ObjectiveTo evaluate the application effect of clinical pathways in hospitalized inguinal hernia patients by using the Meta- analysis. MethodsPublished randomized controlled trials (RCT)in hospitalized inguinal hernia patients were searched and screened in CNKI、VIP、CBMdisc and Wanfang datebase under present standards.The quality of the included studies were evaluated and statistically analyzed by RevMan5.0 software. ResultsTotally 16 literatures including 1649 cases were eligible to the criteria (816 in clinical nursing pathways group and 833 in the traditional health education group)altogether.The Meta-analysis showed there were significant difference between the clinical pathway group and the traditional health education group in grasp of health knowledge,rate of patients,satisfaction degree,length of hospital stay and hospitalization expenses. ConclusionsClinical pathways is superior compared with the traditional health education for hospitalized inguinal hernia patients.

Angiotensin converting enzyme 2 (ACE2) is a new member of renin-angiotensin system found recently. It counterbalances the effects of angiotensin converting enzyme (ACE), hydrolyzes angiotensin Ⅱ to generate angiotensin-(1-7) and hydrolyzes angiotensin Ⅰ to produce angiotensin-(1-9). Angiotensin-(1-9) can be hydrolyzed by ACE to form angiotensin-(1-7), and angiotensin-(1-7) counteracts the effects of angiotensin Ⅱ in many aspects. Bradykinin or atrial natriuretic factor or substance P are not the substrates of ACE2, and ACE2 hydrolyzes the metabolites of bradykinin such as des-Arg~9-BK and des-Arg~(10)-kallidin, and also the dynorphin A, one of the opium peptides. ACE2 is not inhibited by angiotensin-converting enzyme inhibitor (ACEI). Recent studies demonstrate that ACE2 is a functional receptor of SARS coronavirus. To elucidate the mechanisms of cardiovascular diseases and other disease such as SARS, further investigations in ACE2 are needed.

Objective To investigate the mechanism of acupuncture in anti-depression. Methods 100 depressive patients were randomly divided into acupuncture group and Amitriptyline group, 50 cases in each group. They were respectively treated by acupuncture at Neiguan (PC6), Sanyinjiao (SP6), Baihui (DU20), Fengchi (GB20), and oral western meicine. The needles were manipulated once every 20 minutes and treatment was given once a day. HAMD score and levels of serum cell factors of two groups were observed. Results Serum levels of interleukin 1? (IL-1?), interleukin-6 (IL-6) interleukin-2 (IL-2) and tumor necorsis factor-? (TNF-?) in depressive subjects before treatment were significanly higher than that of nomal subjects (all P

0.05). Conclusion Mb-MGM have good properties of drug-targeting and sustained drug releasing properties. Mb-MGM could be used for targeting spinal cord dorsal ganglia for nerve blocking after being injected into the subarachnoid space and under effect of magnet. The motor function is not affected.

Objective To evaluate the reliability and validity of Chinese version of Arthritis Self-Efficacy Scale.Methods Arthritis Self-Efficacy Scale was translated and adapted according to Chinese culture,and content validity was evaluated by panel of experts.Then preliminary test was proceeded and revised the scale.90 effective questionnaires were recollected,and 40 patients were tested once again after two weeks randomly.Correlation analysis and factor analysis was conducted.Results The Cronbach's α of Arthritis Self-Efficacy Scale was 0.920 and the Cronbach's α of each subscale was ranged from 0.807 to 0.831.The test-retest reliability was 0.800 to 0.921.The correlations among subscales were ranged from 0.705 to 0.799,the correlations between each subscale and total scale were ranged from 0.875 to 0.921.Component analysis revealed three factors accounting for 56.47％ of the sample variance.Conclusions Chinese version of Arthritis Self-Efficacy Scale is of better reliability and validity,it could be used in the evaluation of self-efficacy for arthritis patients.

50% was defined as significant stenosis. Results A 98.7% (778/788) of the coronary artery segments (vessel diameter ≥1.5 mm) could be visualized by 64-slice spiral CT. Compared with catheter angiography in the detection of coronary stenosis, the overall sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of 64-slice CT coronary angiography were 81.9%, 99.0%, 95.9%, 95.1%, and 95.2% respectively. Overall sensitivity would be 91.8% if corrected methodologically. The sensitivity after methodological correction became 91.8%. Conclusion Sixty-four-slice spiral CT examiniation provides a promising non-invasive approach in detecting coronary stenosis with fairly good accuracy, but can not totally replace catheter coronary angiography yet.

From visual teaching aids,experiment phenomenon,imagination,clinical cases and the aspects such as daily life phenomenon and computer supplementary teaching,this article has discussed the application of“Image-thinking” in biochemistry teaching,and from the angle of medical educational reform,it has also discussed the importance of its raising the teaching effect.

Objective:To evaluate the association between weight gain in late gestation and glycated albumin (GA),visfatin level and neonatal body composition in gestational diabetes mellitus (GDM) patients who are non-obese.Methods:200 pregnant women were enrolled.The preconception body mass index(BMI) of all the research object was less than 25 kg/m2.According to the speed of body mass growth from 28th week of gestation to delivery,the subjects were divided into two groups:excessive weight gain group (n =77) and appropriate weight gain group(n=123).Variance of serum GA,visfatin levels and neonatal birth weight(BW),the percent of body fat in newborn(F％) between two groups were compared,and the relationship between weight gain in late pregnant GDM patients and above values was analyzed.Results:①Serum GA,HbA1 c,visfatin and total cholesterol,triglyceride,low density lipoprotein,very low density lipoprotein levels in excessive weight gain group were higher than those in appropriate weight gain group(P ＜ 0.05).②Mean gestational age,newborn Apgar score immediately,the ratio of baby boys and vaginal delivery rate in two group had no significant difference(P＞0.05).Compared with the appropriate weight gain group,the excessive weight gain group had higher average birth weight and lower blood glucose levels.The proportion of large for gestational ages(LGA) was increased in appropriate weight gain group,and the ratio of abdomen circumference (AC) and head circumference (HC) and the percent of body fat in newborn(F％) were significantly increased in this group(P ＜0.01).③The speed of body mass growth in late pregnancy in GDM patients was positively related with serum GA,visfatin,HbA1c levels and newborn birth weight and the percent of body fat in newborn(r=0.524,0.470,0.456,0.329,0.473,P＜0.001).Conclusions:The monitoring of the serum GA and visfatin levels may have certain clinical value to evaluate the weight gain in late pregnancy of GDM patients.The rapid body mass growth in those patients may accelerate the visceral fat accumulation and worsen existing glucolipid metabolic disorders,and is also closely related to the increase of neonatal BW and F％.

Objective To study the preventive effect of lipoxygenase inhibitor nordihydroguaiaretic acid (NDGA) on chronic atrophic gastritis (CAG). Methods To construct CAG rat model, 72 male rats were randomly divided into 6 groups, including normal group, CAG model group, NDGA group with different dose and positive groups (folacin). After feeding for 24 weeks, all rats were executed, their stomach mucous membrane was picked out and stained with H.E. The expression of 5-LOX and P16 protein in mucous membrane epithelia cells were detected by immunohistochemistry. Results The CAG incidence rate in model group was significant higher than normal group (77.8% vs 0% , P ＜0. 05), which indicated that C AG model rat was successfully established. The CAG incidence rate of model group was significantly higher than NDGA groups (77.8% vs 25% ,27.3% ,25%, P＜0.05), while no significant difference was found between positive group and NDGA groups (30% vs 25% ,27.3% ,25% , P＞0.05) .The expression of 5-lox in model group was higher than NDGA groups (44% vs 25% ,27% ,25%, P＜0.05). The expression of P16 protein in model group was lower than NDGA groups (66.7% vs 83.3% ,81.8% ,83.3%,P＜0.05) , and there were no significant differences between NDGA groups and positive group (83. 3%,81.8% ,83.3% vs 80%, P＞0.05). Conclusions NDGA could prevent the occurrence of N-ethyl-N-nitro-N nitrosoguanidine-induced chronic atrophic gastritis in rat. NDGA could down-regulate the expression of 5-LOX and up-regulate the expression of P16 in stomach mucous membrane of N-ethyl-N-nitro -N-nitrosoguanidine-induced chronic atrophic gastritis in rat.

Ikaros is a regulatory factor playing an important role in control of the development of hema-topoietic cells and immune system;and as a tumor suppressor,its aberration can cause both T and B lineage development arrest and neoplastic transformation,leading to insensitive to therapy and poor prognosis in actue lymphoblastic leukemia. Recently,researches on how Ikaros affects the leukemogenesis and prognosis become the focus of attention.