Background and purpose:There is growing evidence that metformin,a commonly used drug in the treatment of type Ⅱ diabetes,may impede the growth of human tumors.However in a recent study it was found that metformin treatment might result in promotion of the angiogenic phenotype and increase tumorigenic progression.In this study we investigated the effects of metformin on the migration and invasion abilities of human lung adenocarcinoma cell line A549 in vitro and explored the possible underlying mechanisms.Methods:A549 cells were treated with 0.5,2 and 8 mmol/L metformin for 72 hrs.The laterad-migration and invasion abilities of the cells in vitro were measured by scratch assay and Boyden-Chamber assay,respectively.Expressions of MMP2 and MMP9 mRNA of the cells before and after metformin treatment were measured by Real-time PCR.Results:The migration rate of A549 cells was increased after treated by metformin at the concentration of 8 mmol/L.The invasion ability was also signifi cantly increased by 8 mmol/L metformin treatment from 37.4?4.6 to 59.8?7.2(P

Objective:To explore the combined application effect of failure mode and effect analysis (FMEA) and root cause analysis (RCA) in IV infusion risk management of pediatric outpatient so as to enhance the quality of care and ensure the safety of outpatients.Methods: For this exploration, a special analysis team was established and the flowchart was drawn up, and the potential failure modes were listed by using FMEA. And the RCA was used to analyze and evaluate the key mode in these potential failure modes so as to find the root cause might affect the safety of IV infusion, and then the improved measures were implemented and the effects of new measurement were evaluated. Results:After implemented the improved measures, the risk of top 4 risk priority number (RPN) in intravenous infusion flow decreased obviously. For the transfusion management, patients' satisfaction increased from 78.09% to 95.03% (P<0.05), and nurses' satisfaction increased from 83.79% to 97.80%(P<0.05).Conclusion: The combined application of FMEA and RCA in the IV infusion risk management of pediatric outpatient can effectively reduce the occurrence of risk events, reduce nursing complaints and disputes, and enhance the quality of nursing care.

Objective To evaluate how well the risk factors associated with stroke recurrence been controlled by community-based medical centers in urban areas of Beijing.Methods A cross-sectional study was performed in 5 community-based medical centers in urban areas of Beijing.A total of 999 patients with the experience of ischemic stroke were evaluated from Dec.2004 to Nov.2005.Results Ninety-six percent of patients suffered from at least one of the most common diseases(risk factors) associated with stroke recurrence,i.e.hypertension(HT),heart disease,diabetes,hyperlipidemia and obesity,and 80% of patients were with more than 1 disease.The proportion of HT was 79.1%(790/999) and the awareness,treatment and control rates of HT patients were 93.3%(737/790),84.3%(666/790) and 40.3%(318/790),respectively.The proportion of heart diseases and obesity among 999 stroke patients were 34.4% and 19.1%%,respectively.31.9%(319/999) of patients had diabetes and 84.0%(268/319) of the patients knew their history of diabetes.Of 319 diabetes patients,68.3%(218/319) were under active treatment and 45.4%(99/218) of them had their fasting blood glucose well controlled.The proportion of hyperlipidemia was 72.9% and the treatment rate for hyperlipidemia was as low as 29.5%(215/728).There were 43.7% and 50.0% of patients quit smoking and alcohol drinking after their acute stroke.72.7%(726/999) of patients were receiving aspirin regularly.Conclusion The proportion of cardiovascular diseases were high among the patients with ischemic stroke who were under the management of community-based medical centers.The community-based medical centers have played an important role in the secondary prevention of stroke.However,the management for ischemic stroke patients with diabetes and hyperlipidemia needs to be improved.

0.05). Conclusion:Ti-29Nb-13Ta-4.6Zr alloy is histocompatible.

Objective To approach the design and clinical application of large anterolateral thigh flap and its effect in wound repair.Methods The flaps were designed according to the anatomical features of perforating branches in the anterolateral thigh flaps.When a flap was chipped,a thick branch or a terminal branch of original vessel was reserved,another suitable perforating branch was selected in the proximal or distal end of the flap,and then the two vessels were anastomosed to enlarge the range of blood supply.If the vessel pedicle of a flap was a musculocutaneous perforating branch,the perforating branch of anastomosis was cut at out-point of muscle.If the vessel pedicle of a flap was a intermusclar branch or a direct skin artery,the perforating branch of anastomosis was cut widely.From May 2006 to May 2012,the technique was applied in 28 patients with large skin defect of limbs.The diameters of perforating branches obtained at out-point of muscles were measured during surgery.The survival of flaps was observed after surgery and complications in donor sites were checked during follow-ups.Results There were 18 flaps whose vessel pedicle were musculocutaneous perforating branches.The branches were cut at outpoint of muscles.The diameters of these vessels were measured during surgery.They ranged from 1.3 mm to 1.8 mm with an average of 1.45 mm.All of the vessels could be anastomosed.All 28 flaps survived.All flaps survived.The areas of the flaps ranged from 22 cm × 15 cm to 42 cm × 14 cm.Artery crisis happened in 2 flaps whose vessel pedicle were musculocutaneous perforating branches.The second look operation found that the areas of artery anastomosis of perforating branches and vessel pedicles were compressed by hematoma and thrombus formed.The 2 flaps survived after the hematoma was cleared away and the vessels were reanastomosed.There were no infections.Both the donor and recipient site healed by first intention with no necrosis of flap margin.All 28 patients were followed up by 4-13 months with an average of 8 months.There were no apparent collapse deformities,muscle necrosis,declines of muscle strength and muscle hernia in the donor sites.The appearance of flaps was flat,the color was close to normal and the quality was fine.Conclusion It is a safe and effective method to repair wound surface by large anaterolateral thigh flap obtained by the modus operandi of perforating branch anastomosis.

Objective To observe the influence of hands-washing and non-hands-washing on clinical disinfection effect before surgical hands antisepsis.Methods Totally 40 surgcal staff wee divided into the handa-washing group and the non-hands-washing group.The sterilizing effect of handa at diggerent time points during operations and kinds of bacteria colony were compared between two groups.Results Bacteria colony of hands at different time points during operations showed no significant difference between two groups.Both groups were detected bacteris colony on their hands,mainly made up of coagulase negative staphylococcus,corynebacterium and eaterococcus and no difference was seen between two groups.Conchusions The non-hands-washing method can acquire the same disinfection effect as traditional hands-washing method.Its disinfection effect lasts three hours,easy to operate,little stimulation on the skin,and was worthy of clinical application.

Objective To investigate the relationship between serum uric acid (SUA) and metabolism syndrome (MS) in community-based elderly population in Beijing.Methods A community-based and cross-sectional survey on 1821 elderly person was performed in Beijing in 2000.Questionnaire survey,physical examination and blood biochemical tests were conducted.Relationship of MS and its components with SUA was analyzed.Results Among 1821 subjects,there were 365 cases with MS (20.0％) and 1456 cases without MS (80.0％).SUA level was higher in MS group than in non-MS group [(5.20±2.27) μmol/L vs.(4.50±1.44) μmol/L,t=-7.34,P=0.000].All subjects were divided into 4 groups according SUA level:goup 1 (≤3.5μmol/L,n=443),group 2 (3.6 μmol/L-4.4 μmol/L,n=465),group 3 (4.5 μmol/L-5.4 μmol/L,n=446) and group 4 (≥5.5 μmol/L,n=467).SUA level was increased along with the increased BMI,TG,TC,LDL-C levels,and decreased along with the decreased HDL-C level,which had significant differences (F=43.07,9.32,22.36,8.19,9.39,all P＜0.001).There were significant distribution differences in MS components numbers in the 4 groups (x2=73.62,P=0.000).After adjusting for age,sex,residential,education level,marriage,smoking,drinking and exercise habits,logistic regression analysis showed that MS was related with SUA level,and the risk of MS was increased along with the increased SUA level.Conclusions MS is correlated with SUA level in elderly people.SUA level should be observed and controlled effectively in the elderly.

Objective To investigate the states of psychological condition and the quality of life in patients with functional constipation (FC) by comparing with those of healthy controls.Methods Symptom Checklist-90(SCL-90)and Patient Assessment Constipation-Quality of Life(PAC-QOL)were tested by self-report questionnaire in sixty patients with FC and thirty healthy controls with corresponding age and gender.Results (1)There was no difierence in age,body mass index and sex ratio between the FC patients and healthy controls,but the scores of stool form and frequency of defecation were significantly different between the two groups.(2)The following items of SCL-90 i.e.total scores,total symptomatic index.the number of positive items and positive symptom distress level were obviously higher in the FC patients than in controls (P＜0.05).The scores of the nine factors of SCL-90 except terror were also higher in the FC patients than in controls.(3)The average total score and scores of four sections (physical discomfort,psychological discomfort,anxiety,satisfaction) of PAC-QOL in FC patients were higher than those in basal level.(4)The average score of PAC-QOL was significantly correlated with the scores of SCL-90,especially in anxiety and depression.(5)The severity of symptoms in the FC patients was significantly correlated with the average score of PAC-QOL and the total score of SCL-90.Conclusioils FC patients have obviously psychological abnormality,which affects the quality of life significantly.The scores of quality of life is a better parameter to reflect the healthy status of the FC patients than the laboratory tests and the clinical symptoms.

Objective To discuss the effect and advantage of the navigation-assisted system in total knee arthroplasty (TKA) of the knees with anatomical abnormality. Methods The study involved five patients with anatomical abnormality of the knees who were treated with arthroplasty under the navigation-assisted system from December 2007 to October 2008. Meanwhile, five patients with normal anatomy of the knees treated with total knee arthroplasty without using the navigation-assisted system were used as control. The α, β, γand δ angles were measured based on the X-ray images and the active range of the knee joint was determined. Results No complication caused by navigation occurred. There was no significant difference in the α, β, γ and δ angles between the two groups, but the range of extremum in the navigation group was less than that of the control group. The mean postoperative active range of the knee joint in the navigation group ( 112.67°) was higher than that of the control group ( 106.98° ), while the preoperative active range of the knee joint of the navigation group [(70.87 ± 10.87)°] was significantly lower than that of the control group [( 105.08 ± 30.67)°]. Conclusions Compared with conventional methods, navigation-assisted TKA showas no obvious advantage in short-term outcome but has great advantages in improving the accuracy and the joint movement, especially for the knees with anatomical abnormality.

Objective To investigate the therapeutic effect of total mesorectal excision(TME) for low rectal cancer.Methods One hundred nineteen patients with rectal cancer,located on an average within 8 cm of the anal verge,were included in the study.Fifty-four patients underwent traditional operation,and sixty-five patients underwent total mesorectal excision.Operation time,loss of blood at operation and local recurrence rates were compared between the two groups.Results The average operation time and blood loss were 118 minutes,and 100mL respectively in TME group,and they were 182 minutes,and 340 ml respectively in traditional operation group.There were significant differences between them(all P0.05).Conclusions In TME group,operation time was shorter,operative blood loss was less,and local recurrence rate was lower.TME should be applicated for patients with low rectal cancer.