Objective To systematically evaluate the application effect of clinical pathways in children pneumonia patients by u-sing the system analysis .Methods Published RCT in children pneumonia patients were searched and screened in CNKI ,VIP ,CBM-disc and Wanfang datebase under present standards .The quality of the included studies were evaluated and statistical analyzed by RevMan5 .0 software .Results Total 17 literatures including 2 717 cases were eligible to the criteria (1 359 in clinical pathways group and 1 358 in control group)altogether .The system analysis showed there were significant difference between the clinical path-way group and the traditional treatment group in grasp of health knowledge [RR=1 .30 ,95% CI(1 .17 -1 .44) ,P<0 .01] ,rate of patients ,satisfaction[RR=1 .17 ,95% CI(1 .13 -1 .21) ,P<0 .01] ,length of hospital stay [WMD= -2 .90 ,95% CI(-3 .93 - -1 .86) ,P<0 .01] ,hospitalization expenses[WMD= -620 .02 ,95% CI(-838 .99 - -401 .04) ,P<0 .01] ,the body temperature to restore normal time[WMD= -1 .67 ,95% CI(-2 .10- -1 .23) ,P<0 .01] ,lung sound disappear time[WMD= -1 .80 ,95% CI(-2 .15- -1 .45) ,P<0 .01] .Conclusion Clinical pathways is superior compared with the traditional treatment for children pneumo-nia patients ,be worthy of spread in clinical .

Objective To assess the clinical value of low-frequency mini - probe sonography ( LFMPS) in preoperative localization of pancreatic endocrine tumors comparing with other imaging methods. Methods Twenty one cases with suspected pancreatic endocrine tumors were enrolled from June 2000 to June 2002, we compared the diagnostic results of LFMPS, transcutaneous ultrasonography ( US) , helico-computed tomography ( HCT) and magnetic resonance imaging (MRI) with surgical localization and histopathological results by using Fujinon 7. 5 MHz miniature probe and SP-701 ultrasonic system. Results Sixteen pancreatic insulinomas and 1 extra pancreatic VIPoma (vesoactive intestinal polypeptide tumor) were confirmed by surgery and histopathological examination in 17 of the 21 patients, and the rest 4 patients didn't receive surgical procedure because of the negative results in all imaging studies. Among pancreatic lesions, they located on head, body and tail in 9, 3 and 4 cases respectively; the average diameter of all 17 lesions was 2. 02cm. LFMPS correctly localized the tumor in 14 of 17 patients (82. 4% ) while CT in 15 of 17 patients (88. 2% ) , MRI in 12 of 17 patients (70. 6% ) and US in 9 of 17 patients (52. 9% ). Besides, the diagnostic accuracy of LFMPS in detection of small size (

Objective To study the mechanisms of Hydroxycamptothecin (HCPT) induced apoptosis of gastric cancer cells by detecting the expressions of p53, c myc, bcl 2, bcl xl, bcl xs genes. Methods Apoptosis of gastric cancer cells (SGC 7901,MKN 45) was measured by TUNEL and flow cytometry. The levels of mRNA and protein of p53, c myc, bcl 2, bcl xl,bcl xs genes were determined by reverse transcriptase polymerase chain reaction analysis and immunohistochemistry, respectively. Results Gastric cancer cells SGC 7901, MKN 45 presented some morphologic features of apoptosis, including cell shrinkage, nuclear condensation, DNA fragmentation, formation of apoptotic bodies, after 12 hours expourse to HCPT. Some typical subdiploid peaks before G0/G1 phase were observed. The apoptotic rates of SGC 7901, MKN 45 were 21.88% and 12.34%, respectively. The levels of p53 and bcl 2 mRNA and protein were downregulated after treated with HCPT in SGC 7901 cells. The levels proteins of c myc, bcl xl, bcl xs were unchanged after expourse to HCPT in SGC 7901 cells. The levels of p53 mRNA and protein were increased after treated with HCPT in MKN 45 cells. While the expressions of protein of bcl 2, c myc, bcl xl, bcl xs genes were not affected by HCPT in MKN 45 cells. Conclusion The results have showed HCPT induced apoptosis in gastric cancer cells might be regulated through influencing the expressions of p53 and bcl 2 genes.

Objective To construct recombinant plasmid pEGFP C1 antisense survivin and than transfect it to MKN 45 gastric cancer cells for studying the expression of survivin mRNA and its effects on apoptosis of cancer cells. Methods Recombinant pEGFP C1 antisense survivin plasmid was cloned and transfected to MKN 45 gastric cancer cells by lipofectamine. Apoptosis of gastric cancer cells was assayed by flow cytometry. The levels of survivin mRNA before and after transfection were determined by reverse transcription polymerase chain reaction analysis. Results After recombinant pEGFP C1 antisense survivin plasmid was transfected, the apoptosis of MKN 45 cells was increase, the cell number in G 2/M phase was decreased, and the level of survivin mRNA was inhibited. Conclusions pEGFP C1 antisense suvivin can promote the apoptosis of MKN 45 gastric cancer cells, that might attribute to the inhibition on cell proliferation and expression of survivin mRNA.

Objective Through gene reconstruction we generated pcDNA 3-survivin-mutant(Cys84Ala)plasmid, then the plasmid DNA was further transfected into gastric carcinoma cells by liposomal delivery. The effects of mutant survivin on cytokinetics of the gastric carcinoma cells were obversed. Methods By using immunohistochemical staining, the expression of survivin was detected in the gastric cancer tissues, and apoptosis was detected by flow cytometry. The PARP and cytochrome C expressions were determined by Western blot, the mitotic catastrophe was determined by immunofluorescence. Results Inhibition of survivin by mutant survivin cDNA could induce apoptosis, increase caspase-3 activity, cleave PARP and promote cytochrome C release in gastric cancer cells. Inhibition of survivin also caused mitotic catastrophe in gastric cancer cells. Conclusion Inhibition of survivin may induce apoptosis and mitotic catastrophe in gastric cancer. Survivin targeting gastric cancer therapy might be of potential benefit in the future.

Objective To investigate the application of colposcope in cervical cancer screening in Yunnan ethnic minority areas.Methods The questionnaire survey was conducted on 641 women,and the data of the colposcopy and biopsy were reviewed retrospectively.The colposcopy and pathological diagnosis results were compared.Results The minority women thought colposcopy more acceptable was 78.64％ (383/487).The colposcopy found suspected low-grade cervical lesions were 377 cases,high-grade cervical lesions were 245 cases,cervical condyloma were 15 cases,cervical cancer were 4 cases.The pathological results:278 cases of cervical intraepithelial neoplasia (CIN) Ⅰ,174 cases of CIN Ⅱ,55 cases of CIN Ⅲ,15 cases of cervical condyloma,4 cases of cervical cancer.The consistent rate of colposcopy and pathological examination was 68.17％ (257/377) in low-grade lesions,89.39％ (219/245) in high-grade lesions,cervical cancer and cervical condyloma was entirely consistent.Conclusions The colposcopy is more easily accepted in Yunnan ethnic minority areas,which could be a preliminary diagnosis of cervical lesions,cervical condyloma and cervical cancer.It has an important clinical application value in diagnosis of cervical diseases.

Objective To investigate the clinical efficacy of auricular point therapy for chronic fatigue syndrome.Methods Eighty patients with chronic fatigue syndrome were randomly allocated to treatment and control groups, 40 cases each. The treatment group received ear acupuncture plus auricular plaster therapy and the control group, conventional acupuncture. The overall symptom was scored, the Fatigue Assessment Instrument (FAI) score was recorded and immunoglobulins (IgA, IgG and IgM) were measured in the two groups before treatment and after four courses.Results There were statistically significant pre-/post-treatment differences in the overall symptom score, the FAI score and immunoglobulins in the two groups (P<0.05). There were statistically significant post-treatment differences in the FAI score, and IgA and IgG between the treatment and control groups (P<0.05). Conclusion Auricular point therapy is an effective way to treat chronic fatigue syndrome.

Objective Survivin is overexpressed in gastric cancer. However it not expressed in normal gastric mucosa. The expression of survivin is tightly related to the prognosis of gastric cancer.By gene reconstruction we generated pcDNA3 survivin mutant(Cys84Ala) plasmid, and observed its effect on the gastric carcinoma cell lines. Methods The survivin mRNA and protein expression levels were determined by reverse transcription polymerase chain reaction(RT PCR) analysis,Western blot and immunohistochemical staining respectively . Flowcytometry and acridine orange staning were employed to detect apoptosis. Results Overexpression of survivin mRNA and protein were detected in the gastric cancer cell lines. Inhibition of survivin by survivin mutant cDNA induced apoptosis,activated caspase 3 activity,cleaved PARP and promoted cytochrome C releasing in gastric cancer cells,and effectively sensitized gastric cancer cells to chemotherapeutic agents. Conclusion Inhibition of survivin may induce apoptosis in gastic cancer and sensitize gastric cancer cells to chemotherapeutic agents.Survivin targeted therapeutic protocol may potentially benefit gastric cancer therapy.

Objective To observe the effect of combining virtual reality technology with occupational thera-py in treating children with spastic hemiplegia resulting from cerebral palsy. Methods Thirty-eight spastic and hemiplegic children with cerebral palsy were randomly divided into a treatment group ( n=18) and a control group ( n=20) . Both groups received occupational therapy, while the treatment group was additionally provided with virtual reality-based treatment. The sessions lasted 30 min, 6 times a week for 3 months. Before and after the treatment the upper extremity motor function of both groups was assessed using the fine motor quotients of the Peabody developmen-tal motor scale, the Caroll hand function scale and a activities of daily life scale. Results Before the treatment there was no significant difference between the two groups in terms of any of the measurements. After the 3 months, significant improvement was observed in both groups, but the improvement of the treatment group was significantly greater than that of the control group. Conclusion Virtual reality technology can further improve the motor function of the upper ex-tremities and ability in the activities of daily life beyond that achievable through occupational therapy alone.

Objective To study on the efficiency of topical pharyngeal anesthesia in gastroscopy and the factors related to the tolerance of patients. Methods A randomized double-blind placebo-controlled study was conducted. Two hundred and three subjects consented to participate in this study underwent gastroscopy. Relative Risks (RR) of patients' discomfort in pharyngeal anesthesia were calculated, anxiety and other potential confounding factors by using logistic regression analysis. Results Compared with placebo controls, the RR of patient discomfort on intubation was 0.37 (95 % CI 0. 20-0. 70) , patients aged less than 40 years had RR higher than those of aged 40 or over ( RR 2. 13 , 95% CI 1. 09-4. 15 ) . With subgroup analysis in those patients less than 40 years old and undergoing gastroscopy for the first time, the RR of patients' discomfort was 0. 23 (95% CI 0. 07-0. 77) and 0. 24 (95% CI 0. 10-0. 58) for the topical anesthesia. Conclusion Topical pharyngeal anesthesia appears to be effective in diminishing the discomfort during endoscopy in patients less than 40 years old and those undergoing the procedure first time. Trait-anxiety is not a predictor of discomfort.