Objective To retrieve and analyze the available evidence on prevention of needlestick injuries among healthcare workers and summarize the best available evidence.Methods We searched the BMJ best practice,Uptodata,Cochrane Library(2014),Joanna Briggs Institute Library,Registered Nurses' Association of Ontario,Scottish Intercollegiate Guidelines Network,National Guideline Clearinghouse,and complementally searched the PubMed,EM-base,CNKI and Centers for Disease Control to collect literatures including guideline,evidence summary,best practice information sheet,recommended practice and systematic review.Results Nine references were selected including a clinical decision support system,3 evidence summaries,2 recommended practices and 3 systematic review.Finally,7 items of best evidence were summarized,including:wearing double gloves,never recapping needles,using blunt-tip suture,using a neutral zone for passing sharp device,adopting the safety features of sharps,using sharp disposal containers,and continuous education for needlestick injuries.Conclusion Healthcare workers should regulate their behaviors of using sharp instruments during clinical practice and guarantee personal safety by consulting high level evidence.

Objective:To explore the clinical and pathological features of familial gastric cancer, and to get the early discovery and early treatment of it.Methods:Two kindreds of familial gastric cancer were followed up and their clinical and pathological features were analyzed.Results:Six patients with gastric cancer were found in the 2 kindreds.Autosomal dominant inheritance was observed in these cases.clinical and pathological features of familial gastric cancer were showed according to the document analysis:early onset;poor prognosis;patients suffer simultaneous or metachronous carcinoma;CDH1 germline mutation carriers had higher penetrance;pathologically, tumors are mostly diffuse infiltrative type with lower differentiated degree and earlier metastasis to lymphnodes;in one kindred,the sites of the lesions were relatively consistent.Conclusion:Familial gastric cancer has particular clinical and pathological features:early onset;poor prognosis;patients suffer simultaneous or metachronous carcinoma;CDH1 germline mutation carriers have higher penetrance; pathologically,tumors are mostly diffuse infiltrative type with lower differentiated degree and earlier metastasis to lymphnodes.

Objective To investigate the sedative and hypnotic interaction between remifentanil and propofol by target-controlled infusion (TCI) during induction of anesthesia.Methods Third-two ASA Ⅰ or Ⅱpatients,aged 22-63 yr,body mass index 18-25 kg/m2,scheduled for elective surgery under general anesthesia,were randomly divided into 4 groups(n=8 each).Group Ⅰ only received TCI pmpofol.GroupⅡ,Ⅲ,and Ⅳreceived a target concentration of 2,4 or 6 ng/ml remifentanil respectively.While the blood-effect site concentrations of remifentanil were equilibrated,patients received TCI of propefol,with an initial target concentration of 0.5μg/ml.After the blood-effect site concentrations of propofol were equilibrated then with 0.5μg/ml increments until the loss consciousness was achieved.The eyelash reflex and state of consciousness were assessed and radial arterial blood sample 6 ml was taken every 3 min to determine the remifentanil and propofol concentrations in blood.Propofol and remifentanil concentrations in blood were measured by reversed-phase high-performance liquid chromatography and high-performance liquid chromatography with ultraviolet detection respectively.The sedative and hypnotic interaction between propofol and remifentanil was determined with a pharmacodynamie interaction model by regression analysis and determined using the isobolographic method.Results Propofol concentrations in blood were lower in group Ⅱ,Ⅲ and Ⅳ than group Ⅰ(P<0.05).The propofol concentratopms in blood were significantly decreased in trun with the increase in the remifentanil concentrations in blood in group Ⅱ-Ⅳ(P<0.05).At loss of eyelash reflex and loss of consciousness of patients,the pharmacodynamic interaction model by curve fitting was superior to linear regression (P<0.05).At loss of eyelash reflex of patients,the curve fitting result showed EC50,prop=2.77μg/ml and EC50,rem=26.67 ng/ml,and the isobolographic method equation is ECprop/2.77+ECrem/26.67=0.69.At loss of consciousness of patients,the curve fitting result showed EC50,prop==3.76μg/ml and EC50,rem=31.56ng/ml,and the isobolographic method equation is Ecprop/3.76+Ecrem/31.56=0.65.Conclusion Remifentanil (Cp 2-6 ng/ml) and propofol by TCI shows a synergistic type of pharmacodynamic interaction on the sedative and hypnotic during induction of anesthesia.

Objective To explore the efficacy of multilevel anterior cervical discectomy and fusion for aged patients with cervical spondylotic myelopathy. Methods 25 aged patients with cervical spondylotic myelopathy were treated by multilevel anterior cervical discectomy and fusion. Japanese Orthopedic Association (JOA) scores were evaluated,clinical results were graded from excellent to poor using Odoms criteria,and the sagittal alignment of fusion segements were measured using Cobb method. Bone fusion and complications was evaluated. Results The final follow up score according to Odoms criteria was excellent in 8 patients ,good in 14 patients,and fair in 3 patients ,with excellent and good rate of 88%. The JOA score at final follow up(7.8) was significantly higher than preoperative(12. 8),with average improvement rate of 54%. At final follow up,bone fusion rate was 100%. Conclusion Multilevel anterior discectomy and fusion for aged patients with cervical spondylotic myelopathy was effective.

Objective To observe the therapeutic effect of Qingxiang Concentrated Pill (QCP) on mammary gland hyperplasia (MGH) in rats. Methods Injection of estradiol were given to establish rat models of MGH and QCP was given QCP at the same time. Pathologic changes of mammary gland in rats were observed under light microscope. Changes of breast diameter, mammary gland volume and weight were measured; serum sex hormones levels, SOD activity and MDA content were also estimated. Results QCP could decrease the increased breast diameter, mammary gland volume and weight, reduce the numbers of mammary gland lobules and mammary acini and the diameter of acinar cavities. It could also decrease eatradiol level and MDA content in serum, inhibit the decrease of the coefficient of thymus and increase the serum progesterone level. Conclusion QCP can regulate sex hormone levels, inhibit lipid peroxidation and relieve the pathologic changes of mammary gland in MGH rats.

Objective To investigate the effect of transcatheter bladder arterial chemoembolization on microvessel density(MVD)change in bladder cancer. Methods The MVD count of bladder cancer tissue of 30 patients before and after chemoembolization were examined by SP immunohistochemical staining.Cancer tissues were examined pathology after chemoembolization.All the cases were followed up for 12 to 36 months(mean 24.6 months),the 3 years survival rate was evaluated clinically. Results MVD counts were 69.8±3.4 and 56.4±3.3 before and after therapy respectively(P<0.05).Cancer tissues were severely damaged ultramicroscopically after interventional chemotherapy.The recurrent rate was 16.67%in 30 cases. Conclusions The chemoembolization could decrease MVD,improve survival rate and reduce the recurrence rate.

Objective To assess the association between polymorphisms in HIF1α gene and prognosis of advanced hepatocelluar carcinoma.Methods We collected prognosis data from a cohort of 448 advanced HCC patients treated by transarterial chemoembo-lisation,and used 5ml peripheral blood from patients for extraction DNA.Three SNPs (rs2301 1 13、rs2057482 and rs1 957757 )in HIF1αgene were selected and genotyped.Multivariate Cox proportional hazards model,Kaplan-Meier curve and log-rank test were used for prognosis analyses.Results The variant-containing genotypes (WV+VV)of SNP rs2301 1 13 exhibited a significant associ-ation with a better overall survival in HCC patients who had tumor size smaller than 5 cm (hazard ratio [HR],0.58,95% confidence interval [CI],0.35-0.96,P =0.036).In the patients taken single tumor subgroup,the variant-containing genotypes (WV+VV) of SNP rs2301 1 13 exhibited a significant association with a better overall survival (log-rank P =0.048),comparing to those carrying wild-type genotype.Conclusion Our results suggest that polymorphisms in HIF1αgene may serve as an independent prognosis bio-marker for advanced HCC patient.

Aim To investigate the effects of Rehmannia glutinosa oligosaccharides(ROS)on the damage induced by glutamate in hippocampal neurons.Methods The neurons isolated from hippocampus in new born SD rats were cultured for 7~9 days,which were specifically stained with NSE and then randomly divided into four groups:(Ⅰ)Normal cultures(control);(Ⅱ)ROS control cultures;(Ⅲ)Glutamate-exposed control cultures;(Ⅳ)Glutamate-exposed cultures pretreated with ROS.The neurons morphology was observed under inverted microscope;cell viability was assayed by MTT staining;LDH release was detected with chromatometry and flow cytometric analysis for identification and quantification of cell apoptosis.Results Compared with normal group,after exposure of glutamate for 24 h,the viability of neurons was decreased,LDH release and cell apoptosis were increased(P

Turkey is a presidential republic country located in the Eurasian continent, which has a universal health coverage since the health reform in 2003. The leading causes of death in this country are ischemic heart disease, stroke, and lung cancer. Besides, lower respiratory infections, chronic kidney disease, and hypertensive heart disease are the diseases which have a fastest growing rate. Chinese acupuncture was officially recognized by Turkey in 1991 with the promulgation of Acupuncture Treatment Legislation. At present, only trained practitioners and dentist could conduct acupuncture treatment, which was stated in Regulation of Tradition and Complementary Medicine Practice. The application of Turkish acupuncture and moxibustion is still applied in a simplified way that lack of TCM theory. Moreover, Chinese herbal medicine is still not officially recognized and still under control of the Ministry of Agriculture. Therefore, it is suggested to introduce TCM theory in the spread of acupuncture, to promote acupuncture research and clinical practice, to clarify the different standards between the two countries, and to cooperate in Chinese medicine researches, especially those related to the local high incidence and refractory disease so as to promote the development of TCM in Turkey and provide medical services for local residents.

Thailand is a constitutional monarchy located in the central and southern part in Southeast Asia. It mainly implements the civil service insurance plan, the social insurance plan and the "Thai 30" plan, and the government bears the main health expenditures. The Thai traditional and alternative medicine system includes Thai traditional medicine, indigenous medicine and alternative medicine. Traditional Chinese Medicine (TCM) belongs to the category of alternative medicine. Currently, Thai traditional medicine and Chinese acupuncture have been included in medical insurance. With Thailand’s approval of doctors to use Chinese medicine to treat diseases published (Notification No.1 of BE 2543), a series of activities such as the establishment of national TCM center, the certification of TCM doctors, and the set of TCM courses and training have promoted TCM development in Thailand. However, the application of Chinese herbal medicine is restricted by Thai medicine laws; the practical skills of acupuncture and moxibustion is insufficient; and the TCM education is not systematic and complete. Therefore, it is recommended to carry out extensive and continuous publicity in the future to promote policy and legislative support; to strengthen research and development of Chinese patent medicine on popular diseases in Thailand and promote localization; to establish a special practice training center to improve acupuncture clinical operation capacity; to add and refine the content of TCM regarding university education system as well as short-term training; and to encourage cooperation between China and Thailand in talent exchanges and scientific researches, promoting the development of TCM in Thailand.