Objective To study the effect of new barrel theory in improving evaluation of hospitalized patients. Methods Eight hundred hospitalized patients from September 2012 to August 2013 were randomized equally into the control group and the observation group.The last one or two items affecting patient satisfaction from the control group were used as objectives to be improved.Causal effect analysis was done pertinent to the items and the worksheet was bettered and improved and then enforced.The two groups were compared after intervention with new barrel theory in terms of satisfaction of patients during admission and discharge. Result The satisfaction of patients in the observation group during admission and discharge was significantly better than that in the control group(P<0.05).Conclusion The new barrel theory used to detect the flaws in nursing service and improve the workflow can improve assessment from the patients so that the management quality can be enhanced.

Objective To investigate the effects of treatment of proximal humeral fracture in the elderly with anatomical plate internal fixation.Methods Twenty-seven cases of proximal humeral fractures received operative treatment with anatomical plate.According to Neer classification,there were 18 patients with three-part fractures of the bone,there were 9 patients with four-part fractures of the bone.Results Twenty-seven patients were followed up for 6-24 months.According to the evaluation of Herscovici scales,the result were excellent in 17 cases,and good in 8,92.6％ (25/27) of all reductions were excellent or good.The excellent and good rate of Constant-Murley score was 88.9％(24/27 ).Conclusion It is an ideal way to treat the displaced proximal humeral fracture with anatomical plate,which can provide rigid fixation,it allows early functional treating.

Objective: To evaluate the impairment of semantic memory in Alzheimer's disease.Methods: 22 Alzheimer's disease patients were examined by means of a longitudinal study and compared with 22 normal elders.Two semantic tasks,lexical decision task and semantic knowledge task were used,to evaluate the integrity of the same concepts.Results: In each session,the MMSE scores of the Alzheimer's disease group were significantly worse(P

Objective To evaluate the efficiency and toxicities of Gemcitabine combined with S -1 cap-sule in the treatment of advanced esophageal cancer .Methods Twenty-nine patients with advanced esophageal cancer were treated with S-1 capsule 80 mg/m2 ,twice daily for 14 days and Gemcitabine (1 000 mg/m2 ) was in-travenously administrated on day 1 and 8.The chemotherapy was repeated every 21 days.After two consecutive treatment circles ,the short term efficacy ,adverse effects and follow -up condition were evaluated .Results One case showed complete remission (CR),11cases showed partial remission (PR),9 cases showed stable disease (SD),8 cases showed progressive disease(PD).The responsive rate(CR+PR)was 41.4%;the illness control rate(CR+PR+SD)was 72.4%.The major adverse events were myelosuppression ranging from grade Ⅰto Ⅲ, hand-foot syndrome,disgusting and the damage of liver function .Some patients displayed the damage of liver function.The median time to progress ( mTTP) was 6.9 months.The median 1-year survival rate was 64.3%. Conclusion The combination of Gemcitabine and S -1 capsule is an effective and well -tolerated method for the patients with advanced esophageal cancer .

Objective To study the relationship between nitric oxide(NO)and some cytokines and the pathogenesis of vitiligo.Methods Nitric acid reductase assay and ELISA were used to determine the serum levels of NO,and IFN-?,IL-10and IL-12in32patients with vitiligo,compared with18normal controls.The levels of these molecules in suction blister fluids,including involved skin and uninvolved skin from20patients,were also determined.Results The serum levels of NO and IFN-?in vitiligo patients were significantly higher than those in controls,and the serum level of IL-10in the patients was significantly lower than that in controls.The serum level of IFN-?in generalized type of vitiligo and the serum level of NO in localized type of vitiligo in active stage were higher than those in stable stage.The NO level in suction blister fluid of localized vitiligo of involved skin was significantly higher than that of uninvolved skin.Conclusion These findings suggest that NO,IFN-?and IL-10might be involved in the pathogenesis of vitiligo.

Objective:To investigate the present situation of humanity education for medical students and to provide theoretical evidence for establishing appropriate interventions. Methods:This paper surveyed and analyzed the present situation of humanity education for medical students in a medical university using questionnaires. Re-sults:18. 7% of medical students entirely remembered the specific content of Hippocratic Oath, 7. 3% of medical students had never heard about the concepts such as humanistic quality, 31. 7% of medical students had never bor-rowed humanity and social science books from the school library, 79. 3% of medical students thought it necessary to strengthen humanity education. Some results showed that there were significant differences in different grades and specialties. Conclusion:It is necessary to further strengthen humanity education for medical students, improve the quality of humanity curriculum, and make a fusion of humanity education and the medical professional education. At the meantime, the humanity courses should be increased and the educational program should be diversified.

Objective:To analyze the expression of MUC15 and PI3K/Akt in gastric carcinoma and its association with clinicopathologi-cal characteristics and prognosis. Methods:The expression of MUC15 and Akt was detected in 144 cases of gastric carcinoma tissues and corresponding para-carcinoma tissues by tissue microarray and immunohistochemistry. Results:The positive expression rate of MUC15 in gastric carcinoma was 79.8%, higher than that of para-carcinoma tissues (22.2%, P<0.01). The positive expression rate of Akt protein in gastric carcinoma was 80.6%, higher than that of para-carcinoma tissues (16.7%, P<0.01). The expression of MUC15 and Akt was statistically associated with the grades of differentiation, invasion depth, lymphatic metastasis, TNM stage of tumor tissues (P<0.05), and the positive correlation between the two protein expression that appear in the gastric tumor tissue (P=0.001). Univariate survival analysis showed that the over-expression of either MUC15 or Akt was inversely correlated with the survival time (P<0.05 and P<0.01, respectively). Cox multiple regression analysis indicated that patients with over-expression of both MUC15 and Akt had the worst prognoses (HR=3.115, P<0.05). Conclusion:MUC15 may be involved in the occurrence, development, invasion, and metastasis of gastric cancer through the PI3K/Akt cell signaling pathway, and the expression of MUC15 combined with Akt is a powerful predictor for the prognosis of gastric cancer.

OBJECTIVE:To observe the effect of Compound glycyrrhizin on serum VEGF of patients with alopecia areata. METHODS:36 alopecia areata patients were selected as trial group and treated with Compound glycyrrhizin(50 mg/time,3 times/d) for 3 months. Double-antibody sandwich ELISA method was adopted to determine the content of VEGF in serum before and after treatment. 36 healthy volunteers were included in control group,and serum content of VEGF in control group was compared with trial group. RESULTS:Compared with control group,the serum content of VEGF was lower in trial group,with statistical signifi-cance(t=5.863,P<0.05). After treatment,the serum VEGF levels of trial group increased,with statistical significance(t=4.351, P<0.05);there was no statistical significance in VEGF levels between trial group and control group after treatment(t=1.678,P>0.05). CONCLUSIONS:Compound glycyrrhizin can cure alopecia areata through increasing serum level of VEGF.

Objective To investigate the expression of activated ERK (p-ERK) and activated p38 (p-p38) in the keratinocytes of condyloma acuminata (CA) lesions. Methods Fifty cases of HPV 6/11 CA were diagnosed by in situ hybridization. The expression and distribution of p-ERK and p-p38 in CA lesions and 25 normal human skins (foreskins) were detected by immunohistochemistry technique (En Vision). Results ①The results showed that the expression of p-ERK and p-p38 in keratinocytes of CA lesions were significantly higher than those in normal epidermis (P

Objectives To explore the effects of budesonide (BUD) on airway remodeling and the levels of transforming growth factor-β1 (TGF-β1) in bronchoalveolar lavage fluid (BALF) and its expression in lung tissue of asthmatic rats. To provide a theoretical basis for the intervention and treatment of asthma. Methods Sixty healthy adult male Wistar rats were randomly divided into 3 groups: control group, asthma model group and BUD treated group, 20 rats in each group. A rat asthma model was established by ovalbumin (OVA) challenging. BUD treated group was treated with inhaled BUD 1 mg/kg in 30 min per serving every other day for two weeks. After OVA challenge finished, the rats were anesthetized and sacrificed for BALF and lung tissue collection. The level of TGF-β1 in BALF was measured by enzyme-linked immunosorbent assay. TGF-β1 expression and collagen deposition in the lung tissue were tested with immunohistochemical determination and Masson stain respectively. The computer image analysis system was used for measuring respiratory bronchiole smooth muscle thickness (μm) and the extent of epithelial damage score and other indicators of airway remodeling. Results Compared with that in the control group, TGF-β1 in BALF and lung tissue of asthma model group increased and were correlated significantly with the indicators of airway remodeling (P < 0.01) ;while that of BUD treated group reduced statistically significant than model group (P < 0.05). Pathology examination on asthma rat airway epithelial tissue showed the thickness of airway smooth muscle, the airway deposition of collagen in BUD treated group reduced obviously than asthma model group. Conclusions The expression of TGF-β1 in the rat asthma airway worsens the airway remodeling. The effects of BUD on ameliorating the progression of airway remodeling may be partially made by reducing the expression of TGF-β1. (J Clin Pediatr,2010,28(2):173-177)