Objective To find a grading method for assisting in evaluating hypoxia degree of patients with pulmonary heart disease non-invasively. Methods To design a quantitative method to score degree of hypoxia of 67 patients with pulmonary heart disease by using acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) as a frame and to make comparative analysis between the grading result and artery blood gas to find the correlation. Results There was a negative correlation between evaluation mark and pH、PaO2、SaO2 and a positive correlation between the evaluation mark and PaCO2, according to statistics. Conclusions Although the grading table of hypoxia evaluation can not substitute blood gas analysis, acting as a non-invasive method to assist in evaluating the hypoxia degree of patients with pulmonary heart disease, it can not only relieve patients' repeated punctuation pain, but also achieve the goal of estimating hypoxia.Consequently the non-invasive method to evaluate hypoxia is of clinical value.

Objective To study the expression of carbonic anhydrase 9(CA9) in clear cell renal carcinoma(ccRCC), and the relationship between the expression and recurrence .Methods Paraffin-embedded tissues from 53 ccRCC cases were collected during the past 3 years,and immunohistochemistry was used to detect the expression of CA 9.Fifty-three cases were followed up to evaluate the disease-free survival ( DFS) and recurrence .Association of CA9 expression with recurrence was then analyzed .Results Localized RCC recurred in eleven cases , the median DFS was 10 months, the integral optical density ( IOD) of the recurrent cases was 230 879 .84 ±64 878 .72 while the IOD of the thirteen nonrecurrent cases was much higher,444 993.31 ±146 946.27(P<0.01).Conclusion There might be a positive correlation between the low expression of CA9 and the recurrence of ccRCC .CA9 may help predict the ccRCC patients ’ prognosis.

Neuroanatomy knowledge is the key to improve the teaching quality of neurosurgery and anatomy teachers' participation in neurosurgery teaching can obviously improve teaching effect. Combined with case-based teaching, we enabled medical students to master the system knowledge from the basic to the clinical , cultivating their clinical thinking ability and the ability to solve clinical problems. Cooperation between clinical medicine teachers and basic medicine teachers can promote the update of knowledge, work out teaching plans together, and improve the quality of teaching.

Protons and heavy ion radiation therapy have proven highly effective against a wide range of cancers and in recent decades there have been rapid advances.Due to the physical characteristics of the Bragg-peak and superior biological properties,proton and heavy ion radiation is able to focus its energy on the tumor while minimizing exposure to surrounding normal tissues and organs,which is expected help enhance the tumor dose and reduce normal tissue damage.In recent years,many studies have explored the efficacy and safety of proton and heavy ion radiotherapy on various malignancies,such as head and neck cancer,lung cancer,esophageal cancer,and liver cancer.The results of these studies enable a better understanding of the characteristics and advantages of proton and heavy ion therapy.

OBJECTIVE:To explore the method of pharmaceutical care which influence the effect of the treatment for diabetes mellitus at home. METHODS:163 patients with diabetes mellitus in community who received treatment at home were selected, and then randomly divided into control group (58 cases),family visit group (51 cases) and group education group (54 cases);control group were given pharmaceutical intervention with traditional dispensing window;family visit group received door-to-door service or telephone follow-up service;group education group were given collective education and interactive way. The latter two groups were all given regular drug education,and the advisory desk was set up and provided consulting services about medication knowledge. RESULTS:After providing pharmaceutical care,the regular medication rate of 3 groups were 43.1%,64.8% and 78.4%;medication adherence were 51.7%,70.4% and 82.4%;the rates of blood glucose at target level were 29.3%,48.1% and 54.9%;the rates of glycosylated hemoglobin at target level were 13.7%,31.5% and 31.4%,ADR occurance rates were 31.0%, 13.0%,5.9%. These index of family visit group and group education group were all better than those of control group significantly (P<0.05). CONCLUSIONS:Humane pharmaceutical care can improve the quality and effect of the treatment for diabetes mellitus.

Objective To discuss the predictable factors for the occurrence of intra-operative aneurysm rupture(IAR).Methods A total of 84 patients with 101 aneurysms treated by neurosurgical clipping from September 2009 to September 2014 were retrospectively analyzed.The statistic analysis was performed for the risk factors of IAR such as aneurysm location,aneurysm sac,dome/neck ratio,direction,pre-operative Hunt-Hess Scale,history of hypertension and operation time.Results Eighteen cases (21.4％) occurred LAR (18 (17.8％) of aneurysms) during the operations,2 patients (2.4％) died.Statistic analysis revealed that preoperative Hunt-Hess scale (P =0.042),history of hypertension (P =0.038),aneurysm sac (P =0.012),dome/neck ratio(P=0.027),direction (P =0.010) and operation time (P =0.002) were the predictable factors for the occurrence of IAR,while the location of aneurysm was not included (P =0.199).Conclusion The IAR may be the result of the synthesis of various factors in the occurrence of intracranial aneurysms clipping.Hypertension history,Hunt-Hess scale,direction,aneurysm sac,operation time and dome/neck ratio 1.78-2.89 are the predictable factors for the occurrence of IAR and the combination of various factors leads to the occurrence of IAR.

Atrial fibrillation is the most common arrhythmia in clinical practice.However,the therapeutic effects of traditional antiarrhythmic medicines are far from satisfactory,because of the high rate of arrhythmia recurrence and the potential proarrhythmia effect.Recently,with the further investigation of the mechanisms that initiate and perpetuate atrial fibrillation,and the support of extensive data from clinical trials and animal experiments,thera-peutics based on anti-inflammation,antioxidation,regulation on renin-angiotensin-aldosterone system(RAAS)and gap junction may be new therapeutic targets for the treatment of arrhythmia.In this paper,the potential molecular mechanisms involved in these processes and several clinical trials about some non-traditional antiarrhythmic medi-cines were reviewed,in order to propose a new idea about the development of antiarrhythmic medicines.

Objective To explore the risk factors for hospital acquired pneumonia (HAP) in patients with neural-intensive care unit (NICU).Methods The clinical data were analyzed retrospectively for 207 patients in NICU ≥ 5 d,to determine possible risk factors with HAP.Results The incidence of HAP was 14.01％(29/207).Correlation analysis showed that old age,disturbance of consciousness,dysphagia,vomiting,low pre albumin,NICU residence time ≥ 30 d,indwelling nasogastric tube,the use of the acid-blocking drugs,tracheal intubation,tracheal incision,mechanical ventilation and deep bronchoscopic suctioning were the related factors of HAP (P ＜ 0.05 or ＜ 0.01),but blood glucose,sedative drugs were unrelated with HAP (P ＞ 0.05).Conclusion There is a high incidence of NICU in patients with HAP,taking comprehensive measures actively,reduce risk factors,can effectively control the occurrence of HAP in NICU.

Objective To explore the clinical and epidemiological characteristics of severe measles in infants. Methods Clinical data of 62 infants with severe measles were analyzed retrospectively.Results Of 62 infants with severe measles,42 (67.74%)were aged < 9 months,of whom 37(88.10%)were not vaccinated against measles. The onset months were February-May,41 cases (66.13%)were found in March-April.All patients had fever and skin rash,the rates of other symptoms and complications were as follows :oral leukoplakia 80.65%(n=50),Ca-tarrh symptom 77.42%(n=48),conjunctivitis 79.03%(n=49),history of choked water cough 75.81%(n=47), pneumonia 95.16%(n=59),acute laryngitis 35.48% (n=22),electrolyte disorder 20.97%(n=13),acute respir-atory distress syndrome 9.68%(n=6),liver function damage 9.68%(n=6),pneumothorax 8.06% (n=5),myo-cardial damage 4.84% (n=3),respiratory failure 3.23% (n=2),toxic encephalopathy 3.23%(n=2),measles en-cephalitis 1.61% (n= 1),and pleural effusion 1.61% (n = 1 ).Of all cases,41 cases were cured,19 cases im-proved,1 case died,and 1 case gave up treatment.Conclusion These severe measles cases occurred mainly in in-fants aged<9 months and were not vaccinated against measles;infants had history of choked water cough;the main onset months were March-April ;pneumonia was still a predominant complication of infant measles.

Gastric cancer is one of the most common malignancies in the digestive system.Most of the patients with gastric cancer have advanced disease at the time of diagnosis.Chemotherapy is still the mainstay of treatment for advanced gastric cancer,but efficacy of chemotherapy was modest.Molecular targeted therapies have emerged as a novel approach to the treatment of both hematological and solid tumors in recent years.The understanding of molecular biological mechanisms underlying the formation,progression and metastasis in advanced gastric cancer has enabled us to use the new approach to treat this disease in clinical practice.These therapeutic strategies include targeting EGFR signal transduction pathway,anti-angiogenesis,targeting NF-?B signal transduction pathway and cyclin-dependent kinase inhibitors.In this review,a brief introduction of the current status of the molecular targeted therapies in the treatment of gastric cancer was presented.Bevacizumab,anti-VEGF monoclonal antibody targeting the angiogenesis pathway has been approved for the treatment of colorectal cancer by FDA,has been reported to show effectiveness in metastatic gastric cancer when combined with cytotoxic agents.Inhibition of NF-?B signal transduction pathway such as PS-341(proteasome inhibitor,bortezomib) approved for the treatment of refractory or recurrent multiple myeloma by FDA has also been used to combine with chemotherapy for gastric cancer.There are also encouraging reports on the combination of standard chemotherapy with Cetuximab,Matuzumab,Gefitinib,Erlotinib and Trastuzumab which target the EGFR and HER2 signal transduction pathways.Flavopiridol is a cyclin-dependent kinase inhibitor with low molecullar weight that aims at the regulatory process of the cell cycle but this needs further clinical trial.