Objective To investigate the expressions of gonadotropin-releasing hormone receptor(GnRHR)and epidermal growth factor receptor(EGFR) in gastric carcinoma and to explore its clinical significance.Methods The expressions of GnRHR and EGFR in 31 cases of gastric carcinoma were observed by SP immunohistochemical method and the method of in situ quantification.Results The GnRHR and EGFR positive immunoreactive substances were located in the tumor cells of gastric carcinoma,GnRHR 28 cases (90.32％ ),EGFR 15 cases ( 48.39％ ),the expression of GnRHR increased in accordance with histologic differentiation,well-differentiated 14 cases,moderately differentiated 9 cases,poorly differentiated 5 cases,the expression of EGFR decreased in accordance with its increasing degree of histologic differentiation,well-differentiated 3 cases,moderately differentiated 5 cases,poorly differentiated 7 cases,( P ＜ 0.05 ),and GnRHR was more obvious than EGFR in immunoreaction.Conclusion GnRHR and EGFR could be related to the pathogenesis and the development of the gastric carcinoma.

Objective To explore the effect and utilization of comprehensive treatment on intrahepatic recurrence after hepatic resection for hepatocellular carcinoma.Methods One and two year recurrent rate of 60 patients with hepatocellular carcinoma who underwent hepatic resection in a two-year follow up were analyzed retrospectively,control group 30 cases,comprehensive treatment group 30 cases.Results One and two year intrahepatic recurrent rate of comprehensive treatment is 13％(4/30)and 40％(12/30)respectively.The difference was statistically singnificant(x2=4.176,4.310,all P＜0.05).Conclusion The effect of comprehensive treatment on postponing intrahepatic recurrence after hepatic resection for hepatocellular carcinoma is obvious.

Objective:To assess the effect of basic fibroblast growth factor(bFGF) and chitosan(a water soluble derivation) on human periodontal ligament fibroblasts(HPDLFs). Methods:In vitro cultured HPDLFs of passage 5-7 were in culture medium only(group 1), or exposed to 10 ng/ml of bFGF(group 2), 10 ng/ml of bFGF combined with 0.2 mg/ml chitosan(group 3),10 ng/ml of bFGF combined with 2 mg/ml chitosan(group 4),0.2 mg/ml of chitosan(group 5) or 2 mg/ml of chitosan(group 6) for 5 days respectively. Cell proliferation was examined by MTT assay,alkaline phosphatase activity and osteocalcin synthesis were measured by AMP method and radioimmunoassay respectively.Results:Higher proliferation of HPDLFs was observed in group 2 and 3,higher alkaline phosphatase activity in group 5 and 6, and higher osteocalcin synthesis in group 3 and 4.Conclusions:bFGF combined with chitosan(0.2 mg/ml) may increase the proliferation of HPDLFs, stimulate HPDLFs to differentiate into osteoblasts.

Objective To investigate the effect of persistent hypoglycemia on the cerebral oxidative stress and matrix metalloproteinase-2 (MMP-2) activity of newborn rats and to explore the potential mechanism of hypoglycemia-induced brain injury of newborn.MethodsSeven-day-old rats were injected insulin subcutaneously to induce persistent hypoglycemia.Cerebral cortex,hippocampus and thalamus were collected after 36 hours' observation and stored in -80 ℃.Glutathione (GSH)and glutathione disulfide (GSSG) were detected by commercial kit and GSSG/GSH was calculated.MMP-2 activity was detected by gelatin zymography. The data were analyzed by t test,one or two-wayanalysis of variance and Pearson correlation analysis.Six rats were set as the normal glucose group. ResultsThirty-six hours after induction of hypoglycemia, the cerebral GSSG and GSSG/GSH of hypoglycemic pups elevated about 1.5 times higher than those of control group [GSSG:(15.89 ± 5.46) vs (6.15 ± 3.42) mg/g protein,t =3.704,P =0.004; GSSG/GSH:(5.58± 1.79) ％ vs (2.79±1.76) ％,t =2.712,P=0.022].The GSSG and GSSG/GSH in thalamus of hypoglycemia were significantly higher than those of control [GSSG:(15.93 ± 5.75) mg/g protein vs (5.03±5.14)mg/g protein,P＜0.05; GSSG/GSH:(6.50±3.25) ％ vs (2.41±3.12) ％,P＜0.05],whereas there were no significant differences in the cortex ard hippocampus.The total MMP-2 activity of hypoglycemic animals (2.22±0.59) was significantly higher than that of control (1.21± 0.17)(t=4.064,P=0.002),and significant differences were found between the two groups in cortex (2.14 ± 0.5 vs 1.17± 0.27),hippocampus (2.31± 0.72 vs 1.22 ± 0.37) and thalamus (2.22±0.68 vs 1.24±0.18) with all P＜0.01].The activity of MMP-2 was positively related to GSSG (r=0.575,P=0.0002) and GSSG/GSH (r=0.484,P=0.0003).ConclusionsOxidative stress might play an important role in the persistent hypoglycemia induced brain injury of 7-day-old rat pups and thalamus might be most vulnerable to hypoglycemia.Hypoglycemia might also elevate MMP-2 activity which is positively related to GSSG level and GSSG/GSH of the brain.

Objective To assess the prevalance and distribution of pain in Parkinson' s disease (PD) patients, and to describe the relationship between pain and development of disease and its impact on the quality of life. Methods 113 PD patients were assessed with Visual Analog Scale (VAS), Brief Pain Inventory (BPI), Unified Parkinson' s Disease Rating Scale (UPDRS), Hoehn-Yahr Scale (H-Y), Hamilton Anxiety and Depression Scale (HRSD, HAMA) and Pittsburgh Sleep Quality Index (PSQI). Patients were divided into no pain group, PD-pain group and non-PD-pain group. PD-pain group was divided into PD-pain direct group and PD-pain indirect group. And statistical analysis was performed for each group. Results The incidence of PD-pain was 42. 5% (48/113). And compared with no pain group, PD-pain group had earlier age at onset of disease, longer duration, higher HAMA, HRSD, UPDRS and H-Y score, higher daily L-dopa dose, with statistical significance. Compared with non-PD pain group, the differences in the onset of age (57.4±9.6 vs 65.9±8.7, t= -2.596, P =0.012), HRSD(12. 9±7.9 vs 8.7±3.7, t =2.605, P=0.014) and VAS (61.6±25.9 vs 38.0 ± 30. 1, U = -2.290, P =0.022) were also statistically significant. BPI was different between PD-pain direct group and PD-pain indirect group except normal work and relations with other people. Conclusion Pain is frequent in Parkinsonian population. Most pain was chronic and related to PD (PD-pain). These patients always have earlier onset age and poorer quality of life.

Objective To evaluate the Laparoscopic combined fiber choledochoscope common bile duct cho-lelithotomy for my own clinical experience in rencent five years.Methods Clinic data of 25 cases with choledocholi-thiasis undergoing laparoscopic common bile duct cholelithotomy from June 2010 to March 2014 were retrospectively analyzed.Results The operation was performed successfully in 24 cases,a case conversions to laparotomy,21 cases with T-tube drainage,3 cases with primary ductal submucosa closure.The operative time was 105 to 305min,mean (184.0 ±12.2 ) min, postoperative hospitalization time was 6 to 10 day, mean ( 7.7 ±0.2 ) day, a case residual stones,no bile leakage.Conclusion The beginning of Laparoscopic combined fiber choledochoscope common bile duct cholelithotomy,one-stage suture of common bile duct should be selected carefully, timely transfer laparotomy, should not aim for laparoscopic surgery success rate.

Objective To explore the effect of the team of diabetes care specialists on the management of blood glucose for clinical nurses. Methods The hospital formed a team of diabetes care specialists , they designed a questionnaire of the diabetes care then surveyed the clinical nurses. According to the survey, the team organized the training program for 2 months and compared the result of the training. Result The differences of these five dimensions between before and after training were statistically significant (P﹤0.05). Conclusion The training can greatly improve the monitoring and management of blood glucose critical values and the technical of diabetes nursing.

Objective To investigate the cognition of the monitoring and management of blood glucose critical values among clinical nurses. Method Totally 112 clinical nurses from 28 departments of the hospital were involved in the investigation with a self-designed questionnaire. Results The average score on monitoring and management of blood glucose critical values was (79.69 ± 14.12). 53 nurses (47.32%) were at a medium or lower level. There were significant differences in the scores among the nurses of different age, work experience, education level and professional title (P<0.05). Conclusions The clinical nurses have inadequate knowledge about the monitoring and management of blood glucose critical values. The hospital administration should carry out various training methods for nurses to improve their ability in nursing diabetic patients.

Objective To explore exenatide in the treatment of metformin(MET)alone,sulfonylurea (SU)alone or MET + SU combination therapy with poor glycemic control in type 2 diabetic pa-tients and to find effective nursing measures.Methods 24 patients were randomly divided into the con-trol group and the exenatide group with 12 patients in each group.In the exenatide group,exenatide 5μg twice a day for 4weeks,then 10μg twice a day for 12 weeks.Changes of HbAlc,body weight,BMI,FBG,P2hBG,and rate of adverse reaction were compared between two groups.Results Glycosylated hemoglobin (HbAlc),body weight,BMI,FBG,P2hBG in the control group before and after treatment showed no significant difference,while the exenatide group showed better results compared with those before treatment and the control group.Nursing intervention played evident effect on reducing adverse effect such as nausea,vomiting,diarrhea,low blood sugar,headache.Conclusions For patients with type 2 diabetes,using MET,SU alone or MET + SU combination therapy showed poor results of blood sugar control,addition of exenatide therapy can effectively control blood sugar,nursing intervention can significantly alleviate the adverse effects of patients.

Objective To study the incidence of rapid eye movement sleep behavior disorder (RBD) and its impact on the clinical manifestations of patients with Parkinson' s disease (PD). Methods One hundred and twenty-four PD patients were included into this study and each of them was given the non motor symptoms questionnaire (NMSquest) to investigate the incidence of RBD. The PD patients were then divided into the RBD group and non RBD group, according to their answers to the NMSquest. Then the clinical differences were investigated between PD patients with and without RBD on the aspects of demographic characters, Hoehn-Yahr (H-Y) stage, the scores of Unified Parkinson Disease Rating Scale (UPDRS) sub-items, the incidence of non motor symptoms, and the dysfunctions of non motor systems (cognitive impairment, anxiety, depression and sleep disorders ). The evaluation tools of non motor functions include Mini Mental State Exam ( MMSE), Hamilton Depression Scale (HAMD), Parkins' s Disease Sleep Scale (PDSS) and Epworth Sleepiness Scale (ESS). Results ( 1 ) 62.9% (78/124) of the PD patients have been experiencing RBD. (2) The course of the disease in RBD group ( 3.8 ± 2.8 ) was significantly shorter than non RBD group (5.0 ± 2.5, t = - 1. 972, P = 0. 048 ) while the sex, age, onset age and the mode of onset, Levodopa dose equivalents (LDE) and the kinds of medicines showed no difference between the two groups. (3) H-Y stage, the scores of UPDRS sub-items and the incidence of motor complications showed no difference between RBD and non RBD group. (4) Most of the non motor symptoms, including the gastrointestinal dysfunctions, autonomic dysfunctions, mood disorders and sleep disturbances, occurred much frequently in RBD group, however, the scores of MMSE, HAMD, HAMA,PDSS and ESS showed no difference between the RBD and non RBD group. Conclusion RBD commonly occurred in PD patients, and PD patients with RBD have a tendency to suffer from dysfunction of non motor systems.