Objective:To evaluate the antileukemic activity and side effects of topotecan in patients with refractory and relapsed acute myelogenous leukemia(AML).Method:12cases of refractory and relapsed AML were treated with topotecan combined with chemotherapy,8 accepted 1 course,and the others accepted 2 courses.Result:4 patients achieved complete remission.3 had partial remission.The total response rate was 58%.The main side effect was myelosuppression.Conclusion:The topotecan-based induction therapy has antileukemic effect in some patients with refractory and relapsed AML.

Objective　To investigate the direct antitumor effect of several surface molecules of Bifidobacterium bifidum 1101 such as whole peptidoglycan (WPG), lipoteichoic acid (LTA), and polysaccharides (PS) on human colonic adenocarcinoma cell line LoVo. Methods　MTT assay and flow cytometry (FCM) were used to evaluate the effect of Bifidobacterial surface molecules on the growth of LoVo cells. Morphological study, fluorescent polarimetry and differentiation-specific enzyme analysis were used to determine whether LTA treatment could induce the differentiation of the cells. Results　LTA but not WPG or PS significantly inhibited the proliferation of LoVo cells in a dose and time dependent manner. Cell cycle analysis by FCM revealed that LTA induced changes in cycle distribution resulting in G0/G1 phase commitment. Morphological alterations observed by light and electron microscopy indicated maturity of cytoplasm and nucleus following treatment by 50μg/ml of LTA. Membrane fluidity was also altered, and intestinal alkaline phosphatase specific for the differentiation of LoVo cells roused dramatically during culture in LTA. It was further found that LTA elevated ［Ca2+］i which resulted from Ca2+ influx instead of the release of stored calcium. Conclusion　These observations indicated that LTA was able to inhibit the growth of LoVo cells and induce the differentiation of the cells. Calcium influx may play an important role in this process.

Objective:In the performance appraisal of public hospitals,the lack of detailed degree of personalized appraisal,inadequate attention of hospital leaderships and unreasonable performance appraisal indexes were analyzed to provide measurement.Methods:Using the equity theory to conduct specific analysis on the problem.Results:To promote the stable and sustainable development of public hospitals,it mobilized the enthusiasm,initiative and creativity of the employees.Conclusion:It needed to create more economic and social benefits and enhance the core competitiveness of the hospital.

In recent years,thyroid cancer incidence increased year by year,after the effective prevention of iodine deficiency disorders in many countries,which caused widespread attention in academia.Whether is this increasing trend related to the implementation of policy of iodized salt in many countries? Currently,the association between iodine intake and thyroid cancer is unclear.This review article describes the metabolic and nutritional status of iodine,and the epidemiology of thyroid cancer,and further elaborates the relationship and the pathogenesis of iodine and thyroid cancer.

Background and purpose:The mutation of BRCA1 gene is widely acknowledged to be related to the incidence of triple-negative breast cancer (TNBC). The aim of this study was to investigate the association between TNBC and single nucleotide polymorphisms (SNPs) of BRCA1-associated genes. Methods:This study investigated the associations between the BRCA1-A complex genes and risk of developing TNBC in a case-control study of Chinese Han Women population including 414 patients with TNBC and 354 cancer-free controls diagnosed in the Fudan University Shanghai Cancer Center during 2008-2011. This study also detected 37 common variants in Abraxas, BRE, Rap80, NBA1 and BRCC36 genes encoding the BRCA1-A complex and evaluated their genetic susceptibility to the risk of TNBC. An additional cohort with 652 other types of breast cancer (non-TNBC) cases and 890 controls were used to investigate the associations between TNBC-speciifc SNPs genotype and non-TNBCs susceptibility. Results:This study found that rs7250266 in the promoter region of NBA1 confers a decreased risk to TNBC (P<0.01). Compared with CC genotype, women with the GC genotype (OR=0.70, 95%CI:0.51-0.97) and GG genotype (OR=0.48, 95%CI:0.21-1.07) had a lower risk of developing TNBC (P=0.03). In addition, the haplotypes containing two polymorphisms rs7250266 and rs2278256 were associated with a lower chance of TNBC development. In the second part of the study, the result showed that there was no difference in rs7250266 expression between non-TNBC and normal people (0.19 vs 0.18, P=0.85).Conclusion:Genetic variants in NBA1 may be an important genetic determinant of TNBC susceptibility in Chinese women.

Objective To study the aplication effect of fiber bronchoscope examination in the treatment of respiratory internal medicine emergency and its effect on the quality of life of patients.Methods 156 patients with emergency were randomly divided into the observation group and control group,each group in 78 cases.The control group was given routine treatment plan according to the primary disease type which was the respiratory treatment of the corresponding diseases,the observation group in the control group was added fiberoptic bronchoscopy based on the treatment.Compared blood clinical curative effect,heart rate and quality of life score changes of the two groups of patients after treatment.Results The total effective rate of the observation group was 94.87%,which was significantly higher than 81.01% of the control group(χ2 =6.28,P <0.05).The pH,PaO2 and SaO2 in the observation group after treatment were(7.35 ±0.04),(73.23 ±9.11)mmHg and(92.33 ±4.32)%,which were significantly higher than the corresponding index in the control group(t =3.97,6.08,4.96,all P <0.05);while PaCO2 and HR were (51.53 ±9.24)mmHg,(91.69 ±12.42)times/min,which were significantly lower than the corresponding index in the control group(t =6.73,5.13,all P <0.05);The quality of life score in the observation group was(54.04 ± 10.94)points,which was significantly lower than(77.23 ±12.32)points of the control group(t =5.86,P <0.05). Conclusion Fiberoptic bronchoscopy for respiratory internal medicine emergency treatment can significantly improve the clinical curative effect of treating disease and patient quality of life.

Objective To evaluate the methods for improving diagnostic ratio of unruptured ectopic pregnancy with ultrasonography. Methods A total of 139 patients of small adnexal cysts with thick wall were predicted respectively with sonographic indexes. All patients (61 with unruptured ectopic pregnancy and 78 with small corpusluteum) were confirmed postoperatively or with long-term follow up, and the results were compared. Results The diagnostic sensitivity of with hyperecho or isoecho compared with endometrium, hyperecho compared with ovarian tissue, adnexal cyst without small follicle around was 86.89%, 93.44% and 96.72%, and the specificity of three predictors was 93.59%, 85.90% and 70.51%, respectively. Two sonographic indexes together had a sensitivity of 98.36% and a specificity of 94.87% for diagnosing ectopic pregnancy. Conclusion Observing the relation of adnexal cyst and ovarian and the echogenic of cyst wall are specific and sensitive for the diagnosis of ectopic pregnancy.

Objective To investigate and analyze the effects of problem-based learning used in clinical nursing education. Method The research papers on the effect of problem-based learning used in clinical nursing education were retrieved via CNKI, Wanfang,VIP,PubMed,ProQuest and Google scholar websites and then analyzed by Revman5.0 software.Results Totally 11 RCTs were included.Meta-analysis showed that PBL could significantly promote students’examination scores,self-study ability, critical thinking and clinical skill,but insignificantly improved the effect in improvement of their theory learning,interest and ability in cooperation.Conclusions PBL is a scientific clinical teaching method,which can stimulate students’initiative and exploratory learning and enhance effects of clinical teaching.Meanwhile,we suggest formulating evaluation criteria and implementing rigorous RCT designs in the future.

ObjectiveTo evaluate the application effect of clinical pathways in hospitalized inguinal hernia patients by using the Meta- analysis. MethodsPublished randomized controlled trials (RCT)in hospitalized inguinal hernia patients were searched and screened in CNKI、VIP、CBMdisc and Wanfang datebase under present standards.The quality of the included studies were evaluated and statistically analyzed by RevMan5.0 software. ResultsTotally 16 literatures including 1649 cases were eligible to the criteria (816 in clinical nursing pathways group and 833 in the traditional health education group)altogether.The Meta-analysis showed there were significant difference between the clinical pathway group and the traditional health education group in grasp of health knowledge,rate of patients,satisfaction degree,length of hospital stay and hospitalization expenses. ConclusionsClinical pathways is superior compared with the traditional health education for hospitalized inguinal hernia patients.

Chloridion participated in various kinds of biological function, such as cellular immunologic response , cell migration, cellular proliferation and differentiation, apoptosis. This kind of functional multiplicity corresponded with different gene encoding different chloride channel. It indicated that chloride channel function change or depletion concerned with many kinds of corneal disease. Therefore, the study of corneal chloride channel was very important This article summarized the effect of corneal chloride channel and its advances, and investigated the relationship between corneal disease and chloride channel.