The development of clinical medicine depends on high-quality evidence from clinical research .Strengthening clini-cal research is important for the advancement of new clinical technology and improvement of clinical diagnosis and treatment .In the present paper , the author discusses how to carry out and analyzes the value of clinical research in medical development , offering young clinicians some experience for reference in promoting their clinical research ability and the development of clinical medicine .

The occurrence of cervical cancer is the result of long-term synergy from a variety of carcinogenic factors.Human papilloma virus (HPV),the main biological cause of cervical cancer,is closely related to the occurrence of cervical cancer,while HPV E6/E7 protein plays an important role in the malignant transformation of cervical cancer.This article summarizes the carcinogenic mechanism of HPV E6/E7 and application in cervical cancer screening,and reviews the targeting therapy aiming at HPV E6/E7.

Objective To know the influence of progressive nursing interventions on rehabilitation effect in elderly patients undergoing hysterectomy.Methods 130 cases of elderly patients undergoing hysterectomy who visited our hospital during June 2012 to Deember 2013 were selected as study object,and were randomly divided in to the intervention group (n=65) and the control group (n=65).The intervention group was formulated with mobilization program and method,received commensurate on nursing intervention,the control group was given routine nursing care.The degree of postoperative adverse symptoms occur rate,recovery of gastrointestinal and bladder function,and the quality of life 6 months after surgery were compared between the two groups.Results Compared with control group,the unwell symptom such as dizziness,nausea and vomiting,abdominal pain,abdominal distension and the were decreased obviously in intervention group,respectively as 4.6％,6.2％,13.8％,12.％ vs 23.1％,26.2％,33.8％,36.9％,P＜0.05.The anus exhaust and defecation time,the first meal time were significantly shortened,respectively as (26.4±4.7) h,(48.2±9.6) h,3 (0.6±5.9) h vs (38.1±5.8) h,(86.5±13.3) h,(43.7±6.8) h,P＜0.05.Physiological function (sleep and energy,physical discomfort,the motor function),and the social function of the quality of life (social support,social life and interpersonal) in Intervention group was increased significantly compared with control group,P＜0.05.Differences in the time of taking stitches and postoperative uroschesis incidence rate of the two groups had no significant,P＞0.05.Conclusion Progressive nursing interventions can improve the rehabilitation and the quality of life of elderly patients undergoing hysterectomy.

Rational allocation and effective use of health resources can be fully achieved by implementing in an all-round way regional health planning and reinforcing the macro-control of health resources. The paper gives an account of the ways in which the City of Tianjin, on the basis of investigation and study and guided by regional health planning, readjusted health resources city-wide and actively promoted the developement of community health services. The purpose is to initiate discussion on the topic.

Multidrug resistance (MDR) is one of the major obstacles to cancer chemotherapy. It is now well established that MDR phenotype is strongly correlated with the over expression of P glycoprotein (P gp), a membrane glycoprotein encoded by MDR1 gene. There is very great progress in the research of the P gp inhibitors in recent years. This article describes the current research state of the P gp inhibitors.

Objective To investigate the high-risk factors for cholangitis after endoscopic sphincterotomy (EST), and to provide a reference for clinical prevention and treatment.Methods A total of 196 patients who underwent EST in our hospital from June 2013 to January 2016 were enrolled, among whom 31 experienced cholangitis after EST (infection group) and 165 had no cholangitis (control group).Related factors were analyzed for both groups.The t-test was used for comparison of continuous data between groups;the chi-square test was used for comparison of categorical data between groups, and a multivariate non-conditional logistic regression analysis was performed for variables with statistical significance.Results The univariate analysis showed that there were significant differences between the two groups in the past history of biliary tract surgery [8 (25.81%) vs 10 (6.06%), χ2=12.200, P=0.000 5], number of common bile duct stones (2.8±0.5 vs 2.2±0.6, t=5.234, P=0.000 5), gallstones complicated by cholecystitis [8 (25.81%) vs 13 (7.88%), χ2=6.994, P=0.000 4], intrahepatic bile duct stones [6 (19.35%) vs 8 (4.85%), χ2=8.280, P=0.004 0], time of operation (35.6±5.8 min vs 27.1±6.2 min, t=7.072, P=0.000 4), presence or absence of lithotripsy [10 (32.26%) vs 15 (9.09%), χ2=10.591, P=0.000 1], postoperative pneumobilia [12(60.00%) vs 16 (21.82%), χ2=17.940, P=0.000 2], and duration of the use of antibiotics (3.6±0.7 d vs 4.5±0.8 d, t=5.854, P=0.000 6).The multivariate non-conditional logistic regression analysis showed that past history of biliary tract surgery [OR (95%CI)=1.962 (1.156-3.658), P=0.024], number of common bile duct stones [OR (95%CI)=2.632 (1.366-5.013), P=0.021], intrahepatic bile duct stones [OR (95%CI)=2.976 (1.482-5.536), P=0.024], time of operation [OR (95%CI)=4.859 (2.513-8.622), P=0.006], postoperative pneumobilia [OR (95%CI)=5.326 (2.633-10.524), P=0.005], and duration of the use of antibiotics [OR (95%CI)=0.565 (0.263-0.895), P=0.009] were independent risk factors for cholangitis after EST.Conclusion Positive intervention of related risk factors for cholangitis after EST has important clinical significance in the prevention of cholangitis after EST.

Objective: To explore influencing factors for sudden cardiac death (SCD) in inpatients.Methods: A total of 124 patients died of heart disease were enrolled.According to SCD or not, they were divided into SCD group (n=65) and non-SCD group (n=59).Clinical data, laboratory examination results, biological rhythm and ECG manifestation at death were compared between two groups.Results: For biological rhythm at death, 41.54% death occurred during 6:01~12:00 in SCD group, which was significantly higher than other time period (P<0.01 all);there was no significant difference in mortality among all time periods in non-SCD group (P>0.05).Compared with non-SCD group, there were significant rise in death proportion in 6:01~12:00 (23.73% vs.41.54%,P=0.007), in levels of creatine kinase [CK, (1140.66±176.63) IU/L vs.(1949.52±2141.22) IU/L], creatine kinase isoenzyme MB [CK-MB, (92.43±28.30) IU/L vs.(175.20±231.44) IU/L] and cardiac troponin I [cTnI, (30.09±34.27) mg/L vs.(44.34±10.60) mg/L], and significant reduction in left ventricular ejection fraction [LVEF, (49.83±11.24)% vs.(37.53±23.11)%] in SCD group, P<0.01 all;in SCD group, SCD caused by coronary heart disease occupied 86.15% (56/65), and myocardial infarction occupied 66.15%(43/65).Conclusion: Coronary heart disease, especially myocardial infarction, is an important factor leading to sudden cardiac death.Detection of CK, CK-MB, cTnI and LVEF levels have important sense for prevention and treatment of sudden cardiac death.

BACKGROUND: Studies have proved that rotating magnetic field(RMF) can significantly increase bone mineral density(BMD) in rats, and such high BMD maintains for a long time which is independent of the actions of hormone.OBJECTIVE: To investigative the effect of RMF on bone calcium content and the correlation between bone-specific alkaline phosphatase(BAP) and deoxypyridinoline crosslinks (DPD) in rats.DESIGN: A randomized controlled study in rats.SETTING: A college of life sciences of a university.MATERIALS: The experiment was conducted in Shenzhen Key Lab of Microbiological Genetic Engineering from March 2004 to October 2004, using 90 healthy adult SD rats including 60 females weighing(259 ± 70) g and 30 males weighing (351 ± 104)g. The rats were randomly divided into 9 groups including 6 ovariotomy groups, namely female sham-operation group, normal calcium control group, low calcium control group, low calcium experimental group, normal calcium experimental group, and low calcium group with traditional Chinese medicine(TCM) treatment, besides a male control group,male low calcium experimental group, and male normal calcium experimental group, with 10 rats in each group.INTERVENTIONS: The female rats in each group, except for those in the sham-operation group, received ovariotomy. The rats in the ovariotomy control group had only ovariotomy. After metabolic exhaustion of the remnant estrogen on the 15th day, the rats in the ovariotomy experimental group were treated with RMF for 2 hours once a day for 15 days. The male rats, except for those in the control group, all bad RMF in identical manner. The rats were given food with normal calcium(containing 0.26% calcium), lower calcium (containing 0.1% calcium) and traditional Chinese medicine(powder of Fructus Psoraleae, Radix Astragali, epimedium herb, and herba cistanchis) .After RME treatment, the rats were fed for another 15 days before the femur was collected to measure the bone calcium content. Serum samples were also obtained for measuring the content of BAP and urine samples collected to measure the content of DPD.MAIN OUTCOME MEASURES: The bone calcium content of each group and serum BAP and urine DPD.RESULTS: Of the 90 rats used, 4 died during the experiment and 86 entered the result analysis. The bone calcium content was increased after RMF treatment, and the content in rats in the low calcium group with ovariotomy and TCM treatment and lower calcium control group with ovariotomy was(0.226± 0. 015) and(0. 206 ± 0. 015) g/g, respectively( t =4.63, P ＜ 0. 05). The bone calcium content in the male normal calcium experimental group and male control group was(0. 206 ±0. 031) and(0. 199 ±0. 014) g/g respectively ( t = 4.21, P ＜ 0.05 ) . After treatment with RMF, serum BAP content was increased and was(20. 52 ± 1.78) and(15.68 ±3.68) U/L in normal calcium experimental and control groups with ovariotomy, respectively( t=4.76, P ＜0.05), and(17.69±3.78) and (8.53±2.54) U/Lin the male low calcium experimental and male control groups, respectively( t= 4. 59, P ＜ 0.05). Urine DPD after RMF treatment was (86.97 ± 37.19)and(401.57 ±79. 34) nmol/L in the low calcium experimental group with TCM treatment and ovariotomy and the low calcium control group with ovariotomy, respectively( t =7.45, P ＜ 0.01), and(97.87 ±31.97) and (168.71 ±53.19) nmol/L in the male normal calcium experimental and male control groups respectively( t = 8.31, P ＜ 0.01 ).CONCLUSION: RMF can effectively increase bone calcium content in a short time( 15 days), and the effect was positively correlated with increased blood BAP and decreased urine DPD.

Objective To observe the effects of rotary magnetic to bone mineral content(BMC), bone specific alkaline phosphatase (BAP) and deoxypyridinoline crosslinks (DPD), and to explore if there is synergistic action between the rotary magnetic field and the Chinese Medicine. Methods Experimental rats were exposed to the magnetic field 2 hours a day for 15 days then measured BMC, BAP and DPD then compared with that of the control rats. Results After rotary magnetic treatment, both female and male rats demonstrated a significant increase in BMC and BAP, and a simultaneous decrease in DPD content. Addition of Chinese medicine did not cause any significant difference of these parameters. Conclusion In rats with ovariotomy, rotary magnetic field can increase BAP and decrease DPD in a short time,and increase bone mineral content. These effects were similar in both female and male rats.

BACKGROUND:Scholars have made certain progress in the basic and clinical studies regarding antibacterial bone graft materials. OBJECTIVE: To investigate the mechanical property of antimicrobial silver-loaded coral hydroxyapatite bone usingin vitro mechanical experiments and to explore its ability to repair large segmental contaminative bone defects. METHODS:Compression test and three-point bending test were used to evaluate the mechanical properties of silver-load coraline hydroxyapatite, coraline hydroxyapatite and coral. Thirty-six New Zealand white rabbits were selected and randomly divided into four groups to establish right-side large segment of contaminative radial bone defect models. Rabbits in three groups were implanted silver-load coraline hydroxyapatite, coraline hydroxyapatite andin situ autologous bone, and rabbits in the other group were not implanted any material (as control). At 2, 6 and 10 weeks post-operation, the rabbits were sacrificed to take specimens. The repair of bone defects in each group was observed and compared by gross observation, radiographic examination and histological examination. The antimicrobial condition in each group was evaluated by bacteriological examination. RESULTS AND CONCLUSION:There was no significant difference between the mechanical properties of silver-load coraline hydroxyapatite, coraline hydroxyapatite and coral. At the 10th week post-operation, X-ray and histological observation showed mature bone tissues in the silver-load coraline hydroxyapatite bone group. A large number of lacunae and mature bone cels were visible in bone tissues. Haversian system was visible. Most of the materials were degraded, and there was only a smal amount of residual material. Partial recanalization was visible in bone marrow cavity. The repair effect of silver-load coraline hydroxyapatite bone group was similar with the autologous bone group, and better than the coraline hydroxyapatite group and the control group. Bacteriological examination showed that the silver-load coraline hydroxyapatite had good antibacterial ability. These results demonstrate that the silver-load coraline hydroxyapatite has good mechanical properties and antibacterial properties, which can be used to repair large segmental contaminative bone defects.