Objective To investigate prognostic value of the CHA 2 DS2-VASc score [ congestive heart failure , hypertension , age≥75y (doubled), diabetes mellitus, stroke (doubled)-vascular disease, age 65~74 and sex category (female)] in an initial car-dioembolic stroke with atrial fibrillation .Methods A total of 346 initial cardioembolic stroke patients with atrial fibrillation was en-rolled.The clinical feature, the National Institutes of Health Stroke Scale (NIHSS) score on admission, and clinical outcome [modi-fied Rankin Scale (mRS) score after 90 days] were obtained and evaluated retrospectively according to the CHA 2DS2-VASc score. Results The rate of female, smoking, hypertension, congestive heart failure, anticoagulation and the level of age, NIHSS score, and CHA2 DS2-VASc score were significantly different between two prognostic groups ( P <0.05 ) .A positive correlation was observed be-tween CHA2DS2-VASc score and NIHSS score on admission (ρ=0.324, P <0.01), CHA2DS2-VASc score and mRS score (ρ=0.228, P <0.01).Logistic regression analysis showed that age , smoking, anticoagulation, the CHA2DS2-VASc score, and the NIH-SS score on admission were related to clinical outcome independently .Conclusions The CHA2 DS2-VASc score may be useful for not only evaluation of stroke risk but also prediction of clinical outcomes after stroke .

OBJECTIVE:To explore the new mode and new method for the teaching work mode of clinical pharmacists in phar-maceutical ward rounds. METHODS:Medicine comprehensive ward rounds mode centered by teachers and independent pharmaceu-tical rounds interrogation mode centered by clinical pharmacist trainees were respectively tried by clinical pharmacists to guide clini-cal pharmaceutical cares. Three-level mode of medical rounds was used for reference. Teaching rounds by trainees,teaching staff and teachers were tried to train the learning and practice ability of different levels of trainees. RESULTS & CONCLUSIONS:Ac-cording to the different forms of exploration of teaching work mode in pharmaceutical ward rounds,trainees,teaching staff and teachers has practiced and improved in the pharmacy professional practice skills. Pharmaceutical ward rounds are the important parts of work,and different teaching modes are significant for the advanced quality of trainees.

Objective To identify dosimetric predictors for the development of gastrointestinal toxicity in patients with pancreatic adenocarcinoma treated with TOMO radiotherapy .Methods From January 2014 to Janu-ary 2015 ,we analysed the medical records of 68 pancreatic cancer patients who received helical tomotherapy from Air Force General Hospital .The stomach and duodenum were contoured separately to determine their dose volume histogram(DVH)parameters.Chi-square test was employed to analyze the count data .Spearman correlation anal-ysis was used to analyze the relationship between occurrence of gastrointestinal toxicity and clinical and physical factors.Logistic regression models was performed to identify risk factors associated with gastrointestinal toxicity . Results The median follow-up was 9 months(4~16 months).18 patients experienced grade II acute gastroin-testinal toxicity ,1 patient experienced grade Ⅲ acute gastrointestinal toxicity , whereas 17 patients experienced grade II late gastrointestinal toxicity ,1 patient experienced grade Ⅲlate gastrointestinal toxicity .On UVA,the vol-ume,Dmean,D1,D3,D5,D10,V5 to V40,and V5′to V45′of duodenum were significantly associated with GradeⅡor higher gastrointestinal toxicity ( P <0.05 ) .The MVA, V45′of duodenum was independent predictor for gradeⅡor higher gastrointestinal toxicity(P<0.05).The ROC analysis also showed that V45′of 0.5cm3 was the optimal threshold to predict for gastrointestinal toxicity for the entire cohort .Conclusion V45′of duodenum is of greater importance in the judgment of occurrence of hypofractioned radiation -induced gastrointestinal toxici-ty.

BACKGROUND: How to establish a stable in vitro culture system, including location of corneal limbal epithelial stem cells, in vitro sample harvest, in vitro culture, vector selection, as well as identification methods, play a key role in corneal limbal epithelial stem cells culture. OBJECTIVE: To culture the isolated rabbit corneal limbal epithelial stem cells and to identify the biological properties of cultured cells. METHODS: The primary rabbit cornel limbal epithelial stem cells were isolated and cultured with tissue inoculation using human amniotic membrane as vector. The growth features of cells were observed under an inverted microscope. The morphology of cells was observed by hematoxylin-eosin staining and a scanning electron microscope. Furthermore, the monoclonal antibody AE5 and P63 two-step immunohistochemical staining were used to identify limbal epithelial stem cell protein expression. RESULTS AND CONCLUSION: The rabbit corneal limbal epithelial stem cells could be successfully cultured and maintained a relatively high value-added potential in vitro. Rabbit corneal limbal epithelial stem cells cultured on the amniotic membrane pull netted cellular layer. The AE5 monoclonal antibody positive rate of primary cultured cells was about 5% and P63 monoclonal antibody positive up to 90%. AE5-positive rate increased and P63-positive rate decreased with the increase in the number of subculture. The rabbit limbal epithelial stem cells can be successful culture and amplified on human amniotic membrane in vitro by limbal tissue culture method. The cultured cells maintain the characteristics of corneal epithelial cells. The rabbit corneal limbal epithelial stem cells can form grafts on the amniotic membrane.

Objective To explore the lived experience of children with acute leukemia about acupoint therapy during chemotherapy, so as to provide the theoretical and practice evidence for development of more scientific nursing measures. Methods Totally 14 children with acute leukemia participated in half-structured interviews regarding their experience of acupoint therapy.The NVivo 10.0 software was used to supervise, excavate and seek data.The data were analyzed by the Co1aizzi phenomenological methodology. Results Five themes were extracted including benefit sense,a sense of accomplishment of self-fulfilling, a sense of attachment to medical, sigh with emotion the magic of traditional Chinese medicine and bearable mild discomfort. Conclusions The experience of children with acute leukemiais positive feelings for the most part, nursing staff should listen to them and give corresponding nursing according to specific circumstances in order to improve the quality of nursing.

Cadmium is one of the heavy metals with severe reproductive toxicity,whose half-life lasts 20 to 40 years.Cadmium could induce dysfunction of testis and epididymis for its significant accumulation in human testis,and the amount,motility parameters and morphology of sperm change abnormally.The adverse change could also extend to male offspring and cause the impairment of their reproductive system.There has been no clear mecha-nism of how cadmium induces dysfunction of male reproductive system,and treatment for the adverse influence on male reproductive system by cadmium has not yet been found.Therefore,this problem has been discussed in repro-ductive and environmental field for a long time.A number of previous investigations showed that cadmium could damage male fertility by followed pathways,including interfering with hormone secretion,inducing oxidative stress,activating inflammation and apoptosis,and causing energy metabolism disorder,etc.In order to enlighten new ideas for therapeutic targets of male reproductive function damage induced by cadmium,we systematically reviewed and summarized the findings of previous publications in this paper.

Objective: To compare the clinical efficacy and safety of bortezomib, cyclophosphamide, dexamethasone (VCD) regimen and bortezomib dexamethasone (VD) regimen in the treatment of the patients with newly diagnosed multiple myeloma (NDMM). Methods: The clinical data of 73 patients with NDMM in Shanxi Dayi Hospital from January 2013 to January 2016 were retrospectively analyzed. According to the chemotherapy regimen, the patients were divided into VCD group (41 cases) and VD group (32 cases). The efficacy and adverse reactions of the two groups were evaluated. Results: The overall response rate of VCD group and VD group was 80.5% (33/41) and 78.1% (25/32) respectively, and the difference was not statistically significant (χ ²= 0.061, P= 0.804); and complete remission (CR) rate was 36.6% (15/41) and 15.6% (5/32) respectively, and the difference was statistically significant (χ ²= 3.970, P= 0.046); the median progression-free survival (PFS) was 27 months and 24 months respectively, and the median overall survival (OS) was 35 months and 33 months respectively, and the differences were not statistically significant (all P > 0.05). Most adverse reactions occurred in grade 1-2, in which peripheral polyneuropathy and thrombocytopenia were the most common. Peripheral neuritis was the most common finding among the adverse reactions of grade 3. The incidence of adverse reactions in both groups was not statistically significant (P > 0.05). Conclusions VCD and VD regimen could be recommended as a better induction therapy for NDMM patients. Compared with VD scheme, VCD scheme has a higher CR rate.