Objective To know the current status and problems of Traditional Chinese Medicine Clinic and to provide countermeasures.Methods Using literature research and statistical analysis.Results From 2008 to 2014,the number of institutions,health personnel and services of Traditional Chinese Medicine Clinic rose year by year.The Traditional Chinese Medicine Clinic was ahead of TCM-WM Clinic and Minority Clinic.The increase number and increase rate of the number of Traditional Chinese Medicine institutions,health personnel and services are more than TCM-WM Clinic and Minority Clinic.The age constitute is unbalance and the quality of personnel is different in Traditional Chinese Medicine Clinic.Conclusion The government should conduct multi-site practice.Traditional Chinese medicine clinics and other private medical institutions should have the equitable health care treatment.The development in preventive treatment of disease by TCM should be focused on.

BACKGROUND:microRNA-17 is confirmed to play an important role in the development of pulmonary hypertension. Some research has shown that hypoxia-induced proliferation in human pulmonary artery smooth muscle celldepends on the induction of arginase II. There is no report about whether there is some interaction between microRNA-17 and arginase II in human pulmonary artery smooth muscle cells.
OBJECTIVE:To investigate the possible interactions between microRNA-17 and arginase II in hypoxic human pulmonary artery smooth muscle cells.
METHODS:Passage 4 human pulmonary artery smooth muscle cells were cultured in 21%O 2 and 5%CO 2 (normoxia) or 1%O 2 and 5%CO 2 (hypoxia), and then transfected with mimic or inhibitor of microRNA-17 or arginase II-smal interfering RNA. RNA, microRNA and protein were isolated separately. Expression of microRNA-17 and arginase II was detected with real-time quantitative PCR and western blot assay. RESULTS AND CONCLUSION:The level of microRNA-17 was significantly increased in cultured human pulmonary artery smooth muscle cells exposed to 1%O 2 hypoxia, as was arginase II mRNA and protein expression. Furthermore, inhibition of microRNA-17 expression decreased the mRNA and protein levels of arginase II in the human pulmonary artery smooth muscle cells under hypoxia. Conversely, over-expression of microRNA-17 increased the mRNA and protein levels of arginase II in the human pulmonary artery smooth muscle cells under normoxia and hypoxia. Knockdown of arginase II by siRNA abolished the hypoxia-induced up-regulation of microRNA-17 expression. These findings indicate that arginase II is a target gene of microRNA-17 and can regulate the expression of microRNA-17 in human pulmonary artery smooth muscle cells.

Objective To study the effect of various treatments for the Budd-Chiari syndrome (BCS). Methods The clinical data of different treatments in 260 BCS patients were analysed retrospectively. Results Of the 260 patients,273times of BCS underwent interventional treatment?operative treatment or the combination of operation and interventional therapy, including percutaneous transluminal angioplasty(PTA) or/and stenting of the inferior vena cava(IVC)in 149 cases (160 times), percutaneous transhepatic angioplasty or/and stenting of the hepatic venous in 15 cases (17 times ),the combination of the two methods in 10 cases,radical resection in room temperature in 8 cases, mesocaval shunt in 16 cases,mesojugular shunt in 5 cases,mesoatriumr shunt in 8 cases,IVC-atrium shunt in 6 cases,splenopneumoexy in 18 cases, mesocaval shunt combined with PTA and stenting of the IVC in 17 cases, and transcardic membranotomy combined with PTA and stenting of the IVC in 8 cases . Two patients died in the operation:One died of cardiac tamponade,and the another died of operrative hemorrhagic shock.During the follow-up period of 3 months～6 years,20 patients recurred,of whom 7 died of hepatic failure,the other patients recovered satisfacorily. Conclusions The interventional treatment is the first choice for BCS.For patients unable to get interventional treatments or failure for interventional treatments, operation or operation combined with interventional therapy should be considered.

Objective:To explain the mechanism of benefiting qi and activating blood formula on chronic heart failure (CHF)by observing the signal transduction through the medium of AngⅡ,PKC in rat myocardium.Methods:Healthy male SD rats were selected and CHF model were made by ligation of coronary artery combined with starvation and exhausted swimming. Successful model rats were randomly divided into 4 groups:model group,Chinese medicine high dose group,Chinese medicine middle dose group,west medicine control group,each group with 8 rats.In addition,normal control group was set.After 8 weeks, the content of AngII,PKC in myocardial tissue was tested by ABC immunohistochemical method,and the ultrastructural changes of myocardial cell were observed with transmission electronic microscopy.Results:Compared with normal control group,heart function decreased obviously(P

Objective To investigate whether the accelerator image beam line (IBL) full scan and extend field of view(EFOV) scan mode megavoltage cone beam CT(MV CBCT) images can be used for dose calculation in adaptive radiotherapy.Methods The large aperture CT and MV CBCT were used to scan the CIRS 062M electron density modules,the CT value was established to electron density curves in the Pinnacle treatment planning system.Also,CT and MV CBCT were used to scan the head and neck,chest,abdomen and pelvis phantom.The intensity modulated radiotherapy(IMRT) plans were made with CT images and transplanted to MV CBCT images.The dose of targets and organs with their electron density curves was calculated,and two type IMRT plans with different CT images were compared.Results The dose distribution of head and neck phantom was acceptable,compared with the reference plan,the difference was within 3 ％.The dose distribution of chest and.pelvis was significantly reduced from reference plans,and the difference was 5％ and 10％ separately.This difference was beyond the scope of clinical acceptance.Conclusions MV CBCT images of accelerator IBL full scan mode in patients with head and neck site scan could be used for dose calculation in adaptive radiotherapy,chest and pelvic sites in EFOV mode scanning MV CBCT images could only be used for image guidance.

Objective To determine the peripheral dose ( PD) of a Trilogy accelerator under different conditions and the feasibility of PD measurement using the semiconductor diode ionization chamber. Methods In a solid water phantom, a CC13 air?filled ionization chamber and a semiconductor diode ionization chamber were used for PD measurements with different distances (13 measurement locations within 1?31 cm) , depth ( 3, 5, 15 cm) , field sizes ( 10, 20, 30 cm) , wedge ( W15, W45, VW15, VW45) , and beam energy (6, 18 MV). The relationship of PD with PDleakage and PDscat er was determined by removing the scatter phantom. Simulating the patients with cervical cancer undergoing radiotherapy, a CIRS phantom received volumetric modulated arc therapy ( VMAT) , step?shoot intensity?modulated radiotherapy ( IMRT) , and sliding?window IMRT to measure PDs of the breast, thyroid, and lens. All the data were normalized to the isocenter. Results PD was gradually reduced with the increase in distance ( 13?41% at 1 cm from the edge to 0?25% at 31 cm from the edge) . With a fixed distance from the edge of the radiation field, there was no significant difference in PD between different depths. A radiation field with a size of 30 cm had a PD about two?fold higher than that with a size of 10 cm. PD increased with the increase in the physical wedge angle and increased by 1% compared with the open field;PD decreased with the increase in the virtual wedge angle and decreased by 2?3% compared with the open field. PD decayed from 13?35% at 1 cm to 0?23% at 31 cm under 6 MV X?ray and from 11?06% at 1 cm to 0?20% at 31 cm under 18 MV X?ray. Dscat er was dominant in the regions close to the edge of radiation field and decreased from 62?45% at 1 cm to 5?71% at 25 cm. In all measurements under 6 MV X?ray, the maximum proportion difference between CC13 ionization chamber and diode ionization chamber was less than 1%. PDs of the breast, thyroid, and lens were 6?72, 2?90, and 2?37 mGy in VMAT mode, 7?39, 4?05, and 2?48 mGy in step?shoot IMRT mode, and 9?17, 4?61, and 3?21 mGy in sliding?window IMRT mode, respectively. Conclusions For the measurement of PDs, the CC13 air?filled ionization chamber and semiconductor diode ionization chamber have good consistency and feasibility under 6 MV X?ray. In clinical practice, the understanding of the relationship of PD with different radiation conditions helps to reduce the doses to organs at risk. Shielding and protective techniques can further reduce dose deposition.

Objective? To understand the research status, research hotspots and development trend of compassion fatigue with the bibliometric analysis on compassion fatigue related literatures in China so as to provide a reference for future research and development. Methods? We retrieved compassion fatigue related literatures of our country published in China National Knowledge Infrastructure (CNKI), WanFang data, Chinese Biomedical Database (CBM), VIP, Web of Science and PubMed from January 2008 to July 2018. The included literatures were multidimensionally analyzed with the bibliometric analysis and social network analysis. SPSS 22.0 was used to data statistical treatment. Results? Finally a total of 143 literatures were included with 138 Chinese literatures. The volume of literatures showed a tendency to increase year by year. There were 120 journal articles and 9 (6.3%) of them were published in Chinese Journal of Modern Nursing with the most publications. Ranked by the areas of the first author, a total of 96 (67.1%) literatures were published in the top 10 areas and 16 (11.2%) literatures were published in Hubei Province with the most publications. The rate of coauthor was 85.3% with 3 for the cooperation degree and core authors were 20. There were 31 literatures funded by research fund with 21.7% for the ratio of fund-sponsored articles. The number of quotations were 2106 with 17.6% for the rate of quotation each article. Research type focused on investigations and interviews with 106 articles accounting for 74.1%. A total of 4 key words were with word frequency equal to or greater than 14 including compassion fatigue, nurses, empathy fatigue and influencing factors. Conclusions? Researches on compassion fatigue of our country are in a development stage. We should expand the breadth and depth of the researches, increase the investment of research fund, strengthen cooperation among institutions and promote the establishment of professional core team so as to promote the development of researches on compassion fatigue of our country.

ObjectiveTo systematically review the current status of frailty and its influencing factors in elderly hypertension patients. MethodsArticles about the incidence and influencing factors of frailty in elderly hypertensive patients were retrieved from the established date of databases to 31st, December of 2018 in electronic databases such as Cochrane Library, PubMed, EMbase, Web of Science , CBM , CNKI , VIP and Wanfang database and then RevMan5.3 statistic software was used in meta analysis. ResultsTotally 16 articles were included involving 14 cross-sectional studies, 2 cohort studies, and 11 799 elderly hypertensive patients. Meta-analysis result indicated that, between-study heterogeneity detected was significant(I2=99%,P＜0.01), the pooled incidence based on random-effect model was 32%(95%CI:21%,43%). The main influencing factors of frailty in elderly hypertensive patients were age [OR=1.32,(95%CI:1.09,1.59)], abnormal BMI [OR=0.84, (95%CI:0.28,2.54)], educational level [OR=4.48,(95%CI:1.59,12.63)], comorbidity of diabetes [OR=1.84, (95%CI:1.27,2.67)]and polypharmacy[OR=4.09,(95%CI:0.28,60.06)]. ConclusionsThere is a high incidence of frailty in elderly hypertensive patients led by a variety of causes. However, the majority of studies included were cross-sectional studies and the number was limited with not enough argument, more researches with high quality are needed to evaluate the result.

Objective To compare the relative dose of small fields measured by clinically common detectors and those obtained from Monte Carlo simulation in order to obtain the accurate measurement method, and to modify the inappropriate detectors.Methods The percentage depth-dose distribution curve and profile (flatness and symmetry) curves were collected at 2 cm×2 cm, 3 cm×3 cm, and 4 cm×4 cm under 6-MV X-ray of Trilogy linear accelerator by CC13, PFD, SFD, and blue phantom.The results were compared with the stimulation results from Monte Carlo method (the current gold standard).The correction factors for the detectors with large error were calculated to provide reference data for clinical practice.Results The results measured by SFD detector were most close to the results from Monte Carlo simulation.The measurement errors of CC13 and PFD detectors were large.The correction factor in the penumbra for CC13 and PFD detector was 0.664-1.499.Conclusions SFD detector is better than CC13 and PFD detector in the measurement of small fields, but CC13 and PFD detector can provide reference data for clinical practice after the corresponding correction.

Objective:To explore the relationship between somatic symptoms of major depressive disorder(MDD)and cortisol(COR) rhythm, C-reactive protein(CRP) and other immune-metabolism-related indicators, and understand its mechanism from the perspective of endocrine and immune regulation.Methods:A case-control study was conducted in hospitalized patients with MDD who met DSM-5 diagnostic criteria.According to the Patient Health Questionnaire (PHQ-15), PHQ-15 ≥10 were classified as the somatic major depressive disorder group(S-MDD group) and 73 patients were enrolled.PHQ-15 <5 was classified as the non-somatic depressive disorder group (NS-MDD group) and 70 patients were enrolled.Plasma cortisol (COR8, COR16 and COR24) levels were measured at 8∶00, 16∶00 and 24∶00 on the same day, plasma CRP and interleukin-6 (IL-6) level, serum uric acid (UA), blood glucose (GLU), blood lipid (TC, TG, HDL, LDL) level were detected at 8∶00.Independent sample t test, non-parametric test, chi-square test, repeated ANOVA, covariance analysis, and multivariate Logistic regression were used for statistical analysis. Results:①Time effect, grouping effect and the interaction effect of the time and grouping in the level of COR were statistically significant ( P<0.05). Covariance analysis excluded age as an influential factor, COR16, AUC(total cortisol output/area under the curve, AUC) and COR8-16 in S-MDD group ((90.50±40.57)μg/L, (1 425.12±564.78), (-6.43±5.76))were higher than those in NS-MDD group((68.74±31.51)μg/L, (1 251.57±456.61), (-8.77±5.48)), and the difference was statistically significant ( F=8.971, 4.320, 8.731, P<0.05). ②CRP in S-MDD group ((1.41±1.06)mg/L) were higher than that in NS-MDD group((0.61±0.53)mg/L), and the difference was statistically significant ( F=25.436, P<0.05). The proportion of patients with higher CRP level(CRP≥1 mg/L) in S-MDD group(58%) was higher than that in NS-MDD group(23%), and the difference was statistically significant(χ 2=17.824, P<0.01). ③Multivariate logistic regression analysis found that CRP ( OR=4.953, 95% CI: 2.407-10.193), COR8-16 ( OR=3.451, 95% CI: 1.380-8.633) were main risk factors of somatic symptoms of MDD ( P<0.05). Conclusion:Cortisol rhythm disturbance and high CRP level may be the biological basis of somatic symptoms in patients with MDD.