Objective: To evaluate the efficacy and safety of lobaplatin combined with docetaxel in the treatment of the recurrent ovarian carcinoma. Methods: We collected 31 patients who diagnosed as recurrent ovarian carcinoma according to the histopathology or cytology from Tumor Hospital of Hunan Province from January 2011 to January 2013. The patients received cisplatin-based chemotherapy or carboplatin-based chemotherapy before the combined chemotherapy of docetaxel and lobaplatin. For patients with the recurrence, they received a treatment at a dose of 80 mg/m2 for docetaxel on day 1 and a dose of 30 mg/m2 for lobaplatin on day 2, which lasted for 21 days as a treatment cycle. hTe patients received 6-cycletreatment at most. Results: A total of 153 cycles of chemotherapy were given to 31 patients, with a median of 4 (2–6) cycles. Three patients showed complete response, 11 partial response, 2 stable disease, and 15 progressive disease. hTe objective response rate (ORR) was 45.16% (95% CI, 26.61%–63.72%), and the disease control rate (DCR) was 51.63% (95% CI, 32.98%–70.25%). The median progression-free survival was 7 months (95% CI, 4.27–9.73 months). For the toxic and side effects among the 31 patients, the numbers of the grade 3, grade 2, and grade 1 leukopenia were 1, 8, and 13, respectively. Meanwhile, 18 were grade 1–2 neutropenia, 17 grade 1–2 anemia, and 2 grade 1 thrombocytopenia. At the same time, alimentary canal reaction followed by nausea and vomiting was relatively modest and could be controlled. hTe serious damage of hepatic-renal function was not found. Conclusion: The chemotherapy of lobaplatin combined with docetaxel is effective on recurrent and refractory ovarian cancer with low side effects, which has advantages over the second-line chemotherapy protocols.

Objective To evaluate the neuroprotective effect of electro‐acupuncture(EA) on cerebral ischemia‐reperfusion (IR) injury and deeply investigate the relationship between this neuroprotective effect and PI3K/Akt pathway .Methods A total of 60 Male adult SD rats were randomly divided into five groups:sham control group(SC ,n=12) ,ischemia control group ,(IC group , n=12) electro‐acupuncture group(EA group ,n= 12) ,EA + DMSO group(DMSO group ,n= 12) and EA + LY294002 group (LY2940002 group ,n=12) .Rats in the IC group、EA group、DMSO group and LY2940002 group underwent 2 h of middle cerebral artery occlusion(MCAO) ,followed by 72 h of reperfusion .DMSO or LY294002 was injected into the lateral ventricle at 30 min be‐fore the ischemia .Rats of the IC group ,EA group ,DMSO group and LY2940002 group received electro‐acupuncture at 24 h after the operation and continued until animals were sacrificed at 72 h after the operation ,and the stimulation parameters were set as fol‐lows :disperse wave ,30 min of each time ,once a day .Neurological deficit scores were assessed at 24 h ,48 h and 72 h after the IR in‐jury .The infarct volume was determined at 72 h after the IR injury using TTC staining .Apoptotic cells in the cerebral cortex were quantified under confocal fluorescence microscope using TUNEL staining .The expression of PI3K ,Akt ,p‐Akt ,Bad and p‐Bad at the protein level was assessed by Western blotting .Results Significant differences were observed in terms of neurological deficit scores between and among the EA group ,DMSO group and other groups at 48 h and 72 h after the cerebral IR injury(P<0 .05) .At 72 h after the cerebral IR injury ,the infarct volume of the IC group and LY294002 group was significantly larger than those of the EA group and DMSO group(P<0 .05) .Compared with the IC group and LY294002 group ,EA treatment greatly reduced the number of apoptotic nerve cells(P<0 .01) .The expression of PI3K ,p‐Akt and p‐Bad at the protein level in the EA group and DMSO group were higher than those of the IC group and LY294002 group(P<0 .05) .Conclusion EA treatment at points of Zusanli(ST36) and Quchi(LI11) exerted the neuroprotective effect on the cerebral IR injury through the modulation of PI3K/Akt pathway .

Superselective angiography and embolization is one of the important methods in the management of acute hemorrhage, providing mini-invasion and high efficacy, etc. The implication of angiography and embolization on bleeding were reviewed and the embolic agents as well as the interventional procedures were commented in this article.

Percutaneous radiofrequency ablation (RFA) has been widely used in the treatment of malignant hepatic tumors and has achieved satisfactory effects.Complications after RFA have been taken seriously and the risk of the development of complications is closely associated with tumor location.It is a great challenge for physicians to perform RFA for hepatic tumors in high-risk locations due to related difficulties and risks.This article reviews the complications after RFA for hepatic tumors in high-risk locations and analyzes related control strategies.

NOK is a newly identified receptor protein-tyrosine kinase (PRTK) molecule that can promote tumorigenesis and metastasis. Previous data showed that NOK could activate the phosphatidylinositol 3'-kinase (PI3K) pathway in stable BaF3 cells. But how does NOK activate PI3K in cells remains unknown. It was showed that NOK physically interacted with the PI3K downstream effector Akt and enhanced its activation in human embryo kidney 293T (HEK293T) cells. Deletion mapping indicated that protein kinase B (Akt) was able to directly contact with the kinase domain of NOK. Inactivating the Akt kinase domain significantly reduced the intermolecular interaction between NOK and Akt, while constitutively active mutant of Akt apparently had a stronger interaction with NOK. NOK did not have an additive effect on insulin-mediated Akt activation. Overall, the results indicate that NOK might complex with Akt and directly activate PI3K/Akt signaling pathway.

Antiviral Agents ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; virology ; Hepatitis B virus ; Humans ; Liver Neoplasms ; drug therapy ; virology ; Nucleotides ; therapeutic use

Objective To analyze and monitor the distribution of EBSLs-producing E.coli in our hospital and its resistance to commonly used antibacterial drugs.Methods The drug sensitivity test results of E.coli cultured in our hospital from 2008 to 2011 were continuously observed and performed the summary and the descriptive analysis.Results The detection rate of EBSLs-produ-cing E.coli during these 4 years was more than 50%.The generation rate of ESBLs-producing E.coli from the pharyngeal swab samples was the highest.The drug resistance of EBSLs-producing E.coli was mostly higher than that of non-EBSLs-producing E. coli,the difference was statistically significant(P <0.05).EBSLs-producing E.Coli showed the multi-drug resistant phenomenon. But the resistance rate of EBSLs-producing E.Coli to some antimicrobial drugs had the decreasing tendency year by year.Conclusion The drug-resistance situation of ESBLs-producing E.Coli is serious.The diceovered carbapenems-resistance ESBLs-producing E. Coli should cause the concern.The antibacterial drugs with increased drug-resistance rate should be replaced by the antibacterial drugs with the gradually decreased drug resistance rate.Strengthening the bacterial drug resistance minitoring can timely discover the change trend of clinically isolated bacteria and has the improtant significance to provide reference for clinically empirical medica-tion.

This paper used SWOT analysis to explore the advantages , disadvantages , opportunities and threats of the third-party mediation mechanism of medical disputes .For perfecting third-party mediation mechanism of medical disputes , the authors also put forward some ways:intensifying propaganda , efforts to eliminate public per-ception error; improving the relevant laws and regulations , strict constraints mediation organization behavior; to build a long-term training mechanism , to improve the qualification of the mediators , building both doctors and mediation mechanism of multi -dimensional evaluation system , improve the comprehensive performance evaluation;gradually introduced mandatory medical liability insurance , guarantee of medical dispute compensation funding .

Objective Our aim was to study the influence of integration courses combining the death education and resilience cultivation on nursing students.Methods 290 nursing students were randomly divided into the control group and the intervention group with 145 students in each group.The students in the intervention group was provided with the integration courses for 20 class hours based on the curricula of the control group.The influence on the resilience,death anxiety,feeling of sense of life,coping style of students was observed.Results Measurement results showed that the students of two groups had no differences in the four aspects before education,but after education the two groups students showed significant difference,including the average score of resilience and death anxiety,total score of feeling of sense of life as well as the dimensions score of life goals and life value t value was 5.703,3.294,3.649,4.130 and 2.129,P ＜ 0.05.In addition,the mean effectiveness of positive coping styles,problem solving and seeking social support of the two groups showed significant difference too,and all the difference had statistical sense,t value was 1.992,1.977 and 3.344,P ＜ 0.05.Conclusions The integration course can reduce death anxiety as well as improve the resilience of nursing students.

Objective To investigate the prevalence of morphological abnormalities of the internal carotid artery and relationship with ischemic cerebrovascular disease and carotid atherosclerosis.Methods A total of 511 consecutive patients were enrolled in this study and carotid abnormalities were classified according to the criteria of Wain and Metz by combining high-and low-frequency ultraaonography prospectively.Relationship of carotid abnormalities to ischemic cerebrovascular disease and carotid atherosclerosis were analyzed.Results Of the 511 cases,abnormalities of the internal carotid artery were found in 256(50.1 ％),the unilateral carotid abnormalities were found in 121(23.7％),and the bilateral in 135(26.4％),respectively.There was significantly difference in prevalence of kinking and coiling between ischemic stroke and asymptomatic group(P＜0.001),and prevalence of carotid abnormalities in the plaques and arteriosclerosis groups were statistically higher than the normal group(P＜0.001).Conclusions The kinking and coiling of the internal carotid artery could be additive risk factors in the pathophysiology of an ischemic stroke,and carotid morphological abnormalities could be responsible for carotid atherosclerosis partly.