General practitioners from community health service institutions in Shijingshan,Mentougou,Haidian,Chaoyang,Fengtai and Dongcheng Districts of Beijing were selected to take the examination of chronic wounds management.Questionnaire survey was also performed on the status of community chronic wounds management,medical service motivation,influencing factors and their demand for training.Among 204 general practitioners,55 (27.0％) had mastered basic knowledge,98 (48.0％) passed the examination and 51 (25.0％) failed.The results showed that 179 (87.7％) had changing dressing service,36.8％ offered out-patient consulting service,17.6％ performed surgical debridement,only 10 (4.9％) provided home chronic wounds care service and 2 (0.9％) of them carried out long-term follow-up.According to the motivation survey,all the practitioners expressed the willingness to help the patients and win their trust.Most of the practitioners claimed no supporting from their institutions(91.7％) and chronic wounds management was excluded from daily routine.Furthermore,heavy work load(82.8％) and lack of professional knowledge(80.9％)were also considered to be main obstructive factors.The survey showed that the majority of physicians required classroom teaching (90.1％),case analysis (86.8％),operating video (92.6％) and other teaching forms.More low level doctors(97.1％)had the desire to pursue further specialist training than higher level physicians (56.7％).The results of our investigation indicate that general practitioners in community heath service institutions have strong learning motivation for chronic wounds management and systematic training of knowledge and practical skills in this field should be provided.

CD98 is a transmembrane heterodimer of cell surface.It regulates cell signaling pathway by activating some correlated proteins,and controls cell polarization,proliferation,adhesion and migration.CD98 plays an important role in the development of cancer and may be a novel tumor marker for diagnosis and prognosis in lung cancer.

Gastric cancer is one of the most common malignant gastrointestinal tumors with a high mortality in China. However, the pathogenesis of gastric cancer is not clear. Recently, with the development of cancer stem cell research, more and more studies have been focused on the gastric cancer stem cell. In this review, we will discuss the conception and the study status of the gastric cancer stem cells in addition to the treatment for the cancer stem cell.

Objective To compare the sedative efficacy and untoward effect of dexmedetomidine and midazolam in drunken patients after general anesthesia.Methods Thirty-eight drunken patients having underwent mechanical ventilation after general anesthesia were enrolled.The patients were divided into dexmedetomidine group and midazolam group with 19 cases each according to random digital table method.The sedation onset time,dysphoria,percentage of with good sleep quality,duration of mechanical ventilation,ICU length of staying and untoward effect were compared.Results The sedation onset time and duration of mechanical ventilation in dexmedetomidine group were significantly shorter than those in midazolam group:(45.6 ±8.9) s vs.(112.5 ±20.3) s and (9.4 ±2.1) h vs.(18.6 ±5.1) h,the patients of dysphoria in dexmedetomidine group was significantly less than that in midazolam group:6 cases vs.14 cases,the patients of good sleep quality in dexmedetomidine group was significantly more than that in midazolam group:12 cases vs.4 cases,and there were statistical differences (P＜ 0.05).There was no statistical difference in ICU length of staying between 2 groups (P ＞ 0.05).The patients of bradyarrhythmia in dexmedetomidine group was significantly more than that in midazolam group:9 cases vs.2 cases,but the patients of respiratory depression in dexmedetomidine group was significantly less than that in midazolam group:4 cases vs.12 cases,and there were statistical differences (P ＜ 0.05).There were no statistical differences in delirium and hypopiesis between 2 groups (P ＞ 0.05).Conclusion Compared with midazolam,dexmedetomidine is highly recommended to be used for the sedation of drunken patients after general anesthesia,but the incidence of circulatory adverse reactions should be paid attention to.

Objective To analyze the diagnostic values of plasma albumin and total bilirubin, serum uric acid and inflammatory cytokines levels in patients with bipolar disorder.Methods A total of 48 cases of bipolar disorder patients were selected as research subjects ( study group) , and 45 cases of healthy people in the same period were chosen as control group.The plasma albumin, total bilirubin and serum IL-1β, IL-4, uric acid levels were compared and analyzed between two groups.Results The serum albumin, total bilirubin levels in study group were significantly lower than those in healthy control group, with significant difference (P<0.05).The serum IL-1β, IL-4 levels in study group were significantly higher than those in healthy control group, with a statistically significant difference (P<0.05).The serum uric acid levels in study group was significantly higher than that in healthy control group, with significant difference (P<0.05).Conclusion The serum albumin, total bilirubin and serum IL-1β, IL-4, uric acid levels can be used as a diagnostic reference index for bipolar disorder.

One hundred and thirty four cases were treated by arthroscopic surgery with radiofrequency (RF) from May 2000 to December 2001. In this group of patients the diagnosis and operations included: shoulder rotator cuff tears in 6, calcified supraspinattus tendinitis in 5 , internal fixation of the humerus greater tubercle fracture in 3, debridement of hip joint infection in 3, avascular necrosis of the femoral head in 9, degenerative osteoarthropathy in 6, synovium chondromatosis in 6, gluteus contracture release in 7, osteoarthritis of knee joint in 20, meniscus injury in 21, ACL reconstruction in 14, ACL shrinkage in 4, adheresion release of knee joint in 6, patellar subluxation retinacula release in 6, popliteal fossa in 4 , removal of screw and plate of femur shaft in 3 , ankle joint impingement and synovitis in 11. The clinical results showed that arthroscopic RF had characteristics such as hemostasis at low temperature, (so thermal damage to surrunding tissues would be minimal), tissue shrinkage, vaporization, cutting and hemostasis,and so on. It is excellent for debriding synovial and adherent tissue, and extremely effective in removing articular cartilage, meniscal tears and ACL shrinkage. It causes mild pain and no joint swelling ,thus facilitats rehabilitation.

Objective To investigate the predictive value of Lp-PLA2 on the successful rate of thrombolysis in patients with a-cute myocardial infarction (AMI) .Methods Patients with AMI within 6 hours of onset were enrolled and blood samples before thrombolysis were drawn for laboratory examination .Alteplase was used for thrombolysis and 2 hours later ,successful rate and the predictive value of baseline Lp-PLA2 level on successful rate were evaluated .Results Totally 106 patients with AMI were enrolled and 48 cases were with anterior AMI ,32 cases with inferior AMI ,12 cases with lateral AMI ,and 14 cases with right ventricular and posterior AMI .Serum levels of cardiac biomarkers ,hs-CRP and Lp-PLA2 were all increased .Two hours later ,38 cases (35 .8% ) were with successful thrombolysis and 68 cases(64 .2% )were with failure ,and there were significant differences of baseline levels of hs-CRP and Lp-PLA2(P<0 .05) .hs-CRP was not correlated with successful rate of thrombolysis (r= -0 .17 ,P=0 .084) ,while Lp-PLA2 was negatively correlated with successful rate of thrombolysis(r= -0 .36 ,P=0 .013)as indicated by the Spearman rank correlation analysis .Conclusion Serum level of Lp-PLA2 can be used to predict the successful rate of thrombolysis in patients with AMI .

Objective To study the factors relating to failure of vacuum assisted closure (VAC)therapy for pressure ulcers control in order to guide the clinical indications.Methods A retrospective cohort study of 75 patients with pressure ulcers to undergo VAC therapy was conducted.Correlations between 12 risk factors and VAC therapy failure were analyzed.The statistical prognostic factors were screened and the sensitivity,specificity,positive predictive value and negative predictive value of them were analyzed.Risk factors for VAC failure were determined by using Logistic regression analysis.Results Among the 75 patients,17 patients failed to respond to the VAC therapy.The failure rate of VAC therapy had correlations with positive blood cultures,bony exposure,hypoalbuminemia (alb ＜25 g/L) and wound depths≥ 4 cm (70.0％,50.0％,38.5％ and 40.9％,respectively),but the Logistic regression analysis found that the 4 factors were not the independent risk factors for failure of VAC therapy.Conclusions Pressure ulcer patients with positive blood cultures,bony exposure,hypoalbuminaemia (alb ＜25 g/L),and wound depth≥4 cm tend to have a higher failure rate in VAC therapy,which are the relative indications for VAC therapy.

Objective To observe the effect of Weiyanyin on Substance P(SP) in gastric mucosa of experiment bile reflux gastritis rats. Methods The model of experiment bile reflux gastritis was established by gavage of reflux liquid. Compared with Domperidone, the effect of Weiyanyin on pathological histological features and the mucosal SP content of bile reflux gastritis rats was observed. Results The gastric mucosa of rats in model group was damaged, and alopecia of gastric mucosa, and infiltration of a large number of inflammatory cells could be seen.In most of the rats in the model group, atypical hyperplasia and intestinal metaplasia were present. Meanwhile, the content of SP was decreased( P

Objective To observe the effects of human embryonic fibroblasts ( FBs ) on the biological characteristics of diabetic FBs in vitro , and to explore the possible therapeutic mechanism on diabetic ulcers . Methods Diabetic FBs were isolated and cultured with embryonic FBs (experimental group), adult FBs(control group 1)and alone(control group 2)in transwell chambers.Diabetic FBs growth curves in the coculture systems were described.The cell shape was observed by microscopy with HE staining .On the 4th and 7th day of cocul-ture, diabetic FBs were isolated to measure the expression levels of hydroxyproline and transforming growth factor -beta 1(TGF-β1)in the supernatant of monoculture .The cell senescense was displayed by β-galactosidase histo-chemical staining on the 3th, 5th and 7th day of coculture.Eight patients with diabetic foot ulcers who were can-didates for embryonic FBs constructs after failed traditional treatment were included in the study .The pre and post self-control study was conducted by observing the wound healing process before and after embryonic FBs treat -ment.Results Diabetic FBs in the experimental coculture system displayed more typical pattern and faster grow -ing rate.The level of hydroxyproline and TGF-β1 in the supernatant of diabetic FBs monoculture was significantly higher in the experimental group than in the control group after treated 4 or 7 days ( hydroxyproline:4 d, 7 d :compared with control group 1:P=0.023,P=0.007;compared with control group 2: P=0.007, P=0.003;TGF-β1 4 d, 7 d:compared with control group 1:P=0.000, P=0.000;compared with control group 2: P=0.000, P=0.000).The expression of SA-β-gal tended to be more apparent in control group 1 and 2 than in the experimental group on the 3rd,5th,and 7th day.All of the 8 cases with diabetic ulcers were cured by using em-bryonic FBs constructs .Conclusion Embryonic FBs can promote the proliferation of diabetic FBs , correct cell senescence and increase the production of hydroxyproline and TGF-β1,which maybe enhance the process of dia-betic wound healing .