Objective To explore the operative cooperation and nursing points of holmium laser lithotripsy under percutaneous nephroscope. Methods A retrospective study was carried out to investi-gate the operative cooperation and nursing of 38 patients receiving holmium laser lithotripsy under percuta-neous nephroscope in our hospital from March 2006 to August 2007. Results Stones were completely cleared in 31 patients at first holmium laser lithotripsy,in 5 patients at second holmium laser lithotripsy,in 2 patients at third holmium laser lithotripsy. One patient complicated with water intoxication and septicemia. Operation time ranged from 50 to 190 minutes,blood loss volume reached 50 to 200 ml with a average of 100 ml.No blood transfusion was needed during the operations and no secondary hemorrhage was seen postoperation. Double J catheter was inserted and indwelled for 30 to 60 days with a average of 38 days. Postoperative follow-up was satisfying. Conclusions Holmium laser lithotripsy under pereutaneous nephroscope possesses the advantages of little trauma,hemorrhage and complication and quick recovery.It is the best choice for treatment of calculus in urinary system.

Objective To analyze the current situation of domestic multi-center study of medicine research in order to improve the scientific research level.Method Using the bibliometrics method to analyze the number of coauthors,research institutions, research states distribution,foundation paper numbers and large sample papers of 200 multicenter original research papers published in 10 domestic and foreign journals in 2010.Results There were 112 domestic original research papers,the number of average coauthor was 6.1± 1.1; 15.2％ of them were more than 3research institutions; 2.7％ of them were cooperative study of more than 2 countries.49 papers (43.8％)were supported by fund; 10.7％ of which were more than 3 foundations; large sample papers account for 24.1 ％.In 88 foreign original research papers,the number of average coauthors is 9.8± 2.7; 86.4％ of them are under more than 3 research institutions; 44.3％ of them are cooperative study of more than 2 countries.Fund papers account for 69.3 ％ ; large sample papers account for 50％.There were significant difference in the number of coauthors,research institutions,number of countries,large sample papers and the number of ≥3 foundation papers between both domestic and international paper(P ＜ 0.05).The number of domestic and foreign funded papers had no significant difference (P ＞0.05).ConclusionThere are some differences between domestic and foreign medical cooperative research. We should strengthen the international and domestic cooperative research in order to improve the scientific research level and reduce the waste of resources.

Objective To explore the quality of clinical trial papers published in medical SCI-tech journal.Methods A total of 1201 original research projects were published in 6 medical journals from Mar.2012 to Mar.2014 in China.Fifty-four of them were selected according to the key words randomizedcontrolled,and they were evaluated using 2010 CONSORT statement.Results In 54 articles,the section of background and abstract were described clearly and standardize.Fifty-one (94.44 ％)papers described intervention method in details.Thirty-five (64.81％) papers described the experimental design method.Thirty-one (57.41％) papers defined the primary and secondary outcome indicators,only 3 (5.56％)of them described distribution order,and the method of blindness.Four (7.41％) papers provides the information on sample size calculation.The using of flow chart accounted for 7.41％.Ten (18.52％) papers described the reason of drop out.Two (3.70％) papers evaluated the effect and accuracy,and the trial results were explained clearly and consider other evidences.Only 18 (33.33％) papers wrote the limitation of the studies.For other information of the studies,5 (9.26％) of them was registered somewhere,the information on funding support was on 20 (37.04％)papers.Conclusions The description on most RCT papers were clear and complete,but close attention should be paid to the method of blindness and sample size determine.

Objective To investigate the effect of health education and behavioral intervention on the self-perceived burden of patients with gastrointestinal malignant tumor at end-stage.Methods From March 2012 to April 2013,70 patients with gastrointestinal malignant tumor whose lifetime was estimated to be within 6 months were extracted from five general hospitals in Tangshan.70 patients were randomly divided into the intervention group and the control group with 35 cases in each group.The two groups samely received routine nursing care,while the intervention group was given health education and behavioral intervention.Both groups were evaluated by SPBS-CP before and after intervention.Results The scores of the intervention group after intervention were lower than before intervention and the control group,which were reflected in 3 dimensions such as care burden,psychological and emotional burden and treatment burden.Conclusions Health education and behavioral intervention can effectively relieve self-perceived burden of patients with gastrointestinal malignant tumor at end-stage.

Objective To study the effects of continuous subcutaneous insulin injection in treatment of type 2 diabetic patients with pulmonary infections. Methods 112 type 2 diabetic patients with pulmonary infections were randomly divided into group CSII and group MSII, and the bacteria, period of normalization of the blood glucose and cure of the pulmonary infections were obseroed. Results Blood glucose of all patients in two groups were reduced significantly. Significant diference was observed in the cure of the pulmonary infections, usage amount of insulin and morbidity of low blood glucose. Conclusion Type 2 diabetic patients with pulmonary infection mellitus were majorly infected by pathogenic G bacteria. CSII was able to control the blood ghcose better,reduce the hospital day and decrease the moroidity of low bleod glucose. CSII was a better of method.

Objective To investigate relationship between the expressions of TGF-β1 mRNA, Smad7 mRNA and ki-67 mRNA and the clinicopathologic characteristics in gastric carcinoma. Methods 60 cases with gastric carcinoma tissue and 20 cases with normal gastric tissue, which were surgically removed and certified by pathology, were collected. The expressions of TGF-β1 mRNA, Smad7 mRNA and ki-67 mRNA were detected by RT-PCR in normal and carcinomatous gastric tissue. Results The expressions of TGF-β1 mRNA, Smad7 mRNA and ki-67 mRNA in normal gastric tissue were lower than those in carcinomatous gastric tissue (P < 0.05). The expressions of TGF-β1 mRNA, Smad7 mRNA and ki-67 mRNA in gastric carcinoma which were well differentiated and moderately differentiated were significantly lower than those in poorly differentiated gastric carcinoma (P<0.05). The expressions of TGF-β1 mRNA, Smad7 mRNA and ki-67 mRNA in gastric carcinoma without lymph node metastasis were lower than those in gastric carcinoma with lymph node metastasis. The expressions of TGF-β1 mRNA, Smad7 mRNA and ki-67 mRNA in Ⅰ+Ⅱ stage were lower those in Ⅲ+Ⅳ stage (P < 0.05). Linear correlation showed there were positive correlations among TGF-β1 mRNA, Smad7 mRNA and ki-67 mRNA in gastric carcinoma. Conclusions The canonical TGF-β1 Smad7 and Ki-67 mRNA play a role in the carcinogenesis, development, differentiation of gastric carcinoma.

BACKGROUND: Atrial natriuretic peptide (ANP)-synthesizing cells distribute in all over the body. However, very little is known about the morphological localization and the distribution characteristics of ANP-synthesizing cells in different regions of rat stomach. OBJECTIVE: To investigate the ultrastructural localization and distribution characteristics of ANP-synthesizing cells in rat stomach. DESIGN: Repeated measurement experiment. SETTING: Chengde Medical Collage, Chengde, Hebei Province, China. MATERIALS: This study was performed at the Laboratory for Institute of Chinese Materia Medica Immunology (provincial key laboratory), Chengde Medical College between October 2004 and July 2007. Eighteen adult Wistar rats of either gender, weighing 175-300 g, were provided by the Laboratory Animal Center of Chengde Medical College. The disposal of animals was conducted in accordance with ethical guidelines for the use and care of animals. ANP antibody and serum (Santa Cruz Biotechnology, Inc, USA), Protein A-15 nm colloidal gold labeled (Sino-American Biotechnology Company, China), CMIAS image analysis system (Beijing University of Aeronautics and Astronautics, China) and JEM-1200EX transmission election microscope (Japan) were used in the study. METHODS: After gastric and right atrial tissues (as a positive control in immanohistochemical staining for ANP-synthesizing cells) were fleshly excised from anesthetized Wistar rats, the specimens were longitudinally harvested along rat gastric cardiac region, gastric fundic mucosa and gastric pyloric region. Gastric tissue was performed immunohistochemical staining (for positive control) together with right atrial tissue, to observe the distribution characteristics of ANP-synthesizing cells in different regions of rat gastric tissue, and to localize ANP-synthesizing cells. The ultrastructural localization of ANP-synthesizing cells in the rat gastric mucosa was performed by postembedding immunoelectron microscopy. The area-density percentage of ANP-synthesizing cells in the different regions of rat stomach (gastric cardiac region, pyloric region and fundic region) was calculated with a CMIAS image analysis system. MAIN OUTCOME MEASURES: Morphological appearance and localization of ANP-synthesizing cells as well as the different area-density percentage in different regions of rat stomach. RESULTS: As a positive control, ANP-synthesizing cells showed intense positive expression in atrial myocytes and cytoplasm and in gastric mucosa (mainly within the lower third of rat gastric mucosa). The morphological appearance of the individual ANP-synthesizing cell was variable, exhibiting round, pyramidal and flask shapes. Negative staining for ANP-synthesizing cells was detected in the lamina propria, submucosa, and smooth muscle. ANP-synthesizing cells existed in different regions of rat stomach and its area-density was the largest in the pyloric region. The distribution order of ANP-synthesizing cells in area-density was gastric cardiac region > gastric pyloric region > gastric fundic mucosa in mucosa layer. CONCLUSION: ANP-synthesizing cells mainly exist within the lower third of the rat gastric mucosa. The percentage of area-density of ANP-synthesizing cellswas variable in different regions of rat gastric mucosa, and its percentage of area-density was the largest in the gastric cardiac region.

Objective To investigate the inhibitory effects of PPARγ ligand rosiglitazone in vivo of mice which were transplanted the human gastric carcinoma cells line MGC803 into subrenal-capsule.Methods To establish kunming mouse tumor modles of MGC803 cells transplanted into subrenal-capsule and assay the inhibiting growth effects of 50 mg／kg rosiglitazone which were continuously poured into mice gastric for five days by the dissect microscope and HE stain.Results Rosiglitazone could inhibit the growth of MGC803 cells transplanted into subrenal-capsule of mice in vivo by inhibiting proliferation and inducting apoptosis,the tumor inhibitory rate was 62.9％.Conclusion PPARγ ligand rosiglitazone can inhibit the growth of MGC803 cells transplanted into subrenal-capsule of mice in vivo.

Objective:To observe therapeutic effects of blood glucose control by using acarbose in combination with different insulin.Method:58 patients were randomly divided into two groups treated with either insulin glargine (Lan- tus;Aventis) or human NPH insulin (Novolin;NovoNordisk).Subcutaneous injection of insulin before sleep and oral acar- bose were carried out for the treatment,which lasted three weeks.The degree of blood control,the amount of insulin used, and the cases of hypoglycemia for both groups were observed at the end of the experiments.Result:The fasting blood glu- cose showed its normal and stable result,and the average blood glucose values at different time slots per day in the group treated with insulin glarglne were lower than those in the group treated with human NPH insulin.The maximum difference of blood glucose values occurred after dinner while no significant variance appeared after breakfast and after lunch.Conclu- sion:The therapeutic effects are quite efficient and stable in controlling 24-hour blood glucose in type 2 diabetes by using acarbose in combination with either insulin glargine or human NPH insulin (Novolin;NovoNordisk).In addition,the oc- currence rates of hypoglycemia with both methods are low whereas the therapeutic effects for the first group are superior to those for the latter group.

Objective To investigate the early diagnosis and importance of cesarean section in time.Methods Three cases of AFLP treated in our hospital during the past three years were retrospectively studied with emphasis on symptoms,laboratory findings,maternal complications and the action of well-timed cesarean section.Clinical diagnose was proved by postpartum liver biopsy or autopsy.Results The gestational age at onset of the three multiparae was 35～36 weeks.In the early stage,all cases had malaise,nausea,vomit,loss of appetite and epigastric distress followed by jaundice.Laboratory findings included raised transaminases (≤300IU/L)and total serum bilirubin levels.Neither B ultrasonic nor CT examine found fatty liver.Two of them were received cesarean section after obvious complication,and one died with her baby,the other pulled through MSOF,whose twins died of seriously asphyxia.While the third received cesarean section at early stage and was cured with a healthy baby.Conclusion Increasing awarenessespecially in early piagnosis of AFLP cases and termination pregnancy in time,the prognosis of AFLP is obviously improved.