Taking the library of Beijing Obstetrics and Gynecology Hospital as an example, the paper analyzes the problems existed in literature access of medical personnel, discusses corresponding countermeasures, including constructing one-stop retrieval platform, establishing diversified information communication channel, innovating training mode, improving the quality of librarians, etc.

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group [5.3%(5/94)]and lower than that in young group [18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.

Objective To construct the double hairpin siRNA and green fluorescent protein(GFP) expressing vector pU6/double-siRNA/Neo/GFP/1A/2A to interfere 1A and 2A gene of Coxsackie virus B4.Methods 21 bp fragments of the Coxsackie virus B4 2A and 1A gene were chosen as the targets and 65 bp complimentary fragments were synthesized,then the target gene fragments were cloned into pSilencer2.1U6 Neo and pGCsi-U6/Neo/GFP/siNeGative,respectively,then the double siRNA expressing vector pU6/double-siRNA/Neo/GFP/1A /2A was constructed by restrict endonuclease digestion,elctrophoresis isolation and reclaimer,ligatied by T4 DNA ligase;then the double siRNA expressing plasmid was transfected into Hela cells,and the GFP was observed under fluorescent microscope.Results The correct results showed that the recombinant plasmid had the correct special fragments and DNA sequence detected by restrict endonuclease digestion, electrophoresis and DNA sequencing;and GFP was also observed in Hela cells tansfected with pU6/double-siRNA/Neo/GFP/1A /2A under fluorescent microscope more than 15 d after transfection.Conclusion The double siRNA expressing vector pU6/double-siRNA/Neo/GFP/1A/2A is constructed successfully;it has the correct target viral gene sequences and can express GFP gene in Hela cells more than 15 d after transfection.

Objective To investigate the effect and underlying mechanism of Caudatin combined with Gefitinib on Gefitinib resistance induced by HGF in PC-9.Methods Model of EGFR-TKIs resistance in PC-9 cells was induced by exogenous HGF and co-cultured with MRC-5.Caudatin was tested as a drug resistant modulator to reverse the resistance of Gefitinib in PC-9 cells induced by HGF by MTT assay.Western blot was performed to observe the mechanism of Caudatin combined with Gefitinib reversing the resistance of PC-9 induced by HGF.Results The resistance of gefitinib to PC-9 was induced by exogenous HGF and co-cultured with MRC-5 which could reduce relative inhibitory rate ( P<0.05 ) .Neither caudatin ( 0-32 μM ) or Gefitinib (1μM) alone could significantly inhibit proliferation of PC-9 in the presence of HGF, which could be inhibited in a dose-dependent manner by Caudatin combined with Gefitinib ( P<0.05 ); Caudatin combined with Gefitinib down-regulated the phosphorylation levels of Met and PI3K/Akt simultaneously (P<0.05).Conclusion Caudatin could reverse the drug resistance of Gefitinib in PC-9 induced by HGF, the mechanism of which may be related to the inhibition of Met/PI3K/AKT pathway.

Objective To explore relativity between serum cortisol and post-stroke depression in old patients with stroke. Methods Serum cortisols of 41 stroke patients were examined two weeks after stroke, and they were all assessed through Hamilton Depression Scale and then happening rates of post-stroke depression observed in both normal cortisol group and enhanced cortisol group were tested through χ2 test. Meanwhile relativity between serum cortisol level and post-stroke depression were analysised. Results Happening rates of post-stroke depression had an evidently difference between both normal cortisol group and enhanced cortisol group(χ2=4.11;P <0.05). Mark of normal cortisol group was 15.29±7.28, enhanced cortisol group was 25.85±10.81, both groups had an evidently difference( P <0.01). Serum cortisols were not obviously relative to depression degree in normal cortisol group( r =0.295;P =0.194) while they were obviously relative in enhanced cortisol group( r =0.702;P =0.001). Conclusion Enhanced cortisol could forecast higher possibility of depression after the old post-stroke, and detecting cortisol could offer theory foundation for prevention and cure of post-stroke depression.

Clinical guidelines,coming into being with the development of evidence-based medicine,are of great significance in reducing medical malpractice and regulating medical behaviors.However,more effective and intelligent measures should be taken for their development and application due to their low utilization and poor compliance of doctors in their implementation.The emergence and structure of clinical guidelines were elaborated with related problems summarized.The knowledge expression models of digital clinical guidelines were analyzed and compared with the challenges faced by the current knowledge expression models of clinical guidelines pointed out.

It has been reported that metastasis-associated gene 1 (Mta1) is overexpressed in many malignant tumors with high metastatic potential. In addition, some studies indicated that MTA1 participated in invasion, metastasis, and survival of cancer cells by regulating cell migration, adhesion and proliferation. But the role of MTA1 is unclear in vitro in the development of cervical cancer cells. This study investigated whether and how MTA1 mediated cell proliferation, migration, invasion and adhesion in cervical cancer. MTA1 expression level was detected by Western blot in two cervical cancer cell lines of different invasion potentials. The effects of MTA1 expression on SiHa cell apoptosis, cycle, proliferation, migration, invasion and adhesion were tested by flow cytometry, MTT, wound-healing assay, Transwell assay and adhesion assay, respectively. The expression levels of p53, E-cadherin, and β-catenin activity were evaluated in untreated and treated cells. The results showed that MTA1 protein expression was significantly higher in SiHa than in HeLa, which was correlated well with the potential of migration and invasion in both cell lines. Furthermore, the cell invasion, migration and adhesion capabilities were decreased after inhibition of MTA1 expression mediated by Mta1-siRNA transfection in SiHa. However, no significant differences were found in cell apoptosis, cycle, and proliferation. In addition, E-cadherin and p53 protein levels were significantly up-regulated, while β-catenin was significantly down-regulated in SiHa transfected with the siRNA. These results demonstrated that MTA1 played an important role in the migration and invasion of cervical cancer cells. It was speculated that the decreased migration and invasion capability by inhibiting the MTA1 expression in the SiHa cell line may be mediated through the altered expression of p53, and E-cadherin/β-catenin complex. MTA1 could serve as a potential therapeutic target in cervical cancer.

Objectives To analyze comparatively the adverse reactions of Nedaplatin(NDP)and Cisplatin(DDP)in concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma and summarize the nursing points as well.Methods From March 2012 to March 2013,112 patients with locally advanced nasopharyngeal carcinoma were randomly divided into NDP group and DDP group.Besides intensity modulated radiotherapy for both groups,NDP group were treated with intravenous drop infusion of NDP by 100 mg/m2 and the control group with intravenous drop infusion of DDP by 100 mg/m2 both for three courses of once every three weeks (e.g.day one,day 22 and day 43 during the course).The two groups were compared in terms of therapeutic effects and incidences of adverse reactions.Results The complete remission rates of the NDP group and DDP group were 87.5%and 85.7%,respectively (P>0.05).The incidences of adverse reactions like gastrointestinal reactions and radioactive mucositis in the NDP group were significantly lower than those in the DDP group(P<0.05)and the index of platelet decrease was significantly higher(P<0.05).There were no significant differences between the two groups in terms of liver and kidney dysfunction and white blood cells decrease(P>0.05). Conclusions Chemotherapy with NDP combined with radiotherapy for locally advanced nasopharyngeal carcinoma has fewer adverse effects and is easy to be accepted by patients so that their quality of life can be improved.In the application of the two kinds of chemotherapy,we should pay attention to the adverse reactions on patients in order to give pertinent care.

Objective To investigate the effects of sphingosine kinase 1 (SphK1 ) inhibitor N, N-dimethylsphingosine (DMS)combined with 5-fluorouracil (5-FU)on the proliferation and apoptosis of gastric cancer MGC-803 cells and to explore the possible mechanisms involved.Methods MGC-803 cells were cultured in vitro.The effects of DMS and 5-FU on cell proliferation,apoptosis,and cell cycle distribution of MGC-803 cells were detected by MTT assay and flow cytometer (FCM),respectively.The expressions of SphK1 ,TS,DPD,NF-κB p65 and Bcl-2 proteins were detected by Western blot.Results Different concentrations of DMS or 5-FU alone or in combination could obviously inhibit the proliferation of MGC-803 cells in a dose-dependent and time-dependent manners (P<0.05 ).And the proliferation inhibition rate of MGC-803 cells in the combination group was significantly higher than that in the single drug groups (P<0.05).Treatment of MGC-803 cells with DMS did not affect the cell cycle distribution (P>0.05).As compared with the cells without drug treatment,DMS or 5-FU alone could obviously increase the apoptosis rate of MGC-803 cells (P<0.05);the apoptosis rate in the combination group was significantly higher than that in the single-drug groups (P<0.05).The expression levels of SphK1,NF-κB p65 and bcl-2 proteins were down-regulated with the treatment of DMS alone or in combination,whereas those of TS and DPD were not affected.Conclusion DMS can inhibit the proliferation and induce apoptosis of gastric cancer MGC-803 cells in vitro.It shows a good synergetic effect in combination with 5-FU,probably by down-regulating the expressions of SphK1,NF-κB p65 and Bcl-2 proteins.

Objective To investigate the antibiotics recipe in one third‐grade hospital from January to December 2012 and to pro‐vide reference for clinical rational use and effective management of antibiotics .Methods The defined daily dose(DDD) was treated as analysis unit ,and the total DDDs was calculated .The antibiotics use densities(AUD) were calculated by the value of DDD per 100 days person .Results The average value of AUD in 2012 was 49 .84 ,compared to the first half of the year ,the second half at‐tended to decrease .Qualification rate was 91 .8% for the investigated antibiotics recipe .Conclusion The use density of antibiotics was medium in the investigated hospital in 2012 .The date of usage of antibacterial drugs showed a steady trend and to be more rea‐sonable during the clinical use of antimicrobial agents special rectification activities .