This paper first explains the contextual theory,then it analyses the contextual characteristics under network environment with multimedia.At last,according to systematic functional linguistics,it discusses the implications of how to take advantage of the contextual characteristics in College English teaching and learning.

Objective To understand the current situation of neurology nurses′self-efficacy and quality of nursing services in Lanzhou area, and explore the relationship between self-efficacy and the quality of nursing services. Methods Using the method of questionnaire, one hundred and the neurology nurses and hospitalized patients in 5 Grade 3 Level hospitals of Lanzhou city were investigated by using self-efficacy scales and Servqual scales. Results Neurology nurses′ self-efficacy in Lanzhou area was lower than the general population ( U=-9.875,P=0.042);the scores of quality of care from high to low were at reliability, tangibles, assurance, responsiveness, cost acceptability and empathy, which were-(0.12 ± 0.05) points,-(0.23 ± 0.03) points,-(0.24 ± 0.06) points,-(0.25 ± 0.02) points,-(0.26 ± 0.05) points,-(0.66 ± 0.03)points.Satisfaction arranged from high to low were assurance (89.98%), reliability (89.69%), responsiveness (89.12%), tangibles (87.66%), cost acceptability (87.08%), empathy (86.67%).There were positive correlations between satisfaction and expectations and perceived service quality, and the correlation between satisfaction and perceived qualities of service was higher. Moreover, there might exist positive correlation between self-efficacy score and quality of nursing services (reliability, assurance, responsiveness, empathy) (P values were 0.002, 0.001,0.012 and 0.005). Conclusions Neurology nurses in Lanzhou area have lower self-efficacy, and the perceived qualities of care from patients never exceed their expectations. As results, hospital managers should take measures to improve general self-efficacy of nurses, and thus enhance the quality of care.

Microglia are functionally principal immune effector cells widely spread in the central nervous system ( CNS) and physiological play a role in monitoring and stabilizing the internal environment. Very sensitive to external stimulation, microglia are eas-ily activated by slight pathological changes in the CNS. The activated microglia, on the one hand, phagocytize cellular debris and ex-crete growth factors to promote nerve repair and, on the other hand, also produce some inflammatory cytokines, glutamate, and nitric oxide, which may aggravate the inflammatory response and lead to secondary injury. This article summarizes the characteristics of mi-croglia and their involvement in CNS diseases and provides a new target for their treatment.

Objective To investigate the effects of Yindan-Xinnaotong combined with aspirin on lipidemia levels and hemorrheology in patients with stroke. Methods A total of 62 patients with stroke were randomized into a treatment group (31 cases) and a control group (31 cases). The patients in the control group were treated with aspirin and those in the treatment group were treated with aspirin and Yindan-Xinnaotong capsule (4 capsules each time, 3 times/d) for 30 days. The lipidemia levels and hemorrheology were evaluated before and after the treatment. Results After the treatment, whole blood viscosity (4.15 ± 0.14 mPa?s vs. 5.25 ± 0.40 mPa?s;t=14.452, P<0.01), plasma viscosity (1.70 ± 0.30 mPa?s vs. 2.70 ± 0.25 mPa?s;t=14.258, P<0.01), fibrinogen (3.71 ± 0.51 g/L vs. 5.80 ± 0.41 g/L;t=17.783, P<0.01) and thrombosis index (0.75 ± 0.31 vs. 1.30 ± 0.21;t=8.178, P<0.01) in the treatment group were significantly lower than those in the control group. After the treatment, the serum levels of total cholesterol (3.31 ± 1.19 mmol/L vs. 5.04 ± 1.30 mmol/L;t=5.465, P<0.01), triacylglycerol (0.63 ± 0.31 mmol/L vs. 1.34 ± 0.05 mmol/L;t=12.589. P<0.01) in the treatment were significantly lower than those in the control group, the serum level of high-density lipoprotein cholesterol in the treatment group was significantly higher than that in the control group (1.83 ± 0.49 mmol/L vs. 1.28 ± 0.45 mmol/L;t=4.603, P<0.01), and there was no significant difference in the serum level of low-density lipoprotein cholesterol between the two groups (2.22 ± 0.61 mmol/L vs. 2.11 ± 0.95 mmol/L; t=0.543, P>0.05). Conclusion Yindan-Xinnaotong combined with aspirin can improve the lipidemia and hemorrheology in stroke patients.

Based on the discussion of the present English teaching in medical colleges and universities in China,this paper clarifies the mission and task of English teaching in medical colleges and universities and proposes that medical colleges and universities should attach importance to the education goals and needs of the department,major and students in the information age.It is believed that a scientific,reasonable and perfect English curriculum can be achieved by integrating IT into English curriculum,applying individualized teaching mode and expanding course connotation.

OBJECTIVE:To evaluate clinical efficacy and the effect of pharmacoeconomics of two chemotherapeutic regimens for the first line treatment of advanced gastric cancer. METHODS:98 patients with advanced gastric cancer receiving SOX or FLO regimen as first line chemotherapy in our hospital were enrolled. According to chemotherapy grouping,short-term efficacy,toxic re-action and pharmacoeconomics effect were analyzed and compared between 2 groups. RESULTS:There were a total of 55 patients in SOX group,with effective rate of 38.18%;43 patients in FLO group,with effective rate of 32.56%;there was no statistical sig-nificance in effective rate between 2 groups(P>0.05). There was no statistical significance in toxicities between 2 groups,includ-ing nausea and vomiting,neurotoxicity and neutropenia(P>0.05). The total cost of FLO regimen group was 9 136.98 yuan,while that of SOX regimen group was 12 345.97 yuan. Using minimum cost method,FLO regimen was superior to SOX regimen regard-ing the economical index. CONCLUSIONS:SOX and FLO regimen have no significant difference for the first-line treatment of ad-vanced gastric cancer in terms of response rate and toxicities. Taking into account the parmocyeconomics,FOL regimen is superior to SOX regimen.

Objective To investigate the basic perceptions, attitudes and needs towards delirium among ICU professionals in Shandong province, so that to help the ICU supervisors design target training for ICU professionals. Methods A survey was employed utilizing a self-designed questionnaire among 917 ICU professionals(doctors and nurses) from 62 hospitals in Shandong province. Results The score of ICU professionals′ basic perception and behavioral attitude concerning ICU delirium were (24.56 ± 6.36) and (19.00 ± 3.01) points respectively. The score had significant positive correlation and indicates statistic significance (r=0.53, P<0.01). Academic, work experience and title had influence on the score of basic perception (F=14.49, 26.25, 40.16, P<0.05), work experience, category of ICU, title and category of hospital were the effect on the score of behavior and attitude (F=11.87, 8.64, 6.55, P<0.05;t=4.81, P<0.05). The lower rate of correct responding to knowledge of ICU delirium were as follows:the correct rate of delirium in ICU of typing to 56.92%(522/917); the clinical manifestations of ICU delirium accuracy 65.32%(599/917); andrisk factors for delirium in ICU of the correct rate for 70.34%(645/917).ICU professionals acquire knowledge pertaining delirium mainly through lectures, conferences, knowledge brochure , exchange of experience. Conclusions The ICU professionals in Shandong province have less knowledge on ICU delirjum.ICU management should recognize the importance of ICU delirium to strengthen the training of relevant knowledge, enhance delirium management, ensure the patient's safety and improve the prognosis of patients.

OBJECTIVE:To find the active ingredient of on antithrombotic chuanxiong rhizoma using computer aided drug de-sign. METHODS:Usingthrombosisas keyword,thrombosis related proteins were searched and screened in therapeutic target da-tabase;target proteins'three-dimensional structure were downloaded in protein database,then the protein preparing tool were used to determine the coordinates of the active area center. PyRx software and Discovery Studio Visualizer were used to match the 247 small molecules of chuanxiong rhizoma with target protein that downloaded from Taiwan traditional Chinese medicine database. The active molecules were screened and binding force was analyzed. RESULTS:Active molecules of neochlorogenic acid,1-H-benz-imidazole-2-amine,3,8-dihydrodiligustilide,chuanxiongterpene were selected by blinding energy,and there were high binding ac-tivity among these active molecules,thrombin,antithrombinⅢ,coagulation factorⅩa and thrombomodulin,and the binding ener-gy were -6.1,-4.5,-7.7,-8.6 kJ/mol. Analysis results showed van Edward force and electrostatic interactions played an im-portant role in their respective docking. CONCLUSIONS:Neochlorogenic acid,1-H-benzimidazole-2-amine,3,8-dihydrodiligusti-lide,chuanxiongterpene may be the antithrombotic activity ingredients of Chuanxiong rhizoma.

Objective To investigate the comparison of clinical curative effect and inflammation factors between irbesartan hydrochlorothiazide and candesartan cilexetil in the treatment of patients with hypertension.Methods A total of 86 patients with hypertension in our hospital from June 2014 to October 2015 were collected and randomly divided into two groups, 43 cases in the control group were treated by candesartan cilexetil,43 cases in the experimental group were treated by irbesartan hydrochlorothiazide.The blood pressure, CRP, IL-6 and NO indexes were detected in the two groups and the clinical curative effect of the two groups was compared.Results The systolic pressure and diastolic pressure levels in the experimental group were significantly lower than the control group ( P <0.05 ); the serum CRP, IL -6 levels in experimental group were significantly lower than the control group, the NO level was significantly higher than the control group (P<0.05).Conclusion Irbesartan hydrochlorothiazide in the treatment of patients with hypertension has a better clinical curative effect, and higher security.

Objective To investigate the correlationship of second-trimester serum human chorionic gonadotropin (hCG) level and preeclampsia, premature rupture of membranes and preterm delivery. Methods 200 cases of second-trimester gestational serum hCG level was determined by radioimmunoassay,and the pregnancy outcome was followed up. Results The maternal serum hCG level in every gestative week has no significant differences;hCG level of pregnancies with preeclampsia,premature rupture membranes and preterm delivery was significantly higher than normal pregnancies. The rate of developing preeclampsia,premature rupture of membranes and preterm delivery in those hCG ≥2MOM patients (30.9%、35.8% and 14.8% respectively)was significantly higher than those MshCG