There was the theory that all the disorders of the ve zang-organs can cause cough originated from Inner Canon of Huangdi.Many famous experts in ancient times developed the theory,which is important in guiding the clinical practice.Professor LIAN always treats cough,especially chronic cough from regulating qi activity of five zang-organs.For example,Xiaoyao powder for cough due to liver disorder,Fumai decoction for cough due to heart disorder,and so on.The curative e ect is remarkable because the treatment is based on origin of disease.This article adopts and analyze some proved cases of ve zang-organs,which is helpful in inheriting and developing ancient theory.

Objective To construct the evaluation index system of medical education for clinical departments in grade-three hospitals.Methods Questionnaire were answered by the clinical experts,medical education directors and VP for education in the grade-three hospitals.According to the principle of Delphi method,the survey included the basic situation of experts,the relative importance of each index and the degree of expert authority.SPSS 16.0 was used to analyze the data.Results The questionnaire recovery rate was 90％,with authority of the average value 0.88,and coordination coefficient 0.348.The coordination coefficient was tested by chi square test,P=0.000.Five first level indexes by the authoritative coefficient after correction (residency training,postgraduate education,academic education,continuing medical education,teaching for refresher doctors) of the weighted value (％) were 22、22、22、19 and 15 respectively.Conclusion The experts in this study represent strong and high enthusiasm and authority.After practical application,the index system is supposed to have practical application value.

Objective To explore the clinical effect of microendoscopic discectomy through posterior approach in old patients with multilevel lumber spinal stenosis and analyze the influence factors that related to clinical effect .Methods 64 old patients with multilevel lumber spinal stenosis were selected and divided into microendoscopic group and open group based on different operation method ,each group contained 32 patients .Comparison was made between two groups in respects of operation time ,amount of bleed-ing ,hospital time post-operation and Nakai scores .Analyzed the influence factors that related to clinical effect .Results The opera-tion time ,amount of bleeding ,hospital time post-operation in microendoscopic group were lower than open group ,the differences had statistical significance .Based on the Nakei score ,the curative effect in microendoscopic group was slightly lower than open group ,but the differences had no statistical significance .The JOA score pre-operation ,walking distances and complication were rela-tive factors that could influence the clinical effect of microendoscopic discectomy through posterior approach method .Conclusion Microendoscopic discectomy through posterior approach in old patients with multilevel lumber spinal stenosis had quicker postoper-ative recovery than conventional operation ,and the JOA score pre-operation ,walking distances and complication were relative fac-tors that could influence the clinical effect of microendoscopic discectomy through posterior approach method .

Objective: To test the reliability and validity of a questionnaire on knowledge, beliefs and intentions about AIDS/safe sex for university students. Methods: Based on the data investigated with this questionnaire from 598 university students and the test-retest data from 63 university students, the internal consistency, test-retest reliability and construct validity were calculated. Results: This questionnaire had good reliability, with most parts having Cronbach ? coefficients large than 0.7 and retest coefficients large than 0.6. The factor structure was consistent with the theoretical hypothesis and the factors could explain 58.85% of the whole questionnaire.Conclusion:This questionnaire can be applied among university students to assess AIDS/safer sex related knowledge, beliefs and behavioral intentions.

Objective:To evaluate the potential value of indocyanine green combined with methylene blue and methylene blue alone in the detection of sentinel lymph nodes (SLN) in breast cancer.Methods:The clinical data of 118 patients with early breast cancer from November 2016 to October 2018 in Dalian Central Hospital Affiliated to Dalian Medical University were retrospectively analyzed. Among them, 62 patients underwent SLN biopsy under methylene blue (methylene blue group, 160 SLN), and 56 patients underwent SLN biopsy under indocyanine green combined with methylene blue (combined group, 190 SLN). After SLN biopsy, patients underwent grade Ⅰ and Ⅱ axillary lymph node dissection.Results:There was no significant difference in the positive lymph node rate and accuracy rate between 2 groups ( P>0.05); the SLN dyeing rate and SLN biopsy positive rate in combined group were significantly higher than those in methylene blue group: 97.9% (186/190) vs. 93.1% (149/160) and 28.4% (54/190) vs. 18.1% (29/160), and there were statistical differences ( P<0.05); the false negative rate in combined group was lower than that in methylene blue group: 5.3% (3/57) vs. 14.7% (5/34), but there was no statistical difference ( P>0.05). Conclusions:In breast cancer patients, the dual -tracing method of indocyanine green combined with methylene blue is better than using methylene blue alone in identifying SLN and predicting the status of axillary lymph nodes, and it has a tendency to reduce the false negative rate.

Objective To study the changes and clinical significance of heart rate turbulence(HRT)in patients with diabetic cardiomyopathy.Methods 24h Holter ECG recordings were examined in 33 patients with diabetic cardiomyopathy(DC)and 30 patients in the control group.Turbulence onset(TO)and turbulence slope (TS)were calculated from Holter recordings.The mean value of TO,TS between the two groups were compared,the relativity among TO,TS,SDNN and LEVDD were analyzed as well.Results TO was significantly higher in the DC group compared with the control group[(-0.38 ± 0.12)％ vs(-1.88 ± 0.13)％,t =7.38,P =0.01)].TS in the DC group was significantly lower than that in the control group[(2.02 ± 0.82)ms/R-R vs (9.72 ± 1.18)ms/R-R,t =18.69,P =0.02)].TO was significantly related to SDNN(r =-0.35,P =0.02)and LEVDD(r =0.68,P =0.01),TS was also significantly related to SDNN(r =0.45,P =0.01)and LEVDD (r =-0.39,P =0.03).Conclusion The manifest of heart rate turbulence is significantly impaired in patients with diabetic cardiomyopathy.

Objective To investigate the risk factors involved in the refractory pneumonia caused by multidrug resistant acinetobacter baumannii (MDRAb) in pediatric Intensive care unit (PICU).Methods From January 2009 to August 2011,115 patients with MDRAb pneumonia were treated in Department of Emergency,Wuhan Children's Hospital,Wuhan.Another 45 patients with negative MDRAb (NMDRAb)pneumonia served as control.The patients in the two goups were analyzed using univariate and multivariate Logistic regression to find out the risk factors for MDRAb infection.Results Among the 176 clinical strains of acinetobacter baumannii isolated,128 (72.73％) strains were MDRAb.After drug susceptibility tests,acinetobacter baumannii showed the rates of resistance to β-lactams antibiotics not including cefoperazone-sulbactam were more than 70％,and the rates of resistance to carbapenems antibiotics were higher than 90％.All rates of resistance to antibiotics of betalactams and carbapenems in MDRAb were higher than those in NMDRAb significantly.There were very low rates of drug-resistance found in Amikacin,Levofloxacin,Ciprofloxacin and Minocycline ( ＜20％ ).Multivariate logistic regression revealed that ICU stay,length of time for mechanical ventilation,anemia,hypoproteinemia and the use of carbapenems were independent risk factors involved in MDRAb pneumonia.Conclusions MDRAb was an important conditional pathogen with high rate of drug-resistance to many antibiotics leading to pneumonia in PICU.It increased the mortality of patients significantly.To control the infection of MDRAb was the key to increasing efficacy of treatment of pneumonia in PCIU.

Defensin is a kind of antimicrobiol and cytotoxic peptides which have been found in a large range of living organisms. The mammal defensins have the most wide range antimicrobiol spectrum. The distribution, structure, gene expression regulation of mammal defensins in China and abroad were summarized. Its application on medicine and plant resistant gene engineering were prospected.

Objective To explore sinus heart rate turbulence (HRT) in patients with different subtypes of essential hypertension (EH), and analyze the relationship between HRT and autonomic nervous system function damage in these patients. Methods The study consisted of 107 patients with EH (EH group) and 46 controls (control group). Based on 24 hours dynamic electrocardiogram, all patients were divided into dipper,non-dipper,and anti-dipper blood pressure group. The indexes about HRT and heart rate variability (HRV) among these groups were calculated and compared,and the relationship between turbulence onset (TO),turbulence slope (TS) and 24 hours mean systolic blood pressure,diastolic blood pressure was analyzed. Results There were significant differences in TO,TS,SDNN between EH group and control group(P ＜ 0.05 ). TO in non-dipper and anti-dipper blood pressure group was significantly higher than that in control group( P ＜ 0.05 ), and TS was lower than that in control group(P ＜ 0.05 ). There was no significant difference in TO,TS between dipper blood pressure group and control group (P ＞ 0.05). TO in non-dipper and anti-dipper blood pressure group was significantly higher than that in dipper blood pressure group, but TS was lower than that in dipper blood pressure group (P ＜0.05). Correlation analysis showed that TO had positive relationship with average heart rate and age (rs = 0.265, P = 0.004;rs = 0.217, P = 0.018 ), but had negative correlation with SDNN and left ventricular ejection fraction (LVEF) (rx = -0.287,P = 0.002;rx =-0. 179, P = 0.049). Whereas, TS had negative correlation with average heart rate and age (r = -0.335, P =0.015 ;r = -0.238,P= 0.009), but had positive relationship with SDNN and LVEF(r = 0.540,P = 0.001 ;r =0.432,P = 0.001 ). Conclusions HRT of EH patients becomes significantly low. It suggests that the autonomic nerve function in EH patients be injured seriously.

Objective To study the pathogenic bacteria strains with drug-resistance prevailing in patients with ventilator-associated pneumonia(VAP)in Pediatric Intensive Care Unit(PICU)in order to provide a reasonable guidance to the clinical use of suitable antibiotics.Method A retrospective clinical study in 46 patients with VAP was carried out in PICU of Wuhan Children's Hospital between January 2008 and June 2010.The prevalent strains of the pathogenic bacteria with drug-resistance isolated from lower respiratory tract by aspiration were analyzed.Results In total,119 pathogenic microbial strains were isolated including Gram-negative bacilli(G-,65.55%),fungi(21.01%)and Gram-positive cocci(G+,13.45%).Among pathogens,the most common pathogenic strains were Acinetobacter baummannii, Escherichia coli,Klebsiella pneumoniae,candida albicans and coagulase-negative staphylococci.Antibiotic susceptibility tests indicated that the situation of the multiple drug-resistances to antibiotics found in G- and G+ Was serious. Most of G- were sensitive to ciprofloxacin, amikacin, imipenem, meropenem,cefoperazone-sulbaetam and piperacillin-tazobactam.The G+ cocci were 100% susceptibility to vancomycin, teicoplanin and linezolid.Fungi were almost sensitive to all the anti-funaus agents. Conclusions The oredominant oathogens of VAP were G- bacilli,and their multiple drug-resistances to antibiotics were the serious problems.The monitoring of the drugresistance should be emphasized, and the option of antibiotics should depend on the antibiotic sensitivity test.