ObjectiveTo investigate the efficacy of superficial surround needling plus quadriceps femoris training in treating knee osteoarthritis and observe electromyographic amplitude variations by knee osteoarthritis.MethodNinety patients diagnosed with knee osteoarthritis were randomly allocated to treatment and control groups, 45 cases each. The treatment group received superficial surround needling plus quadriceps femoris training and the control group, acupuncture alone. Both groups were treated for two weeks. Pre-treatment and post-treatment knee joint functions were scored and compared using the Visual Analogue Scale (VAS), the Lysholm Knee Score Scale and the electromyographic integral value. Meanwhile, electromyography was performed and electromyographic amplitude variations by knee osteoarthritis were compared between the two groups of patients.ResultThe total efficacy rate was 88.9% in the treatment group and 60.0% in the control group. It was higher in the treatment group than in the control group (P<0.05). After treatment, the VAS score, the Lysholm score and the electromyographic integral value were significantly better in the treatment group than in the control group (P<0.05).ConclusionSuperficial surround needling plus quadriceps femoris training has a marked therapeutic effect on knee osteoarthritis.

Objective To analyze the policy support of rural doctors for the essential medicine system,and explore the main influence factors and mechanism affecting the support degree.Methods 621 rural doctors from five cities in Shandong province were subject to a stratified random sampling for a quantitative questionnaire,to build a hypothesis model of policy support of rural doctors,which is verified using factor analysis and path analysis.Results 59.1% of rural doctors support the essential drugs policy.It was found that the essential medicine factor,the factor to influence the practitioner,and the supporting policy factor had a direct impact on policy support of rural doctors,with the effect of 0.305, 0.1 59 and 0.135 respectively;Essential medicine factor and the supporting policy factor indirectly influence the policy support of rural doctors through the factor to influence practitioners,with the effect of 0.065 and 0.032 respectively.Conclusion The essential medicine system needs to emphasize such rationality as the quality,list and pricing of essential medicines;it is imperative for the government to better oversee the purchase and supply of essential drugs,to cater to the interests of rural doctors,to encourage the enforcement of the system,and promote the development of village clinics.

Objective To explore the dynamic changes of serum S100B and glial fibrillary acidic protein (GFAP) levels and their clinical significance in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).Methods By means of enzyme-linked immunno-sorbent assay (ELISA),the serum S100B and GFAP levels from 33 DEACMP patients were assayed,and the condition changes were analyzed with three types of scale:the activity of daily living scale ( ADL),information-memory-concentration test (IMCT) and Hasegawa' s dementia scale(HDS).The comparison with 32 patients of acute carbon monoxide poisoning without DEACMP was also conducted.Results (1) The serum S100B( (0.60 ±0.21)ng/ml) and GFAP( (226.58 ±90.05 )ng/ml) in DEACMP group at acute stage were significantly higher than those in acute-CO-poisoning group ( (0.50 ± 0.20) ng/ml,( 183.04 ± 73.01 ) ng/ml) and those in DEACMP group at convalescent stage ( (0.51 ±0.16) ng/ml,(183.25 ±81.76)ng/ml) (all P values ＜0.05).(2)In DEACMP group,the serum S100B and GFAP at acute and convalescent stages were significantly correlated (at acute stage:r=0.466,P=0.006; at convalescent stage:r=0.365,P=0.037 ).(3)The S100B and GFAP in ineffective DEACMP patients at acute stage were significantly higher than those in the other groups ( all P values ＜ 0.05 ).(4) In DEACMP group,the ADL,HDS and IMCT scores( (45.21 ± 9.69),(8.26 ± 6.31 ),(9.91 ± 7.52) ) at acute stage were significantly different from those at convalescent stages( (33.67 ± 13.62),( 15.91 ± 10.83),( 19.06 ± 10.37 ) ) ( all P values ＜0.01 ).Conclusion There is secondary brain insult (SBI) in DEACMP; glial activation may play an important role.The S100B and GFAP levels may be associated with the prognosis of DEACMP.

Objective To investigate the clinical significance of D-dimer in systemic lupus erythematosus (SLE). Methods The study group comprised 261 SLE patients who were admitted in ward from 2005 to 2008 in Peking University People's Hospital Collect the clinical data to investigate the clinical significance of D-dimer. Results ( 1 ) The D-dimer levels of 56 patients were increased due to coexist reduced renal function, infections, disseminated intravascular coagulation ( DIC), liver disorders, pregnancy and injury. With the exception of above patients, 142 ( 69. 3 ) patients were increased in total 205 patients. (2)The level of D-dimer was positively correlated with SLE disease activity index( SLEDAI ) score ( r =0. 598,P =0. 000), and was associated with anti-dsDNA antibody, ESR, C-reactive protein(CRP) and complement C3 and C4. (3)D-dimer level was associated with important organ involvement. (4)All patients with thrombosis had increased D-dimer, but patients without thrombosis had normal or increased D-dimer levels. Conclusion The level of D-dimer elevates in patients with active disease or important organ involvement , it can not identify thrombosis. All patients with thrombosis had increased D-dimer levels.

Objective: To compare the blood lfow of left internal mammary artery (LIMA) graft vessel between minimally invasive direct coronary artery bypass (MIDCAB) and traditional median sternotomyin off-pump coronary artery bypass (Traditional OPCAB) by transit-time lfow meter (TTFM). Methods: We retrospectively studied 300 patients who received OPCAB in our hospital from 2013-01 to 2015-07, all patients had LIMA to left anterior descending coronary artery (LAD) anastomosis. The patients were divided into 2 groups: MIDCAB group, n=70 and Traditional OPCAB group,n=230. Intra-operative blood lfow in graft vessel was measured by transit-time lfow meter. Pre- and post-operative indexes and the mean lfow (MF), pulsatile index (PI), diastolic fraction (DF) of LIMA graft were compared between 2 groups. Results: The following indexes in Traditional OPCAB group and MIDCAB group were as below: intra-operative transfusion was (3.00±5.42) U vs (1.06±2.17) U, post-operative peak value of cTnI was (2.84±9.93) ng/ml vs (0.69±1.74) ng/ml, mechanical ventilation time was (27.9±66.9) h vs (14.2±20.8) h and ICU stay time was (64.1±89.6) h vs (35.2±39.2) h, allP<0.05; while for the graft from LIMA to LAD, MF was (29.45±18.19) ml/min vs (29.04±15.85) ml/min, PI was (2.68±1.19) vs (2.44±0.84) and DF was (71.47±11.12) % vs (70.25±11.30) %, allP>0.05. Conclusion: With LIMA to LAD graft, MIDCAB may achieve the same effect as traditional OPCAB, the early post-operative anastomosis has been reliable.

Grounded theory was used to summarize and analyze influencing factors and their mechanism on availability of essential medicine.Four factors which influenced the availability of essential medicine were singled out:defective top design in the essential medicine system,interactions among its policies,deviations in the policy implementation by government agencies,and deficiency of supporting policies for the system.The availability of essential medicine in rural areas was influenced by a variety of factors.The ideas and methods of the grounded theory prove helpful for this study.In the future studies,both qualitative and quantitative study should be made to perfect this model formed by the grounded theory,to identify roadblocks and underlying causes in order to provide evidence for improving availability of essential medicine in rural areas.

Objective To study the different types of medication guidance for community doctors in the context of essential medicine system,and analyze its influencing factors.Methods SPSS 1 9.0 was called into play for statistical analysis of data gathered,and the medication guidance behavior of the doctors were graded on the two dimensions of personal willingness and practical action.With important quadrant method,the medication guidance behavior of such doctors was classified,while the multiple linear regression was used to study the influencing factors.Results Most of the community doctors of the fourteen counties fall into the area of “high willingness and less action”,with only a few falling into the area of the “high willingness and more action”. Major influencing factors of their willingness on medication guide were found to include impacts on job autonomy,attention to essential medicine system, and the forms to improve income.Major factors of the doctors'actions on medication guide include awareness of essential medicines,awareness of essential medicines catalog,and training outcomes. Conclusion The community doctors have high personal willingness for medication guidance related to essential medicines,but only a number of them carried it in their work.Therefore,it is necessary to take actions to strengthen awareness of the doctors for medication guidance and encourage them to carry it out.

Objective To identify the impact factors for community doctors with the essential medicine system in place,in support of mobilizing them and successful implementation of the essential medicine system in the community.Methods Based on the theory of ERG hierarchy of needs,the pathway analysis method was called into play to identify the three factors affecting community doctors,namely personal survival,interpersonal relations and self-development.Results Major factor of which is the interpersonal factor,with a score of 0.549,while the latter two factors do not directly affect the survival and development.The two however work on each other,and work on the interpersonal factor as well,with the impact coefficients of 0.320 and 0.402 respectively.Conclusion With the essential medicine system in place,the largest impact factor for community doctors'enthusiasm is the interpersonal one,involving the doctor-patient communications among others.This serving as the breakthrough point may improve the enthusiasm of the community doctors,paving the way for the system in the communities.

OBJECTIVE:To systematically evaluate the therapeutic efficacy and safety of perospirone versus risperidone in the treatment of schizophrenia,and to provide evidence-based reference for clinical treatment.METHODS:Retrieved from Wanfang database,VIP,CJFD,CBM and PubMed,randomized controlled trials (RCTs) of perospirone(trial group) vs.risperidone (control group) in the treatment of schizophrenia were collected.After data extraction and quality evaluation of included studies according to modified Jadad evaluation criteria,Meta-analysis of response indexes was performed by using Rev Man 5.0 statistical software.RESULTS:A total of 12 RCTs were included,involving 1 050 patients.Results of Meta-analysis showed,the cure rate of 2 groups had no statistical significance [OR=0.99,95％CI(075,1.30),P=0.93].The incidences of extrapyramidal reactions [OR=0.63,95％CI(0.43,0.92),P=0.02],the incidences of prolactin levels increasing [OR=0.23,95％CI(0.14,0.38),P＜0.001] and the incidences of weight gain [OR=0.23,95％CI(0.13,0.39),P＜0.001] in control group were significantly higher than trial group,with statistical significance (P＜0.05).CONCLUSIONS:The therapeutic efficacy of perospirone and risperidone is similar in the treatment of schizophrenia,but the safety of perospirone is better than that of risperidone.

OBJECTIVE:To systematically evaluate the pharnacoeconomic effect of venlafaxine and escitalopram in the treat-ment of depressive disorders. METHODS:Usingvenlafaxineescitalopramdepressiondepressive episodeantidepressantas key words,retrieved from CNKI,VIP and Wanfang database during base creation date to Dec. 2015,related literatures about venlafaxine and escitalopram in the treatment of depressive disorders were selected. The cure rate of two therapy plans for depres-sive disorders and HAMD score were analyzed statistically by cost-effectiveness analysis of pharnacoeconomics. RESULTS:There was no statistical significance in cure rate and HAMD score between 2 groups(P>0.05),so minimum-cost analysis was adopted. The costs of venlafaxine and escitalopram in the treatment of depressive disorders were 772.03 yuan and 935.77 yuan. CONCLU-SIONS:Therapeutic efficacy of venlafaxine is similar to that of escitalopram in the treatment of depressive disorders,but the for-mer scheme is more economical.