Objective An initial study on the cognition of the relationship between clinical and management staff for the purpose of improvements. Methods Questionnaires were issued to 38 clinical medical staff and 26 hospital management staff, regarding this relationship. Results Consensus is found between the two groups regarding clinical involvement in management, teamwork and exchange, and cognition on the competence and capability of the other party, P>0.05. On the other hand, however,cognitive differences are found regarding mutual penetration, power balance and implementation of policies and systems. Conclusions In-depth cooperation and understanding between the two groups and the mutual conversion of their behaviors and concepts are the cornerstones of an ideal relationship between clinical staff and management staff.

Aquaporins (AQP) are membrane channel proteins which facilitate water transport through cell membranes.AQP4 is abundantly expressed in brain which is located in endfeet of astrocytes adjacent to capillaries,neurons,and neuronal synapses.It has also been identified in neurons of the supraoptic and paraventricular nuclei of the hypothalamus.AQP are closely related to many central nervous system diseases.Researches have showed that AQP4 participates in regulating and controling process of cerebral edema that caused by brain trauma,cerebral ischemia,intracranial infection and mmour,etc.AQP4 antibody is specific biological markers in serum of patients with neuromyelitis,which helps diagnosis of neuromyelitis optica and multiple sclerosis,predicting prognosis and therapy of neuromyelitis optica.AQP4 has been shown to play roles in pathological and physiological process of neurodegenerative diseases,epilepsy,migraine.This article aims to review the distribution,function,influential factors of AQP4 and research development of AQP4 in common diseases of the central nervous system.

Gene chip technology is a large amount of information,simple operation,fast speed of the nucleic acid sequence determination and quantitative analysis technique.The advantages of this technology include high integration and high content of micromation,parallelism,diversification and automatization.Currently,gene chip technology is increasingly being used in clinic,including disease diagnosis,treatment guidelines and prognosis.The progresses of the diagnosis of the gene chip technology in unexplained mental retardation are summarized in this paper.

Dendritic spines are functional protrusions on neuron dendrites and formation of excitatory synaptic sites.Dendritic spines contain a variety of cell surface receptors,actin cytoskeleton,scaffolding proteins and other components,which regulate the growth of dendritic spines maturation and structure.Multiple components within dendritic spines not only have effects on expression of its shape and structure,but also on the function.Morphology of dendritic spines is closely related with its function.Its shape is affected by many factors in the changing process.So dendritic spine plasticity is an important aspect of synaptic function in the central nervous system,and is closely related with learning and memory function and central nervous system diseases.

ObjectiveTo discuss the infiuence of personalized nursing intervention on success rate of holding breathing in patients undergoing dual-source CT imaging.Methods167 cases of patients were randomly divided into the observation group(100 cases)and the control group(67 cases). The control group implemented routine care, on the basis of routine care, the observation group was given pertinent and individualized nursing intervemion according to the factors causing failure of holding breathing, including better psychological counseling for patients, the right guidance, to alleviate symptoms, to improve comfort degree, to give clinical evaluation after inspection, et al.ResultsThe success rate of holding breathing in the observation group and the control group was 99.0％ and 88.1％, the observation group was significantly higher than the control group.ConclusionsHealth education for patients, attention to patients' illness, mental state, cognitive and behavioral changes in a timely manner to give individualized nursing intervention and seriously check the implementation of results in patients, can effectively improve the success rate of holding breathing in patients undergoing dual-source CT coronary angiography.

ObjectiveTo obtain data related to various periods of acupuncture treatment for rat focal ischemia and reperfusion and infer the optimal time point of acupuncture treatment by examining cerebral ROCK expression on the ischemic side in different periods of acupuncture for rats with focal ischemia and reperfusion.MethodOne hundred andeighty male adult Wistar rats were enrolled and randomly allocated to blank, sham operation, model and acupuncture groups. The model and acupuncture groups were separately divided into 5 subgroups: the 6 h, 24 h, 48 h, 72 h and 2 w subgroups. There were atotal of 12 groups, 15 rats each. An animal model of focal cerebral ischemia was made using a thread occlusion method for obstructing rat right middle cerebral artery. The carotid artery was only separated in the sham operation. Materials were taken in the blank and sham operation groups on day 2 after model making. Materials were taken for examination in every subgroup of the model group at 6, 24, 48 and 72 hours and 2 weeks after model making. Materials were taken for examination after acupuncture at Baihui(GV20), Dazhui(GV14)and Zusanli (ST36)in every subgroup of the acupuncture group at 6, 24, 48 and 72 hours and 2 weeks after model making.ResultAcupuncture markedly improved neurological deficits in rats with cerebral ischemia and reperfusion. Areduction in the neurological deficit score was largest in the 6 h acupuncture group and there was a statistically significant difference compared with the other acupuncture groups (24 h, 48 h and 72 h) (P<0.05). There was no statistically significant difference in ROCK expression between the sham operation and blank groups (P>0.05). There was a statistically significant difference in ROCK expression between the model (ischemia-reperfusion 6 h, 24 h, 48 h and 72 h) and blank groups (P<0.05). ROCK expressionreached the peak value at 6 hours after ischemia and reperfusion. There was a statistically significant point-to-point difference in ROCK expression between the acupuncture (ischemia-reperfusion 6 h, 24 h, 48 h and 72 h) and model (ischemia-reperfusion 6h, 24 h, 48 h and 72 h) groups (P<0.05). ROCK expression was down-regulated most markedly in the ischemia-reperfusion 6 h acupuncture group.Conclusion Acupuncture has an inhibitory effect on Rho/Rock in a rat model of cerebral ischemia and reperfusion. Six hours after ischemia and reperfusion is the optimal time point of acupuncture treatment. Acupuncture at that time can protect and improve post-ischemic injured brain tissue to the largest extent.

“Expert consensus for the diagnosis and management of septic shock( infectious shock) in children (2015)” has been published based on the “Recommended protocol for diagnosis and treatment of septic shock in children” which was published in 2006.The definition, diagnosis and early management pro-t ocol of pediatric septic shock was revised partly in the latest expert consensus.The goal of the expert consen-sus was to guide the clinical physicians on early identification and early intervention of pediatric septic shock, and reduce mortality and improve prognosis of septic shock in children.

BACKGROUND:There is a close relationship between tumor stem cels and tumor occurrence and recurrence, but there are stil some disputes in the presence of tumor stem cels in al tumors.
OBJECTIVE:To investigate the differentiation and culture of tumor stem cels in human primary gastric cancer cels.
METHODS:Primary gastric cancer cels isolated from fresh gastric cancer tissues were stained with hematoxylin-eosin and identified by immunohistochemical detection of carcinoembryonic antigen. The CD44 expression of the cels was detected using immunofluorescence method. Magnetic activated cel sorting was used to isolate CD44+gastric cancer cels that were then seeded subcutaneously behind the armpit of mice. Growth of implanted tumor cels was observed.
RESULTS AND CONCLUSION:Human primary gastric cancer cels were isolated in serum-free medium. Compared with the routine culture group, the number of CD44+cels(P< 0.05)and the tumor volumewere significantly increased in the spheroid culture group. Furthermore, at 90 days after transplantation, the tumor volume of mice in spheroid culture group was significantly higher than that in the routine culture group. These experimental findings indicate that gastric cancer cels with certain tumorigenicity can be successfuly isolated from gastric cancer cels using serum-free culture method and magnetic activated cel sorting method.

Invasive aspergillosis (IA) is a major cause of morbidity and mortality in immunocompromised children.The purpose of the review was to provide epidemiological,clinical aspects,diagnosis and antifungal treatment options in the pediatric population.Diagnosis of IA remains a challenge as the clinical and imaging manifestations are not specific,and a histological diagnosis is often unfeasible,and blood culture shows low sensitivity rates.In recent years,great progress has been made in the detection of fungal biomarkers,which is mainly described in this paper.

With the development of income per capita,"high personal medical expenditure" shows the wider of disease risk,which is resulted from the increasing medical payment and imperfect risk pooling.The former that is related with the excess delivery of advance medical technology and drug has been a dominating reason since 1980.And the imperfect risk pooling means the imperfect social medical insurance,of which the government should take charge.However,influenced by the reform policies of the economic systems,similar to all the transitional economies reducing the government role in healthcare financing,China has put an increasing emphasis on the payroll tax-based social insurance system and out-pockets payment,moving away from a predominantly general revenue-based financing system under the old command economy.In a conclusion,the Chinese Government should make clear the financing function,and replace fee-for-service(FFS) payment according to the distorted pricing system with aggregated pre-payment for patients covered by social insurance to mitigate the incentive for cost escalation.Meanwhile,the target of the new medical reform that should resolve the problem of high personal medical expenditure is demanding and perfecting the social medical insurance with wider risk pooling.