[Objective]To investigate the clinical effect of Chinese herbal medicine washout combined with lactic acid bacteria vaginal capsule on refractory vaginitis. [Method] Divide 500 patients into 3 types: downward flow of damp-heat, damp toxin implication, internal heat due of Yin deficiency, which treated with different decoctions with lactic acid bacteria vaginal capsule. Fol ow up for 3m after treatment course, observe recurrence; make vaginal secre-tion tests before and after treatment. [Result] In downward flow of damp heat type, 139 cases were cured, 11 effective, the total effective rate 100%; on damp toxin implication type, 183 cases were cured, 13 effective, total effective rate 100%;for internal heat due to Yin deficiency, 141 were cured, 9 effec-tive and total effective rate 100%. There’s no recurrence after 3m. [Conclusion] The said method can effectively regulate vaginal micro-ecological envi-ronment and reduce recurrence of refractory vaginitis, with safe clinical application and definite cure effect.

Two kinds of incorrect cultivation modes were existed since the launch of cultivation for professional degree postgraduate of clinical medicine:taking professional degree postgraduates as scientific degree postgraduates to cultivate or taking scientific degree postgraduates as professional degree postgraduates to cultivate.In this paper,taking the cultivation of oncologic professional degree postgraduates as example,we put forward some suggestions:strengthening clinical skill training,promoting thinking mode of evidence-based medicine and enhancing clinical trial and statistical training.

One hundred and five patients with non-ST segment elevation acute coronary syndrome were followed up for 1 year.They were assigned to the event group or non-event group according to the presence of endpoint events(cardiac death and nonfatM myocardial infarction).B-type natriuretic peptide level was measured at 30 days and 1 year and compared between the two groups.The results showed that the level of B-type natriuretic peptide was higher in the event group[(235±107)μg/L vs(154±49)μg/L at 30 days;(259±100)μg/L vs(143±57)μg/L at 1 year].Thus,B-type natriuretic peptide is an important prognostic factor for patients with non-ST segment elevation acute coronary syndrome.

Objective To investigate the clinical effect of low molecular weight heparin (LMWH) and pressure pump on perioperative deep vein thrombosis (DVT) in patients with hip fracture and analyze the effect of LMWH on coagulation function. Methods Retrospective analysis of 95 cases hip fractures patients with clinical data, according to the preventive medication of DVT were divided into LMWH group of 42 cases and LMWH joint pressure pump group of 53 cases. The incidence rate of DVT and the degree of limb swelling after operation in two groups were observed. The differences of blood coagulation function indexes, blood rheology and hip function recovery were compared between the two groups. Results The the incidence rate of DVT in combination group was 1.89% (1 cases ), lower than LMWH group of 14.29% (6 cases )(χ2=5.278,P=0.022). After two weeks' treatment, the difference of anterior thigh circumference and calf circumference in combination group was less than LMWH group (P<0.05). The prothrombin time (PT) and activated partial thromboplastin time (APTT) in two groups post-treatment were lower than those pre-treatment, the D-dimer (D-D) was higher than that pre-treatment(P<0.05), but there was no significant difference between two groups. After 3 months' treatment, the Harris functional independence measure (FIM) in combination group was higher than that in LMWH group (P<0.05). Conclusion LMWH combined with pressure pump could significantly reduce the incidence of perioperative DVT in patients with hip fracture, improve the blood coagulation function and hip function.

PurposeAs a main method to detect thyroid nodules, ultrasonography seems to have a rather low accuracy in differentiating benign and malignant ones. The present study aims to explore the diagnostic value of thyroid imaging reporting and data system (TI-RADS) in identifying benign and malignant thyroid nodules.Materials and Methods A total of 168 patients with thyroid nodules conifrmed pathologically (with 251 suspicious nodules) underwent ultrasonography and were further grouped into category 3-5 according to TI-RADS classiifcation standard. The results were retrospectively compared with histopathological ifndings. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of TI-RADS classiifcation in the diagnosis of benign and malignant thyroid nodules were calculated, and the differences in ultrasonic features between benign and malignant thyroid nodules were also compared.Results The surgical and pathological findings showed that 94 nodules were benign and 157 were sinister; TI-RADS regarded 93 nodules were benign and 185 were malignant. The difference of the two means of identification was significant (χ2=149.6,P<0.01). The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of TI-RADS were 91.2% (144/157), 85.1% (80/94), 89.3% (224/251), 91.2% (144/158) and 86.0% (80/93), respectively. The ultrasonic manifestations of benign and malignant nodules were signiifcantly different with regard to aspect ratio, echogenicity, shape, calciifcation inside the nodule (χ2=8.7-121.4,P<0.01).Conclusion TI-RADS classiifcation standards have a high accuracy in the differentiation of benign and malignant thyroid nodules as a means of ultrasound examination, and thus can serve as an important guiding method in clinical diagnosis and treatment.

Objective To observe the alteration of duodenogastric reflux after cholecystectomy so as to explore the basis for diagnosis and therapy. Methods Intragastric bile reflux during 24 hours was assessed using ambulatory bilirubin monitoring and 24-hour pH monitoring techniques in 20 cholecystectomy patients, 10 cholelithiasis patients and 15 healthy volunteers. Results Bile reflux and alkaline reflux of cholecystectomy patients did not increase compared with those of cholelithiasis and the control. Conclusion Duodenogastric reflux of patients receiving postcholecystectomy patients does not increase.

8 hours and without and binding nursing in these 3 groups respectively. Observed the condition of respiratory tract infection in 3 groups. Results The incidence rate of respiratory tract infection in binding nursing groups was 50%, which was significant higher than that of in no binding nursing group (P8 hours group was 66.67%, and this rate had an tendency of rising with the time of binding nursing lasting (P

Objective To explore the efficacy,safety and life quality of patients of morphine hydrochloride sustained-release tablets combined with celecoxib in the treatment of advanced lung cancer with moderate to severe cancer-induced pain.Methods A total of 247 patients of advanced lung cancer with moderate to severe cancer-induced pain were randomly divided into combination therapy group (n =127) and morphine monotherapy group (n =120) using simple random sampling digital table method.The differences of dose,efficacy,adverse drug reactions and life quality between the two groups were analyzed.Results In achieving similar analgesic effect,the average maintenance dose of morphine in combination therapy group was (52.51 ±19.92)mg/d,lower than that in monotherapy group [(58.75 ±20.64)mg/d,t =-2.414,P =0.017].The incidence of constipation in combination therapy group was 34.6％,lower than that in monotherapy treatment group (47.5 ％,x2 =4.218,P =0.040).The life quality of the two groups were improved,and the life quality improvement rate in combination therapy group was 59.8％,higher than that in monotherapy treatment group (43.3％,x2 =6.736,P =0.009).Conclusion Morphine hydrochloride sustained-release tablets combined with celecoxib is effective in the treatment of moderate to severe cancer pain,which can reduce the dosage of morphine and reduce adverse reaction,so as to improve the life quality of the patients with advanced lung cancer.

Objectives To compare the migrating motor complex (MMC) in irritable bowel syndrome (IBS) patients with that in healthy controls. To explore whether discrete clustered contractions (DCC) are connected with abdominal pain in IBS patients. To improve the method of measuring gastroenteric motility (esp. jejunum). Methods By using 16-channel water-perfused catheter and manometry instruments, MMC in 16 cases of IBS with constipation (IBS-C), 18 cases of IBS with diarrhea (IBS-D) and 18 cases of healthy controls were monitored. Results The MMC durations of IBS-C and IBS-D patients were (127.5±25.5) min and (74.5±18.7) min, respectively. Comparision with those in the control group [(87.5±24.2) min]showed significant differences (P<0. 001). The contraction amplitudes of stage Ⅲ in different sites of IBS-C patients decreased significantly as compared with those in the controls [jejunum, (39.8±11.7) mm Hg vs. (61.1±14.1) mm Hg,P<0.001,1 mm Hg=0.133 kPa]. The propagation velocities of stage Ⅲ in different sites of IBS-C patients also decreased significantly as compared with those in the controls [jejunum, (1.8±0.9) cm/min vs. (2.6±0.8) cm/min,P<0.01].The contraction amplitudes of stage Ⅲ in different sites of IBS-D patients increased significantly as compared with those in the controls [jejunum, (69.7±20.5) mm Hg vs. (61.1±14.1) mm Hg, P<0.01]. The propagation velocities of stage Ⅲ in different sites of IBS-D patients also increased significantly as compared with those in the controls [jejunum, (4.1±2.5) cm/min vs. (2.6±0.8) cm/min, P < 0. 01]. DCC incidences of IBS-C and IBS-D were 87.5% and 88. 8%, respectively. Comperision with those in the normal group (83.3%) did not show significant difference (P>0.05). The prevalences of abnormal stage Ⅲ contractions (include disturbances and interferences of stage Ⅲ contractions) in IBS-C and IBS-D patients were 68.8% and 66. 7%, respectively; there were no significant differences between the two groups (P > 0. 05). However abnormal stage Ⅲ contractions did not exist in healthy controls. Conclusions (1) The MMC of IBS-C and IBS-D patients are changed, as compared with that in healthy people; this implies that small intestinal motility dysfunction is one of the pathogenetic factors of IBS. The abnormal stage Ⅲ contractions in jejunum may be a predominant change in IBS gastroenteric motility. (2) No apparent connection is found between DCC and pain in IBS. (3) By using 16-channel water-perfused catheter, we first carried out the method of monitoring jejunum contractions in China. Parameters of MMC in Chinese healthy people were investigated, esp. those of jejunum.

Objective To explore the risk factors of skeletal related events (SREs) in non small cell lung cancer with bone metastases and its effect on the prognosis .Methods Totally 223 cases of NSCLC patients with bone metastasis were retrospective studied from January 2010 to December 2012 in our hospital .The clinical features ,predictive factors for SREs were analysed by sin‐gle factor and multifactor analysis .Results Among 223 cases of NSCLC patients with bone metastasis ,119 cases occured with SREs(53 .4% ) .Univariate analysis showed that the occurrence of SREs in female ,no smoker ,adenocarcinoma ,solitary bone metas‐tasis lesions were less than the male ,smoker non‐adenocarcinoma ,and multiple bone metastases (P<0 .05) ,but the rost without statistically significant(P>0 .05) .The multivariate analysis revealed only multiple bone metastases was an independent risk factor for SREs .The median survival time of the NSCLC patients with bone metastasis was 15 .3 months .Moreover ,survival analysis showed that SREs had no statistical significance on the prognosis of bone metastasis in NSCLC patients (P>0 .05) .Conclusion The female ,adenocarcinoma ,smoking history ,solitary bone metastasis lesions occurred in patients with lower risk SREs .Multiple bone metastasis is an independent risk factor for SREs ,attention should be paid to monitoring and prevention .