Tumor necrosis factor receptor-associated protein 1(TRAP1),also known as HSP75,is a molecular chaperone protein of heat shock protein 90(HSP90)which can be expressed in a variety of human malignant tumor cells.TRAP1 is involved in cell apoptosis,metabolism,intercellular adhesion,movement,invasion and metastasis,and is associated with tumor cell resistance.The latest studies have demonstrated that abnormal expression of TRAP1 was found in the development process of breast cancer,colon cancer,ovarian cancer and other tumors.Further studies have confirmed that TRAP1 plays a key role in the regulation of energy metabolism in tumor cells,by blocking its function can lead to the death of tumor cells,and will not affect the normal cells.As a new target for tumor therapy,TRAP1 is receiving more and more attention.

Objective:To explore means of process quality assessment for antibacterial drug utilization among a-cute appendicitis patients under the New Rural Cooperative Medical Scheme ( NCMS) through the use of the explicit method in order to provide evidence for the rationality of drug utilization in NRCMS. Methods: Data was collected from the NCMS information system of one county in Shandong Province from 2007 to 2011 and included 1 ,721 cases of acute appendicitis in county and town-level hospitals. The explicit method was employed, which adopted the ad-herence rate to represent drug process quality by comparing the actual antibacterial drug utilized with those recom-mended by quality standards. Descriptive statistics were used to analyze quantitative data with Excell2007, Microsoft SQL 2005 and SPSS 17 . 0 . Results: The average overall adherence rate from 2007 to 2011 was 22 . 4% ( SD =22. 3%) at the individual level. The overall adherence rate of township health centers was very low, between 14. 6%and 19. 6%, with no significant difference among the five years. The utilization of cephalosporin drugs was relatively stable at town-level hospitals, that is, third-generation cephalosporins was used most frequently, while cephalosporin, recommended by quality standards, was the least utilized in all five years. At county-level hospitals, fourth-genera-tion drugs were gradually substituted with second and third-generation drugs. Utilization of the recommended drug metronidazole of the nitromidazoles drug group decreased over time at both the town and county-level hospitals, and the drug was gradually substituted by tinidazole and ornidazole, especially in county-level hospitals. Conclusions:From 2007 to 2011 , the rationality of drug utilization was low in the NCMS designated hospitals at both town and county-level hospitals, particularly in town-level hospitals. The underuse of recommended quality standard drugs was the main issue at hand, and this situation experienced no significant changes during the study period.

Objective To achieve the software automatic updates and maintenance in the local area network which is developed based on the C/S structure. Methods Based on the existing software and hardware development platform,we use PowerBuilder to exploit and compile a program which can determine whether the software need to update automatically or not under the premise of unchanging the existing LAN software system. Results When the user terminal in the local area network runs this program,they can update it automatically whenever they need. Conclusion This method will greatly reduce the later maintenance software,upgrade works and also improve the work efficiency and accuracy.

This article summarized nursing care and management of a child with hypereosinophilic syndrome presenting five foot wounds.Nursing key points included:wound care,pain management and comprehensive interventions.Debriding and selection of dressing were based on the wound bed and acceptance of the patient;medication and psychological intervention were applied to reduce pain;the patient and his family members were encouraged to be involved in the management of wound management.Patient adherence was improved and pain was greatly reduced.After dressing change for 21 times in 93d,five foot wounds were all healed.

The health care system has always faced challenges from two competing fronts: rising costs and quality concerns. The common issue of debate confronted by various health care systems is whether or not rising medi-cal expenditure can lead to quality improvements. The key to addressing this issue is to figure out the correlation be-tween quality of care and medical expenditure. Based on Donabedian’s structure, process and outcome quality theory, this study reviews relevant international studies related to this topic in order to provide empirical evidence in a clearer way. Results show that the analysis of current studies have typically been based on the regional level, health provider level and patient level; the quality indicators used varied among studies while expenditure indicators had much in common;more studies were found to focus on the association between outcome quality and expenditure while less studies explored the link between structure or process quality and expenditure; additionally, the majority of relevant studies were located in the inpatient setting and studies from outpatient settings were found to be lacking. Overall, ac-cording to current knowledge, no inclusive conclusion could be obtained, but quality indicators, data and methods, and limitations revealed in these studies can be reviewed by future study to explore the correlation between quality and expenditure of medical care in a more objective way.

Costimulatory signals have become a hot field in immunological researches. As co-inhibitory molecules, programmed death-1 ( PD-1) and its ligands (PD-1/PD-L) have been demonstrated to play an important role in autoimmune disease, organ transplant rejection, microorganism infection, tumor immune escapes etc. . In recent years,some studies about PD-1/PD-L pathway in ophthalmology have been curried out and reported. Some changes were found in PD-1/PD-L pathway, such as ocular immunologic diseases, ocular infectious diseases, ocular tumors, immune privilege in ocular tissues and so on. Through the research on PD-1/PD-L pathway,we can further understand the pathogenesis of some ocular diseases and find new methods for their prevention and treatments. This article reviewed the recent advances in PD-1/PD-L pathway in ophthalmological physiopathology.

Objective To compare the levels of thrombomodulin in acute cerebral infarction patients with different blood glucose levels.Methods Four hundred and eighty-nine patients with acute cerebral infarction were selected including 237 patients of non-diabetes (non-diabetes group),117 patients of diabetes and HbA1c ≤7.0％(diabetes controlled well group) and 135 patients of diabetes and HbA1c ＞7.0％ (diabetes controlled badly group).The level of thrombomodulin was assayed by enzyme-linked immunosorbent assay and compared among three groups.Results The level of thrombomodulin was (2.66 ± 1.20) μg/L in non-diabetes group,(2.80 ± 1.43) μg/L in diabetes controlled well group,(3.22 ±1.60) μ g/L in diabetes controlled badly group.There was the increasing of thrombomodulin among non-diabetes group,diabetes controlled well group and diabetes controlled badly group (P =0.030).There was difference between non-diabetes group and diabetes controlled badly group (P =0.008).Conclusion There is the increasing of thrombomodulin in patients with acute cerebral infarction when their blood glucose rising.

Objective To probe into the employment and turnover changes of health workers at township health centers,for analysis of the incentive preferences and methods characteristic of such people.Methods Questionnaire and interview investigations were made for 16 health centers to learn their personnel turnover from 2008 to 2010 in Junan county,Shandong province,and to learn their incentive preferences.Results Health workers of turnover tendency are mostly found among women,clinicians and nurses of college or above degree and those less than 39 years old.The top five incentive factors for such health workers are as follows:better working environment; better pay; better security for living; better hospital management; and better career development opportunities.Conclusion Township health centers should seize policy support of the health reform,by focusing on not only economic incentives such as the income and living conditions of health workers of turnover tendency,but also on non-economic factors such as career development opportunities.

Objective To evaluate the advantage of laparoscopic total mesorectal excision (TME) and the clinical value of pull-through anastomosis in the treatment of rectal carcinoma. Methods From November 2005 to December 2006, laparoscopic TME combined with pull-through anastomosis was carried out on 8 patients with rectal cancer. Results In all of the 8 patients, TME was completed under a laparoscope without additional incision, and the pull-through anastomosis was performed by hand.The mean operation time was 220 minutes (range, 180 to 300). The patients were followed up for 8-18 months (mean, 13 months), during which none of them developed implantation at puncture sites or local recurrence. Conclusions Laparoscopy provides a direct, magnified and reliable view for TME. Pull-though anastomosis is a convenient and low-cost method.

[Objective] To expound the diagnosis and treatment of chronic heart failure by tranditional Chinese and western medicine, to make the syndrome differentiation and treatment more accurate and the efficacy better. [Method] The progression of chronic heart failure can be divided into four stages, to combine the tranditional Chinese and western medicine to use the traditional Chinese theory to treat the four stages. [Result] Pre-heart failure and pre-clinical heart failure most belong to Qi deficiency of heart and lung syndrome, deficiencies of Qi and Yin syndrome; Clinical heart failure belongs to Qi deficiency and blood stasis syndrome, turbid-phlegm and water-rheum collecting internally syndrome; refractory end-stage heart failure belongs to heart-kidney Yang deficiency and water flooding syndrome, spleen-kidney Yang deficiency and endogenous turbid-phlegm syndrome, even depletion of Yin and Yang syndrome.[Conclusion] The pattern of diagnosis and treatment of combind tranditional Chinese and western medicine is the result of the development of modern medicine which contributes to the diagnosis of tradition Chinese medicine. This paper expounds the syndrome differentiation and treatment based on the western medical staging to make the syndrome differentiation and treatment accuracy and the curative effect better.