Objective To observe and analyze the clinical effect of Modified Decoction for the treatment of lung -qi and spleen -qi deficiency syndrome in patients with stable stage of chronic obstructive pulmonary disease (COPD).Methods 86 patients with lung -qi and spleen -qi deficiency syndrome in stable stage of COPD were divided into the observation group (n =43) and control group (n =43) according to a random number table method. The control group was treated with conventional western medicine therapy,the observation group was given modified Bufei decoction treatment on the basis of western medicine treatment.The clinical therapeutic effect of two groups was assessed.Results The effective rate of the observation group was 83.72%,which was significantly higher than 72.09% of the control group,the difference was statistically significant (χ2 =3.9289,P <0.05).After treatment,the FEV1 ,FEV1 /FVC,FEV1% expected values of the two groups were significantly higher than those before treatment (t =3.6984,3.6915,3.7431,4.2675,4.6821,5.0567,all P <0.05).After treatment,the FEV1 ,FEV1 /FVC, FEV1% predicted value of the treatment group were (2.45 ±0.35)L/s,(63.91 ±7.42)%,(47.29 ±7.52),which were significantly higher than those of the control group (t =3.6884,3.7581,4.1957,all P <0.05).After treatment, the levels of IL -8 and TNF -αwere not significantly changed in the control group.The levels of IL -8 and TNF -αin the observation group were significantly lower than those in the control group (t =8.864,9.571,all P <0.05). Conclusion In COPD patients of stable stage with lung -qi and spleen -qi deficiency syndrome,plus or minus fill lung soup can effectively relieve clinical symptoms and improve pulmonary function of patients,reduce the acute attack,and improve the quality of life of patients,it is worthy of clinical application.

ObjectiveTo study the characteristics of coping style and social support of college students and the relationship between them.Methods336 students from Xi'an International Studies University was surveyed with the coping style questionnaire and the social support sale.Results and ConclusionThe social support factors of college students and problem solving factor as well as asking for help are positively correlated, but it is negatively correlated with the withdrawing factor. A significant difference is shown in the imaginative coping style and the objective supporting score between male and female students, in the problem solving factor and the imaginative coping style among students of different grades, in self-criticism and the imaginative factor among students coming from different areas, finally, in the imaginative factor and withdrawing factor between single child and non-single child of a family.

Adolescent ; Adult ; Busulfan ; therapeutic use ; Female ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Male ; Middle Aged ; Transplantation Conditioning ; methods ; Young Adult

Objective To explore the value of urinary albumin/creatinine ratio (ACR) in coronary heart disease(CHD) compli-cating thyroid dysfunction and its correlation with the various detection indicators of thyroid function.Methods The results of uri-nary ACR and thyroid function detection in 863 patients with CHD in our hospital from November 2015 to August 2016 were col-lected.According to the standards of American National Kidney Foundation (NKF) and Food and Drug Administration(FDA) ,863 CHD patients were divided into the group A (ACR≤10.0 mg/g · Cr) ,B(10.0 mg/g · Cr< ACR≤30.0 mg/g · Cr) ,C (30.0 mg/g · Cr300 mg/g · Cr).According to the reference values of thyroid functional indica-tors ,these patients were divided into the thyroid function normal and abnormal groups.Results The ACR level was negatively cor-related with the FT3 level in 863 CHD patients(r= -0.297 ,P<0.05) ,and was positively related with the FT 4 level(r=0.172 , P<0.05).The abnormal rate of thyroid function had significantly statistical difference among four groups (χ2 =33.533 ,P<0.05). The abnormal rate of thyroid function had significantly statistical difference between the patients with ACR >10.0 mg/g · Cr and the patients with ACR ≤ 10.0 mg/g · Cr ,the difference was statistically significant (P< 0.05) ,its risk degree was 2.083. Conclusion ACR is likely to be a risk factor for CHD patients complicated with thyroid dysfunction.It is necessary to monitor the thyroid function when ACR level >10.0 mg/g · Cr in CHD patients.

Objective To establish a comprehensive evaluation system for clinical pathway quality for evaluation and verification.Methods Literature retrieval, clustering mergers and experts consultation method were used to determine indicators for clinical pathway quality evaluation, while gray correlation method was employed to calculate indicators weight coefficient and to evaluate indicators scoring,and sum indicators weighted scoring, so as to establish a clinical pathway quality comprehensive evaluation model.Indicator data of Shanghai′s 18 tertiary hospitals were used for verification.Results A total of 12 evaluation indicators, such as entry rate, mutation rate, completion rate and average length of stay were selected.After the weight calculation and grade scoring, the mathematical model of clinical pathway quality comprehensive evaluation was constructed.Data of these hospitals were put into the evaluation system for assigning ratings calculation, harvesting the overall score and ranking of each hospital.These data can help find out key management and key hospital intervention indicators in the next stage.Conclusions Different hospitals will be put on the same platform for comparison in this clinical pathway evaluation system, and the results can be quantified.The authors suggest that the next stage of health administration focus on the management of the hospitals and the key management of the sectors, making possible the prospective management of clinical pathways.

Objective To analyze the correlation between the diagnosis and treatment and the postoperative death and complication of the elderly patients.Methods A total of 1 932 cases of surgical patients (over 70 years old) were collected from a three-level general hospital 2013-2015.Their medical information of the treatment methods were recorded,including incision category,surgical approach,surgical grade and patient outcome after surgery(death or postoperative complications).Then we analyzed the incidence of death or postoperative complications,as well as the effects of treatment and postoperative outcome on complications or mortality.Results The admission status and incision type were the risk factors of postoperative death in elderly patients.Admission status pollution type,surgical approach and surgical grade were the risk factors of postoperative complications.Conclusion In order to reduce the risk of postoperative death and complications in elderly patients,the effect of admission and incision on the postoperative risk of elderly patients should be evaluated.

OBJECTIVE:To discuss how to carry out clinical pharmacy in second-class medical institution.METHODS:The contents,methods and experience of implementing clinical pharmacy in our hospital in recent 6 years were summarized.RESULTS:The practice such as reorganizing departments,training professionals,pharmacists' ward round,providing information services and supervising of ADR etc facilitated the combination of medicine and pharmacy,enhanced the quality of medical treatment and shed insights into the exploring of a suitable clinical pharmacy mode.CONCLUSION:The support of policy and the training of clinical pharmacists are essential factors for the successful clinical pharmacy.

Medical morality,especially dental ethical account is usually demonstrated by ethical theories,including theory of utilitarianism,deontology,and virtue ethics.In fact,the true purpose of medical education is to produce erudite and humane practitioners and medical researchers.The present study discussed the efficacy of dental ethical educations through clinical practical issues.

Objective To discuss the characteristics of ultrasonic images obtained by color Doppler per rectum after intrarectal pouring and the advantages of this method.Methods 40 cases who were diagnosed as rectal carcinoma prior to surgeries were investigated.The rectum was cleand and then was poured with normal saline before examination.Color Doppler ultrasonography per rectum was performed with intrarectal probe touching the inferior edge of the tumor.The 2-dimensional images and color Doppler images were then analyzed.Results The accurate typing of rectal tumors(detailedly,the ulcerative,intumescent,and confined types)can be obtained with this method.Within the 40 cases,24 were ulcerative,12 were intumescent and 4 were confined.Only one case with ulcerative tumor was misdiagnosed as intumescent.The total accuracy rate was 97.5%.As with rectal tumors less than 5cm,there was no significant difference between the measurement by ultrasonography and that by pathologic methods (P＞0.05).While for tumors larger than 5cm,the measurement by ultrasonography was significantly different from that by pathologic methods (P＜0.05).There was no significant correlation between the bloodstream signal of color Doppler and pathological grading(P＞0.05).The method can be applied for patients who have a narrow rectal duct or are suffering from agonies which prevent the passage of the colonoscope.For cases failing to detect the margin and surface of the tumor with routine method,or ultrasonic probe failing to pass the confined area leading to illegible 2-dimensional images,This method is competent as well.Conclusion Color Doppler ultrasonography per rectum after intrareetal pouring can be applied for the diagnosis of rectal tumors of all types.

Objective To investigate the protective effect of NS398,a specific cyclooxygenase-2 inhibitor,on microglial activation-mediated neuronal damage.Methods The microglia of neonatal SD rat were isolated and cultured in the medium containing 1 μg/ml of LPS.The morphological changes of microglial were observed.The IL-1β and TNF-α levels were detected by Western blot in LPS group (group L) and control group (group C).The hippocampal neurons of neonatal SD rats were cultured in the control medium (group C),LPS-activated microglial conditioned medium (group L) and LPS-activated microglial conditioned medium with NS398 (group N),respectively.The survival rate of neurons were detected by MTT.The respiration of hippocampus neurons was determined by detecting the ratio of lactic acid/pyruvic acid.Results LPS-induced microglial activation was characterized by the morphological change and increased secretion of IL-1β and TNF-α.The survival rate of neurons cultured by microglia activated conditioned medium was 64.37％,while the group N was 80.25％ (P＜0.01).In group L,the ratio of lactic acid/pyruvic acid (27.34±8.53) was significantly higher than that of group N (20.32±6.05,P＜0.01) and group C (14.95±4.72,P＜0.01).Conclusion NS398,a specific cyclooxygenase-2 inhibitor,has a protective effect on rat hippocampus neuron damaged by activated microglia.