TCM service trades grew rapidly and enjoyed optimistic future during the 12th five-year period, which was in good development trend. However, it is still in its primary stage of development and facing various challenges. This article argued that the development of TCM service trades will meet great opportunities, such as governmental policy encouragement, cooperation with other industries, the increasing acceptance of international market and the acceleration of internationalization of TCM. Meanwhile, there are also some difficulties - small industry scale and weak brand management, absence of legislation, lack of qualified professionals and various service trade barriers.

The traditional ways of doctor -patient communication , are limited by the communication time and scope , both of them have been unable to meet the patients'communication needs .With the continuous development of network , social media extends the application scope in the field of healthcare .The application of social media in doctor-patient communication has some applicability and feasibility .This paper analyzes the limitations of tradi-tional doctor-patient communication , tries to apply the experience of social media in the field of healthcare , and puts forward some new application strategies:push information initiatively and enhance the doctor -patient interac-tion;carry out pre-hospital and aftercare communication to extend communication scope; collect feedbacks from patients and handle patients'complaints.

Objective To measure the size and area of the vestibule of normal inner ear to provide basic data for further study of the vestibule-related diseases.Methods Two hundred forty patients (480 ears) who underwent temporal bone 64 slices CT scans were enrolled in this study from April 2011 to July 2012.These patients were divided into 4 groups,including Child group (＜ 18 years),Youth group (18-44 years),Adult group (45-59 years),and Elder group (≥ 60 years).The size and area of the vestibules were measured on the multiplanar reformatted images in post-processing workstation.Results There were no statistically significant differences in the size and area of vestibules in sides,genders and among the different groups (P ＞ 0.05),while there were statistically significant differences of those in different positions (P ＜ 0.05).Conclusion The measurements in different planes were as follow:1) In axial plane,the length of vestibule and its 95％ confidence interval were (5.89 ± 0.34),5.22-6.56 mm,respectively; the width (2.47 ± 0.36),1.76-3.18 mm; the area(13.97 ± 1.71) 10.62-17.32 mm2 2) in coronal plane,the length of vestibule and its 95％ confidence interval were (5.10 ± 0.32),4.47-5.73 mm,respectively; the width (2.42 ± 0.21),2.01-2.83 mm; the area (11.30 ± 1.33),8.69-13.91 mm2 ;3)in sagittal plane,the length of vestibule and its 95 ％ confidence interval were(5.27 ± 0.33),(4..62-5.92) mm,respectively; the width (3.72 ± O.35),(3.03--4.41) mm; the area (13.77 ± 1.55),(10.73-16.81)mm2.The volume CT combined with post-processing technology can accurately measure the size and area of the vestibules.The data can provide quantitative basis for diagnosis of the vestibule-related diseases.

Objective To evaluate the management of acute diarrhea in adult and to assess physician's adherence to guidelines recommended by Manatsathit working group.Methods A multicenter cross-sectional survey was carried out in 10 hospitals in Shaanxi Province with assignment of 40 patients each hospital.The difference of enumeration data between groups was analyzed using chi square test.Quantitative data were compared using t test.Results Data were collected from 400 patients.60.5％ (242/400) were female and mean age was (38.4 ± 17.5) years.In Manatsathit guideline,stool examination and stool culture for bacteria are recommended in patients with watery diarrhea with dehydration and in patients with bloody diarrhea.In this survey,of the 64 patients with dehydration,only 38 (59.4％) and 13 (23.3％) patients had done stool routine test and vibriocholera culture,respectively.Compared to Manatsathit guideline,the differences were obvious (x2 32.627 and 84.779,respectively; both P＜0.01).Of the 30 patients with bloody diarrhea,25 (83.3％) cases had stool examination done,which was roughly in line with Manatsathit guideline (x2 =3.491,P=0.062).However,stool culture for bacteria was performed only in 3 (10％) patients,which was significantly different with the guideline (x2 =49.091,P＜ 0.001).Overall,30 (7.5 ％) cases were diagnosed with acute bacillary dysentery clinically,and the remaining 370 (92.5％) were diagnosed with acute infectious diarrhea.Of the 370 patients with watery diarrhea,only 189 (51.1％) patients were prescribed with rehydration therapy,which was different with the recommendation of Manatsathit guideline (x2 =239.600,P＜0.01).Of the 216 patients who received rehydration therapy,144 (66.7％) cases should be prescribed with oral rehydration salts (ORS) and 72 cases should be prescribed with intravenous fluid replacement according to Manatsathit guideline.However,only 31 (14.4％) were prescribed ORS and up to185 (85.6％) patients received intravenous fluid replacement instead (bothx2 =122.700; both P＜0.01).On the basis of the guidelines,only 76 (19.0％) patients were eligible to use antibiotics.However,up to 258 (64.5％) patients were treated with antibiotics,which was absolutely against the recommendation of Manatsathit guideline (x2 =170.300,P＜0.01).Conclusions There are deep gaps between the clinical practice of treatment for acute diarrhea in adults in various levels of hospitals in Shaanxi Province and the recommendation of Manatsathit guideline.It is imperative to make domestic guidelines for adult acute diarrhea and to widely train physicians with algorithm for the management of adult acute diarrhea.

The introduction of anti-vascular endothelial growth factor (VEGF) therapy represents a landmark in the management of wet age-related macular degeneration (AMD).However,as a new therapy,several problems such as durability of the therapeutic effects,medication side effects,and medication selection have emerged.We should make appoint of improving the therapeutic effect and safety by realizing the limitation of the therapy,monitoring the clinical potential adverse reactions of anti-VEGF agents,and recommending individualized treatment.

Hemorrhage ; pathology ; Humans ; Thrombocytopenia ; pathology

Hematopoietic Stem Cell Transplantation ; Humans ; Multiple Myeloma ; pathology ; therapy ; Neoplasm Staging ; Transplantation, Autologous

Objective To observe the effect of Changtong Oral Liquid (CTOL) on serum TNF-? and IL-4 levels in rats with postoperative intestinal adhesion. Methods Sprague-Dawley (SD) male rats were randomly divided into six groups: normal control, no treatment control, Simo Oral Liquid (SOL) group, and CTOL group (minimal, medium and maximal dosages). Except for normal control group, intestinal adhesions were produced in all the other rats with the method of Ellis. The blood samples of rats with CTOL medium dosage and no treatment group were collected on the 1st, 3rd, 5th, 7th and 9th day, and that of the rest was drawn on day 7 after surgery for the determination of TNF-? and IL-4 levels. Results The serum TNF-? levels were higher in no treatment rats compared with the normal controls (P0.05). Conclusions TNF-? was closely related to adhesion formation, and it may be regarded as a marker of adhesion formation.

Objective To analyze the epidemiological characteristics and disease control of epi-demic cerebrospinal meningitis (meningitis) in Xi′an in order to optimize the measurement for disease con-trol and prevention .Methods The reported cases , pathogen surveillance data and immunization coverage for meningitis were analyzed to evaluate the epidemic status , the number of healthy carriers and the disease control efficacy.Results The incidence of meningitis was 22.51/100 000 from 1951 to 1984 in Xi′an. Since the implementation of Expanded Immunity Program in 1984 , the incidence dropped significantly from the average incidence of 4.87/100 000 in 1980′s to 0.59/100 000 in 1990′s.The average incidence of men-ingitis was 0.095/100 000 from 2001 to 2011 and then showed a dramatic downtrend with no cases reported during 2012 to 2013 .Conclusion The analysis suggested that an expanded coverage of vaccine immuniza -tion and an enhanced disease surveillance system for meningitis should be used as the comprehensive meas -urements for the prevention and control of disease .

Among all the road traffic injuries(RTI ),limb and spine fractures have a very high inci-dence.They can be caused by a variety of traumatogenic mechanisms,of whi ch crash is the most common.The distribution of types of fracture in RTI assumes a centrifugation-like p attern.Multiple fractures,homola teral limb injuries and violence-conducted in juries are common.The priority in RTI emergency is to treat serious concu rrent injuries and life-threatening comp lications.Only after the overall condition of the victim get stabilized can open injuries and fractures be treated ac tively.To treat victims of fracture s caused by RTI,especially those with a poor overall condition or an old age,appl ication of external fixation,espec ially a unilateral one,is a good consider-ation.And application of lockable i ntramedullary nailing to treat long tubular bone fractures has proved ve ry satisfactory.As for pelvis fractur es caused by RTI,external fixation c an be used initially while massive hemor-rhage resulted from the injury shoul d be treated vigorously.Internal fixation should be adopted as soon as th e vital signs get stabilized.To treat spine and spinal cord injuries,titanium a lloy is the first choice for fixation material.In most cases,anterior cervical fix ation and fusion with steel plate and screw is advisable for treatment of f ractures of cervical spine,while posterior i mmobilization with screw through pedicle of vertebra is usually suggested for treatment of fracture-dislocation of thoracolumbar vertebrae.