Atrial fibrillation is one of common arrhythmias and can significantly increase risks of stroke and heart failure with high rates of mortality and disability. The incidence of atrial fibrillation increases year by year due to aging population, high incidences of coronary heart disease and hypertension, and lifestyle changes. As one of widely consumed drinks in the world, coffee affects the daily life of modern people. The intake of caffeine, which is the main ingredient of coffee, can influence the incidence of atrial fibrillation, but the relationship between them is still controversial. Most studies deem that the intake of caffeine is negatively correlated with the incidence of atrial fibrillation. This paper reviews current studies in China and abroad on the relationship between the intake of caffeine and the incidence of atrial fibrillation.

The article reviewed the concept,characteristics,basic steps and main form of PBL as well as the wide application and superiorities in nursing courses teaching.It also analysed the deficiencies of teaching courses,raised the proposal or advice on how to improve from 3 following aspects and explore the possibilities of application in nursing filed.

Objective To observe the effect of IMRT combined with astragalus polysaccharide (ASP) injection on cervicocerebral tumor,radiation side effects and its influence on immune function. Methods 61 head and neck tumor patients were randomly divided into two groups.One groups received the IMRT combined with Astragalus Polysaccharide (ASP) injection (n=30) while the other group only received the IMRT(n=31). The recent effect, immune function and the side effects of radiotherapy between the 2 groups were observed and compared , changes of T-lymphocyte subsets, natural killer (NK) cell activity and the dermatitis,oral mucosa reaction,thirsty condition on patients in intraoperative or postoperative period were also observed and compared. Results The total effective rate in experimental group and the control group were 83.0% and 80.6% respectively.The cell viability of peripheral blood lymphocyte and NK cell as well as the T3、T4、NK cell value increased in IMRT-ASP group (P<0.05) after treatment. While T3、T4、NK cell value in peripheral blood decreased (P<0.05). Mucosa,dermatitis and salivary gland damage showed in IMRT-ASP group were significantly better than in control group after 3 weeks treatment (P<0.05). Conclusion ASP can improve immune function effect in head and neck tumor patients during RT, and can also eliminate the side effects of radiotherapy.

Objective:To investigate the clinical characteristics, treatment, and evaluation of the prognosis of syndrome of inap-propriate anti-diuretic hormone (SIADH) in lung-cancer patients. Methods:We review the clinical data of six lung cancer cases, includ-ing four small cell lung cancer, one adenocarcinoma, and one squamous cell carcinoma, with SIADH complication. All six cases were treated in our hospital over the past three years. Results:Patients with various serum sodium levels were provided different therapeutic regimens. Symptoms of fatigue and nervous system disorders, plasma sodium, urine sodium, and plasma osmotic pressure were alleviat-ed. Conclusion:SIADH is a common complication of lung cancer, particularly in small lung cancer cases. Electrolyte disturbances indi-cate poor prognosis, high mortality rate, and delay in treatment because of clinical interest. After a final diagnosis has been made and ap-propriate treatment has been administered, clinical symptoms were relieved and blood sodium levels were quickly and significantly im-proved in these patients.

ABSTRACT:Objective To investigate the bone marrow stem cell mobilization and homing changes of peripheral blood due to diabetic myocardial ischemia in rats and the change of expression of the vascular endothelial growth factor (VEGF)and the tumor necrosis factorα(TNFα)in ischemic myocardial tissue.Methods The diabetic model of male Sprague-Dawley rats was created by intraperitoneal injection of streptozotocin first.Then the diabetic myocardial ischemia model was established through ligation of the left anterior descending coronary artery. The rats were divided into ischemic day-1,day-3,day-7,and day-28 groups.And their time-matching diabetic sham operation control group and normal sham operation control group were also established,with 6 rats in each group. Flow cytometry was used to measure the percentage of CD34+ cells in peripheral blood mononuclear cells for each group.Immunohistochemistry was used to observe the homing of CD34+ cells and the expression of VEGF and TNFαin the ischemic myocardium.Results The mobilization of bone marrow stem cells was initiated after the surgery in the rat models of myocardial ischemia in diabetes and it peaked within 1 week and decreased with the passage of time.Accordingly the homing of CD34+ cells and the expressions of VEGF and TNFαin the ischemic myocardium were significantly increased.Conclusion During the early stage,the diabetic ischemic myocardium can mobilize bone marrow stem cells into the peripheral blood and start homing to the ischemic myocardium by increasing VEGF and TNFαin the ischemic myocardium,thereby initiating the self-protection mechanisms.

Objective To analyze the risk factors of intracranial infection after neurosurgery and the effect of vancomycin.Methods 28 cases of craniotomy in this study, The First Hospital of Ningbo City from January 2011 to July 2014 during the years after the occurrence of intracranial infection patients as the research object, a retrospective analysis of the age, gender, emergency, basic diseases, mastoid airroom, ventricle drainage, posterior fossa surgery, reoperation and operation time (more than 4h).The clinical data, summarize the risk factors of postoperative intracranial infection in department of neurosurgery and to observe the clinical effect of vancomycin in the treatment of such patients.Result The high risk factors of intracranial infection include: Open mastoid gas room during operation, ireoperation, ventricular drainage and operative time (more than 4h).In 28 cases with intracranial infection after craniotomy, the total effective rate of vancomycin treatment was 100.00%.Conclusion The high risk factors of intracranial infection after operation include open surgery, mastoid room, reoperation, ventricular drainage and longer operation time.Vancomycin is an effective drug in the treatment of intracranial infection in the department of neurosurgery.

As a stable marker to reflect the average level of blood glucose,HbA1c is very important in glycaemic control evaluation.However,more and more data from evidence based medicine demonstrated that blood glucose fluctuation can also contribute to diabetic complication and prognosis which can not be neglected.Multiple capillary glucose measurements and continuous glucose monitoring are major methods to detect glucose fluctuation.Apart from insulin,various oral anti-diabetic drugs can reduce postprandial glucose excursion.Representative drugs include ?-glycosidase inhibitors,glinides and short-acting sulfonylureas,each have their own way of acting. Abstract:Summ ary:As a stab le m arker to reflect the average level of b lood glucose,HbA1c is very important in glycaem ic control evaluation.However,more and more data from evidence based m ed ic ine demonstrated that b lood glucose fluctuation can also contribute to d iabetic comp lication and prognosis wh ich can not be neglected.Mu ltip le cap illary glucose m easurem ents and continuous glucose mon itoring are m ajorm ethods to detect glucose fluctuation.Apart from insu lin,various oral anti-d iabetic drugs can reduce postprand ial glucose excursion.Representative drugs inc lude?-glycosidase inh ib itors,glin ides and short-acting su lfonylureas,each have the ir own way of acting.

Objective To investigate the relationship between depression and personality and social support of the urban and rural empty-nest, clear the influence factors of depression in the empty-nest elderly. Methods 398 cases of urban and rural empty-nesters selected from the Chifeng district, were valuated with the general information questionnaire, the Geriatric Depression Scale (GDS), Eysenck personality Questionnaire- Revised Short Scalr for Chinese (EPQ-RSC) and the Social Support Scale (SSRS), and to investigate the demographic data, depression, personality and social support. Results Rural cases had a higher level (14.41±3.09) points of depression than (12.90±2.64) points of urban cases, and the difference was statistically significant (t=5.254, P<0.01);rural empty nesters′subjective support (18.35 ± 2.14) points, objective support (6.37 ± 1.40) points, support utilization degree (6.01 ± 1.17) points and social support score (30.37 ± 4.24) points, were lower than (19.83 ± 2.27) points, (7.34 ± 1.13) points, (6.95 ± 1.12) points, (34.12 ± 3.73) points of urban′s, and the difference was statistically significant (t=6.673-8.490, P<0.01); the extraversion score of urban empty nesters was (7.58 ± 2.51) points which was higher than (6.37 ± 2.02) points of rural empty nesters, and the difference was statistically significant (t=5.273, P<0.01);the neuroticism score (10.38 ± 2.06) points and psychoticism score (9.42 ± 2.17) points of urban empty-nest were lower than (12.41 ± 2.25) points, (10.94 ± 2.10) points of empty-nest′s, and the difference was statistically significant (t=9.401, 7.107, P<0.01). Neuroticism and psychoticism was shown to be positively associated with depression while extraversion and social support to be negatively associated with depression (P<0.01). Regression analysis showed that marital status, income, children visit frequency and the education level were the main influencing factors of depression in the urban and rural empty-nesters. Conclusions There are differences between rural and urban empty-nest elderly in the aspect of general data, depression status, personality and social support, and should intervention them effectively according to their different characteristics.

Objective The research aimed to identify symptom clusters of head and neck cancer (HNC) patients.Methods The M.D.Anderson Symptom Inventory-Head & Neck (MDASI-H&N) was applied to measure symptoms of 247 HNC inpatients.Factor analysis was applied to identify symptom clusters.The Spearman correlation analysis was used to find the relationship of symptoms within symptom clusters.Results Five clusters were identified and the Cronbach's α coefficients of symptom clusters were 0.904,0.928,0.898,0.815 and 0.662 respectively.Symptoms within clusters were all significantly interrelated to each other (r=0.393-0.856,P＜0.01).Conclusions Symptoms of HNC patients tend to occur not in isolation,but in symptom clusters.Effective management can not only eliminate or alleviate the symptom burden of HNC patients,but also be cost-effective.

Aurora-B as an important kinase to adjust the cell normal mitosis is a potent target for cancer treatment. Aurora-B is overexpressed in a broad range of tumor and tumor cells are more sensitive while Aurora-B is inhibited. Due to the key role of the Aurora-B in cell mitosis, the development of its inhibitors is becoming more and more important. Several small molecules inhibit with a similar efficacy both Aurora-A and Aurora-B, however, in most cases the effects resemble Aurora-B disruption by genetic methods, indicating that Aurora-B represents an effective therapeutic target. There were several Aurora-B kinase inhibitors which had entered the clinics and displayed good antitumor activity. In this review, we will outline the functions of Aurora kinase B in normal cell division and in malignancy. We will focus on recent preclinical and clinical studies that have explored the mechanism of action and clinical effect of Aurora-B inhibitors in cancer treatment.