e and feasible for postcolectomy patients.

Chronic obstructive pulmonary disease (COPD) with high morbidity and mortality has become a major public health problem.Health education can improve the quality of life in patients with COPD, and reduce the number of exacerbations and cost due to repeated hospitalizations. There is no unified conclusion in content, manner, time for health education. There are large number of patients with COPD in China. Patients are generally poorly aware of the disease, and need various content and form of education, which can't meet for lack of knowledge and less focus on health education of medical workers. Many new progresses are emerging, such as the commonwealth of education, integrity and improvement of education, and enhancement of the educators.

ObjectiveTo observe the effect of eicosapentaenoic acid (EPA) on the proliferation and apoptosis of human gastric cancer cells and to explore the potential mechanism involved.MethodsHuman gastric cancer cell lines SGC-7901 and MGC-803 were treated with EPA at 10,20,40 μg/ml for 24-72 hours.The inhibition of cell proliferation was evaluated by methyl thiazolyl tetrazolium assay.The apoptosis and the distribution of cell cycle were analyzed by flow cytometry.Mitochondria membrane potential was determined with a fluorescence probe rhodamine 123.Cellular distribution of cytochrome C was quantitatively detected with enzyme-linked immunosorbent assay.Caspase-3 activity was measured with spectrofluorometry.ResultsAfter incubation with 10-40 μg/ml EPAfor 24-72 hours,the proliferation of human gastric cancer cells was markedly inhibited in a time-dependent manner.The treatment of 40 g/ml EPA for 72 hours increased the proportion of G0/G1 phase cells in both SGC-7901 and MGC-803 (P=0.006,P=0.009).In SGC-7901 and MGC-803 cells incubated with 40 μg/ml EPA for 24 hours,mitochondria membrane potential decreased significantly (P =0.001,P =0.047 ); cytochrome C level significantly declined in mitochondria (P=0.001,P=0.000) but increased in cytosol (P =0.001,P=0.000).In SGC-7901 cells,the apoptotic effector caspase-3 activity increased time-dependently along with incubation with 40 g/ml EPA.ConclusionEPA could inhibit the proliferation and promote the apoptosis of human gastric cancer cells through inducing cell cycle arrest and activating intrinsic death pathway mediated by mitochondria.

Objective:To investigate the improvement in antibiotics use in our hospital by comparing the prophylactic application of antibiotics in type I incision before and after antimicrobial drug special rectification. Methods:The medical records of 100 hospital-ized patients undergoing I incision respectively from May to December in 2011 (before the rectification), from May to December in 2012 ( during the rectification) and from May to December in 2013 ( after the rectification) were withdrawn randomly. The prophylactic application of antibiotics was statistically and comparatively analyzed. Results: After the antimicrobial drug special rectification, the prophylactic application rate of antibiotics was reduced from 100% to 28%, and in 7 kinds of operations stressed by the National Health and Family Planning Commission ( inguinal hernia repair, thyroid disease, breast disease, arthroscopy, carotid endarterectomy, skull tumor resection and endovascular interventional diagnosis) , the prophylactic use rate of antimicrobial drugs was reduced to 11%. The variety choice of antibiotics in type I incision was more reasonable. The irrationality rate of medication time and course was de-creased obviously, and the accuracy of dosage and usage was improved significantly. The combination of antibiotics was also notably decreased. Conclusion:The antimicrobial drug special rectification is effective, which can significantly improve the prophylactic appli-cation rationality of antibiotics for type I incision in our hospital.

Objective To analyze the clinical characteristics of patients with acute pancreatitis (AP) in Jiangxi Province.Methods From 2007 to 2012,the data of 2 625 hospitalized patients diagnosed as AP were retrospectively analyzed.The changes of composition in gender,age and etiology during 2007-2009 time period and 2010-2012 time period were compared.Mann Whitney U test was performed for non-normal distribution measurement data analysis and x2 test was for count data analysis.Results Among the 2 625 patients with AP,from 2007 to 2009 there were 1 028 cases and 1 597 cases in the period 2010 to 2012.The ages of the patients in these two period were 50(38,61) and 50 (40,63) years old,respectively.There was statistically significant difference in the age distribution between these two period (U=783 635.5,P＜0.05).Biliary factor was the most common cause of AP in the two time period 2007 to 2009 and 2010 to 2012,which accounted for 55.9％ (575/1 028) and 62.9％ (1 005/1 597),respectively,and the difference was statistically significant (x2=12.778,P＜ 0.01).Alcoholic AP accounted for 1.9％ (19/1 028) and 7.3％ (117/1 597),respectively,hyperlipidemic AP were 14.0％ (144/1 028) and 17.7％ (283/1 597),and idiopathic AP were 22.0％ (226/1 028) and 5.9％ (94/1 597),all the differences were statistically significant (x2 =38.204,6.330 and 151.416,all P＜0.05).In male patients,biliary AP accounted for 52.4％ (732/1 398),which was lower than that of female patients (69.1％,848/1 227),and the difference was statistically significant (x2 ＝76.524,P＜0.01).Alcoholic AP and hyperlipidemic AP accounted for 9.0％ (126/1 398) and 21.4％ (299/1 398) in male patients,which were significantly higher than those of female patients (0.8％,10/1 227; 10.4％,128/1 227),and the differences were statistically significant (x2 89.396 and 57.585,both P＜0.01).Biliary AP accounted for 79.9％ (631/790) in elderly group,which was higher than that of non elderly group (51.7％,949/1 835),and the difference was statistically significant (x2＝182.720,P＜0.01).In elderly group hyperlipidemic AP and alcoholic AP accounted for 2.5％ (20/790) and 1.3％ (10/790),which were significantly lower than those of non-elderly group (22.2％,407/1 835; 6.9％,126/1 835),and the differences were statistically significant (x2 =156.524 and 35.262,both P＜0.01).Conclusions The middle-aged and elderly people are the vulnerable population of AP.Biliary factor is the most common cause of AP,especially in the female and elderly.The proportions of hyperlipidemic AP and alcoholic AP both significantly increase,in the male higher than that of the female and in the non-elderly higher than that of the elderly.The proportion of idiopathic AP significantly decreases.

Objective To retrospectively study the clinical features in elderly patients with epilepsy.Methods Clinical data of 72 elderly patients with epilepsy aged over 60 years from outpatients and inpatients were studied.Results In the 72 cases,cerebrovascular disease associated with epilepsy occurred in 52 cases (72.2％),with partial seizures in 50 cases (69.4％),and with generalized seizures in 22 cases (30.6％).In 38 cases with epilepsy secondary to cerebral infarction,the cerebral cortex infarction occurred in 26 cases (68.4％).In 14 cases with epilepsy secondary to cerebral hemorrhage,cerebral cortex hemorrhage occurred in 11 cases (78.6％).In interictal electroencephalogram (EEG) of the 72 cases,8 cases had normal EEG (11.1％),64 cases had abnormal EEG (88.8％).31 cases (48.4％) presented with sharp wave,spikes wave or tip--slow composite wave,33 cases (51.6％) presented with low amplitude of slow wave activity,which were non-specific abnormalities.Conclusions The main cause of seizures in the elderly is cerebrovascular disease.Partial seizures is the main type of seizure.Most of seizures caused by cerebrovascular disease occur in the region near the cortex.

Pancreatic necrosis (IPN) is a serious complication of acute pancreatitis (AP), with a mortality reported to be as great as 32.0%. At present, it is considered that patients with proven or suspected infected necrotizing pancreatitis, invasive intervention (i.e. percutaneous catheter drainage, endoscopic transluminal drainage/ necrosectomy, minimally invasive or open necrosectomy) should be delayed where possible until at least 4 weeks after initial presentation to allow the collection to become 'walled-off'. With the development of endoscopic technology, endoscopic transmural (stomach or duodenum) drainage and necrosectomy has been recommended as one of the preferred methods for walled-off necrosis. This article introduces the diagnosis and evaluation of the walled-off necrosis ; the indications, operation procedures, postoperative evaluation and management of postoperative complications of endoscopic transmural drainage and necrosectomy. At last, the research progress of endoscopic drainage and debridement in recent years was introduced.

Objective To study the influence of clinicopathologic characteristics and surgical treatment of gastric cancer on patients' survival rate.Methods From Apr.1994 to Aug.2005, the data of 759 gastric cancer patients concerning surgical treatment, pathological diagnosis and outcome were collected. Retrospective analysis of the results was made, 3-year and 5-year survival rates were calculated by Kaplan-Meier curve method, univariate analysis was done through Log-rank and multiple factors comparison through Cox regression analysis, and follow-up duration was 4-131 months.Results Single factor analysis indicated that age,tumor location,diameter of tumor, Borrmann type, type of histology, TNM stage, depth of infiltration, lymph node metastasis, liver metastasis, peritoneal dissemination, blood of transfusion during operation, extent of the radical cure of the tumor and excision techniques were significantly influential factors for the prognosis of patients. Cox regression analysis showed that tumor location, diameter of tumor,depth of infiltration, lymph node metastasis,liver metastasis, TNM stage, peritoneal dissemination, blood transfusion during operation, extend of the radical cure of the tumor and excision techniques were independent factors influencing the postoperative survival rate.Conclusion Independent factors influencing the postoperative survival rate include tumor location, diameter of tumor, lymph node metastasis, infiltration depth of the tumor, pathological classification, liver metastasis, peritoneal dissemination, and TNM stage, extent of the radical cure of the tumor, lymphanodectomy techniques and blood transfusion during operation are also important factors.

Objective To summarize the clinicopathologic characters and the route of lymphatic metastasis of cancers at the gastroesophageal junction. Methods Clinicopathologic data of 86 cancer patients treated from October 2000 to December 2004 were analyzed retrospectively. Results There were 66 males and 20 females, the mean age was 60 years. Most patients were of Bormann typeⅢadenocarcinoma. The incidence of high differentiated adenocarcinoma in TypeⅠcancer was higher than that in other two types (P = 0. 002, P = 0. 004) , while the incidence of poor differentiated carcinoma in typeⅢcancer was higher than other two types(P = 0. 005 ,P = 0. 015). Metastatic rate of lymph nodes in group 1 and group 2(34. 9% ) .group 3 and group 4(36. 0% ), group 7 through to group 9(27. 9% ), group 10 and 11 (15. 1% ) was higher than in other groups, while that in group 5 and 6(11. 6% ) , and group 12(5. 8% ) was lower compared with other lymph nodes (P

Objective To explore the significance of health education for patients with stable chronic obstructive pulmonary disease (COPD) in community-based rehabilitation based on the previous research. Methods 46 patients with stable COPD recruited in Implementation and Management of COPD Community Rehabilitation Program (23 patients from the intervention group and 23 from the control group) were followed up with telephone twice in October 2013 and January 2014, with the Bristol COPD Knowledge Questionnaire (BCKQ), modified Borg Scale, Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and COPD Assessment Test (CAT). Individual health education was given once in the first follow-up in October 2013. Results In the follow-up in October 2013, scores of each assessment were worse in the intervention group (P<0.05). There was no longer statistical significance between the intervention group and the control group (P>0.05) in all the assessments except the mental status (SAS, SDS). But the cases with higher education level in the intervention group were not worse too much (P>0.05). In the follow-up in January 2014, the scores of each assessment improved in the intervention group (P< 0.01) and the control group (P<0.05). There was statistical significance between the intervention group and the control group again in the scores of BCKQ, modified Borg Scale and CAT (P<0.05). Conclusion The benefit from community-based rehabilitation can be reversible for patients with stable COPD. Health education with telephone in follow-up can improve the patients' awareness of disease, reduce dyspnea, and improve their mental status and quality of life.