Objective To observe the difference in therapeutic efficacy between acupuncture with distant acupoints selection and proximal acupoints selection in treating acute headache.Method Sixty patients with acute headache were randomized into group A and group B, 30 cases in each group. Group A was intervened by acupuncture with distant acupoints selection, while group B was by acupoints with topical acupoints selection. The Visual Analogue Scale (VAS) and Present Pain Intensity (PPI) from McGill Pain Questionnaire (MPQ) were observed before and after intervention, and the clinical efficacies were compared between the two groups. Result After treatment, the VAS and PPI scores were significantly different from that before treatment in both groups (P<0.01). The changes of VAS and PPI scores in group A after intervention were significantly different from that in group B (P<0.01). The total effective rate was 90.0% in group A versus 73.3% in group B, and the difference was statistically significant (P<0.01). Conclusion Acupuncture with distant acupoints selection can produce a better therapeutic efficacy than acupuncture with topical acupoints selection.

Objective Improve the efficiency of radiology doctors on reading bone age films by sharing Tanner-Whitehouse(TW2)bone algorithm on the network. Methods The bone age algorithm web was Programmed with a Java script implementation of Tanner-Whitehouse Method and putted on a Web server based on HTTP service. The program allows to select a stage (from a set of 8 stages) for every bone (from a set of 20 bones), and also allows doctors to input some specific data such as birthday, sex. Based on TW2 reported values, selected and input data, the program computes the bone age. We assessed the bone ages on 50 left hand and wrist X-ray films of Chinese children aged 2-18 (1000 bones totally) with computer-aided method and manual method. The grading agreement of bone development and the time spent for bone age assessment were compared (U test) between the two methods. Results Computer-aided method is easy to use, better than manual method in accuracy of bone development grading, and it also has a friendly interface. For the 1000 bones assessed by TW2, the rate of the same maturity classification was 83.8%(838/1000), the rate of one-level maturity difference (+ 1 and - 1) was 14. 9% (149/1000), the rate of two-level maturity difference (+2 and -2) was 1.3% (13/1000). For the 1000 bones assessed by manual method, the rate of the same maturity classification was 65.7% (657/1000), the rate of one-level maturity difference (+ 1 and -1) was 27. 2% (272/1000), the rate of two-level maturity difference (+ 2 and -2) was 7.1% (71/1000). TW2 bone algorithm was significantly better than manual method (U =9.31595 ,P <0.01). The average time of assessing bone age by the two methods was 3-5 min and 15-20 min, and the TW2 method saved time for radiologists doctor. Conclusion Sharing TW2 bone age algorithm through the network can be quick and easy.

Objective:To analyze one case of drug-induced liver injury to provide reference for clinical pharmacists participating in the clinical practice. Methods: Through the participation in the diagnosis and therapy of one patient with drug-induced liver injury, clinical pharmacists found the correlation between the suspected drugs and the disease, which provided basis for the clinical diagnosis and therapy. Results:Clinical pharmacists actively assisted physicians by providing reasonable defining characteristics and drug therapy scheme for the patient free from drug interactions and adverse reactions. The function of the patient recovered after the treatment. Con-clusion:Clinical pharmacists participating in clinical practice can make use of pharmacy knowledge to search causes of diseases and optimize therapeutic scheme.

Objective To explore the association between mild cognitive impairment (MCI) and hypersensitive C reactive protein (hs-CRP),interleukin-1β (IL-1β) and interleukin-6 (IL-6) among Uygurs and Hans in Xinjiang region,China.Methods From July 2008 to October 2010,the epidemiological investigation was performed in Southern,Eastern and Northern of Xinjiang.Based on the diagnostic standard of United States psychiatric society of spirit obstacles diagnosis and statistics manual Ⅳ amendment version in the mild cognitive function,483 MCI patients were diagnosed.Finally,314 MCI patients were selected from above according to the completion of data.Moreover,299 subjects were randomly selected as the control group from the investigation.General information and fasting plasma were collected,and blood glucose,blood lipid and biochemical indexes,serum hs-CRP,IL-1β,IL-6 of concentration were tested.The association between MCI and hs-CRP,IL-1β and IL-6 were analyzed with SPSS 17.0 software.Results (1) The concentrations of serum hs-CRP,IL-1β and IL-6 in MCI group (3.40 (6.53) mg/L,0.09 (0.09) ng/L,136.08(96.77) pg/L) were significantly higher than that in control group (2.99 (3.91) mg/L,0.07(0.06) ng/L,79.32(68.79) pg/L) respectively (Z =-2.525,-2.946,-9.361,all P ＜0.05).(2)The concentrations of serum hs-CRP,IL-1β,IL-6 in Han MCI patients were significantly higher than that in Han non-MCI subject; The concentrations of serum IL-1β,IL-6 in Uygur MCI patients were significantly higher than that in Uygur non-MCI subjects; However,the hs-CRP concentration between MCI and non-MCI group is not statistically different among Uygurs.(3)Non-conditional Logistic regression analysis showed that serum IL-1β(OR =1.008,95％ CI0.897-1.071,P =0.006),hs-CRP (OR =1.096,95％ CI1.056-1.137,P =0.000),IL-6 (OR =1.011,95％ CI1.008-1.014,P =0.000) were associated with MCI.Conclusion The hs-CRP,IL-1β and IL-6 were independent risk factors for MCI.

Objective: To investigate the relationship between blood pressure, blood glucose or blood lipids and patients with cerebral infarction (CI) or intracerebral hemorrhage (ICH) in diff erent age or gender. Methods: hT e case-control study consecutively recruited patients with if rst-ever-in-a-lifetime CI (n=358) and ICH (n=230) and community-acquired pneumonia (n=165) as controls between January 2010 and December 2013 at the Second Xiangya Hospital of Central South University. hT epatients with CI or ICH were divided into the young group, the middle-aged group and the older group, and the risk factors were compared between the 3 groups. hTe patients with CI or ICH were respectively further divided into the male group and the female group. hTe blood pressure, glucose and lipids were measured. Results: Data from logistic regression models showed that CI was closely associated with high blood pressure, hypertension, diabetes mellitus (DM) or fasting plasma glucose (FPG) (P<0.05), and ICH was closely related to high blood pressure, hypertension, low density lipoprotein-cholesterol (LDL-C), FPG, serum creatinine (SCr) or alcohol drinking (P<0.05); hypertension was the main risk factor for stroke. hTe odds ratios for the young, the middle-aged and older group were 10.43, 4.74 and 7.39 respectively (P<0.05). Systolic blood pressure (OR=28.74) was the important risk factor for the young stroke, and the OR is 2.81 for the middle-aged stroke. Diastolic blood pressure (OR=2.96) and DM (OR=6.25) were the risk factor for the middle-aged stroke. LDL-C (OR=2.87) was a risk factor for the older stroke; the mean levels of diastolic blood pressure in males were signiifcantly increased compared with that in females with CI, while the mean levels of TC, HDL-C or LDL-C in females were signiifcantly higher than that in males with ICH (P<0.05). Conclusion: Hypertension, systolic blood pressure in particular, is the most common risk factor for young stroke patients. DM and hypertension are the risk factors for the middle-aged patients, while hypertension, DM, LDL-C and alcohol consuming are the risk factors for the aged patients.

Objective:To analyze that if the quality of ethics review is closely related to the protection of human subjects' right and interest. Methods:This article has analyzed all the issues raised by local Ethics Committee in the process of review in recent two years since guideline of ethical review of drug clinical trials was published, summed up the most common problems occurred in protocols and informed consents. Results:Total 94 new drug or medical device clinical trial projects were reviewed by the local ethics committee, among which 29 projects were ap-proved through regular full board meeting, the approval rate in the initial review was 31%. The most common prob-lems in protocols include: the research backgrounds, design, and risk-benefit ratio; Main issues raised on in-formed consent focused on the contents, language and signature terms. Conclusions:The protection of subjects needs more improvement of capability of investigator, sponsor, drug clinical trial institution and the ethics commit-tee.

Objective To explore the effect of continuous nursing based on WeChat public platform on the patients with high risk of pressure ulcers. Methods Selecting 165 pairs of high-risk patients and their caregivers from the emergency department of pressure ulcers in the General Hospital of Chinese People′s Armed Police Forces, and they were divided into control group and experimental group by paired random method. There were 83 pairs in control group, and 82 pairs in experimental group. The control group gave oral education according to the traditional model, and adopted the way of telephone follow-up for continuous nursing. While the experimental group let patients and their family members follow the Wechat public account that specially developed on Wechat platform and get continuous nursing in new models to come true networking health education and communicate with patients and their family members by multi-dimensional nurse. After 3 months intervening, compared patients′quality of life, the care behavior of caregivers and acquisition of knowledge of pressure scores, the incidence of pressure ulcers, degree of satisfaction of high-risk patients and caregivers between the two groups. Results The psychological function score, social function score and quality of life score was respectively ( 67.61 ± 1.67), (58.60 ± 1.52), (50.41 ± 2.70) points in experimental group, and (63.21 ± 1.30), (53.23 ± 1.92), (45.83 ± 2.59) points in control group, the comparative difference of the two groups was statistically significant( t=-4.638,-4.930,-2.749, P<0.05). There was no significant difference in the material life and body function score between two groups(P>0.05). The care behavior of caregivers score and pressure sores knowledge score was respectively (50.84 ± 1.92), (27.83 ± 1.48) points in experimental group, and (46.43 ± 2.40), (19.28 ± 1.31) points in control group, the comparative difference of the two groups was statistically significant (t=-3.192,-9.738, P<0.05 or 0.01). The incidence of pressure ulcers was 15.9%(13/82) in experimental group, significantly lower than that in control group (50.6%, 42/83), two groups was statistically significant (χ2=22.413, P<0.01). The satisfying degree and scores of patients or caregivers for follow-up form, nursing service attitude, follow-up content and the total score was respectively (24.83 ± 3.11), (24.10 ± 2.55), (25.03 ± 2.12), (76.23 ± 2.17) points in experimental group, and (18.34 ± 1.41), (17.41 ± 1.34), (19.85 ± 1.92), (63.25 ± 3.03) points in control group, the comparative difference between two groups had statistical significance (t=-7.797--4.061, all P<0.01). Conclusions Utilizing Wechat public platform continuity of care for patients at high risk of pressure ulcers can improve the patients quality of life, reduce the incidence of pressure ulcers, improve the efficient communication of nurses and patients, and enhance the degree of satisfaction of the patients. This method is convenient, shortcut, economic, practical and worthy for clinical use and promotion .

Objective To compare the accuracy of stroke volume variation (SVV),central venous pressure (CVP) and puhnonary arterial wedge pressure (PAWP) in monitoring the changes in blood volume in the patients undergoing renal transplantation.Methods Sixteen patients with chronic renal failure,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,aged 18-55 yr,scheduled for elective allograft renal transplantation under general anesthesia,were enrolled in the study.SVV was continuously monitored with the FloTrac/Vigileo monitor,and CVP,PAWP and stroke volume index (SVI) were continuously monitored with the volumetric pulmonary artery catheter during surgery.The parameters of hemodynamics were recorded at 30 min after induction of anesthesia,5 min before renal artery opening,5 and 30 min after renal artery opening,and at the end of surgery.Hydroxyethyl starch 130/0.4 electrolyte solution 6 ml/kg was infused over 15 min via the central venous catheter to perform fluid responsiveness starting from 30 min after induction of anesthesia.Positive fluid responsiveness was defined as the change in SVI ≥ 15％.The relationship between SVV and CVP and between SVV and PAWP was analyzed using the Pearson correlation analysis.The receiver operating characteristic curve for CVP,SVV and PAWP in monitoring the changes in blood volume was drawn,and the area under the curve was calculated.Results Compared with the value at 5 min before renal artery opening,SVV was significantly increased after renal artery opening (P＜0.05),and no significant change was found in CVP and PAWP after renal artery opening (P＞0.05).SVV was negatively correlated with CVP,and r=-0.82 (P＜0.01);SVV was negatively correlated with PAWP,and r=-0.77 (P＜0.01).The area under the curve of SVV in monitoring the changes in blood volume was 0.87,and of CVP and PAWP was 0.69 and 0.66,respectively.Conclusion SVV provides better accuracy than CVP and PAWP in monitoring the changes in blood volume in the patients undergoing renal transplantation.

OBJECTIVE:To systematically review the difference of phlebitis induced by Alprostadil injection with different ad-ministration routes,and to provide evidence-based reference for clinical rational use. METHODS:Retrieved from PubMed,EM-Base,Cochrane Library,CBM,CJFD,VIP and Wanfang database,RCTs about phlebitis induced by Alprostadil injection with dif-ferent administration routes were collected. Meta-analysis was conducted by Rev Man 5.2 statistical software after literature screen-ing,data extraction and quality evaluation according to Cochrane System Evaluator's Manual 5.1.0. RESULTS:A total of 20 RCTs were included,involving 2562 patients. The results of Meta-analysis showed that the incidence of phlebitis induced by intravenous injection was significantly higher than that induced by intravenous dripping [OR=4.11,95%CI(1.59,10.67),P=0.004] and intrave-nous pump [OR=3.50,95%CI(1.50,8.16),P=0.004]. The incidence of phlebitis induced by general apparatus infusion was signifi-cantly higher than that induced by fine filtering infusion [OR=0.03,95%CI(0.01,0.08),P<0.001],with statistical significance. CONCLUSIONS:The incidence of phlebitis induced by low-concentration of Alprostadil injection or fine filtering infusion is low-er,and that of intravenous injection is higher.

Objective To explore the ideal living states and expectations of the elderly residing in Chengdu city,Sichuan Province and the most favorite pension system they want.To provide a theoretical basis for our country to build a suitable pension system and improve the quality of life and happiness of the elderly.Methods Qualitative-quantitative combined methods and convenient sampling were used in this study.The qualitative data with semi-structured in-depth interviews had been obtained from the selected 40 elderly who live in Chengdu,while the quantitative data with the questionnaires were obtained from other 130 elderly.Results Family location,gender,educational background,age had impact on the expected pension system of the elderly(P＜0.05).Conclusion Different elderly have different expectation on the pension system,the current pension system should be reformed according to their expectations.