Objective To discuss the clinical efficacy of compound methylene blue liquid local closure combined with Gegen Jiazhu decoction in the treatment of anal pruritus.Methods 88 cases of anal pruritus patients from June 2015 to June 2016 in our hospital were randomly divided into observation group and control group,44 cases in each group,the observation group was treated with ompound methylene blue liquid local closure combined with Gegen Jiazhu decoction,patients in control group were treated with miconazole cream,the efficacy of the two groups were compared.Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05); There were no significant differences in anal eczema,skin eczema,skin licheniformis and skin pigmentation symptoms before treatment between two groups; After treatment,the anal eczema,skin eczema,skin licheniformis and skin pigmentation symptoms score of the observation group was significantly lower than the control group(P<0.05); patients in the observation group,skin itching disappeared disappeared and the improvement of sleep time was significantly shorter than the control group(P<0.05); After treatment one,three,six months,the recurrence rate of observation group was significantly lower than the control group(P<0.05).Conclusion The clinical efficacy of compound methylene blue liquid combined with Gegen Jiazhu decoction can effectively improve the clinical symptoms of patients with anal itching,the treatment effect is good,the recurrence rate is low.

Objective To investigate the clinical efficacy of thiophene tiotropium powder inhaler for postop-erative lung function recovery in lung cancer patients.Methods 80 patients of thoracic surgery lobectomy who had lung cancer were selected as research subjects.The patients were randomly divided into two groups.The observation group received tiotropium bromide powder for inhalation therapy,the control group was inhaled salmeterol /fluticasone propionate powder for inhalation therapy.Before treatment,after treatment,2d,6d of CRP,absolute neutrophil ANC, tumor necrosis factor α(TNF -α) were observed.Before treatment,after treatment 4 weeks,8 weeks of forced vital capacity (FVC),within one second force expiratory volume in FEV1 ,FEV1 percent predicted (FEV1%),FEV1 /FVC, PaO2 ,PaCO3 were detected.Results Before treatment,CRP,AND,TNF -αhad no significant differences between the two groups (all P >0.05).Postoperative 2d,CRP,ANC,TNF -αof the two groups were all increased.Postopera-tive 6d,the above indicators of the two groups were declined,and the decline of the observation group was significantly lower than the control group (t =3.163 4,3.651 8,4.025 3,all P <0.05).Before treatment,FVC,FEV1 ,FEV1%, FEV1 /FVC,PaO2 ,PaCO3 between the two groups had no significant differences (all P >0.05).4 weeks,8 weeks af-ter treatment,FVC,FEV1%,FEV1 /FVC,PaO2 of the observation group were significantly higher than the control group (t =2.041 8,4.116 7;2.043 1,3.722 8;3.056 2,4.138 6;3.227 6,5.161 9;all P <0.05),FEV1 ,PaCO3 were significantly lower than the control group (t =1.523 7,3.427 6;3.439 2,4.521 7;all P <0.05).Conclusion Tiotropium bromide inhalation powder agents has certain effect on lung function recovery for lung cancer patients after surgery,it is worthy of clinical application.

Objective To investigate infection rate of human papillomavirus as well as the correlation between cervical precancerous lesions and co-infection of human HPV,herpes simple virus-2 (HSV-2) and cytomegalovirus (CMV) in Chinese women of childbearing age in Kunming,Yunnan province.Methods A total of 2128 women (18-24,25-34,35-49 years of age),who had healthy care examination in our institute from January 2010 to March 2011,were selected prospectively in this study.The infection of HPV,HSV-2 and CMV were detected by real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) and cervical precancerous lesions were determined by the ThinPrep liquid-based cytology test (TCT).Results The overall infection rates of high risk HPV (HR-HPV),HSV-2,CMV were 11.04％(235/2128),3.52％ (75/2128) and 5.26％ (112/2128),respectively.The HR-HPV infection rates in groups of Negative for Intraepithelial Lesion or Malignancy (NILM),Atypical Squamous Cells of Undetermined Significance (ASCUS),Low grade Squamous Intraepithelial Lesion (LSIL),High grade Squamous Intraepithelial Lesion(HSIL),and Squamous Cell Carcinoma (SCC) were 4.29％ (82/1912),55.93％ (66/118),84.62％ (44/52),93.19％ (41/44) and 2/2,respectively.HR-HPV infection rates was increased with the development of cervical lesion (r =0.644,P =0.000).No significant difference on the infection rates of HR-HPV and HSV-2 was identified between different age groups (x2 =2.979,P =0.226; x2 =0.798,P =0.671).The peak age groups for CMV infection (7.62％) were 18 to 24 years old and the infection rates of CMV decrease with age.No significant difference of HSV-2 and HR-HPV coinfection was found between the TCT-abnormal (3.24％,7/216) and control groups (2.41％,46/1912,x2 =0.557,P=0.455),and no relationship was found between HSV-2 and HR-HPV infection groups (OR =0.56,95％ CI:0.17-1.82).The infection of HR-HPV were related significantly with CMV infection (OR =3.14,95％ CI:1.25-7.86).Conclusion HR-HPV infection appears to be the key risk factor for cervical cancer and synergistic interaction may occur between CMV and HPV infections in the development of cervical lesion.

Objective To customize the optimal plans for radioactive 125I seeds volumetric implants in selected regular target volumes.Methods 125I seeds were symmetrically and uniformly implanted into 3 spherical targets with the diameters of 1,2 and 3 cm and 7 ellipsoidal targets with the 3 dimensions of 1 cm×1 cm×2 cm,1 cm×1 cm×3 cm,1 cm×2cm×2cm,1 cm×2 cm×3 cm,1 cm ×3 cm×3 cm,2 cm×2 cm×3 cm and2 cm×3 cm×3 cm.The activity and inter-space of seeds were adjusted to obtain the conformal and uniform dose distribution,with the prescribed D90 (the dose delivered to 90％ of the targets) greater than 145 Gy.The inter-space of seeds was changed from 1 cm to 0.75 cm,to improve the conformity and uniformity of dose distribution.Plan quality was assessed using homogeneity index (HI),external index (EI) and conformal index (CI).The activity and number of seeds implanted were also recorded and compared.Results For the spherical target with the diameter of 1 cm,when seeds were implanted with the inter-space of 1 cm and 0.75 cm,the HI were 40.0％ and 55.9％,the EI were 98.3％ and 95.1％,the CI were 0.44 and 0.44,respectively.For the spherical target with the diameter of 3 cm and the target with the 3 dimensions of 1 cm × 2 cm × 2 cm,the implant with the inter-space of 1 cm provided better indices of HI,EI and CI than those with the inter-space of 0.75 cm.For the other targets,the implants with the inter-space of 0.75 cm provided better indices of EI and CI than those with the inter-space of 1 cm,although they displayed a little worse homogeneity in terms of HI.The activity per seed was 17.0-27.8 MBq and 30.0-58.8 MBq in the implants with the inter-spaces of 0.75 cm and 1 cm,respectively.2-10 more seeds were needed in the implants with the inter-space of 0.75 cm.Conclusions For the studied targets except the spherical targets with the diameter of 1 cm and 3 cm and the ellipsoidal target with the dimension of 1 cm × 2 cm × 2 cm,125I seeds implanted with the inter-space of 0.75 cm could provide more conformal dose distribution.It could be the better customized plans for uniformly spaced seed implantation.

Objective To observe and analyse the application effect and value of problem based learning (PBL) combined evidence-based learning (EBL) in emergency medicine clinical teaching.Methods A total of 53 clinical medicine students were selected.The combined teaching method was applied in emergency clinical teaching.After the end of the teaching,the teaching effectiveness survey and theory test of the combined teaching group was performed,and the theory test scores was compared with the traditional teaching group.Results The combined teaching method could stimulate learning enthusiasm,improve learning efficiency,the abilities of selfstudy,literature retrieval,and the ability to analyze and solve problems.77.4％ of students thought this new teaching method had good application value in clinical teaching.Furthermore,the excellent rate of the theory test scores combined teaching group was better than traditional teaching group (41.5％ vs 15.6％,x2 =7.868,P =0.007).Conclusions The PBL joint EBL pedagogy can overcome diadvantages of tradional teaching and provide higher interest,ability of self-study as well as higher teaching quality of the medical students.It will be worth to spread in medical clinical teaching.

Objective To establish a three-dimensional finite element model of rapid canine tooth movement by reducing resistance and distracting procedures,and to discuss canine distal movement and force distribution of periodontium,and to provide theory basis for its clinical application.Methods Through 64-slice spiral scanning,temporomandibular joint (TMJ),the mandible,lower jaw denture section phantom DICOM data were obtained.Mimics software,Geomagic Studio 8.0 software,Unigraphics NX software,and Ansys11.0 software were mixed,and the three-dimensional finite element model were established under the conventional condition to move the canine (model 1 ),rapid canine movement through distracting osteggenesis of the periodontal ligament (model 2),rapid canine movement tooth movement through reducing resistance and distracting method (model 3),the strength were carried on three kind of models and the canine,the pericementum,the tooth socket bone stress distribution were observed.Results The biggest displacements on those three models occured in canine crown on 1/3,biggest displacement quantity:model 3 ＞model 2 ＞model 1,and the canine crown displacement reduced gradually from crown to the root point; in the model 1 most greatly equivalent stress mainly concentrated in the middle of distal alveolar crest,but in the models 2 and 3 most greatly equivalent stress centralism area shifted liguodistal alveolar crest.Conclusions In the process of canine distal movement,reducing bone resistance,can accelerate the tooth moving speed effectively and simultaneously,the canine has distal motion tendency.While under the action of force,the canine tends to move ligually with the canine distal movement,and thus appropriate measures should be taken to prevent canine lingual rotation in clinical work.

Objective To study the expression of pericyte and the association between pericyte and angiogenesis in the endometriosis. Methods the endometriosis group is consisted of 20 ectopic endometrium, 20 eutopic endometrium dur-ing proliferation phase, 20 eutopic endometrium during secretory phase of patient with endometriosis. The control group (non-endometriosis ) include 20 normal endometrium during proliferation phase and 20 normal endometrium during prolifer-ation phase of women without entometriosis. The histological morphology parameters such as mean density of microvessel (MVD), pericytes number(PN)as well as the average ratio of pericyte to endothelial cells in microvessels were measured by immunohistochemical and morphological assesses. Results The expression of MVD was lower in the normal endometrium and eutopic endometrium compared with it in ectopic endometrium tissue. The difference of the MVD among the different groups was statistical significant (P＜0.05). The expression of MVD in secretory phase endometrium was higher than it in proliferative phase endometrium (P＜0.05), and it shows no significant difference between eutopic endometrium and normal endometrium. The expression of PN and PN/MVD in ectopic and eutopic endometrium in EMs group were lower than those in control group. However, we also found that the difference of PN and PN/MVD was not statistically significant. Conclusion Pericytes play an important role in angiogenesis of the endometriosis ,and pericyte coverage contribute to maturing of func-tional vasculature of endometriosis.

Purpose:To summarize the experences of treating malignant obstructive jaun- dice by percutaneous transhepatic drainage of the bile duct,as well as discussing its clinical effect and practical value.Materials and Methods:Among the 39 patients who were all unsuitable for sur- gical operations,5 were benign,34 were malignant.All patients underwent percutaneous transhep- atic puncture of bile duct.38 cases who were successfully aspirated continued to undergone canal- ization of the obstructive parts 28 be finally successful.Among these patients,metallic stents were placed in 17 cases,balloon dilation in 2 cases,canalization with multi-side-hole catheter in 9 patients.Only external biliary drainage were performed in 10 patients.Results:All of there canal- ization method effected well in verious degrees,but the best result was obtained in the metallic stents group.Conclusion:(1)There is less injury and complication in percutaneous transhepatic drainage,either external or antegrade biliary drainage,and it ts also easy to operate,Interventional treatment is the first choice for patients who suffered from benign or malignant obstructive jaundice unahe undergone surgical operation(2)All the methods amend with each other,but the placement of metallic stent is the best one.

Objective To study the dosimetric characteristics of thermoluminescent dosimeter (TLD).Methods A total of 350 pieces of TLD 2000 type TLDs having the same sensitivity within ± 3.0％ were selected.The TLDs were irradiated to study the repeatability and dosage effect of TLDs by using 6 MV X-rays and 125I seeds.In order to study the dose response,the TLDs were irradiated at different dosages by using 137Cs (662 keV γ-rays),125I seeds and 6 MV X-rays.In order to study the energy response,the TLDs were exposed to the same dose,from 125I seeds,137Cs and X-rays(48,65,83,118,250 keV and 6 MV).Results The maximum deviations of the repeatability were 2.7％ and 4.0％ for 6 MV X-rays and 125I seeds,respectively,and there was no effect of dose rate observed.The dose response of TLDs to 137Cs and 125I seeds were linear.For 6 MV X-rays,the linear response was within the range of 0.74-10 Gy and non-linear range was beyond 10 Gy.The energy response to 125I seeds,48,65,83,118,250 keV and6 MV X-rays,relative to the energy response of 137Cs,were 1.70,1.25,1.08,0.99,0.91,0.96 and 1.22,respectively.Conclusions TLD 2000 has a good repeatability and linear dose response for 137Cs,125I seeds and 6 MV X-rays with no dose rate effects,but the dose response is energy dependent.

Objective To study the effects of acute low temperature and hypoxia on serum SOD and MDA of myocardial ischemia rabbit. Methods 24 rabbits were randomly divided into 3 groups, such as normally low tamperature and hypoxia group, myocardial ischemia normal temporature and normal oxygen group and myocardial ischemia low temporature and hypoxia group. Put myocardial ischemia rabbits into the condition in which low temperature(-10?2) ℃ and hypoxia (oxygen content 8.5% ) existed, superoxide dismutase (SOD) activity and malondialdehyde (MDA) contents were measured after an hour. Results Serum SOD activity were decreased significantly in acute low temperature and hypoxia compared with normal temperature and normal oxygen pressure (P