Objective To study the effects of 5-azacytidine’s demethylation for P16 gene on hemangioma cell’s proliferation and apoptosis.Methods Bisulfite sequencing PCR was applied to detect P16 gene′s promoter methylation status in 5-azacytidine treated and untreated EOMA cell line.RT-PCR and western blot were used to detect the P16 gene mRNA and protein expressions.Flow cytometry was used to detect cell proliferation, cell cycle and cell apoptosis.The differences of P16 gene′s promoter methylation status,mRNA and protein expressions,cell proliferation,cell cycle and apoptosis in two groups were compared. Results The methylation rates in 1st and 13th CGs were 0%after 5-azacytidine treatment in EOMA hemangioma cell line,which were lower than in untreated cells.The mRNA and protein expressions increased after 5-azacytidine treatment,which were significantly higher than in untreated cells.The absorbance,S phase and G2/M phase and PI after 5-azacytidine treatment were lower than untreated cells,while the G0/G1 phase and apoptosis rates were higher.Conclusion The P16 gene promoter is hypermethylated in hemangioma cells with silent gene expressions.5-azacytidine could reverse P16 gene′s promoter methylation and silent gene expressions,which inhibit hemangioma cell’s proliferation and promote apoptosis.

Objective To study the effects of Lentinan on bleomycin A5’s inhibition effects in hemangioma-derived endothelial cell. Methods Hemangioma-derived endothelial cell line EOMA were divided into LTN group (only lentinan treatment), BLE group (only bleomycin A 5 treatment), L+B group (Lentinan and bleomycin A5 treatment) and CON group (no lentinan and bleomycin A5 treatment). Cell proliferation, cell cycle, PI and apoptosis were detected and compared among four groups. Results The differences of absorbance in LBE group was significantly higher than that in L+B group after treatment for d 1-d 7 (P<0.05), but both of them were significantly lower than in CON group and LTN group (P<0.05). The G 0/G 1 stage and apoptosis rate in L+B group was significantly higher than in BLE group(P<0.05), while it was significantly lower in S stage, G 2/M stage and PI(P<0.05). Conclusion Lentinan could significantly promote bleomycin A5’s inhibition effects on hemangioma-derived endothelial cell.

A cross-sectional survey on two-way referral using self-report questionnaire was conducted in a sample of 1423 residents living in 4 communities in Caobeidian area, Chaoyang District and 4 communities in Dongcheng District from April to July 2009. Among the residents who responded the questionnaire, 19.7% (88/446) from Gaobeidian and 8.2% ( 80/977 ) from Dongcheng District were referred to hospitals in 2008. And 30.7 % (27/88) in Gaobeidian and 43.8% (35/80) in Dongcheng District referred to hospital based on their own decision rather than doctors' recommendation; 45. 5% (40/ 88) in Gaobeidian and 45. 0% (36/80) in Dongcheng District of referrals were officiary processed by health institutions. The survey also showed that 57.6% and 59.4% of the respondents from the two districts preferred to free referral between community health service centers and hospitals.

Objective To investigate the effect of knee joint injection of sodium hyaluronate combined with oral administration of diacerein and/or glucosamine sulfate on knee joint of Kaschin-Beck disease.Methods The method of prospective study was used,80 patients with Kaschin-Beck disease admitted to the General Internal Medicine,Guang'an People's Hospital from January 2015 to December 2017 were selected as subjects.They were divided into 4 groups according to the difference of their medication methods,20 cases per group.Group A was treated with intra-articular injection of sodium hyaluronate,Group B was treated with intra-articular injection of sodium hyaluronate + oral diacerein,Group C was treated with intra-articular injection of sodium hyaluronate + oral glucosamine sulfate,Group D was treated with intra-articular injection of sodium hyaluronate + oral diacerein and glucosamine sulfate,and the overall therapeutic effects of the 4 groups were compared.Results The knee joint scores of Group D at 7,14,90,and 180 days after treatment were (6.25 ± 2.01),(4.22 ± 1.15),(2.21 ± 1.01),and (1.15 ± 0.15) scores,respectively,they were significantly lower than those of Group A [(12.11 ± 3.02),(11.91 ± 2.98),(11.85 ± 2.85),(11.05 ± 2.52) scores],Group B [(9.11 ± 2.85),(8.32 ± 2.45),(7.55 ± 2.32),(6.15 ± 2.01) scores] and Group C [(9.12 ± 2.84),(8.23 ± 2.32),(7.43 ± 2.29),(6.11 ± 2.00) scores],the differences were statistically significant (P ＜ 0.05).The total effective rates of the 4 groups were 60％ (12/20),65％ (13/20),70％ (14/20),and 90％ (18/20),respectively,Group D was significantly higher than those of other 3 groups (x2 =18.250,18.250,16.000,P ＜ 0.05).The scores of 20 m walking pain and joint tenderness in Group D after treatment and follow-up period were lower than those of other 3 groups (P ＜ 0.05).Conclusions In the clinical practice of Kaschin-Beck disease,intra-articular injection of sodium hyaluronate combined with oral diacerein and glucosamine sulfate can improve the knee joint function of patients,alleviate pain and enhance the overall therapeutic effect.The combined therapy has great clinical value.

Objective To explore the nursing measures in blue laser endoscopy. Methods Endoscopy was performed in 102 patients. The nursing was done including preoperative preparation, nurse's coordination for different mode of endoscpy, postoperative nursing and so on. Result The endoscopy for the 102 patients was successfully done,the time ranging between 10~25 min,averaged 13.85 min.No complications were found. Conclusion The nursing measures including careful preoperative preparation,intraoperative cooperation and postoperative nursing are key to the successful detection and diagnosis of diseases by blue laser endoscopy.

Objective: To investigate the cleaning effects of biofilm cleaning agent and two kinds of multi-enzyme detergents on endoscopic biofilm. Methods: Endoscopic biofilm model was established using pseudomonas aeruginosa, and soaked with No. 1 multi-enzyme detergent, No. 2 multi-enzyme detergent, and biofilm cleaning agent respectively. The control group was cleaned with sterile water. After 5, 10, and 15 minutes at room temperature, the cleaning effects were evaluated by bacteria counting method and scanning electron microscope. Arova was used for the comparison of viable counts among groups. Results: At 5, 10, and 15 minutes of soak, the standard colony counts (CFU/cm²) of biofilm was 5.31±0.10, 5.04±0.08 and 4.90±0.16 in the No.1 multi-enzyme detergent group, 5.53±0.30, 5.39±0.21 and 5.03±0.42 in the No.2 multi-enzyme detergent group, and 3.53±0.30, 3.01±0.07 and 2.82±0.26 in the biofilm cleaning agent group, and 7.92±0.21 in the blank control group. There was no significant difference in the colony counts between the two multi-enzyme detergent groups (P>0.05). However, the colony counts of biofilm cleaning agent group was less than that of the two multi-enzyme detergent groups (P<0.05), and decreased with time (P<0.05). Under scanning electron microscope, the biofilm cleaning agent group had the least residual biofilm and bacteria. Conclusion Biofilm cleaning agent can significantly improve the quality of endoscopic cleaning, and is worthy of clinical promotion.

Pharmacy active consultation refers to the spontaneous activity that clinical pharmacists take the initiative to go to clinical departments to help doctors solve problems related to drug use in clinical practice ，put forward drug treatment suggestions or provide pharmaceutical services ，and form medical documents . The difference between pharmacy active consultation and pharmacy consultation is that the latter is generally proposed by the clinician ，who sends a consultation invitation to the pharmacy department in the hospital information system ，and the clinical pharmacist will go to the consultation after receiving it ，while the former is a pharmaceutical service mode that the clinical pharmacist takes the initiative to carry out in the clinical department . On the basis of routine pharmacy active consultation ，clinical pharmacists in our hospital also further carried out a special active consultation mode （including prompt special active consultation for patients with multidrug resistance bacteria positive ，active monitoring and intervention for patients with drug -induced liver injury ），and patient pharmaceutical supervision in the form of return visit of pharmacy active consultation . Pharmacy active consultation and its special active consultation possess the characteristics of initiative ， early and extensive coverage ，as a supplement to resident clinical pharmacy services . Pharmacy active consultation could help the pharmacy department to improve service efficiency ，provide a new perspective for medical institutions to carry out efficient pharmaceutical services ，and supply new ideas for the reform of pharmaceutical services in China .