Early diagnosis and timely treatment are two critical factors in reducing the cerebral damage and improving prognosis for ischemic stroke patients.The only proved effective way is to intravenously administer recombinant tissue plasminogen activator for thrombolytic therapy.However,the narrow time window restricts its application.One rapid and effective blood test,or auxiliary examinations such as computer tomography which may aid early diagnosis of ischemic stroke would contribute to treatment and intervention promptly,then take a pivotal role for the disease prognosis.Herein,the reported proteins and RNA markers are summarized and analysed in clinical application of acute ischemic stroke likewise.

This study was aimed to explore effect of Gui-Zhi Fu-Ling W an (GZFLW) on HIF-1α and vascular en-dothelial growth factor (VEGF) in patients with endometriosis. A total of 68 endometriosis patients in the First Peo-ple's Hospital of Xining from June 2011 to June 2013 were included. All patients received treatment of GZFLW, once a day. After one-month treatment, the treatment efficacy was analyzed. The endometrial tissues (both ectopic endometrium and eutopic endometrium) were obtained before and after treatment. The protein levels of HIF-1α and VEGF as well as the relationship of HIF-1α and VEGF were analyzed by SP immunohistochemistry. The results showed that the total treatment efficacy was 86.76%. Compared with pretreatment, the posttreatment protein levels of HIF-1α and VEGF were significantly reduced (P< 0.05). The decreasing of VEGF protein level and HIF-1α expres-sion level were positively correlated (P< 0.05). It was concluded that GZFLW had better efficacy in the treatment of endometriosis. One of the reasons may be the downregulation of protein levels of HIF-1α and VEGF in endometriosis tissues.

Objective To investigate the clinical efficacy and safety of endoscopic variceal ligation (EVL) combined with endoscopic variceal sclerosis (EVS) for treating patients with esophageal variceal bleeding (EVB).Methods Ninety patients with EVB were divided into observation group and control group by treatment methods with 45 patients each.The observation group was given EVL combined with EVS and the control group was given EVL.The elimination of varicosity after the first treatment,time and times required to eliminate,rehaemorrhagia,varicosity recurrence,complication and prognosis of the 2 groups were observed.Results The elimination rate of varicosity of observation group was 97.8％(44/45),the control group was 93.3％(42/45),there was no significant difference (P＞ 0.05).The elimination rote of varicosity after the first treatment of observation group was significantly higher than that of control group,the time and times required to eliminate were significantly lower than those of control group [71.1％(32/45) vs.48.9％(22/45),(17.24±5.65) d vs.(36.01 ± 11.81) d,(1.42 ±0.47) times vs.(1.87 ±0.61) times,P ＜ 0.05 or ＜0.01].The rates of early-onset rehaemorrhagia,delayed rehaemorrhagia and varicosity recurrence of observation group were significantly lower than those of control group [4.4％(2/45) vs.17.8％(8/45),6.7％(3/45) vs.22.2％ (10/45),2.2％ (1/45) vs.22.2％ (10/45),P ＜0.05].The rate of complication of observation group was significantly lower than that of control group [11.1％ (5/45) vs.42.2％ (19/45),P ＜0.01].Conclusion The EVL combined with EVS is an effective method for emergency hemostasis and preventing rehaemorrhagia in the patients with EVB.

Objective To investigate the influence of inspired oxygen fraction (FiO2) on the ratio of PaO2/FiO2(P/F) during the implementation of lung protective ventilation strategy in patients with acute respiratory distress syndrome(ARDS) in order to unravel its clinical significance. Method This was a prospective study of 16 selected patients with ARDS treated with mechanical ventilation ( MV ) to get ratio of P/F in range of 100 to 200 by PEEP≥5 cmH2O and high inspired oxygen. After lung recruitment maneuvers by BiPAP with high pressure (PH) of 40 cmH2O for40 s, the MV was maintained the basic requirement for stabilizing the patients for 30 minutes. A series of FiO2 were set at fractions of 0.5,0.6,0.7,0.8,0.9 and 1in random sequence, and the changes of respiratory mechanics, blood gas and hemodynamics under the different concentrations of FiO2 were analyzed by using SPSS version 13.0 software. Results ( 1 ) The ratio of P/F increased as FiO2 increased, and it's significant as FiO2 increased to 0.7 or above. As the fractions of FiO2 were set at 0.5 and 1. O, the ratios of P/F changed in 24.70% ± 23.36% respectively. ( 2 ) Of them,6 patients ( 37.5% ) treated with FiO2 set at 0.5 had the ratio of P/F ＜ 200, and the fraction of FiO2 was increased to 1.0, the P/F ＞ 200. (3) FiO2 and Qs/Qt were negatively correlated ( r = - 0.390, P = O. 027 ),the higher inspired oxygen fraction, the lower shunt. When the fractions of FiO2 were set at 0.5 and 1.0 ,there was a positive correlation between △Qs/Qt and △P/F( r = 0.82, P = 0.005 ). Conclusions The inspired oxygen fraction affects the ratio of P/F, which may be resulted from shunt and it may influence the diagnosis of ARDS.

Objective To understand and explore the lived study feeling and experience of nursing undergraduate students during high- fidelity simulation training so as to provide the evidence of reforming teaching methods and performing the teaching practice of nursing educators. Methods Phenomenological study of qualitative research was used. In- depth interviews were conducted among 4 focus groups. 28 nursing undergraduate students were interviewed to understand their lived study feeling. Results 5 themes were emerged using Colaizzi's phenomenologic method, including cooperating explicitly, integrating theory with practice closely, promoting disease observation ability and nursing decision making, enhancing self-confidence. Conclusions High- fidelity simulation training was beneficial to integrate theory with practice, cultivate students' comprehensive ability and increase clinical practical opportunities.

An investigation was made on reforrs of connty public hospitals in Yulin region,Shaanxi province.With theories of public administration,the authors probed into the government investment behavior in county-level public hospitals reform,hospital operation mechanism,and govemmem regulation,as well as multi-sector involvement in healthcare services Proposals made in the paper advocate constructing a responsible and limited service-based government in the county-level public hospitals reform.

With the change of diet and lifestyle,the development of medical concepts and techniques,the spectrum of disease has changed dramatically. The standardization of gastrointestinal surgery will be the key to further improvement.Endoscopic ultrasonography,computed tomography,magnetic resonance imaging, positron emission tomography-computed tomography and laparoscopy are helpful for preoperative staging of gastrointestinal carcinoma.The standards of operation,such as D2 lymph node dissection for gastric cancer and total mesenteric excision for rectal cancer,are also very important.Creating standards for multi-disciplinary treatment of gastrointestinal diseases will be important factors for improving outcomes.

ObjectiveTo explore help-seeking behavior and treatment towards people with mental illness,so as to provide evidence for intervention measures.Methods 1988 mental disorders in outpatient were selected with a self-developed questionnaire randomly,and regression analysis was carried out.ResultsUnstable marriages and the lack of mental health knowledge were risk factors for actively professional help-seeking contact after first onset of a mental disorder.Median delays of seeking help and treatment in depression,schizophrenia,anxiety disorders and somatoform disorders were 113.5 days,34.0 days,86.5 days,309.0 days and 6.0 months,3.0 months,3.0 months,5.5 months orderly.There were notable difference for primary treatment contact between the four mental disorders ( x2 =46.317,P =0.029 ).No-professional recognition ratio was 17.8％.The ratio of correctly diagnosed and rationally cured with drugs ratio was 10.5％.89.5％ of outpatients had not been given rational drugs then they sought to psychiatry.ConclusionThe delay of help-seeking and treatment in mental illnesses are serious,so it should be taken effective measures to promote the popularization of mental health knowledge and train no-professional doctors in order to improve the behavior of seeking help and provide the ratio of recognition and treatment.

ck.

The tight junction of intestinal epithelium plays an important role in maintaining the function of intestinal barrier and regulating the cell differentiation. The intestinal epithelial cells interact with neighboring cells and the extracellular matrix and then affect the epithelial barrier as well as the proliferation, polarization, and apoptosis of cells. As an important cell junction, the tight junction of intestinal epithelium participates in a series of signal transduction pathways including the classic cyclic adenosine monophosphate-protein kinase A-cyclic adenosine monophosphate response element-binding, inositol trisphosphate, Ras-mitogen-activated protein kinase, phosphatidylinositol 3-kinase, and in some special pathways including zonula occludents protein 1-associated Y-box factor,cyclin related protein, phosphorylation, and methylation. Furthermore, regulations of gene and protein expression of the tight junction are also complex, while disorders of such regulations may lead to clinical diseases, such as disruption of the intestinal barrier, refractory infection, and even cancers. This article reviews the research advances in gene expressions, related signal transduction, and self-regulation in the tight junction of intestinal epithelium.