A survey on clinical knowledge of coronary artery disease (CAD) management in general practitioners (GPs) in Beijing was conducted from March to September,2013.The questionnaire contained 4 cases (stable angina pectoris,post-percutaneous coronary intervention,acute anterior myocardial infarction and acute inferior myocardial infarction) and related clinical questions.Five hundred questionnaires were distributed and 471 valid questionnaires were returned with a recovery rate of 94.2％.The correct rate was 87.3％ and 61.8％ for diagnosis and treatment of emergent events in acute anterior myocardial infarction; however,the correct rate for other knowledge was ranged between 23.4％ and 40.6％.The correct rate increased with the educational levels in 5/11 items(P ＜ 0.01)and increased with the professional titles(P ＜ 0.001)in 3/11 items,which was not associated with the attendance of training or frequency of training attendance.The results indicate that clinical knowledge of CAD management for GPs in Beijing should be improved and the training methods should be focused on the clinical capacity.

Objective To explore pathological characterization of the enlarged contrast enhanced area of hepatocellular carcinoma ( HCC) on contrast enhanced ultrasonography ( CEUS). Methods Thirty-five HCC patients underwent conventional ultrasonography and CEUS before hepatectomy. The tumor sizes were measured on conventional ultrasonography,CEUS and postoperative resected specimen at the largest section. The infiltration depth of the HCC was observed under microscope in the peripheral area of the tumors. HCC with the size of contrast enhancement area on CEUS 0. 3 cm larger than that on conventional ultrasonography was defined as group A, and the others as group B. The pathological character of the tumor and tissues surrounding the tumor were analyzed and compared between the two groups. Results Among 35 HCC, 40% (14/35) HCC increased in size on CEUS compared with ultrasonography. Of them,9 tumors with increased area on CEUS were confirmed to be invasive HCC on pathology. Using the enlarged contrast enhanced area on CEUS as the diagnostic criteria of invasive HCC, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 90%, 80%, 82.9%, 64.3%, 95. 2%, respectively. Conclusions The contrast enhanced area on CEUS can reflect the infiltrative tumor size more accurately compared with conventional ultrasonography.

Objective To systematically review the evidence for the effect of vitamin D supplementation on insulin resistance and blood glucose in people who are obese or people with abnormal glucose metabolism. Methods We searched databases including Pubmed, Elsevier, Web of Science, and WANFANG Database etc. for randomized controlled trials comparing vitamin D or analogues with placebo. We extracted data on insulin resistance and blood glucose, including homeostasis model assessment of insulin resistance( HOMA-IR), fasting blood glucose, HbA1C (% ). A1l data were analyzed using Review Manager 5. 0. Results Nine studies involving 867 participants were included. The results of meta-analysis showed that: ( 1 ) For people who are obese and with abnormal glucose metabolism, meta-analysis showed a small improvement in HOMA-IR(SMD -0. 34,95% CI -0. 61 to -0. 06, P<0. 05) and a small effect on fasting glucose (SMD -0. 41 mmol/ L, 95% CI -0. 68 to -0. 15, P<0. 05),while such effects were not seen in people who are obese but with normal blood glucose. (2) No serious adverse events were associated with the administration of vitamin D. Conclusion vitamin D supplementation may be benefit for improving insulin resistance and fasting blood glucose in people who are obese and with abnormal glucose metabolism, but has no effect on obese people with normal blood glucose.

ObjectiveTo explore the effect of Yinaotongluo capsule on preventing the microcirculation dysfunction in rats.Methods40 SD rats were randomly divided into the thrombosis model group, three Yinaotongluo capsule groups (low, moderate and high dosages) and control group with 8 rats in each group. Photosensitizer was injected through vessel. Endothelium damage, cell adhesion and thrombosis were induced by photochemistry. The change of microcirculation was recorded and analyzed by microphotography technique.ResultsYinaotongluo capsule groups could prolong the time to thrombosis induced by photochemistry compared with control group (P<0.05). However, the area of thrombus to vessel significantly decreased in all Yinaotongluo capsule groups compared with control group (P<0.01). The effect of moderate dosage group of Yinaotongluo capsule was superior to Buchangnaoxintong group.ConclusionYinaotongluo capsule can improve the microcirculation of mesentery of rats, in part it can improve the systematic microcirculation of rats.

Objective:To explore whether esketamine (ESK) can inhibit the proliferation and induce apoptosis of breast cancer cells, and explore the mechanism.Methods:CCK-8 assay was used to detect the inhibitory effect of ESK on the proliferation of breast cancer cells. Annexin V/PI staining was used to detect the morphological changes of cells; Apoptosis and reactive oxygen species were detected by flow cytometry. Western blot was used to detect apoptosis and pathway expression.Results:CCK-8 experiment results proved that ESK could inhibit the proliferation of breast cancer cells in a time-dependent manner. The survival rate of MDA-MB-468 cells treated with ESK at 20 μM was (35.47±2.61) %, which was statistically different from that treated with vinorelbine at the same concentration ( P<0.05). The IC50 value of ESK on MDA-MB-468 cells was (14.54±2.12) μM. After treatment with ESK, the mitochondrial membrane potential was significantly reduced. In the protein level, the expression of Cytochrome C, Bax and Caspase-3 was up-regulated, and the expression of Bcl-2 was down regulated, which induced the mitochondrial dependent apoptosis of MDA-MB-468 cells. ESK could up regulate the level of reactive oxygen species in MDA-MB-468 cells and regulate the expression of PI3K/AKT signaling pathway. Conclusions:ESK can inhibit the proliferation and migration of breast cancer cells and induce them to play a mitochondrial dependent apoptosis. Its mechanism is achieved by up regulating the level of ROS in breast cancer cells, thereby regulating the PI3K/AKT signaling pathway, which provides a theoretical basis for the development and utilization of Aln.

Objective: To understand the level of compassion satisfaction of medical oncology nurses and to explore the mediating effect of resilience in the relationship between empathy ability and compassion satisfaction of medical oncology nurses, and to investigate the moderating effect of social support in this mediating role. Methods: A total of 291 medical oncology nurses from 7 general hospitals in Dalian were measured with self-made general questionnaire, professional quality of life scale, Chinese version of Jefferson empathy scale, perceived social support scale and Ego-Resiliency Scale. Results: The scores of compassion satisfaction of medical oncology nurses was (34.79±5.87).Pearson correlation analysis showed that there was a significant positive correlation between empathy, resilience, social support and compassion satisfaction (r=0.222-0.402, P<0.01). Resilience partially mediated the relationship between empathy ability and compassion satisfaction, the value of mediating effect was 23.1% of the total effect. The effect of resilience and compassion satisfaction among medical oncology nurses was also moderated by social support, that is, social support regulates the latter half of the process of empathy, resilience and compassion satisfaction. The higher the level of social support, the stronger the mediating effect of empathy through resilience on compassion satisfaction. Conclusions The level of compassion satisfaction of medical oncology nurses in Dalian is low and needs to be improved. The are close relationships among empathy ability, resilience, social support and compassion satisfaction. It is a moderated mediating effect model. It is suggested that managers should pay attention to the role of psychological resilience and provide high-level social support to improve the level of compassion satisfaction of medical oncology nurses.

Objective: To verify the safety and efficacy of IONTRIS particle therapy system (IONTRIS) in clinical implementation. Methods: Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial: 31 males and 4 females with a median age of 69 yrs (range 39-80). Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non-metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation. Results: Twenty-two patients received carbon ion and 13 had proton irradiation. With a median follow-up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression-free survival rate was 93.8% (15/16). Among the 19 patients with prostate cancer, biological-recurrence free survival was 100%. Particle therapy was well tolerated in all 35 patients. Twenty-five patients (71.4%) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow-up. Six (17.1%) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed. Conclusions IONTRIS is safe and effective for clinical use. However, long term follow-up is needed to observe the late toxicity and long term result.