OBJECTIVE:To provide experience and reference for the reform ofintegration of medicine and nursingunder the strategy ofHealth China 2030. METHODS:By literature analysis,the demand characteristics and supply situation ofinte-gration of medicine and nursingservice model in China were analyzed. The development bottleneck ofintegration of medicine and nursingservice model in China was discussed to put forward countermeasures and suggestions. RESULTS&CONCLUSIONS:Integration of medicine and nursingis a new model of the development of pension services in China. Throughout whole country, it is still in the stage of exploration and practice. There are some problems,such as serious inadequate beds,low participation of private pension institutions,pension service quality ofintegration of medicine and nursinghaving to be improved,weak market competition of pension institutions,social forces participation having to be improved,big demand gap of medical and nursing staff,inadequate high-quality medical and nursing talent. A clear positioning ofintegration of medicine and nursingservice model in China should be put forward andintegration of medicine and nursingmonitoring system should be improved. It is suggested to establish service complaint mechanism of pension institutions,encourage the active participation of diverse social forces,broaden the financing channels ofintegration of medicine and nursing,build service information sharing platform ofintegration of medi-cine and nursing,establish electronic health records for the elderly and set up maintenance personnel training mechanism so as to promote the rapid development of the reform ofintegration of medicine and nursing.

Advances in clinical transformation research has facilitated discovery of a number of novel somatic mutations and aberrant intracellular signaling pathways involved in malignant proliferative B-cell lymphoma.Meanwhile,small molecular inhibitors targeting those mutation genes or signaling pathways have also been shown to be effective in treating relapsed and refractory B-cell non-Hodgkin lymphoma.This paper reviewed important discoveries in clinical transformation research in lymphoma field in 2013.

Rituximab in the combination of CHOP regimen has been widely used as the standard treatment of several kinds of B cell non-Hodgkin lymphoma (B-NHL),but there are still about 1/3 of the late B-NHL patients become primary and secondary resistant to the drug.Recently,many translational research progress in malignant lymphoma promoted the development of promising candidate drugs for the treatment of lymphoma.The advances in translational research field were summarized in this manuscript.

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 treatment and outcomes of gastric stump cancer(GSC) after subtotal gastrectomy,and to analyse the possible related factors for the development of GSC. Methods The clinical data of 693 patients with subtotal gastrectomy were retrospectively analysed.The development,treatment and outcomes of GSC were observed,and the possible factors associated with the development of GSC were analysed. Results Seventy-six cases of GSC emerged in the 693 patients with subtotal gastrectomy.Fifty-one of the 76 cases were perfomed radical operations(n=36) or palliative resection(n=15).No death was found during the perioperative period,and the median survival time was 32.7 and 14.2 months,respectively.Those 25 without surgical management died 3 to 11 months after the development of GSC.Among the 76 cases with GSC,stomach was found as the original site of ulcer in 59(22.3%,59/259),and duodenal bulb in the other 17(3.9%,17/434)(P

WHO has issued three editions of pathologic classification of bladder urothelial carcinoma in 1973,1999 and 2004.The 1973 version classification had been widely and the longest applied.However,WHO 2004 classification had been prevalent in past years.There were two issues in the applications of WHO 2004 classification.On one hand,there were some difficulties in quick grading in a given case.On the other hand,there were some misunderstandings in the conversion of different WHO classification.In this article,the changes of different pathologic classification of bladder urothelial carcinoma were reviewed and the outline of different pathologic classification was generalized.The criterion of all the systems was cell anaplasia.In WHO 1973 version classification,the definition of the various grades was vague.It was relatively precise in WHO 1999 classification.However,the grading of Ⅰ,Ⅱ and Ⅲ in WHO 1999 classification still remained confusions.The major changes in WHO 2004 classification was that this system divided urothelial carcinoma into low-and high-grade,which may solve the heterogenesis of grade Ⅱ in the other two classifications.

Objective To observe the bone mineral density(BMD)in type 2 diabetic women and discuss the methods for evaluation of BMD.Methods BMD was measured by dual-energy X-ray absorptiometry(DEXA)at skeletal regions of supine and lateral spine,left femur neck and left hip in 484 type 2 diabetic women and 868 healthy women.The relation of BMD of healthy women in skeletal regions with age changes was found to fit a cubic regression model.Results The peak BMD of lateral spine and hip appeared at 25-34 and 35-44 years old respectively.BMD in diabetic women was not different from age-matched healthy women.The BMD values of the different age stages in diabetic women showed no difference(P>0.05)as compared with healthy women,and decreased with the age increase.The numbers of damaged bone sites were increased with the age increase.The BMD difference values between peak value and values of different age stages showed no difference between diabetic and healthy women groups(P>0.05).Conclusion The changes of BMD in type 2 diabetic women show no difference from age-matched healthy women.And in both diabetic and healthy women,BMD decreases with age increasing.

Objective To investigate the effect of sevoflurane pretreatment on the expression of tight junction protein Occludin and ZO-1 in the lung following ischemia-reperfusion (I/R) injury in rats. Methods Ninty-six adult male Wistar rats weighing 250-350 g were randomly divided into 4 groups ( n = 24 each): group Ⅰ sham operation (group S);group Ⅱ I/R; group Ⅲ sevoflurane (group Sevo) and group Ⅳ Sevo + I/R. The animals were anesthetized, tracheostomized and mechanically ventilated. Right femoral vein and left carotid artery were cannulated for BP monitoring, blood sampling and drug and fluid administration. Lung I/R was induced by clamping left pulmonary hilum for 45 min followed by 120 min reperfusion in group Ⅱ and Ⅳ. In group Ⅲ the animals inhaled 2.2 % sevoflurane for 30 min. In group Ⅳ the animals inhaled 2.2 % sevoflurane for 30 min before lung ischemia. Six animals were killed at the end of 45 min ischemia (T1), and 60 and 120 min of reperfusion (T2, T3 ). The lungs were immediately removed for determination of W/D lung weight ratio and the expression of Occludin and ZO-1 protein (by Western blot). Tissues of lung were obtained for observation of histopathology with light microscope. Lung permeability index (LPI) was calculated. Another 6 animals were killed at 120 min of reperfusion for lung lavage. Results I/R significantly increased W/D ratio and LPI and significantly reduced Occludin and ZO-1 protein expression in the lung tissue as compared with group C and Sev. Sevoflurane pretreatment significantly attenuated the I/R-induced changes. The pathological damage to the lung tissue was significantly less in group SP than in I/R. Conclusion Sevoflurane pretreatment may protect the lungs from I/R injury by up-regulating the expression of Occludin and ZO-1.

Histocytological Preparation Techniques ; methods ; Microtomy ; methods ; Tissue Embedding

Food Contamination ; prevention & control ; Public Health Practice