.

Pregnancy associated breast cancer(PABC) is a special kind of breast cancer,it is difficult to diagnose at early stage since the mammary epithelial cells are actively proliferative.Whether pregnancy will affect the biological behavior of breast cancer and how the treatment strategy for the patients with PABC impact on the outcome in terms of side effects,response,etc,those factors have to be taken into special consideration.The standard management of PABC still remain controversial.This article summarized the studies on PABC and discusses the advances in the management of the disease.

Background and purpose:Cyclooxysenase-2(COX-2)was first researched in colon caner,and extensively studied in breast cancer.However it was rarely reported in lymph node negative breast cancer.This study assessed the effect of expression of COX-2 in the prognosis of lymph node negative breast cancer and its use as information of COX-2 status to perfect the prognostic mathematic model.Methods:The expression of COX-2 protein was detected by IHC in 119 cases of lymph node negative breast cancer,the survival data was analyzed.Results:Elevated expression of COX-2 was associated with unfavorable distant disease-free survival(74% vs 93.86%).In subgroups by the simple prognostic model PI=size+HER2-2.5?age-CT-0.55?(ER?ET),the 5-year DFS were decreased with subgroups of low-risk,mid-risk and high-risk and the rate of elevated expression of COX-2 was increased with higher risk subgroups.Furthermore,in mid-risk group,the elevated expression of COX-2 was still able to predict poorer prognosis.Conclusion:The information of expression of COX-2 can be used to perfect the simple prognostic mathematic model,thus it would be more effective for treatment of breast cancer with auxiliary lymph nodes metastases.

Obesity is a developing public health issue. As a core organ in energy storage and metabolic modulation, adipose tissue becomes an important target in body weight control. Total caloric intake limitation and /or macronutrient ratio regulation are commonly used in obesity therapy. The anti-obesity agents derived from adipocyte products may bring us new ways more suitable to physiological status in the future.

Objective:To investigate the therapeutic medication for inpatients with cancer pain, and compare with the latest cancer treatment guidelines to improve the rational drug use. Methods:By a retrospective study, the medical record analysis for the inpatients with cancer from October to December in 2014 was performed, and the incidence of pain and the therapeutic medication were investiga-ted and the rationality of drug use was evaluated based on the latest cancer pain treatment guidelines. Results:The incidence of cancer pain was 25. 46% of 774 cases with new cancer, and 76. 58% of the patients with cancer pain were treated with analgesic drugs. In ac-cordance with the guidelines for the treatment scheme, there was no significant difference between the Opioid-Naive group ( guide group 1) and the Opioids-Tolerant group (guide group 2) in the combination therapy, while there was significant difference in the drug selec-tion and the time of administration. In the guide group 1 the proportion of oxywdone controlled-release tablets was signiticantly higher than that in the guide group 2, the ratio of taking the medicine on time in the guide group 1 was also higher than that in the guide group 2. Both groups showed difference from the guidelines in the pain assessment and titration and specific analgesic drug use. Conclusion:The findings indicate the difference between the pain treatment and the guidelines in therapeutic medication of cancer pain, and the propaganda and education of relevant knowledge should be strengthened to promote the treatment standard.

Objective To investigate the diagnosis and surgical management of Hashimoto's thyroiditis and coexisting disease. Methods The clinical data of 54 patients with Hashimoto's thyroiditis were analyzed retrospectively. Results 25 cases were diagnosed as Hashimoto's disease by clinical physical examination, FNAB and immune antibody assay. Diagnostic treatment with medicine was adopted firstly. Of them 24 cured, one was found coexisting thyroid cancer, and then a radical operation was performed. The other 29 cases had been misdiagnosed as surgical diseases because of atypical features and undergoing thyroidectomy; the diagnosis of Hashimoto's disease had been confirmed by pathology, and some coexistence had been found(hyperthyroidism in 3, thyroid carcinoma in 4, malignant lymphoma in 2, thyroid adenoma in 5). Conclusions Attention should be paid to the atypical Hashimoto's disease. FNAB, immune antibody assay, diagnostic treatment, operative exploration and biopsy would be helpful to make the sound diagnoses of Hashimoto thyroiditis and the disease in coexistence, which ought to be operated on corresopondingly.

Objective To realize information management in the clinical treatment process and provide efficient services for patient. Methods From the requirement of the First Clinical College of Harbin Medical University, construction of digital clinical system was thoroughly elaborated. The functions and characters of the system were summarized. The application effect of the system was expatiated. Results The application of the system realized the whole network management for medical care, charging and pharmacy, thus optimizing the medical treatment process. Conclusion The management level and work efficiency are enhanced.

Objective:Through reading a lot of literature on the critical path planning of FDA, analyzed the contribution and shortage of the critical path plan to China's medical device market access system.Methods: To analyze the critical path planning of FDA by using the method of literature review.Results: China should reference the critical path plan, reform the existing medical instrument market access system, improve the efficiency, simplify the procedure and promote the safety and development of the product.Conclusion: The research on the critical path planning of FDA is very important for the construction of China's modern medical device market access path.