Objective To illustrate the relationship between the temporary alteration of renal functions of rats with obstructive jaundice due to ischemia reperfusion injury(RI) and lipid peroxidation and the expression of heat shock protein 70 in rat kidney. Methods Wistar rats were divided into 4 groups of sham operation group(S group), sham operation and renal RI group(SRI group), common bile duct ligation group(J group), common bile duct ligation and renal RI group(JRI group). One week after bile duct ligation, rat bilateral renal arteries were transiently occluded for 10 minutes. The variations of renal function were observed at different time phases after renal reperfusion. Simultaneously, the expression of heat shock protein 70 in kidney was evaluated by immunohistochemistry. Results In JRI group, endogenous creatinine clearance rate(Ccr) decreased progressively along with the prolongation of the duration of reperfusion. In J and JRI groups, the level of malondealdehyde(MDA) in renal tissue increased but superoxide dismutase(SOD) decreased. In JRI group, the expression of heat shock protein 70 reached its peak at the 4th hour after reperfusion and began to decrease at the 12 th hour and became lowest at the 24 th hour. No expression of HSP70 was found in other groups. Conclusion The sensitivity of rat kidneys with obstructive jaundice to ischemia reperfusion injury is significantly elevated. Ischemia reperfusion injury, as well as lipid oxidative stress, may be involved in acute renal failure(ARF) after obstructive jaundice surgery. The expression of heat shock protein 70 is a protective response to RI.

With the child behavioral questionnaire developed by Rutter,39 Chinesechildren(group 1-C),27 Japanese children(group 1-J)and 87 South Korean children(group1-S)were identfied as with behavioral problems,together with matched norman children of27 from China(group 2-C),30 from Japan(group 2-J)and 26 from South Korea(group 2-S)respectively,to engage in this EEG study.In a comparison between behavioral problemschildren and normal ones in each country no significant difference was found in EEG data.However,in the comparison among group 1s,group 2s and ADD-H children(group 3s:41from China as group 3-C,21 from Japan as group 3-J and,29 from South Korea as group3-S)diagnosed clinically with DSM-Ⅲ,significant difference among groups was found inEEG analyses in each country respectively.Some index of slow wave of group 3s'EEG weremuch higher than that of normal ones(group 2s).EEG data from group 3-C and gruop 3-Jshowed that the frequency-peak moved to slow frequency area.This indicates the develop-ment of ADD-H may associate with some functional abnormalities of nervious system.

Objective To compare the curative effects between one‐stage anterior debridement bone graft fusion and posteri‐or fixation fusion combined with anterior debridement bone graft fusion in the treatment of multiple lower thoracic spinal tuberculo‐sis .Methods A total of 62 patients with multiple lower thoracic spinal tuberculosis in our hospital from March 2002 to March 2010 were treated by the anterior debridement bone graft fusion ,including 32 cases of anterior internal fixation by one screw‐rod system (group A) and 30 cases of posterior internal fixation by two nail‐stick systems(group B) .The cure rate ,operation time ,bleeding volume ,the Cobb′s angle and recovery situation of spinal cord injury were compared between the two groups .Results All patients were followed up for 24-36 months (average 28 months) and showed successful bone graft fusion .In the Frankel classification e‐valuation at postoperative 12 months ,the improvement rate of spinal cord injury was 76 .92% (10/13) in the group A and 81 .82%(9/11) in the group B ,showing no statistically significant difference (χ2 =0 .087 ,P>0 .05) .The total cure rate was 84 .38% (27/32) in the group A and 85 .48% (26/30) in the group B ,showing no statistically significant difference (χ2 =0 .066 ,P>0 .05) .The Cobb′s angles before operation ,immediately after operation and at the last follow‐up were (28 .16 ± 4 .16)° ,(5 .03 ± 3 .24)° and (8 .81 ± 2 .44)° in the group A and (26 .83 ± 5 .41)° ,(5 .50 ± 3 .03)° and(8 .06 ± 2 .45)° in the group B ,showing no statistically sig‐nificant difference (t=1 .038 ,t=0 .588 ,t=1 .200 ,all P>0 .05) .The operation time was (171 .31 ± 12 .84)min in the group A and (219 .23 ± 21 .44)min in the group B ,showing statistically significant difference (t=10 .754 ,P<0 .05) .The bleeding volume was (341 .25 ± 76 .10)mL in the group A and (440 .67 ± 67 .16)mL in the group B ,showing statistically significant difference (t=5 .439 ,P<0 .05) .Conclusion One‐stage anterior debridement ,and anterior or posterior internal fixation for treating multiple lower thoracic spinal tuberculosis can obtain the better curative effect ,but selecting case is very important .

Gastrointestinal stromal tumor (GISTs) are a new recognized tumor entity. The incidence increases with time for the greater awareness of GISTs. Latest reports of the epidemiology of GISTs have been collected and sorted. Besides, it is still a controversy on the management of GISTs. While surgical en-bloc resection is the treatment of choice, imatinib is still optimal for patients with recurrent or metastatic GISTs. Preliminary promising effects have been showed on neo-adjuvant and post-operational adjuvant therapies. Imatinib-resistant GISTs become common and more targeted medication have been investigated and tested.
Gastrointestinal Stromal Tumors ; epidemiology ; therapy ; Humans ; Incidence

Objective To investigate the clinical short-term outcomes after laparoscopic total mesorectal excision (TME)for rectal cancer in China.Methods A systematic literature searching was performed to identify all randomized controlled trial(RCT) studies or well-designed retrospective studies on laparoscopic surgery(LS) and open surgery(OS) for rectal cancer published from January 2003 to October 2010 in China.Two reviewers independently screened and extracted the data.The reports which matched the inclusion criteria were analyzed with Revman 5.2.Results A total of 17 RCT studies and 3 retrospective studies (2246 patients)was included in this study.The basic features of 2 groups were balance.Compared to group OR,the incidence of complications such as postoperative wound infection (RR =0.30,95 ％ CI:0.17 ～0.54,P ＜ 0.01),pulmonary infection (RR =0.47,95％ CI:0.25 ～0.91,P ＜0.05),and ileus (RR =0.41,95％ CI:0.19 ～0.88,P ＜0.05)were significantly lower in group LS.No difference was observed in the incidence of peritoneal abscess(RR =0.78,95％ CI:0.38 ～ 1.60,P ＞0.05),anastomotic leakage(RR =0.66,95％ CI:0.38 ～ 1.16,P ＞0.05),and uroschesis(RR =0.57,95％ CI:0.26 ～ 1.25,P ＞0.05).Furthermore,parameters of postoperative recovery were compared between groups,LS group manifested early recovery.Conclusions Laparoscopic total mesorectal excision for rectal cancer,with minimal invasion,benefits the postoperative recovery and reduces incidence of complications.LS radical resection of rectal cancer is technically feasible,safe,and prospectively favorable.

Objective To explore the influence of organizational climate and job burnout on turnover tendency among contract nurses, and establish a model of this influence. Methods Totally 450 nurses were selected and investigated with Organizational Climate Questionnaire(OCQ), Maslach job burnout inventory(MBI) and Turnover Intention Scale(TIS). Results The total score of OCQ was 2.71 ± 0.58, the emotional exhaustion was 25.99 ± 13.89, the depersonalization was 10.21 ± 5.37,the personal accomplishment was 21.92 ± 9.27, and the score of TIS was 2.66 ± 0.94. Emotional exhaustion and depersonalization were significantly and negatively correlated to OCQ(r=-0.26,-0.22 ,P<0.01),and positively correlated to TIS(r=0.27,0.25,P<0.01). The personal accomplishment was positively correlated to OCQ(r=0.26,P<0.01), and negatively correlated to TIS(r=- 0.26,P<0.01).OCQ was negatively correlated to TIS(r=-0.37,P<0.01).Multiple linear regression analysis showed that OCQ and personal accomplishment could negatively predict nurses′ turnover tendency(β=-0.43,-0.14,P<0.01), and emotional exhaustion could negatively predict nurses′ turnover tendency(β=-0.10,P<0.01). The path analysis showed organizational climate negatively influenced nurses′ turnover tendency via job burnout, and the value of mediating effect was 23.8%(-0.10/-0.42). Conclusions Turnover tendency is significantly correlated with organizational climate and job burnout among contract nurses. The relationship between organizational climate and nurses′ turnover tendency among contract nurses is mediated in part by job burnout.

Legal relationship between doctors and patients is constructed by the three el-ements:the subject,the object and the contents.The subject is the medical side and patient side.The object is a medical act.The content of medical and legal relations is rights and obligations of both sides.

Objective To investigate the relationship between sarcoplasmic reticulum Ca2+modulation proteins and postresuscitation myocardial dysfunction. Methods Thirty-eight SPF male Sprague-Dawley (SD) rats were randomly divided into control group(n=12)and cardiac arrest(CA)group(n=26). CA was induced by intravenous bolus of potassium chloride(40μg/g),and cardiopulmonary resuscitation(CPR)was conducted 8 minutes later. No CA was induced in control group except catheter placement for monitoring cardiopulmonary parameters after anesthesia. Invasive hemodynamic parameters were monitored for 1 hour after CPR. Echocardiogram was performed to evaluate cardiac function. Myocardial samples were harvested 5 minutes and 1 hour after restoration of spontaneous circulation (ROSC),and sarcoplasmic reticulum Ca2+ ATPase (SERCA2a),phosphorylated phospholamban (p-PLB) and rynodine receptor(RyR)were determined by Western Blot. Results ROSC rate of CA group was 92.3%(24/26),and mean recovery time was (68 ±39)seconds. Cardiac function was significantly impaired in CA group at 1 hour after resuscitation, and ejection fraction, fraction shortening (FS), the maximal rate of left ventricular pressure increase/decline (±dp/dt max)were significantly decreased compared with those in control group 〔ejection fraction:0.548±0.060 vs. 0.809±0.043,F=71.692,P=0.000;FS:(34.4±4.4)%vs. (46.0±3.5)%,F=55.443,P=0.000;+dp/dt max(mmHg/s):4 718±743 vs. 7 098±394,P<0.01;-dp/dt max(mmHg/s):-3 824±612 vs.-6 187±473,P<0.01〕. Compared with control group,the expression levels of p-PLB (gray value)was significantly decreased at 5 minutes and 60 minutes(5 minutes:0.64±0.15 vs. 1.29±0.13,P<0.01;60 minutes:0.95±0.08 vs. 1.30±0.09,P<0.05)after resuscitation in CA group,while the level of sarcoplasmic SERCA2a(gray value)and RyR (gray value)showed no significant differences(SERCA2a 5 minutes:1.01±0.18 vs. 1.24±0.07,60 minutes:1.03± 0.14 vs. 1.25 ±0.06;RyR 5 minutes:0.96 ±0.13 vs. 0.97 ±0.13,60 minutes:0.88 ±0.14 vs. 0.99 ±0.11,all P>0.05). Conclusions The impairment of the p-PLB is closely related to postresuscitation myocardial dysfunction.

To explore and identify the therapeutic components of traditional Chinese medicine (TCM) as a complex intervention through grounded theory, and the correlation and interaction within this model and the possible effects that they may have on the therapeutic effects of TCM.

Clinical trials play a critical role in medical research. However, only a few clinical trials conducted at present have been registered at various clinical trial registries. Clinical trial registration can prevent bias in these registered trials effectively and avoid unnecessary waste of resources due to meaningless repeats. Moreover, it will benefit the development of evidence-based medicine, and promote human welfare. Great attention has been paid to the importance and necessity of clinical trial registration. This review briefly introduced the definition, justification, contents, history, current status of clinical trial registration, and introduced the information regarding important international clinical trial registries in detail. Clinical trial registration should be developed toward a transparent, compulsory and comprehensive stage.