Objective To investigate the clinical application value of ultrasound-guided catheter drainage and vacuum-assisted Mammotome system in the treatment of lactational breast abscess. Methods The clinical data of 46 patients with lactational breast abscesses were analyzed retrospectively. All patients were divided into control group (28 patients) and treatment group (18 patients). Homemade irrigation and drainage tube was used in control group,and vacuum-assisted Mammotome system was used in treatment group. The curative effect of 2 groups was compared. Results All patients were cured. The mean healing time in treatment group was (9.5 ± 1.3) d,in control group was (12.5 ± 2.2) d, and there was significant difference (P < 0.01). The rate of breast-feeding in control group was 57.1% (16/28), in treatment group was 13/18,and there was no significant difference (χ2=1.069, P>0.05). All patients recovered well without recurrence. Conclusions Ultrasound-guided catheter drainage should be employed as first line treatment of breast abscess with diameter greater than the 3 cm. If patient′s economic conditions are good and have high requirement on the beauty outcome, vacuum-assisted Mammotome system can be applied as treatment option.

Objective To investigate the effect of two different detection methods of reagent kits on blood concentration of Tacrolimus in liver transplantation .Methods 81 cases of liver transplantation patients received Tacrolimus testing in Zhoushan Hospital from February 2013 to August 2016 were selected, fasting venous blood of upper limb were collected 12h after treatment, blood concentrations of Tacrolimus in whole blood samples were detected by Enzyme linked immunosorbent assay ( ELISA) kit and Enzyme enhanced immunoassay ( EMIT) kit respectively , the results of the two methods were observed and compared .Results The intra day and inter day precision and accuracy of ELISA method were good , RSD <5%, in the low concentration range , the precision of detection was slightly worse; the intraday and inter day precision and accuracy of ELISA method were good , RSD <5%, in the low concentration range , the precision of detection was slightly worse; the Tacrolimus blood concentration measured by ELISA (5.19 ±0.73) μg/L test kit was significantly lower than that measured by EMIT kit (8.29 ±1.14) μg/L, the difference was statistically significant (P<0.05); correlation coefficient of the detection results of two kinds of reagent kit was r =0.9176, the detection results were positively related; the determination results of ELISA kit ( 1.116 ±0.125 ) μg/L were obviously lower than that of EMIT kit (1.507 ±0.201) μg/L when Tacrolimus blood concentration <2g/L, with significant difference (P<0.05).Conclusion ELISA detection kit and EMIT kit can be used to monitor the blood concentration of Tacrolimus in liver transplantation patients , and the correlation was good, but the blood concentrations of Tacrolimus were significantly different between the two kits , need to establish their own of therapeutic window to judge,the test results can not be replaced with each other .

[Objective]To report the results of treatment of enchondroma of the hand with curettage and porous bioceramic bone grafting. [Methods]Fifteen patients with digital enchondroma were reviewed.The average follow-up period was 30 months.The final function and radiographic appearance of the surgically treated digits were analyzed.[Results]At final evaluation the bony incorporation was uneventful in all patients.The mean functional Muskuloskeletal Tumor Society Score was 29.Radiographs showed apparent partial absorption of bioceramic bone in only two patients.All digits achieved full range of motion after surgery.No complication was found.[Conclusion]Porous bioceramic bone is safe and effective as a bone-filling substance after curettage of enchondroma of the hand.

The theory of multiple streams,a vehicle of public policy analysis in the West,was used to analyze the policy development at Beijing′s suburban village clinics.This approach can clarify the issue steams,policy streams,and political streams,as well as the links between them,as a reference for standardized and quickened development such clinics.

Objective To evaluate the efficacy and safety of Qianliejiedu capsule in the treatment of chronic prostatitis. Methods A multi-central,randomized,double-blind clinical trial was conducted.A total of 209 patients diagnosed as chronic prostatitis were randomly divided into two groups:the trial group were treated with Qianliejiedu Capsule,5 pills were taken orally for each time,twice a day;the control group were given Qianlietai Pill,5 pills were taken orally for each time and 3 times a day.All patients of the tWO groups were treated for 4 weeks,The efficacy was evaluated by urethra irritating,painful or discomfortable symptoms,and the WBC count in EPS after the treatment.Clinical criteria divided into 4 types,cure:symptom score compared with a decrease≥90%;markedly effective:symptom score compared with a decrease of 60%to 89%;effective:symptom score comparedwith a decrease of 30%to 59%;invalid:symptom score compared with a decrease of＜30%.Results There were 102 patients in the treatment group,11 got cured,49 cases were remarkably effectire,28 eases were effective,14 eases were ineffective and the total effective rate was 86.2%(88/102).There were 98 patients in the treatment group,4 got cured,38 cases were remarkably effective,35 cases were effective,21 cases were ineffective,and the total effective rate was 78.6%(77/98).The trial group and the control group could improve the symptoms such as frequent micturition,the remaining urine,the lower abdomen ache,the urethra stabbing pain,the unwell perineum,the waist and sacrum ache,the moist scrotum,and the testicle ache.The vanishing rate of the trial group was 87.6%,82.1%,74.5%,84.1%,93.7%,80.3%,82.5%,82.3%;and the control group was 74.7%,73.0%,71.0%,74.2%,71.4%,67.9%,72.3%,76.2%.The vanishing rates of frequent micturition symptom of the 2 groups were significantly different(P=0.032).The result of WBC of the trial group before treatment was as follows:WBC 10-19 28 cases,WBC 20-29 33 cases,WBC≥30 41 cases.The result of WBC of the trial group after treatment was as follows:WBC＜10 45cases,WBC 10-19 34 cases,WBC 20-29 20 cases,WBC≥30 3 cases.The result of WBC of the control group before treatment was as follows:WBC 10-19 26 cases,WBC 20-29 35 cases,WBC:≥30 37 cases.The result of WBC of the control group after treatment was as follows:WBC＜10 42 caaes,WBC 10-19 33 cases,WBC 20-29 15 cases,WBC≥30 8 cases.There were significant differences between the before and after treatment results(P＜0.05).Two cases in the trial group and 3 cases in the control group had mild adverse reactions such as nausea,epigastric discomfort,and watery stool. Conclusion Qianliejiedu capsule is effective and safe for the treatment of chronic prostatitis.

Objective To study the expression of transcription factor FOXO1 and FOXO3a on peripheral blood mononuclear cells (PBMC) in patients with active or inactive systemic lupus erythematosus (SLE) and investigate the effect of FOXO1 and FOXO3a on the clinical features of SLE. Methods Thirty SLE patients and 10 healthy controls were enrolled. PBMC were separated from the peripheral blood. Reverse transcription-polymerase chain reaction (RT-PCR) and western blot were applied to analyze the expression of FOXOI and FOXO3a. Results The level of FOXO1 expression was significantly decreased in active SLE patients compared with controls and patients with inactive SLE (P<0.05). The level of FOXO1 expression in inactive SLE patients was lower than that of the controls (P<0.05). The expression of FOXO1 mRNA was negatively correlated to SLEDAI. However, the level of FOXO3a was similar among the three groups. Conclusion The result suggests that FOXO1 may be involved in the pathogenesis of SLE and the expression level of FOXOI may be a good indicator for the disease activity of SLE.

Objective To investigate the relation between coagulation disorders and sepsis severity of infected patients.Methods In this retrospective study,75 patients,51 males,24 femalse,with age(55.8± 18.1),were included from January 2010 to March 2011.They were clinically diagnozed as infection,and had Thromboelastography(TEG)and routine coagulation test within 24 hours after admission to emergency department.They were divided into 3 groups based on SIRS and SOFA score within 24 hours after admission:a)infection group,patients without SIRS; b)sepsis group,patients with SIRS and SOFA score less than 5; c)severe sepsis group,patients with SOFA score greater than or equal to 5.LSD was used to compare between two groups if one-way ANOVA of three groups comparasion showed significant differences.Results In comparasion to sepsis group(n =29)and infection group(n =27),D-dimer elevated significantly in severe sepsis group(n =19)(F =3.388,P =0.004),and platelet count decreased significantly(F =3.839,P =0.026),INR and KPTT showed an increase trend without significant difference (F =2.657,P =0.077 ; F =2.782,P =0.069); TEG showed MA obviously decreased(F =5.841,P =0.004),while there were nostatistically significant differences among other data.Conclusions The extent of coagulation disorders and sepsis severity of infected patients is closely correlated to each other.

10.3969/j.issn.2095-4344.2013.26.014

BACKGROUND:The improvement of athletic achievements needs a super-limited exercise to gain,how to protect athletics health under the prerequisite of gaining excellent achievements?OBJECTIVE:To reduce the injury of athletic renal function following maximum exercise by using traditional Chinese medicinal methodDESIGN:A randomized and controlled trial,taking students majoring in sports education specialty as subjects.SETTING:Internal Medicinal Department of Traditional Chinese Medicine (TCM) Hospital of Qufu Hospital of Traditional Chinese Medicine and Sports Education College of Qufu Normal University.PARTICIPANTS :Two small natural classes were randomly drown up from 16 small natural classes of 2000 grade in Sports Education College of Qufu Normal University, with 20 students in each class, on April 20, 2004.METHODS:All 40 students were according to natural class divided as experimental class and control class.The urine specimens for test were collected 15-20 minutes after one time maximum loading training on April24,2004 and immediately after morning getting-up. The procedure was performed once more on May 24. During the process the students in experimental group had taken the capsule of kidney-and-spleen-strengthening Chinese drug (KSSD, containing mainly Rhizoma Dioscoreae, Radix Polygoni Multiflori, Herba Epimedii, Fructus Lycii, Gynostamma Pentaphyllum,Radix Acanthopanacis Senticosi,Radix Salviae Miltiorrhizae,Radix Bupleuri, etc., 0.3 g/pellet), 6 pellets, 3 times a day. Urinary glucoprotein,β2-microglobulin, albumin and globulin were detectedby radio-immunoassay.MAIN OUTCOME MEASURES:The changes of urinary proteins of the students before and after administration following maximum exercise and getting-up in next morning.RESULTS: All students involved were good for the trial, without any loss.① The contents of various urinary proteins for the subjects after the maximum exercise or before administration were all obviously increased,and the conditions of natural recovery of proteinuria on getting-up next morning were quiet different: the recovery of urinary albumin was the fattest, basically to the normal;recoveries of β2 micro-globulin and immune-globulin were obvious, but the recovery of glucoprotein was inconsiderable.② After the second trial,in comparing the experimental group with the control group it was found that KSSD can obviously influence the recovery of proteinuria following maximum exercise:The effect in 12 hours did not be shown because of too fast natural recovery of albuminuria. It could promote the recoveries of β2 micro-globulin and immune-globulin. The effect on recovery of urinary of glucoprotein was obvious,basically to the normal for experimental group and basically no change for control group,there was a significant differentiation between the two groups.CONCLUSION:The contents of urinary proteins were obviously increased following maximum loading training, and natural recoveries of the four kinds of proteins presented regulatory changes.KSSD can promote the recovery of proteinuria following maximum exercise to normal volume,suggesting that the medicine has a protecting role to renal function.

The clinical practice of medical students relates to many complicated interests. There exist insufficiency and irregularity in present law,so perfecting the law in medicine stu-dents’clinical practice is necessary. The lawmaking should insist on the balance in every main body’s right,obligation and responsibility,justice in restriction,acknowledgement and agreement and the principle of multi-factors and level partition.