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.

Objective To explore the clinical features diagnosis and treatment of left main coronary artery (LM) disease. Methods According to the results of coronary angiography,significant stenosis was defined as ≥50% stenosis. Isolated LM group had 9 patients (4.62%),one-vessel stenosis LM group 15 patients (7.69%),two-vessel stenosis LM group 53 patients (27.18%) and three-vessel stenosis LM group 118 patients (60.51%). Results 195 cases (6.74%) of LM stenosis were found. The incidence rate was low. 164 patients (84.1%) had unstable angina,and 125 patients (64.1%) had myocardial infarction. Coronary artery bypass surgery was performed in 57 patients (29.2%) and the angina disappeared in most of them (84.2%). Five patients received unprotected LM stenosis and angina disappeared in all. Conclusion LM stenosis has sever symptoms. Coronary angiography is the only way for diagnosis and CABG the best treatment. Unprotected LM stenosis is valuable for some patients.

Objective To investigate the clinical efficacy of one-stage posterior internal fixation with pedicle screw and anterior debridement of bone grafting through the extraperitoneal approach the medial edge of rectus abdominis in treating severe lumbosa-cral tuberculosis .Methods 17 cases with L4-S1 tuberculosis were treated by internal fixation with pedicle screw ,anterior debride-ment through the extraperitoneal approach the medial edge of rectus abdominis ,and application of allogenic bone from January 2008 to December 2011 .All patients performed X-ray ,CT and MRI examinations before surgery .L5-S1 were involved in 8 cases ,L4-5 were involved in 6 cases ,and L4-S1 were involved in 3 cases;unilateral psoas abscess was found in 6 cases ,while bilateral psoas ab-scess was found in 3 cases ;Among the 17 cases ,8 cases had intraspinal invasion ,and 5 cases were combined with neurological dys-functions ,however ,according to Frankel grade ,4 cases were grade D ,and 1 case was grade C .Regular anti-tuberculosis treatment was given for more than 2 weeks before surgery ,and regular supportive treatment and anti-tuberculosis treatment were given for 9-12 months after surgery .As for regular follow-up(3 ,6 ,9 ,and 12 months after surgery ,and every 6 months later on) ,patients had examinations including ESR and X-ray to evaluate the tuberculosis activity and the condition of bone graft fusion ;while accord-ing to Frankel grade of nerves function ,changes in nerve function before and after surgery were evaluated in patients ,and changes of lumbosacral angle were also comparatively studied before and after surgery .Results There were no great vessel injuries and no nerve injuries except one case who had intraoperative ureteral injury which was repaired in time .The 17 patients were all followed up for 10-36 months(18 months average) ,and all reached clinical healing without complications such as tuberculous peritonitis ,e-rectile dysfunction and retrograde ejaculation .During the follow-up period ,there were no tuberculosis recurrence ,no loosening of in-ternal fixation ,and no break of rod and nail ;the grafted bones were fused in all patients with an average time of 7 .5 months ;accord-ing to Frankel grade of nerves function ,only one patient was grade D ,while the other four cases recovered to grade E .The lumbosa-cral angle of patients was corrected from 23 .8° ± 4 .0°(19 .8°-27 .8°) before surgery to 29 .1° ± 3 .6°(25 .5°-32 .7°) after surgery , and the change was statistical significance(P<0 .05) .Conclusion The one-stage posterior internal fixation with pedicle screw and anterior debridement of bone grafting through the extraperitoneal approach inside of rectus abdominis is a safe and effective meth-od ,which can thoroughly remove the focus ,reconstruct the lumbosacral stability ,and prevent the loosening of bone grafting .

Objective To analyze the level and change trends of cancer mortality in the media focused area,Yingcheng of Hubei Province,to further support the authenticity and reliability of the information from media report.Methods Use the data of the first national retrospective death survey and the third national retrospective sampling death survey to describe cancer mortality and change trends in Yingcheng of Hubei Province.Results Crude cancer mortality in Yingcheng was 148.26/100 000.In the past 30 years,cancer mortality significantly increased by 9.27 times.Among 100 000 people in the county,each year 43 cases of malignant tumor death occurred more than the national average level.A variety of malignant tumors' mortality change in the county is significantly different from those of the country,such as esophageal cancer,stomach cancer did not fall but rise;liver cancer,lung cancer,leukaemia and colorectal cancer increased 5.84 times,5.61 times,5.07 times and 17.91 times more than the national average,respectively.The excess mortality rate of stomach cancer,liver cancer,lung cancer and colorectal cancer were 15.32/100 000,16.78/100 000,8.32/100 000 and 3.98/100 000 respectively.Negative binomial distribution fitting results suggest that death of stomach cancer exists village aggregation.Conclusions The level of historical cancer mortality in Yingcheng was low,but increase quickly,presently it is on the national high-incidence level.It presents the phenomenon that a variety of malignant tumors is generally on high-incidence level and stomach cancer exists village aggregation.

BACKGROUND:Currently, transplantation of bone marrow mesenchymal stem cel s into the spinal cord is very limited to the recovery of animals fol owing spinal cord injury. Methylcobalamin is a common drug for the treatment of neurological diseases and injuries, but its effects on bone marrow mesenchymal stem cel s are unclear. OBJECTIVE:To study the feasibility of bone marrow mesenchymal stem cel s differentiating into neuron-like cel s induced by methylcobalamin in vitro and to observe the cel viability and proliferation of differentiated cel s. Methods:Rat bone marrow mesenchymal stem cel s were isolated, cultured and purified by density gradient centrifugation and adherent culture. The fourth to fifth generation of bone marrow mesenchymal stem cel s were treated for 24, 48 and 72 hours with different concentrations (25, 50 and 100 mg/L) of methylcobalamin. The morphological changes and cel growth were continuously observed under an inverted phase constract microscope. The viability of induced cel s was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The expressions of Nestin and neuron-specific enolase were identified by reverse transcription PCR and western blot. RESULTS AND CONCLUSION:Most of bone marrow mesenchymal stem cel s could differentiate into neuron-like cel s after induction with methylcobalamin. The expressions of Nestin and neuron-specific enolase were up-regulated after 48 hours of methylcobalamin treatment at different concentrations, especial y after treatment with 100 mg/L methylcobalamin. Similarly, the expressions of Nestin and neuron-specific enolase could be increased significantly after 100 mg/L methylcobalamin treatment for 24, 48 and 72 hours, especial y for 72 hours. It is indicated that methylcobalamin can induce bone marrow mesenchymal stem cel s differentiating into neuron-like cel s, and the optimal concentration of methylcobalamin is 100 mg/L.

Objective To analyze the influence of multiple myeloma tumor-associated gene MYEOV2 on NIH/3T3 cells growth. Methods The recombinant plasmid, pcDNA3.1(+)/MYEOV2, was constructed and subsequently transfected into NIH/3T3 cells by liposome. The positive clones of the transfected NIH/3T3 cells were obtained by G418 selection. RT-PCR was used to detecte the expression of MYEOV2 gene in the cells. Fluorescence-activated cell sorting (FACS) and cell grow curve drawing were applied to analyze the influence of MYEOV2 gene on NIH/3T3 cells proliferation. Results The cell clones stably expressing MYEOV2 gene were obtained. FACS analysis showed that the percentage of S phase cell of pcDNA3.1(+)/MYEOV2-transfected cells, pcDNA3.1(+) -transfected cells and non-transfected cells was 30.9%, 20.1% and 16.1%, respectively, and the difference of sphase cell percentage between pcDNA3.1(+)/MYEOV2-transfected cells and the other two groups of cells was significant (P

In hippocampus, numerous studies have shown that N-methyl-D-aspartate (NMDA) receptors are essential for the initiation of long-term potentiation (LTP), whereas the expression of LTP is primarily mediated by the phosphorylation of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors and the increased insertion of postsynaptic AMPA receptors. However, in recent years there is also evidence that NMDA receptor channels contribute to the expression of LTP under physiological conditions. It was examined whether NMDA receptor channels contributed to the expression of LTP of C-fiber evoked field potentials in rat spinal dorsal horn by intravenous or spinal application of NMDA receptor antagonists after the establishment of LTP. It was found that MK 801 (a non-competitive NMDA receptor antagonist) at dose of 0.1 mg/kg (iv) had no effect on the spinal LTP and at the dose of 0.5 mg/kg depressed the LTP significantly. However, the inhibitory effect of MK 801 at higher dose (1.0 mg/kg)was not different from that produced by the dose of 0.5 mg/kg. The similar inhibitory effect on spinal LTP was also observed, when MK 801 was applied locally at the recording segments of spinal cord. To confirm the above results, a competitive NMDA receptor antagonist AP V was tested. Spinal application of AP V at a concentration of 100 μmol/L produced a stronger depression than at 50 μmol/L. When the concentration of AP V increased to 200 μmol/L, no further depression was observed. These results indicate that NMDA receptor channels are involved in the expression of LTP of C-fiber evoked field potentials in the rat spinal dorsal horn.

Background:C-MET is expressed in a variety of tumor,and its expression may help to predict the prognosis of patients with gastric cancer. Aims:To explore the association of C-MET protein expression with survival in patients with stage Ⅲ gastric cancer. Methods:A total of 178 consecutive initially treated patients with stage Ⅲ gastric cancer from April 2010 to April 2014 at Beijing Pinggu Hospital were enrolled in this study. The expression of C-MET protein was determined by immunohistochemistry. Kaplan-Meier method was used to analyze the survival in patients with high C-MET protein expression and low C-MET protein expression,COX proportional hazards model was used to analyze the influence of various factors on prognosis. Results:C-MET protein was low expressed in 139 patients(78. 1%),and high expressed in 39 patients(21. 9%). Median survival(25. 1 months vs. 45. 0 months),1-year survival rate(69. 2% vs. 91. 4%),2-year survival rate(41. 0% vs. 84. 0%)were significantly decreased in high C-MET protein expression group than in low C-MET protein expression group(P all <0. 05). C-MET protein expression,N staging,and age were the influencing factor for prognosis of gastric cancer(P all <0. 05),however,gender and tumor differentiation were not related with prognosis(P>0. 05). Conclusions:C-MET protein expression rate is 21. 9% in patients with stageⅢgastric cancer,C-MET expression is significantly associated with survival;1-year survival rate is lower in patients with high C-MET protein expression.

Objective To discuss the effect of the quality control circle(QCC)activities in reducing the incidence of cold in reflux-enema of children.Methods The QCC team was built,reducing the incidence of cold in reflux-enema of children was named as the theme,to grasp the present situation,set the goal,fix the methods and carry out countermeasures.Results Through the development of QCC,making the standards of reflux-enema,the incidence rate of cold reduced from 25.0％(7/28) down to 3.6％(1/28),the nurses' abilities of technical operation and communication improved significantly.Conclusions Application of QCC in reflux-enema of children is practical.It can effectively improve the nurses' awareness of participating in the implementation management and nursing management system.By making the standardization of reflux-enema,nurses can improve the quality and effect of the reflux-enema and ensure the quality and safety of nursing.

The formation of physique was influenced by many factors and was closely related to the disease, especially by the social and cultural factors. According to the characteristics of physique, physique conditioning was conducive to rehabilitation of the disease. It was also the internal evidence for individualized treatment of rehabilitation. Traditional Chinese medicine (TCM) rehabilitation advocated functional rehabilitation as the main treatment purpose. Attentions were paid to promoteqi circulation. The psychological characteristics of the rehabilitation subject were especially emphasized on, in order to improve the therapeutic effect of rehabilitation. There were many classifications of physical evaluations, which were widely used in a variety of clinical diseases rehabilitation. The pathological physique correction and adjustment cannot be ignored in rehabilitation. Therefore, the application of physical evaluation in the guidance of rehabilitation therapy can enrich the content of TCM rehabilitation evaluation. It further improved TCM physical evaluation system to meet the needs for clinical practice and TCM modernization.