Objective To evaluate the relationship of serum thrombospondin?1(TSP?1)with the micro?inflammation in maintenance hemodialysis(MHD),and to explore its clinical prognosis value in the MHD patients. Methods A total of 84 MHD patients in our hospital were enrolled and prospectively followed for 2 years. The serum levels of TSP?1 and clinical inflammatory markers were detected. Patients were divided into groups according to different serum TSP?1 levels. The clinical inflammatory markers were detected by using ELISA analysis. Pearson simple correlation analysis method was applied to analyze the correlation between TSP?1 levels and inflammation related indicators. At the same time the prognosis and turnover of MHD patients was analyzed by using Kaplan Meier survival curve and survival rate was compared by Deleted:compared log?rank test. Cox regression analysis was used to calculate the hazard ratio (HR) and Deleted:using 95% confidence interval (CI). Results The indexes of blood lipid and inflammatory factors in the TSP?1 high?level groups were higher than that in TSP?1 low?level groups (P<0.05). Correlation analysis showed that the serum TSP?1 level was positively correlated with the serum lipid and inflammatory factors. Survival curve analysis showed that the mortality rate of TSP?1 high?level group was higher than that of TSP?1 low?level groups. Cox hazards analysis revealed that the patients with high?level TSP?1 had a higher risk for mortality than these TSP?1 low?level patients. This predictive value still existed after multivariate adjustment for age,blood lipid,serum albumin and other factors (P < 0.001). Conclusion The serum TSP?1 levels were associated with micro?inflammation and had a significant value in predicating the prognosis of MHD patients.

Objective To analyze the trend of transitional care in recent ten years and to find the advantages and shortages in this field between home and abroad, so as to provide reference for nursing researchers in China. Methods The literatures about transitional care pub-lished from January, 2005 to August, 2016 from Web of Science and CNKI were retrieved, and the visualizing map was drawn by operating CiteSpaceⅡ. Results The annual number publication of transitional care steadily increased in the world in recent ten years. China issued a small amount of documents before 2012, and then the research of transitional care obviously increased, while the number was comparable to the international in 2015. USA played a leading role in the field;China issued only 2%of the total, ranking the 9th. By comparing domestic and foreign research hot topics, international transitional care studies paid more attention to nursing program and the effect, while China fo-cused on the research of the disease. Research frontier showed that international transitional care service expanded to more and more sub-jects gradually, and inclined to the continuation of management, community and family support nursing research, which was relatively lack in China. Conclusion In recent years, the research of transitional care received increasing attention in China, while the depth and breadth of study was still lacking. China should learn from foreign research hot topics and frontiers to explore transitional care system, and provied pa-tients discharged nursing support and self care knowledge, to enrich high quality nursing connotation.

With the improvement of people's living standard and changes of their lifestyle, the incidence of coronary artery disease (CAD) has increased quite significantly, which has attracted great concern. Examination methods for CAD are more and more advanced, while the cost of inspection is rising. As a traditional test, the exercise treadmill test (ETT) is convenient, safe, and cheap. ETT can be conducted in almost every hospital as it doesn't need advanced equipments. The values of some new evaluation indexes for diagnosis and prognosis of CAD are reviewed in this article.

This paper reports the pathological changes and MDA content of the brain tissue in the early stage of cerebral ischemia due to middle cerebral artery occlusion (MCAO) in Wistar rats. The neurones showed changes of the rough endopiasmic reticulum and the mitochondrium as early as 2 minutes after MCAO. Under the light microscope, "ischemsc cells" with shrunken and condensed cytoplasm and nucleus appeared 10 minutes after MCAO. The end-product of lipid peroxidation, MDA, in the isch. emic brain tissue also significantly increased 2 minutes after MCAO, being correlated synchronously with the ultrastructural changes of the neurones. This suggested that free radicals play a role in the early stage of brain injury due to ischemia.

Objective To study the effects of High frequency two -way jet ventilation on the function respiratory and circulation of patients with Trachea and Carinal reconstruction.Methods Fifty patients with lung cancer,who were scheduled for elective trachea and carinal reconstruction,were intubated with double lumen tube following anesthesia induction and general anesthesia.High frequency ventilation was used on the healthful main bronchus during carinal reconstruction,a Hunsaker tube was inserted 3cm into the healthful main bronchus.HFTJV was applied with the respiratory rate of 120 /min,the ratio of inspiration and expiration E =1:1 and drive pressure of 0.2 -0.25Mpa.Blood gas analysis was made before the anesthesia,15 min following one -lung ventilation,10,20, 30 min following HFTJV and 15min following one -lung ventilation,respectively and monitor MAP,HR,SpO2 , PetCO2 .Results PaO2 in high frequency ventilation increased significantly compared with preoperative (78.0 ± 10.5)mmHg,was respectively (161.4 ±10.2)mmHg,(156.0 ±15.7)mmHg,(153.0 ±15.1)mmHg (P <0.01);PaO2 in high frequency ventilation 30min was (153.0 ±15.1)mmHg (P <0.05).It was lower than single lung venti-lation (front 165.50 ±11.3mmHg)and higher than 100mmHg equally;PaCO2 in the high frequency ventilation was slightly increased compared with OLV 30min (front),and the difference was not statistically significant (P >0.05). Conclusion HFTJV is safe and reliable for Trachea and carinal reconstruction.

Objective To explore the abnormal apoptosis and lupus nephritis pathology and disease activity relationship.Methods Forty patients with LN renal biopsy tissue, cell apoptosis with TUNEL method and counting cell apoptosis index ( AI) , application of SLE activity score ( SLEDAI) 2000 judged the disease activity, and correlation analysis.Results All patients of renal tissue apoptosis detection were positive, apoptotic cells in the glomerulus and renal tubules were scattered distribution, SLEDAI was posi-tively correlated with the AI ( r =0.38, P =0.029).Conclusions Cell apoptosis and remove obstacles exist in Patients with LN, the more the number of apoptotic cells, the more active SLE disease.

Insulinoma is a rare tumor derives from pancreatic islet B cells,the cause of etiology is unknown with insidious onset.Its clinical manifestations are of diversification,the high misdiagnosis rate with the low cure rate owing to the complex of pancreatic anatomy and the lack of effective localization diagnosis and differential diagnosis method for benign and malignant lesions,the treatment of insulinoma is still one of challenge in clinical application considering that some patients unable to tolerate surgery or unwilling surgery.In recent years there have been some new treatments except surgery,this review will introduce the some treatment methods of insulinoma for the moment.

The effective guarantee of the supply of low-price medicine in common use is of great significance for the protection of public health, the safeguard of social equality and the smooth progress of new healthcare reform. On the basis of the governance tools theory, the paper focuses on an analysis of approaches to combine and optimize the diverse utilization of governance tools in order to integrate the means of supply of the low-price medicine in com-mon use. In other words, the paper utilizes the ‘Voluntary-Directive-Mixed’ governance tools framework to provide possible solutions for the supply of low-price medicine in common use, namely, the locations of the voluntary tools ( household and community, volunteers, and market) , the directive tools ( government command-control regulation, establishment of public enterprises, and direct provision) , and the mixed tools ( information disclosure and advice, subsidies, auctions of property rights, tax and user charge) . Lastly the paper proposes specific policy suggestions in four aspects to confirm the total strategy of guaranteeing the supply of low-price medicine in common use:clever use of price leverage, improvements to procurement methods, establishment of an information disclosure system for medi-cine price, and a confirmation of government subsidies and industrial policy strategies.

Tumor metastasis to sentinel lymph nodes represents the first step of tumor dissemination in most human cancers and serves as a major prognostic indicator for disease progression.Recent studies have revealed that tumor lymphangiogenesisis correlated with lymph node metastasis in experimental cancer models and in several types of human Cancers.Metastatic tumor cells may continue to promote lymphatic vessel growth even after their metastasis to sentinel lymph nodes,likely promoting further cancer spread.Vascular endothelial growth factor-C(VEGF-C)and VEGF-D are the first specific lymphangiogenesis factor identified,and a large number of clinical studies have shown a correlation between tumor expression of VEGF-C or VEGF-D and lymph node metastasis.Additional tumor lymphangiogenesis factors have been recently identifled,including VEGF-A.Importantly,blockade of the VEGFR-3 pathway by specific antibodies,by soluble receptor constructs,and by small molecule kinase iubibitors efficiently inhibits experimental tumor lymphangiogenesis and metastasis and might also represent a novel therapeutic avenue for the treatment of human cancers.

The author made a deep analysis to the enrollment situation in the College of Continuing Education, Henan University of TCM, in 2008. The analysis showed that the enrollment source of the undergraduate students is better than the junior college student; Enrollment source of the preponderance professions of TCM such as traditional Chinese medicine, Integrated Chinese and Western medicine, acupuncture and moxibustion and Tuina of Chinese medicine, and science of Chinese material medica is better than non-preponderance profession; The enrollment source of local city is better than other cities. Thus we advocate: paying adequate attention to the enrollment of undergraduate students, increasing the teaching level; setting up preponderance professions of TCM, highlighting characteristics of schooling ; digging enrollment source of local area, and expanding enrollment source from other cities.