Objective To investigate the related factors and preventive measures of nasopharyngeal massive hemorrhage in patients with nasopharyngeal carcinoma after radiotherapy. Methods Clinical data of 43 nasopharyngeal massive hemorrhage patients with nasopharyngeal carcinoma after radiotherapy were analyzed retrospectively. Results Thirty-nine cases(90.7 %) had abroad skull base invasion due to tumor, 36 cases (83.7%) received high dose of radiation, and 13 cases (30.2 %) were accompanied by diabetes. Conclusion Tumor location is the major factor for nasopharyngeal massive hemorrhage, while radiation dosage, fractionation patterns and diabetes are the secondary factors. The measures in cluding hyperfractionation, overall dose control and blood sugar regulation should be taken for the high risk patients. Prevention is more important than salvage.

Objective To observe the changes in blood glucose,albumin/creatinine ratio and isletβcell function,after calcitriol therapy was used on patients with type 2 diabetes mellitus and microalbuminuria.Methods Sixty patients with type 2 diabetic microalbuminuria were randomly divided into experimental group and control group,each had 30 cases.Patients in the experimental group were given calcitriol 0.25ug once a day for three months,the changes of blood glucose,glycosylated hemoglobin,albumin/creatinine ratio,islet βcell function were observed.Results After the intervention,the albumin/creatinine ratio level in the experimental group was lower than that in the control group ((127.48±139.94) mg/g vs.(151.02±96.25) mg/g,P=0.04).The insulin resistance index in the experimental group was lower than that in the control group ((2.99±1.24) vs.(3.72±2.58),P=0.233),the difference was not statistically significant.Conclusion Calcitriol can reduce microalbuminuria in patients with type 2 diabetes.Calcitriol may be helpful in improving insulin resistance in patients with type 2 diabetes mellitus.

Purulent pericarditis is still a life-threatening disease for children.Utilizing antibiotics and performing completely drainage of pus are the major treatment options.Constrictive pericarditis is an important complication of purulent pericarditis.Intrapericardial fibrinolysis can effectively reduce fibrin deposition in pericardium, prevent pericardium adhesion and fibrosis, therefore it will prevent constrictive pericarditis.However, it is seldom used in the treatment of children with purulent pericarditis.This article reviews the domestic and international reports on intrapericardial fibrinolysis in children with purulent pericarditis, introduces the indications, mechanisms, treatment protocols, effectiveness studies and complications of intrapericardial fibrinolysis, thus providing a reference for the treatment protocol of children with purulent pericarditis.

Objective:To verify the effects of microlecture based on robot carrier on standardized residency training of orthopedics.Methods:Sixty orthopedic residents from our hospital were divided into two groups according to different training methods. One was control group ( n = 30), receiving regular training methods, and the other one was experimental group ( n = 30), receiving additional microlecture based on robot carrier besides regular training methods. The teaching effects of the two groups were compared after the training in orthopedics department. SPSS 20.0 was used for t test. Results:There was no significant difference between the experimental group and the control group in theoretical tests results [(88.63±10.24) vs. (87.85±9.62), P > 0.05]. The operation test scores in experimental group (92.12±7.52) were significantly better than that in control group (85.35±8.12), with statistical significance ( P < 0.05). The satisfaction scores for teaching in experimental group (90.00%) was significantly higher than that in control group (70.00%) ( P < 0.05). Conclusion:Microlecture based on robot carrier could enhance abilities of skills operation for orthopedic residents during the standardized residency training and improve their satisfaction for the teaching effect.

OBJECTIVE: To study the mechanism of intestinal absorption of protocatechualdehyde .METHODS: Using invivo rat intestinal absorption model and HPLC, the apparent small intestine absorption rate of protocatechualdehyde was mea-sured. RESULTS: Under low, medium and high concentrations of drug, the apparent small intestine absorption rates of proto-catechualdehyde were 1.1 341/h, 1.1 637/h and 1.0 847/h respectively .CONCLUSION: The protocatechualdehyde absorptionmechanism is passive diffusion.

0.05),respectively and the cost-effectiveness ratios were 689 and 1 202 respectively.CONCLUSION:The treatment group was superior to as compared with the control group.

Background and purpose:Actin related protein 2/3 complex subunit 5 (ARPC5) is involved in the packaging of actin, and then affects the mobility of cells. It plays an important role in the formation of invadopodia of cancer cells. This study aimed to investigate the effect of ARPC5 gene-silence on cell proliferation, migration and invasion of lung squamous carcinoma cell line SK-MES-1. Methods:Under the induction of LipofectamineTM RNAiMAX, the recombinant of si-ARPC5 was transfected into SK-MES-1. The experiment set up 3 groups:blank (mock) group, negative control (NC) group and si-ARPC5 transfected group. Cell proliferation, migration and invasion assays were investigated by cell counting kit(CCK-8) method, scratch assay and Transwell Chambers respectively. Results:The result of qRT-PCR and Western blot displayed downregulation of ARPC5 in mRNA and protein level of SK-MES-1 cell. Proliferation rate of SK-MES-1 cells in 72 h after si-ARPC5 transfection was lower than those in mock and NC groups (t=7.993, t=8.681, P<0.05). Compared to the mock and NC groups, the scratch repairing rate of the si-ARPC5 group was lower [(43.32±0.23)%vs (73.11±0.43)%and (76.58±0.88)%] (t=7.348, t=10.614, P<0.05);And the number of penetrating the membrane was signiifcantly reduced [(27±6) vs (101±11) and (92±9)] (t=10.229, t=8.391,P<0.05). Conclusion:Downregulation of ARPC5 gene can inhibit the proliferation, migration, and invasion of SK-MES-1 cell.

Objective To explore the rationality of clinical blood transfusion since the Ministry of Health enacted the The Technical Criterion of Clinic Blood Transfusion' in 2000. Methods Retrieved the literatures on the appraisal of rationality of clinic blood transfusion published in core journal between 2000 and 2010, and analyzed the rationality of clinical blood transfusion in recent 10 years. Results In 35 literatures entered, the proportion of appropriate blood transfusion of platelet was the highest compaved with the lowest proportion of plasma. the proportion of appropriate blood transfusion in operational department is higher than that in non-operational department. The primary reason of inappropriate blood transfusion is transfusion without indications. Conclusion The proportion of appropriate blood transfusion in china is low. The government should enhance the regulation of blood usage,and the public should he educated to realize the importarce of appropriote blood transfusion in order to promote it to develop healthily.

Objective To evaluate the clinical efficacy of integration of traditional Chinese and western medicine (ITWM) or pure western medicine on the patients with immune thrombocytopenia (ITP). Methods Randomized controlled trials (RCTs) on ITWM treatment of ITP were searched in PubMed, EMBASE, Wanfang database, CBMDisc, CNKI and VIP. Quality of the RCTs was evaluated strictly, and statistical analysis was performed with Cochrane Collaboration’s RevMan5.1.7 software. Results Twenty-two trials involving 1527 patients were included. The results of Meta-analysis showed that the ITWM treatment of ITP significantly improved the total effective rate [RR=1.23, 95%CI (1.17, 1.29), P<0.000 01] compared with that of pure western medicine treatment. Funnel plot showed that publication bias was small. Meanwhile, peripheral platelet count and the number of megakaryocyte which can generate platelet in bone marrow increased, obvious advantage was showed in long-term effect, and adverse reactions were reduced with ITWM treatment in ITP patients. Conclusion The existed limited evidences suggest that ITWM treatment of ITP can significantly improve clinical efficacy. The quantity and quality of research literature were limited, and well-designed randomized double-blind controlled trials with large sample and multi-centers are required for a more reliable conclusion.

Objective To assess the interobserver reliability and intraobserver reproducibility of Neer classification system and its influencing factors.Methods The present study reviewed the series preoperative radiographs (including those of scapular anteroposterior view,scapular lateral view and modified Velpeau axillary view and an axial CT scan) of 40 patients who had been treated in our department from January 2010 to December 2010 for proximal humeral fractures.The radiographs were assessed by 12 individual observers on 2 separate occasions with an interval of 3 months at least Half of the observers (the professional group; n =6) had received a shoulder fellowship training and the other half (the control group; n =6) had not All the observers were asked to categorize the radiographs according to the Neer classification system of 16 types of fractures in a same process.The reliability and reproducibility of the system were assessed with the Kappa statistics.Comparisons of classification agreement were made between the professional group and the control group.We also evaluated the simplified Neer system of only 6 types of fractures with recombinant data.Results The interobserver reliability coefficients were 0.534 and 0.473 for the first and second assessments,with an intraobserver reproducibility coefficient of 0.669.The agreement level in the professional group was significantly higher than in the control group ( P ＜ 0.05).The interobserver reliability coefficients of the simplified Neer system were 0.581 and 0.502,with an intraobserver reproducibility coefficient of 0.680.Use of the modified Neer system did not elevate the agreement level beyond the moderate range.The classification was agreed on by all the observers in 17.5％ of the fractures during the first assessment and in 15.0％ during the second assessment.Conclusions Neer classification may have fair interobserver reliability and moderate intraobserver reproducibility.Experience of shoulder fellowship training is an important factor influencing the reliability of the Neer system.Simplification of the system may not help increase its reliability.