OBJECTIVE:To systematically review the short-term efficacy and safety of paclitaxel combined with cisplatin in the treatment of advanced cervix cancer,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from CJFD,Wanfang database,VIP datebase,Cochrane library and EMBase,the randomized controlled trials(RCT)of paclitaxel+cisplatin(test group)versus surgery alone and/or combined with cisplatin(control group)in the treatment of advanced cervix can-cer were collected,and Meta-analysis was performed by using Rev Man 5.0 statistics software after extracting data and evaluating quality. RESULTS:A total of 9 RCTs were enrolled,involving 1 097 patients. Results of Meta-analysis showed total effective rate [OR=4.12,95%CI(2.91,5.83),P<0.001] in test group was significantly higher than control group,incidence of gastrointestinal re-actions [OR=0.22,95%CI(0.10,0.47),P<0.001] and incidence of alopecia [OR=0.48,95%CI(0.24,0.95),P=0.03] were signifi-cantly lower than control group;there were no significant differences in the incidence of myelosuppression [RR=1.02,95%CI (0.37,2.79),P=0.97] and incidence of allergic reaction[OR=1.87,95%CI(0.18,19.18),P=0.60] between 2 groups. CONCLU-SIONS:Paclitaxel combined with cisplatin has good short-term efficacy in the treatment of advanced cervix cancer,can reduce the incidence of adverse reactions and complications,with good safety. Due to the limit of research methodological quality,high quali-ty and large-scale RCTs are required for further validation of the conclusions.

Objective To explore the dispassed reason of Anhui provincial health senior titles evaluation.Methods The senior professional titles of the year 2009-2011 assessment results which were announced by the office of personnel titles of Anhui Provincial Health Department and the recorded results of the jury assessment were analyzed.Results In Anhui Province from 2009 to 2011 for three years,a total of 4 523 people participated in the senior title review by staff 3 039 people,by the proportion of 67.2％.2009,2010,2011 pass rate was 69.14％,66.85％,65.89％,respectively.1 484 people did not pass,and the rate was 32.8％.The main reason was the lack of reporting by professional and technical proficiency,non-standard format of application materials,assessment reporting material falsification.Conclusion Increasing the professional title appraisal policy propaganda,assessment focus which should be focused,the RAE quantitative score standards of health senior professional title,the establishment of a senior title of the series of health reporting assessment information system can improve this conditions.

Objective To observe the clinical efficacy of acupuncture in treating severe pneumonia complicated with gastrointestinal dysfunction (GIDF).Method Sixty patients with severe pneumonia complicated with GIDF were randomized into a treatment group and a control group, 30 cases in each group. The two groups were both given conventional Western medications. In addition, the treatment group was intervened by acupuncture, and the control group by oral administration of Mosapride citrate capsules and enteral nutrition via nasogastric tube. After 7-day treatment, the changes of GIDF score, intraabdominal pressure, bowel sound and gastric retention were observed in the two groups, and the clinical efficacies were compared.Result The total effective rate was 93.1% in the treatment group versus 78.6% in the control group, and the between-group difference was statistically significant (P<0.05). The scores of GIDF and the indexes (intraabdominal pressure, bowel sound, and gastric retention) were significantly changed after the treatment in both groups (P<0.05). The scores of GIDF and the indexes in the treatment group were significantly different from those in the control group after the intervention (P<0.05).Conclusion Acupuncture can promote the recovery of gastrointestinal function in severe pneumonia patients, since it can significantly improve the intraabdominal pressure, bowel sound and gastric retention.

Objective To observe the effect of Jiaotai Pills ( JP) on hypothalamic neurotransmitters of Orexin A and gamma-aminobutyric acid ( GABA) in rapid eye movement ( REM) sleep deprivation rats. Methods Rat model of REM-sleep deprivation was established by water small platform method. The rats were randomized into 6 groups, namely normal control group, model group, Diazepam group (3 mg/kg), and high-, medium-and low-dose JP groups ( JP in the dosage of 18.6, 9.3 and 4.6 g/kg respectively) . Enzyme-labeled instrument was used to detect the absorbance ratio of rat hypothalamic Orexin A content, and high performance liquid phase electrochemical detection method was adopted for the detection of hypothalamic GABA content. Results Compared with the normal control group, all of the rats in the model group suffered from insomnia, and the Orexin A content was increased ( P<0.05) . Compared with the model group, insomnia in rats of high-, medium- and low-dose JP groups was markedly relieved, and Orexin A was decreased (P<0.05) . The difference of GABA was insignificant between model group and JP groups (P>0.05) . Conclusion The sedative and hypnic mechanism of JP is probably related with the inhibition of hypothalamic Orexin A.

Objective To investigate the utility of combined test of neutrophil CD64 and C-reactive protein(CRP)for early diag-nosis of burn sepsis.Methods A prospective study was conducted in 76 hospitalized burn patients,including three groups:burn sepsis(n=27),local infection(n=31)and controls without bacterial infection (n=18)based on their diagnosis.Blood samples were collected within 24-48 h after hospital admission for analysis of neutrophil CD64,CRP,white blood cell count (WBC), neutrophils percentage (N)by flow cytometry,and bacterial culture.These parameters were re-evaluated for the patients in sepsis group 7 and 14 days after antibiotic therapy.Results Neutrophil CD64,CRP,WBC and N were significantly higher in sepsis patients than the corresponding values in the patients with local infection or control patients (P < 0.01 ).Neutrophil CD64 and CRP in the patients with local infection were significantly higher than those in the control patients without bacterial infection (P < 0.01).Neutrophil CD64 was positively correlated to CRP.Neutrophil CD64 and CRP decreased 7 days after an-tibiotic therapy,but the difference was not statistically significant compared to the pretreatment levels.Neutrophil CD64 and CRP decreased significantly 14 days after antibiotic therapy compared to the pretreatment levels (P < 0.01),but still higher than the levels in the control group.The receiver operating characteristic (ROC)curve of CD64 + CRP combined test,CD64, CRP,WBC,N for detecting bacterial infection showed an area under curve (AUC)of 0.952,0.923,0.904,0.756 and 0.728,respectively.Conclusions Neutrophil CD64 is useful in early diagnosis of burn sepsis.The expression of neutrophil CD64 does not have significant difference between gram-positive and gram-negative bacterial infections.Combined test of neutrophil CD64 and CRP can improve the efficiency for diagnosis of burn sepsis.

Objective To analyze the influencing factors on hospitalization costs of osteoporosis hip fracture in elderly patients.Methods The hospitalization expenses of patients with osteoporotic hip fracture and influencing factors were analyzed by single factor analysis of variance and multiple regression analysis method in Beijing Ji Shuitan Hospital from 2009 July to 2010 December.Results Among 565 patients who underwent operation treatment,hospitalization costs of femoral neck fracture was (42 127±20 821) yuan,wherein the treatment fee was (27 283± 14 959) yuan,other expenses (expenses for medicine,examination and chemical examination) were (14 844 ± 8717) yuan.The above values of intertrochanteric fracture were (52 965± 15 901) yuan,(36 872±11 763) yuan and (16 093±7793) yuan,respectively.Treatment fee occupied 65％ of hospitalization expenses.Multivariate regression analysis of influencing factors of costs intertrochanteric revealed that femoral neck fractures hip arthroplasty,femoral intertrochanteric fracture,venous thrombosis of the lower extremity,and albumin infusion in perioperative period were correlated firmly with the increased hospitalization expenses and treatment expenses (P＜0.001).Comorbidities such as diabetes and anemia,perioperative complication such as delirium,cardiac disease,pulmonary embolism,pulmonary infection were related to the other higher expenses (P＜0.05).The longer of hospital stay resulted in higher cost of hospitalization (P ＜ 0.001).Conclusions Comorbidities and preoperative complications can increase other expenses.Osteoporotie hip fracture,with a high hospitalization cost,is a heavy economy burden.It is important to emphasize the disease prevention of both osteoporosis and aging chronic illness.

Objective To investigate the effect of radiation on the expressions of RANKL and OPG in osteoblasts in order to disclose the molecular mechanism of bone injury induced by ionizing radiation.Methods The osteoblasts were differentiated from MC3T3-E1 cells.After 2 or 4 Gy137 Cs γ-irradiation,the mRNA and protein expression levels of RANKL and OPG of osteoblast precursor and osteoblast were detected by real-time PCR and Western blot.Results The expressions of RANKL mRNA (t=5.41,P＜0.05)and protein(t=68.37,P＜0.01)were up-regulated after 4 Gy irradiation,while the expressions of OPG mRNA(t=5.20,7.02,P＜0.05)and protein(t=7.78,9.45,P＜0.05)were down-regulated after 2 and 4 Gy irradiation.Conclusions 2 and 4 Gy ionizing radiation alters RANKL/RANK/OPG pathway in osteoblasts,which may promote the osteoclast differentiation and maturation and hence promote bone resorption of osteoclasts.

Objective In order to know the influence factors about treatment compliance among patients with type 2 diabetes,and then offer certain positive reference for health education and prevention.Methods Selected 504 patients with type 2 diabetes among 4 hospitals in Guangzhou,interviewed them by self-designed questionnaire.The interview contents included patients' basic socio-demographic characteristics,treatment compliance,diabetes knowledge,social supprot and self-efficacy,and then analyzed the datum about the interview.Results After adjusting for gender,disease course,patients' type,education level,and incoming level,multiple linear regression analysis indicated that drug treatment compliance was positively associated with age,subjective social support,objective social support and degree of support utilization.Lifestyle was positively associated with age,objective social support and degree of support utilization.Conclusions There are several factors associated with the treatment compliance of patients with type 2 diabetes,enhance paitents' self-efficacy and carry out health education are the keys to promote their treatment compliance.

Objective:To study the antimicrobial properties of CaO/ZnO core-shell nanoparticles.Methods:The CaO/ZnO core-shell nanoparticles were prepared via precipitation method.The pH and calcium ion release from the samples which composed of eugenol and nanoparticles were examined respectively.The form of the particles was observed under electron microscope,the ions were analysed by inductively coupled plasma(ICP).The antibacterial activities against Streptococcus mutans,Enterococcus faecalis,Escherichia coli and Staphylococcus aureus were evaluated by agar diffusion test (ADT).Results:CaO/ZnO core-shell nanoparticles were spherical with core-shell structure and with the diameter of 80-90 nm.The calcium ion release and pH were gradually increasing from the nanoparticles in PBS.The antibacterial activity of CaO/ZnO core-shell nanoparticles-eugenol was significantly greater than that of iRoot SP and zinc oxide-eugenol sealer(P<0.01).Conclusion:CaO/ZnO core-shell nanoparticles possess antibacterial activity.

Objective To investigate the effect of the nursing care of critically ill patients in intensive care unit(ICU) with non-invasive ventilation assisted by sedation simultaneously. Methods During the intervention phase from June 2012 to June 2013 of 28 patients in ICU treated by non-invasive ventilation, sedatives were adjusted according to Ramsay Scale, and the parameters of the life signs (heart rate, blood pressure, oxygen saturation,etc) were measured by nurses. Results 89.3%(25/28) patients obtained the improvement of the disease despite of the complications such as over-sedation and instable hemodynamics. Conclusion The key points can increase tolerance of non-invasive ventilation and improve clinical outcomes, develop comprehensive nursing strategies on safety and effectiveness of sedation and non-invasive ventilation .