Autophagy is a lysosomal degradation of intracellular material composition,and plays an important role in nerve cell survival and clear senescent cells and misfolded proteins.Autophagy can protect nerve cells,but also can be used as one of the ways about nerve death.Repeated seizures can cause brain damage,but the specific mechanism is not clear.Recent studies have shown that,convulsion can activate apoptosis pathway and start autophagy,which can mediate the adaptation,injury or apoptosis of neurons.Convulsion brain injury is closely related to cell autophagy.Autophagy as a new important signaling pathway can provide a new therapeutic direction of convulsion brain damage.

Objective To study the clinical effect of nerve stimulator combined with low back piexus sciatic nerve block for the arthroscopic surgery anesthesia. Methods 86 patients who required the arthroscopic surgery from March 2010 to March 2013 in our hospital were randomly divided into observation group (43 cases) and control group (43 cases). The observation group accepted nerve stimulator combined with low back plexus sciatic nerve block under the arthroscopic surgery;the control group adopted waist hard joint anesthesia during the arthroscopic surgery. Data of hemodynamics, effects of anesthesia, anesthesias maintaining time, rehydration fluids and adverse effect in both groups were recorded and compared. Results The time for preparation and control of anesthesia operation (Tr), time for feeling completely block (T1), time for recovery (T2), time for completely blocking (T3), time for movement recovery (T4) in observation group were significantly shorter than that of the observation group (P<0.05); the first time of urination (Tu) after operation was significantly longer in control group than that in the observation group (P < 0.05); MAP in the control group were lower than that in the observation group 20 minutes after anesthesia (T20,P < 0.05); complications in the control group were more frequent than that in the observation group. Conclusion The clinical effect of nerve stimulator combined with low back plexus sciatic nerve block for the arthroscopic surgery anesthesia is more obvious , especially for patients with relatively long operating time.

Objective To develop a fair performance appraisal method for clinical departments,as a reference for grading performance pay.Methods Ridit method with consideration of medical risks is used to evaluate clinical departments'performance.Results Both quality of care and medical risk are graded and overlaid,to arrive at the comprehensive values on which the performance pay is divided into grades Ⅰ,Ⅱ,Ⅲ,and Ⅳ.In this practice,values 7 ~8 is grade Ⅰ,6 grade Ⅱ,4 ~ 5 grade Ⅲ,and 2~3 gradeⅣ.Conclusion A fair and justifiable department performance evaluation system that is based on performance proves vital for the sustainable development of the hospital. Ridit method with consideration of medical risk evaluation advocates the performance appraisal principle of encouraging better performance,high risk and high efficiency.

Based on the "requirements on the submitted documents for consistency evaluation of generic oral solid dosage forms of chemical drugs" and relevant guidance, this article summarized and formulated the decision tree of in vitro consistency evaluation of oral solid generic drugs, discussed the differences and common problems of in vitro evaluation research projects under different conditions, selective analyzed the technical requirements and concern problems of unconventional research projects, and proposed corresponding recommendations for concern problems, in order to provide more references for the follow-up study on consistency evaluation of oral solid generic drugs.

With the rapid growth of incidence of non-small cell lung cancer (NSCLC),more and more studies have been made about its occurrence,development and metastatic mechanism m recent years.Researches about Fas/FasL protein expression and Fas/FasL-mediated apoptosis,immune escape mechanism and their roles in the pathogenesis,progression and prognosis of lung cancer are constantly emerging.Discussion about the roles of Fas/ FasL system in NSCLC could provide evidence for early diagnosis,prognosis prediction and new treatment of NSCLC.

Objective To evaluate the clinical effect of cluster nursing measures and conventional nursing measures to prevent the ventilator associated pneumonia.Methods The domestic related literatures were searched using computer,and the results underwent comprehensive analysis according to RevMan 5.2 in the Cochrane collaboration.The quantitative comparison of two different nursing measures in reducing the incidence of ventilator associated pneumonia was conducted.Results A total of 23 articles which contained 6 146 patients met the inclusion standard.Due to heterogeneity between the included studies,the random effects model analysis was adopted to merge the RR combined (Total)=0.46,95％ CI(0.38,0.56),showed that cluster of nursing measures to significantly reduce the incidence of ventilator associated pneumonia.Conclusions The effect of cluster nursing measures for ventilator associated pneumonia prevention is superior to the conventional nursing measures,which should vigorously be advocated in clinic.

Objective To conduct the performance verification of the Stago STA-R automatic blood coagulation analysis system once every year to evaluate the analysis system for ensuring its accuracy and reliability .Methods According to the related docu-ments of the Clinical and Laboratory Standards Institute (CLSI) ,5 items of prothrombin time (PT ) ,activated partial clotting en-zyme live time (APTT) ,thrombin time (TT) ,fibrinogen (Fib) and antithrombin Ⅲ (ATⅢ) were selected to conduct the verifica-tion and preliminary evaluation on the accuracy ,imprecision ,carry-over rate ,linearity range and reference interval of the instrument analysis system .Results The relative bias(SE% ) of accuracy in each item was less than 5% .The intra-batch and inter-batch im-precisions (CV) were less than 3% and 5% respectively .The carry-over rates were within 4% .The linearity of Fib and AT Ⅲ was very well ,r2 were 0 .9980 and 0 .9979 respectively .Validated reference interval was consistent with quotative reference range . Conclusion The Stago STA-R automatic blood coagulation analysis system has good analytical performance ,can provide accurate and reliable test results for clinical doctors .

Objective To investigate the turnover and factors influencing amniotic membrane transplantation into corneal stroma.Methods Amniotic membrane stained with dichlorotriazinyl aminofluoresclin (DTAF)was implanted into the corneal stroma of 1 5 New Zealand white rabbits.After transplantation,we observed the clinical changes.The tissue samples from grafted area were observed with HE staining and laser confocal microscope to trace amniotic membrane at 4,8,13,1 7 and 22 week after surgery.And the tissue samples at week 22 after surgery from grafted area were also observed by transmission electron microscopy.Results After 4 weeks of operation, amniotic membrane tissue bent with visible multi-layer homogeneous red dye.The structure remained intact;basement membrane and stroma were no dissolved.After 8 weeks, amniotic tissue was a strip structure of homogeneous red dye,and the substance layer was complete.After 13 weeks,amniotic membrane morphology appeared fuzzy,but still took the shape of strips;a small number of corneal cells accumulated around the amniotic membrane.At 1 7 weeks after operation,fragmented amnion was evident.At 22 weeks after operation,small pieces of amnion tissue remained in the corneal stroma.Laser scanning confocal microscopy revealed that amniotic membrane could retain for over 22 weeks in the corneal stroma.After 22 weeks,amnion stroma collagen fibers that were integrated into the corneal stroma were irregular.Corneal stromal ultrastructure surrounding the amniotic membrane did not obviously change.Conclusion Retention time of amniotic membrane transplanted into corneal stroma can be as long as over 22 weeks and amniotic membrane can be merged into the corneal tissue as a substitute, which wins time for corneal transplantation operation.

Objective To explore the clinical efficacy of nasal irrigation for pediatric chronic sinusitis. Methods 92 children with chronic sinusitis were selected and randomly divided into treatment group(48 cases) and control group(44 cases) .The two groups were treated with routine clinical basic drugs,and the treatment group took nasal irrigation in addition.The efficacy after 1 month was compared, and then the patients were followed up for 3 months.Results The total effective rate of the treatment group was 91.7% after 1 month,which of the control group was 72.7%.After 3 months,the total effective rate in treatment group was 95.9%,which of the control group was 86.4%.There were statistically significant differences between the two groups in treatment outcomes( P=0.024, 0.011) .Conclusion The therapeutic effect of nasal irrigation for pediatric chronic sinusitis is obvious, safe and reliable.

This article selects chronic disease management research of academic literatures published in the national library in PubMed database from January 2000 to December 2013.Literature Bicomb co-occurrence analysis system was used for data extraction,analysis on the current international research achievements of chronic disease management,development situation and existing problems,reveal the research trend of chronic disease management and the status quo,which provided reference for the similar domestic research.