Objective To observe the clinical efficacy of low-dose erythromycin combined with salmeterol-fluticasone in the treatment of stable COPD, focus on the quality of life and respiratory function of patients.Methods 87 patients with stable COPD admitted to Hangzhou Red Cross Hospital from January 2014 to January 2016 were selected.Patients were divided into two groups by therapeutic methods, observation group ( salmeterol-fluticasone+erythromycin) 46 cases and control group (salmeterol-fluticasone) 41 cases.Six months of treatment, the quality of life of two groups of respiratory function assessment, acute COPD and peripheral inflammatory factor and other indicators of change.Results After treatment, both of the two groups got significantly decreased in SGRQ and MMRC scores, while the observation group was significantly lower than the control group, the difference was statistically significant(P<0.05).After treatment, FEV1/FVC%levels were significantly increased in both groups, but the observation group was significantly higher than the control group, the difference was statistically significant(P <0.05).The cumulative incidence of acute exacerbation of COPD was 10.87%(5/46) in the observation group, which was significantly lower than that in the control group 29.27%(12/41), the difference was statistically significant(Log-rankχ2 =4.833, P=0.028).After treatment, the levels of IL-1βand TNF-αin the peripheral blood of the patients in the observation group were significantly lower than those in the control group, the difference was statistically significant (P <0.05).Conclusion In the treatment of stable COPD, low-dose erythromycin could significantly improve the clinical efficacy, improve the quality of life and respiratory function.

Group B Streptococcus ( GBS) is a conditional pathogenic bacteria related to late-term abortion, premature delivery, premature rupture of membranes, perinatal infection, neonatal sepsis and other diseases.Prevention and treatment guidelines by the US Centers for Disease Control and Prevention ( CDC) suggest that all the pregnant women at 35-37 gestational weeks should screen for GBS .The detection methods for GBS include microbiology , immunology, molecular biology, etc.The appropriate method should be chosen depending on circumstances .Penicillin is recommended for the preventive treatment of GBS , and the treatment for the insensitive should base on the antibiotic susceptibility results .No vaccine against GBS is currently available for clinical use .

A total of 65 patients of condyloma acuminatum (CA) received cryotherapy plus 5-aminolevulinic acid-photodynamic therapy (ALA-PDT) or ALA-PDT alone.During cryotherapy,handling was gentle with a moderate depth.The nursing of PDT was both meticulous and comprehensive.Patients with adverse reactions received Kangfuxin liquid for wet packing and topical antibiotic ointment.The combination group received cryotherapy for 2 sessions and then PDT for 1-3 sessions while PDT was administered for 1-4 sessions in single PDT group.Then all patients received PDT once for consolidation therapy.For groups 1 and 2,the effective rates were 83％ and 70％ and the recurrent rates 17％ and 30％ respectively.Cryotherapy plus ALA-PDT is feasible for CA and it offers better efficacies and lower recurrent rates.And comprehensive,meticulous and comfortable nursing may achieve clinical efficacies,reduce the recurrent rate and minimize discomforts during treatment.

Objective To understand the clinical medicine graduates competency status of Kunming Medical University in the past 5 years and provide important reference for cultivating students in medical university. Methods The questionnaire results in the relevant departments responsible person of Yunnan provincial municipal and district 26 hospitals were system analyzed by fuzzy comprehensive evaluation method. Results In the past 5 years, the graduates occupation competence of clinical medicine in Kunming Medical University is good. Among them, the graduates’core competency gets the lowest score, but the graduates’post competency gets the highest score. Conclusion The graduates’core competency should be strengthened in training of doctor-patient communication skills and quality evaluation of clinical practice for medical students.

Objective:To discuss the applicative value of 1.5TMR-diffusion weighted imaging (DWI) sequence and apparent diffusion coefficient (ADC) measurement in the diagnosis and differential diagnosis of endometrial carcinoma.Methods: Thirty seven cases were collected in endometrial carcinoma group, 11 cases were selected in benign group and other 20 normal volunteers. Data of the DWI and ADC value, common-MRI(c-MRI) sequence in the 48 patients and 20 normal volunteers was contrasted and analyzed.Results: The differences between endometrial malignant tumors, benign lesions and the normal have statistical significance.Conclusion: 1.5 T MR-DWI sequence and ADC value has a superior ability in detecting endometrial lesions. It can be used to differentiate the endometrial carcinoma from either benign or normal cases, it can provide reliable assistance in the clinical cure.

Environmental Pollutants ; Flame Retardants ; Hydrocarbons, Brominated

Objective To investigate the superiority of augmentation rhinoplasty by using ear cartilage.Methods We excised ear cartilage from patient's unilateral ear.106 cases were performed through suitable ear cartilage that was carved to some shape and then transplanted to nasal tip and columella,and two alar cartilages were sutured and implant was used for rhinoplasty.Results All cases were followed up for one year after operation without implant slipping and malposition of implant,with better figure after enhancing and lengthening nasal tip.Conclusions This method of augmentation rhinoplasty using ear cartilage can avoid complications such as slipping,malposition and exposure of implant.Therefore,it is deserved to recommend clinical application.

Patient satisfaction evaluation is an important approach in hospital management. Since the health services have traits of service, specialty and some extent of public welfare, patient satisfaction evaluation meets doubts about the reliability of its results and the effectivity of its application in hospital management practice. The paper summarizes the difficulties in patient satisfaction evaluation from perspectives of theory, institution and technology, and puts forward some suggestions on improving the reliability of evaluation results and enhancing the effectivity of application of evaluation results.

Objective An initial study on the cognition of the relationship between clinical and management staff for the purpose of improvements. Methods Questionnaires were issued to 38 clinical medical staff and 26 hospital management staff, regarding this relationship. Results Consensus is found between the two groups regarding clinical involvement in management, teamwork and exchange, and cognition on the competence and capability of the other party, P>0.05. On the other hand, however,cognitive differences are found regarding mutual penetration, power balance and implementation of policies and systems. Conclusions In-depth cooperation and understanding between the two groups and the mutual conversion of their behaviors and concepts are the cornerstones of an ideal relationship between clinical staff and management staff.

Full-field electroretinalgraphy (ffERG) is an indispensablemeans in assessment of retinal disease;it is invasive,effective,objective,quantifiable,and reproducible.Currently ffERG has been extensively applied domestically,but it also has disadvantages such as too few detected diseases,nonstandardised methodology,and inaccurate description of the results.It is important to place more emphasis on the internationalization,standardisation,and normalization of the application;obtaining the differences of indication,detection techiniques,and description of the results among ffERG,multifocal ERG and pattern ERG;expanding the new fields and methods of clinical applications.So that ffERG could play an more important role in the diagnosis and management for the patients with retinal disease.