Objective:To reflect the training of basic-level medical stuff by investigating the doctor-patient cognition status of patients in a county-level hospital.Methods:The questionnaire of 180 patients collected from a county hospital in Shaanxi province was analyzed by Rank sum test and Descriptive analysis with SPSS17.0.ReSults:There were no statistically significant differences in the evaluation of current doctor-patient relationship from patients of different ages,occupations and degrees of education (P ＞ 0.05).82.2％ of the patients believed that the doctor-patient relationship is harmonious or somewhat harmonious.Moreover although the patient's trust in doctors is not high,there is a certain sense of recognition;and they put forward some expectation and requirements on doctor's professional skills,communication skills and professionalism.Conclusion:Considering the patients' feedback,local medical colleges and universities should reflect medical education ideas,play an active synergy model in the training of students' professional skills.In the meantime,they should strengthen the medical internship management,while paying equal attention to enhance students' responsibility and professionalism to serve the grassroots.

Objective] To observe the clinical efficacy and 5-HT of Shugan Jianpi Tiaoshen acupuncture treatment for senile patients with constipation type of irritable bowel syndrome(IBS-C). [Method] A total of 68 patients with IBS-C were allocated into control group and acupuncture group from June 2015 to June 2014. 34 patients in the control group, who accepted Lactulose oral solution and Citrate Mosapride Citrate, of in 15 males and 19 females, the mean age was 66.8, the average duration of disease was 15.6 months;34 patients in acupuncture group, who accepted acupuncture treatment based on control group, in 17 males and 17 females, the mean age was 65.9, the average duration of disease was 17.1 months. Acupoint selection:Tianshu, Zusanli, Taichong, Xingjian, Qimen, Baihui, Neiguan. Observe constipation symptoms, depressive symptoms, and quality of life and serum 5-HT levels before and after treatment. [Result] The pre-treatment constipation symptoms and depressive symptom scores in two groups were decreased than post-treatment( P<0.05), which showed two methods can improve constipation and depressive symptoms of IBS-C patients. After treatment, constipation symptoms and depressive symptoms score in acupuncture group were lower than that in control group(P<0.05), which showed the effect of acupuncture was better. The eight dimensions of SF-36 were higher than those before treatment in total patients(P<0.05), which showed two methods can improve quality of life of patients; differences of physiological function, physiological function between acupuncture group and control group had no statistical significance( P>0.05), but body pain, vitality, emotional function, mental health, social function, and general health values were higher than that of the control group( P<0.05), which showed acupuncture treatment can reduce physical discomfort and improve the quality of life of patients. After treatment,serum 5-HT in control group was 33.8 pg/ml, in acupuncture group was 27.6 pg/m, which were lower than pre-treatment. 5-HT in acupuncture group was lower than control group( P<0.05), which showed the effect of acupuncture on regulation of 5-HT was more significant. [Conclusion]Shugan Jianpi Tiaoshen acupuncture can modulate 5-HT level of elderly patients with IBS-C, and play its role in modulating gastrointestinal function, improving constipation symptoms, depressive symptoms and quality of life.It is an effective method for the treatment of elderly patients with IBS-C.

OBJECTIVE:To establish an optimal method for microbial limit test for ciclopirox olamine vaginal suppository.METHODS:The microbial limit test for antibacterial agents was validated by plating method and membrane filtration method,and the optimal method for the test of bacteria and mold were confirmed based on the recovery rate of artificially sprayed bacteria.RESULTS:By plating method,the recovery rate of artificially sprayed E.coli was more than 70%,whereas that of mould was 0%;however,by membrane filtration method,the recovery rates of bacterial and mould were all higher than 70% when flushing doses of bacteria,mold,and control bacteria were 200 mL,300 mL,and 200 mL,respectively.CONCLUSIONS:The membrane filtration method could be used for the microbial limit test of the preparation the drug quality can be kept under effective control,and the established method is accurate and reliable.

Clinical thoughts based on symptoms, physical signs and examine outcomes is a process of analysis, judgement and conclusion of disease diagnosis. To cultivate an exact thinking model can avoid taking a part for the whole or a miss in disease analysis, so to cultivate clinical thoughts in clinical practice can elevate medical students'clinical skills.

Applying the principle of Evidence-Based Medicine to the clinical teaching,we have made the students raise the cognition level on the diagnose of diseases and treating policy and trained their clinical logic thinking ability.

OBJECTIVE: Comparison of operation of epitympanic/antrum cholesteatoma excised by endoscopy and microscope. METHOD: Eleven patients with epitympanic/antrum cholesteatoma were analysed, 5 cases were excised by endoscopy and 6 cases were excised under microscope. RESULT: No complication occurred after operation and all patients got dried ear. There were no difference in hearing recovery and closure of perforation of tympanic membrane between two group. The operation time, injury degree, length of stay in hospital and hospitalization expense with endoscopy was superior to that of microscope. CONCLUSION Considering financial constraints of patients, resection of epitympanic/antrum cholesteatoma cholesteatoma can be adopted by endoscopy.
Adolescent ; Adult ; Cholesteatoma, Middle Ear ; surgery ; Endoscopy ; Female ; Humans ; Male ; Microscopy ; Middle Aged ; Treatment Outcome ; Young Adult

BACKGROUND:Extracel ular vesicles (EVs) are a kind of subcel ular component produced by paracine mechanism including exosomes, microparticles and microvesicles, which have become hotspots in recent years. OBJECTIVE:To review the research status and progress of EVs, especial y in the studies about definition, secreting mechanism, isolation and identification, biological characteristics and functions in diseases as wel as in biomedical research. METHODS:The first author retrieved PubMed and CNKI databases for relative articles published from July 2006 to August 2016. The keywords were“extracel ular vesicles, exosome, microvesicle, microparticle”in English and Chinese, respectively.RESULTS AND CONCLUSION:A total of 44 eligible literatures are enrol ed. Almost al cel s can secrete EVs, which contain a variety of metrocyte-derived bioactive molecules, such as lipids, proteins, mRNAs, microRNA, lncRNA, cicrRNA, and non-coding RNA. These bioactive molecules are encapsulated in EVs or binding with the membrane. EVs are described to be involved in inflammation, immunity, signal transduction, cel survival and apoptosis, angiogenesis, thrombogenesis, and autophagy, which are of great significance to the maintenance of homeostasis and disease progression. Special EVs may be used as new biomarkers for the diagnosis and prognosis of many diseases and serve as novel tools in the fields of antitumor therapy, regenerative medicine, immunoregulation and vaccination and drug delivery. But the molecular mechanisms regulating the secretion of EVs and the specific pathways activated upon EVs interaction with the target cel are not ful y understood. Based on miRNA, lncRNA and circRNA are attracting researchers’ attention.

Objective To investigate the efficacy of dexmedetomidine in reduce of hyperalgesia in patien with remifentanil anesthesia.Methods 84 patients scheduled for laparoscopic hysterectomy from December 2014 to April 2016 were selected and randomly divided into two groups: the observation group and the control group,42 cases in each group,two groups were intravenous infusion of remifentanil,propofol and inhaled sevoflurane to maintain anesthesia.In the observation group,0.6μg/kg of dexmedetomidine was given 40minutes before the end of the operation(adding to 100mL 0.9％sodium chloride solution,infusion within 10minutes),the control group was given the same volume of 0.9％sodium chloride solution.The visual analogue scale(VAS)and the bruggrmann comfort scale(BCS)were used to evaluate the postoperative pain and comfort of the two groups of patients at different time points,and compare the incidence of adverse events between the two groups.Results The VAS scores of the two groups were significantly different at 1h(T1),4h(T2)and 24h(T3),and the VAS score of the observation group was significant better than that of the control group,the difference was statistically significant(P<0.05),the BCS scores of two group were compared at T1 and T2,the difference was statistically significant(P<0.05),but there was no significant difference between the two groups at T3.The incidence of adverse reactions in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine can relieve and prevent the incidence of hyperalgesia and adverse reactions in patients with remifentanil anesthesia,and improve the analgesic effect of postoperative patients.

The current situation is that the study of blood system diseases is difficult, and the students lack both the initiative and enthusiasm to learn. Clinical teachers' energy is limited because of other clini-cal, management and research roles, so the quality of teaching varies greatly. Meanwhile, teaching quality has nothing to do with personal reviews. Furthermore, the relationship between doctors and patients is in trouble in current medical environment. All of these above affect the quality of clinical practice in hematology department. Aiming at these problems, we improve the teaching quality significantly by raising the students' interests, enhancing their initiative, improving teachers' teaching level and enthusiasm, carrying out the in-ternship system, and strictly enforce the elimination system.

Objective To study the possible relationship between mitochondrial DNA(mtDNA)and hereditary ataxia(HA).Methods Polymerase chain reaction(PCR)was used to amplify 4 mtDNA segments of 30 patients with HA、some of their relatives and 35 volunteers.The point 3243、8993、8344 and point 11778 lied in the 4 mtDNA segments respectively.For the PCR products of point 3243 and 8993,restriction fragment length polymophism(RFLP)was performed to search for A3243G、T8993G or T8993C point mutations.For point 8344 and 11778 PCR products,single strand conformation polymorphism(SSCP)was executed to detect mutations.The HA patients’ results of SSCP were compared with their relatives and volunteers’.Sequencing would be carried out to find out exact mutations in those subjects whose SSCP results were abnormal.Results We had not found the A3243G、T8993G or T8993C point mutations in our study.All subjects’ mtDNA segments of point 8344 had not been found mutations.However,a new mtDNA point mutation-A11893G-was identified in 2 patients and 1 relative without symptoms from pedigree 1.Conclusion This new point mutation of mtDNA might be related to HA.