Objective To discuss the promoting effect of clinical pathway in the standard and reasonable medication by the application of clinical pathway in the anticoagulation treatment of warfarin and health education for patients with atrial fibrilation.Methods Sixty eight patients with atrial fibrilation and receiving anticoagulation treatment of warfarin were divided randomly into the intervention group(36 cases)and the control group(32 cases).The control group received routine nursing while the intervention group underwent nursing intervention with clinical pathway based upon routine nursing intervention.The time cost to achieve the aims,compliance,incidence rate of complications and satisfaction degree were compared between the two groups.Results All the items in the intervention group were superior to those of the control group except for the items of satisfaction degree and health knowledge score(P<0.05).Conclusion Application of clinical pathway in the anticoagulation treatment of warfarin for patients with atrial fibrilation could ensure standard and reasonable medication in order to decrease medical cost,lower the incidence rate of complications,improve patients compliance and increase nursing quality.

Objective To improve the capability of diagnosing and treating renal chromophobe cell carcinoma (RCCC) and the recognition of this subtype of renal cell carcinoma (RCC). Methods The clinical data of 15 cases of RCCC (10 men and 5 women) were analyzed.Their age ranged from 47 to 74 years,with a mean of 57 years. Radical nephrectomy was performed in all these cases. Results Postoperative pathological findings confirmed the diagnosis of RCCC.The pathologic TNM stage of RCCC was as follows:pT 1N 0M 0 in 6 cases,pT 2N 0M 0 in 5,pT 3bN 0M 0 in 2,pT 1N 2M 0 in 1 and pT 2N 2M 0 in 1.The pathologic grade of RCCC was G 2 in 10 cases and G 3 in 5.Eleven cases were followed up.During the follow-up of 2 to 31 months (mean, 19 months),1 died of heart attack,1 had local recurrence and 9 were surviving tumor free. Conclusions RCCC is a morphologically distinctive uncommon subtype of RCC.Radical nephrectomy is the first choice for the treatment of RCCC.Compared with other types of RCC at the same stage and of the same grade,RCCC has a better prognosis.

Objective To introduce and evaluate the procedure of suprapubic tensionless Sparc TM sling system in treating female stress urinary incontinence (SUI). Methods A total of 42 patients (mean age,54 years) diagnosed with SUI (a mean course of 12 years) were treated by Sparc TM sling method.Of them 4 cases had detrusor instability.Under local anesthesia,this procedure took about a mean of 20 min.The urinary catheters were removed the next morning after the procedure.The patients were counseled on abstaining from heavy lifting,exercises and intercourse for 4 weeks. Results After removal of catheters,all the 42 patients successfully voided without incontinence.Detrusor instability to various degrees developed in 7 patients and was relieved by expectant treatment.All the patients were followed up for 3 to 12 months (mean,6 months).Neither recurrence of SUI nor lower urinary tract obstruction was found.No implant related complications such as local irritation,extrusion,erosion through the urethra,migration from the desired location,fistula formation and inflammation occurred. Conclusions Sparc TM sling system is a simple,safe and efficacious method of treating SUI under local anesthesia.

OBJECTIVE:To establish a HPLC method for the determination of levodopa in levodopa inclusion complex.METHODS:The separation was performed on C18,and the mobile phase consisted of methanol-0.01mol?L-1 potassium dihydrogen phosphate buffer solution(25∶75,pH 3.0)with a flow rate of 1.0mL?min-1.The column temperature was 30℃,the detection wavelength was 280 nm and the sample size was 20?L.RESULTS:A good linear relationship was obtained for levodopa within the range of 5～80?g?mL-1(r=0.999 8),and its average recovery was 100.1%(RSD=0.19%,n=15).CONCLUSION:This method is simple,rapid,accurate,and it can be used for the content determination of levodopa in levodopa inclusion complex.

[Objective]To demonstrate the shift of the spinal cord to the concave side of the spinal canal in adolescent patients with idiopathic thoracic scoliosis,to investigate possible cause of the shift of the spinal cord and to explore its clinical relevance.[Method]Thirty-nine adolescents with idiopathic thoracic scoliosis were recruited in this study.Cobb's angle,relative apical translation and relative trunk shift of the major thoracic curves were recorded from standing posteroanterior roentgenography of the whole spine.The shift of the spinal cord was determined through the measurements of distance between the spinal cord and the medial walls of the pedicles on the convex and concave sides,which were performed in transverse magnetic resonance images of the spinal canal in the major thoracic curves(T5~12).The variations of the shift of the spinal cord were determined,and the relationships between the shift of the spinal cord at the apical region and Cobb's angle,and between that and the relative apical vertebral translation were analyzed.[Result]In the region of the major thoracic curves,the distance from the spinal cord to the pedicle on the convex side was significantly less than the distance to the pedicle on the concave side(P

Cell adhesion mediated by cell adhesion molecules (CAMs) constitutes essential life phenomenon. In inflammation, immunity, infection, thrombosis, tumor metastasis and wound healing, cell adhesion comes into being the basic physiological and pathological process. Intervening with cell adhesion has been the important therapeutic and prophylactic strategies for diseases. Accumulated evidence has indicated that plant polysaccharides especially those exacted from Chinese traditional and herbal drugs displayed various pharmacological effects such as anti-inflammation, anti-cancer, anti-infection, immunomodulation, cardiovascular protective effects and so on. In this paper, the research progress of plant polysaccharides on cell adhesion is reviewed.

Apoptosis ; Ceramides ; biosynthesis ; Sphingomyelins ; metabolism

Objective To explore the effect of rapamycin on pulmonary fibrosis in rats and its mechanism.Methods Pulmonary fibrosis model was induced by intratracheal instillation of bleomycin (5mg/kg).Control group was treated by intratracheal instillation of saline (1.25 ml/kg) to obtain the negative control.The rats of the rapamycin-treated group were given rapamycin (1 mg/kg per day) by gastric perfusion for consecutive 10 days beginning on the third day after intratracheal instillation of bleomycin.On the 28th day,all rats were sacrificed and the peripheral blood and the lung tissues were harvested.Lung tissues were performed hematoxylin-eosin (HE) staining.The severity of pulmonary fibrosis in rats was assessed by Ashcroft score.Lung tissues were performed immunohistochemical staining to detect the expression of transforming growth factor beta (TGF-beta).The expression level was judged by integrated optical density.Results The severity of pulmonary fibrosis was improved in rats of rapamycin-treated group compared with the rats of bleomycin-treated group.A significant difference in Ashcroft score was found between rapamycin-treated group and bleomycin-treated group(2.92 ± 0.64 vs 5.76 ± 1.76,P ＜ 0.01).The expression level of TGF-β was increased in rapamycin-treated group compared with the normal control group (5520.00 ± 1614.20 vs 3370.00 ± 1478.14,P ＜0.01).The expression level of TGF-β was decreased in rapamycin-treated group compared with the bleomycin-treated group (5520.00 ± 1614.20 vs 7772.00 ±1526.46 P ＜0.01).Conclusions Rapamycin can prevent bleomycin-induced pulmonary fibrosis.

Vibrio parahaemolyticus has been considered as one of the most important foodborne bacterial pathogens.The loop-mediated isothermal amplification(LAMP) that amplifies DNA with high specificity and rapidity under an isothermal condition was applied for rapid detection of this pathogen for the first time.A set of four primers,two outer and two inner primers,was designed specifically to recognize the thermolabile hemolysin gene(tlh) of V.parahaemolyticus.The LAMP reaction mix was optimized.The most optimal reaction temperature and time of the LAMP assay for the tlh gene were 60℃ and 60min,respectively.Genomic DNAs from 28 bacterial strains including 14 V.parahaemolyticus strains were amplified using LAMP,and no amplicon was observed in other bacterial strains.The detection limit of this LAMP assay was around 90 fg of V.parahaemolyticus genomic DNA and 24 colonies forming units for pure cultures.In addition,this method was applied to detect artificially contaminated food samples,and the detection limit was 89 cfu/g for non-cultured artificially contaminated food samples.These results suggested that detection of V.parahaemolyticus by LAMP is an effective and low-cost procedure with high specificity and sensitivity that requires no specialized equipment.This assay is expected to become a valuable tool for rapid detection and identification of V.parahaemolyticus.

Teaching competency is one of the basic skills for teachers to accomplish daily teaching routine.This article focused on issues like imbalanced development in teaching competency,young teachers' lack of solid basic teaching ability,teachers' weak research ability and their lack of research ability to support teaching process in local medical colleges.In theory it systematically explained the teachers' teaching competency structure.Through the implementation of three linkage training of university-faculty-teaching and research department,normalized and institutionalized training for teachers from teaching-hospital,cooperation between clinical and basic medicine teachers,teachers' basic teaching ability was improved.And by transforming teaching evaluation philosophy,setting teaching quality standards at different levels,strengthening teachers' teaching introspection,teachers' ability in teaching evaluation was increased.Besides,by delivering encouragement policy and project driven teachers were guided to upgrade research ability in order to reflect on teaching.