Pain is one of usual symptons of mid-late cancer patients, radioactive particle interstitial im- plantation can not only control tumor advancement,but also alleviate pain in different degree by inactivating part nerves or relieving compression. It has showed significant effect in system tumor--gastric cancer, colon cancer and head and neck cancer without severe cemplication,effering a new method of curing cancerous pain.

Objective To discuss the training mode of intensive care unit (ICU) nurse specialists. Methods The trainees of class of 2014-2015 ICU nurse specialists were chosen as the object of the study, diversified training mode was utilized, namely, an optimized combination of multiple different training modes, theoretical courses+clinical practice+assessments (scenario simulation in small groups and individual practical capability)+review (a survey for the training contents, methods and effectiveness of the courses and instructors/teaching assistants, as well as position competency of the trainees)+case study in nursing+comprehensive review. Results After the training of ICU nurse specialists with diversified training mode, the scores had increased from 54.88 ± 12.45 to 79.63 ± 6.15 in theoretical courses, and from 64.69 ± 11.61 to 92.38 ± 3.10 in clinical operating skills, the differences between the above indexes were statistically significant (t=101.60, 169.96, both P<0.01);the numbers of required 140 skills in clinical practical programs mastered by trainees had increased from 66.53 ± 16.17 to 84.78 ± 21.34, the differences between the above indexes were statistically significant (t=14.866, P<0.01). After the ordered chi-square test the value of position competency before and after the training were statistically significant (χ2=24.62, P < 0.05). The trainees also expressed 100% satisfaction rate of the training courses, instructors/teaching assistants and the training effectiveness. Conclusions The diversified training mode benefits to the improvements of professional knowledge and skills, position competency and team-working, as well as the cultivation and comprehensive quality of ICU nursing specialists.

Alkaloid is one of the main antineoplastic activities in Chinese Herbal Medicine.There has been big progress on the mechanism of antitumor in natural alkaloids and their derivatives in recent years,especially focusing on the targets of hypoxia inducible factor 1,telomere,and topoisomerase.The new trends of these three targets have been reviewed in this paper.

Objective　To investigate the relationship between soluble tumor necrosis factor receptors (sTNF-R), TNF-α, TNF-α/sTNF-R and rheumatoid arthritis. Methods　 Serum levels of sTNF-RⅠ, sTNF-RⅡ and TNF-αwere measured in 28 patients with active RA and 12 patients with inactive RA and 30 healthy controls, using double antibodies sandwiched ELISA. Results　The results showed that serum levels of sTNF-RⅠ, sTNF-R Ⅱ and TNF-α　were significantly higher in the group of patients with active RA than those　found　in healthy group and　in the patients with inactive RA. Serum levels of both sTNF-RⅠ, sTNF-RⅡ and TNF-α　were also significantly higher in patients with inactive RA than in healthy group(P＜0.01 for all). In RA, the serum concentrations of sTNF-RⅠ and sTNF-RⅡ were positively correlated with the levels of ESR，CRP，Ritchie index. Conclusions　These results suggest that the serum levels of sTNF-RⅠ and sTNF-RⅡwere significantly increased and positively correlated with the disease activity. The determination of serum levels of sTNF-RⅠ and sTNF-RⅡ can be regarded as a useful laboratory parameter for diagnosis of RA,monitoring of the disease activity and assessment of prognosis.

BACKGROUND:Internal fixation is commonly used in an early stage of intertrochanteric fractures of the aged worldwide, and can apparently reduce complications and fatality rate. The commonly used internal fixators contain proximal femoral nail anti-rotation and dynamic hip screw, whose comparison is current research hotspot.
OBJECTIVE: To evaluate the hip function and stability after internal fixation with proximal femoral nail anti-rotation and dynamic hip screw in repair of intertrochanteric fractures of the aged.
METHODS:A total of 64 aged patients with intertrochanteric fractures were enroled in this study, and assigned to dynamic hip screw group (n=30) and proximal femoral nail anti-rotation group (n=34). The fracture reduction and healing were evaluated using anterioposterior and lateral X-ray films. Operation time, intraoperative blood loss, complication rate, healing time and postoperative hip function were compared and analyzed between the two groups, and then assessed in accordance with Sander’s scoring system.
RESULTS AND CONCLUSION:Compared with dynamic hip screw group, operation time, intraoperative blood loss, healing time and complication rate after treating unstable intertrochanteric fracture (Tronzo-Evans III, IV and V types) showed significant advantages in the proximal femoral nail anti-rotation group (P < 0.05). Hip function restored better, and the complication rate of stable intertrochanteric fracture (Tronzo-Evans I and II types) was lower after treatment in both groups (P > 0.05). These data show that the effects of proximal femoral nail anti-rotation were better than that of dynamic hip screw for treatment of intertrochanteric fractures, and hip function recovered better. Moreover, proximal femoral nail anti-rotation had biomechanical stability, especialy for unstable fracture.

Objective To investigate the pathogenicity of late-onset Alzheimer disease from the viewpoint of comparative proteomic technology and to screen it from diseases with related protein markers.Methods Cerebral cortex tissue of temporal layer of 8 cases of late-onset Alzheimer disease and 5 cases of age-matched autopsied controls with normal brain was chosen for this study.Cerebral proteins were run through immobilized pH gradient (IPG) isoelectric focusing electrophoresis as the first dimension and then vertical SDS-PAGE electrophoresis as the second dimension.Differential proteins were identified with visionworks LS and then analyzed with matrix assisted laser desorption ionization time of flight mass spectrometry(MALDI-TOF-MS) and eleetrospray ionization mass spectrometry (ESI-MS).Finally,the protein was identified by searching in the data bank.Results Different 2-dimensional gel electrophoresis maps were obtained for the protein spots in the late-onset Alzheimer disease group and the control group gels.11 protein spots showed a significantly differential expression between the two groups of cerebral cortex samples.It was found that the expression of DJ-1 protein was increased in the late-onset Alzheimer disease group in comparison with the control group after searching in the database.Conclusion DJ-1 protein may be a potential marker related to Alzheimer disease pathogenicity.This finding would be helpful to develop new drugs which focus on this protein and prevent nearodegeneration.

Objective To investigate the causes of complications induced by peripherally inserted central catheters(PICC)in cancer patients and summarize pertinent nursing measures.Method The clinical data of 26 tumor patients with PICC were analyzed retrospectively .Result The complications occurred in 8 patients with a rate of 30.8%, among which unsuccessful catheteration occurred in 1 case,oozing of blood at the mouth of catheter in 1 case,phlebitis in 1 case,dislocation in 1 case,skin allergy-like reactions in 2 cases and catheter emersion in 1 case,catheter breaking in 1 case and dislocation in 2 cases.Conclusion The skilled operation,preventive maintenance of catheters and health education to the patients are the important measures for prevention and reduction of the complications.

Objective To detect the expression of bcl-2 and c-Met genes in lung cancer cell lines with different mutations of epidermal growth factor receptor (EGFR), in order to explore the association between expression of bcl-2 and c-Met genes and drug resistance in non-small cell lung cancer (NSCLC). Methods Direct sequencing was used to detect EGFR mutations status in HCC827 cells, A549 cells and H1975 cells. Immunocytochemistry was conducted to test bcl-2 and c-Met expression. RT-PCR was performed to analyzed bcl-2 gene expression and ARMS was used to detect EGFR mutations status in malignant pleural effusion of NSCLC patients. Results A549 cells, HCC827 cells and H1975 cells were EGFR wild type, EGFR exon 19 deletion (19del), and EGFR exon 21 L858R and exon 20 T790M double mutations. c-Met and bcl-2 protein located in cytoplasm and the intensity of positive expression was highest in HCC827 cells, followed by A549 cells and H1975 cells. The bcl-2 mRNA expression was higher in HCC827 and A549 cells than that in H1975 cells (10.93±1.90 vs. 0.83±0.15, P=0.013; 7.13±1.33 vs. 0.83±0.15, P= 0.000). However bcl-2 mRNA expression was not associated with EGFR mutations (wild type, 19del and L858R) in malignant pleural effusion of NSCLC patients. Conclusion bcl-2 and c-Met gene in HCC827 cells (EGFR 19del) expression is significantly higher than those in H1975 cells (EGFR L858R/T790M), implying EGFR L858R mutations and 19del mutations may be regulated by different signaling pathways.

Objective To analyze the efficacy and safety of different chemotherapy regimens for treatment of progressive patients with small cell lung cancer (SCLC) brain metastasis after radiotherapy. Methods 96 SCLC brain metastasis patients with progressive intracranial lesions after radiotherapy were divided into four groups: carmustine group (Group A, 28 cases), temozolomide group (Group B, 19 cases), topotecan group (Group C, 24 cases) and no chemotherapy group (Group D, 25 cases). Results In terms of brain metastases, there were no complete response cases in the whole groups. The rates of partial remission (PR), stable disease (SD) and progression of disease (PD) in Group A were 17.8%(5/28), 53.6%(15/28) and 28.6 % (8/28), respectively, the response rate (RR) of intracranial lesions was 17.9 % (5/28), and disease control (CR+PR+SD) rate was 71.4%(20/28). The rates of PR, SD and PD in Group B were 15.8%(3/19), 63.2 % (12/19) and 21.1 % (4/19), respectively, the RR of intracranial lesions was 15.8 % (3/19), and disease control rate was 78.9 % (15/19). The rates of PR, SD and PD in Group D were 8.3 % (2/24), 54.2 %(13/24) and 37.5 % (9/24), respectively, the RR rate of intracranial lesions was 8.3 % (2/24), and disease control rate was 62.5 % (15/24). In Group D, there was no response case, and 20 patients with PD (80.0 %) were found. The median progression-free survivals (PFSs) were (3.64 ±0.43) months, (4.68 ±0.49) months,(3.58 ±0.50) months, (2.60 ±0.31) months in Group A, B, C and D, respectively, and the median overall survivals (OSs) were (18.80±1.74) months, (18.76±1.85) months, (19.10±1.64) months and (9.64±0.84) months, respectively. The median OS of Group A, B or C was longer than that of Group D (P=0.002). The differences of grade Ⅲ-Ⅳhematologic toxicities among the four subgroups were not statistically different. Patients in Group B had better tolerance to nausea and vomit. In Group D, the central nervous system symptoms such as fatigue and headache occurred frequently. Conclusions The response rate and OS of SCLC brain metastasis patients with progressive intracranial lesions after radiotherapy are improved after chemotherapy, however, PFS is not significantly prolonged. The efficacies of carmustine, temozolomide and topotecan are similar in short and long term, besides, temozolomide shows less adverse events and a higher disease control rate. The application of chemotherapy that could penetrate the blood-brain barrier can improve the efficacy on SCLC brain metastasis patients with progressive intracranial lesions after radiotherapy with well tolerance.

Objective To investigate the efficacy and safety of blood purification therapy in the treatment of diuretic resistance in patients with nephrotic edema.Methods 40 cases of primary nephrotic syndrome with diuretic resistance in our hospital were randomly divided into hemodialysis (HD) group and continuous blood purification (CVVH) group and each group were 20 cases.All the patients were given basic treatment (lipid modulation,anticoagulation and glucocorticoid) and the observation time was 4 weeks.The changes of biochemical indexes (24 h urine protein,plasma albumin,serum urea nitrogen and serum creatinine) were observed before and after treatment in two groups.In addition,the complications of four groups were recorded.Results After blood purification treatment,urinary volume of two groups were significantly increased,the quantity of 24 h urinary protein and serum albumin were significantly improved,levels of serum urea nitrogen and serum creatinine were significantly decreased.The differences were statistically significant (P ＜ 0.05 or P ＜ 0.01).Compared with HD group,the urine volume increased more obviously in CVYH group after 2 weeks' treatment (P ＜ 0.05).The same time,24 h urinary protein was reduced and plasma albumin was improved more significantly (P ＜ 0.05),levcls of serum urea nitrogen and serum creatinine were not differ between the two groups (P ＞ 0.05).There was no difference in urine volume and renal function between the two groups (P ＞ 0.05) after 4 weeks' treatment.24 h urinary protein was significantly decreased and serum albumin was significantly higher than HD group (P ＜ 0.05).There were no serious complications in the two groups.Conclusion Blood purification in the treatment of diuretic resistance in patients with nephrotic edema is safe and effective.Continuous blood purification treatment can effectively alleviate nephrotic edema with diuretic resistance,promote the recovcry of renal function and improve the prognosis of kidney disease.