OBJECTIVE:To provide reference for the standardization of the instruction of levonorgestrel emergency contraception. METHODS:Instruction of levonorgestrel emergency contraception in the market was compared with the national regulations and foreign instruction of the same kind of productions in order to discover the problems in domestic specification. RESULTS:The major problems of domestic instruction of levonorgestrel emergency contraception included instructions without population limits, unclear frequency and interval of drug use,without attention to ADR of levonorgestrel emergency contraception,lack of pharmacy research data. CONCLUSIONS:The problems existing in domestic instruction of levonorgestrel emergency contraception are shortage of items and warnings of drug safety. Related administration departments and enterprises are suggested to modify and perfect the instruction of levonorgestrel emergency contraception.

Objective To investigate the clinical features of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and the significance of anti-NMDAR antibody assay in clinical diagnosis.Methods Sixty-two patients were divided into 3 groups of encephalitis,encephalopathy and other central nervous system diseases based on their affliction. Anti-NMDAR antibody was detected by transfected cell-based indirect immunofluorescence assay in the serum and cerebrospinal fluid. The clinical features,laboratory tests,treatment and prognosis of NMDAR encephalitis were analyzed.ResultsAnti-NMDAR antibody was positive in serum and (or) cerebrospinal fluid of 9 patients (9/32,28％ ) from encephalitis group.The positive rate of anti-NMDAR antibody in cerebrospinal fluid was higher than that in serum of these patients.Among them,5 patients with higher antibody titer had impaired blood-brain barrier.No tumor was detected in these 9 patients.The most predominant symptoms of anti-NMDAR encephalitis include fever,psychiatric disturbances,seizures,dystonia and autonomic dysfunction.Brain MRI and electroencephalography were also abnormal. Patients were responsive to early immunotherapy. Conclusion Detection of the anti-NMDAR antibody may be important for early diagnosis and treatment of autoimmune encephalitis.

Objective To evaluate the traditional Chinese medicine(TCM) output efficiency of the coUnty-level TCM hospitals in Jiangsu Province before and after the reimbursement mechanism reform,and to analyze the factors which affect the efficiency of county-level TCM hospitals.Methods Using DEA to analyze the efficiency of county TCM hospitals,and using the Tobit regression to analyze the influence factors.Results The output efficiency of county-level TCM hospitals in Jiangsu Province is low,and the reimbursement mechanism reform in county-level hospitals of TCM efficiency further decreases;payment model,cost model and revenue model of regression analysis indicate that different factors has different influence on output efficiency of county hospitals of TCM.Conclusion The reimbursement strategy of county-level TCM hospitals should be optimized,the balance of revenue and expenditure structure be adjusted,and the intensity of TCM services reimbursement be increased.

Objective:To analyze different age group elderly’s financial burden and risk due to non-communicable chronic diseases (NCDs). Methods:Based on CHARLS baseline investigation data, disease economic burden, disease economic risk for family and disease relative risk are used to analyze the economic risk and economic burden of the different age groups of urban and rural NCDs elderly. Results: The diseases financial burdens of urban NCDs elderly are greater than rural; for diseases family risk and relative risk, NCDs elderly are greater than non-NCDs elderly, urban NCDs elderly are greater than rural, high-age group NCDs elderly are greater than low-age group NCDs elderly. Conclusion: It is needed to improve the NCDs elderly’s medical security ability with basic health insurance, especially to improve medical security ability of the high-age group for rural elderly.

The development and progress of gastric mucosal diseases is a complex process associated with multiple factors and underlying mechanisms,and individuals may present different genetic susceptibilities to gastric mucosal diseases. Various studies have demonstrated a strong link between Toll-like receptors( TLRs),as pattern recognition receptors,and the development and progress of gastric mucosal diseases. The gene polymorphisms of TLRs may change its encoded proteins or related signaling pathways,which results in different susceptibilities to gastric mucosal diseases;this might affect the development,progress and clinical outcome of the disease. In this review article,the advances in study on TLRs and its gene polymorphisms in gastric mucosal diseases were summarized.

Objective To explore the operation al skills of laparoscopic appendectomy(LA) and to improve its proficiency.Methods The clinical data of 121 patients under went LA during February 2013 to May 2014 were summarized retrospectively.Results All the 121 cases were completed successfully with no complication.Conclusion With the development of laparoscope and accumulation of experiences LA can be safe and complications can be minimized if the this operation skill being obtained.

A female patient with a dark red mass in the of preauricular area for over 3 months was hospitalized. Enhanced CT scan and ultrasonography showed that the mass had clear boundaries and was rich in blood supply. The patient was misdiagnosed as preauricular hemangioma, then the mass was removed as a benign tumor and found irrelevant to parot, SMA(+), Vim(+), S-100(+), indicating myoepithelial carcinoma. So a radical excision was performed to get negative incised margin. The patient didn't undergo postoperative chemotherapy but demonstrated no evidence of recurrence over a 12-month follow-up.
Adult ; Ear Neoplasms ; Female ; Follow-Up Studies ; Humans ; Myoepithelioma

OBJECTIVE: To observe the clinical effect of endoscope-guided low temperature plasma ablateing adenoidectomy with tympanic membrane incision drainage and tympanic membrane indwelling catheter to treat secretory otitis media of children. METHOD: Fifty-two cases (98 ears) of secretory otitis media in children with adenoid hypertrophy were treated. Respectively endoscope-guided tympanic membrane incision drainage parallel low temperature plasma ablateing adenoidectomy and endoscope-guided tympanic membrane indwelling catheter parallel low temperature plasma ablateing adenoidectomy. RESULT: In group A, 30 cases of 58 ears, cure 36 ears, improving 14 ears, invalid 8 ears, the effective rate was 86.2%. In group B, 22 cases of 40 ears, cured 32 ears, improvement in 6 ears, invalid 2 ears, the effective rate was 95.0%. According to statistical analysis of curative effect, there was no significant difference by effective rate between two groups. CONCLUSION For the patients with secretory otitis media caused by adenoidal hypertrophy, the endoscope-guided tympanic membrane incision drainage parallel low temperature plasma ablateing adenoidectomy can be regarded as a kind of method to reduce the risk of tympanic membrane perforation.
Adenoidectomy ; methods ; Adenoids ; pathology ; Catheters, Indwelling ; Child ; Cold Temperature ; Humans ; Middle Ear Ventilation ; methods ; Otitis Media with Effusion ; surgery ; Tympanic Membrane Perforation

Objective To explore the relationship between the family conditions and internet addiction of medical college students with limb disabled. Methods 400 medical college students were investigated by the University Student Going-online Investigation table, EMBU and Chinese Internet Addiction Scale. Results There was significant correlation between parental occupations and internet addiction total score of medical college students with limb disabled( r= 0.195, P < 0.01 ; r = 0.163, P < 0.05 ). There was significant correlation and prediction between negative parental rearing patterns such as the parents' punishment-severity and rejection-denying and dimensions of interpersonal relations, health, forced going-online behaviors, time management( P < 0.05, P< 0.01 ), but there was no significant correlation and prediction between parents' warmth-comprehension and all dimensions. Conclusion Family conditions play a important role in influencing internet addiction of medical college students with limb disabled.

BACKGROUND: Previous studies have indicated that hyperhomocysteinemia can induce atherosclerosis by enhancing oxidative stress, whereas Ginkgo biloba extract (GbE) can scavenge oxygen-derived free radicals.OBJECTIVE: To observe the role of reactive oxygen species (ROS) and nuclear factor-kappa B (NF-κB) in the expression of cell adhesion molecules (CAMs) induced by homocysteine (Hcy), and investigate the effect of GbE.DESIGN: A randomized controlled animal trial.SETTING: Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.MATERrALS: Twenty-four healthy male rabbits of 6 months old. Dl-methionine (Sigma Chemical, Co.,Ltd.); GbE (Guizhou Yibai Pharmaceutical Company; powder).METHODS: The experiment was accomplished in the Laboratory of Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from March 2003 to April 2004. ① After adaptive feeding for 2 weeks, the rabbits were randomly divided into three groups: Model group (n =12): The rabbits were treated with subcutaneous injection of dl-methionine (80 mg/kg per day); GbE group (n =8): The rabbits were administrated with GbE (mixed with feed, 50 m/kg per day) at 1 hour before the subcutaneous injection of dl-methionine; Control group (n=4): The rabbits were injected with equivalent sodium chloride. They were administrated for 7 weeks continuously. ②Histological changes were observed under light and electron microscopes: ROS level was determined with colorimetries (721 visible spectrophotometer); The expressions of CAMs and NF-κB in endothelial cells were detected with immunohistochemical methods; The concentration of plasma Hcy was measured with high-performance liquid chromatography.MAIN OUTCOME MEASURES: Histological changes, ROS level and expressions of CAMs and NF-κB in endothelial cells.RESULTS: All the 24 rabbits were involved in the analysis of results. ① ROS level: After administration, the ROS level in the model group was obviously increased (2.92±0.20,2.48±0.26, P ＜ 0.05), whereas those in the GbE group and control group (2.41±0.23, 2.43±0.20) had no obvious differences as compared with those before administration (2.31±0.27,2.47±0.32, P ＞ 0.05). ② Histological changes: Aortas of rabbits in the model group presented initial changes of atherosclerosis, including shedding or necrosis of endothelial cells and nuclear pyknosis or standing in a clutter of smooth muscle cells. There were scarcely any changes in the GbE group and control group. ③ Expressions of CAMs and NF-κB in endothelial cells: After treatments, the expressions of vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and NF-κB in the model group were obviously higher than those in the control group (P ＜0.05), and there were no significant differences between the GbE group and control group (P ＞ 0.05). ④ Concentration of plasma Hcy: After 7 weeks, the concentration of plasma Hcy was higher in the model group and GbE group than in the control group [(25.01±6.80), (26.71±2.36), (16.85± 1.64) μmol/L, P ＜ 0.05].CONCLUSION: Hcy-induced oxidative stress plays an important role in NF-κB activation. GbE might suppress the activation of NF-κB and expression of CAMs by reducing ROS.