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.

Establishment of depressive animal model is the premise for evaluating the effect and mechanism of traditional Chinese medicine on depression. Many traditional Chinese medicines for depressive treatment in a mouse model of experimental studies have demonstrated a sound antidepressant effect, indicating that traditional Chinese medicine treats depression effectively. Therefore, more and more attentions have been paid in recent years. My article made a summary on depressive animal models of experiment study.

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.

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.

Cardiac arrest (CA) is an acute critical illness with the high occurrence in the world. The directions of cardiopulmonary resuscitation (CPR) development are to improve CA patients' survival rate and to decrease the poor prognosis. β-blockers can selectively block the neurotransmitter or receptor agonists. They offer beneficial pharmacological properties and have been widely used in the treatment of cardiovascular diseases. Based on the search result of the domestic and foreign medical databases, the usage of β-blockers including clinical research, animal experiments and clinical work of CPR patients was summarized. Finally, the CPR research progress of β-blockers in recent years was reviewed in the article.

Objective To investigate the methods for the detection of serum samples with low-concentration HBsAg and its clin-ical value.Methods Serum samples with HBsAg weak positive were measured by ELISA or using Roch cobas e601 were collected from the clinical laboratory.The samples with low-concentration HBsAg were confirmed by neutralization assay by using Lizhu ELISA reagent Kit or Roch cobas e601 analyzer.at the same time,ALT/AST concentrations and HBV DNA copies were also deter-mined.Results Among 53 samples that showed weak positive reaction by using Kehua reagent kit,37 samples were positive in neu-tralization test,while the other 16 samples were negative.Among 18 samples that showed weak positive reaction tested by using Roch cobas e601 analyzer,13 samples showed positive in neutralization test,and the other 5 samples showed negative.Conclusion The results of HBsAg test varies in different detection System.The clinical significance of samples with low-concentration HBsAg needs further study.