Objective To study the characteristics of the inpatients with cancer pain, the application of WHO three steps analgesic solution (three steps analgesic) and the application of traditional Chinese analgesic (TCM). Methods Retrospective investigation of distribution of cancer pain, situation of pain, application of TCM, and the application of conbination of three steps analgesic and TCM treatment, by using, clinical data from the oncology department of afflicated hospital of Liaoning university of TCM ranging from May, 2009 to June, 2010. Results 47.4% (517/1 090) of patiens were combined with cancer pain. Among the patients, majority were the middle-aged and old (59.19%) and male patients (57.63%). The abdominal pain (57.45%) and chest pain (37.91%) were topranks, and the distributions of pain period such assustainability (65.37%), moderately (53.38%), bloated pain (49.71%) and dull pain (29.98%) had larger proportion. The TCM excessive patterns(50.87%) were more than the TCM deficiency patterns (28.63%) or mixed TCM patters of excessive and deficiency patterns (20.50%). A total of 46 patients had mild pain, 76.09% of whom used TCM, 15.22% used first step drugs, and 8.69% used combination treatment, while 276 patients with moderate pain used second step analgesic, and 91.67%of them also used TCM, the rest195 patients with severe pain used third step analgesic, and 55.38%of them also used TCM. The time of pain release of TCM alone or combination of TCM and three steps analgesic were longer than the three steps analgesic alone. Conclusions Early intervention of traditional Chinese medicine on the patients with mild pain could reduce the dose of first step analgesic drugs, and TCM application at the second step could delay the speed of transtformfrom second to third step pain, and TCM could prevent the side effects of morphine when patients were with severe pain.

Objective:To explore the effect of oxycontin combined with gabapentin on the clinical cure and immunity for patients with neuropathic cancer pain.Methods:80 patients with neuropathic cancer pain were enrolled in our hospital from June to 2016 July,of which patients divided into two groups randomly,Group A(n=40) accepted oxycontin treatment,and Group B (n=40) adopted gabapentin based on the patients in Group A.The VAS score and curative effect of the patients were compared between two groups;The quality of life of all patients were evaluated post-treatment,and the change of immunity indexes were compared and analyzed.Results:The VAS score of all patients was decreased significantly compared with pre-treatment (P＜0.05),and the score of Group B was lower than those patients in Group A (P＜0.05);The total remission rate of Group B was significantly higher than those of Group A (P＜0.05);after treatment,the score of appetite,emotion,sleep,daily activities,social communications of all patients decreased significantly compared with pre-treatment (P＜0.05),and the change of Group B was decrease significantly higher than those patients in Group A (P＜0.05);the immune index of two groups was significantly increased (P＜0.05),and the level of the indexes including IgG,IgA,IgM,CD4+,CD4+/CD8+ and circulating immune complex (CIC) increased compared with pre-treatment remarkably (P＜0.05),and which change in Group B was significantly higher than Group A (P＜0.05).Conclusions:Oxycontin combined with gabapentin for patients with neuropathic cancer pain deserved popularization in clinical,and which not only possessed well clinical effect,but also increased the quality of life.

Objective:To systematically review the efficacy and safety of acid-suppressive therapy including proton pump inhibitors (PPI) and histamine 2 receptor antagonists (H2RA) and compare with those of placebo or blank control in the postoperative patients with stress ulcer bleeding (SUB) to provide evidence-based reference for clinical practice.Methods:The Cochrane library,Medline,Embase,CBM,CNKI,VIP,Wan Fang Data,clinicaltrials.gov,ISRCTN Register and WHO ICTRP were searched.Only randomized controlled trials (RCTs) of acid-suppressive therapy compared with placebo or blank control for postoperative stress ulcer bleeding were selected with bleeding rate,mortality,adverse drug reactions,gastric juice pH and length of stay as the indices.After the quality evaluation and data extraction,Meta-analysis was performed by using Stata12.0 statistics software.The results were expressed as relative risk(RR) and its corresponding 95% confidence interval(CI).Funnel plot and Eggers test were used to determine the publication bias;and then Grade approach was applied to assess the confidence in the evidence for each outcome.Results:Totally 15 trials enrolling 971 patients were selected,and acid-suppressive therapy was more effective than placebo or blank control in reducing the risk of stress ulcer bleeding,overt upper gastrointestinal bleeding and clinical important bleeding(RR 0.29,95% CI:0.19-0.45;RR 0.25,95%CI:0.10-0.64;RR 0.36,95%CI:0.17-0.77)(moderate),however,there was no statistical significance in the incidence of occult bleeding,mortality and adverse drug reactions (RR 0.79,95%CI:0.41-1.50;RR 0.49,95%CI:0.17-1.38;RR 0.78,95%CI:0.33-1.85,very low confidence).The subgroup analysis of drug classification,operation types and administration juncture showed that the incidence of SUB using PPI (RR=0.27) was lower than that using H2RA (RR=0.33);that of heart surgery (RR=0.20) was lower than that of general surgery (RR=0.31) and neurosurgery(RR=0.37);that of postoperative administration (RR=0.26) was lower than that of preoperative administration (RR=0.23).Conclusion:Acid-suppressive drugs seem to be more effective than placebo or blank control in reducing the risk of bleeding without significant increase of the risk of mortality or adverse drug reactions.The robustness of the conclusion is limited because of the low quality of the trial methodology,incomplete outcome indicators and lack of safety indices for pneumonia and clostridium diffcile-associated infection.Trials with high-quality and larger sample size are still needed to verify its clinical effects.

To meet the need of cultivating the high-quality medical personnel,we have ad-justed and reformed the content of the "Clerkship" teaching in obstetrics and gynecology and conducted the survey and research among teaching philosophy,training mode and management mechanism,and have obtained more satisfactory teaching result.

To promote clinical medical students' personal harmonious development,we have established the new problem-based teaching mode and reform the evaluation system in clinical teaching of obstetrics and gynecology and have obtained more satisfied teaching result.

AIM: To purify and refold the inclusion body of a human anti-HBsAg scFv with a 6?His tag, and to determine the affinity constant of the purified recombinant product.METHODS: Solubilizing in buffers containing urea or guanidine hydrochloride (GuHCl), the inclusion body was purified by IMAC, and then refolded by dialysis against urea or GuHCl, at the same time, Ni 2+ charged chelate column was utilized for in situ refolding. The affinity constant of the refolded scFv, polished by immune-affinity chromatography, was determined by non-competitive ELISA. RESULTS: The refolded scFv with highest specific bioactivity was produced by dialysis against GuHCl. Under this condition, the recovery of target protein reached (61.08?1 45)%. The affinity constant of the polished scFv was confirmed to be(2.30?0.32) ?10 7 L/mol. CONCLUSION: The inclusion body studied in this paper can be refolded efficiently under optimal dialysis condition in vitro . The antigen-binding property of this recombinant scFv is not affected by the purification tag fused to the N terminal of the protein.

Medicine is a practical subject,which requires medical students to deepen and expand the understanding of the theory by clinical training,and establish clinical thinking.In our noviciate reform of obstetrics and gynecology,we have established the new problem-based teaching mode,which is an effective method in fostering the ability of information collection,innovation and practice,and have obtained more satisfactory results.

Objective To investigate the value of monochromatic curve features parameters in assessing various types of upper urinary calcium calculi in vivo on dual-energy CT(DECT).Methods Total 55 calcium calculi underwent dual-source CT in dual-energy mode were analyzed retrospectively.According to the result of infrared spectrometer,four types of calcium calculi were seen in this study:group 1(COM,12),group 2(COM+COD,9),group 3(COM+CaP,8),group 4(COM+COD+CaP,26).For each stone,mono-chromatic images from 40 keV to 190 keV(interval of 10 keV)were reconstructed.We used the different single spectral CT values and curve slope to differentiate of various types of calcium calculi.Results The parameters of the different single spectral CT values and curve slope were significantly different among the four groups.110 keV could differentiate the most groups.The curve slopes of group 1 with group 2 and group 3,group 2 with group 4,group 3 with group 4 were significantly different.Conclusion The spectral curve features parameters is helpful in the characterization of various types of calcium calculi.

Objective To investigate the clinical status about the utility of compound amino acid (15) and dipeptides (2) in-jection, and to promote the rational drug use in our hospital .Methods Data from 127 patients who used compound amino acid (15) and dipeptides(2) injection in surgical wards were collected in July 2012.The data about the drug usage method , duration, administra-ted timing, drug combination and the differences in all departments was analyzed .Results Existing problems:62.2% patients used compound amino acid (15) and dipeptides (2) injection by peripheral intravenous infusion , 6.3% patients used more than 14 days and 7.1%patients infused singly.Conclusion Compound amino acid(15) and dipeptides(2) injection had problems of off-label drug use in surgical ward , which need to be improved .

Objective To explore the effect of the modular teaching for nursing students based on WeChat in the comprehensive training before the practice.Methods The undergraduate students of nursing were randomly divided into 5 classes,among which class 1,2,3 as the control group,and class 4,5 as the experimental group.The control group used the traditional ‘Case Teaching Method',taking the group as a unit to practice the clinical nursing skills individually;while the experimental group took the method which integrated individual nursing skills and practical materials with humanistic qualities in clinical cases.They conducted practical training by dividing the learning module with the ‘representative patients',using WeChat as the learning and exchange platform andbuilding modular training model.After the training,the results were evaluated by the score sheet for integrated skills,a critical-thinking scale and the learning model questionnaire.The data was analyzed by T-Test and Chi-Square inspection.Results All of the nursing students were willing to use WeChat for autonomous learning.The scores of the nursing students in the experimental group were higher than those in control group in the abilities of judgement,communication,operation and introspection.The difference was statistically significant (P＜0.05).In addition to the cognitive maturity,the scores of experimental group were higher than those in control group in the searching for truth,opening mind,abilities of analysis and integration and self-confidence in critical thinking and desire for knowledge,The difference was statistically significant (P＜0.05);Also the proportion of experimental group was higher than the control group in students' attitude to study,knowledge acquisition and practical training mode.The difference was statistically significant (P＜0.05).Conclusion The implementation of nodular teaching mode based on WeChat is beneficial to improve the clinical comprehensive ability of nursing students,and help to train the high quality nursing talents who meet the needs of clinical practice.