Objective To investigate the clinicopathologic features of gastrointestinal neuroendocrine carcinomas. MethodsThe diagnosis and treatment results of 45 cases were studied, and clinicopathologic features and immunohistochemical expressions of NSE, Syn and CgA were detected.ResultsMicroscopically carcinomas were divided into three types: type Ⅰ(25 cases), type Ⅱ(10 cases) and type Ⅲ(10 cases). The histologic categories were correlated with lymph node metastasis significantly( P0.05). The 5-year survival rate for type Ⅰ, type Ⅱ and type Ⅲ was 70%, 65% and 52%, respectively.ConclusionsThe combination of NSE, Syn and CgA immunohistochemical stainnig is necessary for the diagnosis of gastrointestinal neuroendocrine carcinomas. The histologic classification is coincident with the requirement of clinical treatment and prognosis.

Malaria is the one of major diseases which threatens people’s life in Africa. Out of humanitarianism, Chinese scientists has contributed to research of Artemisinin and ACTS more than 30 years, China provides long-term antimalaria assistance to Africa and gain great achievements. In Moheli, the island of Comoros, the antimalaria group used a new strategy which universal medication and proactive intervention. They established not only an effective antimalaria system and reporting system but also a local antimalaria team. Furthermore, they enhanced publicity and put mass protection and treatment into effect. Finally, they achieved significant result. In order to apply those successful experience to other countries in Africa, this paper summed up those experience and inspirations.

Malaria is the one of major diseases which threatens people’s life in Africa. Out of humanitarianism, Chinese scientists has contributed to research of Artemisinin and ACTS more than 30 years, China provides long-term antimalaria assistance to Africa and gain great achievements. In Moheli, the island of Comoros, the antimalaria group used a new strategy which universal medication and proactive intervention. They established not only an effective antimalaria system and reporting system but also a local antimalaria team. Furthermore, they enhanced publicity and put mass protection and treatment into effect. Finally, they achieved significant result. In order to apply those successful experience to other countries in Africa, this paper summed up those experience and inspirations.

OBJECTIVE:To investigate the utilization and trend of bisphosphonates drugs in patients with bone metastasis of breast cancer from Zhejiang province,so as to provide reference for the further promotion of their rational use. METHODS:The utilization of this type of drugs in 11 hospitals of Zhejiang province during 2010-2015 was analyzed statistically,counted and ranked by using the method of cost ranking analysis and DDDs analysis in the respect of amount,DDDs,DDC,etc. RESULTS:The amount of bisphosphonates drugs was increased steadily in 6 years(increasing greatly in 2011),increased by 96.26% in 2015,compared to 2010. Top 3 drugs in the list of amount were Zoledronic acid for injection(imported),Zoledronic acid for injection(domestic)and Pamidronate disodium for injection. Among them,Zoledronic acid for injection(imported)basically showed an upward trend,while Pamidronate disodium for injection showed decline trend. Top 3 drugs in the list of DDDs were Zoledronic acid for injection(domestic),Zoledronic acid for injection(imported)and Pamidronate disodium for injection;DDDs of Zoledronic acid for injection(domestic)and Zoledronic acid for injection(imported)were generally on the rise,while that of Pamidronate disodium for injection showed an overall downward trend. B/A value of bisphosphonates ranged 0.33-2.00,among which B/A value of Zoledronic acid for injection(domestic)was 2.00 and that of Zoledronic acid for injection(imported)was 0.50 during 2012-2015. The first and second drugs in the list of DDC were Clodronate disodium for injection and Zoledronic acid for injection(imported). CONCLUSIONS:The total amount of bisphosphonates drugs in patients with bone metastasis of breast cancer from 11 hospitals of Zhejiang province during 2010-2015 was increased steadily. Some varieties of second and third generation bisphosphonates with definite curative effect,good safety and reasonable price are dominant in clinical use. The selection and use of bisphosphonates is basically reasonable,but price is still the primary factor restricting the further wide application of some varieties.

Malaria is one of the major diseases threatening the lives of people in Africa. Over the past decade, China has provided anti-malaria assistance to Africa. In November 2007, fast control malaria team of Guangzhou University of Chinese Medicine cooperated with the Comoros health authority. In Moheli Island of the Comoros, the anti-malaria team adopted a new strategy of Mass Drug Administration (MDA) and active intervention. They established an effective anti-malaria system and reporting system, as well as a local anti-malaria team. Furthermore, they treated patients with malaria in Moheli Island and implemended health education in local people. In a very short time, they have achieved remarkable results. This paper summarized the experiences of the project in order to provide useful reference for China to better carry out anti-malaria action in Africa and expand foreign health assistance.

Background and objective hTe invasive tumor front (ITF) refers to cells or invasive nests in the junc-tional region of a tumor and its host. hTe ITF contains the most invasive cells of a tumor, and has a high prognostic value in carcinoma. hTe aim of this study is to investigate the epithelial-mesenchymal transformation phenotype in ITF cells of lung squamous cell carcinoma (SCC), and analyze the relationship between clinicopathological features and clinical outcomes of pa-tients. Methods Semiquantitative immunohistochemistry was used to examine the expression of epithelial markers (E-cadherin andβ-catenin) and mesenchymal marker (vimentin) in 104 lung SCC tumor tissues. Results A decrease in E-cadherin expres-sion in ITF cells was observed in 56 of 104 (53.8%) tumors from patients. hTis result was markedly lower than that of non-ITF cells, which eventually developed metastatic tumors and were also associated with death (P=0.04). Vimentin expression was observed in 44 of 104 (42.3%) ITF cells, which was much higher than that of non-ITF cells. hTe downregulation of E-cadherin and overexpression of vimentin were associated with tumor invasive pattern, lymphatic metastasis, and poor prognosis (P<0.01). hTe expression ofβ-catenin was 67.3%(70/104) in ITF cells. Moreover, ITF cells showed more nuclear and plasma-positive cells, which were closely associated with metastasis (P<0.01). Conclusion hTe loss in expression of E-cadherin/β-catenin and overexpression of vimentin in ITF cells may be associated with poor prognosis of lung SCC patients.

Objective To investigate the influence of inclusive leadership on organizational performance of nurses and to test the mediating role of empowerment behavior. Methods From November to December 2016, 293 nurses from 2 public hospitals in Harbin were investigated with Inclusive Leadership Scale, Empowerment Behavior Scale and Team Performance Scale. A total of 293 questionnaires were distributed and 251 questionnaires were effectively recovered. Descriptive statistics, Pearson correlation analysis and multiple linear hierarchical regression analysis were performed to analyze and process data. Results The Score of Inclusive Leadership Scale, Empowerment Behavior Scale and Team Performance Scale was (5.28±1.184), (5.25±1.216) and (5.71±1.233) respectively. Inclusive leadership had a positive correlation with empowerment behavior and organizational performance of nurses (r=0.742,0.605;P＜0.05). In addition, there was a positive correlation between empowerment behavior and organizational performance of nursing staff (r=0.615,P＜0.05). Multivariate linear hierarchical regression analysis showed that inclusive leadership had a positive predictive effect on empowerment behavior and organizational performance, and empowerment behavior of nurses partially mediated between them. Conclusions Inclusive leadership can enhance subordinate nurses' high level of empowerment awareness, thereby directly or indirectly improving nursing organization performance.

Objective To explore the effects of inclusive leadership on affective commitment of nurses and to test the mediating effect of leader-member exchange. Methods From November 2016 to December 2016, we investigated 293 nurses from two Class Ⅲ Grade A governmental hospitals of Harbin with the Inclusive Leadership Scale, Leader-member Exchange Scale and Affective Commitment Scale. Pearson correlation analysis and multiple hierarchical linear regression analysis were used to test the correlations and mediating effect among the variables. A total of 293 questionnaires were sent out and 251 valid questionnaires retained finally. Results Among 251 nurses, the scores of inclusive leadership scale, leader-member exchange scale and affective commitment scale were (5.283±1.184), (5.216±1.139) and (4.902±1.061) respectively. Pearson correlation analysis showed that inclusive leadership had positive correlations with the leader-member exchange (r=0.771,P＜ 0.01) and affective commitment (r=0.537,P＜ 0.01);leader-member exchange had a positive correlation with affective commitment (r=0.543,P＜ 0.01). Multiple hierarchical linear regression analysis indicated that inclusive leadership had positive effects on leader-member exchange and affective commitment of nurses;leader-member exchange played a partial mediating role between them. Conclusions As a whole, the inclusiveness of nursing managers on nurses is in the upper level and the leader-member exchange of nurses has a high level. Inclusive leadership has positive correlations with the leader-member exchange and affective commitment of nurses. Nursing managers should lead nurses to contribute their wisdoms with the manner of inclusive leadership so as to provide the high quality of nursing service.

Objective To investigate the influence of inclusive leadership on job embeddedness of nurses and the mediating role of insider status.Methods A total of 293 nurses from two ClassⅢ Grade A public hospitals in Harbin City were recruited by convenience sampling method,and investigated with questionnaire survey from November to December 2016.Inclusive Leadership Scale,Job Embeddedness Scale and Insider Status Scale were used as evaluation tools.Data processing was done by descriptive statistics,Pearson correlation analysis and multiple linear regression analysis.A total of 293 questionnaires were distributed,and 251 valid questionnaires were collected.Results The total scores of Inclusive Leadership Scale,Insider Status Scale and Job Embeddedness Scale of the 251 nurses were (5.28±1.184),(5.57±1.185) and (4.81±1.027) respectively.Pearson correlation analysis showed that inclusive leadership was positively correlated with the insider status and job embeddedness of nurses (P＜ 0.01).At the same time,the insider status was positively correlated with the job embeddedness of nurses (P＜ 0.01).Multiple linear hierarchical regression analysis showed that inclusive leadership had a positive predictive effect on nurses' insider status (β=0.655,P＜0.01) and job embeddedness (β=0.557,P＜0.01).The insider status played a partial mediating role between inclusive leadership and job embeddedness.Conclusions Inclusive leadership can enhance the perception of insider status,thus directly or indirectly improve the job embeddedness level of nursing staff.

Objective To evaluate the accuracy of three-dimensional(3D)reconstruction of the gallbladder volume based on computed tomography(CT)images and study the biomechanical changes in gallbladder motility to explore the relationship between gallbladder dynamics and gallstone formation.Methods A method for calculating gallbladder volume based on CT 3D reconstruction of The gallbladder model was proposed and compared with the ellipsoid method.A finite element model of the gallbladder was constructed for fluid dynamics analysis to simulate changes in gallbladder motor function under different angles of convergence between the cystic and common bile ducts and in the presence of gallstones.Results The mean errors of the specific gallbladder model volume and ellipsoid volume of the 50 patients were 7.26％and 25.35％,respectively.During the refilling period,the maximum pressure,deformation,and flow velocity of the pear-shaped gallbladder were significantly higher than those of the gourd-shaped gallbladder.The angle between the gallbladder and common bile duct had little effect on the bile flow pattern,and the maximum bile flow rate was reached at an angle of 120°.The bile flow velocity of the gallbladder with calculus was lower than that of the gallbladder without calculus,and there was a vortex near the calculus.Conclusions Calculating gallbladder volume based on CT 3D reconstruction is more accurate than the ellipsoid method.Compared with a pear-shaped gallbladder,a gourd-shaped gallbladder has lower gallbladder wall contraction,bile flow rate,and poor motor function.The bile flow rate in the gallbladder is slow,which is more likely to lead to the enlargement of gallstones or the formation of new gallstones.