Gastroenteropancreatic neuroencrine tumors (GEP-NETs) originate from the neuroendocrine cells of the digestive system.Over the past few years,the incidence has increased gradually.The clinical manifestations are diverse,and the related molecular mechanism is also more complex.Although there are more and more basic researches for GEP-NETs,the mechanism for carcinogenesis and metastasis has not been fully elucidated.This paper summarizes the latest progress on the development of GEP-NETs,and elaborates the new findings on tumor molecular mechanisms,mainly including the related receptors and its signaling pathways,gene mutations and epigenetic changes.

BACKGROUND:Pedicle screw implantation is a common method to repair various spinal diseases, but there is a big difficulty in the safety and accuracy of screw placement. OBJECTIVE: To explore the effects of spinal pedicle screw implantation in the implementation of image guidance. METHODS:A retrospective analysis was performed on clinical data of 118 cases of pedicle screw implantation in the Luohe Hospital of Traditional Chinese Medicine from December 2010 to December 2013. They received internal fixation with pedicle screws. They were equaly divided into two groups according to guidance method. Observation group underwent three-dimensional imaging of spinal navigation. Control group received conventional X-ray fluoroscopy. Screw placement and repair-related indexes were observed in the two groups. After implantation, they were folowed up for 1-12 months. Postoperative complications were compared in both groups. RESULTS AND CONCLUSION: 59 patients in the observation group were implanted with 325 screws, and 59 patients in the control group were implanted with 319 screws. In the observation group, the excelent and good rate was 95% (319 screws). In the control group, the excelent and good rate was 78% (250 screws). There were significant differences in the excelent and good rate between the two groups (P < 0.05). The time required in screw placement was significantly shorter in the observation group than that in the control group (P < 0.05). Operation time and the intraoperative bleeding were significantly better in the observation group than in the control group (P < 0.05). The incidence rate of postoperative complications was lower in the observation group than in the control group (P < 0.05). These data suggest that under the guidance of three-dimensional imaging of spinal navigation, spine pedicle screw fixation can effectively shorten the time required for screw placement, improve the accuracy of implantation, and reduce the occurrence of postoperative complications.

Objective:To provide some suggestions for improving the pharmaceutical advertisement supervision system and standardizing the pharmaceutical advertisement market. Methods: Literature reviews, statistical analysis and interviews were adopted to study the status quo and difficulties of pharmaceutical advertisement supervision and pharmaceutical advertisement trends. Results:The top-level design of pharmaceutical advertisements supervision sys-tem has two defects:the separation between approval and penalty and the obstacles to cooperation at all levels of the drug administration. The worsening status quo of illegal drug advertising has elicited concern from scholars and regu-lators. However, there are still some difficulties in the supervision of drug advertisers, advertising agents, and pub-lishers. Conclusion:It is suggested that the drug advertising regulation system should be perfected by strengthening information supervision, establishing a coordination mechanism and consolidating self-discipline consciousness. Addi-tionally, laws and regulations should be promptly revised as an essential way to improve the effects of supervision.

One hundred and sixty-two low back pain cases due to intervertebral disc problem were treated by puncturing 30 mm in depth with even reinforcing and reducing manipulation on Jiaji points (Ex-B 2) in the lumbar area plus patterned oral herbal decoction, Tao Hong Siwu Decoction. The result showed that 65 cases got marked effect, 53 cases got good effect, 37cases got certain effect, 6 cases got no effect and the total effective rate was 96.3%.

Objective:To investigate the effect of occupation moral training for nursing students .Methods:By cluster sampling method , two nursing professional classes were included as the research objects .One class was re-garded as the experimental group .The other class was regarded as the control group .The various measures were taken to cultivate occupation moral .The teaching reform of nursing ethics was carried out .The occupation moral education was integrated into the specialty courses .The occupation moral education was strengthened in clinical practice stage .After the culture period , two groups′nursing ethics knowledge was tested .Their satisfaction on oc-cupation moral cultivation effect was surveyed .The hospital satisfaction on their occupation morality level and qual-ity was surveyed too .The occupation moral cultivation effect was evaluated through these .Results: The experi-mental group′evaluation score of nursing ethics knowledge , the satisfaction rate of occupation moral cultivation effect , teaching hospital′satisfaction rate of occupation moral standards and quality were higher than those of the control group with a significant difference (P<0.05).Conclusion:The construction of occupation moral educa-tion system effectively improves the occupation moral level and comprehensive quality of nursing students .

Objective To investigate the clinical results and prognosis between proximal and total gastrectomy in proximal advanced gastric cancer.Methods The clinicopathological data of 221 patients with proximal advanced gastric cancer who undcrwent radical gastrectomy were retrospectively analyzed.82 patients and 139 patients underwent proximal and total gastrectomy respectively.The number of dessected lymph nodes,postoperative complications and mortality were compared.Kaplan-Meier survival rate curves and Log-rank test were drawn and compared.Results A total of 1 411 (11-34) and 3 345 (14-35) lymph nodes were harvested from the surgical specimens of 82 and 139 patients with proximal and total gastrectomy respectively,the average number of harvested lymph nodes was 17 ± 11 and 24 ± 10 (t =2.586,P ＜0.05).The overall complications in proximal gastrectomy were higher than total gastrectomy (73.2％ vs.30.2％,x2 =38.291,P ＜0.01).The ratio of functional delayed gastric emptying,anastomotic leakage and stenosis,reflux esophagitis in proximal gastrectomy patients was higher than total gastrectomy.The survival rate in proximal gastrectomy were lower than total gastrectomy in proximal advanced gastric cancer (P ＜0.01).Conclusion Total gastrectomy is recommended for proximal advanced gastric cancer.

Objective To explore the role and possible mechanism of transforming growth factor (TGF)-β autocrine in CDH17 regulating invasion of gastric cancer cells.Methods Construction and transfection of siRNA-CDH17 into MKN-45 gastric cancer cell line to silence the expression of CDH17.Expression of TGF-β and concentrations of TGF-β in supernatants were detected before and after CDH17 silence by immunofluorescence,immunoblotting and ELISA.The autocrine situation of TGF-β was observed.Meanwhile,the activation of TGF-β/Smad3 signaling pathway was also detected by immunoblot.After giving signaling pathway inhibitor,the changes of invasion ability of MKN-45 cells were observed by Transwell invasion experiment.The role of TGF-β autocrine and related signaling pathway activation in CDH17-regulated invasion of gastric cancer cells was evaluated.Results After transfecting siRNA-CDH17 for silencing CDH17 expression in MKN-45 cells,the expression of TGF-β was significantly decreased compared with non-transfection group,its concentration in supernatants was also significantly reduced[(510 ±55)pg/mL vs.(115±20) pg/mL,P<0.01].The immunoblots revealed that phosphorylation level of Smad3 after CDH17 silence was also significantly diminished.However,giving the TGF-β/Smad3 signaling inhibitor SIS3 (10 μmol/L) could also suppress the phosphorylation level of Smad3 when CDH17 was highly expressed,meanwhile silencing CDH17 and inhibiting Smad3 phosphorylation could significantly decrease the invasion of MKN-45 gastric cancer cells (P<0.05).Conclusion CDH17 could participate in the invasion of gastric cancer cells by promoting TGF-β autocrine to activate TGF-β/Smad3 signaling pathway.

OBJECTIVE:To evaluate the pharmacoeconomic(PE) efficacies of three therapeutic schemes in the treatment of community acquired pneumonia.METHODS:By applying the principle of decision tree analysis in pharmacoeconomics,a retrospective analysis and evaluation was performed on the following 3 therapeutic schemes:sequential therapy of levofloxacin hydrochloride injection,cefuroxime sodium for injection by iv gtt,and azithromycin for injection by iv gtt.RESULTS:The total costs of the three schemes were 4 327.56 yuan,5 327.32 yuan,and 5 074.14 yuan,respectively,and the total effective rates were 89.80%,88.80%,and 85.29%,respectively.The anticipant costs for each cured case of community acquired pneumonia were 3 886.15yuan,4 730.66yuan,and 4 327.73yuan,respectively.CONCLUSION:The sequential therapy of levofloxacin hydrochloride injection is the optimal one among the 3 schemes.

OBJECTIVE:To study the bioequivalence between cefadroxil capsules and its reference capsules and pharmacokinetics in 22 male healthy volunteers METHODS:A dose of 1 000mg cefadroxil(test and reference products)was given according to a randomized cross-over design Plasma concentrations of cefadroxil and internal standard(amoxicillin) were determined by HPLC RESULTS:The concentration-time curves of both preparations fitted to a one-compartment model The main parameters of test and reference products were as follows:T1/2ke were (1 40?0 15)h and (1 44?0 23)h;Tmax were (2 3?0 5)h and (2 2?0 3)h;peak concentrations(Cmax) were (30 59?4 25)?g/ml and(30 57?4 24)?g/ml,AUC were(99 31?14 50)?g/(ml?h) and (99 22?15 11)?g/(ml?h)respectively CONCLUSION:Relative bioavailability was(100 42?7 62)% The two formulations were bioequivalent

Objective To investigate the capabilities of Plasmodium microscopic examinations of professional staff in medi-cal institutions in Wuxi City,so as to provide evidences for improving malaria control and elimination work in the future. Meth-ods The data of questionnaires for laboratorial staff in charge of Plasmodium microscopic examinations were collected and ana-lyzed in the medical institutions in Wuxi City in 2016,and the influencing factors related to the capabilities of Plasmodium mi-croscopic examinations were analyzed by the method of logistic regression. Results Totally 54 laboratorial workers in 54 medi-cal institutions in Wuxi City were investigated,16 of them were male,and 38 were female,and the ratio of male to female was 0.42:1. Among the 54 laboratorial workers,12 persons(22.22％)had the experience of detecting Plasmodium in the work. The multivariable analysis showed the ability to detect Plasmodium was associated with male laboratorial workers(adjusted OR =0.11,95％CI:0.02-0.53),laboratorial workers with intermediate or higher professional titles(adjusted OR=5.31,95％CI:1.04-27.19)and laboratorial workers from county and township medical institutions(adjusted OR=0.04,95％CI:0.01-0.98). Conclusions All of the medical institutions in Wuxi City have the capability of microscopic examinations of Plasmodium. How-ever,the ability of laboratorial staff in primary hospitals still should be improved.