Objective to observe the effects of ulinastatin(UtI)and xuebijing on treatment of burns sepsis after coagulation and systemic inflam-mation. Methods A total of 103 patients diagnosed of sepsis in burn department of our hospital during 2009-01 - 2014-01 were recruited for the study and randomly divided into 2 groups. the control group(51 cases)received conventional fluid resuscitation,mechanical ventilation,renal re-placement,wound dressing or operation,metabolic nutrition support;the treatment group(52 cases)received vein infusion of xuebijing 100 mL, bid on the basis of conventional therapy,ulinastatin 400 000 U intravenous drip,bid,for 10 d. the blood routine,blood coagulation function and in-flammatory reaction index and plasma lipopolysaccharide(LPS),tumor necrosis factor-alpha(tNF-alpha),interleukin-6(IL-6),interleukin-10 (IL-10),C- reactive protein(CRP)and procalcitonin(PCt)of the patients in each group were respectively detected before treatment and after treatment in the 1,3,7,10 days. Results After treatment of coagulation,indexes of blood fibrinogen degradation product(FDP),plasma fibrino-gen(FIB),blood concentration of two D- dimer(D-Dt),platelet and inflammatory reaction index compared were significantly improved compare with those before treatment in both two groups(P < 0.01). In addition,the treatment group showed significantly better effects than the control group, and the difference was statistically significant(P < 0.05). 7 d after treatment inflammation index levels in treatment group decreased more significant-ly compared with the control group,and the difference was significant(P < 0.05). Conclusion Combined application of xuebijing,ulinastatin with auxiliary treatment of post-burn sepsis can reduce the systemic inflammatory response,improve blood hypercoagulable state.

Pregnant women drug research is quite necessary and urgent,of which human trail is an important link.Pregnant women are vulnerable subjects,but they should not be excluded from drug clinical trials because of possible special risks.The governments should refine the relevant laws and regulations to standardize the clinical trials of pregnant women and safeguard their rights and interests.In order to prevent and control the risks of human trail in pregnant women drug research,it is suggested that the subjects should be limited to the pregnant women who are ill and carry out the 0 phase clinical trial of pregnant women drug research.The ethical review of pregnant women drug research should adhere to the principle of risk minimization,informed consent and reasonable compensation.Meanwhile,the ethical review should emphasize the tracing review.Risk prevention and control of pregnant women in clinical trials should form a joint force.

Objective To discuss the application valueof the multi-slice spiral CT indiagnosing breast cancer. Methods The images of scanning, enhancing and reconstruction were analyzed in 71 cases of breast cancer proved by clinical pathology. Results All the 71cases were the type of mass. The shapes of the tumor in 57 cases were irregular, burrs can be seen in 48 cases , the skin in 8 cases changed, the nipples in 4 cases sunk, the tissue around the tumor was invaded in 12 cases; The CT value of the tumor rised greatly after enhancement, theranges of value was form 18 to 83 HU. Axilla lumph nodes were detected in 32 cases, Wecan find the lumph node in mediastinum and lung metasis; The tumor and tissue around it can be shown well in multi-orientations through images reconstruction. Conclusions The multi-slice spiral CT has the evident application value in pualitative diagnosing breast cancer.

Objective To study the therapeutic effects of mycophenolate mofetil(MMF) in the treatment of refractory idiopathic thrombocytopenic purpura(ITP).Methods 16 refractory ITP patients were treated with MMF (1.0～1.5g/d),which were given in divided doses for three months as one course;the patients with significant therapeutic effect were given the dose for another three months and reduced by degree.Results Very effective results were obtained in 4 cases,striking improvement in 7,partial response in 1 and no response in 4.The total efficacy was 68.75%.The main side effect was observed as light digestive malaise.Conclusion MMF has striking therapeutic effect in treating refractory ITP with little side effect and can be used as an effective way of treatment.

Objective:To understand the attitudes of medical students to public elective courses of humanistic quality and the existing problems. Method:Questionnaires were used in 1 ~5 grade students in randomly selected five medical colleges in Guizhou. Results:Total 1000 questionnaires were sent out, 957 were received, the recovery rate was 95. 7%;817 valid questionnaires, the effective rate was 81. 7%. 75. 56% of the students supported for medical colleges and uni-versities setting up humanistic quality public elective courses, but 24. 44% had negative attitude. Conclusions:It's nec-essary to make efforts to improve the mind medical student's humanistic quality. From the perspective of serving students, school should improve medical college students' humanistic quality from various aspects.

With the availality of new nucleotides (acid) analogues,the experience of anti-virus treatment has been continuously enriched.However,the problem of drug resistance becomes increasingly significant and the concern of individualized strategies,duration and endpoints of therapy as well as drug-resistance prevention for nucleoside (acid) analogues treatment has become a hot issue.Thus,the European Association for the Study of the Liver updated their guideline on diagnosis and treatment of chronic hepatitis B based on the principles of evidence-based medicine,so as to make it more flexible and practical.We briefly review and compare the updated content of this new guideline,and make analysis combined with the clinical practice,so as to promote the standardization of diagnosis and treatment of chronic hepatitis B.

At present,the most commonly used methods for liver function evaluation in clinical practice is static detection represented by blood biochemical examinations,with a focus on the degree of liver injury and liver dysfunction;however,such methods have significant timitations on the reflection of liver reserve function.Indocyanine green (ICG) clearance test is commonly used for the testing of liver reserve function in clinical practice and it is a minimally invasive,simple,and quick procedure available for bedside real-time monitoring and can be repeated during a short period of time.The application value of ICG clearance test in the field of liver surgery has been widely recognized.In recent years,more and more studies have been focusing on the application of ICG clearance test in the fields of internal medicine,liver interventional therapy,critically ill patients,and drug safety assessment.This article reviews the current clinical application,related advances,and future perspectives of ICG clearance test.

OBJECTIVE To explore the clinical characteristics of hospital infection in diabetic nephropathy(DN). METHODS To retrospectively analyze the incidence rate of hospital infection,the infection sites,pathogenic bacteria,and predisposing factors in 348 cases with diabetic nephropathy,and to compare the index above with the homeochronous 466 diabetic patients without DN. RESULTS Sixty two cases occurred hospital infection from 348 cases with DN,the infection rate was 17.82%,the infection sites were most frequently in respiratory tract(37.10%),then urinary tract(24.19%) and digestive tract(19.35%),the major predisposing factors were out of control of blood glucose,renal sufficiency,advanced age,and longer stay in hospital. CONCLUSIONS The incidence rate of hospital infection is higher,the valid measures to control the hospital infection are to control the blood glucose effectively,to improve the renal function and timely to use the method of anti-infection with forcefulness.

Emergence and broad spread of chloroquine resistance urge human beings to change drug policy in malaria control and to find more effective new drugs. Nevertheless, chloroquine is still used in the treatment of falciparum malaria in some poor endemic regions due to economic and development reasons. It should be of great significance to un-derstand the mechanism of chloroquine resistance and find the way to reverse it in order to bring chloroquine with high efficacy and low cost back to the first line of the combat to malaria. Advent and development of resistance reversal agents provide a new clue for this purpose. When used together with chloroquine, it can partly restore the efficacy of chloroquine in resistant Plasmodium falciparum. The article summarizes the research progress on chloroquine resistance in P. falciparum and resistance reversers.

Objective To study the potentiation of chloroquine activity and mechanism by ketotifen and cyproheptadine in in vitro cultured Plasmodium falciparum Fcc SM1/yN strain. Methods In vitro cultured Fcc SM1/yN strain was added to pre-prepared drug plates at 50 ?l/well after synchronization to make final concentration of 0.312 5-2 560 nmol/L for chloroqine and of 9.80-5 000 nmol/L for ketotifen or cyproheptadine. After 34 hours' culture in 37 ℃, the number of schizonts with 3 or more nuclei was calculated among 200 parasites under microscope. Calculated half inhibitive concentration ( IC50 ) of chloroquine and every drug combination to parasite as well as chloroquine activity enhancement index ( AEI) of ketotifen (or cyproheptadin) . Time dependency of potentiation was studied. All data were analyzed statistically with SPSS 13.0. After 20 hours' action of one optimal combination dose of chloroquine/ketotifen or chloroquine/cyproheptadine, RNA of the Fcc SM1/yN strain was extracted and real-time PCR was used to determine the expression level of pfcrt and pfmdr1 genes. Results The best potentiation effect was observed with ketotifen or cyproheptadine of 625 nmol/L, with IC50 of 74.53 nmol/L for chloroquine/ketotifen and 89.7 nmol/L for chloroquine/cyproheptadine respectively, and activity enhancement index (AEI) of 0.42 for chloroquine/ketotifen and 0.30 for chloroquine/cyproheptadine respectively. Combination of 625 nmol/Lketotifen or cyproheptadine with 5 nmol/L chloroquine showed the highest potentiation potency. 6-7 hours during which ketotifen or cyproheptadine was added after chloroquine showed the highest effect, with IC50 of 67.70 nmol/L for chloroquine/ketotifen and 81.53 nmol/L for chloroquine/cyproheptadine respectively, and the AEI was 0.47 for chloroquine/ketotifen and 0.37 for chloroquine/cyproheptadine respectively. After action of chloroquine/ketotifen or chloroquine/ cyproheptadine at one optimal combination dose, expression level of pfcrt gene increased by 91% and that of pfmdr1 gene decreased by 14% respectively. Conclusion Appropriate combination of chloroquine/ketotiphen or chloroquine/ cyproheptadine potentiates chloroquine against in vitro cultured P. falciparum. 6-7 hour period is an optimal time when ketotifen or cyproheptadine was added after chloroquine. Potentiating activity of ketotifen and cyproheptadine may be related to the expression level of pfcr t and pfmdr1 genes.