ObjectiveTo evaluate the treatment of lower ureteral calculi.Methods Clinical data of 300 cases of lower ureteral calculi were retrospectively analyzed.Among the 300 patients with lower ureteral calculi,171 patients were treated with extracorporeal shock wave lithotripsy (ESWL),95 patients were treated with ureteroscopic lithotripsy (URL),34 patients were treated with laparoscopic ureterolithotomy.ResultsThe clearances of the calculus was 91.81％ with the treatment of ESWL,86.32％ with the treatment of URL and 100％ with the treatment of laparoscopic ureterolithotomy after one month of the treatments.ConclusionESWL is the preferred methods for the treatment of lower ureteral stones.But when the stones≥ 1 cm,URL is superior to ESWL in efficacy; Laparoscopic ureterolithotomy is effective for the treatment of lower ureteral stones which combined with ureteral stricture or ureteral polyps,and with serious incarceration,granulation tissue wrapped around the stone.

Objective To study the change of coagulation function in the patients of systemic inflammatory response syndrome (SIRS) , and to provide evidences on anticoagulation therapy. Methods All of the patients in ICU were divided into two groups: SIRS (30 patients) and non-SIRS(25 patients). Thirty healthy adults were recruited as controls. Prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT) , fibrinogen(FIB),levels of platelet (PLT) and D-dimer were measured in all patients and healthy adults. Results The levels of PT, APTT,TT.DD in the SIRS group((16.48 ± 1. 57) s, (22. 67 ± 1. 48) s, (43. 56 ±4.33)s and (2.25 ±0.18)mg/L respectively) were significantly higher than those in the non-SIRS group((12. 83 ± 1.23)s, (17. 05 ±1. 97)s,(33. 34 ±2. 38)s and(0. 58 ±0. 15)mg/L respectively)and the control group ((12. 04 ±0. 98) s,(16. 88 ±1. 37)s,(29. 84 ±1.98)s and (0.43 ±0. 11)mg/L respectively) (P <0. 05). The levels of PLT,FIB in the SIRS group((110. 69 ±50. 23) × 109/L and(2. 05 ±0. 33) g/L, respectively) were significantly lower than those in the non-SIRS group((180. 58 ±45. 70) × 109/L and(3. 54 ±0. 29)g/L,respectively)and the control group ((204. 95 ± 46. 83) × 109/L and (3. 78 ± 0. 54) g/L, respectively) (P < 0. 05). Conclusions The dysfunction of coagulation exits in SIRS. Coagulation system abnormity might play an important role in the development of SIRS.

BACKGROUND:At present,withthe aging trend of the world’s populationand social development,the proportion of hip fracture is on the rise, and the morbidity and mortality ratearehigh. Therefore, it is necessary to analyze the risk factors for death in old patients with hip fractures. OBJECTIVE:To review and systematicaly analyze the deathrisk factors for hip fracture al over the world. METHODS:The PubMed, Medline, EMBASE, the Cochrane library, China Knowledge Resource Integrated Database, VIP database resources were reviewed for mortality risk factors for hip fracture in the elderly. Meta analysis of mortality risk factors for hip fracture in the elderly was conducted by Stata11.0 software, and then the pooled odd ratio (ORs) and 95% confidence interval (95%CI) of each risk factor were calculated from the patient’s own factors and iatrogenic factors in order to analyze risk factors for hip fracture in the elderly. RESULTS AND CONCLUSION:(1) 47 literatures were searched and among them 27 literatures were included in our meta-analysis. (2) The results of meta-analysis showed that mortality risk factors for hip fracture in the elderly included male, older than 60 years of age, body mass index, high American Society of Anesthesiologists Score, delay time from fracture to surgery, poor daily living before fracture, type of fracture, pre-fracture lung disease, pre-fracture cardiovascular disease, and pre-fracture dementia. (3) Results indicated that high mortality of the elderly patients with hip fractures possibly resulted from combined actions of physiological condition, operative factors andpostoperative rehabilitation. Before treatment, fuly understanding the patient’s physical function and health status, fuly assessing the risk of surgery, and selecting the appropriate type of surgery can reduce complication rate and mortality and improve patients’ prognosis.

AIM: The studies on meridians show that the meridians are the system with known structures and unknown functions. It is inseparably related with the vessels and tissue fluid and controlled by the nerve, endocrine,and immune systems. Analysis on these issues will be helpful in understanding the meridians. METHODS: To make a comprehensive analysis through the review and summarization of historical literature together with the discoveries of modem studies on meridians. RESULTS: The nature of meridians is probably the Regulation System of Directed Water Environment. That is, taking the continuous water environment of human body as the basis, especially the low resistance of flowing passage (14 meridians) as the trunk, the nerve system transmitting information quickly as the guide, the blood system transporting materials quickly as the source, and the point as the pivot, to create the coordination between the human body and environment and the whole and the local. CONCLUSION: The human body is an organic whole carrying out a series of transmission activities of material, energy, and information through the Regulation System of Directed Water Environment. The effect achieved by stimulating points through acupuncture and moxibustion is a kind of comprehensive regulation for the whole body, not only an influence on a certain system or function. Removing obstruction of meridians is the means of treatment and keeping meridians unobstructed is the purpose of TCM for health-care.

Professor HUANG Huang, a famous TCM doctor, proposing clinical research for classical prescription, has handled ancient classical prescription to regulate patients with coronary artery disease, and received good therapeutic effect. This article elects effective cases from Wendan Decoction, Bupleuri plus Fossilia Ossis Mastodi Ostreae Decoction, Pinelliae and Magnoliae Officinalis Decoction to analyze and introduce Professor HUANG Huang’s clinical experience as references by TCM occupation .

Objective:To establish a method for content determination of ferulic acid in Xiaojin Wan soft capsule by high performance liquid chromatography(HPLC).Methods:Analysis was carried out on Shimadzu LC-2010A HPLC.The separation was performed on DiamonsilTM C18 column(4.6?250mm,5?m),with methanol:1% acetic acid(25:75) as mobile phase,the flow rate was 1.0ml/min,column temperature was 25℃ and the detection wavelength was 320nm.Results:A good linear relationship was found within the range of 3~18?g/ml,Regression equation was Y=100708.7X+24(r =0.9991)and the average recovery was 101.1%(RSD=1.86%,n=5).Conclusion:This method was highly sensitive,accurate and well represented,which could be used to determine the content of ferulic acid in Xiaojin Wan soft capsule.

BACKGROUND:Hip fracture is often clinical y treated by surgical, but the elderly patients due to viscera function recession are faced with the risk of postoperative secondary complications. OBJECTIVE:To summarize the research progress of hip fracture implants and its complications at home and abroad in recent years. METHODS:The articles related with hip fracture implants and its complications were retrieved from PubMed database and CNKI Chinese periodical ful-text database from January 1994 to October 2015 by the first author using computer. The English and Chinese key words were“Hip Fracture, Implants, Complications”. Total y 128 relevant documents were retrieved, and 52 met the inclusion criteria. RESULTS AND CONCLUSION:Total y 20%of patients with hip fracture wil have complications. Some of these are medical, and other relate to the surgical treatment itself. Our review expounded the two aspects of hip fracture implant complications according to different clinical classification of hip fracture. On one hand, the common complications of hip fracture surgery were explained by taking the commonly used implants in hip fracture surgery as the breakthrough point;on the other hand, the implant complications of hip fracture were explained by taking the fracture site as the breakthrough point. Common complications related to hip fracture implants were hip varus, joint dislocation, implants exit or femoral head cutting. Early surgical internal fixation, anti-thromboembolic and anti-infective prophylaxis, perioperative pain management, timely detection and control of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and the improvement of early functional activities are basic recommendations for an optimal maintenance of hip fractured patients. In recent years, with the increasing improvements of internal fixation technology and post-operative management, as wel as early rehabilitation intervention, more scholars advocate in an early internal fixation treatment, so as to accelerate the functional recovery of patients’ hip joint and prevent further fal s.

Objective To observe the effect of acupuncture on antagonistic muscles with spastic paralysis stroke. Methods A total of 84 patients with stroke spastic paralysis according to the inclusion criteria were randomly divided into treatment group (42 cases) and control group (42 cases). Both groups were given rehabilitation training. The treatment group combined the acupuncture on antagonistic muscles, while the control group combined the convertional acupuncture and acupoints. All patients were treated for 2 months. Modified Ashworth, clinic spasticity index(CSI), Fugl-Meyer motor function (FMA) and daily living ability (ADL-Barthel index ) were used for evaluation of the therapeutic effect. Results After the treatment, the CSI score of the ankle (10.70 ± 1.49 vs. 11.60 ± 1.17, t=-2.586) of the treatment group was significantly lower than the control group (P<0.05), while the Fugl-Meyer motor function score (67.40 ± 13.91 vs. 54.65 ± 8.41, t=4.200) and Barthel index score (69.15 ± 12.43 vs. 57.65 ± 8.35, t=4.475) of the treatment group were significantly higher than the control group (P<0.01). The ashworth scale of elbow, wrist, knee joint spasticity changed significantly in the treatment group when that index after treatment was compared with that before treatment (χ2 value 10.627, 10.261, 10. 200, respectively, P<0.05). Conclusion Acupuncture on antagonistic muscles could improve the spasticity, motor function and daily living ability of patients with spastic paralysis stroke.

OBJECTIVE:To promote the rational use of Chinese patent medicines in treating acne.METHODS:The composition,efficacy,property and indications of the common 12 kinds of patent Chinese medicines used for treating acne were analyzed respectively.RESULTS: The basis for the treatment of acne is clearing away the heat-evil and expelling superficial evils.Based on the potency in clearing away the heat-evil and expelling superficial evils,the 12 patent Chinese medicines can be divided into 3 groups.CONCLUSION: In treating acne,the Chinese patent medicines used for clear away the heat-evil and expel superficial evils should be considered preferably based on the degree of pyretic toxicity followed by the choice of the matched drugs if accompanied with other pathogenic factor.

This paper analyzes how to raise higher vocational medical students' efficiency in physiological teaching with concept map as the teaching tactics.