OBJECTIVE:To study the distribution of dosage form of drugs used for outpatients in a general hospital.METHODS:The general information of the outpatients in a general hospital,the total number of the varieties of the prescription drugs as well as the average number for each visit,the rate of using injection for every one hundred patients,and distribution of form of prescription drugs etc were analyzed statistically.RESULTS:Leading the first 5 places on the list of distribution of dosage forms of drugs used for outpatients were tablet,injection,capsule,granule and solution for oral use.Of the total varieties of prescription drugs,drugs taken orally,drugs for injection and drugs for external use stood at 81.07%,13.05%,and 5.88% respectively.CONCLUSION:The use of new variety of drugs such as specific tablets and capsules was little for outpatients in the general hospitals,which deserve to be widely used.

Objective To study the effects of light on body weight,learning and memory of mice.Methods Fifty mice aged 20 days were randomly assigned to one of the five groups: 200 W light group,100 W light group,60 W light group,40 W light group and normal control group,with 10 in each.They were exposed to different intensities of light 8 hours per day for 1 week.Then we monitored their body weight,examined the mean latency and inaccuracy number in step-down test,and examined the mean latency using a Morris' water maze to observe the effect of light pollution on the mice's learning and memory.Results Compared with the other four groups,there were significant decelerations of body weight increase in 200 W light group.No significant difference in body weight gain was found among the other four groups.The four light-treatment groups had no significant differences from control group in the mean latency,inaccuracy number in step-down test or the mean latency,or the mean crosses to the target in the Morris' water maze.Conclusion Short time high-intensity light can inhibit body weight increase in mice,but short-time light has no effect on the learning and memory of mice.

Objective To analyze the hot research spots of MOOC research of higher medical edu-cation in China. Methods We searched the database of China National Knowledge Infrastrucure (CNKI), VIP database of Chinese journal (VIP), Wanfang Database for published studies on MOOC research of higher medical education from 2005 to April 2015. The high frequency words were counted by an analysis program-Bibliographic Item Co-occurrence Matrix Builder (BICOMB). According to the ranking word frequency threshold formula by Donohue, we collected the high-frequency keywords. The corresponding co-word ma-trixes were constructed by Bibexcel, then the data was input into SPSS 19.0 software for hierarchical clus-tering analysis. Results Finally 2 459 articles were included. 11 177 keywords and 13 high frequency words (the number of the real selected was 24) were taken into account. The keywords “stanford” clus-tered with “education module”, “online education”, “online courses”, “distance education”, “learning pro-cess”, “self-regulated learning”, “information technology”, “classroom teaching”. The keywords “network course” clustered with “teaching design”. The keywords “online learning” clustered with itself. The key-words “challenge” clustered with “colleges and universities”. The keywords “flipped classroom” clustered with“micro-lecture”,“MOOC”,“higher education”, “library”, “teaching module”, “teaching reform”, “big data”,“open education”. The keywords“SPOC”clustered with itself. Conclusion The research of MOOC research of higher medical education in our country has formed the basic characteristics with six hot spots involving teaching design, the model of online learning, dispassion thinking, teaching reform, and develop-ment. And there are many potential areas.

Objective Breast intraductal papillary lesion ( BIPL) has a low incidence but a high rate of malignancy .This study discusses the diagnostic value of conventional ultrasonography ( US) combined with ultrasonic elastography ( UE) for breast papil-lary lesion. Methods We analyzed the preoperative ultrasound data of 48 patients with 63 BIPLs, and classified them according to the characteristics of two-dimensional ultrasound (2DUS) images.Then we compared their color Doppler ultrasound characteristics and UE features with the pathological results . Results Based on the 2DUS findings, the BIPLs were divided into 4 types.The sensitivi-ty, specificity, and accuracy of conventional US +UE in the diagnosis of BIPL were 93.2%, 88.9%, and 90.5%, respectively, markedly higher than those of conventional US (75.6%, 66.7%, and 73.0%), with statistically significant differences in the areas under the curve between the two methods (0.918 vs 0.838, P<0.05). Conclusion Conventional US combined with UE can im-prove the diagnosis of breast intraductal papillary lesion .

Objective To study the effects of restructuring tissue inhibitor of matrix metatloproteinase-3 (rhTIMP-3) in combination with cisplatin (DDP) on the growth and apoptosis of A549 lung cancer cell line.Methods We made individual and combined use of different concentrations of rhTIMP-3 and DDP on A549 cells.Methyl thiazoyl terazolium (MTT) colorimetry was used to analyze cell growth inhibition,and flow cytometry technique was used to determine the cell cycle distribution and apoptosis rate.Results rhTIMP-3 and DDP both could inhibit the proliferation of A549 cells.rhTIMP-3 exerted its effect in the time-and concentration-dependent manners while DDP did so in the concentration-dependent manner;both induced the apoptosis of A549 cells.rhTIMP-3 could make the cells stay in S and G2/M phases,and DDP made the cells stay in S phase.The combination of them obviously strengthened the inhibition of A549 cell growth,and had obvious synergy in inducing apoptosis.Conclusion Both rhTIMP-3 and DDP can inhibit the proliferation of A549 cells and induce their apoptosis.The combined use of them not only can increase the inhibition of cell growth but also has synergy in inducing cell apoptosis.

Objective To study the effect of anterolateral calf flap with extra-territorial blood supply in repairing large area of foot skin tissue injury. Methods 40 cases of arge area of foot skin tissue injury were divided into the observation group which were given anterolateral crural flap transplantation and the control group which were given anterolateral thigh flap transplantation. The wound healing condition and walking ability were observed. Results The level of wound healing, Holden walking ability and FAC walking ability were better than control group (P<0. 05). In the observation group, wound healing time was (15. 2 ± 6. 2) d and donor skin crusting time was (9. 4 ± 1. 5) d, which were less than the control group(P<0. 05). Conclusion Anterolateral calf flap with extra-territorial blood supply has positive clinical value as it can improve wound healing and walking function.

Objective To investigate the clinical features and the imaging examination changes of bacterial meningitis in children of different age groups,and to offer theoretical basis for the clinic diagnosis of bacterial meningi-tis. Methods The sick children with bacterial meningitis treated in Guangzhou Women and Children′s Medical Center from January 2011 to June 2013,were recruited and divided into three groups according to the age,including newborns group,infants group and more than 1 year group. Eighty-nine cases with purulent meningitis were recruited,included 58 males and 31 females. Among them,there were 34 cases in the newborns group,41 cases in the infants group and 14 ca-ses in the more than 1-year group. The information on the clinical features,laboratory examination and the imaging ex-amination were summarized and analyzed,and were compared among the 3 groups. Results (1)Among them,54 cases with high fever,44 cases with respiratory symptoms,12 cases with alimentary tract symptoms. (2)The major neurologi-cal features included convulsions(44 cases,49. 4%),fatigue(36 cases,40. 4%),vomiting(21 cases,23. 6%),cervical rigidity(9 cases,10. 1%),fontanel full(7 cases,7. 9%),headache(6 cases,6. 7%),limb paralysis(5 cases,5. 6%). The percentage of high fever,vomiting,headache,cervical rigidity in the more than 1 year group were significantly more than those of the newborns group and the infants group(χ2=10. 093,12. 063,34. 466,7. 177,all P<0. 05). (3)Among them,whitebloodcell(WBC)accountswerefrom2.20to60.60×109/L,themeanwas(16.49±10.37)×109/L.Hy-persensitive C-reaction protein concentration in blood was 4. 00 to 376. 53 g/L,the mean was (131. 07±86. 91) g/L. In cerebrospinal fluid(CSF),WBC accounts were from 1 to 21 800×106/L,the mean was (910. 05±274. 07)×106/L, the glucose concentration from 0. 00 to 4. 50 mmol/L,the mean (1. 72±1. 03)mmol/L,the protein concentration from 0. 42 to 4. 89 g/L,the mean was(1. 64±1. 03)g/L. In 40 cases with atypical CSF change, 23 cases with CSF glucose ratio(CSF glucose/blood glucose) less than or equal to 0. 4, and 15 cases with blood cultures positive. (4)The image examination showed magnetic resonance imaging( MRI) abnormalities in 51/75 cases,computerized tomography( CT) scan abnormalities in 15/30 cases. The percentage of convulsions,the brain MRI abnormalities and the MRI display rate of bacterial meningitis in the infants group were significantly more than those of the newborns group and the more than 1 year group(χ2=11. 768,9. 047,7. 674,all P<0. 05). The display rate of meningitis and subdural hydroma by the brain MRI were significantly more than those of the head CT scan(χ2=7. 430,5. 291,all P<0. 05). Conclusions Be-cause of the atypical clinical features of bacterial meningitis in newborn and infant, lumber puncture should be per-formed in all doubtful cases who had a fever and/or seizure. CSF glucose less than or equal to 0. 4 of simultaneously ob-tained blood glucose value,the enhanced MRI sequence or blood cultures were useful for the likelihood of meningitis,if CSF chemistries and cytology vary atypically. The MRI sequence can significantly mostly improve the display rate of bacterial meningitis than the enhance CT.

Objective To investigate the effects of PM2.5 exposure on the quality of IVF eggs and the quality of embryos. Methods 40 healthy female Kunming mice and 10 male mice were used in this study. 40 female mice were randomly divided into 4 groups:low dose of PM2.5 group (1.5 mg/kg),middle dose of PM2.5 group (7.5 mg/kg),high dose of PM2.5 group (15 mg/kg) and the control group (to give the same volume of saline),with 10 mice in each group. PM2.5 was administered via tracheal instillation. The number of oocytes ,fertilization rate ,abnormal fertilization rate ,2PN cleavage rate ,2PN blastocyst rate and blastocyst formation rate were determined ,as well as levels of TNF-α and IFN-γ. Results The number of oocytes , fertilization rate and cleavage rate of 2PN were significantly higher in PM2.5 high dose of PM2.5 group than those in PM2.5 group. The rate of high quality embryos and blastocyviast formation were decreased ,but abnormal fertilization rate were decreased (P < 0.05). The expressions of TNF-α and IFN-γ in the high-dose of PM2.5 group were significantly higher than those in the middle-dose of PM2.5 group and in the low-dose of PM2.5 group(P < 0.05),while the expressions of TNF-α and IFN-γ in the middle dose group was significantly higher than those in the low dose group(P<0.05). Conclusions PM2.5 exposure can decrease the number of oocytes , fertilization rate ,2PN cleavage rate ,2PN blastocyst rate and blastocyst formation rate of in vitro fertilization in mice.

Objective: To investigate the operating key steps and the initial experience of IUPU (Institute of Urology, Peking University) modified extraperitoneal laparoscopic VIP (Vattikuti institute prostatectomy) technique and the initial follow-up outcomes. Methods: 46 patients of prostate cancer underwent the modified extraperitoneal laparoscopic VIP and were reviewed from November 2017 to September 2018. Patients aged 54 to 77 years, with mean age of 65.5 years old. Their preoperative PSA was 0.15 to 69.76 ng/ml with an average of 13.4 ng/ml. All patients were diagnosed by prostate biopsy and Gleason score was 6 to 10 with an average of 7.5. MRI was used to assess their clinical stage before operation. All the modified laparoscopic VIP were done through the extraperitoneal approach by a single surgeon and the follow-up by telephone for the PSA level and continence recovery (urine pad test). The major differences between modified laparoscopic VIP and the routine steps of radical prostatectomy are as follows: use of extraperitoneal approach and traditional laparoscopic operation; after the setup of the extraperitoneal cavity, the bladder neck is separated, isolated and cut down first; the management of DVC: Cut down the super-facial and deep layers of DVC just along the capsule of the prostate apex and it’s unnecessary to suture it. Perioperative data of these patients were collected retrospectively, including operation time, intraoperative blood loss, length of hospital stay, postoperative pathology, and continence outcome after surgery. Result: All 46 patients underwent the IUPU modified extraperitoneal laparoscopic VIP successfully without converting to open surgery. The operation time was 69-143 min with an average of 95.7 min and the estimated blood loss was 20-200 ml with an average of 81.5 ml. It was 3-17 days for the average time to remove the retropubic drainage tube postoperatively, with an average of 4.3 days. The postoperative hospital stay was 3-17 days with an average of 5.3 days. The Foley catheter was removed 14 days postoperatively. Five patients suffered from urine leakage and were managed successfully with conservative treatment. For the postoperative pathological stage, 1 patient was pT_2a, 12 patients were pT_2c, 12 patients were pT_3a and 21 patients were pT_3b. The postoperative Gleason score was 6-9 with an average of 7.7. The postoperative follow-up time was 1-11 months with an average of 6.3 months. The PSA was 0.001-0.966 ng/ml with an average of 0.181 ng/ml 1 month postoperatively and the continence rate was 54%(25/46) and 89%(34/38) 1 month and 3 months after operation respectively. Conclusions The IUPU modified extraperitoneal laparoscopic VIP might be a safe and feasible for the radical prostatectomy. It’s simplified for the operative steps, unnecessary to isolate and suture DVC and doesn’t increase the blood loss. It’s almost left intact for the surrounding tissues of the prostate apex and satisfactory for the early urinary continence. The oncological outcomes are needed to followup further.

OBJECTIVETo compare the efficacy of laparoscopic versus open tension-free mesh repair using biologic mesh for inguinal strangulated hernia.

METHODSClinical data of 27 patients with inguinal strangulated hernia in the Shanxi Provincial People's Hospital between January 2012 and April 2014 were analyzed retrospectively. All the patients underwent one-stage tension-free repair using biological mesh, including laparoscopic(n=13) and open procedures(n=14).

RESULTSAs compared with the open group, the laparoscopic group had shorter operative time [(90.8±11.6) min vs. (130.8±32.5) min, P<0.01], lower rates of hematoma/seroma and wound infection[(7.7% vs. 42.9%) and (0 vs. 28.6%) respectively, both P<0.05], faster recovery of bowel function [(2.5±0.3) d vs. (3.8±1.4) d, P<0.01], and shorter hospital stay [(6.3±1.8) d vs. (9.8±3.2) d, P<0.01]. The mean follow-up was 5.7 months (ranged from 2 to 12 months), and no recurrence or serious complications occurred.

CONCLUSIONLaparoscopic tension-free hernia repair using biological mesh for inguinal strangulated hernia has significant advantage versus open operation.