Four key attributes,position,rate,shape and force,are programs of pulse tracing put forward by ZHOU Xue-hai,a medical practitioner in late Qing dynasty.The essences of four key attributes are'images'of di erent levels.There are complex relationships between pulse tracing and position,rate,shape and force attributes,which include not only subordinate relationship and static-dynamic relationship between four attributes but double relationship between four attributes and pulse tracing.

OBJECTIVE:To investigate the application and feasibility of the PDCA cycle management method in pharmacy management of three-level general hospital re-accreditation in our hospital and promote continuous improvement of hospital pharma-cy management. METHODS:Referring to 2011 edition of Detailed Rules for Three-level General Hospital Accreditation,the work of hospital pharmacy management was checked and continually improved based on the PDCA cycle management method. RE-SULTS:After the application of PDCA,prescription error rate in outpatient pharmacy dropped from 0.0314% to 0.0192%;the number of dispense error in center pharmacy decreased by 60.2% and the accuracy rate of drug stock increased from 87.14% to 97.32%;the number of dispensing errors in pharmacy intravenous admixture service reduced from 5.6 bags/week to 1.8 bags/week, and the error rate reduced by 67.86%;the proportions of irrational prescriptions of glucocorticoid drugs dropped from 19.26% to 4.23%. CONCLUSIONS:The application of PDCA cycle management method in pharmacy management of three-level general hos-pital reaccreditation and the establishment of relevant system can obviously improve the work of pharmacy management continuously.

Acupuncture Points ; Acupuncture Therapy ; Child ; Child, Preschool ; Encephalitis, Arbovirus ; physiopathology ; psychology ; therapy ; Female ; Humans ; Language ; Male ; Meridians ; Muscles ; physiopathology ; Treatment Outcome

Cartilage ; surgery ; Humans ; Tympanoplasty

Objective To compare cardiac output continuously measured by transesophageal echocardiograph (TEE)with Flotrac /Vigileo system.Methods Thirty -six patients,aged 30 -60years,of American Society of Anesthesiologists physical status ⅠorⅡscheduled for laparoscopic hysterectomy (LH )were included in this study.The radial artery puncture on the left connecting the Flotrac /Vigileo system monitoring was established before anesthesia and ultrasonic probe was inserted into the esophagus after anesthesia induction.The depth of the probe was located at the middle esophagus with monitoring of transesophageal echocardiography(tee).At the same time the value of CO after anesthesia,before and after pneumoperitoneum were recorded and the application of SPSS 13.0 software package for statistical analysis was made.Monadic linear correlation and regression analysis were both used in measured CO. Results Each point,the determination of transesophageal echocardiography(tee)between the CO and the determination of the Flotrac /Vigileo CO,had high correlation(r =0.850,P =0.002).The CO at the time of T2 monitored by TEE group and Flotrac /Vigileo group were (3.3 ±0.2)L/min,(3.2 ±0.2)L/min,which were significantly lower than (5.6 ±0.3)L/min,(5.4 ±0.3)L/min(t =2.248,2.178,P =0.032,0.029).But there were no statistically significant differences at other time respectively(tT =0.102,0.199,0.201,0.124,0.198,PT =0.918,0.887,0.894, 0.908,0.898;tF =0.098,0.189,0.214,0.119,0.112,PF =0.953,0.874,0.898,0.913,0.932).Conclusion The correlation of CO monitored by transesophageal echocardiography(tee)and Flotrac /Vigileo was good,which can be safely and efficiently used in intraoperative monitoring of patients.

Objective The aim of this paper is to know about the pollution of microcystin-LR(MC-LR)in Fenhe First reservoir and Fenhe Second reservoir in Taiyuan and provide reference for making the policy of prevention microcystin-LR pollution.Methods During the low water period(May,2005)and common period(Oct,2005),5 liter water was sampled in the entrance,the center and the exit in Fenhe First reservoir and Fenhe Second reservoir respectively.The concentrations of MC-LR in two reservoirs were determined by the high-performance liquid chromatography(HPLC).Results The average concentration (0.875 ?g/L)of MC-LR in low water period was 3 time of that(0.283 ?g/L)in common period in Fenhe First reservoir.The average concentration(0.815 ?g/L)of MC-LR in low water period was 17 time of that(0.048 ?g/L)in common period in Fenhe Second reservoir.The level of MC-LR in the entrance was the highest,that in the exit was the lowest,that in the center was middle. The concentration of MC-LR of the entrance in low water period was more than the MC-LR limit(1 ?g/L)in Life drinking water hygienic guide(2001).Conclusion MC-LR pollution has been found in Fenhe First reservoir and Fenhe Second reservoir and the pollution is serious in low water period.

Objective To investigate the significance of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scoring system in evaluating elderly patients with hyperglycemic hyperosmolar state. Methods Elderly patients with hyperglycemic hyperosmolar state were enrolled in the study from January 2003 to May 2008. The patients were divided into two groups according to the outcome: death group and survival group. APACHE Ⅱ scoring system was used on the day of admission and the scores were compared in the two groups. The risk factors for death were evaluated by logistic regression analysis. Results Forty patients were registered including 10 cases in death group and 30 cases in survival group. The mortality rate was 25%. There were no differences in blood glucose, serum sodium, blood osmotic pressure, serum creatinine and hemoglobin between two groups before the treatment (t=-1.50～1.53, all P>0.05). The APACHE Ⅱ scores were significantly higher in death group than in survival group on the day of admission(30.1±5.4 vs. 22.9±3.9,Z=-4.08, P<0.01). Multiple logistic regression analysis showed that APACHE Ⅱ scores on the day of admission were the independent risk factor for death. Age, sex, blood glucose, effective blood osmotic pressure, serum creatinine and hemoglobin were not related to mortality rate. Conclusions APACHE Ⅱ scoring system is a helpful method for evaluating the severity and outcome of patients with hyperglycemic hyperosmolar state.

Cyclodextrin(CD) is gradually applied in the nonviral gene vector system,due to its biocompatibility and flexibility of tailing via structural modification,polymerization or supramolecular combination.The ideas and research progress of the CD,its low molecular derivatives,CD polymers and CD supramolecular combination in the field of norviral gene vectros were reviewed,and their "structure-safety-transfection efficiency" relationships were discussed.

Cells, Cultured ; Fibroblasts ; cytology ; drug effects ; metabolism ; Humans ; Lung ; cytology ; metabolism ; Macrophages, Alveolar ; metabolism ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Silicon Dioxide ; toxicity ; Silicosis ; metabolism

Objective To assess the effect of two-dimensional speckle tracking imaging (STI) on prognosis of patients with acute infarcted myocardial(AMI).Methods Eighty patients with AMI and 30 healthy subjects were selected as our subjects.Among the AMI patients,there was 30 cases were emergency percutaneous coronary intervention (PCI),25 cases were selective PCI group and 25 cases with conservative.All were performed a 4-6 months following up after discharge from hospital.Left ventricular ejection fraction(LVEF) was measured by Simpson's.Rotation were measured in the left ventricular basal and apical short-axis views using STI.LV Peak twist (Ptw),apical Peak rotation (PAR),the basal Peak rotation (PBR),twist at aortic valve closure(AVC tw),twist at mitral valve opening(MVO tw),untwisting rate (Untw R),and half time of untwisting (HTU) were calculated.And the correlation between Ptw and LVEF was analyzed.Results Compared with the control group,the value of Ptw,PAR,AVC tw and MVO tw were significantly decreased in myocardial infarction group(F =22.481,12.899,18.923 ;P ＜ 0.05).Ptw,PAR in emergency PCI group at following up periods were (18.61 ± 8.08) ° and (12.16 ± 6.98) °,higher than that in hospital periods ((13.76 ± 6.31) °,(7.03 ±5.76)°).Ptw,PAR in selecting PCI group were (19.5 ±7.73)° and (13.4 ±7.02)°,higher than that in hospital periods((15.25 ± 6.83) °,(9.69 ±.6.72) ° ; t =-2.607,-3.104,-2.079,-1.955 ; P ＜ 0.05).Significant correlation was found between Ptw and LVEF (r =0.527,P ＜ 0.05).Conclusion Left ventricular twist can be measured using STI.LV rotation can be the quantitative index to evaluate the systolic function of LV.STI can be the new method to guide clinic diagnosis and therapy.