Insulinoma is a rare tumor derives from pancreatic islet B cells,the cause of etiology is unknown with insidious onset.Its clinical manifestations are of diversification,the high misdiagnosis rate with the low cure rate owing to the complex of pancreatic anatomy and the lack of effective localization diagnosis and differential diagnosis method for benign and malignant lesions,the treatment of insulinoma is still one of challenge in clinical application considering that some patients unable to tolerate surgery or unwilling surgery.In recent years there have been some new treatments except surgery,this review will introduce the some treatment methods of insulinoma for the moment.

Parathyroid carcinoma is a rare endocrine tumor.Clinical manifestations are varied with multiple organs involved,mainly due to hypercalcemia.So far the etiology and pathogenesis of parathyroid carcinoma are still unclear and preoperatively diagnosis is difficult.Technetium-99 m sestamibi scan and ultrasound can help to find the early lesions.Complete surgical resection with suspicious involved lymph nodes is the recommended treatment.Parathyroid carcinoma is insensitive to chemotherapy and radiotherapy.New immune therapy yields unsure efficacy.Therapeutic effect and prognosis mainly depend on primary surgical resection of the tumor.The disease recurs in more than 50％ of patients with poor prognosis.

ObjectiveTo explore the clinical effect of edaravone combined with Shuxuetong in treatment of elderly patients with acute cerebral infarction.Methods120 cases of acute cerebral infarction,according to the different treatment methods,were divided into two groups.The conventional treatment was given in two groups,the control group plus Chuanqiong hydrochloride injection,and the observation group adopted edaravone and Shuxuetong.The clinical efficacy,activities of daily living(ADL) and neurological deficit score were compared between two groups.ResultsThere were 25 cases of basic recovery,18 cases of significant progress,progress in 12 cases in the observation group,total effective rate was 91.7％ (55/60),the control group was 75.0％ (45/60),the difference was statistically significant ( x2 =6.86,P ＜ 0.05 ).Observation group had statistically significant difference than the control group between ADL and neurological deficit scores ( all P ＜ 0.05 ).ConclusionOn the basis of conventional therapy,the use of edaravone combined with Shuxuetong for acute ischemic stroke patients could significantly promote the recovery of neurological function and was worthy of promotion.

Objective: To investigate the acidogenicity and aciduric ability of Streptococcus mutans isolated from the children with different caries susceptibility.Methods: The acidogenic and aciduric ability of Streptococcus mutans strains isolated from children was investigated.Acidogenicity ability was compared among high caries-susceptible group,middle caries-susceptible group and caries-free group.Results: The acidogenicity and aciduric ability of Streptococcus mutans isolated from the high caries-susceptible children and middle caries-susceptible group were significantly higher than that isolated from caries-free group(P

0.05). As compared with Qingkailing group, the body temperature at the 5th day of treatment and WBC at the 3rd day of treatment were significantly decreased (P

This paper reports the pathological changes and MDA content of the brain tissue in the early stage of cerebral ischemia due to middle cerebral artery occlusion (MCAO) in Wistar rats. The neurones showed changes of the rough endopiasmic reticulum and the mitochondrium as early as 2 minutes after MCAO. Under the light microscope, "ischemsc cells" with shrunken and condensed cytoplasm and nucleus appeared 10 minutes after MCAO. The end-product of lipid peroxidation, MDA, in the isch. emic brain tissue also significantly increased 2 minutes after MCAO, being correlated synchronously with the ultrastructural changes of the neurones. This suggested that free radicals play a role in the early stage of brain injury due to ischemia.

Objective To evaluate the relationship of serum thrombospondin?1(TSP?1)with the micro?inflammation in maintenance hemodialysis(MHD),and to explore its clinical prognosis value in the MHD patients. Methods A total of 84 MHD patients in our hospital were enrolled and prospectively followed for 2 years. The serum levels of TSP?1 and clinical inflammatory markers were detected. Patients were divided into groups according to different serum TSP?1 levels. The clinical inflammatory markers were detected by using ELISA analysis. Pearson simple correlation analysis method was applied to analyze the correlation between TSP?1 levels and inflammation related indicators. At the same time the prognosis and turnover of MHD patients was analyzed by using Kaplan Meier survival curve and survival rate was compared by Deleted:compared log?rank test. Cox regression analysis was used to calculate the hazard ratio (HR) and Deleted:using 95% confidence interval (CI). Results The indexes of blood lipid and inflammatory factors in the TSP?1 high?level groups were higher than that in TSP?1 low?level groups (P<0.05). Correlation analysis showed that the serum TSP?1 level was positively correlated with the serum lipid and inflammatory factors. Survival curve analysis showed that the mortality rate of TSP?1 high?level group was higher than that of TSP?1 low?level groups. Cox hazards analysis revealed that the patients with high?level TSP?1 had a higher risk for mortality than these TSP?1 low?level patients. This predictive value still existed after multivariate adjustment for age,blood lipid,serum albumin and other factors (P < 0.001). Conclusion The serum TSP?1 levels were associated with micro?inflammation and had a significant value in predicating the prognosis of MHD patients.

Objective To analyze the trend of transitional care in recent ten years and to find the advantages and shortages in this field between home and abroad, so as to provide reference for nursing researchers in China. Methods The literatures about transitional care pub-lished from January, 2005 to August, 2016 from Web of Science and CNKI were retrieved, and the visualizing map was drawn by operating CiteSpaceⅡ. Results The annual number publication of transitional care steadily increased in the world in recent ten years. China issued a small amount of documents before 2012, and then the research of transitional care obviously increased, while the number was comparable to the international in 2015. USA played a leading role in the field;China issued only 2%of the total, ranking the 9th. By comparing domestic and foreign research hot topics, international transitional care studies paid more attention to nursing program and the effect, while China fo-cused on the research of the disease. Research frontier showed that international transitional care service expanded to more and more sub-jects gradually, and inclined to the continuation of management, community and family support nursing research, which was relatively lack in China. Conclusion In recent years, the research of transitional care received increasing attention in China, while the depth and breadth of study was still lacking. China should learn from foreign research hot topics and frontiers to explore transitional care system, and provied pa-tients discharged nursing support and self care knowledge, to enrich high quality nursing connotation.

The effective guarantee of the supply of low-price medicine in common use is of great significance for the protection of public health, the safeguard of social equality and the smooth progress of new healthcare reform. On the basis of the governance tools theory, the paper focuses on an analysis of approaches to combine and optimize the diverse utilization of governance tools in order to integrate the means of supply of the low-price medicine in com-mon use. In other words, the paper utilizes the ‘Voluntary-Directive-Mixed’ governance tools framework to provide possible solutions for the supply of low-price medicine in common use, namely, the locations of the voluntary tools ( household and community, volunteers, and market) , the directive tools ( government command-control regulation, establishment of public enterprises, and direct provision) , and the mixed tools ( information disclosure and advice, subsidies, auctions of property rights, tax and user charge) . Lastly the paper proposes specific policy suggestions in four aspects to confirm the total strategy of guaranteeing the supply of low-price medicine in common use:clever use of price leverage, improvements to procurement methods, establishment of an information disclosure system for medi-cine price, and a confirmation of government subsidies and industrial policy strategies.

Objective To study the effects of High frequency two -way jet ventilation on the function respiratory and circulation of patients with Trachea and Carinal reconstruction.Methods Fifty patients with lung cancer,who were scheduled for elective trachea and carinal reconstruction,were intubated with double lumen tube following anesthesia induction and general anesthesia.High frequency ventilation was used on the healthful main bronchus during carinal reconstruction,a Hunsaker tube was inserted 3cm into the healthful main bronchus.HFTJV was applied with the respiratory rate of 120 /min,the ratio of inspiration and expiration E =1:1 and drive pressure of 0.2 -0.25Mpa.Blood gas analysis was made before the anesthesia,15 min following one -lung ventilation,10,20, 30 min following HFTJV and 15min following one -lung ventilation,respectively and monitor MAP,HR,SpO2 , PetCO2 .Results PaO2 in high frequency ventilation increased significantly compared with preoperative (78.0 ± 10.5)mmHg,was respectively (161.4 ±10.2)mmHg,(156.0 ±15.7)mmHg,(153.0 ±15.1)mmHg (P <0.01);PaO2 in high frequency ventilation 30min was (153.0 ±15.1)mmHg (P <0.05).It was lower than single lung venti-lation (front 165.50 ±11.3mmHg)and higher than 100mmHg equally;PaCO2 in the high frequency ventilation was slightly increased compared with OLV 30min (front),and the difference was not statistically significant (P >0.05). Conclusion HFTJV is safe and reliable for Trachea and carinal reconstruction.