Minichromosome maintenance proteins are novel cell proliferation markers. These proteins have demonstrated clinical values in cancer diagnosis, prognosis, and screening, and have shown promising potentials in targeted treatments of cancer.

This paper analyzes the explore the factors influencing the TCM clinical pathway using the fishbone dragram. We found that the main impacting factors of TCM clinical pathway were government policy factors, hospital management factors and personal factors. It was suggested to promote Chinese medicine clinical pathway pilot job, not only need to cooperate with the administrative departments of health and medical institutions, also need to strengthen the change of the idea of both doctors and patients.

Child ; Disease Susceptibility ; etiology ; Environmental Exposure ; Environmental Pollutants ; Health Status ; Humans

Child ; Health Knowledge, Attitudes, Practice ; Humans ; Lead Poisoning ; prevention & control

Child ; China ; Humans ; Lead Poisoning ; prevention & control ; Public Health Practice

Objective A comparative study of clinical factors and dose-volume histogram (DVH)parameters on the impact of radiation pneumonitis occurred in the three-dimensional conformal radiotherapy of lung cancer (lung target)and mediastinal tumors and esophageal (mediastinal target).Methods Review 83cases lung cancer,mediastinal tumors and esophageal patients,and analyzed with chi-square tests on the correlation of the clinical factors (gender,age,tumor location,stage,chemotherapy) with radiation pneumonitis;have relevance analysis between the DVH parameters of two targets and radiation pneumonitis; lung target and mediastinal target volume DVH parameters compared to the t-test.Results ≥2 radiation pneumonitis was 36.5 ％.≥2 radiation pneumonitis occurred in various clinical factors had no significant effect.DVH parameters of the two targets,V5,V10,V20,V30,whole lung dose (MLD) were significantly related to RP.Two targets of RP patients V5 [(50.9±17.8) ％,(69.9±20.4) ％],V10 [(38.6±15.2) ％,(53.5±18.8) ％] were statistically significant by t-test (t =2.434,P ＜ 0.05),while V20 (t =0.388,P ＞ 0.05),V30 (t =0.005,P ＞ 0.05) and MLD (t =0.138,P ＞0.05) were no significant difference (P ＞ 0.05),so the same results with the two targets of patients without RP obtained.Conclusion In the lung target and mediastinal target of radiotherapy radiation pneumonitis is related with DVH parameters,especially V20,V30 and MLD impact on the occurrence of RP.

Objective To evaluate the survival benefit of amphotericin B (AmB) plus flucytosine or fluconazole for treatment of patients with acquired immunodeficiency syndrome (AIDS)-associated cryptococcal meningitis.Methods The following database were searched from the beginning to October 2013,including Cochrane library,PubMed,OVID,Embase,Wanfang Date,CNKI and Chinese Biomedical Database,and the references of eligible studies were manually screened.Reference lists of relevant articles were screened according to selection and extraction criteria.Meta-analysis was performed using RevMan 5.2.Results Four prospective controlled studies with a total of 399 patients with cryptococcal meningitis were identified,including 386 patients with AIDS-associated cryptococcal meningitis and 13 human immunodeficiency virus (HIV)-negative patients.Two hundred and twentyseven patients were treated with AmB and flucytosine combination therapy,including 217 patients with AIDS-associated cryptococcal meningitis and 10 HIV-negative patients.One hundred and seventy-two patients were treated with AmB and fluconazole combination therapy,including 169 patients with AIDS-associated cryptococcal meningitis and 3 HIV-negative patients.The Meta-analysis revealed that the mortality rate in AmB plus flucytosine combination therapy group was 6.6％ (95％ CI:18.5％-31.6 ％) at two weeks point,which was significantly lower than that in AmB plus fluconazole combination group (19.7％,95％CI:-23.6％-62.9％; OR=0.51,95％CI:0.27-0.93,P＜0.05).But at 10 weeks point,the mortality rate in flucytosine combination group was 12.9％ (95％oo CI:-22.2％-48.0％),which was lower than that in fluconazole combination group (31.4％,95％ CI:-23.1％-85.9 ％).However,there was no statistically significant difference between these two groups at 10 weeks point (OR=0.70,95％CI:0.44-1.13,P=0.15).Conclusion Administration of AmB plus flucytosine at early stage can reduce the mortality rate in patients with AIDS-associated cryptococcal meningitis.

Objective To discuss the relationship between the fracture of the clavicle which was fixed by tor-sional-shaped plate and nonunion after operation.Methods Retrospective analysis was conducted in 426 patients with midshaft clavicle fractures.Among the patients,the A group used torsional-shaped plate to meet the anatomical structure of the clavicle:the medial plate matched under the front face of the clavicle,and the lateral plate matched the up face of the clavicle.And the traditional method was used in the B group.Patients were followed up for at least 12 months,the patients were judged by X-ray criteria for nonunion.Results A total of 28 patients with nonunion, including 4 cases in A group,24 cases in B group.After statistics processing,the difference between A group and B group was significant (χ2 =6.679,P=0.010).Conclusion We find that the treatment of the fracture of the middle part of the clavicle with torsional-shaped plate can effectively reduce the incidence of nonunion.

BACKGROUND: Dexmedetomidine has been shown to fight against ischemia/reperfusion injury induced by tourniquets. OBJECTIVE: To study the effects of dexmedetomidine on the oxidative stress and inflammatory damage caused by tourniquet-induced ischemia/reperfusion injury. METHODS: Seventy-six patients scheduled for lower limb operation were randomized into two groups: patients in dexmedetomidine group were given the intravenous injection of 1 μg/kg dexmedetomidine for 10 minutes, followed by 0.5 μg/kg?h until the end of operation; while the controls were subjected to 0.9% saline injection at an equivalent velocity and volume. The levels of serum propanediol, lactic dehydrogenase, superoxyde dismutase, tumor necrosis factor-α, interleukin-6 and -8 were detected before tourniquet inflation, 10, 60 and 120 minutes after tourniquet release. RESULTS AND CONCLUSION: In both two groups, the serum levels of propanediol, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and -8 after tourniquet release were significantly higher and the serum superoxide dismutase level was significantly lower than those before tourniquet inflation (P < 0.05). Compared with the control group, dexmedetomidine significantly reduced the serum levels of propanediol, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and -8, and increased the serum superoxyde dismutase level after tourniquet release (P < 0.05). These results suggest that dexmedetomidine can attenuate the oxidative stress and inflammatory damage resulting from tourniquet-induced ischemia/reperfusion injury probably by up-regulating the serum superoxyde dismutase level, and down-regulating the serum levels of propanediol, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and -8.

Objective To describe the distribution of body mass index (BMI) and evaluate the prevalence of overweight and obesity among first to sixth graders in 8 Chinese provinces.Methods Data came from the baseline survey of the Chinese Center for Disease Control and Prevention (CDC) funded project Study on Intervention Models for Main Chronic Diseases among children in China.A stratified random cluster sampling strategy was used to select study participants in 8 provinces,including Inner Mongolia,Jiangsu,Anhui,Shandong,Hunan,Guangxi,Gansu provinces,and Chongqing,with diverse geographical and economic level distributions in China.Counties in each province were stratified into three strata according to economic level,and one county was selected systematically from each stratum.In each county,one urban and one rural elementary school were randomly selected ; and in each school,2-3 classes were randomly selected from each of 1-6 grades.All students in these selected classes were invited for participation.Physical examination was performed by trained local CDC staff using standardized instruments to measure height and weight.Overweight and obesity were diagnosed based on the BMI classification standards for Chinese children and adolescents by Working Group for Obesity in China (WGOC).Results A total of 26558(14225 boy,12333 girl) students aged 6-12 years eventually participated in 8 provinces.The average age was 9.3 ±1.8 years old.Mean BMI among boys (17.0 kg/m2) was higher than that among girls (16.4 kg/m2,t =19.60,P＜0.01).There were statistically significant differences in mean BMI of each age group of boys and 6-11 age groups of girls between urban and rural regions and among those with three economic levels (P＜0.05).The 85th and 95th percentiles of BMI among boys aged 7-11 years in urban region were higher than BMI reference in the standards from WGOC.Lower percentiles were observed among girls aged 7-12 years in rural region.The prevalence of overweight and obesity were 9.3％ and 6.5％ among schoolchildren aged 7-12 years.The prevalence of overweight among boys (10.9％) was higher than that among girls(7.6％,x2 =88.89,P＜0.01) ; while prevalence of obesity were 8.0％ among boys and4.7％ among girls,respectively (x2 =107.17,P＜0.01).The prevalence of overweight was 11.3％ in urban and 7.4％ in rural children(x2 =131.94,P＜0.01).The prevalence of obesity was 8.7％ in urban and 4.3％ in rural children(x2 =188.99,P＜0.01).The prevalences of overweight were 10.3％,8.6％ and 9.0％ in individuals with high,medium,and low economic levels,respectively(x2 =10.76,P＜0.01) ; while the prevalences of obesity were 8.2％,5.6％,and 5.4％,respectively (x2 =51.71,P ＜ 0.01).Conclusions The overall prevalence of overweight and obesity in Chinese school children was high.The prevalence in urban region with high economic level was significantly higher than that in rural region with middle and low economic level.The nutritional and behavioral intervention programs are needed to control the rising trend of obesity in children.