The clinical classification of metastatic spinal tumors is based on the degree of malignancy, nervous system function, osteoclasia, and prognosis of patients. The application of this classification system is relatively simple. The assessment and evaluation of patients to estimate the period of survival can guide the individualized treatment of patients. Patients with clear surgical indications can choose to undergo a palliative operation, tumor resection, or total spondylectomy. Alternatively, other patients can opt to have mini-mally invasive surgery aside from the normal surgical approach. Stereotactic radiotherapy and intensity-modulated radiation therapy combined with the use of radiofrequency ablation, radiation, and other therapies can achieve local tumor control, relieve pain, and main-tain normal neurological function. Thus, the quality of life of the patient is improved. Percutaneous vertebroplasty, radiofrequency abla-tion, spinal endoscopy, and other modern forms of minimally invasive surgery will have more applications in the treatment of spinal metastatic tumors.

Objective To explore the significance of thyroid function determination at the first and second trimesters of pregnan‐cy .Methods Electrochemiluminescence immunoassay was used to detect the levels of TSH ,FT3 and FT4 in first trimester women (T1 group) ,second trimester women (T2 group) and non‐pregnant women (control group) ,respectively .And the results were an‐alyzed .Results There were significant difference in the levels of TSH ,FT3 and FT4 between T1 group and control group (P<0 .05) .The total prevalence rate of thyroid diseases in pregnant women was 28 .85% ,which was significantly higher than that in control group(15 .00% ) ,P<0 .05 .Hypothyroidism and subclinical hypothyroidism were the main forms of thyroid dysfunction in pregnant women .Conclusion The determination of thyroid function at the first and second trimesters of pregnancy will benefit pre‐natal and post‐natal care .

Focal adhesion kinase (FAK), a type of protein tyrosine kinase in the cytoplasm, is highly expressed in many types of malignant tumors. FAK is named as such because of its close relationship with the cell adhesion function. Recent studies show that FAK is expressed in many tumor cells and has a definite relationship with cancer progress, metastasis, and prognosis. Accordingly, FAK has become one of the new tumor therapeutic targets that will bring new methods for tumor therapy.

Objective To study the effect of different dialysis modalities on pruritus in uremic patients .Methods Patients with maintenance hemodialysis who were suffered with severe cutaneous pruritus were randomly divided into hemodialysis group (HD group) ,hemodialysis combined with hemodiafiltration group (HD+ HDF group) ,hemodialysis and hemodiafiltration combined with hemoperfusion group (HD+ HDF+ HP group) .Plasma P3+ ,parathyroid hormone (PTH) and β2-microglobulin (β2-MG) were measured at pre-dialysis ,1 weeks ,4 weeks and 12 weeks after dialysis ,cutaneous pruritus was scored too .Results Compared with pre-dialysis ,the level of plasma P3+ ,PTH ,β2-MG and the scores of cutaneous pruritus were significantly lower at 4 weeks and 12 weeks after dialysis in HD+ HDF+ HP group (P<0 .05) .The were statistically significant difference in P3+ ,PTH ,β2-MG and cu-taneous pruritus scores among 3 groups after 12 weeks (P<0 .05) .Conclusion HD+ HDF+ HP is superior to HD+ HDF in effi-ciently clear P3+ ,PT H andβ2-M G ,and relief cutaneous pruritus and itching .

Objective Identifying the factors of psychological pressure from medical disputes on clinical doctors and possible solutions. Methods Self-rating Anxiety Scale (SAS) and the Occupational Stress Indicator (OSI) were called into play, to study 52 clinical doctors in a tertiary hospital in a city, who had encountered medical disputes in recent two years. In parallel, 63 clinical doctors without such disputes and 50 non-clinical workers were randomly selected as the control group for questionnaires. Results Clinical doctors with such an experience were commonly found to be anxious, and their SAS score (58. 27±11.38)averaged higher than those in the control group. Doctor-patient relationship, legal liabilities and clinical positions were found to be positively correlated to psychological pressure of clinical doctors. Conclusions Medical disputes tend to add to psychological pressure of the doctors. Clinical doctors deserve psychological counseling and training and improvement of their working conditions.

Subcortical ischemic vascular dementia is a subtype of vascular cognitive impairment. Its major pathological features are lacunar infarcts and deep white matter changes, and its major clinical manifestation is executive function impairment. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) provides an opportunity for the study of pure subcorticai ischemic vascular dementia in the absence of Alzheimer's disease. There is currently lack of the gold standard for diagnosing subcortical ischemic vascular dementia. Imaging examination plays an important role in its diagnosis, while the treatment must first consider the control of vascular risk factors, especially hypertension.

Objective To study the effect and mechanism of Plantago depressa Willd. extract on rats with chronic nonbacterial prostatitis. Methods Sixty rats were divided into six groups randomly: normal control group, model control group, cernilton group, high-, medium- and low- dose Plantago depressa Willd. extract group, ten rats in each group. Chronic nonbacterial prostatitis rat model was established in the animals except of normal control group. Rats in the cernilton group were administrated with cernilton solution( 100 mg . kg-1 ) . High, middle and low dose Plantago depressa Willd. extract groups were given 150, 300 and 600 mg . kg-1 of Plantago depressa Willd. extract, respectively. The rats in the normal control and model control group were treated with the same volume of purified water.The administration was performed once every day, and lasted for three weeks.Effects of Plantago depressa Willd.extract on prostate index (PI), prostate specific antigen (PSA), tumor necrosis factorα ( TNF-α) , interleukin-1β ( IL-1β) , cycloxygenase 2 ( COX-2) , prostaglandin E2( PEG2 ) , transforming growth factor-β1( TGF-β1 ) , and connective tissue growth factor ( CTGF ) levels and pathological changes of prostate tissue in rats were observed. Results PI and PSA levels of the normal control group were(0.8±0.3)mg.g-1 and(106.5±10.6)pg.mL-1, respectively;those of the model control group were(2.2±0.2)mg.g-1 and(319.4±23.4)pg.mL-1 respectively;Those of the cernilton group were(1.6±0.3)mg.g-1 and(179.5±13.7)pg.mL-1 respectively;Those of the low-, medium- and high- dose Plantago depressa Willd.extract groups were(1.8±0.4),(1.3±0.3),(0.8±0.3)mg.g-1 and(263.4±28.6),(178.5±21.5), (143.5±12.9)pg.mL-1, respectively.Compared with the model control group, PI and PSA were significantly decreased(P<0.01) , TNF-α, IL-1β, COX-2, PEG2 , TGF-β1 and CTGF levels in the prostate tissues were decreased ( P<0. 01 ) , and inflammatory cell infiltration and fibrosis of prostate tissue was significantly alleviated in the model control group. Conclusion This study confirms Plantago depressa Willd.extract exerts effective therapeutical effect on chronic nonbacterial prostatitis in rats.

Objective To investigate researches on magnet hospital and nursing management from January 1,2010 to December 31,2014 in PubMed database and provide reference information for the majority of professionals in deep research.Methods Bibliographies from research literature of magnet hospital and nursing management from January 1,2010 to December 31,2014 in PubMed database were downloaded.The publication years,journals,countries of publication,the high yielding first authors and the high frequency of main subject were counted by Bicomb 2.0 software.The affiliations were analyzed artificially.main subject appeared no less than two times were intercepted as high frequency ones and the high frequency main subject co-occurrence matrix were formed.SPSS20.0 statistical software were applied for clustering analysis with matrix,then to get the topic hotspots.Results A total of 62 literatures were screened out.The data of research trend,journals,research degree of countries were acquired.The number of high frequency main subject were 18 and among which 4 research hotspots were clustered,respectively workplace environment and job satisfaction,nursing education,nursing quality administration,creation and leadership.Conclusions Researches on magnet hospital and nursing management from January 1,2010 to December 31,2014 in PubMed database are mainly in terms of workplace environment and job satisfaction,nursing education,nursing quality administration,creation and leadership.They are the foundation of the current research situation and trend of magnet hospital nursing management,and can improve management efficiency and provide reference for scientific research topic selection project.

Brain metastases (BM) are one of the main cause of death in patients with non small cell lung cancer ( NSCLC ).The prognosis is still poor, despite standard therapy based on surgery and radiotherapy.In recent years,with the deepening understanding of molecular mechanisms in lung cancer, epidermal growth factor receptor (EGFR) mutation might be considered as an effective therapeutic target for NSCLC with BM.Therefore,we review the current knowledge about the correlation between EGFR mutation with prevalence and prognosis in BM.

TheInner Canon of Huangdi originated from moral.In the aspect of knowledge, it advocatesthat the doctor should not teach bandits, selecting and teaching, upright character, open but not narrow;In terms of career pursuit, it advocatesthat the doctor should adopt and frequently ask, work hard and to be a good doctor;In the as-pect of ethics, it advocatesthatdoctor should cherish life, be meticulous;In terms of professional belief, it advocat-esthatdoctor should learn from the ancient, firmly believe that science, opposing superstition; TheInner Canon of Huangdi advocate consummate medical skillthe noble medical ethics, with far-reaching influence, become the ori-gin of Chinese medical ethics thought germinal, future generations of today′s high-quality professional talents of Chinese medicine has a very important guiding significance.