In China, health care system is not perfect,the trust is lack between doctors and patients. Introdu-cing medical social workers to hospitals is to manage social resources as a whole, optimize medical treatment service process,enhance the quality of medical service, and relieve the pressure of doctors and nurses. Under this back-ground, this paper gave an overview of the medical social work and its contents. Then, it analyzed the necessity of introducing medical social workers to hospitals and pointed out the existing plight of medical social work. Finally, it put forward the suggestions and countermeasures to promote medical social work.

Objective: To observe the clinical efficacy of lung-clearing and spleen-strengthening tuina on exogenous cough in children. Methods: A total of 77 children with exogenous cough that met the inclusion criteria were randomly divided into a treatment group and a control group according to the random number table, with 39 cases in the treatment group and 38 cases in the control group. The routine lung-clearing manipulation was used in the two groups, while the spleen- strengthening manipulation was added in the treatment group. Both groups were treated once a day, 5 times as a course of treatment. After one course of treatment, the symptom score and clinical efficacy were observed. Results: There were one dropout in the treatment group and 2 dropouts in the control group. Therefore, a total of 74 cases were finally included in the analysis, with 38 cases in the treatment group and 36 cases in the control group. After treatment, there was a statistically significant difference in cough score between the two groups (P<0.05). There was a statistically significant difference in the score of poor appetite between the two groups (P<0.05). After treatment, the total effective rate was 89.5％ in the treatment group versus 75.0％ in the control group, showing a statistically significant difference (P<0.05). Conclusion: The therapeutic efficacy of lung-clearing spleen-strengthening manipulation is better than that of lung-clearing tuina manipulation alone for children with exogenous cough; regulating spleen and stomach can improve the curative efficacy of exogenous cough in children.

AIM: To compare the effect of small incision extracapsular cataract extraction and phacoemulsification on corneal endothelial cells and explore the differences between these two most commonly used surgeries for grade Ⅱ-Ⅲ lens nucleus. · METHODS: Retrospective study. We retrospectively evaluated the data of age-related cataract patients who had completed surgery in our hospital between June 2013 and December 2015. There were 84 eyes of 84 patients. The corneal endothelial cell density of all the patients were greater than 2000/mm2 and lens nucleus were gradeⅡ- Ⅲ. The patients were divided into manual small incision cataract surgery ( MSICS ) group and phacoemulsification ( Phaco ) group. MSICS group included 42 cases (42 eyes) and Phaco group included 42 cases ( 42 eyes ) . Postoperative evaluations were performed at 1d, 1wk, 1mo and 6mo and included uncorrected visual acuity ( UCVA ) , corneal endothelial cell density and the proportion of hexagonal cells. · RESULTS: There were no statistically significant differences of the two groups in preoperative basic data, UCVA, corneal endothelial cell density and the proportion of hexagonal cells, nuclear classification. The postoperative UCVA were significantly improved in both groups (x2=148. 01, P<0. 001; x2=165. 97, P<0. 001). The postoperative UCVA were on the rise as time goes on. The postoperative corneal endothelial cell density was obviously reduced in both groups compared with the preoperative (F=37. 74, P<0. 001; F=24. 56, P<0. 001). The proportion of hexagonal cells in Phaco group was declined at 1d (P=0. 002) after the operation and returned to baseline by 1wk (P=0. 894) after surgery. There was no significant difference between the two groups in UCVA, corneal endothelial cell density and the proportion of hexagonal cells at each observation point (P>0. 05). ·CONCLUSION: Manual small incision cataract surgery and phacoemulsification can indiscriminately improve UCVA and decrease the density of corneal endothelial cells. However, the change of hexagonal cells proportion was not obvious. These two surgeries for cataract patients with corneal endothelial cell density greater than 2000/mm2 , grade Ⅱ-Ⅲ lens nucleus have similar efficacy and safety.

Objective To study pathogenesis role of CD28:CTLA4/B7 costimulatory molecules in experimental autoimmune myasthenia gravis(EAMG). Methods Female lewis rats were divided into EAMG group and control group. The rats were immunized thrice with R?97-116 peptide in EAMG group, or only with phosphate buffer saline(PBS) in control group. 5 d after the third immunization, the expressions of CD28,CTLA4,B7-1, B7-2 on the surface of peripheral blood cells, lymphocytes and monocytes were exaimed by flow cytometry. Results In EAMG group,the achievement ratio of EAMG model was 75%; the expressions of CD28,CTLA4,B7-1, B7-2 on the surface of peripheral blood cells were significantly increased than those in control group (P

Objective To evaluate surgical performance of reconstruction of the cistern magna for the treatment of Chiari Ⅰ malformation associated with syringomyelia.Methods Suboccipital craniotomy and laminectomy of C1 segment were performed.The superior edge of bone window was limited to the inferior nuchal line.The dura mater and arachnoid were opened Y-shaped.The cerebellar tonsils were removed by electrocoagulation or subpially.A communication of cerebrospinal fluid between the fourth ventricle and subarachnoid space was achieved.The pseduomembrane,which is a very thin membrane over the opening of the central canal,should be cut away,with fascia grafting.Then a new enlarged cistern magna was established.Results The procedure was successfully completed in all the 36 patients with Chiari Ⅰ malformation and syringomyelia.The pseduomembrane was found in 30 patients.Postoperative follow-up checkups for 3 months ~ 5 years showed various degrees of recovery of sensation and muscle strength.Re-examinations with MRI revealed that the spinal cord cavity disappeared in 6 patients and decreased in size in 30 patients.Conclusions The decompression of the posterior cranial fossa,the communication of cerebrospinal fluid between the fourth ventricle and subarachnoid space,and the removal of pseduomembrane are key processes for treating Chiari Ⅰ malformation associated with syringomyelia.

Objective To study the impact of pregnancy on differentiated thyroid cancer. Methods Retrospective comparative analysis were made between pregnancy-related thyroid cancer patients ( including nine months before delivery and one year after delivery) and the age-matched non-pregnancy-related thyroid cancer patients treated in the Department of head and neck, Fudan University Shanghai Cancer Center. Results There were 125 cases of pregnancy-related thyroid cancer patients from 1998 to 2008, including 28 cases (22.4%) of neck recurrence and metastasis after the surgery of thyroid cancer, meanwhile there were 691 cases of the agematched non-pregnancy thyroid cancer patients, including 90 cases ( 13% ) of neck recurrence and metastasis after the surgery of thyroid cancer. The rate of neck recurrence and metastasis after the surgery of thyroid cancer in the pregnancy-related group was higher than that in the non-pregnancy related group ( P ＜ 0.05). The maximum diameter of tumor in the pregnancy-related group and the non-pregnancy group is 2. 1 cm and 2.6cm respectively.There were 19 cases of multi-focal cancer ( 19.6% ) in the pregnancy-related group and 58 cases (9. 6% ) in the non-pregnant group, P ＜0.05. There were 23 patients (23.7%) of extrathyroid invasion in the pregnancy-related group and 65 patients ( 10.8% ) in the non-pregnant group, P ＜0.05. There were 67 cases (53.6%) and 35 cases (28%) of the central and lateral cervical lymph node metastasis in the pregnancy-related group respectively and 296 cases (42.8%) and 117 cases (16. 9% )in the non-pregnant group, P ＜0.05. There were 19 cases (15.2%) of extralymph invasion in the pregnancy-related group and 32 cases (4.6%) in the non-pregnant group, P ＜ 0.05. Conclusions The incidence of Extrathyroid invasion, multi-focal cancer, cervieal lymph node metastasis and extralymph invasion of the differentiated thyroid cancer is higher in pregnancy-related patients.Pregnancy may deteriorate the prognosis of thyroid cancer. For patients after the surgery of thyroid cancer, pregnancy may increase the risk of neck recurrence and metastasis. However, pregnancy does not affect the stage of thyroid cancer and the prognosis is still good.

Acupuncture Therapy ; Humans ; Male ; Meige Syndrome ; therapy ; Middle Aged

Objective Chronic persistent infection following hydrophilic polyacrylamide gel (HPG) injection is one of serious complications in augmentation mammaplasty.It was to search for a perfect treatment for the infection.MethodsA total of 126 patients who accepted HPG injection appeared serious chronic infections.Operation was performed to cut out the HPG and necrotic tissues.The cavities were repeatly washed with negative pressure drainage to control the infection.ResultsAll the symptoms were relieved one to 3 weeks after the treatments in 126 cases.The examination showed that no visible HPG and infection remained in the cavity.No defects existed in the breast and chest wall.ConclusionsFor this infection,the best therapy is to remove the pathologic tissue by surgery and to efficiently control the infection with medication.

Objective To study the clinical and coronary characteristics of drug abuse women patients with acute myocardial in-farction .Methods Data of 70 women patients ,who were diagnosed with acute myocardial infarction(AMI)and underwent emergent coronary angiography in department of jurisdiction ,Guangdong Provincial Corps Hospital ,Chinese People′s Armed Police Force from January 2006 to July 2012 ,were analyzed .Results 66 of 70 were ST-segment elevated myocardial infarction ,4 were non-ST-segment elevated myocardial infarction ;67 of 70 were obstructive lesion ,underwent percutaneous coronary intervention .With the drug abuse time prolonging ,the combining risk factors increased ,the occurrence rate of AMI increased(P<0 .05) .Data of coronary angiography showed that the culprit vessels of most AMI patients with different drug abuse time were single vessel lesion ,which was significantly higher than the rate of three vessel and main stem .the most common culprit vessel was the left anterior descending artery ,followed by the right coronary artery and left circumflex artery lesion .three vessel and main stem lesion were short in pa-tients of drug abuse time <5 years ,with the prolonging of drug abuse time ,three vessel and main stem lesion increased .There was 1 death example in prison and 5 re-admission fore agnia during the follow-up .Conclusion Most AMI in drug abuse women patients with acute myocardial infarction is STEMI .Single vessel and obstructive lesion is the most common .The most common culprit ves-sel was the left anterior descending artery .Most female patients were complicated with congenital coronary malformation or autoim-mune disease .With the prolonging of drug abuse time and increasing of combining risk factors ,the rate of AMI increases .

Objective To investigate the prognostic factors of sorafenib treatment in patients with advanced hepatocellular carcinoma (HCC) underwent surgical therapy or transcatheter arterial chemoembolization (TACE).Methods 62 patients with advanced HCC underwent surgical therapy or TACE were post-treated with sorafenib (400mg,bid).The overall survival (OS) and progress-free survival (PFS) were evaluated by Kaplan-Meier method.Results There were 30 patients in surgical group and 32 patients in TACE group.The median OS in surgical group and TACE group were 12.2 and 5.7 months (P =0.019) and the median PFS were 16.7 and 10.6 months (P =0.033),respectively.The liver cancer volume / liver volume ＞50 ％ and Child-Pugh classification were independent risk factors for PFS in surgical group,the Child-Pugh classification and vascular invasion were independent risk factors for OS in surgical group.Conclusion The patients' PFS and OS in surgical group by oral sorafenib are better than those of patients in TACE group.The effective ways to prolong the PFS include decreasing volume of liver cancer and the better liver function.