Objective To evaluate the prognostic significance of metastastic lymph node ratio in patients with gastric cancer. Methods Clinical data of 319 patients with gastric cancer who underwent radical gastrectomy with at least 15 lymph nodes dissected per patient were analyzed retrospectively. Patients were divided into 4 groups according to the TNM staging system (1997,5th edition): pN0 (no positive lymph node), pN1(with 1～6 metastatic lymph nodes), pN2 group (with 7～15 metastatic lymph nodes), and pN3 group (with more than 15 metastatic lymph nodes), or into 4 groups according to the lymph node metastatic ratio: rN0 group (without metastasis of lymph node), rN1 group (with a lymph node metastatic ratio of <30%), rN2 group (with a lymph node metastatic ratio of 30%～60%), and rN3 group ( with a lymph node metastatic ratio of >60%). Survival was determined by the Kaplan-Meier method and differences were assessed by the Log-rank test. Multivariate analysis was performed using the COX proportional hazard regression model in forward stepwise regression with SPSS 13.0. Results Kaplan-Meier survival analysis demonstrated that the metastatic lymph node ratio significantly influenced the postoperative survival time. According to the lymph node metastasis system 77 patients were in group 1, 109in group 2, 60 in group 3, and 73 in group 4. The 2-year survival rate was 84.4%,66.1%, 35.0%,and 15.1% respectively, 3-year survival rate was 80.5%,45.0%,15.0% and 5.5% respectively, and 4-year survival rate was 71.4%,33.0%,5.0% and 1.4% respectively. If cases with the same positive number of lymph node (pN) group were stratified futher by lymph node metastatic ratio, there were no significant differences in the 3-year survival rate among the new rN groups (P>0.05), but there was a great difference in the distribution of prognosis among different groups. COX proportional hazard regression model analysis showed that the metastatic lymph node ratio was an independent factor for poor prognosis. Lymph node metastatic ratio was closely related with the location, modality of the operation and infiltration depth. Conclusions The staging system based on metastatic lymph node ratio is more reliable than the system based on the number of metastatic lymph nodes in the prediction of the prognosis of gastric cancer.

Tooth bleaching has become a routine way of treating tooth staining. It is necessary to teach tooth bleaching in undergraduate education of Stomatology. The possibility of teaching bleaching was explored in our school and the teaching effects were assessed by questionnaires to undergraduate students of Stomatology in 2005 and 2006 degree after class. The outcomes indicated that a teaching mode of “3+3+2” made a positive effect on the teaching of tooth bleaching, combining with multimedia teaching,problem-based learning and bilingual teaching. The present article summed up the experience of teaching tooth whitening in undergraduate education of Stomatology and gave some advice for improving the quality of teaching.

Objective To investigate the level and influencing factors of self-efficacy among nurses with needlestick injuries and explore effective strategies to improve self-efficacy.Methods 713 clinical nurses with needlestick injuries had been enrolled by convenience and stratified sampling method to comphte the investigation using the self-designed demographic questionnaire and General Self-Efficacy Scale.Results The average score of the self-efficacy was (2.70 ±0.52) points.69.1％ of the needlestick injury nurses had the sclf-efficacy score at the middle level; only 19.1％ of them had a higher level score on self-efficacy.Gender,title,section,initiative report,work environment,and occupational safety training were identified as the influencing factors of the self-efficiency.Conclusions Even though more than half of the nurses with needlestick injuries had a middle level self-efficacy,they need further improvement.Other influencing factors should be explored in future in order to develop the corresponding management intervention which can strengthen the self-efficacy of nurses with needlestick injuries.

Objective To study the inhibitory effect of panax notoginseng saponins (PNS) on 3-nitrotyrosine (3-NT) formation in brain induced by heme/NO2 -/H2O2 or ONOO - pathways in vitro. Methods According to the two major pathways of 3-NT formation in vivo, the models of protein nitration induced by heme/NaNO2/H2O2 or ONOO-system were established, respectively, in vitro. Bovine serum albumin (BSA)/rat plasma protein or rat brain homogenate protein were utilized as reactive substrates in both systems. Samples were divided into blank-control group, 3-NT group and PNS group (including low-, medium-and high-concentration subgroups). In 3-NT group, samples were exposed to heme/NaNO2/H2O2 or ONOO-system, respectively, at 37℃for 30 min, whereas in PNS group, samples were pre-incubated with PNS (at final concentrations of 50 mg/L, 100 mg/L, and 200 mg/L) at 37℃for 5 min before the nitrating system exposure. The 3-NT level in each group was detected by Western blot assy. Results Compared with the blank-control group, both heme/NaNO2/H2O2 and ONOO-system can induce significant 3-NT generation in BSA/rat plasma protein or rat brain homogenate protein (P<0.05). Compared with model group, PNS pre-treatment markedly inhibited 3-NT expression in BSA/rat plasma protein in a dose-dependent manner (P<0.05), the inhibitory effect of low intervention on the level of 3-NT in rat brain homogenate protein was not significant (P>0.05). Medium- and high-concentrations of PNS pre-treatment markedly inhibited 3-NT accumulation, with maximum effect at the concentration of 200 mg/L (P<0.05). Conclusion Medium- and high-concentrations of PNS can inhibit 3-NT formation in brain tissue mediated by either heme/NO2-/H2O2 or ONOO-pathways, implying that potential neuroprotective action against 3-NT involves pathological conditions, like trauma, stroke, and neurodegenerative diseases.

Objective To investigate the effects of transcutaneous electro acupuncture stimulation (TEA) on esophageal motility of patients with refractory gastroesophageal reflux disease (RGERD) by high resolution manometry (HRM),and to provide a new treatment option for RGERD.Methods From February 2014 to June 2015,a total of 45 patients with RGERD were enrolled.TEA instrument was used for electro acupuncture stimulation at the points of Zusanli and Neiguan.HRM was carried out before and after treatment.The changes of HRM parameters such as lower esophageal sphincter pressure (LESP),distal contractile integral (DCI),and amplitude of 3 cm,7 cm above lower esophageal sphincter (LES),esophageal body velocity and contractile front velocity (CFV) were also compared.The paired-samples t test was performed for statistical analysis.Results According to LESP value,45 patients were divided into low LESP group (10 patients) and normal LESP group (35 patients).According to parameter of esophageal motility function,patients were divided into esophageal dysmotility group (25 patients) and normal esophageal motility group (20 patients).After TEA treatment,the LESP of lower LESP group was (14.83± 4.17) mmHg (1 mmHg =0.133 kPa),which was higher than that before treatment ((9.54 ±2.42) mmHg),and the difference was statistically significant (t=4.92,P=0.001).LESP of esophageal dysmotility group was (19.04±5.91) mmHg,which was higher than that before treatment ((16.20±6.09) mmHg),and the difference was statistically significant (t=4.92,P=0.001).There was no statistically significant difference in LESP of normal LESP group and normal esophageal motility group before and after treatment (both P＞0.05).After treatment,DCI of esophageal dysmotility group was (530.76±215.53) mmHg· cm· s,which was higher than that before treatment ((363.92 ± 279.17) mmHg · cm · s),and the difference was statistically significant (t=2.86,P＜0.05).There was no statistically significant difference in esophageal body velocity,amplitude of 3 cm,7 cm above LES andCFV before and after treatment (all P＞0.05).There was no statistically significant difference in all of the esophageal motility parameters in normal esophageal motility group before and after treatment (all P＞0.05).Conclusion TEA can increase LESP and DCI in RGERD patients with esophageal motility dysfunction,improve contraction of entire esophagus and raise esophageal clearance capacity.

Objective:To investigate the effect of compound Sanggou granules on the activity of Fib, AT-Ⅲ, t-PA, PAI-1 and t-PA/ PAI-1 in hyperlipidemic rats. Methods: The hyperlipidemic rat model was established by feeding high fat diet to SD male rats. Sixty healthy SD rats were randomly divided into five groups: the normal diet control group, high fat control group, high dose drug group, low dose drug group and fluvastatin sodium group. Four weeks after the administration, the blood samples were withdrawn for the determination of the levels of blood lipid, Fib, A-Ⅲ, t-PA, PAI-1 and t-PA/ PAI-1. Results:Compared with those of the normal diet control group, the levels of TC, LDL-C, Fib and PAI-1 were increased and the levels of HDL-C, t-PA , AT-Ⅲand t-PA/ PAI-1 were decreased significantly (P<0. 01) in the high fat control group. Compared with those of the high fat control group, the levels of TC, LDL-C, PAI-1 and Fib were decreased(P<0. 01 or P<0. 05),and the levels of HDL-C, t-PA AT-Ⅲ and t-PA/PAI-1 were in-creased significantly in the high dose drug group (P<0. 05 or P<0. 01). The similar effects were shown in the fluvastatin sodium group with the stability of AT-Ⅲ. The levels of TC, LDL-C and PAI-1 were decreased and the levels of t-PA/PAI-1 were increased no-tably in the low dose drug group. Conclusion: Compound Sanggou granules exhibit hypolipidemic effect in hyperlipidemic rats, and can improve hypercoagulability and enhance anticoagulation and fibrinolytic activity in hyperlipidemic rats. Furthermore, compound Sanggou granules at high dose show the same effect as fluvastatin sodium, even in anticoagulation, the granules are superior to fluvasta-tin sodium.

Objective To study the effect of selective COX-2 inhibitor NS398 on IL-10 and IFN-γexpression in human keratinocytes induced by UVA,and further to explore the effect on anti human skin photoaging.Methods HaCaT cells were divided into three groups:simple UV exposure group,NS398-intervene group and blank group.For UV radiation,simple UV exposure group and NS398-intervene group were irradiated with UVA at a dose of 30 J/cm2.In order to assess the effect of NS398,HaCat cells were treated with NS398 at the dose of 0,20,40,80μmol/L respectively and then incubated without irradiation for 2h,substrate changed and cultured for 24h,and then the expression of IL-10 and IFN-γ mRNA was detected via RT-PCR.Results Simple UV exposure group had obviously higher expression of IL-10 mRNA and lower expression of IFN-γ mRNA than that of control group,while NS398-intervened group had significantly lower expression of IL-10 mRNA and higher expression of IFN-γ mRNA than that of simple UV exposure group,and dose-dependency existed.Conclusions NS398 may delay photo-damage of human skin via inhibiting the expression of IL-10 mRNA and up-regulating the expression of IFN-γ mRNA in human keractinocytes.

An indexing system is constructed,based on the implementation of prevention and control technology for chronic non-communicable diseases in community health service institutions,using both literature review and Delphi method,and using the Analytic Hierarchy Process (AHP) to calculate the weight of the indexing system.The system comprises three level-1 indexes,8 level-2 indexes and 33 level-3 indexes.The research proposed a transition from emphasis of therapeutic means to prevention,and emphasis on prevention and control technologies to the high-risk population in the prevention and control technology of chronic non-communicable diseases,along with development of techniques and measures to encourage behavioral changes of the population with chronic diseases.

AimTo find out the comprehensive strength and trends in scientific research area,and to provide foundation for decision-making on pushing the paediatric research forward,we reviewed the achievements of the scientific papers publication and the professional background of the authors between 2001 and 2010. Methods We extracted data and described the distribution characteristics of the paper publication amount,degree in the 10 years,as well as age,construction of professional and technical title,the education qualification of the authors. Moreover,we statistically analyzed the variability of the publication conditions within statistical source journals among the authors with different technical title.ResultsThe amount of paper publication increased anually in the 10 years,but with few published in statistical source journals,and the core authors group have not formed yet.Meanwhile,the general internal medicine maintained the dominant propotion.Authors aged 30 -50 years old,with middle technical title and with bachelor degree published the majority of the papers.The propotion of the papers published in statistical source journals and in the Zhonghua series medical journals were significantly higher in authors with master degree and above.ConclusionsIn order to construct a stable core authors group and increase the amount of the paper publication,we should continue to encourage those author groups with high output rate and make greater support on the potential authors.Furthermore,we must take more effort on impoving publication quality in the future.

OBJECTIVE:To analyze the features of risperidone-induced leucocytopenia ADR.METHODS:Twenty-one ADR cases of risperidone-induced leucocytopenia reported by our hospital were collected and analyzed during 2004-2015.The characteris tics of risperidone-induced leucocytopenia were discussed.RESULTS:Among 21 patients,there were 10 male and 11 female.The age was from 15 to 72 years old.Nine cases of patients were 31-40 years old (42.9％).Most of the original disease was schizophre nia.Incubation period of leucocytopenia caused by risperidone was (28.6 ± 21.4) d.Patients had no discomfort complain when leucocytopenia occurred.The lowest white blood cells reported was(3.1 ± 0.5)× 109 L-1.The leucocytopenia were improved after reduc tion,drug withdrawal and symptomatic treatment.CONCLUSIONS:Patients usually have no body discomfort complain when risperidone-induced leucocytopenia appears.Doctors should moniter ADR regularly,identify it earlier and treat carefully.