Objective To explore the clinical efficacy and safety of rabeprazole in combined with flupentixol melitracen in treatment of non -erosive gastroesophageal reflux disease with anxiety and depression.Methods 84 cases with non -erosive gastroesophageal reflux disease with anxiety and depression of outpatient and inpatient admitted from October 2012 -October 2013 and they were randomly divided into two groups according to the order,all had 42 cases.The control group was given rabeprazole treatment,observation group used flupentixol melitracen treat-ment on the basis of the control group.The clinical efficacy and the occurrence of adverse reactions of the two groups were compared.Results The total effective rate of the observation group was 95.24%,which was significantly higher than 76.19% in the control group,the difference was significant (χ2 =11.20,P <0.05).After treatment,HAMD score (7.64 ±2.58)and HAMA score (5.60 ±2.41)of the observation group were significantly lower than HAMD (21.72 ±2.96)and HAMA scores (14.32 ±2.59)of the control group,the differences were significant (t =9.66, 10.04,all P <0.05).The incidence rate of adverse reaction of the observation group (14.29%)compared with the control group (16.67%),had no statistically significant difference (χ2 =1.29,P >0.05 ).Conclusion Rabe-prazole in combined with flupentixol melitracen in treatment of non -erosive gastroesophageal reflux disease with anxi-ety and depression had good effect,and the adverse reactions were mild and safe.

Recent studies show that tumor cells get rid of the connections between cells,and induce tumor invasion and metastasis through epithelial-mesenchymal transition (EMT).EMT becomes an important way to invasion,metastasis and chemotherapy resistance of epithelial cell carcinoma which accounting for more than 90％ of malignant carcinomas.Members of Snail family,especially Snail is regarded as important adjustment factor of EMT,which induce the transformation from epithelial cell to mesenchymal phenotype through competitive inhibition E-calcium protein gene expression.Many researches show that EMT exists widely in digestive system tumors,which is closly related to the invasion,metastasis and chemotherapy resistance of digestive system tumors.

Objective To investigate the clinical value of endoscopic ultrasonography (EUS)on minute gas-tric stromal tumor (MGST).Methods 90 patients diagnosed with MGST were randomly divided into two groups. 45 patients in A group were given conventional endoscopic diagnosis,45 cases in B group were treated with endoscopic ultrasound diagnosis.After the two groups of patients with endoscopic treatment,the coincidence rate of preoperative diagnosis and pathological inspection test results was recorded,clinical features in MGST under EUS diagnosis were analyzed.Results All patients were diagnosed in the case of endoscopic surgery,endoscopic submucosal dissection (ESD)accounted for 94.44%,which was significantly higher than the use of endoscopic full -thickness resection (EFR)percentage of 5.56%,and the difference was statistically significant (χ2 =14.22,P <0.05);The two groups of patients after endoscopic treatment,were diagnosed as pathological inspection MGST.Preoperative diagnosis showed that EUS MGST suspected cases of 40 patients,conventional endoscopy MGST suspected cases of 31 cases.The diag-nosis coincidence rate of B group (88.89%)was significantly higher than that in A group (68.88%),the difference was statistically significant (χ2 =5.40,P <0.05);MGST of EUS images could be clearly observed in patients with tumor morphology,size,location,growth pattern,internal parenchyma,echo pattern,strengthening methods,the compo-sition ratio in line with the results of endoscopic treatment,diagnosis results in line with the pathological diagnosis. Conclusion EUS has significant value for the diagnosis of MGST,it has advantages in the clinical guidance and treatment.

Through the questionnaire on bilingual teaching in medical students,some problems were presented. This paper is intended to discuss the necessity and the present condition of bilingual teaching and find out some measures to improve bilingual teaching quality.

By means of literature review,the authors initiated the behavior expression system of hospitals' social responsibilities,which is further refined and revised with questionnaires and Delphi method.13 expressions of such behavior expressions were determined,namely “providing quality of care to patients”,“undertaking rescue assignment for emergencies”,and “fulfilling government-assigned tasks”.All of the 13 expressions were supported by 75％ of the experts during the second round of experts consultation.

Objective To investigate risk factors that affect type 2 diabetic cardiac arrhythmia.Methods Clinical data of 292 diabetic patients who were performed examination of low limb vascular were analyzed retrospectively.Based on electrocardiogram,the patients were divided into cardiac arrhythmia group and non-cardiac arrhythmia group with case-control study,and the clinical data and evaluation indexes of lower extremity vascular disease were compared between two groups.Results Data comparison between two groups indicated age [(59 ± 14) years vs (54 ± 12) years],symptoms of low limbs [40.7％ vs 29.0％] had statistical significance (P ＜ 0.05).Glycosylated hemoglobin,hypertension history,results of color Doppler ultrasound for lower limbs artery,ankle-brachial index,toe-brachial index,transcutaneous oxygen pressure,heat-controlled laser Doppler between two groups had no statistical significance (P ＞ 0.05).Age,gender,history of high blood pressure,symptoms of low limbs,and heat-controlled laser Doppler were analyzed with multiple logistic regression,which indicated that age was risk factor of type 2 diabetic arrhythmia.Conclusions Age is correlated with type 2 diabetic arrhythmia,and evaluation indexes of lower limb vascular disease have no significant correlation with type 2 diabetic arrhythmia.

Aim To investigate the effect of curcumin on the expressions of NR2A, NR2B and apoptotic neurons in hippocampus after global brain ischemia-reperfusion in SD rats. Methods Global ischemic model induced by 4-vessel occlusion was adopted. Rats were randomly divided into 5 groups: sham group (SH), ischemia-reperfusion group (I/R), curcumin 30(Cur 30), 100 (Cur 100) and 300 mg?kg-1 group (Cur 300). At different time points after ischemia, animals were designated as subgroups 2 h, 6 h, 1 d, 3 d, 7 d. Cell morphology was observed on HE stain slides. The apoptotic neurons were detected in CA1 region by TUNEL method. Expressions of NR2A and NR2B in hippocampal CA1 and CA3/DG regions were detected by Immunohistochemical technique. Results At each time point the number of apoptotic neurons was much more in I/R group than that in SH group and Cur 100 group,and in Cur 300 group than that in Cur 100 group. The expression of NR2A was higher in the hippocampal CA1 and CA3/DG regions in Cur 100,Cur 300, Cur 30 and SH groups than that in I/R group at each time point(P

Objective To examine whether activation of nuclear factor-?B (NF-?B) exists in skin lesions of patients with systemic lupus erythematosus (SLE ) and its association with disease activity. Methods The skin lesions were inves tigated histopathologically in patients with SLE, and NF-?B activation was ass essed by immunohistochemical analysis semi quantitatively. Results Expression o f NF-?B was found on skin lesions in 14 of 15 patients with SLE, including 8 s trong positive (), 3 moderate positive (), and 3 mild positive (+). Brown-coloured particles were mainly distributed in keratinocytes, especially in prick le cells and granular layer cells, as well as in mononuclear cells of dermis. Th ere was no correlation between NF-?B activation and disease activity. However, NF-?B was not detected in skin lesions of all patients with non-SLE and heal thy controls. Conclusions NF-?B activation may be associated with the developm ent of skin lesions in patients with SLE,and not with disease activity.

Objective To investigate curative efficacy of tetramethylpyrazine in combination with chemotherapy in treatment of medium and advanced liver cancer and its effects on level of brain-derived neurotrophic factor ( BDNF).Methods 90 patients of medium and advanced liver cancer who received therapy from January 2011 to June 2012 were selected as research objects.According to therapeutic schemes, those patients were divided into the control group (n=42) and the observation group (n=48).The control group was treated with transcatheter hepatic arterial chemoembolization ( TACE) , while the observation group was treated with tetramethylpyrazine in combination with TACE.Then, the short-term curative efficacy, long-term curative efficacy, level of BDNF and adverse reactions were compared.Results The total short-term therapeutic efficacy ratio in the observation group was statistically higher than that in the control group ( 83.3% vs 64.3%, P <0.05 ).During the three-year follow-up, the one-year and two-year survival rate in the observation group was statistically same with that in the control group respectively (75.0% vs 66.7%, 66.7% vs 59.5%), while the three-year survival rate was statistically higher than that in the control group (52.1%vs 30.9%, P<0.05).After treatment, in comparison with the control group, level of BDNF in the observation group was statistically lower(P<0.05).During treatment, incidences of liver function deterioration, abdo minal pain and diarrhea, nausea and vomiting, fever and headache in two groups were statistically same.Conclusion Tetramethylpyrazine in combination with TACE is effective for medium and advanced liver cancer, which can increase short-term and survival rate to some extent, significantly reduce level of BDNF with not increasing incidence of adverse reactions.

Some problems were present with the universities combination,such as the relative scarcity of medical students and some students'lower enthusiasm for medicine.The university should establish policies to improve the quality of medical students,such as enlarging self-determination right to recruit medical students,strengthening the specialty thought of students.And further reformation and self-enhancement of medical college were more important for attracting excellent students.