Objective:To explore the influencing factors on patients' health seeking behavior in rural China by employing the theory of planned action.Methods:Data from cross-sectional household-based health survey carried out in 2008 were used in the study.Correlations between outcomes and explanatory variables were studied by Logistic regression.Results:The studying population included 19 389 adult patients over the age of 15.Illness awareness,medical experience and structural restriction factors had strong effect on whether the patients chose medical service.Pepople in different socioeconomical status suffered different influences.Conclusion:Responding to the changing trend of health service demand among rural residents,we should recognize the differentiation and allocate the healthcare resources more rationally.

Object To study the technological conditions of refining ?-linolenic acid by short-path distillation (SPD). Methods According to the characteristic of SPD, the effect of the operating parameters, such as the distillation temperature, the system pressure, the feeding rate, and the agitating speed, were studied on the purity of ?-linolenic acid. Results The appropriate process conditions for the purification of ?-linolenic acid by SPD are: distillation temperature 90 ℃—120 ℃, pressure 0.3 Pa, feeding temperature 60 ℃, feeding rate 90—100 mL/h, and rotating speed 150 r/min. Conclusion Refining ?-linolenic acid by SPD is a simple and convenient method. It is easy to achieve industrialization.

Objective To analyze the genetic diversity of snail populations from five provinces in China mainland. Methods Genomic DNA was amplified by random primer and the products were electrophoresed by 8% polyacrylamide and stained by 0.6% silver nitrogen. The results were recorded and analyzed. Results The average similarity and match percentage among the nine snail populations were 0. 721 4 and 0. 680 9 respectively. The cluster trees showed that the nine snail populations could be divided into three groups ; snails from Dali of Yunnan Province and Puge of Sichuan Province were the first isolated group; snails from Fuqing of Fujian Province and Dongtai of Jiangsu Province were clustered into the second group; the other four populations from Anhui Province and snails from Yixing of Jiangsu Province belong to the last group. Conclusion There is a large diversity among smooth-shelled snails in China although close relationship exists. The cluster trees gained by different snail populations are basically the same and consistent with the distribution of these populations. However, further study should be carried out on the cluster of smooth-shelled snails from Dongtai of Jiangsu Province.

Objective: To improve the diagnosis and treatment level of secretory otitis media (SOM) of children. Method :Clinical information of 80 children with SOM were colletcted and analysed. All of the 80 cases (144 ears)were treated by myringotomy with Grommet insertion. Among them, 30 cases by adenotonsillectomy. 10 cases by palatoplasty. Secretions of 54 ears were carded out by bacterial culture. Result:80 cases were followed up for 6 to 12 mothes. 120 ears of 144 were cured (83％) ,with hearing improved. The tympanograms and hearing threshold of pure tone were found to be normal. The Gram＇s positive and negative germs of bactevial culture were 20.7％ (6/29 samples ) and 24％ (6/25 samples ) respectively. Conclusion: Children with secretory otitis media should be treated as early as posible to improve the patients＇ hearing and develope their speech.

Abstract: Relapse and metastasis are the main causes responsible for failure of surgical operation in treating malignant tumors. This article introduces the present development in post-operation treatment of lung cancer, liver cancer and stomach cancer, showing that the synthetic treatment by stages combined with traditional Chinese medicine is the important way to prevent and treat the post-operation relapse and metastasis of tumors, and suggesting the optimized method for treatment.

OBJECTIVE:To investigate the value of genetic testing in clopidogrel individualized antiplatelet therapy for acute coronary syndrome(ACS)patients after percutaneous coronary intervention(PCI). METHODS:Clinical pharmacists participated in therapy for 3 ACS patients after PCI,and analyzed risk factors of stent thrombosis as the degree of lesion complexity,length and number of stents,complication,smoking history,etc. Clinical pharmacists suggested conducting clopidogrel genetic testing (CYP2C19,PON1,ACBC1),and suggested replacing antiplatelet agents,maintaining original plan and strengthening monitoring according to the results of genetic testing. RESULTS:The physicians adopted the suggestions of clinical pharmacists. After optimiz-ing antiplatelet therapy according to the results of genetic testing and clinical factors,3 patients were stable and discharged from hospital with drugs. CONCLUSIONS:Genetic testing can provide evidence for the formulation of individualized antiplatelet thera-py in ACS patients after PCI,and can be regarded as one of the breakthrough points for clinical pharmacists to carry out pharmaceu-tical care. In conducting genetic testing,clinical pharmacists should evaluate the risk of thrombosis in ACS patients and select the appropriate population for testing. At the same time,the clinical factors as medication compliance,stent thrombosis risk,therapeu-tic efficacy,ADR,and evidence-based pharmaceutical evidence should be comprehensively evaluated on the basis of genetic test-ing,and antiplatelet therapy plan should be optimized so as to guarantee the safety and effectiveness of drug use.

Correspondence between man and nature theory is the core of TCM chronomedicine, and also plays an important role in ancient Chinese philosophy. The theory believes that distinguishing the rhythm is the foundation of treatment; complying with nature is the core of treatment; taking advantage of wane and wax is the method of treatment. This article combined the physiological and pathological characteristics of children to review the prevention and treatment of pediatric diseases based on chronomedicine, with a purpose to provide inspirations for clinical treatment.

OBJECTIVE To survey the antibiotic usage and its rationality in clinical.METHODS From Jan 2009 to May of 2009,950 medical records were selected to conduct a retrospective investigation.RESULTS The incidence of antibiotic usage was 88.2%,71.6% cases were intended for active treatment,28.4% for preventive regimen.72% cases in internal medicine were for active treatment whereas 94% were for surgical prophylaxis.In terms of the antibiotic use,single drug accounted for 56.2%,two-drug 38.9% and three-drug 4.9%.Inspection rate of drug treatment was 69.7% and hospital infection rates was 2.1%.CONCLUSIONS To improve antibiotic administration,systematic efforts are required to keep the medical staff updated of antibiotic principles so as to improve clinical rational use of antibiotics.

Objective To compare the clinical effects of modified single open-door laminoplasty combined with segmental lateral screw fixation with conventional single open-door combined with continuous screw fixation in the treatment of multilevel cervical spondylotic myelopathy (MCSM).Methods Retrospective analysis was used to analyze the fifty-five cases of MCSM who underwent posterior operation in Lianyungang Hospital Affiliated to Xuzhou Medical University from March 2009 to January 2017.Among them,26 cases in the modified group were treated by modified single open-door laminoplasty combined with segmental lateral screw fixation;29 cases in the traditional group were treated by conventional single open-door combined with continuous screw fixation.JOA score collected before the operation and at the last time of the follow-up,the cervical spine mobility,cervical curvature,cervical axial symptom,C5 nerve root palsy and the incidence rate of screw fracture in both groups were compared.Operation time and the intraoperative blood loss were recorded.Results 55 cases were all followed up.The cervical spine mobility at the last time of the follow-up in the modified group was significantly higher than that of the traditional group ((39.63°±5.98°) vs.(36.14°±6.05°),P=0.036).The cervical curvature in the modified group was higher than that of the traditional group ((19.83°±5.61°) vs.(16.02°±7.05°),P=0.030).The operation time and intraoperative blood loss in the modified group were significantly lower than those of the traditional group ((116.3±13.2) min vs.(128.7±14.3) min,(186.7±39.8) ml vs.(228.7±42.5) ml,P=0.002,0.000).In the modified group,the proportion of patients with postoperative cervical axial symptom was 15.38%,the rate of C5 nerve root palsy cases was 8.69%,compared with 48.27% and 34.48%,respectively in the control group,the difference between the two groups was statistically significant (P=0.011,0.022).In the traditional group,2 cases of screw fracture were found at the last follow-up,while there was no such case in the modified group.Conclusion The modified cervical single open-door laminoplasty combined with segmental lateral screw fixation can obtain good effect of nerve decompression,maintain cervical mobility and cervical curvature,reduce the occurrence of postoperative cervical axial symptom,C5 never root palsy,screw fracture and other complications,is a safe and effective surgical method.

Objective:To solve the problems that the accounting treatment of donated business of each hospital was not uniform caused by the imperfect provisions of hospital accounting system.Methods:The relevant systems and policies were comprehensively reviewed and regularly analyzed.Results:The current accounting treatment was contrary to the matching and substance over form principle,which effected the authenticity and accuracy of the financial statements.Conclusion:Social donation was an important way of financing in hospital.It needed to divide the donated fund by limited or not limited,set up related subject and improve hospital accounting system.