Objective Construct a scientific and reasonable evaluation index system for clinical specialties of tradi-tional Chinese medicine in Shandong Province to provide a scientific basis for improving the service capacity of clini-cal specia lties of traditional Chinese medicine.Methods Based on relevant policies and literature research,the analytic hierarchy process and Delphi expert consultation method were used to determine the index system and its weight,and 509 clinical specialties of traditional Chinese medicine capacity levels of 178 medical institutions in Shandong Province were evaluated.Results A scientific and effective evaluation index system for clinical specialty capacity of traditional Chinese medicine in Shandong Province was constructed,with 23 secondary indicators in 5 dimen-sions.It comprehensively evaluats the service capacity and management level of orthopedics and traumatology de-partments of traditional Chinese medicine class hospitals in Shandong Province,uses orthopedics and traumatology as an example.Conclusion Driven by the dynamic monitoring of the evaluation index system,improve the service ca-pacity for clinical specialties of traditional Chinese medicine,guide it to strengthen the internal construction of tradi-tional Chinese medicine,and give full play to the advantages of traditional Chinese medicine characteristics.Increase the support for clinical specialties of traditional Chinese medicine in Shandong Province,and then promote the high-quality development of traditional Chinese medicine.

Objective: To know condom use negotiation with clients and regular sex partners and condom use in female sex workers (FSWs), and provide reference for the development of comprehensive HIV/AIDS intervention for FSWs. Methods: The cross sectional survey was conducted in Jianshui county and Mengzi county in Honghe Hani and Yi autonomous prefecture. A total of 476 FSWs aged 16 years and above were recruited from entertainment venues, and the information about their demographic characteristics, condom use negotiation and condom use were collected by using questionnaires. Logistic regression model was used to analyze related factors of condom use after negotiation between FSWs and clients unwilling use condom. Results: A total of 852 FSWs who aged (24.29±8.44) years old participated in the survey. In past month, 499 FSWs had negotiation for condom use with unwilling clients (58.6%, 499/852), after negotiation, 441 FSWs (88.4%, 441/499) had consistent condom use in each sex with the clients. In the past one month, 99 FSWs had negotiation for unwilling use condom with regular sex partners (14.4%, 99/687), after negotiation, 54 FSWs (54.5%, 54/99) had consistent condom use in each sex with regular sex partners. Among the FSWs, 266 (53.3%, 266/499) reported that they could say "It is a mandatory requirement" to persuade clients who were unwilling to use condom. 97(19.4%, 97/499) reported that they could say "There is risk for infection" to persuade clients who were unwilling to use condoms. 115 (23.1%,115/499) reported that they could say "It is a mandatory requirement" and "there is risk for infection" to persuade their unwilling clients to use condoms. 21 (4.2%, 21/499) reported that they used other strategies. 22 (4.4%, 22/499) felt that it was difficult to persuade clients to use condoms. Multivariate logistic regression analysis showed that compared with FSWs who felt difficult in persuading clients to use condoms, FSWs who felt moderate difficulty were more likely to have consistent condom use after negotiation (OR=4.00, 95%CI: 1.55-10.32) and FSWs who felt easy in persuading clients to use condoms were also more likely to have consistent condom use (OR=30.17, 95%CI: 3.22-282.44). Compared with FSWs used other strategies to persuade their clients to use condoms, FSWs who said it was a mandatory requirement were more likely to have consistent condom use after negotiation (OR=4.44, 95%CI: 1.41-14.01) and FSWs who said it was a mandatory requirement and there was risk for infection were also more likely to have consistent condom use (OR=5.52, 95%CI: 1.55-19.73). Conclusions Negotiation for condom use increased the rate of condom use in FSWs in sex with clients who were unwilling to use condom. The negotiation strategy of "It is a mandatory requirement" would promote condom use in FSWs in sex with clients who were unwilling to use condom. Besides, the negotiation strategy of saying "there is risk for infection" had additional effects.

Objective To observe the clinical effect of CT-guided percutaneous puncture of stylomastoid foramen and radiofrequency ablation on primary hemifacial spasm. Methods Twenty-seven patients with primary hemifacial spasm, admitted to and accepted CT-guided percutaneous puncture of stylomastoid foramen and radiofrequency ablation in our hospital from August 2018 to May 2019, were chosen in our study. Clinical data and efficacy of the patients were retrospectively analyzed. Results All patients were punctured to the stylomastoid foramen precisely under the guidance of CT localization; 21 could detect facial muscle twitch with 0.1-0.5 mA current, and positive results were also found in 6 patients with 0.5 mA current after adjusting the position of the needle tip. After standard radio frequency ablation (mean 83.3 ℃ for 23.7 seconds), 26 patients had complete disappearance of facial spasm, but left grade II (n=18) or grade III (n=8) facial paralysis; one patient with disappearance of abnormal electromyographic response waveform as the end criterion only partially relieved, but no facial paralysis. No facial hematoma, intracranial hemorrhage, infection, or death occurred. Follow-up for 2-12 months showed no recurrence or aggravation of facial paralysis. Conclusion CT-guided percutaneous puncture of stylomastoid foramen by radio frequency ablation can effectively treat primary hemifacial spasm, but there will be mild facial paralysis.

Brazil, Russia, India, China and South Africa are the five BRIC countries which have showed a rapid growth in economic development in recent years especially in international health assistance area, which has gradually become a force that cannot be ignored. This article compares and analyzes the current status and character-istics of the BRIC countries in the field of international health assistance and compares them with the Countries of the Economic Cooperation and Development Organization's Development Assistance Committee ( ECDO-DAC) . It will also summarize the new features, advantages and disadvantages of the health development assistance exerted by the BRICS countries;and ultimately provide suggestions for the future international health development aid policy of China.

Objective To evaluate the efficacy and safety of using alteplase for intravenous thrombolysis combined with vascular intervention for treatment of patients with acute intracranial large arterial occlusion.Methods Clinical data of 7 patients with acute intracranial large arterial occlusion treated by using alteplase for intravenous thrombolysis combined with intravascular intervention admitted to Department of Neurosurgery in Affiliated Hospital of the Logistics University of Cinese People's Armed Police Force from July 2015 to August 2016 were retrospectively analyzed.All the 7 patients were treated by alteplase dry powder (50 mg or 20 mg each ampule),solvent dose was 0.9 mg/kg,the maximum dose being ＜ 90 mg,firstly 10％ dose was intravenously injected,and the remaining dose was continuously infused into a vein in 60 minutes,during or after intravenous thrombolysis,digital subtraction angiography (DSA) was performed immediately,and according to the results of the angiography,at least one of the 3 kinds of intravascular mechanical intervention therapy,thrombectomy,balloon dilatation or stent placement,were chosen,and 24 hours after surgery,the anti-platelet aggregation drug and calcium channel antagonists were given,The effect of interventional therapy was analyzed,and the clinical outcome of 90-day treatment was evaluated.Results The mean age of the patients was (60.0 ± 12.6) years.Seven patients all successfully completed the treatment,and satisfactory re-canalization was achieved [they all obtained grade 3 or 2b in accord with the gradation of Thrombolysis in Cerebral Ischemia Scale (TICI)] in all the 7 cases (100％),after treatment,the National Institutes of Health Stroke Scale (NIHSS) score was significantly lower than that before treatment (5.86 ±4.10 vs.19.71 ± 5.56,P ＜0.01).Clinical outcome of 90-day follow up was excellent [Modified Rankin Scale (mRS) score 0-2] in 3 cases (42.8％).Conclusion Using alteplase for intravenous thrombolysis combined with endovascular intervention for treatment of patients with acute intracranial large arterial occlusion can achieve good re-canalization rate.

Objective :To explore the clinical value of serum C reactive protein (CRP) combined with hematocrit (Hct) in prediction of severe acute pancreatitis(SAP) .Methods :Seventy five patients ,who were admitted due to AP during April 2011 and December 2014 ,were enrolled .The levels of CRP and Hct ,which were determined within 24 h after admission ,were compared between the patients with SAP and those with mild acute pancreatitis (MAP) .The diagnostic efficiency of CRP combined with Hct in early prediction of SAP was evaluated by ROC curve .Results : The levels of CRP and Hct in SAP group were significantly higher than those in MAP group (P< 0 .05) .The sensitivities of CRP and Hct in the diagnosis of SAP were 61 .56% and 49 .57% ,respectively . The specificities were 83 .27% and 80 .23% ,respectively . And the positive predictive values were 53 .52% and 40 .35% ,respectively .Furthermore ,the negative predictive values were 90 .37% and 85 .26% , respectively .The sensitivity of CRP combined with Hct in diagnosis of SAP was 51 .23% .The specificity was 94 .29% .And the positive predictive value was 76 .12% . Furthermore , the negative predictive value was 87 .23% . Conclusions : CRP combined with Hct is conducive to early diagnosis of the severity of AP .Thus ,it is worthy of clinical practice .

Objective:To investigate the value of magnetic resonance cholangiopancreatography(MRCP)in the evaluation on Calot’s triangle adhesion before laparoscopic cholecystectomy(LC).Methods:A total of 254 patients received MRCP before LC,and the type of Calot’s triangle adhesion was evaluated,which included whether or not the cystic duct had been displayed, adjacent relations between the cystic duct and the gallbladder ampulla,and the open position of the cystic duct in the gallbladder ampulla.The type of Calot’s triangle adhesion by preoperative evaluation was compared with that by intraoperative findings. The relation between the type by preoperative evaluation and the difficulty of operation was analyzed.Results:The type of Cal-ot’s triangle adhesion by preoperative MRCP corresponded with that by intraoperative findings.The rabbit tail type of adjacent relation between the cystic duct and the gallbladder ampulla,the cystic duct starting at the middle portion of the gallbladder am-pulla and the absent imaging of cystic duct could indicate difficult LC procedures.Conclusions:MRCP could be used in preoper-ative evaluation on Calot’s triangle adhesion,to predict the difficulty degree of the LC procedure.

10.3969/j.issn.1008-9691.2013.03.008

Objective To explore the application of steatosis liver donor (SLD) in piggyback liver transplantation (PBLT). Methods Sixty-four cases of SLD were subjected to PBLT and classified into light steatosis liver (S1,22 cases),moderate steatosis liver (S2,25 cases),and severe steatosis liver (S3,17 cases) groups.Eighty cases of non fatty liver selected randomly in the same period served as controls. The liver and renal function at the day of surgery,postoperative liver function recovery,complications one month after surgery,and the death of recipients were recorded.Results There was no significant difference in the liver and renal function between steatosis liver groups and control group at the day of surgery (P＞0.05). At 21st day after surgery,the liver function of 95％ recipients in control group returned to the normal level,and the liver function recovery rate in S1,S2 and S3 groups was 90.9％,80.0％,and 70.6％ respectively.Graft primary nonfunction occurred in 2 cases (11.8％) of S3 group. The incidence of complications such as bleeding,infection,hepatic artery thrombosis,ascites,sepsis in S1,S2 and S3 groups was higher than in control group (P＜0.05).One year after operation,there were two deaths in control group,one in S1 group,one in S2 group,and 5 in S3 group,respectively.Conclusion SLD can be used for transplantation,but for the transplantation with severe steatosis liver,it should be carried out carefully.

Polysaccharide was extracted by boiling water reflux method from the fruiting body of Ganoderma lucidum. Additionally, the purified polysaccharide was obtained by removing protein with Sevage way, ethanol precipitation, centrifugation, run water dialysis, membrane separation, concentration and frozen-drying. The structural characteristics, chain conformation and triple-helix conformation of ganoderma lucidum polysaccharide (GLP) were distinguished by Smith degradation, methylation analysis, and the wavelength change of the red shift of the mixture of polysaccharide and Congo red in alkaline solution, as well as IR, GC-MS, NMR, and visible spectrometry. The results indicated that GLP was a linear (1→3) β-D-Glcp main chain linkage. Its monosaccharide component was predominantly composed of D-Glc, and small amount of galactose, mannose, xylose and idose, residues of branches terminated with substituted at 1→6 by a small number of single-unit β-D-Glcp side-chains, it′s also observed that the (1→3)-linked β-D- glucan contained a triple-helical conformation, which was composed of a repeating unit with a structure as below:→3)-β-D-Glcp-(1→3)-[β-D-Glcp-(1→3)-]_n-β-D-Glcp-(1→.↑6/1β-D-Glcp