Objective To investigate the clinical effect of low molecular heparin combined with mesalazine in patients with active ulcerative colitis(UC).Methods 90 cases of patients with UC were randomly divided into three groups:A group,B group and C group,with 30 cases in each group.A group was given oral treatment with sulfasalazine enteric-coated tablets,B group was given oral treatment with mesalazine and C group was given low molecular heparin calcium combined with mesalazine (4100 iu,1 /d).The three groups were treated for 2 weeks. Coagulant function index such as activated partial prothrombin time (APTT),fibrinogen(FIB),platelet count(PLT), platelet maximum aggregation rate(PAG(Max)),D-dimer(D-D),C-reactive protein(CRP)were detected in the two groups before and after treatment of 7 and 14d.Mayo disease activity index score was also recorded before and after treatment of 7 and 14d.And the differences among three groups were compared.Results There were significant differences in APTT,FIB,PLT and PAG(Max)after 7d,14d treatment among A,B and C groups(7d:F value were 17.652,12.427,42.873,14.318 respectively;14d:F value were 43.804,139.172,51.932,79.440 respectively,all P value <0.05).APTT of C group after 7d,14d[(36.32 ±3.56)μg/mL,(40.15 ±4.24)μg/mL]were higher than B group[(32.14 ±2.86)μg/mL,(33.04 ±3.32)μg/mL]and A group [(31.82 ±3.36 )μg/mL,(32.15 ± 3.24)μg/mL];FIB of C group after 7d,14d[(4.07 ±0.41 )g/L,(3.14 ±0.28)g/L]were lower than B group [(4.47 ±0.40)g/L,(4.06 ±0.33)g/L]and A group[(4.58 ±0.44)g/L,(4.23 ±0.37)g/L];PLT of C group af-ter 7d,14d[(262.22 ±60.61)×109 /L,(201.38 ±49.42)×109 /L]were lower than B group[(296.34 ±63.51)× 109 /L,(253.25 ±55.47)×109 /L]and A group[(301.71 ±70.62)×109 /L,(262.05 ±64.11)×109 /L];PAG (Max)of C group after 7d,14d[(0.46 ±0.08),(0.30 ±0.05)]were lower than B group[(0.57 ±0.10),(0.46 ± 0.06)]and A group[(0.59 ±0.12),(0.51 ±0.08)].There were significant differences in CRP,D-D after 14d treatment among A,B and C groups(F value were 91.967,139.172 respectively,all P value <0.05).CRP of C group after 14d[(7.50 ±1.35)mg/L]were lower than B group[(10.80 ±1.37)mg/L]and A group[(12.12 ±1.64)mg/L];D-D of C group after 14d[(0.26 ±0.02)mg/L]were lower than B group[(0.47 ±0.03)mg/L]and A group[(0.51 ± 0.04)mg/L].There were significant differences in Mayo index score,△Mayo index score after 14d treatment among A,B and C groups (F value were 182.170,89.802 respectively,all P value <0.05).Mayo index score of C group after 14d(1.51 ±0.33)were lower than B group(2.93 ±0.46)and A group(3.42 ±0.63);.△Mayo index score of C group after 14d(5.67 ±1.60)were lower than B group(4.25 ±1.32)and A group(3.79 ±1.21);Pearson corre-lation analysis showed that △Mayo Mayo index score were positively correlated with PAG(Max)reduction△PAG (Max),△D-D,△CRP,△PTL(r value were 0.616,0.702,0.734,0.569,respectively,all P <0.05).Multiple step-wise linear regression analysis showed that △PAG(Max),△D-D,△CRP,△PTL were closely related to △Mayo Mayo index score(partial regression coefficient were 4.209,2.451,0.801 respectively;t value were 7.890,4.787, 2.201,respectively,all P <0.05).Conclusion The clinical effect of low molecular heparin combined with mesala-zine in patients with active ulcerative colitis is effective,and the method can significantly improve the inflammation in patients with UC and high coagulation state,improving the clinical symptoms is better than the single drug,and worth clinical recommendations.

Improving the basic medical and health service system is an important measure to deepen health care reform.Jilin province has explored its unique way of comprehensive reform of the primary organizations in the province by means of reforming grassroots medical operation mechanism and mode of service,and perfecting the compensation mechanism,achieving remarkable results.This article,based on the overall situation of Jilin province,main contradictions and countermeasures research,made detailed analysis of healthcare reform and bottlenecks encountered in the reform.The author pointed out the direction of Jilin province primary medical and health institutions reform,and put forward feasible policy adjustments and suggestions for such a reform.

[Summary] When accompanied with pulmonary disease ,the lung functions of diabetic patients usually represent decreases of diffusing capacity ,ventilation function ,bronchomotor tone and respiratory muscles. The mechanisms of lung damage may include non‐enzymatic glycosylation of proteins ,oxidative stress ,IR ,local defensive ability change ,and autonomic neuropathy. Diabetes mellitus is a risk factor for lung function damage ,and lung function damage is an independently predictive factor of diabetes mellitus. The change of lung function in diabetic patients is associated with age ,duration ,blood glucose level and complications.

Objective To evaluate the risk factors for healthcare-associated infection (HAI)in patients in depart-ment of cardiology.Methods Clinical data of inpatients were performed retrospective case-control analysis,patients with HAI were as case group,while without HAI were as control group,factors for HAI between two groups were compared.Results 117 cases of HAI occurred among 2 308 patients,infection rate was 5.07%.The main infection site was respiratory tract (n=71 ,60.68%);a total of 90 pathogenic isolates were isolated,gram-negative bacteria, gram-positive bacteria,and fungi accounted for 72.22%(n=65),22.22%(n=20),and 5.56%(n=5)respective-ly.Univariate analysis revealed that 7 variables were risk factors for HAI,multivariate non-conditional logistic re-gression analysis revealed that independent risk factors for HAI were age,cardiac function classification,serum al-bumin level,and invasive operation.Conclusion HAI rate is higher among cardiology inpatients,which is related to many factors.Attention should be paid to the elderly,long term hospitalization,heart failure correcting,treatment for complications,reducing of invasive procedure,and strict sterile manipulation.

Breast cancer stem cells (BCSC) are group of cells exhibiting self-renewal and multi-directional differentiation potentials. These cells have an important role in the occurrence, development, metastasis, and recurrence of breast cancer. In normal circumstances, the ability of mammary stem cells to differentiate and undergo self-renewal is governed by related signaling pathways. After this mechanism is destroyed, breast stem cells undergo abnormal differentiation, forming breast cancer stem cells that unlimitedly proliferate to develop into breast cancer. As research on BCSC increasingly deepens, regulation of BCSC by notch signaling and its crosstalk with several signaling pathways have drawn a great deal of attention in this field. This paper reports the signaling pathways of breast cancer stem cells and latest studies on this field to better understand the essential role of notch signaling pathway in the occurrence and development of breast cancer and corresponding clinical targeted therapy.

AIM:Toinvestigatetheinteractionofpolymorphismsofintercellularadhesionmolecule-1(ICAM-1) gene K469E and monocyte chemoattractant protein-1 (MCP-1) gene -2518A/G in the invasion and metastasis of gas-tric carcinoma .METHODS:Based on TNM classification , 4 500 patients with confirmed gastric carcinoma from the First Affiliated Hospital of Xinxiang Medical University in China from December 2009 to November 2014 were divided into stageⅠ group, stageⅡgroup, stageⅢgroup, stageⅣgroup, and stage 0 group, with 900 cases in each group.No significant difference among the 5 groups in age, gender, ethnicity, birthplace and living habit was observed .The genetic polymor-phisms of ICAM-1 gene K469E and MCP-1 gene -2518A/G were analyzed by the technique of polymorphism-polymerase chain reaction ( PCR) in peripheral blood leukocytes of above-mentioned cases .RESULTS:Statistical tests showed signi-ficant differences in the frequencies of K469E (EE) and -2518A/G (GG) among each group (P<0.01).The risk of the invasion and metastasis of gastric carcinoma significantly increased in subjects with K 469E ( EE) genotype and in those with -2518A/G (GG) genotype.Combined analysis of the polymorphisms showed that distribution frequency of K 469E (EE)/-2518A/G ( GG) in stage Ⅰ group, stage Ⅱ group, stage Ⅲ group, stage Ⅳ group and stage 0 group was 39.22%, 53.22%, 59.22, 65.44%and 12.11%, respectively (P<0.01).The people who carried with K469E (EE)/-2518A/G ( GG) had a high risk of the invasion and metastasis of gastric carcinoma , and statistical analysis suggested a positive interaction in a super-multiplicative model between K469E (EE) and -2518A/G (GG) in increasing the risk of the invasion and metastasis of gastric carcinoma .CONCLUSION: ICAM-1 gene K469E ( EE) and MCP-1 gene-2518A/G ( GG) are the risk factors in the invasion and metastasis of gastric carcinoma , and significant interactions be-tween genetic polymorphisms of K 469E and -2518A/G added the risk of the invasion and metastasis of gastric carcinoma .

AIM:ToinvestigatetheregulationofmiR-21onFasLexpressionanditseffectonthegrowthand apoptosis in glioma cells , and to evaluate the molecular mechanism .METHODS:Differential expression levels of miR-21 in human glioma U251 cells were achieved by transfecting with miR-21 mimics, miR-21 inhibitor or scramble .The viability and apoptosis of U251 cells were detected by CCK-8 assay and flow cytometry with Annexin V-FITC/PI double staining. The recombination vector pmirGLO-FasL was constructed .Dual-luciferase reporter experiment was performed to validate the target genes of miR-21.The expression vector pcDNA3.1-FasL was also constructed , and the biological activity and regula-tory role of miR-21 in U251 cell apoptosis were analyzed by a restore experiment .RESULTS:Exogenous overexpression of miR-21 increased the viability and decreased the apoptosis of U 251 cells ( P<0.05 ) , while miR-21 inhibitors generated the opposite results (P<0.05).Dual-luciferase reporter assay and restore experiment revealed that miR-21 negatively reg-ulated the expression of FasL gene which was regarded as the target gene , thus decreasing the apoptosis of U 251 cells. CONCLUSION:miR-21 increases the viability of glioma U251 cells, in which FasL may be one of the target genes .

It is considered that cancer-related malnutrition is caused by the imbalance of the nutritional consumption of patients,the tumor itself and the nutrient available internal.Patients with abdominal neoplasm have a great risk of getting malnutrition,which is resulting from the changes of their biochemical status,clinical symptoms and the impacts by surgery.In 1980s,people began to realize that it is important to assess the nutritional status of patients and now so do the most of doctors.Until now,there is some acceptable assessment questionnaire,by using which,we find that a large proportion of patients with abdominal cancer have malnutrition,and when it comes to different kind of abdominal cancer,the rate is not same.

Objective To describe the current status and existing problems on the specialist nurse in China and provide references for nurse management.Methods The following databases were searched:Chinese Biomedical Literature Database (SinoMed),China Academic Journal database,Chinese Science and Technology journals database,using the key words specialty nurse,clinical nurse specialist and advanced practice nurse.Strict inclusion and exclusion criteria were applied.Results Seven hundred and eighteen papers were eligible for inclusion.The earliest paper was published in 1992,then the number increased yearly.Most of the papers were reviews or summaries of experience,and the hotspot were about the nurse specialist in ICU,operating room,emergency,oncology and diabetes department.Conclusions The attempt about nurse specialist have been carried out in the whole country,but further improvement and practice are needed to solve the existing problems such as the definition,training,certification and nurse management,and it is urgent for us to explore a suitable way for the development of specialist nurse in China.

AIM:To investigate the interaction of polymorphisms of resistin gene promoter -420C/G, cyto-chromes P4501A1-MspI and cigarette smoking in nonalcoholic fatty liver disease (NAFLD).METHODS: The genetic polymorphisms in resistin gene promoter -420C/G and CYP1A1-MspI were analyzed by the technique of polymerase chain reaction ( PCR) in peripheral blood leukocytes of 900 NAFLD cases and 900 healthy persons.RESULTS:The frequencies of -420C/G (GG) and CYP1A1-MspI (m2/m2) were 49.75%and 50.08%in NAFLD cases and 24.00%and 24.25%in healthy controls, respectively.Statistical tests showed a significant difference in the frequencies between the 2 groups ( P<0.01).The risk of NAFLD with -420C/G (GG) was significantly higher than that of controls.Individuals who carried with CYP1A1-MspI (m2/m2) had a high risk of NAFLD.Combined analysis of the polymorphisms showed that the per-centages of -420C/G (GG)/CYP1A1-MspI (m2/m2) in NAFLD and control groups were 39.83% and 12.83%, re-spectively (P<0.01).The people who carried with -420C/G (GG)/CYP1A1-MspI(m2/m2) had a high risk in NAFLD group.The cigarette smoking rate in NAFLD group was signi-ficantly higher than that in control group ( P<0.01) , and the statistic analysis suggested an interaction between cigarette smoking and -420C/G (GG) and CYP1A1-MspI (m2/m2), which increased the risk of NAFLD.CONCLUSION: -420C/G (GG), CYP1A1-MspI (m2/m2) and cigarette smoking are the risk factors in NAFLD.The interactions between genetic polymorphisms in -420C/G, CYP1A1-MspI ( m2/m2) and cigarette smoking increase the risk of NAFLD.