Objective To observe the effect of SSRI and SNRI drugs combined with clinical nursing path of untreated depression in patients with executive function. Methods From October 2014 to April 2016, the third people's Hospital of Yuyao was admitted to the 4 people's Hospital, who met the criteria of diagnosis and inclusion criteria. 80 cases of untreated depressive patients were randomly divided into two groups, according to clinical medication and nursing methods were defined as SSRI group, SSRI group and SNRI group, SNRI group, SSRI group were treated with 8 cycles of Pa Rossi Dean oral treatment, during the treatment group were given routine clinical care, SNRI group were given venlafaxine 8 During the period of oral treatment, treatment group Ⅱ were given clinical nursing path on the basis of conventional nursing, treatment and nursing care of patients before and after the change of executive function evaluation. Results SSRI Ⅱ, SNRI Ⅱ group WCST scores were better than SSRI Ⅰ, SNRI Ⅰ group; SNRI group Ⅱ WCST scores were better than SSRI group; SSRI group, SNRI group Ⅱ TMT evaluation results is better than that of SSRI group, SNRI group; SNRI group Ⅱ TMT evaluation results is better than that of SSRI group; the SSRI Ⅱ SNRI Ⅱ group the experimental results of TOL is better than that of SSRI group, SNRI group; SNRI group Ⅱ TOL experimental results better than SSRI Ⅱ group. Conclusion SSRI and SNRI drug treatment untreated depression patients exactly, combined with clinical nursing path can effectively improve the patients with degree of functional recovery, is worthy of clinical application.

This article is aimed to establish the method of quality standards for highland barley Monascus.Microscopic and TLC were adopted to identify Araliataibaiensis. Referring the relevant method in Chinese Pharmacopoeia (2010 edition) for the determination of its moisture, total ash, acid insoluble ash and extracts,lovastatin in acid and lactone form was determined using high performance liquid chromatography. The characteristics of highland barley Monascus in microscopic and TLC were obvious and specific. The contents in barley red yeast are: water 6.04%-8.78%, total ash 2.15%-2.92%, acid insoluble ash 0.23%-0.29%, water extracts 27.99%-30.17%; alcohol extracts 14.12%-18.51%. The ranges of lovastatin in acid and lactone form are 0.11%-0.29% and 0.02%-0.08%, respectively. The established method is simple, accurate, reliable and duplicable, and can be used to control the quality of highland barley Monascus.

Objective To investigate the clinical application of acupuncture combined with general anesthe -sia in gynecologic laparoscopic surgery .Methods 60 ASA( the American society of anesthesiologists )Ⅰ-Ⅱpatients undergoing elective gynecologic laparoscopic surgery were randomly divided into the acupuncture group and control group.Patients in the acupuncture group were chosen Hegu (LI 4),Neiguan(PC 6) on both sides.After acupuncture, the two acupoints,electroacupuncture stimulated 20-30min,then administered general anesthesia ,electroacupuncture until surgery finished ,the control group received general anesthesia only .The drug dosages of the two groups was regu-lated,maintained anesthesia depth bispectral index ( BIS) between 40 and 60.The changes of the blood pressure ( BP) ,heart rate and BIS of the two groups at the same time points were observed;the propofol and remifentanil dos-age after the surgery ,the awaken time and extubation time ,OAA/S score and pain score after wake ,the happening of restlessness,chills,nausea and vomiting ,the usage of narcotic analgesics postoperation ,and the intraoperative aware-ness were recorded .The effect of acupuncture combined with general anesthesia was evaluated .Results Anesthetic dosage propofol of the acupuncture group [(7.44 ±1.30)μg· kg-1· h-1] was less than [(8.66 ±1.24)μg· kg-1· h-1] of the control group (t=3.720,P=0.001),remifentanil dosage was also less than the control group [acupunc-ture group (10.59 ±2.58)μg· kg-1· h-1,control group (11.93 ±2.27)μg· kg-1· h-1,t=2.168,P=0.034]. Compared with the basic value ,the BP values were higher at the time of intraoperation ,waking,extubation and 10 min after extubation (all P<0.05),the acupuncture group had more stable BP .Compared with the acupuncture group , heart rates in the control group were faster at extubation and 10min after extubation .Recovery time and extubation time of the acupuncture group were (9.05 ±2.36)min and (1.61 ±2.40)min,which were shorter than (12.50 ± 3.20)min and (15.90 ±3.37)min of the control group (P<0.05).Pain score(VAS) in the acupuncture group was lower than that of the control group .Consciousness score was higher in the acupuncture group ,the incidence rates of restlessness,chills were less.Conclusion The use of acupuncture combined with general anesthesia in gynecologic laparoscopic surgery can reduce the dosage of general anesthetics ,shorten the awaken time and extubation time ,increase the OAA/S score of the patients ,relieve pain ,and the recovery quality is higher .

Objective:To explore the application and influence of task-driven teaching in the internship of rehabilitation medicine among general medical students.Methods:A total of 256 students of the same grade from the fifth clinical college of Chongqing Medical University were included in this study. 128 students were selected as the experimental group to receive task-driven teaching, and another 128 students were selected as the control group to receive traditional teaching. Course design for students in the experimental group was evaluated, and the learning effects were compared between the two groups.Results:In the experimental group, more than 88% students were relatively satisfied with the tasks designed. The ability of self-study and independent thinking of students in the experimental groups was better than those in the control group ( P<0.05). In the aspect of problem solving, expression, cooperation, modern information utilization and creative thinking ability, students in the experimental group did a significantly better performance than those in the control group ( P=0.000), and students' learning motivation was significantly increased in the experimental group than in the control group ( P=0.000). Conclusion:In the internship of rehabilitation medicine, task-driven teaching was highly accepted among students and received fair satisfaction. It improves the learning effect of students majoring in general medicine and promotes the understanding for rehabilitation medicine, which lays a foundation for the work of primary hospitals in the future.

The aim of this study was to conduct the preparation and pharmaceutical characterization of a new type of terbinafine hydrochloride bioadhesive film-forming gel. The viscosity of the gel of(13 299±51)mPa ·s, pH of 3. 50±0. 50, and the shearing viscosity of(196±4)g/cm2 was found. This new gel turned out to be a layer of solid film on the application site in a very short time. The remaining solid ratio of the resulting film was estimated to be(50. 74±2. 81)%; the tensile strength was(1. 17±0. 21)MPa; and the breaking elongation was(21. 42±3. 24)%. In vitro release behavior of terbinafine hydrochloride from the film was investigated according to the paddle over disk method in ChP2010. Terbinafine hydrochloride released continuously for 10 h from the film. Improved Franz type diffusion cells were used in vitro transdermal studies by the application of excised minipigs skins. No penetration of drug into the receptor medium across the skin existed and so it could imply the safety for local application. It was found that(93. 05±5. 66)% of drug stayed on the skin surface while(1. 15±0. 85)% entered into the skin, which was beneficial for the treatment of superficial skin fungal infection.

Objective:To explore the effect of "flash" traingingand traditional training on improving the insulin theoretical knowledge and identification ability of nurses in non-endocrinology department.Methods:We selected 443 nurses from the non-endocrine ward of our hospital by stratified sampling, and divided them into the experimental group (227 cases) and the control group (216 cases). Before the training, questionnaires on insulin knowledge were conducted. The experimental group was trained in the form of "flash", and the control group was trained with traditional training. After the training, the theoretical and operational results of the two groups were compared to analyze the error rate of common problems and training satisfaction. Chi-square test and t test were carried out by SPSS 22.0. Results:The scores of questionnaire about insulin identification knowledge and operation in the experimental group were significantly higher than those in the control group, ( P<0.01). The experimental group have significantly better control in insulin classification and insulin onset time than the control group ( P<0.01). The satisfaction of nurse was significantly higher in the experimental group than in the control group ( P<0.01). Conclusion:Non-endocrinology nurses are lack of theoretical knowledge and recognition ability of insulin. The "flash" training can improve their training satisfaction, and ensure the effectiveness and safety of insulin treatment.

Objective:To study the influence of the choice of main diagnosis on diagnosis-related groups(DRG) grouping and weight change, by taking cerebral infarction as the entry point.Methods:From January 1, 2019 to March 31, 2019, 331 patients in three DRG groups(BR25, BR23, BR21) with cerebral infarction were selected. The original group was used as the control group; the main diagnosis was exchanged with the first other diagnosis, then DRG group was used as the experimental group. The difference of the number of cases and weight between the two groups was analyzed.Results:41.4%(137/331) of the patients in the experimental group were enrolled in BZ11 with other neurological disorders associated with important comorbidities and comorbidities, and 82.5%(273/331) patients′ weight increased after diagnostic conversion.Conclusions:Choosing other diagnosis as the main diagnosis may change the weight of the disease and affect the corresponding disease benefit. In order to prevent downcoding, DRG grouping should be detailed, and DRG payment should consider how to reflect the value of difficult cases; for upcoding behavior, medical insurance center and relevant medical institutions should check the correctness of coding, and monitor in place.

This study aimed to explore the effect of miR-23b-3p on the differentiation of goat intramuscular preadipocytes, and to confirm whether miR-23b-3p plays its roles via targeting the PDE4B gene. Based on the pre-transcriptome sequencing data obtained previously, the miR-23b-3p, which was differentially expressed in goat intramuscular adipocytes before and after differentiation, was used as an entry point. real-time quantitative-polymerase chain reaction (qPCR) was used to detect the expression pattern of miR-23b-3p during the differentiation of goat intramuscular preadipocytes. The effects of miR-23b-3p on adipose differentiation and adipose differentiation marker genes were determined at the morphological and molecular levels. The downstream target genes of miR-23b-3p were determined using bioinformatics prediction as well as dual luciferase reporter assay to clarify the targeting relationship between miR-23b-3p and the predicted target genes. The results indicated that overexpression of miR-23b-3p reduced lipid droplet accumulation in goat intramuscular adipocytes, significantly down-regulated the expression levels of adipogenic marker genes AP2, C/EBPα, FASN, and LPL (P < 0.01). In addition, the expressions of C/EBPβ, DGAT2, GLUT4 and PPARγ were significantly downregulated (P < 0.05). After interfering with the expression of miR-23b-3p, lipid droplet accumulation was increased in goat intramuscular adipocytes. The expression levels of ACC, ATGL, AP2, DGAT2, GLUT4, FASN and SREBP1 were extremely significantly up-regulated (P < 0.01), and the expression levels of C/EBPβ, LPL and PPARγ were significantly up-regulated (P < 0.05). It was predicted that PDE4B might be a target gene of miR-23b-3p. The mRNA expression level of PDE4B was significantly decreased after overexpression of miR-23b-3p (P < 0.01), and the interference with miR-23b-3p significantly increased the mRNA level of PDE4B (P < 0.05). The dual luciferase reporter assay indicated that miR-23b-3p had a targeting relationship with PDE4B gene. MiR-23b-3p regulates the differentiation of goat intramuscular preadipocytes by targeting the PDE4B gene.
Animals ; MicroRNAs/metabolism* ; Goats/genetics* ; PPAR gamma/metabolism* ; Adipogenesis/genetics* ; Cell Differentiation/genetics* ; Luciferases ; RNA, Messenger

OBJECTIVETo evaluate the cost-effectiveness of two-stage and three-stage hearing screenings for newborns.

METHODSHearing screening was performed for the normal newborns born in 7 hospitals in Beijing from October 2010 to December 2012 by using two stage and three stage strategies as well as hearing diagnostic test, and the cost effectiveness evaluation of two strategies was conducted. The data about the cost of screening and diagnostic test were from the hospitals. The data about car fare and charge for loss of working time of parents were collected through questionnaire survey. The sensitivity was analyzed according to the compliance rate.

RESULTSA total of 62,695 newborns received initial hearing screening, 5,809 newborns failed, the positive rate was 9.30%. A total of 4,933 newborns received rescreening, 972 newborns failed, the positive rate was 19.70%. Among the newborns failed in rescreening, 412 were provided with hearing diagnostic test and 360 received diagnostic test. The diagnostic test indicated that the hearing of 217 newborns were abnormal (60.28%). A total of 276 newborns received the third screening, 163 newborns failed, in which 125 received diagnostic test and 112 had abnormal hearing (45 had moderate and above hearing impairment), the abnormal rate was 89.60%. The average cost for three-stage screening (37,242 yuan RMB per case) was higher than that for two-stage screening (19,985 yuan RMB per case). With the increase of compliance, the cost-effectiveness of three-stage screening increased.

CONCLUSIONThe cost-effectiveness of three-stage screening was influenced by screening compliance. It is recommended that three-stage screening strategy might be taken in area where the screening compliance rate is >90%.

Cost-Benefit Analysis ; Hearing Loss ; diagnosis ; Hearing Tests ; economics ; methods ; Humans ; Infant, Newborn ; Neonatal Screening ; economics ; methods