OBJECTIVE To study the effect of vibration sputum elimination apparatus on the brain injury patients to reduce the lung infection.METHODS From Jan 2008 to Nov 2008 90 cases of brain injury patients were divided into test group(45 cases) and the control group(45 cases),and in the test group the BT-2008 multi-functional vibration sputum elimination apparatus were used to promote sputum excretion,in the control group the traditional artificial beating were used to promote sputum excretion.RESULTS The average daily volume of sputum expectoration of the test and control groups were [(40.70? 4.10)ml vs(35.50? 3.40)ml,P

Objective To explore the effect of psychological intervention on the quality of life in patients with advanced non-small cell lung cancer chemotherapy. Methods A total of 60 patients with advanced non-small cell carcinoma chemotherapy in our hospital from January 2015 to January 2017 were enrolled and divided into two groups according to different intervention methods. The control group was treated with Shengmai injection alone. The observation group was treated with psychological intervention + compound Kushen injection.The changes of scores of depression (SDS), anxiety (SAS) and pain (VAS), quality of life (QLQ-CCC) score and adverse reactions were recorded and analyzed before and after intervention in two groups. Results The clinical intervention effect of the observation group was better than that of the control group, the stability of the tumor focus, the degree of pain, the quality of life and other aspects were better than the control group, the difference between the two groups was statistically significant (P<0.05). Conclusion Patients with advanced non-smal cel lung cancer chemotherapy choose psychological intervention +compound sophora injection combined treatment effect is remarkable, which can effectively improve the patient's clinical symptoms and quality of life, is worth widely used clinically.

OBJECTIVE To investigate the status of the sharp injuries among medical workers in operating department and explore the countermeasures for the occupational protection.METHODS The status of the sharp injuries was investigated retrospectively from Jul 2006 to Jun 2007 used a self-designed questionnaire among 255 medical workers in three grade 2A hospitals in Tongcheng city.RESULTS Among the medical workers 63.14% suffered sharp injuries.Furthermore,the proportion of sharp injuries among doctors,nurses and nurse students were 46.67%,80.00% and 92.73%,and the sharp injuries rate was closely associated with the working years.The type of sharp injuries was closely associated with occupation.The proportion of reporting sharp injuries among doctors,nurses and nurse students was 38.57%,87.50% and 3.92%,respectively.The proportion of taking on gloves among doctors,nurses and nurse students was 88.0%,80.0% and 16.37% when they worked in contact with blood or body liquid.CONCLUSIONS The medical workers meet the danger of sharp injury.Nurse students and new medical workers have high incidence of the sharp injury,so they are high-risk subjects who should enhance their safeguard procedures.Thus,perfecting the operating protocols and standardizing the managements of occupational prevention and protection could reduce the sharp injuries rate.

Objective To evaluate the value of MRI used in the shoulder pain. Methods 34 cases with complaint of shoulder pain underwent MR scanning, the findings of both MRI and surgery were analyzed comparatively.Results MRI of shoulder in 34 cases showed full-thickness and partial-thickness tears of the rotator cuff, tendinitis, glenoid labrum tear, synovitis, biceps tendinitis, biceps dislocation and tumors. In 13 patients received arthroscopy or operation. MR findings of 11 cases were correlated to surgical result, one case diagnosed as tendonitis by MRI was showed partial-thickness tears of the rotator cuff during operating, one case in which the MRI showed normal was found biceps tendonitis by arthroscopy. Conclusion MRI can show complex anatomy of shoulder and has high accuracy in diagnosis of shoulder pain, it is a value method for shoulder pain.

Objective To evaluate the effect of lactulose on spinal cord ischemia-reperfusion (I/R) injury in rats.Methods One hundred forty-four male Sprague-Dawley rats, aged 3 months, weighing 300-350 g, in which gastric tube was successfully inserted, were randomly divided into 4 groups (n=36 each) using a random number table: sham operation group (group S), spinal cord I/R group (group I/R), lactulose group (group L), and lactulose + antibiotics group (group LA).Spinal cord ischemia was induced by occlusion of the thoracic aorta combined with controlled hypotension for 9 min, followed by reperfusion.Lactulose 0.5 g/kg was administered intragastrically immediately after onset of reperfusion in group L.Metronidazole 30 mg/kg and gentamicin 40 mg/kg were administered intragastrically three times a day during 1-3 days before operation in group LA, and the other procedures were similar to those previously described in group L.Hydrogen concentration in cerebrospinal fluid was detected before ischemia and at 10, 30, 60, 90, 120, 150 and 180 min after reperfusion.At 12, 24 and 48 h of reperfusion, 8 rats in each group were sacrificed, and the L3-5 segment of the spinal cord was isolated for determination of nuclear factor E2-related factor 2 (Nrf2) expression (by Western blot), superoxide dismutase (SOD) activity (by using xanthine oxidase method), catalase (CAT) activity (ammonium molybdate method), and 8-hydroxy-2'-deoxyguanosine (8-OHdG), 3-nitrotyrosine (3-NT) and malondialdehyde (MDA) contents (by ELISA).Neurological function was assessed and scored at 48 h of reperfusion.Six animals in each group were then sacrificed after assessment of neurological function, and the L3-5 segment of the spinal cord was removed for detection of apoptotic neurons.The cell survival rate and apoptotic rate were calculated.Results Compared with group S, no significant change was found in the hydrogen concentration in the cerebrospinal fluid at each time point, and in the level of Nrf2, CAT and SOD at 12, 24 and 48 h of reperfusion, the contents of 8-OHdG, 3-NT and MDA were significantly increased, the neurological scores and cell survival rate were decreased, and the apoptotic rate was increased in group I/R, and the hydrogen concentration in the cerebrospinal fluid at 30-180 min of reperfusion was increased, the level of Nrf2, CAT and SOD was increased at 12, 24 and 48 h of reperfusion, and no significant change was found in the contents of 8-OHdG, 3-NT and MDA, neurological scores, cell survival rate, and apoptotic rate in group L.Compared with group I/R, the hydrogen concentration in the cerebrospinal fluid at 30-180 min of reperfusion was increased, the level of Nrf2, CAT and SOD was increased, the contents of 8-OHdG, 3-NT and MDA were decreased, the neurological scores and cell survival rate were increased, and the apoptotic rate was decreased in group L, and no significant change was found in the parameters mentioned above in group LA.Conclusion Lactulose can reduce spinal cord I/R injury in rats.

Interventional therapy is characterized by mini-invasion, accuracy, obvious curative effect and little side effect. In China, interventional therapy has been applied widely in the treatment of malignant carcinoma in recent 10 years. Traditional Chinese medicine (TCM) also has been adopted in the interventional therapy in recent years. This article reviews the history, status quo and prospect in interventional treatment of carcinoma with traditional Chinese medicine in experimental and clinical domains in recent years. Interventional therapy combined with TCM preparation directly or TCM therapy as a supplementary method of interventional therapy for carcinoma has played an active role in improving clinical curative effect, controlling and reducing toxic side effect and complications.

Objective To gain a better knowledge of the education for masters in clinical medicine (general practice) and provide a reference for the better exploration of the training mode of GP students.Methods 9 colleges and universities enrolling students for this program were selected with stratified sampling.A questionnaire was conducted in terms of admission,curriculum setting,clinical training,guidance and evaluation through officials in charge of graduate affairs from February to July in 2014.Descriptive analysis was performed to the investigation results,using SPSS 20.0 statistical software.Results A full-time undergraduate degree in clinical medicine was explicitly required in 88.9％ (8/9) of colleges and universities.The average total credits of the course were 23.7 and the average clinical training duration was 32.4 months.Tutor group was adopted in all colleges and universities.The assessment and evaluation of the GP masters was mainly composed of multiple forms of process assessment and final evaluation.Conclusion We suggest attaching more importance to the improvements of enrollment policy,curriculum system,clinical training,standardized training base construction,teaching staff,and evaluation system in order to explore GP training mode in accord with the law of general practice and suitable for China's national conditions.

Objective To evaluate the role of autophagy in survival of hypoxia-preconditioned bone marrow mesenchymal stem cells (BMSCs) in damaged tissues resulting from spinal cord ischemiareperfusion (I/R) injury in rats.Methods In vitro experiment Rat BMSCs were seeded in 12-well plates at a density of 1× 106 cells/ml (1 ml/well) , and randomly divided into 6 groups (n =30 wells each) : control group (group C) , normoxia-incubated group (group N) , hypoxic preconditioning (HP) group (group H), HP + AMP-activated protein kinase (AMPK) inhibitor Compound C group (group HC), HP + autophagy inhibitor 3-methyladenine group (group HM) and HP + mammalian target of rapamycin (mTOR) inhibitor rapamycin group (group HR).In HC, HM and HR groups, 10 mmol/L Compound C, 5 mmol/L 3-methyladenine and 10 nmol/L rapamycin were added to the culture medium, respectively, at 3 h before HP.Twelve wells in each group were selected, and the expression of phosphorylated AMPK (p-AMPK) , phosphorylated mTOR (p-mTOR), microtubule-associated protein 1 light chain 3 Ⅰ (LC3 Ⅰ), and LC3 Ⅱ in BMSCs was determined.Eighteen wells in each group were selected, and BMSCs were co-cultured with 500 μ mmol/L H2O2 for 24 h, the survival and apoptotic rate of BMSCs were measured, and the activities of caspase-9 and caspase-3 were detected.In vivo experiment Adult male Sprague-Dawley rats, weighing 300-350 g, aged 3 months, underwent spinal cord I/R.A total of 192 rats with spinal cord I/R injury were randomly divided into C, N, H, HC, HM and HR groups (n =32 each) using a random number table.At 30 min of reperfusion, BMSC suspension 5 μ l (1×106 cells/ml) processed in N, H, HC, HM and HR groups of in vitro experiment was implanted into the lumbar segment (L1-5) of the spinal cord in N, H, HC, HM and HR groups, respectively.Neurological function was scored at 4, 12, 24 and 48 h of reperfusion.The lumbar segment of spinal cord was removed for detection of apoptosis in BMSCs.Results In vitro experiment Compared with group N, the p-AMPK expression, LC3 Ⅱ/LC3 Ⅰ and survival rate were significantly increased, and p-mTOR expression, apoptotic rate and activities of caspase-9 and caspase-3 were decreased in group H (P＜0.05).Compared with group H, the p-AMPK expression, LC3 Ⅱ/LC3 Ⅰ and survival rate were significantly decreased, and p-mTOR expression, apoptotic rate and activities of caspase-9 and caspase-3 were increased in group HC, LC3 Ⅱ/LC3 Ⅰ and survival rate were decreased, and apoptotic rate and activities of caspase-9 and caspase-3 were increased in group HM, and p-mTOR expression, apoptotic rate and activities of caspase-9 and caspase-3 were decreased, and LC3 Ⅱ/LC3 Ⅰ and survival rate were increased in group HR (P＜0.05).In vivo experiment Compared with group N, the neurological function scores were significantly increased, and the number of apoptotic BMSCs was decreased in group H (P＜0.05).Compared with group H, neurological function scores were significantly decreased,and the number of apoptotic BMSCs was increased in HC and HM groups (P＜O.05).Conclusion Enhanced autophagy is involved in survival of hypoxia-preconditioned BMSCs in damaged tissues resulting from spinal cord I/R injury, and the mechanism is associated with activated AMPK/mTOR pathway in rats.

This study conducted questionnaire survey to graduate medical students in Medicine (M.D.) and Stomatological Medicine (S.M.D) enrolled at Peking University Health Science Center in the year 2013,analyzed on the understanding,period,forms,mentoring and effect of research training.Suggestions are proposed to strengthen the research training,for example,focusing on clinical training as well as research training,aiming at clinical issues,emphasize of clinical scientific research,permeating the concept oftransformation medicine,promotion of intense full-time research,strengthen the mentoring of professors.

Objective To obtain the shear wave velocity(SWV) in breast tumors at different probe orientations.Methods SWV was measured on 92 breast tumors in 48 female patients with the probe placed on transverse,longitudinal and 45 degree planes.Pathological test results were followed up.Results Pathological tests showed benign tumors in 48 patients (92 tumors).Of the three planes,values of the biggest and the smallest SWV showed significant difference (P ＜0.001).Conclusions SWV differs on different planes of breast tumors.So the effect in different probe orientations should be considered using SWV for the differential diagnosis of breast tumors.