Kisspoptin signaling plays an essential role in the onset of puberty and reproductive development.Recently studies implicate that steroid-responsive NKB,kisspeptin,NK3 R,and estrogen receptor α (ERα) coexpress in arcuate nucleus of hypothalamus of variety of mammalian species and regulate the secretion of gonadotrophic hormone.The function of neurons in the hypothalamus is to regulate the estrogen negative feedback on gonadotropin-releasing hormone (GnRH) secretion.Loss of function of neurokinin B (NKB) or its receptor,the neurokinin-3 receptor produces idiopathic hypogonadotropic hypogonadism.These studies demonstrate NKB and neurokinin-3 receptor as the essential elements of the human reproductive axis.

Apoptosis inhibitors ( inhibitor of apoptosis proteins, IAPs) are a class of highly conserved apoptotic endogenous anti-cytokine family, primarily by inhibiting caspase activity and par-ticipation in regulation of nuclear factor NF-κB inhibition of ap-optosis. caspases cascade of protease activation is a central part of the apoptotic process, Bcl-2 family proteins and IAPs family proteins are the main controlling factors. In recent years, we found that abnormal expression of some IAPs members is closely associated with the tumor, a potential target for cancer therapy. Therefore, this paper reviews the major protein associated with IAPs family and anti-tumor research targeting IAPs.

Objective:To evaluate the surface free energy and Streptococcus mutans(S.mutans)adhesion on the surfaces of Co-Cr al-loy specimens fabricated by selective laser sintering(SLS)and casting method(SG and W280)respectively.Methods:The specimens of three groups were polished by SiC sandpaper.Surface morphology test,surface contact angle test and surface adhesion test of S.mu-tans were performed.Results:With the same surface roughness value,the surface contact angle of group SLS,W280 and SG was 66.200 ±3.112,74.212 ±3.206 and 67.238 ±2.047(P >0.05),the surface adhesion of S.mutans colone was 8.88 ±2.90,9.25 ± 2.05 and 8.50 ±1.85(P >0.05),respectively.Conclusion:The cobalt chromium alloy fabricated by SLS and casting method have similar surface performance.

Objective To explore the effect of related factors on survival of patients with unresectable pancreatic cancer aged 70 years and over. Methods Fifty-seven patients with unresectable locally advanced or metastatic pancreatic cancer aged 70 years and over were enrolled.Their survival time were analyzed with SPSS 13.0 by taking account of gender, age, smoking history,alcohol history, pancreatic disease history, diabetes mellitus history, Eastern Collaborative Oncology Group (ECOG) scoring, chemotherapy, radiotherapy, CEA and CA199 levels. Results Gender,ECOG scoring, chemotherapy and radiotherapy had relationship with overall survival. The median survival time was 8.9 months and one-year survival rate was 28.1%. The median survival was (10.7±5.4) months in male group and (5.5±2.3) months in female group (P=0.000). The median survival was(10.1±5.8) months in patients with ECOG 0～1 group and(7.3±3.8)months in patients with ECOG 2 group (P=0.040). The median survival was(7.76±5.27) months in nochemotherapy group and(11.5±5.0)months in chemotherapy group (P=0.038). The median survival was(8.87±5.36)months in no radiotherapy group and (13.7±3.8) months in radiotherapy group (P=0.048). Conclusions The patients who have better ECOG performance status and receive chemotherapy or radiotherapy show better survival.

Objective The research is to understand students' mobile learning (M-learning) attitudes and behaviors,and provide a reference for the development of mobile learning systems and learning resources.Methods The research used the method of questionnaires to investigate nursing students' present situation of M-learning.Results About 2/3 of the students were so eager to have targeted mobile tutorial course.Most of the students were not satisfied though there were a lot of resources.More than 2/3 of the students used telephone to surf on the internet almost every day (mainly on reading web pages and communicate with classmates using chat software,see / write blog lowest).The mobile learning time of more than 60％ students was not more than 10 minutes.1/3 of students used the time between 10 to 30 minutes.The highest cost that students spent on monthly mobile learning was less than 10 Yuan,accounting for the total number of 1/3.Compared with the junior college students,the proportion of undergraduates who support to use phone to surf on the internet was higher.Undergraduate students were more likely to read pages and see multimedia,most of them hope to see courseware within 2 to 5 minutes,etc.Conclusions Nursing students have good hardware conditions on mobile learning.Students are recognized on mobile learning.The current mobile learning resources are chaos and lack of design so that it hindered the development of mobile learning.Mobile learning courses should be short and pithy,rich and colorful.Application design of mobile blog in mobile learning needs to be strengthened.Generally speaking,undergraduate college students are more actively to take mobile learning into their learning and life.

Objective To evaluate CT diagnositic value for endo-bronchial tuberculosis(TB).Methods CT findings of 14 cases with endo-bronchial TB proved by fibro-bronscopy(FOB) were studied retrospectively.Results The bronchiarctia was seen at lobar bronchas or segmental bronchas in all 14 cases.Of them,in 6 cases,the bronchiarctia appeared as conic stenosis accompanied with atelactasis and a large amount of plearal effusions,in 8 cases,the bronchial walls were thichened including centrality stenosis in 3 cases,unilateral stenosis in 5 cases and accompanied with polyus in 3 cases.No hilar mass and opposite "S" sign were found.The "bronchial air sign" was showed at the area of ateectasis.9 cases were accompanied by active pulmonary TB(64.3%).Conclusion CT is of important value in diagnosing endo-bronchial TB and differentiating the tumorous or no-tumorous bronchiarctia,while the diagnonsis at early stage of this disease has to depend on FOB.

The authors study the character of properties,micro-organization and general physical and chemical identification of Radix Tetrastigmae from Zhejiang and Guangxi,that provides an experimental basis for identification and establishing quality specifica- tions of Radix Tetrastigmae.

Objective To observe the therapeutic effect of Baizhu Shengjiang Decoction combined with Prucalopride Succinate Tablets for chronic functional constipation. Methods Sixty patients with chronic functional constipation were randomly divided into treatment group and control group, 30 cases in each group. The treatment group was treated with Baizhu Shengjiang Decoction combined with Prucalopride Succinate Tablets orally, and the control group was treated with oral administration of Prucalopride Succinate Tablets alone. The therapeutic effects on traditional Chinese medicine (TCM) symptoms and constipation, and the follow-up therapeutic effect of the two groups were evaluated after treatment. During the three months after the completion of treatment course, the recurrence of constipation was monitored. Results (1) The cure rate of the treatment group was 90.0％ and that of the control group was 60.0％, indicating that the therapeutic effect on TCM symptoms in the treatment group was stronger than that of the control group(P < 0.05).(2) In respect of the relief of constipation, the markedly effective rate was 93.3％ in the treatment group and was 50.0％ in the control group, and the overall effective rate was 100.0％ in the treatment group and was 73.3％ in the control group, the difference being significant between the two groups(P<0.05 or P<0.01).(3) During the treatment, the percentage of patients with weekly completely spontaneous defecation frequency ≥3 was 86.7％ in the treatment group, and was 53.3％ in the control group, the difference being significant (P < 0.05). (4) The results of 3-month follow-up after the completion of treatment course showed that one case from the treatment group had the recurrence of constipation, and the recurred cases from the control group were 6, the difference being significant (P < 0.05). Conclusion Oral use of Baizhu Shengjiang Decoction combined with Prucalopride Succinate Tablets exerts certain therapeutic effect for chronic functional constipation, which is effective both on relieving constipation symptoms and on reducing recurrence rate.

Objective To explore the distribution and drug resistance of extended-spectrum beta-lactamase (ESBLs)producing Klebsiella pneumoniae in elderly and young and middle-aged patients,and provide reference for rational use of antibiotics for clinicians.Methods Specimens of elderly (≥ 60 years old) and young and middle-aged (18-59 years old) patients who with various clinical infection in Shengjing Hospital of China Medical University from January 2016 to December 2016 were collected as the research object.ESBLs-producing Klebsiella pneumoniae was isolated from 125 patients (60 elderly patients and 65 young and middle-aged patients).The preliminary screening and phenotypic confirmatory test of ESBLs were carried according to the method which was recommended by American Clinical and Laboratory Standards Institute.The drug resistance of ESBLs-producing Klebsiella pneumoniae was analysed and the resuh of the two groups were compared.Results The specimens of ESBLs-producing Klebsiella pneumoniae strains of elderly patients were mainly from urine (36.67％),sputum (33.33％) and whole blood (11.67％);the specimens of young and middle-aged patients were also mainly from urine (24.62％),sputum(24.62％) and whole blood (15.38％).There was statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the specimens secretions between the elderly patients and the young and middle-aged patients(P ＜0.05).There was no statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the specimens of urine,sputum,whole blood,bile,pus,drain,cerebrospinal fluid,ascitic fluid and catheter between the elderly patients and the young and middle-aged patients (P ＞ 0.05).ESBLs-producing Klebsiella pneumoniae strains of elderly patients were mainly isolated from department of respiration (20.00％,12/60) and department of urinary surgery (18.33％,11/60);the ESBLs-producing Klebsiella pneumoniae strains of young and middle-aged patients were mainly isolated from department of intensive care (16.92％,11/65) and department of neurosurgery (16.92％,11/65).There was statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the department of respiration and obstetrics and gynecology between elderly patients and young and middle-aged patients(P ＜ 0.05);there was no statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the department of urinary surgery,general surgery,intensive care,neurosurgery,rheumatoid immunology,invasive technology,oncology,digestion,infection,kidney,orthopaedics,rehabilitation,hematology,neurology and other department between elderly patients and young and middle-aged patients(P ＞ 0.05).The drug resistance rates of ESBLs-producing Klebsiella pneumoniae to beta-lactam antibiotic in elderly and young and middle-aged patients were more than 90.00％;the drug resistance rates of ESBLs-producing Klebsiella pneumoniae to carbapenems were nearly 0.00％ in elderly and young and middle-aged patients.There was significant difference in the drug resistance rates of ESBLs-producing Klebsiella pneumoniae to ceftazidime and gentamicin between elderly patients and young and middle-aged patients(P ＜ 0.05);there was no significant difference in the drug resistance rate of ESBLs-producing Klebsiella pneumoniae to another antibiotic between elderly patients and young and middle-aged patients (P ＞ 0.05).Conclusion Both elderly and the young and middle-aged patients can be infected with ESBLs-producing Klebsiella pneumoniae.There was no significant difference in the distribution of ESBLs-producing Klebsiella pneumoniae in most clinical departments (except respiratory and obstetrics and gynecology).The most effective antimicrobial drugs at present for the treatment of ESBLs-producing Klebsiella pneumoniae was carbapenems.There is no significant difference in the drug resistance rates of ESBLs-producing Klebsiella pneumoniae to common antibiotics between elderly patients and young and middle-aged patients.Clinicians should rationally use antibiotics according to the results of susceptibility tests.

Objective To analyse the efficacy of lamivudine(LAM) combined adefovir dipivoxil(ADV) and entecavir(ETV) in the treatment of naive patients with chronic hepatitis B (CHB) .Methods Cochrane Library ,MEDLINE ,Web of Science ,CNKI (China National Knowledge Infrastructure ) ,WANFANG database and VIP database were searched and the references of eligible studies were screened .All relevant literatures published before March 6th ,2012 were reviewed .Comparison of the efficacy of lami-vudine combined adefovir dipivoxil and entecavir in the treatment of naive patients with chronic hepatitis B was included and Rev Man 5 .1 software was used for Meta analysis .Results Four eligible studies (587 patients in all) were included for the analysis .In the entecavir monotherapy group ,the serum ALT normalization rate was a little higher at the 12 weeks and 24 weeks of the treat-ment compared to the combination group[OR=0 .52 ,95% CI(0 .28 ,0 .97) ,Z=2 .04 ,P=0 .04] ,[OR=0 .45 ,95% CI(0 .22 ,0 .95) , Z=2 .11 ,P=0 .04] ,respectively .But after 36 weeks there was no significance between the two groups .For HBV DNA undetect-able rate ,there were no significant differences between the two groups at the 12 weeks ,24 weeks ,36 weeks ,48 weeks ,18 months , 24 months and 30 months of the treatment (P=0 .22 ,P=0 .30 ,P=0 .86 ,P=0 .31 ,P=0 .93 ,P=0 .84 and P=0 .83 respectively) . At the 48 weeks ,HBeAg negative rate has no significant difference between the two groups [OR=0 .93 ,95% CI(0 .29 ,2 .95) ,Z=0 .13 ,P=0 .90] .Conclusion Both LAM+ADV combination therapy and ETV monotherapy are effective in the treatment of naive patients with CHB ,but further studies are still needed to obtain long term results and safety by high quality ,large scale randomized controlled trials .