The technology role in diagnosing and treating gastroenterological of digestive endoscopy plays a significant diseases at present.The trainees for advance study are required to get familiar with the appliance,to learn about the indication,the contraindication,and the complication of using digestive endoscopy,to understand the advanced diagnosing and treating technology of digestive endoscopy in the world and they are also instructed without reservation the gist of endoscopic technique in accordance with their aptitude.

In an uncertain and dynamic environment,medical research institutions must often balance between the usual medical research and emergent medical research.We interpreted this as a balance between exploitation-oriented innovation and exploration-oriented innovation.We pointed out that a flexible organization can coordinate the competition of scientific research resources between the two kinds of innovation; then we built an organizational flexibility model based on resource flexibility and coordination flexibility,and extended the model to medical research institution.And finally,we discussed the strategies for increasing organizational flexibility.

Objetive: To study the effect of genistein on the invasion and metastasis of human gastric cancer cells SGC-7901 in vitro. Method: MTT was used to study the effects of adhesion by genistein on SGC-7901. The Boyden Chamber membrane invasion culture system was used to study invasion and metastasis. Cell-immunochemistry was used to observe the change of TGF- 1. Results: In the membrane invasion culture system, the numbers of invading and migrating SGC-7901 cells were significantly lower in genistein treated groups than those in the control groups (P

Objetive: To study the effect of soybean isoflavone(SI) on the growth of gastric cancer cell SGC-7901 during hypoxia and its mechanisms. Method: The environment of hypoxia was established by GasPaK method. The effect of SI was determined by MTT and FCM which was used for studying apoptosis and cell cycle of SGC-7901. Electron microscopy was used to study the effects of SI on apoptosis and necrosis of SGC-7901. Cell-immunochemistry was used to observe the change of hypoxia-inducible factor HIF-1? and FAS expression. Results: SI could inhibit significantly the growth of SGC-7901, and arrest the cell in G2/M phases during normal and hypoxia environment. The inhibitory effect was elevated significantly during hypoxia. Electron microscopy showed the cell apoptosis and necrosis. FAS expression was elevated by SI during normal and hypoxia environment, and HIF-1? expression was downregulated during hypoxia. Conclusion: SI can inhibit SGC-7901 cell growth via arrest of cell cycle, elevated expression of FAS, apoptosis and necrosis induction and other pathways. The inhibition of the increased HIF-1? expression is probably the mechanism of the inhibitory effects of SI during hypoxia.

Military medicine has to restructure itself to meet military needs and e-Science patterns of the information age.This restructuration is known asinformationization of military medicine ( IMM).IMM is a process of vision refresh-ing into information thinking, mission expansion to the information field and paradigm shift to normal forms of information. The result is the emergence of military med-information technologies, military med-information research fields, and military med-informatics disciplines.

Objective To explore the role of the preoperative DSA examination and selected embolization in surgical treatment of intracranial huge meningiomas .Methods The clinical materials of 13 patients was collected and analyzed .Preoperative DSA was carried out in all cases ,10 of 13 underwent selected preoperative embolization ,the meningiomas were totally excised by surgery 4 to 7 days after the embolization .Results After the embolization ,DSA showed that the blood fed to the tumors was completely blocked in 8 cases ,and in great part in 2 cases .All tumors were totally removed ,the bleeding during operation was significantly decreased in patients who underwent preoperative embolization compared to the patients without embolization (P<0 .05) .Necrosis in different degree of meningiomas was found in postoperative pathological examination .There were no severe complications occurred during and after operations in all patients .Conclusion Preoperative selective embolization could significantly decrease the bleeding during operations .

Objective To analyze the causes for the thigh pain after treatment of femoral trochanteric fractures by proximal femoral nail antirotation Ⅱ( PFNA Ⅱ) . Methods Included in this ret-rospective study were 236 patients who had been treated by us for femoral trochanteric fracture from October 2011 to December 2015. They were 103 men and 133 women, aged from 42 to 86 years (average, 50. 3 years) . According to AO classification, 13 cases belonged to type 31-A1. 2, 32 to type 31-A1. 3, 35 to type 31-A2. 1, 27 to type 31-A2. 2, 33 to type 31-A2. 3, 38 to type 31-A3. 1, 39 to type 31-A3. 2 and 19 to type 31-A3. 3. All the fractures were single, fresh and closed and treated with PFNAⅡinternal fixation. Results This cohort was followed up for 8 to 26 months (average, 13. 2 months). Nonunion occurred in one case who had to accept artificial hip replacement. The remaining 235 cases obtained bony union after 22 to 39 weeks (average, 29. 3 weeks). By the Harris evaluation at final follow-ups, the affected hips scored from 81 to 93 points (average, 85. 1 points) . Post-operative thigh pain was reported in 19 cases (8. 05％) . The causes included varied anatomic morphology of the proximal femur in 6 cases, distal defects of the intramadullary nails in 4, insufficient stability of internal fixation or uneven biomecanical distribution in 3, unskillful operation in 2, and severe oesteoporosis in 4. Avascular necrosis of femoral head was not observed during follow-ups. Conclusions Postoperative thigh pain is worthy of serious atention from orthopaedists following PFNA Ⅱtreatment of femoral trochanteric fractures. PFNA Ⅱshould be modified according to the specific Chinese features of the proximal femur, especially in the respects of anterior arch and distal structure of the main nail and lateral declination as well.

Objective The aim of this study was to analyze the characteristics of upper gastrointestinal bleeding (UGIB) admitted on Ramadan or no-Ramadan.Methods We analyzed HuiNation patients' admissions of UGIB in Ningxia Medical University General Hospital from 2000 to 2013 (a total of 1192 admissions).Differences in etiological,transfusion undergo early esophagogastroduodenoscopy (EGD) and hospital stays between Hui-Nation patients on Ramadan.Results Ramadan admissions were associated with significantly higher hemorrhage rates than no-Ramadan admissions among Hui-Nation patients.Peptic ulcer (56％),esophageal varices (17％) and gastric erosive (12％) were the main reason of UGIB in Ramadan.Ramadan admissions were associated with significantly blood transfusion,less likely to undergo early EGD,mortality and long length of stay (p ＜ 0.05).Conclusions Ramadan admission of UGIH was higher than no-Ramadan.Doctor should pay more attention to this phenomenon.

Objective To analyze the correlation between the resistance of Acinetobacter baumannii and the utilization of antimicrobial agents in the hospitalized patients of Beijng Chuiyangliu Hospital,and provide the basis for clinical rational use antimicrobial agents.Methods A retrospective analysis was conducted for the drug resistance rate and specimen source of the 2 194 strains of Acinetobacter baumannii from 2010 to 2014 in the hospital and DDDs/DUI of antimicrobial agents was analyzed by Pearson correlation.Results The resistance rate of Acinetobacter baumannii was positively correlated with the DDDs and DUI of imipenem/cilastatin(r=0.991,0.994,all P<0.01), and was positively correlated with the DDDs of cefepime(r=0.934,P=0.020).The resistance rate of Acinetobacter baumannii to amikacin was positively correlated with the DDDs of etimicin(r=0.931,P=0.022).The resistance rate of Acinetobacter baumannii was negatively correlated with the DUI of levofloxacin(r =-0.986,P =0.002). Conclusion The resistance rate of Acinetobacter baumannii was high and there was correlation between the drug resistance and the utilization of some antimicrobial agents.

OBJECTIVE:To systematically review the efficacy and safety of the generic and original preparation of atorvas-tatin,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Li-brary,CJFD,Wanfang Database,VIP and CBM,related randomized controlled trials(RCT)about generic preparation of atorvas-tatin(test group)versus original preparation of atorvastatin(control group)were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extract and quality evaluation. RESULTS:Totally 16 RCTs were included,involving 2 077 pa-tients. Results of Meta-analysis showed,compared with control group,there were no significant differences in reducing total choles-terol (TC) [MD=-0.06,95%CI(-0.14,0.01),P=0.11],triglyceride (TG) [MD=-0.00,95%CI(-0.08,0.08),P=0.99], low-density lipoprotein cholesterol (LDL-C) [MD=-0.07,95%CI(-0.16,0.01),P=0.09],increasing high-density lipoprotein cholesterol(HDL-C)[MD=-0.00,95% CI(-0.03,0.03),P=0.96] and the incidence of major adverse cardiac events(MACE) [OR=1.18,95%CI(0.71,1.97),P=0.52] in test group;in terms of safety,compared with control group,there were no significant differences in the resulting in alanine aminotransferase (ALT) increased [OR=1.08,95%CI(0.51,2.30),P=0.83],the incidences of myalgia [OR=2.46,95%CI(0.70,8.65),P=0.16] and gastrointestinal adverse reactions [OR=1.11,95%CI(0.64,1.95),P=0.71]. CONCLUSIONS:Both the generic and original preparation of atorvastatin can effectively reduce blood lipid levels,with sim-ilar safety.