Syncope is a temporary loss of consciousness state caused by the transient cerebral insufficiency,often accompanied by decreased muscle tone and failure in maintaining a certain position. Syncope is a common clinical disease of children,the causes of which include nerve-mediated (reflex) syncope,cerebral vascular disease syncope, psychogenic syncope, cardiac syncope, metabolic syncope, unexplained syncope,etc. Nerve-mediated syncope is the most common cause, and vasovagal syncope is the most common type. Al-though the incidence of cardiogenic syncope is low, but its onset is abrupt and dangerous, which should be payed attention.

Objective To investigate the clinical efficacy of gemcitabine in the treatment of elderly patients with advanced non-small cell lung cancer.Methods 50 patients in our hospital from January 2014 to September 2015 were selected as the research object, and were randomly divided into the control group and the experimental group, each group of 25 patients each.The patients in the control group were treated with special therapy, and the patients in the experimental group were treated with gemcitabine.The clinical indexes of the experimental group and the control group were compared and analyzed.Results After the treatment, the experimental group of 25 patients, 12 cases of patients with complete remission, 8 cases partial remission, 3 cases were stable, 2 patients progressed, the effective rate was 75%, clinical benefit rate of 92%.In the control group, 4 patients had complete remission, 2 patients had partial remission, 9 patients were stable, 10 patients progressed, the treatment efficiency was 24%, and the clinical benefit rate was 60%.The effective rate and the clinical benefit rate of the experimental group were significantly higher than that of the control group (P<0.05).1 years later, the survival rate of patients in the experimental group was 22, the survival rate was 88%, and the number of patients in the control group was 14.The survival rate of the experimental group was significantly higher than that of the control group, with statistical difference (P<0.05).Conclusion Gemcitabine monotherapy in the treatment of elderly patients with advanced non-small cell lung cancer can improve the therapeutic effect to a great extent, good safety, low incidence of adverse reactions, high survival rate, with further clinical promotion and application significance.

The operation of the culture and quality education is one of the best effective forms to execute education of various cultures and self-quality to our university students right in the classroom . But in the practical teaching work ,there is a series of questions such as the lower curricular quality , utilitarianism in teaching and studying , loose management and so on .The existing questions are analyzed and the appropriate measures are put forward in this paper.

ObjectiveTo study streptococcus pneumonia capsular polysaccharide antibodies of patients with chronic obstructive pulmonary disease(COPD) in acute exacerbation and the feasibility of vaccination for patients with COPD.MethodsThe COPD in acute exacerbation without respiratory failure (RF)(COPD without RF group),COPD in acute exacerbation with RF (COPD with RF group),asthma (asthma group),healthy elderly examination(elderly examination group) and healthy youth examination (youth examination group) were selected,and each group had 15 cases.The levels of streptococcus pneumonia capsular polysaccharide antibodies IgG,IgM and IgA were measured in all groups.Results There was no significant difference in IgG among the five groups (P ＞ 0.05 ).The levels of IgM in COPD without RF group and elderly examination group were significantly lower than those in COPD with RF group,asthma group and youth examination group (0.554 ± 0.309 and 0.538 ± 0.327 vs.0.810 ± 0.387,0.887 ± 0.278 and 0.852 ± 0.305,P ＜ 0.05 ).Although the level of IgA in COPD without RF group was significantly lower than that in youth examination group(0.532 ±0.297 vs.0.930 ±0.502,P ＜0.05),there was no significant difference among the five groups.Conclusion Patients with COPD should inoculate pneumococcal vaccination.

Objective To investigate effect of levocarnitine on maintainance hemodialysis in patients with hypotension.Methods 64 cases with continuous hemodialysis hypotension were randomly divided into control group and treatment group, 32 cases in each group.Patients in the control group were treated with erythropoietin treatment after regular hemodialysis, and the treatment group based on the control group with levocarnitine.Blood pressure, hemoglobin, urea clearance rate, hypotension and changes of C-reactive protein (CRP), arteriovenous fistula occlusion and cardiovascular events incidence were compared after the treatment.Results Compared with before treatment, the incidence of two groups of blood pressure and hemoglobin levels were significantly increased ( P <0.05 ) and CRP levels decreased ( P <0.05 ) , hypotension, arteriovenous fistula occlusion and cardiovascular events rate were decreased (P<0.05); compared with the control group, systolic blood pressure and minimum systolic blood pressure and hemoglobin levels of treatment group were higher (P<0.05) and CRP levels were lower (P<0.05), the incidence of hypotension, arteriovenous fistula occlusion and cardiovascular events were lower (P<0.05), the clinical curative effect was higher (P<0.05).Conclusion Levocarnitine can effectively reduce the occurrence of hypotension in hemodialysis patients continuously, with good clinical efficacy and safety.

With the intense development of neoadjuvant chemotherapy for breast cancer research in recent years, this approach has been used widely in clinical treatment. Neoadjuvant chemotherapy can increase the chance of operation for patients with local y advanced breast cancer. Moreover, it can improve breast-conserving rate in larger-tumor patients, thereby improving the quality of life of these patients. However, some controversies regarding the use of neoadjuvant chemotherapy for breast cancer patients remain to be resolved. This review focuses on clinical studies and re-recognition of neoadjuvant chemotherapy as a viable treatment for breast cancer.

Objective To study the effect of different negative pressure values of negative pressure wound therapy (NPWT) effect on skin graft .Methods Eighty patients were selected ,who underwent chronic wound bed and preparedto treat with skin graft in surgical ward of emergency department in the Second Affiliated Hospital of Chongqing Medical University from January 2012 to July 2012 .Eighty patients were divided into 8 groups ,group A were treated with packing pressure after skin graft ,group B~ H were treated with continuous NPWT ,pressures were -10 ,-20 ,-30 ,-40 ,-50 ,-60 and -70 kPa ,respectively .Whether they were in comfortable situation at second day after surgery were observed .Flap survival area at Seventh day after surgery was meas‐ured .Results The patient comfort ,flap survival area ,wound healing time of group B to H were higher than those of group A (P<0 .05) .Patient comfort tended to decrease with the increasing negative pressure values between -10 - -40 kPa(P<0 .05) .Flap survival area ,healing time of group B ,C were higher than those of group D to F(P<0 .05) .Conclusion Application of NPWT technology in wound ,-10 kPa negative pressure value can not only improve wound blood circulation ,but also ensure patient be comfortable .

Objective To study the characteristics of serum lipid metabolism in cadres aged 90 and above.Methods A total of 105 in-patient cadres aged 90 and above were assigned to the longevity group,and another 85 in-patient cadres aged 60 to 80 years were used as controls.Medical history of the participants were retrospectively reviewed,and serum levels of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),apoB,apoA-I,Lp(a)and body mass index(BMI)were tested.Results Compared with the control group,TC,TG,LDL-C,apoB and non-HDL-C were significantly decreased in the longevity group[3.90 +0.89 vs 4.36 ± 1.06,0.89(0.57)vs 1.16(0.69),2.35 ±0.72 vs 2.70 ±0.88,0.68 ±0.19 vs 0.75 ±0.22,2.69 ±0.79 vs 3.18 ± 1.00,respectively].However,HDL-C/TC and HDL-C/LDL-C were significantly increased in the longevity group [0.32 ±0.084 vs 0.28 ±0.082,0.52(0.22)vs 0.43(0.28),respectively].Lp(a)of the longevity group was higher than that of the control group,although no statistically significant difference was found.BMI of the longevity group was significantly lower than that of the control group.In the longevity group,the percentage of individual who were combined with hypertension,hyperglycemia,hyperlipidemia and overweight/fat was lower (24.8％ vs 43.5％).Conclusions Serum lipid level is relatively lower in cadres aged 90 and above,and those who are combined with hypertension,hyperglycemia,hyperlipidemia and overweight/fat are significantly lower in this populations.

BACKGROUND: Because dopaminergic neurons are particularly sensitive to oxidative stress, microglia is characteristics of being prone to activation, and activated microglia is the main source of oxygen free radical production, so microglia activation is more important in the pathogenesis of Parkinson's disease and illness progress.OBJECTIVE: To summarize the correlation between microglia and Parkinson's disease.METHODS: An online computer-based retrieval was performed by the first author among the Chinese Journal Full-Text Database (CNKI: 2000/2010) and Medline (2000/2010) Database, with key words of Parkinson's disease, microglia in English and Chinese. The correlation between microglia and Parkinson's disease was discussed through two aspects, one is the influence of cell factors and toxic substance produced after microglia activation on Parkinson's disease, the other is the inhibition of microglia and prevention of nerve toxic factors on Parkinson's disease progress.RESULTS AND CONCLUSION: A total of 112 articles were screened out according to inclusion and exclusion criteria, and 27 of them were involved in the analysis. Results showed that microglia activation will damage dopaminergic neurons, and cause Parkinson's disease. And the occurrence and development of Parkinson's disease may further reduce the neurotransmitter dopamine, continue to damage dopaminergic neurons and release the inflammatory factor, thus promoting microglia activation. Inhibition of microglia activation is likely to stop the progress of Parkinson's disease.

Six hours after inhalation pulmonary injury,the pulmonary microvascular permeability (PMVP),pulmonary malondialdehyde (MDA) level,superoxide dismu-tase activity (SOD),the contents of protein and leucocytes in broncho-alveolar lavage fluid(BALF),and serum MDA level were determined in rats pretreated with allopurinol.In addition,the pathological changes of the lung tissues were also studied.It was found that early administration of allopurinol resulted in marked reduction of PMVP,and the protein content and leucocyte count in BALF.His-topathological examinations revealed that allopurinol could reduce the leucocyte accumulation in pulmonary vessels,interstitial leucocyte infiltration,interstitial and alveolar edema and hemorrhage,and vascular congestion.The serum and pulmonary levels of MDA also markedly decreased.The changes of pulmonary level of MDA were parallel to those of PMVP,and the protein content and leucocyte count in BALF in time course and in degree.The results listed here imply that the mechanism of the therapeutic effects of allopurinol on inhalation pulmonary injury is to reduce the production of superoxide anions through the inhibition of xanthine oxidase,in turn to inhibit the peroxidation of pulmonary lipids to alleviate pulmonary damage.