Background:Tissue microarray has been increasingly used in research of malignancies. It has been revealed that TGF-β signaling pathway contributes to the tumorigenesis and progress of malignancies. Aims:To determine the expressions of Runx3,Smad4,Cdk2 and p21,the key molecules in TGF-β signaling pathway by tissue microarray,and investigate their correlations with clinicopathological features and prognosis of gastric cancer. Methods:A total of 378 paraffin embedded tissue blocks,including 130 gastric cancer tissue and 248 para-cancer tissue from 130 patients undergoing radical resection of gastric cancer were obtained. Tissue microarray and immunohistochemistry were used to determine the expressions of Runx3,Smad4,Cdk2 and p21. Results:The aberrant expression rates of Runx3,Smad4, Cdk21 and p21 in gastric cancer tissue were significantly higher than those in para-cancer tissue(67. 7% ,35. 4% , 63. 8% and 70. 0% vs. 14. 1% ,12. 5% ,18. 1% and 37. 1% ,P < 0. 05,respectively). Aberrant expression of Runx3 was closely correlated with histological grade and lymph node metastasis of gastric cancer( P < 0. 05),while aberrant expressions of Smad4 and p21 were correlated with histological grade only(P < 0. 05);aberrant expression of Cdk2 was correlated with histological grade,lymph node metastasis and TNM staging(P < 0. 05). Pairwise correlations were seen among aberrant expressions of Runx3,Smad4 and p21 in gastric cancer,while Cdk2 was correlated with Runx3 only. Kaplan-Meier survival curve showed that 5-year survival rates in Runx3,Smad4 and p21 aberrant expression groups were significantly lower than those in normal expression groups(P <0. 05). Furthermore,Cox proportional hazard model indicated that Runx3 and Smad4 were independent prognostic factors for gastric cancer. Conclusions:Runx3,Smad4,Cdk2 and p21 might play pivotal roles in tumorigenesis and progression of gastric cancer. As interactions occurred among these four proteins,whether Runx3 and Smad4 could be used for predicting the prognosis of gastric cancer needs to be further studied.

Objective To analyze the clinical features of hyperperfusion syndrome occurring after carotid artery stenting, and to discuss its nursing measures. Methods Among 220 patients who received carotid artery stenting, nine developed hyperperfusion syndrome after stent implantation. Their clinical materials were retrospectively analyzed. The nursing measures, including properly controlling blood pressure, relieving brain edema, monitoring cerebral blood flow, medication with sedation drug, stopping or reducing antiplatelet therapy, close observation of blood pressure and clinical symptoms, cooperation with physicians to control the blood pressure and to dynamically make reexamination, etc. Results Of the nine patients with hyperperfusion syndrome, complete recovery was achieved in eight at the time of discharge and death due to intracranial hemorrhage occurred in one. Conclusion The key point of nursing for patients with hyperperfusion syndrome is close cooperation with physicians to control the patient ’s blood pressure so as to ensure a proper cerebral blood flow.

Bepridil (10mg ? kg-1) iv elevated the threshold dose of ouabain (15ug ? min-1 iv) in guinea-pig and aconitine (10?g ? kg-1 ? min-1 iv) in rat induced ventricular extrasystole, ventricular tachycardia, ventricular fibrillation and cardiac arrest. It shortened the duration of arrhythmia elicitde by Adr (50ug ? Kg-1 iv) in conscious rabbits and by BaCl2 (3mg ? kg-1 iv) in rats. It is also effective in preventing reperfusion-induced arrhythmias in aneasthetized rats.

Objective To explore the characteristics of auditory brainstem response(ABR) in children with otitis media with effusion(OME) before and after myringotomy with grommet insertion and the significance of ABR in diagnosing OME.Methods ABR were recorded in 50 cases(100 ears) before receiving myringotomy with grommet insertion for OME,30 cases(60 ears) underwent ABR monitoring after surgery again.For comparison,50 age-matched healthy children(100 ears) were also tested with ABR.Furthermore,30 cases were divided into two groups according to the viscidity of tympanic cavity secretion and the response threshold of wave Ⅴ were compared between the two groups.Results The response threshold of wave Ⅴand the peak latency of wave Ⅰwere normal in 13 percent of 50 cases(100 ears) before surgery.The rate of missed diagnosis was 13%.Among 50 cases,41% had normal response threshold for wave Ⅴ,52% had slight abnormal responses of thresholds of wave Ⅴ and 7% had medium response threshold of wave Ⅴ.The peak latency of wavs Ⅰwas normal in 19% OME children,but it prolonged in 72% OME children and absent in 9% OME children.The prolonged peak latencies(waves Ⅰ,Ⅲ andⅤ) and eleveted response thresholds of wave Ⅴ and shorted transmission time between waves(Ⅰ-Ⅲ andⅠ-Ⅴ) significant when compared to the control group.After surgery,the response thresholds of wave Ⅴand the peak latency of wave Ⅰwere normal in 46.7% children,the response threshold of wave Ⅴ were normal in 70.5% and slight abnormal in 29.5%.Occuring(elicit) rate of wave Ⅰwas 100% and peak latency of wave Ⅰwas normal in 50.2% chilren.The differrence of peak latencies(waves Ⅰ,Ⅲ andⅤ) and the response threshold of wave Ⅴ before surgery

Objective:To investigate the efficacy and safety of insulin glarsine combined with sitagliptin in elderly type 2 diabetic patients whose blood glucose levels were inadequately controlled by oral anti-diabetic drugs ( OAD) . Methods: In the open-labeled, randomized and parallel study, 98patients (≥60 years) were randomly divided into two groups: insulin glargine/sitagliptin combina-tion group (n=52, the observation group ) and insulin Aspart 30 injection group (n=46, the control group). The dose was adjusted according to the blood glucose. The fasting blood glucose (FBG), 2h postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA1c), the incidence of hypoglycemia and body mass index (BMI) after the 12-week treatment were compared between the two groups. Results:The fasting glucose and the incidence of hypoglycemia in the observation group were lower than those in the control group (P<0. 05). There were no significant differences in 2h postprandial blood glucose, HbA1c and BMI between the two groups (P>0. 05). Conclusion:The treatment of insulin glargine combined with sitagliptin is safe, effective and convenient in elderly type 2 diabetes patients with poor glycemic control. By diabetic education, the lower incidence of hypoglycemia treatment will be a better choice for elderly type 2 diabetic patients.

Objective: To explore the application value of ablation catheter for pacemaker atrial lead restoration in relevant patients.
Methods: A total of 6 patients with atrial lead dislodgement after pacemaker implantation were selected for our study. The atrial lead restoration was conducted by using ablation catheter via femoral vein pathway.
Results: The average operational time was (15.0 ± 3.7) min which was obviously less than traditional operational time. The position of electrode restoration was ideal with well immobilization.
Conclusion: Ablation catheter is feasible for arial lead restoration in patients with atrial lead dislodgement after pacemaker implantation.

Objective To observe the effect of traditional Chinese medicine internal and external treatment on chronic osteomyelitis.Method Chronic osteomyelitis experimental animal models were set up with debridement, then it was random divided into two groups ( antibiotics group for the control group, antibiotics and traditional Chinese medicine group for the observation group).After treatment for 10 days, new capillaries in the tissues surrounding sinus crossings were detected by pathological observation and VEGF expression was determined by ELISA.Result VEGF expression and vascular points of tissues surrounding sinus crossings of antibiotics with traditional Chinese medicine group were obviously higher than that of antibiotics group[ (47.48 ±3.22) μg/ml vs (28.26 ±2.61)μg/ml, P ＜0.01;8.03 ±1.73 vs5.17 ±2.89, P＜0.05 ].Conclusion Traditional Chinese medicine internal and external treatment can improve VEGF expression and increase capillary number inside tissues surrounding sinus.crossings , thus it can promote the healing of chronic osteomyelitis.

Objective To investigate the effect of transitional care on postpartum negative mood for puerpera. Methods One hundred sixty eligible puerperas were recruited between January 2013 and October 2014. By order of hospitalization, participants were randomly assigned into two groups. The control group (80 cases) received routine care. The study group received transitional care which consisted of predischarge assessment, structured home visits and telephone follow-ups, psychological rehabilitation group activities, phone and internet consulting services within six months after discharge. Screenings of predischarge depression and anxiety symptoms of the study group were done by Hospital Anxiety and Depression Scale (HADS). Evaluations of depression and anxiety symptoms of two groups were done by Edinburgh postnatal depression scale (EPDS) and Self-Rating Anxiety Scale(SAS)on postpartum forty-two days and six months. Results There were no differences in demographics, maternal indicators and completion of follow-up between groups (P > 0.05). On postpartum forty-two days, the study group had significantly better depression and anxiety scores (P < 0.05), the depression and anxiety scores of study group were 7.71 ± 2.61and 44.3 ± 6.1, those of control group were 8.31 ± 2.72 and 47.6 ± 5.4. There were no differences in the incidences of depression and anxiety between the two groups (P>0.05). On postpartum six months, the study group had significantly better depression and anxiety scores, less incidences of depression and anxiety than the control group (P<0.05). The depression and anxiety scores of the study
group were 7.13±2.52 and 42.6±6.0, those of control group were 8.87±2.66 and 48.8±5.9. The incidences of depression and anxiety of study group were 6.4%(5/78)and 7.7%(6/78), those of control group were both 26.0%(20/77). Analysis of multiple linear regression suggested that age, education level and family income would affect transitional care intervention on postpartum depression. Conclusions This study established a nurse-led transitional care model which selected the gynecology and obstetrics professional nurse as advanced practice nurse. Results demonstrated that transitional care was effective on improving maternal postpartum depression and anxiety.

Objective To explore a rapid,simple and effective therapy for serious pneumothorax which could be used in pre-hospital and in-hospital first-aid.Methods Sixty-seven patients were randomly divided into the observation group and control group .Patients in the observation group were treated using laparoscopic trocar for rapidly closed thoracic drainage,and patients in the control group were treated by using the traditional large caliber drainage tube and the intercostal incision method of conventional closed thoracic drainage.The operation time,remaining time of drainage,length of stay,effective rate,and complications,including of postoperative pain,hemorrhage,subcutaneous emphysema and infection were observed in both groups. Results The total effective rate was 94.1%(32/34) in the observation group,which was significantly higher than that in the control group(90.9%,30/33)(x2=1.876,P＞0.05).No significant difference was found on the remaining time of drainage and length of stay between the two groups(remaining time of drainage:[4.56±1.65]d vs.[6.26±3.45]d;length of stay:(6.0±2.6)d vs.(6.7±2.2)d ,t=1.335 and 0.779,respectively,Ps＞0.05).The operation time of using laparoscopic trocar was significantly lower than that of the control group((5.00±1.28)min vs.(15.00±4.03)min,t=3.031,P＜0.05).The incision length was(0.95±0.11)cm in the observational group,which was significantly lower than that in the control group((2.41±0.52)cm ,t=2.585,P＜0.05).Postoperative pain occurred in 14.7%(5/34) of patients in the observational group,which was significantly lower than that in the control group(87.9%(29/33))(t=2.983,P＜0.05).In the observational group no hemorrhage and infection occurred,whereas in the control group the hemorrhage and infection rate was 36%(12/33) and 33%(11/33),respectively(x2=5.880 and 3.687,respectively,Ps＜0.05). Conclusion The use of laparoscopic trocar for rapidly closed thoracic drainage in the treatment of serious pneu-mothorax is simple,easy,convenient,effective and reliable,with few complications.This therapy is suitable for using in pre-hospital and in-hospital first-aid.

Objective To build a multi-system chain transitional care programme for postpartum pelvic floor training and test its effect.Methods By a prospective randomized controlled trial,the study group (n=60) received a multi-system chain transitional care programme which consisted of ward nurse,home visiting doctor,post-natal care clinic doctor,pelvic floor doctor and pelvic floor nurse.The control group(n=60) received routine care.The pelvic floor muscle strength,sexual function and patient satisfaction of baseline,on the 42th days,3rd months and 6th months were compared between two groups by short-term follow-up.Results There was no difference in baseline consisting of age,gestational weeks,birth weight and so on between groups.Participants in the study group had significantly better improvement and score in pelvic floor muscle strength,sexual thoughts,sexual arousal,sexual psychopathy and problems affecting sexual function.There was no difference in score of sexual pleasure and ejaculation time between two groups.Conclusions This study was an original effort to establish and evaluate a multi-system chain transitional care program for postpartum pelvic floor training.Results demonstrated that this transitional care was effective in improving pelvic floor function.