Hypoxia is a common physiological and pathological stimulus in many human diseases .The cellular oxygen sensors and the following activation of multiple cellular signal transduction pathways involved in hypoxia responses can regulate cell survival as well as respiration , blood circulation , metabolism and so forth .The cell response to hypoxia has a complex diversity .Hypoxia-induc-ible factor ( HIF) pathway in an oxygen dependent manner plays a central role during the hypoxia response .The HIF-independent path-ways are equally important under hypoxic conditions which can maintain the oxygen balance and metabolism balance .

The suggestion of microcosmic syndrome differentiation is to meet the needs of clinical diagnosis and treatment of traditional Chinese medicine (TCM), the needs of evidence based medicine and the needs of the development of syndrome differentiation in TCM. The possibility of microcosmic syndrome differentiation might be the development of integration of traditional Chinese and Western medicine as well as modern science and technology. Microcosmic syndrome differentiation has its superiority and limitation. There are some problems in developing microcosmic syndrome differentiation, such as lack of standard for syndrome differentiation, contradiction between single microcosmic index and the entirety, non-specificity of the relationship between microcosmic indexes and syndromes, and the influence of disease on microcosmic syndrome differentiation, discrepancy between the essence study of TCM syndromes and the clinical practice. It is suggested that the concept of TCM syndrome is a certain pathological process during the onset and development of disease, composed of some subjective and objective indexes. The objective indexes include the macrocosmic and the microcosmic indexes, the entirety and the part.

Bibliometrical method was used in this article to analyze the publications in a hospital from 2004 to 2013.Results show that the number of publications increased during 8 years,and the quality has been improved consistently.However,the rate of clinician participation in research and the present of core authors were still on the lower side.Besides,the age structure of core authors is steady and lack of growth.Based on this analysis,we summarized the past experience and explored the strategies of research management.

Objective To observe the clinical efficacy of Tiao Shen Kai Yu (regulating mind and anti-depression) needling plus mental intervention in treating mild post-stroke depression. Method A total of 100 eligible subjects with mild post-stroke depression were randomized into a control group and an observation group, 50 cases in each group. The two groups were both intervened by basic treatment, while the control group was additionally given mental intervention and the observation group was given Tiao Shen Kai Yu needling plus mental intervention. The two groups were treated once a day, 5 times a week, for 30 d in total. The Self-rating Depression Scale (SDS) and Hamilton Depression Scale (HAMD) were observed before and after the treatment. Result The HAMD scores were both significantly improved in the two groups after the treatment (P<0.01), and the between-group difference was statistically significant (P<0.01). The SDS scores were significantly improved after the treatment in both groups (P<0.01), and the between-group difference was statistically significant (P<0.01). Conclusion Tiao Shen Kai Yu needling plus mental intervention can more effectively improve mild post-stroke depression than single mental intervention.

Hologram is a theory to study the properties and laws of the world under a holographic interaction.Traditional Chinese Medicine(TCM) shares many common fi elds with hologram theory.Although some originally diagnostic folk methods such as Zhejiang.sixian pulse theory,Kunlun?tianyuan pulse theory have been rarely known and have not been widely recognized in modern time,the diagnostic methods of Jiugong pulse and hologram pulse based on the two pulses theories have shown its uniqueness and effectiveness through hundreds of years of clinic practices.Based on holographic principles and holism,a physician can make diagnoses noninvasive,simple and rapid,which is benefi t for inheritance and development of TCM pulse methods.

With the widespread adoption of screening mammography, the incidence of ductal carcinoma in situ (DCIS) has been dramatically increased. The spectrum of local treatment advances from mastectomy to breast conservation surgery plus whole breast irradiation (WBI), and hypofractionated WBI or accelerated partial breast irradiation. Although the efficacy of WBI on reducing local recurrence is clear, such benefit in the low-risk DCIS is still controversial. Further studies are required to establish a more precise local recurrence risk stratification system for better tailoring local treatment in patients with DCIS. In this review, the latest advances and controversies in surgery, radiation therapy and local recurrence risk stratification system for patients with DCIS were summarized.

Objective To investigate the current working status and explore the relationship among job stress, job burnout and organizational commitment in ICU nurses. Methods By using cluster random sampling method, 233 nurses from 5 general hospitals were selected to accept investigation by Commitment Questionnaire and Nurses' general situation questionnaire. Results The job stress and job burnout were both significant negatively correlated with organizational commitment (r=-0.33, P<0.01;r=-0.22, P < 0.01).The management issues and interpersonal relationships and decreased personal accomplishment both had significant impact on affective commitment and continuance commitment of ICU nurses (r=0.539, P < 0.01; r=0.387, P < 0.01). The management issues and interpersonal relationships, professional and career issues and emotional exhaustion had significant predictive power on normative commitment(r=0.458,P < 0.01). Conclusion It generally was in a higher level of job stress in ICU nurses, which indicates that hospital mangers should try to eliminate the causes ,assist them to reduce job stress and relieve the job burnout.

Objective To evaluate efficiencies of 4 kinds of γ‐interferon release assay(IGRA) detection kits in diagnosis of pul‐monary tuberculosis .Methods 4 kinds of IGRA reagents produced by Oxford Immunotec Ltd (Oxford) in British ,Shanghai Fuxing Changzheng Medical Science Co .,Ltd(Fuxing) ,Cellectis in Australia(Cellectis) and Haikou VTI Biological Institute(VTI) ,respec‐tively ,were used to determine release levels of peripheral bloodγ‐interferon which had antigenicity of Mycobacterium tuberculosis in 86 cases of patients with tuberculosis and 80 cases of healthy individuals ,and diagnostic efficiencies were evaluated .Results Among the 4 kinds of IGRA reagents ,including Oxford ,Fuxing ,Cellectis and VTI ,the sensitivity was 93 .02% ,88 .37% ,90 .70% and 91 .86% ,respectively ;the specificity was 92 .50% ,75 .00% ,82 .50% and 87 .50% ,respectively ;the positive predictive value was 93 .02% ,79 .17% ,84 .78% and 88 .76% ,respectively ;the negative predictive value was 92 .50% ,85 .71% ,89 .19% and 90 .91% ;the diagnostic accordance rate was 92 .77% ,81 .93% ,86 .75% and 89 .76% ,respectively ;the area under receiver operating charac‐teristic(ROC) curve was 0 .975 ,0 .892 ,0 .958 and 0 .963 .Conclusion There are no significant differences among Oxford ,Fuxing , Cellectis and VTI reagents ,and reagents could be selected according to clinical requirements .