AIM To investigate the inhibition and apoptosis mechanism of GBC-SD cells induced by rubescensine B. METHODS Using MTT, convert microscopy, electron microscopy, flow cytometry, an immunohistochemical assay, and spectrofluorometry demonstrate the presence and pathogenesis of apoptosis after treated by rubescensine B. RESULTS After exposure to Rubecensine B GBC-SD cells were induced to apoptosis in dose-dependent manner, and the level of Bcl-2,p53,C-myc,Fas/APO-1 were decreased within 24 hours, reversely the activity of Caspase-3 was enhanced with the appearance of apoptosis. CONCLUSION Rubecensine B can induce GBC-SD cells apoptosis related to Bcl-2,p53,Fas/APO-1 and C-myc.

China has entered the aging society , in urban communities and rural grassroots their are still many older people lack of health insurance , elderly patients with chronic diseases become the most difficult people to see a doctor, this needs to train more general practitioners to solve these problems .From a macroscopical view , general practitioners can bring substantial economic benefits and broad social benefits .From a microscopic view , they also can make effective use of family medical resources , bring convenient for old people going to a doctor and carry out an important role of health education .Improving the General Practitioner -Elderlyservice mode , the govern-ment needs to further improve the elderly medical service system and security system , vigorously promote grass -roots community health service institutions of medical conditions , develop specialized general medical personnel ac-cording to the needs of the elderly , implement contractual service relationships between general practitioners and the elderly.

In order to improve the clinical outcomes and promote the development of enhanced recovery after surgery(ERAS),a full-time specialized role of nurse navigator(NN) was established in Department of Surgery in February,2016. Clinical pathway for ERAS was designed,and role functions,core competencies and responsibilities of NN were formulated. According to the functions and the working frame,NN connected and coordinated teamwork activities,monitored the implementation of ERAS during the overall process. After implementation,the NN had dealt with 10 unusual incidents,the execution efficiency of the 14(82.4%) measurements were 100%,1 measurement was 97%,2 measurements were 94.1%,and 33 patients and 42 medical staff thought highly of the NN. This practice effectively promoted the development of ERAS team and specialist nurse role in our hospital.

Objective To investigate whether octreotide,as somatostatin analogue,can enhance the sensitivity of the human lung adenocarcinoma cell line A549 to chemotherapeutic drugs.Methods Different concentration of octretide,cisplatin and 5-Fluorouracil (5-Fu) was respectively acted on the lung adenocarcinoma cell line A549.The absorbance value was tested by colorimetry through MTT method to evaluate the effect of octreotide,cisplatin,5-Fu or the three drugs combined respectively after 48 hours.Each drug concentration had six holes and it repeated three times.The effects of combination therapy was analysed with isobologram.Results It was proved that octreotide could inhibit the proliferation of A549 cells in a dose-dependent manner at the concentration range of 1.3 mg/L ～ 166.7 mg/L.The inhibition rate was dose-dependent which was higher when octreotide combined with cisplatin and 5-Fu than it alone.It has statistically significant difference (P ＜ 0.05 ).The effect plots of IC50 were located in the synergy areas of isobologram.Conclusion It can be concluded that octreotide could inhibit the proliferation of A549 cells in vitro.This inhibition enhances when octreotide is combined with cisplatin and 5-Fu.Octreotide can enhance the susceptibility of A549 cells to cisplatin and 5-Fu.

ObjectiveTo discuss the clinical results of surgical reduction and fixation via posterolateral knee approach in the treatment of postemlateral tibial plateau fractures.MethodsThe study involved 32 patients with posterolateral tibial plateau fractures treated through posterolateral knee approaches from January 2006 to July 2009.There were 19 males and 13 females,at the age of 27-70 years (mean,38.1 years).Injury causes included traffic injuries in 19 patients,high fall injuries in nine and other in four.There were seven patients combined with anterior cruciate ligament injuries,which was all tibial plateau insertion avulsion. Results All patients were followed up for 12-36 months (mean,18.2 months),which showed bone union,without presence of incisional infection,loosening or breakage of screws,varus or valgus deformity of the knee,or fracture redisplacement.One patient had tension injury of common peroneal nerve postoperatively and recovered after two months conservative treatment of Methycobal.According to the Rasmussen knee function score,the results were excellent in 19 patients,good in 11 and fair in two,with excellence rate of 94％.ConclusionPosterolateral knee approach facilitates the reduction and fixation of posterolateral tibial plateau fractures and has advantages of clear exposure,convenient placement of internal fixation,small invasion and good clinical results.

This study was aimed to compare different preparation methods of Wei-Chang Fu-Yuan (WCFY) De-coction, which is a self-made traditional Chinese medicine (TCM) decoction of our hospital, through the investiga-tion of difference in recovery time of gastrointestinal function after gynecological abdominal surgery. A total of 120 cases after gynecological abdominal surgery in our hospital between 2011 and 2012 were randomly divided into the treatment group and the control group, with 60 cases in each group. The hospital self-made WCFY Decoction was given to patients 8 hours after surgery in the treatment group and control group. Decoctions given to two groups were prepared with different methods. Decoction given to the treatment group was by the decoction ma-chine of multiple decoctions preparation. Decoction given to the control group was prepared as the traditional sin-gle dose decoction. The first anus flatus time was observed in both groups. The results showed that the flatus time of treatment group was 16 h and that of the control group was 13 h. The flatus time of patients from two groups was in skewed distribution, so the distance between the median and quartile was used to describe. The non-para-metric tests (Kolmogorov-Smirnov method) were used in the comparison of flatus time of two groups. There was statistical significance between two groups (P < 0.05). It was concluded that different preparation methods affect the clinical efficacy of WCFY Decoction. Compared with the traditional single dose decoction, the fist flatus time was postponed 3 hours by the decoction machine of multiple decoctions preparation. Therefore, with the widely using of decoction machine of multiple decoctions preparation today, the function of decoction machine should be improved and the program should be perfected in order to increase the clinical efficacy of this preparation method.

Objecitve To investigate the changes of chronotropic response before and after percutaneous coronary intervention ( PCI)in patients with coronary disease .Methods A total of 339 patients with coronary disease was included in this study .All sub-jects underwent treadmill exercise test and coronary angiogram , and some patients underwent PCI if necessary .The parameters of chro-notropic response were recorded and analyzed , including ratio of the highest to predicted heart rates ( rHR) ,chronotropic response in-dex ( CRI) , and heart rate reserve ( HRR) .After coronary angiogram , the score of gensin was recorded and analyzed .Results There was significant difference in the parameter of CRI between unstable angina pectoris and silent myocardial ischemia groups ( P <0.05 ) , CRI were 0.80 ±0.11 and 0.89 ±0.07 , respectively .After coronary angiogram and PCI , there were significant differences in the parameters of rHR, CRI, and HRR between pre-therapy and post-treatment ( t =2.440, 1.977, 2.529, all P <0.05).A nega-tive correlation was found between the parameters of rHR , CRI, and HRR and the score of Gensin ( r =-0.686 , -0.673 , and-0.672, all P <0.05).The significant difference in rHR, CRI, and HRR existed between the groups of <20 and >40 ( t =2.567, 2.223, 2.062, all P <0.05).Conclusions Parameters (rHR, CRI, and HRR) had important clinical values in evaluating the changes of chronotropic response before and after PCI in patients with coronary disease with a negative correlation with the score of Gensin.

BACKGROUND:Silk fibroin/mesoporous glass ceramic composites have been reported to exert satisfactory repair outcomes in bone defects and hold good biocompatibility. However, the biosafety and preparation methods are rarely reported. OBJECTIVE:To investigate the preparation method and treatment outcomes of silk fibroin/mesoporous bioactive glass ceramic in skul repair. METHODS:Thirty-two Sprague-Dawley rats were enrol ed to establish the skul defect models and were thenrandomized into two groups:fibroin/mesoporous glass ceramic materials and silk fibroin were respectively implanted into the defect region in experimental and control groups. At 4 and 8 weeks after implantation, the CT examination and histological observation were performed. RESULTS AND CONCLUSION:CT examination showed that at 4 weeks after implantation, the defect area in the experimental group diminished in size, showing more dense new bones. The defect area of the control group was reduced, and a smal amount of new bones were observed. At 8 weeks after implantation, bone defect repair was completed in the experimental group, but not in the control group. The bone volume in the experimental group was significantly larger than that in the control group at different time points after implantation (P<0.05). Hematoxylin-eosin staining found that at 4 weeks after implantation, in the experimental group, there was new bone between the implant and the bone, which did not cause inflammation;there were few new bones and fibrous tissues in the control group. At 8 weeks after implantation, many new bones formed in the experimental group, with similar morphology to the host bone and the scaffold was degraded completely. Conversely, the implant material stil existed in the control group. In conclusion, the silk fibroin/mesoporous glass ceramic composite can promote bone repair.

Objective To observe the curative effect and adverse reactions of IMRT and conventional radiotherapy combined with chem-otherapy in treating patients with advanced nasopharyngeal carcinoma. Methods The patients were divided into the IMRT group (46 cases) and conventional radiotherapy combined with chemotherapy group ( 50 cases ) . Making the IMRT and conventional radiotherapy combined with chemotherapy treatment plan, and analyze the curative effect and adverse reaction of the two groups. Results Compared with the con-ventional radiotherapy combined with chemotherapy group, IMRT group has a significantly increase in complete remission rate and overall re-sponse rate, but there is no significant difference in long-term efficacy. The skin, dry mouth ( parotid) ,and oral mucositis response is lower in IMRT group, and the neutropenia incidence, prevalence of anemia, liver and kidney function damage rate is also significantly lower than conventional radiotherapy combined with chemotherapy. Conclusion The IMRT can significantly improve the curative effect in treatment of advanced nasopharyngeal carcinoma and reduce the adverse reactions compared with the conventional radiotherapy combined with chemotherapy.

Objective To explore the role of fibrogenic cytokines and inflammatory cytokines in the pathogenesis of frozen shoulder. Methods From September, 2014 to April, 2016, 20 patients with frozen shoulder accepted arthroscopic surgery were included, ten of them were diagnosed as primary frozen shoulder (group A), the other ten were secondary frozen shoulder (group B). Other ten patients undergo-ing shoulder arthroscopy for instability (4 cases), rotator cuff injury (3 cases) and subacromial impingement (3 cases) were as the controls (group C). The mRNA levels of matrix metalloproteinase (MMP) 1, MMP3, tumour necrosis factor-α (TNF-α), interleukin (IL)-1, IL-6, IL-8, granulocyte-macrophage colony stimulating factor (GM-CSF) and M-CSF in synovium were analyzed with quantitative polymerase chain reaction. Results The expression of mRNA of MMP1, MMP3, TNF-α, IL-1, IL-6, IL-8, GM-CSF and M-CSF were more in group A and group B than in group C (P<0.05). There was no significant difference between group A and group B (P>0.05). Conclusion The fibro-genic cytokines and inflammatory cytokines may play a role in the pathogenesis of frozen shoulder.