OBJECTIVE:To study influence factors of medical students’rational drug use in clinical practice and to provide references for improvement of medical educations and rational drug use. METHODS:The information was obtained by 325 designed questionnaire"questionnaire for prescription behaviors of medical students’rational drug use"performed by students in two medical colleges of Jiangxi Province and was inputted using Epidata3.0 software. SPSS13.0 software was adopted to analyze data by means of descriptive statistical analysis and multiple linear regression analysis methods. RESULTS & CONCLUSIONS:The level of medical students’rational drug use was just a little below the average level. It was positive correlated to the self-evaluation on instructors’conducting frequency and the achievements in medical course,but with negative correlation to the performances of rational drug use knowledeg. The achievements in medical course in self-evaluation has great impact on rational drug use behaviors while the performances of rational drug use knowledge has little impact on it.

This experiment was done to compare the effects of antegrade and retrograde cold cardioplegic solutions on myoeardium in the presence of coronary obstruction. Twelve mongrel dogs were anesthetized with intravenous pentobarbital, and immediately after the left anterior descending of coronary artery (LAD) was tied off, all subjects were randomly allocated to receiving antegrade cardioplegic solution (4 C) through arotic root at initial dose of 20ml?kg~(-1) and supplemental dose of 10ml?kg~(-1) with perfusion pressure being 10.7kPa every 20 minutes (group n=6), or antegrade cardioplegic solution in the same way as mentioned above at initial dose of 10ml?kg~(-1) and retrograde cardioplegic solution at initial dose 10ml?kg~(-1) and supplemental dose of 10ml?kg~(-1) with perfusion pressure being 5.3kPa every 20 minutes (group Ⅱ, n=6), respectively. The occlusion of LAD lasted 60 minutes. As compared with the values of group Ⅰ, in group Ⅱ, there was a lower hypothermia in the myocardial re gion supplied by LAD during ischemia (P

BACKGROUND:Percutaneous kyphoplasty for the treatment of vertebral compression fractures has gained good clinical results and it is characterized as smal trauma, less bleeding and very low rate of complications. The vast majority of elderly patients can tolerate it, but this method cannot prevent fracture replase in the elderly. OBJECTIVE:To evaluate clinical outcomes of percutaneous kyphoplasty combined with anti-osteoporosis drug for the treatment of acute osteoporotic vertebral compression fractures METHODS:According to strict inclusion and exclusion criteria, 137 patients, including 26 males and 111 females, mean age of (75.55±6.96) years, with a total of 198 acute osteoporotic vertebral compression fractures treated by kyphoplasty that involves injection of polymethyl methacrylate cement under radiologic control into a treated vertebral body were conducted in this study. Al patients were asked to take anti-osteoporosis drugs for 3 post-treatment months. The primary outcomes were visual analogue scale, ertebral restoring rate, Oswestry disability index, Cobb angle at different time (pre-operation, 1 week and 3 months after operation). In addition, the rate of complications and the replase rate of vertebral compression fractures after operation were recorded. RESULTS AND CONCLUSION:There were significant differences in the mean visual analog scale scores, vertebral restoring rate, Oswestry disability index, Cobb angle at pre-procedure and post-procedure (at 1 week and 3 months) (P<0.001). In addition, the rate of postoperative complications was 0.7%and there were no vertebral compression fractures during 3-month fol ow-up period. Our study suggests that percutaneous kyphoplasty combined with anti-osteoporosis drug for the treatment of acute osteoporotic vertebral compression fractures can gain good clinical results.

Objective To investigate the efficacy and toxicity of concurrent chemoradiotherapy with nedaplatin versus cisplatin for patients with middle-advanced stage uterine cervical carcinoma.Methods 180 patients with middle-advanced stage uterine cervical carcinoma were randomized into concurrent chemoradiotherapy with nedaplatin group (nedaplatin group) and concurrent chemoradiotherapy with cisplatin group (cisplatin group).The short-term efficacy and the toxicity were observed.Results In the nedaplatin group,the short-term response rate、the one-year relapse-free surviva l、one-yea metastasis-free survival、the two-year relapse-free survival、the two-year metastasis-free survival were 98.85％、89.66、86.21％ 、85.06％ 和 80.46％,But in the cisplatin group,the short-term response rate 、the one-year relapse-free surviva l、one-yea metastasis-free survival、the twoyear relapse-free survival、the two-year metastasis-free survival were 97.60％ (x2 =3.07,P ＞ 0.05) 、81.93％(x2 =3.07,P ＞0.05) 、83.13％ (x2 =0.31,P ＞0.05) 、78.31％ (x2 =1.30,P ＞0.05) 和 80.72％ (x2 =0.00,P ＞ 0.05),so there was no significant difference.The incidences of nausea and vomiting in the cisplatin group were 52.27％ (grade Ⅰ ～ Ⅳ toxicities),12.50％ (grade Ⅲ ～ Ⅳ toxicities),which were higher than those in the nedaplatin group 27.27％ (grade Ⅱ ～ Ⅳ toxicities),6.82％ (grade Ⅲ ～ Ⅳ toxicities) (P ＜ 0.05),while there were no significant difference in the other toxicities such as anemia,granulocytopenia,thrombocytopenia,diarrhoea between the two groups (x2 =12.18,P ＞ 0.05).Conclusion The efficacy of concurrent chemoradiotherapy with nedaplatin is the same as that of concurrent chemoradiotherapy with cisplatin,and its toxicity is well-tolerated.

Objective To study the MR imaging technology and 3D reconstruction of the articular cartilage of knee.MethodsConventional,2D,3D and multiparameter MR imaging scans of knee were performed in ninety patients with trauma(n=34)andosteoarthritis(n=56) of knee and 10 healthy volunteers.The articular cartilages on 3D images were reconstructed using maximum intensity projection(MIP).The mean thickness of articular cartilage was measured and analysed statistically.Results Articular cartilages of knee were clearly depicted by MR imaging technique and 3D.On 2D FSE sequence,about 50% of articular cartilage appeared as three laminar apearance.On 3D imaging,the three-dimensional morphology of articular cartilage was showed clearly.Conclusion MR imaging and 3D reconstruction of the articular cartilages of knee is helpful in early diagnosis and treatment of disordered cartilages.

Objective To study the clinical features,diagnosis and treatment of polycystic liver disease (PLD)complicated with portal hypertension (PHT).Methods The clinical data of one patient with PLD and PHT was retrospectively analyzed,and relevant literature was reviewed.Results The patient presented fatigue,dyspepsia, abdominal distension and lower limb edema.Laboratory examination showed mild liver dysfunction(Alkaline phospha-tase 291.2U/L,gamma glutamyl transpeptidase 168.1U/L,59.9g/L,total protein,albumin 32.2g/L,21.0μmol /L, total bilirubin,direct bilirubin 11.5μmol /L).Abdominal ultrasound (US)and computerized tomography (CT) showed multiple noncommunicating cysts of varying size in both liver and kidney.Antioxidant supplements and diuretic were introduced,and the therapy was approved to be effective.Conclusion The case in this report illustrates that PLD could occasionally present with PHT.Physician should be alert to prevent misdiagnosis.

Objective To investigate the prognostic value of amino-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with sepsis.Methods A total of 162 patients was enrolled with consecutive pediatric intensive care unit (PICU) admissions during the study period of Jan 1st,2013 to June 30th,2013 at Hunan Children's Hospital.The 162 septic patients were divided into sepsis group and severe sepsis group,sepsis group and septic shock group,and survival group and death group.NT-proBNP was tested in the first and third day after 162 septic patients in hospital.Pediatric critical illness score (PCIS) score was assessed in all patients.NT-proBNP was compared between groups.The change of NT-proBNP was summarized between groups.The relationship between NT-proBNP and PCIS was analyzed.Results (1) The plasma NT-proBNP level of the first day after admission in the severe sepsis group and septic shock group was higher than sepsis group,the PCIS in the sepsis group was higher than severe sepsis group and septic shock group,with significant difference (P ＜ 0.05).(2) The plasma NT-proBNP level of the first day after admission in the death group was higher than the survival group,the PCIS in the death was lower than the survivor group,with significant difference (P ＜ 0.05).In the death group,the plasma NT-proBNP level of the third day after admission was higher than the NT-proBNP of the first day after admission (P =0.037) ; contrarily,the plasma NT-proBNP level of the third day after admission was lower than the NT-proBNP of the first day after admission in the survival group (P =0.023).Conclusions NT-proBNP could be used to assess the condition of septic patients,and dynamic test NT-proBNP can help to predict septic patient’s prognosis.

Objective To investigate the mutation screening of the GJB3,GJB2,mtDNA 1555 A>G and SLC26A4 gene in Hainan Pronive population with non-syndromic hearing impairment.Methods PCR were performed with one pair of primer in the coding sequence of GJB3,GJB2,mtDNA 1555 A>G and SLC26A4 gene.Bidirectional sequencing of PCR products was subsequently applied in 429 patients with hearing loss.Results 55 patients gene mutation of 429 patients were found. The point mutation in mtDNA was found in 5 patients (1.1 7%).1 5 5 5 A>G mutation of mtDNA was found in 4 patients. 1494 C>T mutation of mtDNA was found in one patients.GJB2 gene mutation was found in 25 patients (5.83%).235 del C mutation of GJB2 gene was found in 9 patients.235 del C/GJB2 299 del AT mutation was found in two patients.235 del C mutation was found in 10 patients.176 del 16 mutation was found in 4 patients.SLC26A4 mutation was found in 22 patients (5.13%).IVS7-2 A>G mutation of SLC26A4 was found in 4 patients.2168 A>G mutation of SLC26A4 was found in one patient.IVS7-2 A>G mutation was found in 12 patients.2168 A>G mutation was found in 5 patients.538 C>T mutation of GJB3 gene was found in 3 patient.IVS7-2A>G mutation and 2168 A>G muation of SLC26A4 gene was found in 4 of 22 EVA patients.Conclusion GJB2 gene and SLC26A4 gene have revealed responsible genes for Hainan deafness patients.

Objective To explore the therapeutic effect of rhIL-11 and rhG-CSF on mouse bone marrow injury induced by neutron irradiation.Methods 130 male BALB/c mice were irradiated by 3.0 Gy neutron and mice peripheral blood cells,bone marrow pathological changes,bone marrow nucleated cell counts,AgNOR content,apoptosis and necrosis rates and Bax protein content were observed by means of blood cells automatic analyzer,HE staining,AgNOR staining,flow cytometry,immunohistochemistry staining and image analysis.Results In the irradiation group and the rhIL-11 group,the mice peripheral blood white blood cells,bone marrow nucleated cell counts and AgNOR content was decreased progressively.The Bax protein was positively or strongly positively expressed in the cytoplasm of the hematopoietic cells and the Bax protein content was increased progressively at 6 h,1 d,3 d after irradiation.In the irradiation group,the rates of apoptosis and necrosis in the mice hematopoietic cells were greatly increased and that of necrosis was significant at 6 h after irradiation.In the rhIL-11 + rhG-CSF group,the counts of bone marrow nucleated cell and AgNOR were increased and the Bax protein content was decreased at 3 d after irradiation,while in the rhIL-11 group,the indexes mentioned above were not obviously different compared with those of the irradiation group.Conclusions The mice bone marrow hematopoietic function is seriously damaged by 3.0 Gy neutron irradiation,rhIL-11 and rhG-CSF could improve the mice hernatopoietic function after neutron irradiation,and combination of them is more effective to stimulate the hematopoitic function than either of them alone.

ObjectiveTo assess the relationship between the estimated glomerular filtration rate (eGFR) and the severity of coronary artery stenosis in elder people. MethodsSix hundred and fifty-seven patients who underwent selective coronary artery angiography were divided into 3 groups according to age: group Ⅰ (202 patients aged <60 years), group Ⅱ (181 patients aged from 60 to 69 years) and group Ⅲ (274 patients aged ≥70 years). According to the simplified MDRD equation,impaired renal function and severe renal dysfunction, respectively. Clinical features and the severity of coronary artery stenosis were compared among the 3 groups. ResultsThe level of average eGFR tended to he decreased with the narrowed coronary arteries. The difference of average eGFR between patients with muhivessel versus two-vessel coronary artery disease was of statistical significance in Group Ⅲ(P = 0. 035). After controlling for the effects of smoking, hypertension, dyslipidemia,aging, and diabetes, the Gensini score which reflected the severity of coronary artery stenosis was negatively correlated with the level of eGFR (r =-0. 110, P = 0. 005). ConclusionsIt suggests that the eGFR decrease is associated with the severity of coronary artery stenosis, and there is a linear correlation between eGFR and Gensini score in elder people, eGFR can be used to evaluate the severity of coronary artery disease and prognosis.