Skin toxicities are the most common adverse effects of epidermal growth factor receptor inhibitors(EGFRI).It can result in significant physical and psyehological discomfort,and even leads to interruption or dose modification,and consequently affect the curative effect. Nowadays this adverse effect has attracted lot of attention.It is proposed that clinical management and treatment measures for skin toxicities should be further studied to improve the patients life quality,and guarantee the continuity and best curative effect of the treatment.But more researches on the pathogenesis and its prognostic significance are still expected.

Ceramide (Cer),as the center molecular of sphingolipids metabolism,functions as a bioactive mediator of different cellular processes,such as cell growth,differentiation,senescence and apoptosis,besides being structural component of cellular membrane.It can inhibit cell proliferation and promote cell apoptosis via multiple signal pathawys.Chemicals anti-cancer properties based on Cer metabolism that upregulate its level are confirmed in plenty of experimental researches,and parts of research productions are applied in anticancer clinic experiments.

The check methods of thyroid nodules include palpation,serum thyroid hormone and high-frequency ultrasound.When the diagnosis is difficult,fine-needle aspiration (FNA) is carried to differentiate benign and malignant nodules.In clinical practice,approximately 20％ of FNA-derived cytology reports can not meet the standard of benign or malignant.Some specific molecular biomarkers are applied to the derivative detection of FNA,which achieve considerable progress and improve the preoperative diagnostic rate.

Objective To explore the adjustment and posttraumatic growth of people with spinal cord injury from the community. Meth-ods From January 2013 to May 2015, Semi-structured in-depth interviews were used to interview 12 participants with spinal cord injury from Sunshine Rehibilation Center. Interviews were recorded on audio-tape with participants' permission and then transcribed verbatim. The transcribed interviews were analyzed according to interpretative phenomenological analysis. Results 3 superordinate themes emerged includ-ing struggling in despair, disentangling from the shadow of disability and continuing with life as normal, facing challenge and achieving pos-itive growth. Conclusion It is necessary to explore the process of adjustment and posttraumatic growth of people with spinal cord injury, which contribute to understand their psychological experience, psychological feature, and coping strategies, promote their physical and psy-chological recovery, and provide theory and practice guidance for family and society re-integration.

Objective To compare effects between the laparoscopic surgery and open surgery for the bigger adrenal adenoma(＞4cm) patients in Qinghai.Methods Altogether 57 cases of bigger adrenal adenoma patients(＞4cm)in the affiliated hospital of Qinghai university and Qinghai People's Hospital from 2012 to 2016 were selected and divided into two groups (A and B) according to surgical programs difference.Group A (23 cases)wcre givcn laparoscopic surgcry and Group B (34 cases)were given open surgery (And 2 cases in group A turned into open surgery were out of statistics).The operative time,blood loss,hospital stay and drainage tube removal time were compared.Results The operative time,blood loss,hospital stay and draiuage tube removal time in Group A were significantly better than those in Group B,with statistical significance (P ＜ 0.05).Conclusion The use of laparoscopic surgery for the bigger adrenal adenoma(＞4cm) patients is safer and more effective than open surgery.

ObjectiveTo revise the Chinese version of the screening for somatofonn symptoms-7( SOMS-7).Methods——( 1 )306 patients with somatoform disorder were selected in Psychiatry Clinic of Shengjing Hospital of China Medical University.(2) With convenient sampling,207 residents were selected in Xian village of Xintang town of Zengcheng district in Guangzhou and 288 in Tongji Road community of Chancheng district in Foshan.Besides,283 residents were selected in Changnan Community of Huanggu District and Jixiang Community of Dadong District in Shenyang.After 10 to 14 days,63 female and 73 male of the community subjects were selected randomly to fill in the scale again.All of the subjects filled in the Chinese version of the SOMS-7.Results ( 1 ) The internal consistency of the Chinese version of the SOMS-7 was 0.944 for female and 0.945 for male.The test-retest reliability was 0.869 for symptom count and 0.823 for severity index.The correlation with somatization subscale of SCL-90 was 0.805 for symptom count and 0.824 for severity index.(2) Based on the diagnostic criteria of somatoform disorder in DSM-Ⅳ,ROC curves were drawn.The AUC was 0.935 for symptom count and 0.942 for severity index in female,while 0.916 for symptom count and 0.926 for severity index in male.When 2.5 (female) or 1.5 (male) was chosen for symptom count and 15.5 (female) or 14.5 (male) for severity index,the youden in-dex reached a maximum.ConclusionThe Chinese version of the SOMS-7 showed a good reliability and validity,being reliable and valid as a tool to screen patients with somatoform disorder.

Objective To investigate the change of plasma L-threonine (L-Thr) ,D-threonine (D-Thr) ,L-alanine (L-Ala) and D-alanine (D-Ala) in the patients with primary hepatocellular carcinoma (HCC) by using the reversed-phase high-performance liquid chromatography (RP-HPLC) .Methods The o-phthaldialdehyde (OPA) and N-acetyl-L-cysteine (NAC) column with pre-column derivatization was adopted to perform the separation .The mobile phase was 20 mmol/L sodium dihydrogen phosphate solution and acetonitrile with a programmed gradient elution and the flow rate of 1 .0 mL/min .The excitation wavelength was set at 350 nm and the emission wavelength was set at 450 nm .Results The threonine and alanine enantiomers could be simultaneously determined by this method .The regression equation showed the good linear correlation The limits of detection (LOD) for L-Thr ,D-Thr ,L-Ala and D-Ala were 11 .4 pg/mL ,9 .77 pg/mL ,4 .11 pg/mL and 3 .50 pg/mL respectively .The recovery rate was 90 .22% -105 .7% .With-in-day and between-day RSD was 1 .04% -4 .11% .Conclusion The threonine and alanine enantiomers could be simultaneously de-termined by this method .The regression equation showed the good linear correlation The limits of detection (LOD) for L-Thr ,D-Thr ,L-Ala and D-Ala were 11 .4 pg/mL ,9 .77 pg/mL ,4 .11 pg/mL and 3 .50 pg/mL respectively .The recovery rate was 90 .22%-105 .7% .Within-day and between-day RSD was 1 .04% -4 .11% .

Liquichip is a new type of biochip emerging in the 1990s, which is integrated flow cytometry, laser technology, digital signal processing and traditional chemical technology with the greatest features of high-throughput and high-flexibility. Luminex has promoted new products from Luminex 100/200 to Flexmap 3D. This is an introduction to the development, principle, and application of Luminex liquichip.

Objective To compare the efficacy of 10-day sequential therapy (including rabeprazole amoxillin clarithromycin tinidazole) and 7-day traditional trigeminy therapy (including rabeprazole amoxillin and clarithromycin) in patients with duodenobulbar ulcer and Hp infection. Methods Ninty-five patients with duodenobulbar ulcer and Hp infection were enrolled into the study and divided into two groups randomly:sequential therapy group and traditional trigeminy therapy group. Patients in the first group received 10-day sequential medications:rabeprazole 10 mg plus amoxillin 1 g for the first 5 days,followed by rabeprazole 10 mg plus clarithromycin 500 mg and tinidazole 500 mg for another 5 days;while in the second group patients received the standard 7-day traditional triple medications:rabeprazole 10 mg plus clarithromycin 500 mg and tinidazole 400 mg. All drugs were given twice daily. All patients received rabeprazole 10 mg daily following the two types of therapys for another four weeks. Hp statuses were assessed by rapid urease test and 14C urea breath test at baseline and 4 weeks after completion of the treatment. Ulcer cicatrization was assessed by gastroscope. Results The eradication rate of Hp infection was significantly higher in sequential group than triple group (89.5%vs. 70. 2%, P ＜ 0. 05 ), but we found no statistically significant difference in the comparison of the ulcer cicatrization rate between sequential group and triple group ( 87.5% vs. 82. 9%, P ＞ 0. 05 ). Conclusion Sequential therapy had a better Hp eradication effect than standard triple therapy, but the eradication rate was very close between the two therapys.

Objective: To investigate the the sleep quality of frontier armymen located in the Gobi desert and its corre- lated factors. Methods: The sleep quality of 302 frontier armymen located in the Gobi desert was assessed with Pittsburgh Sleep Quality Index (PQSI). Results: The total scores of PQSI was 6.79?3.39,and 49.7% of the armymen suffered from sleep problems.The total scores of PQSI were correlated with health status,satisfaction with work,influence by the relation- ship with opposite sex,pressure from study and work,et al. Conclusion: The sleep quality problem of the frontier armymen located in the Gobi desert was more than normal people, and special measures should be taken to improve their sleep quality.