Objective To investigate the effect of different intervention times on the efficacy of catheter balloon dilatation therapy for cricopharyngea] achalasia after stroke.Methods Forty-eight cases diagnosed as cricopharyngeal achalasia were divided into 4 groups,groups A,B,C,and D according to the time of intervention from the onset (i.e.0.5,0.5-1,1-3,and 3-6 months),with 12 cases in each group.A 14# urethral catheter was inserted into the esophagus and water was injected into the balloon to make it turgid.The catheter was then pulled upwards through the stricture in the esophagus to dilatate the cricopharygeal muscle.The patients also received low frequency electrical stimulation combined with dysphagia rehabilitation behavioral therapy once daily.The treatment end point was either when the patient resumed an oral diet or after 6 weeks of treatment.The effects of the treatment were evaluated in terms of the number of times the dilatation therapy was administered,the pharyngeal transit duration,swallowing function and fluoroscopic examination before and after treatment.Results Groups A,B and C required significantly fewer treatment sessions than group D.Groups A and B required significantly fewer sessions than group C,but the difference between groups A and B was not statistically significant.After treatment,there were 11 patients can eat water,liquid,paste and solid food both in groups A and B.But the number of patients who can eat the4 traits of food was 9,9,10,9 in group C and 6,6,7,5 in group D respectively.Swallowing function in groups A,B and C was adjudged,on average,significantly better than in group D.Compared with group C,swallowing function in groups A and B was also significantly improved,but the difference between groups A and B was not statistically significant.The pharyngeal transit duration in all 4 groups was shorter than before treatment,but the duration in groups A,B and C was significantly shorter than in group D.Compared with group C,the pharyngeal transit duration in groups A and B was significantly shorter,but the difference between groups A and B was again not statistically significant.Fluoroscopy showed the efficiency in groups A and B to be over 91 ％.In group C it was 83％ and in group D 58％.The difference between group D and groups A,B and C was significant.The efficiency in groups A and B was significantly better than in group C,but the difference between groups A and B again was not statistically significant.Conclusions Early intervention using catheter balloon dilatation therapy can facilitate the improvement of swallowing function in patients with cricopharyngeal achalasia after stroke and improve their quality of life.

Objective:To study the integrated information nursing mode of perioperative medical care under the multidisciplinary cooperation of hip fracture in the elderly patients, provide reference for perioperative nursing of elderly hip fracture.Methods:A total of 1 019 patients with hip fracture from May 2018 to May 2019 in Beijing Jishuitan Hospital were randomly selected as the study object, and the non synchronous control was used for the study. From May to December 2018, 527 elderly patients with hip fracture in orthopaedic department of general trauma were taken as the control group, adopting the traditional treatment and nursing mode; from January to May 2019, 492 elderly patients with hip fracture in elderly trauma orthopaedics department were taken as the intervention group. Under the multidisciplinary cooperation, the information-based nursing mode of integrated medical care was implemented, and a multidisciplinary integrated medical care team was established. The information-based platform was used to optimize the clinical nursing path, and standardized, individualized and continuous nursing scheme was developed. The time from visit to hospitalization, the time from hospitalization to operation, hospitalization time, incidence of more than moderate pain, incidence of venous thromboembolism, incidence of stress injury, incidence of delirium and satisfaction of patients and their families at discharge were compared between the two groups.Results:The number of patients in the intervention group was higher than that in the control group within 4 and 24 hours. The rate of operation in 48 h increased from 8.0%(42/527) to 50.0%(246/492), and the rate of operation in 1 week increased from 70.0%(369/527) to 99.0%(487/492). Compared with the control group, the incidence of more than moderate pain in the intervention group decreased from 85.0%(448/527) to 2.0%(10/492), the incidence of venous thromboembolism in the hospital decreased from 12.0%(63/527) to 4.1%(20/492), and the incidence of pressure injury in hip fracture in the elderly decreased from 2.1%(11/527) to 0.2%(1/492); the incidence of delirium in the hospital decreased from 21.1%(111/527) to 8.1%(40/492); the hospital stay was shortened from (13.42 ± 3.36) d to (7.26 ± 2.03) d, and the satisfaction of patients and their families increased from 60.9%(321/527) to 95.9%(472/492). There were statistical significance between the two groups (χ 2 values were 4.157-708.006, t value was -35.119, P<0.05 or 0.01). Conclusions:The information-based nursing mode of integrated medical care under the multidisciplinary cooperation can adapt to the development of hip fracture in the elderly, which is conducive to the accelerated rehabilitation of patients.

Hormone receptor-positive and human epidermal growth factor receptor 2-positive (HR + HER2 +) breast cancer is a highly heterogeneous disease, accounting for about 10% of breast cancers. The molecular biological characteristics, therapeutic effect and prognosis of all subtypes have significant differences. This paper reviews the research progress of molecular biological characteristics, diagnosis and treatment condition and single-cell level in HR + HER2 + breast cancer from the perspective of heterogeneity.

BACKGROUND:Three-dimensional self-assembling peptide nanofiber hydrogel scaffold can simulate the in vivo microenvironment and provide a structural model for cells, which promotes the right composition of extracel ular matrix and cel growth, as wel as improves the cel functions. OBJECTIVE:To review the fundamental research and the experimental study of the self-assembling peptide nanofiber scaffold in the nerve tissue engineering. METHODS:Literatures concerning basic and experimental studies on the self-assembling peptide nanofiber scaffold in the nerve tissue engineering were reviewed via searching PubMed and VIP databases (2000/2013) using the key words of“self-assembling peptide, nanofiber scaffold, RADA16, nerve tissue engineering, neural stem cel . RESULTS AND CONCLUSION:Self-assembling peptide nanofiber scaffold is a novel and ideal tissue engineering material which provides new method for nerve injury repairing, for it not only solves the problem of poor compatibility between the material and cells, but also plays a much more pivotal role in maintaining three-dimensional properties, promoting cel activities and mimicking the extracel ular matrix, which is superior to other materials. However, there stil exist some chal enges in the area of self-assembling peptides, including short-term issues such as integrating of self-assembling peptide with bio-macromolecular material or relatively developed traditional transplant;and long-term issues such as adapting immune system in vivo, treating targets within cells and anticipating the future fate of highly integrated scaffolds.

Cervical cancer was the most common gynecological malignant tumor, and endanger the lives of women. In recent years, research on antioxidant system confirmed that the antioxidant system of defects was closely related with the risk factors of cervical cancer. The lack of antioxidants that generates excessive reactive oxygen species, damaged the cervix cells. Human papilloma virus (HPV) infection was the main pathogenic factor of cervical cancer.Epidemiological studies had shown that including oxidative stress and antioxidant defects may prompt some auxiliary factors of HPV infection were finally for the development of cervical cancer. Because the oxidation has small side effects, safety, etc, so its anti-tumor effect was becoming more and more attention. Recently, on the antioxidant therapy in the treatment of cervical cancer research has made great achievements. This article expounds the antioxidant system defects and relationship between occurrence and development of cervical cancer, also reviewed the antioxidant therapy of cervical cancer research foundation and the latest clinical research.

Objective To investigate the incidence of the common respiratory viruses in children with respiratory tract infection and to compare the results among different ages and to analyze the relationship between wheezing of children and various viruses.Methods Nasopharyngeal secretions of 618 children with respiratory infection hospitalized were assayed for 7 respiratory viruses, including respiratory syncytial virus ,adenovirus, influenza A virus, influenza B virus, parainfluenza virus Ⅰ 、 Ⅱ、 Ⅲ.Results (1) A total of 166 cases, affected with viral etiology,were detected in 618 samples,and the total positive rate was 26.86％.The most common virus was RSV (17.96％), followed by PIV Ⅲ (5.99％), IFA (1.62％), ADV (0.81％), PIV Ⅰ (0.49％).Moreover, 1 case infected with RSV and PIVⅠ was included, with the positive rate 0.16％.(2)The positive rates were different in various ages, with 14d ～ ＜ 1-year 35.04％, 1 ～ ＜ 3-year 18.25％, 3 ～ ＜ 6-year 17.11％ and ≥ 6-year 9.26％.(3) There were differences of positive rate of viruses among different respiratory infectious diseases, and capillary bronchitis occupied the highest percentage(47.37％).(4)Among all the detected children, infants were more likely to whee in auscultation of lung, and RSV was the primary etiology.Conclusion RSV,which was the primary viral etiology in children with wheezing, was the most common virus leading to respiratory infection of children, followed by PIV Ⅲ.In the children with respiratory tract infection, the viral infection tends to occur in younger children.

Graduate education is the maln approach to cultivate advanced medical talents. However, the current clinical research ability tralning for postgraduate students is poor. This article discusses about four possible reasons: the misunderstanding of the medical research, system defects of the endowment of scientific research fund, drawbacks of evaluation criteria, and deficiency of grad-uate student curriculum. In order to improve the clinical research ability of medical graduates, this article also discusses the possible solutions: clarifying the understanding, strengthening policy support, im-proving the evaluation methods, and perfecting the tralning course of the clinical medical research.

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.

OBJECTIVE:To evaluate the effects of compound amino acids capsul es on hypoalbuminemia in patients with chronic renal failure undergoing hemodialysis.METHODS:30hemodialysis patients were selected to orally take2compound amino acids capsules(0.35g per capsule)twice daily for12weeks,renal and liver function and levels of serum albumin and pre-albumin were measured before and after the experiment.RESULTS:The levels of serum albumin and pre-albumin were increased significantly after the treatment,it were(30.5?4.6)g/L vs(35.9?7.1)g/L,and(213.0?46.9)mg/L vs(275.8?52.3)mg/L respectively(P

Through all times and around the world,those who discipline themselves with high ethical standards can be regarded as truly noble men successfully taking advantage of moral authority of the people.Books on the art of war in ancient China raised a couple of ethical requirements for those superior military officers and governors.If officers want to affect his men′s mental state and generate the army′s spirit of combat effectiveness,they must assume a certain degree of ethical responsibility.Also,active share of ethical responsibility calls to take the initiative to develop a sense of ethical responsibility.Furthermore,to develop a sense of ethical responsibility calls for the building of ethical self-consciousness to participate in the training of ethical responsibility.However,the participation of ethical building consciousness can not be separated from the ethical sense of responsibility.In conclusion,each part of the three links,complementing each other,can not be biased and separated.