Objective To study the effects of treating irritable bowel syndrome (IBS) with modified TongXieYaoFang. Methods 83 IBS patients were randomly recruited into a treatment group (45 patients) and a control group (38 patients). In the control group, Trimebutine, 200mg, and Bifid triple viable capsule, 420mg, 3 times/day was given orally to the patients, while on the basis of that, the treatment group was administrated with modified TongXieYaoFang in addition. Both groups were treated for one course of 4 weeks. Results The total effective rate of the treatment group and the control group was 93.3% and 71.1% respectively, showing significant difference between the two groups (X2=7.2938, P<0.01 ). Conclusion TongXieYaoFang combined with western medicine is effective in treating IBS.

Objective To explore the clinical characteristics of multiple primary carcinoma (MPC) in elderly patients and the effects of postoperative adjuvant chemotherapy on the prognosis and advanced cancer genesis. Methods The study population consisted of 220 elderly patients with malignant tumor. Thirty-seven elderly patients with MPC were selected in the study. The characteristics including onset age, carcinoma sites, effects of postoperative adjuvant chemotherapy, interval and survival time between first and advanced cancer were analyzed. Results of the 220 subjects,37(16.8%) patients were MPC, among whom 2 patients were synchronous multiple primary carcinomas (SMPC) and 35 patients were metachronous multiple primary carcinomas(MMPC). The median ages at onset were 70,77 and 77.5 years old for the first,second and third tumor respectively. Among a total of 82 tumor focus, the most predilection site of MPC was gastrointestinal tract, with a 34.2%(28 cases) in colorectum and a 13.4%(11 cases) in stomach. The postoperative patients were divided into two groups: 23 accepted adjuvant chemotherapy (chemotherapy group) and 14 accepted no adjuvant chemotherapy (no chemotherapy group). The survival time of chemotherapy group was significantly longer than no chemotherapy group (x2= 4.63, P = 0.0427 ). The median intervals between the first and the second cancer were 6 years and 4 years in chemotherapy group and no chemotherapy group, respectively(x2=1.63, P = 0.207), while the median intervals between the second and the third cancer were 7 years and 2 years, respectively(x2 = 4.255,P=0.043). The mediansurvival time of the third cancer postoperative patients were 3.5 years and 7 months in chemotherapy group and no chemotherapy group, respectively (x2 = 4.62, P = 0.0316 ) . ConclusionsPostoperative adjuvant chemotherapy may prolong the survival time and delay the advanced cancer genesis in elderly patients with MPC.

Objective To study the influence of the operation through tubular stomach plus mechanical anastomosis on the life quality of patients with esophageal cancer.Methods Seventy patients with esophageal cancer were treated by operation,tubular stomach plus mechanical anastomosis were used.They were followed up for six months.The quality of life was evaluated.Results The average time for the operation was 120 min and the average amount of bleeding was 291.3ml.Compared with before surgery,there was significant difference in emotion,activity,sleep and diet ( P ＜ 0.05 ).Conclusion The operation through tubular stomach plus mechanical anastomosis could significantly improve the quality of life of patients with esophageal cancer.

Objective:To analyze the effect of bisoprolol on the cardiopulmonary function in the patients with CHF complicated with COPD. Methods:A retrospective study was used. Totally 60 cases of patients were divided into the observation group(30 cases) and the control group(30 cases)according to the different treatment method. The patients in the control group were treated with con-ventional methods including cardiotonic drugs,vasodilators,anticoagulation,myocardial nutrition and so on,while the patients in the observation group were treated with bisoprolol additionally at the initial dose of 1. 25mg,and the dose was increased to 10mg at the rate of 1. 25 mg/1-2 weeks. The cardiopulmonary function,clinical efficacy and adverse reactions of the two groups were compared after 3-month treatment. Results:The complete response rate and effective rate of the observation group were both higher than those of the control group(P<0. 05). All indices of cardiac function were improved in the two groups after the treatment(P<0. 05),and the im-provement of the observation group was better than that of the control group(P<0. 05). There was no obvious change in the pulmonary function before and after the treatment(P>0. 05). The incidence of adverse reactions in the two groups showed no significant differ-ence(P>0. 05). Conclusion:Bisoprolol combined with conventional treatment can improve cardiac function of the patients with CHF and COPD. The adverse effect on lung function is mild. Bisoprolol is safe and effective,which is worthy of promoted application.

?AIM: To investigate the compliance in patients with topical glaucoma therapy, and identify the most frequent barriers to adherence.?METHODS: One-on-one interview and questionnaire were taken to investigate the compliance with hypotensive eye drops in 366 patients who had been diagnosed as glaucoma and received the therapy for at least 6mo in Wuhan and suburban district from July 2014 to June 2015 in Wuhan Aier Eye Hospital.?RESULTS: The proportion of compliance was 44. 3%( 162/366 ) . Factors significantly influencing compliance included severity of the better eye, the severity of symptom when attacked, duration of medication and whether to administrate on the same time daily ( OR=5. 700,0. 554,0. 336,0. 558,P<0. 05). Age, gender, marital status, education level, economic status, domicile, knowledge of the disease, suffering from other diseases with medication, type of glaucoma, type of eye drop, frequency were not associated with a higher rate of non-compliance.? CONCLUSION: Compliance in patients with topical glaucoma therapy in Wuhan is poor. Regularly carrying out relevant health education and interventions is very important.

Abstract?AIM: To assess the efficacy and adverse reactions of two concentrations of diluted botulism toxin A ( BTX-A) for blepharospasm.?METHODS:Totally 220 patients (440 eyes) confirmedas blepharospasm in our department ( from January 2013 to January 2015 ) , were divided randomly into two groups:110 in high concentration group and 110 in low concentration group.The two groups were given local injections with 25 U/mL or 40 U/mL concentration of botulism toxin type A to the upper and lower eyelids orbicular muscle, corrugator, reducing eyebrow muscle and procerus respectively.We observed dosage of two groups, the treatment effect, the duration of the effect and the incidence of adverse reactions.?RESULTS: The high concentration group was given the BTX-A with 48.33 ±4.02U, the low concentration group was given the BTX-A with 28.51 ±3.42U,the differences were statistically significant( P<0.05).The differences of post-operative evaluation of curative effect, onset time and duration of the effect between the groups were not statistically significant ( P >0.05 ). Sixteen cases had ptosis in different levels in the high concentration group, and 2 in the low concentration group, the differences were statistically significant ( P<0.01).There were no serious complications such as intoxication, drug allergy in both groups.Ptosis relieved after using naphcon-A and disappeared in 2-3 wk.?CONCLUSION: The efficacy of local injection with two concentrations of diluted botulinum toxin A for blepharospasm was positive. Considering the high incidence of ptosis in high concentration group, we recommended the 25U/mL botulism toxin A for blepharospasm.

Based on summarizing the importance of education environment and the development and current status ofresearch on medical education environment, the authors measured the status of, and the problems existing in, educationenvironment of China Medical University by DREEM (Dundee Ready Education Environment Measure), and then sug-gested strategies to modify the education environment and hence to improve the quality of medical education on thebasis of the advanced concepts of education environment design and construction in the world and the authors' experi-ence in the reform of medical curriculum.[

Toxoplasma gondii is a medically and agriculturally important protozoan parasite that can infect virtually all the mammalian and avian species. Previous studies showed that the family of rhoptry proteins (ROPs) plays a key role in the invasion process of T. gondii, and its several members can be potential marker for population genetic researches of Toxoplasma. In order to estimate whether other member is also suitable as the novel genetic marker, the variation of ROP41 gene among 11 T. gondii isolates from different hosts and geographical locations and two reference strains was examined in this study. Our results showed that all the examined sequence of TgROP41 gene was 1473 bp in length, and their A+T contents were between 48.47% and 48.88%. Sequence analysis presented 14 nucleotide mutation positions (0%-0.54%), leading to 5 amino acid substitutions (0%-0.61%) through alignment with T. gondii ME49 strain (ToxoDB: TGME49_266100). Furthermore, phylogenetic analyses by MP and BI methods based on deduced amino acid sequences of TgROP41 gene was only able to distinguish the type I strain, but not able to separate the two classical genotypes (Type II and III) into the respective clusters. These results indicated limited sequence diversity in the TgROP41 gene.

To improve the quality of health care by improving the quality of residency training,the Accreditation Council for Graduate Medical Education of USA has renewed the standards and methods of residency training to improve health care,and issued the compe- tence-based training standards. The residents have to achieve six key competences when they finish the training. The University of Washington,School of Medicine,responds to the new re- quirements and standards by reforming its residency training pathway,enriching formal teach- ing/training activities,and improving its supervision and the evaluation. We should use for refer- ence reforming the residency training in China.