Objective To screen nursing workload items in the perioperative period of lumbar disc herniation by using Delphi method for providing scientific basis in order to undertake nursing care cost calculation of single disease. Methods The measuring content of nursing workload was firstly designed on the basis of consulting literature and experts discussion,then two rounds of consultations were made with experts by using the Delphi method. Results Valid questionnaires collected back were 35 and 37,respectively, accounting for 89% and 94% in the two rounds of consultations with the experts,by which fully reflected the support of experts to the study. The average number of authoritative coefficients in the two rounds of consultations with the experts was respectively 0.79, 0.88,which indicated high reliability of the consulting. The overall coordination index for nursing care items in the preoperative/intraoperative/postoperative period of consulting experts respectively was 0.265/0.305/0.359 and 0.435/0.316/0.425, which had statistical significance and indicated the good coordination among the experts advice in determining the nursing care items and the desirability of the results. Conclusions Measurement items of nursing workload in perioperative period of lumbar disc herniation had been screened scientifically and reliably,which could accurately measure the nursing workload of the disease and lay the foundation for further accounting of nursing care cost.

OBJECTIVE To investigate theradiosensitization of combined inhibition of signal transducer and activator of transcription 3(STAT3) and hypoxia-inducible factor-1α(HIF-1α)on laryngeal squamous carcinoma of xenograft mice and its underlying mechanisms.METHODS Xenograft mice were divided into 5 groups randomly: control group(A), irradiation group(B), irradiation and AG490 group(C), irradiation and PX478 group(D), irradiation combined AG490 and PX478 group(E). The size of xenograft tumor was measured and calculated. The expression of Ki67 and HIF-1α was detected by immunohistochemical method. Western blot was used to detect the expression of PARP1.RESULTS The size of xenograft tumor in group E was smaller compared with that in group C and group D. There were significantly difference between them respectively (t=12.367,11.598,P=0.000). The expression of HIF-1α in group E was lower than that in group C and group D respectively, and there were significantly difference respectively(t=5.422, 3.000,P<0.05). Ki67 index in group E was lower compared with that in group C and group D respectively and there were significantly difference respectively (t=4.479, 4.352,P<0.05). The level of cleaved PARP-1 in group E was higher than that in group C and group D respectively and there were significantly difference respectively (t=5.507, 7.102,P<0.05). CONCLUSION Combined inhibition of STAT3 and HIF-1α can increase the radiosensitivity of human laryngeal squamous carcinoma in the xenograft mice.

Phyllanthus emblica L.and Terminalia chebula Retz.were the most common Tibetan medicines.The combination of Phyllanthus emblica L.,Terminalia chebula Retz.and Term inalia bellirica (Gaertn.) Roxb.was known as Triphala,which was the basis of the most frequently-used prescriptions.The present study summarized and made a further comparison between Phyllanthus emblica L.and Terminalia chebula Retz.over chemical constituents and pharmacological activities,which provided evidence for their clinical use and the basic theory.

Phyllanthus emblica L.has a long history and is abundant in the world.It was used for treating various diseases in nearly twenty countries or nations in regard to traditional medicine system.By retrieving Tibetan medicine in classical books,recent literatures and clinical studies,the application of Phyllanthus emblica in traditional Tibetan medicine system was introduced,including its utilization in hypertension,indigestion,abdominal distension,cough and arthralgia and their related diseases.In the sight of modern pharmacological research,the theory Tibetan medicine of explained Phyllanthus emblica scientifically.Its related researches and development prospects were also deliberated for further researches and various applications,which demonstrated the value of the development of new drugs and health products.

This study aimed to investigate the effects of tannins extracted from Tibetan medicine Phyllanthi Fructus on cytochrome P450 enzyme of liver microsomes in rats.Cocktail probe substrates were incubated with liver microsomes in vitro.Metabolic elimination percentages of the six probe substrates,including dapsone,dextromethorphan hydrobromide,coumarin,phenacetin,chlorzoxazone and tolbutamide,were determined by HPLC.The effects of tannins extracted from Tibetan medicine Phyllanthi Fructus on the enzymatic activity of rat liver microsomal P450s was evaluated.It was found that tannins extracted from Phyllanthi Fructus did not impact P450 enzymes.The IC50 values of CYP3A4 and CYP1A2 were over 200 μg·mL-1,while the IC50 value of CYP2C9 was superior to 500 tg·mL-1.In conclusion,Tannins extracted from Tibetan medicine Phyllanthi Fructus did not significantly affect cytochrome P450 enzymes.

Phyllanthus emblica L.,related to common Tibetan medicine,has a function on clearing heat and cooling blood,promoting digestion and invigorating stomach,and producing saliva and slaking thirst.The compound of Dasanguo,made of Phyllanthus emblica,F.terminalia billericae and F.chebula,was a widely used preparation in Tibetan medicine,and was also a basic formula in other prescriptions.This study summarized the untilization of Phyllanthus emblica in traditional Tibetan medicine and elucidated the effects of Phyllanthus emblica in the compounds of Tibetan medicine,which provided a reference for the studies of Tibetan medicine and its modern application.

Phyllanthus emblica L.is related to traditional tibetan medicine,containing diversified pharmacological and physiological functions,such as anti-tumor effects,anti-inflammatory effects,anti-oxidation funtions,slow down in glycemia and blood pressure and the prevention of cardio-cerebral vascular diseases,etc.In this study,the research progress on the anti-tumor efficacy of monomer compounds and the extraction of Phyllanthus emblica L.were reviewed,providing references for the anti-tumor studies of Phyllanthus emblica L.

Triphala consists of Terminalia chebula Retz, Terminalia bellirica (Gaertn.) Roxb. and Phyllanthus emblica L, which are made into Dasanguo Powder. Triphala is rich in a variety of chemical components, including tannins, phenolic acids, triterpenoids and flavonoids. The content of tannin is abundant in Triphala, which are often used as the main indicators of analysis. Modern research found that Triphala has a variety of pharmacological activities such as prevention of gastrointestinal diseases, antibacterial, anti-inflammatory, anti-oxidation, anti-tumor and so on. This paper briefly summarized the chemical constituents and pharmacological effects of Triphala, combining the relevant national and international literature in recent years to provide reference for the development and further study of Triphala.

To determine there characteristic components content of Tibetan Medicine Triphala through establishing a HPLC method and its total tannin content through spectrophotometry. The chromatographic column of Agilent ZORBAX SB-Aq (250 × 4.6 mm, 5 μm) with methanol-0.1％ formic acid/water as the mobile phase, the flow rate 1 mL/min, and the detection wavelength 270 nm was applied to determine the Gallic acid, colijing and ellagic acid content in medicinal materials and the tannin parts of Tibetan Medicine Triphala. With the gallic acid as control group, total tannin content of Triphala and its tannin parts was determined through spectrophotometry. It revealed in the HPLC test that the linear range of gallic acid, coracine and ellagic acid was 0.91-4.55 μg, 0.274-1.368 μg and 0.329-2.634 μg respectively. It also showed that the average recovery rates of the three components in the medicinal materials were 101.06％, 101.72％and 100.27％ respectively. And the average recovery rates of the three components in the tannins were 100.4％, 100.85％and 101.70％ respectively. The result of spectrophotometry showed that gallic acid was linear in1.008-10.08 μg·mL-1, and that the recovery rate of medicinal materials and tannin parts were 100.25％ and 100.52％ respectively. The method is rapid, accurate and repeatable, and it can provide basis for the quality control of Tribescens and its tannins.

OBJECTIVE To systematically review the efficacy and safety of induction chemotherapy before concurrent chemoradiotherapy.METHODS We comprehensively searched the CBM,Pubmed,Embase,and the Cochrane databases to identify published studies.Quality assessment of RCTs was conducted according to the methods of Cochrane collaboration.A meta-analysis was performed by using the Revman 5.3 software and Stata12.0software.Primary outcomes included overall survival (OS),progression-free survival (PFS) and overall response rate (ORR).Serious adverse events include neutropenia,anemia,skin reactions,vomiting,etc.RESULTS A Total 6 randomized controlled trials involving 1141 patients were included.There was no significant difference in 1-year survival rate,2-year survival rate,3-year survival rate,5-year survival rate between the two groups(P＞0.05).The 1-year PFS,2-year PFS,3-year PFS,5-year PFS,ORR also showed no difference between the 2 cohorts(P＞0.05).However,the incidence of grade 3 to 4 febrile neutropenia and oral mucositis was higher in the group of induction chemotherapy followed by concurrent chemoradiotherapy (OR=6.99,95％CI:2.43～20.12;OR=1.92,95％CI:1.43～2.58).CONCLUSION Additional induction chemotherapy before concurrent chemoradiotherapy does not improve OS and PFS in locally advanced HNSCC compared to concurrent chemoradiotherapy alone,and can cause a higher incidence of adverse events.