Objective To detect the expression intensity and distribution of minichromosome mainte-nance 2 protein (MCM-2) in normal skin and lesions of malignant and non-malignant hyperplasia. Methods Three groups of samples were collected, I.e., malignant group (including 15 cases of Bowen disease or highly differentiated squamous cell carcinoma of Grade Ⅰ or Ⅱ ), non-malignant group (including 4 cases of chro-momycosis, 2 cases of sporotrichosis, 5 cases of seborrheic keratosis, 4 cases of verruca vuigaris, 4 cases of chronic eczema, 4 cases of cutaneous fibroma), and normal group (10 cases of normal human control). The distribution and intensity of MCM-2 expression in the epidermis of these samples were assessed by immuno-histochemical SP method. Results The expression of MCM-2 was observed in basal and superbasal layer of epidermis in lesions of malignant and non-malignant hyperplasia, and only in epidermal basal layer in normal skin. A significant increment was observed in the density of MCM-2 positive cells in superbasal layer in malignant lesion compared with the non-malignant lesion. The epidermal expression level of MCM-2 in the non-malignant lesion was significantly lower than that in the malignant lesion, but higher than that in the normal skin (μ = -2.529, -3.705, respectively, both P < 0.05); the same was true for the proportion of MCM-2-postive basal cells. Conclusions The expression of MCM-2 protein varies with the proliferation status of epidermal cells, and may serve as an objective marker for epidermal cell proliferation.

Objective To systematically evaluate the clinical efficacy and safety of Fufang-Danshen Injection (FD) in the treatment of unstable angina pectoris(UAP). Methods Randomized controlled trials (RCTs) and quasi-RCTs regarding FD in the treatment of UAP were collected through comprehensive searches of China National Knowledge Infrastructure(CNKI), Chinese Scientific Journals Database(VIP), Wan fang Database, Chinese Biomedical Literature Database(CBM), PubMed, Embase and Cochrane Library from January 1979 to December 2013. Two reviewers independently assessed the quality of the included studies by the Cochrane risk of bias, and extracted the information from the included studies. Meta-analysis was conducted with the software Review Manager 5.2. Results A total of 13 studies with 1156 participants were included. In the meta-analysis, ①the total effective rate of UAP:in term of FD+conventional therapy with western medicine(WM)vsWM, the difference between two groups was statistically significant [RR=1.32, 95%CI(1.21, 1.43), P<0.01]; FD+low molecular weight heparin+WM vs WM, difference between two groups was also statistically significant [RR=1.29, 95% CI(1.17, 1.42), P<0.01], which indicated that the efficacy of experimental group was higher than the control group. Other interventions, such as FD+WM vs low molecular weight heparin+WM and FD vs WM, there was no significant difference between two groups. ②the total effective rate of ECG:in term of FD+WM vs WM, the difference between two groups was statistically significant [RR=1.34, 95%CI (1.14, 1.57), P<0.01]; in term of FD vs WM, difference between two groups was statistically significant [RR=1.49, 95%CI(1.13, 1.96), P<0.01], which indicated that experimental group can effectively improve the total effective rate of ECG. ③ frequency of angina attacks:in term of FD+WM vs WM, the difference between two groups was statistically significant [MD=1.07, 95%CI(0.48, 1.66), P<0.01]. No differences between groups existed in other analysis. ④ adverse drug reactions(ADRs):4 articles cleared that there was no ADRs in the studies, 4 studies reported ADRs, which represented headache, nausea, flushing and so on. There were 9 cases in the experimental group, and 9 in control group. Conclusion Based on the meta-analysis, FD was effective and relatively safe for the treatment of UAP in clinical. However, since the articles enrolled in the study were not in high quality, more qualified studies should be conducted for the further assessment of efficacy and safety of FD for UAP.

Objective To systematically evaluate the clinical efficacy and safety of Danshen Chuanxiongqin Injection (DCI) in the treatment of angina pectoris. Methods Randomized controlled trials (RCTs) regarding DCI in the treatment of angina pectoris were searched in CNKI, VIP, Wanfang Database, CBM, PubMed, Embase and Cochrane Library by Feb. 2014. Two researchers independently retrieved the RCTs and extracted the information. The Cochrane risk of bias method was used to assess the quality of the included studies, and a meta-analysis was conducted with Review Manager 5.2 software. Results A total of 12 RCTs with 1145 participants were included. The meta-analysis indicated that the combined use of DCI and conventional treatment with western medicine was more effective in the outcomes of the total clinical effective rate [RR=1.27, 95%CI (1.19,1.35), P<0.000 01], the total effective rate of ECG [RR=1.34, 95%CI (1.23,1.46), P<0.000 01], and decrease of plasma viscosity [MD=-0.15, 95%CI (-0.25,-0.05), P=0.004] and fibrinogen [MD=-0.96, 95%CI (-1.14,-0.78), P<0.000 01]. And there were no adverse drug reaction reports. Conclusion Based on this systematic evaluation, DCI combined with conventional therapy is effective and relatively safe in treating angina pectoris, but it still needs larger samples, multi-center, and high quality RCT to verify.

Objective To investigate the employment status of higher vocational medical col-lege graduates in Hainan province, analyze the existing employment problems, and put forward some effective suggestions. Methods A questionnaire was applied to survey the employment problems of 1 048 medical graduate in 11 medical related field of Grade 2012. A total of 989 valid questionnaires were collected. The questionnaires covered six aspects including graduates' basic information, their employment intention, access to employment information channel, service and satisfaction about school employment agencies, and employment psychology etc. SPSS 13.0 was used to analyze the statistical numbers in each option and the percentage was calculated. Results Only 22.9%(227/989) of the graduates were willing to accept the provincial employment, 49.1%(486/989) of the graduates obtained employment information channels through the school employment sector; 10.6%(105/989) of gradu-ates expressed dissatisfaction with employment services; graduates' entrepreneurial intention reached 26.9%(267/989); only 19.8% of graduates signed employment agreement, and 25.1%(248/989) of gradu-ates face the employment with anxiety and confusion. Conclusion The higher vocational medi-cal graduates in Hainan provinces need to change their employment concept and school employment guidance needs strengthening to link up the employer position requirements and expectations of grad-uates employment. Besides, the school enrollment professional settings and employment market demand also need to be linked up, to guarantee the system interface between career guidance, internship and training base.

Objective To explore the medication rules of state medical master Yan Zhenghua from the prescriptions. Methods After analyzed by the statistical report module and the data analysis module, the method of data-mining that including association rules and apriori algorithm was used to analyze the frequency of Poria and drug combination, the association rules between drugs and core drug combinations in Pro. Yan’s prescriptions via a database based on Traditional Chinese Medicine (TCM) inheritance assist system. Results The prescriptions containing Poria were commonly used to treat vertigo, stomachache, diarrhea and other syndromes. The highest frequently used drugs were Pericarpium Citri Reticulatae, Radix Paeoniae Rubra, Radix Salviae Miltiorrhizae, Parched Semen Ziziphi Spinosae, and Caulis Polygoni Multiflori. The most frequently used drug combinations were “Pericarpium Citri Reticulatae, Poria”, “Radix Salviae Miltiorrhizae, Poria”, and“Poria, Parched Semen Ziziphi Spinosae”. The drug association rules that the confidence coefficient was more than 0.9 were “Carina→Oyster”, “Poria, Carina→Oyster”,“Oyster, Caulis Polygoni Multiflori→Carina”, and“Rhizoma Atractylodis Macrocephalae→Poria”. Conclusion The drugs in the prescriptions containing Poria that built by Pro. Yan mostly had the effects of regulating the flow of qi, relieving uneasiness of body and mind, and cooling the blood, which reflected the clearly thought when Pro. Yan made the prescriptions.

Objective To explore the rules of the compatible application of antagonistic combination Ginger and Radix Scutellariae in clinical.Methods The prescriptions included the compatibility application of Ginger and Radix Scutellariae were systematically retrieved in literature. Using Excellas a storage and analysis tool, the information about treatments, dosage, compatibility proportion, and dosage form were analyzed with the method of bibliometrics.Results The prescriptions included the compatibility application of “Ginger and Radix Scutellariae” were mainly used for the treatment of internal diseases (746 cases, 76%), followed by gynecological diseases (62 cases, 6%), ear-nose-throat diseases (43 cases, 4%), etc. The largest number of internal diseases was spleen-stomach diseases, which accounted for 26% (193 cases) of the total internal diseases. And the others were diseases of liver-gallbladder 189 cases (25%), and diseases of lung (185 cases, 25%). In the prescriptions, the dosages of Radix Scutellariae were primarily 10, 12, 9, 15 g, 69% (532/772) of which were in the dose range provided by Chinese Pharmacopoeia. The dosages of Ginger were mainly 10 g and 6 g, 84% (356/424) of which were in the dose range provided by Chinese Pharmacopoeia. The compatibility proportion of Ginger and Radix Scutellariae was mostly 1∶1, which accounted for 32%.Conclusion The antagonistic combination Ginger and Radix Scutellariae was widely used in a variety of interior, exterior, gynaecology, paediatrics and other syndromes. The two drugs were contrary in the property (one cold and the other hot) and the function (one warming lung and the other clearing away the lung-heat), but their compatibility application can achieve a satisfactory efficacy.

Objective To investigate the epidemiological characteristics of adverse drug reactions (ADRs) induced by Chinese herbal injection for tonify, and provide reference for safety evaluation and rational use. Methods The ADR cases that issued on the domestic medicinal periodicals from 1972 to 2011 in China were collected comprehensively to build a database, and analyzed by statistic methods. Results Totally 233 ADR cases involving 7 different kinds of Chinese herbal injection for tonify were collected, in which 86 cases weighted the most were related to Huangqi Injection. Chinese herbal injection for tonify may induce multiple systematic ADRs. The incidence of respiratory damage was 27.0%(80 cases), which was dominated in the ADRs. The incidence of ADRs had no difference between the genders (male was 117 cases, 50.2%, and female was 116 cases, 49.8%), and the average age of patients was (51.40±16.67) years old. ADRs often occurred within half an hour after the start of infusion (64.5%). The diseases of patients mostly were cancer (19.3%), coronary heart disease (15.9%), and hypertension (6.0%), etc. Only 76 cases mentioned the combination therapy, which mainly combined with the drugs of antibiotics, other traditional Chinese medicines and vitamin. Conclusion ADRs of Chinese herbal injection for tonify are always induced by drug combinations, inappropriate medication, and other factors. To use Chinese herbal injection more rational and enhance prevention awareness may be the key to reduce the occurrence of ADRs.

Objective To analyze the epidemiologieal characteristics of the pre-hospital care cases in Shanghai in the year 2007. Method Based the demographic records in the year 2007, the cases which from the database of Shanghai pre-hospital care center with full items were analyzed. Chi-square test and exact probabilities were used to compete the consfituent ratio; and the method of circular distribution was used to calculate the peak time, date and month. Results There were 86 815 patients with pre-hospital care well documented from the ur-ban districts of Shanghai. The ratio of male to female was 3.89: 1. The senile patients accounted for 84.95% of all the pre-hospital care ones. The major causes of disease in patients with pre-hospital care were trauma, eere-brovascular disease,cardiac diseases, coma, high fever, tumor emergency, acute abodomen emergency,OB/GYN emergency and upper G1 tract bleeding in turn. During the daytime, the occurrence of those emergency patients with pre-hospital care usually peaked at 2:15 o' clock with the high frequency in the period of 5:45 to 17:45 o' clock.The top nine diseases had their own peak time and high frequency period, respectively. Within a year, no peak date occurrence of patients with prehospital care, in tolal, was found. Howerer, the occurrence of patients with high fever, acute abdomen and upper GI bleeding had specific peak dates within a year, respectively. Conclusioes The pre-hospital care eases in the urban of Shanghai have own epidemiologieal characteristics. Perfect the construc-tion of pre-hospital emergency care system, improving the professional training, and thereby meeting the require-ments are factors in the fundamental guarantee of improving the rescue full success rate of severe patients.

The main transmission route of chronic hepatitis B virus infection is mother-to-child transmission of hepatitis B virus and the main cause of combined immune prophylaxis failure in neonates at the end of pregnancy is high viral load. Moreover, oral administration of nucleos(t)ide analogues (NAs) during the second and third trimesters of pregnancy can significantly reduce or even completely block mother-to-child transmission of HBV. This article focuses on the necessity and feasibility of oral NAs antiviral therapy for HBV carrier pregnant woman with high viral load, and the issues commences at the time of medication and viral load thresholds.

OBJECTIVETo assess the relationship between nodular goiter and hepatitis C virus infection.

METHODSNinety-seven cases of early treatment in patients with chronic hepatitis C were collected for analysis.Data on patient age,sex,hepatitis duration and other general information were collected.In addition, data on clinical measures of thyroid function (including T3, t4, tSH) and thyroid autoantibodies (thyroid peroxidase antibody TPO-Ab, thyroglobulin antibody Tg-Ab), as well as findings from thyroid dimensional ultrasonography were collected. One hundred and eleven cases of early treatment in patients with chronic hepatitis B and 106 eases of females 40 years old or older with high risk of nodular goiter were collected for use as controls.The relationship between nodular goiter with thyroid function, thyroid autoantibodies levels,sex,age,and hepatitis C virus infection were statistically analyzed.

RESULTSThe prevalence rates of nodular goiter in the chronic hepatitis C group, the chronic hepatitis B group and the more than or equal to 40 year-old women with high risk of nodular goiter were 53.6%,36.9% and 59.4% respectively.The prevalence rates of nodular goiter in the chronic hepatitis C group and the more than or equal to 40 year-old women with high risk of nodular goiter were significantly higber than that in the chronic hepatitis B group (x² values: 5.820 and 10.996, P < 0.05). The average age of patients with chronic hepatitis C combined with nodular goiter was significantly higher than their counterparts without goiter (F=6.408, P < 0.05),and the prevalence rate in the more than or equal to 40 year-old women with high risk of nodular goiter was significantly higher than that of their counterparts who were less than 40 years-old (60.0% vs. 23.5%; x² =7.499, P less than 0.05). The prevalence of nodular goiter in patients with chronic hepatitis C was significantly greater for females than for males (62.1% vs. 41.0%; x 2 =4.152, P < 0.05).The prevalence of nodular goiter in patients with chronic hepatitis C was also significantly higher for females more than or equal to 40 years old than for males (70.2%, 33/47 vs. 45.5%,15/33; x² = 4.952, P < 0.05).The duration of hepatitis, thyroid function and thyroid autoantibodies were similar between the patients in the chronic hepatitis C group with or without nodular goiter.

CONCLUSIONSThe patients with chronic hepatitis C had a higher prevalence of nodular goiter,with an average of up to 53.6%, than the patients with chronic hepatitis B,and the women the more than or equal to 40 years old had even higher prevalence, at 70.2%, suggesting that patients with chronic hepatitis C should be routinely examined by thyroid ultrasound. Thyroid function and thyroid autoantibodies were not correlated with prevalence of goiter among the chronic hepatitis C patients.