The paper investigates 31 foreign representative clinical knowledge base,analyzes development status including the establishment and maintenance institutions,user version control,localization application,clinical evidence resources,clinical specific content representation,evidence quality evaluation criteria and so on,summarizes revelation for domestic clinical knowledge base construction.

In vitro fertilization and embryo transfer(IVF-ET) technology is one of the important means to treat infertility in recent years,although it had made remarkable progress in the field of reproductive medicine,but IVF-ET pregnancy success rate is not very ideal,the reasons that influent the success of IVF-ET include both parents donor of various unfavorable factors and stimulate ovulation itself produces all sorts of malpractices,its influence factors are complicated.In recent years,how to reduce the adverse factors affecting IVF-ET,to improve the success rate of pregnancy of IVF-ET has become the hot topics in the study of domestic clinical intervention in IVF-ET,and the domestic research shown that the quality of the follicle and endometrial environment is the key to determine the success of IVF-ET.

Sentinel lymph node biopsy has been proved to be the standard treatment for early breast cancer patients with negative axillary lymph node. The study related to the tracer has become one of the hottest topics in breast cancer research. At present, the biopsy is often performed using the tracer of isotope, blue dye or both of them. However, some deifciencies of the 2 tracers restrained their applications, which resulted that the rate of the procedure is limited to only about 60% of patients in developed countries and less than 5% of patients in China and other developing countries. In recent years, a variety of new tracers have emerged, such as indocyanine green, contrast-enhanced ultra-sound using microbubbles, superparamagnetic iron oxide nanoparticles. In this article, we introduced the characteristics of these 3 substances and reviewed the related research on the new tracers. In conclusion, the new tracers are still in the preliminary stage of research, and further research is needed for clinical application.

Objective To explore the C-type fixation in the application of the catheter tunnel peritoneal dialysis. Methods One hundred and twenty patients undergoing peritoneal dialysis were selected from January to December 2014 in Xijin Hospital and were randomly divided into the control group and experiment group. The peritoneal dialysis catheters of the control group were fixed vertically at the tube orifice with surgical tape, while the peritoneal dialysis catheters of the experiment group were fixed horizontally first and then placed with a shape ofC and fixed at the tube orifice with surgical tape. The two groups were compared in terms of tunnel score, infection, tube shedding and pulling-induced stimuli. Result The tunnel score and the cases of infection rate, tube shedding and pulling-induced stimuli in the experiment group were lower and fewer than those of the control group with statistical significance (all P <0.05). Conclusion The type C fixation of tube for peritoneal dialysis can effectively reduce the incidence of infections in patients with peritoneal dialysis tunnel, reduce pulling-induced stimuli, and improve comfort of the patients.

Gastric neuroendocrine neoplasms (G- NEN) is a type of relatively rare and heterogeneous tumors mainly derived from enterochromaffin-like cells (ECL-cells) localized in the gastric mucosa. The incidence of G-NEN has increased over the past few decades, which may contribute to factors such as improved clinical and pathological experience in diagnosing this disease, as well as increased access to endoscopy. The biological behavior, clinicalpathological features and treatment response of G-NEN are different from those of pancreatic or intestinal neuroendocrine neoplasms. The diagnosis of G-NEN mainly depends on endoscopy and pathology. Conventional imaging and somatostatin receptor imaging may help to diagnose the disease stage. Treatment requires a multidisciplinary approach that may include endoscopic resection, surgery, chemotherapy, somatostatin analogues, intervention, PRRT, etc. The present study reviews the relevant guidelines in combination of our experience and research and aims to elaborate the epidemiology, clinical classification, diagnostic modalities and treatment options.

Humans ; Hypertension ; Occupational Diseases ; Stress, Psychological

BACKGROUND:Although increasing studies have shown that autologous bone marrow stem celltransplantation can treat myocardial infarction, but there is a lack of large-scale multi-center randomized control ed trials to il ustrate the therapeutic effectiveness of autologous bone marrow stem celltreatment for myocardial infarction. OBJECTIVE:To systematical y evaluate the improvement of heart function in patients with myocardial infarction undergoing autologous bone marrow stem celltransplantation. METHODS:Cochrane Central Register of Control ed Trials (Central), MEDLINE, EMbase, PEDro (www.pedro.org.au), OpenSIGLE, National Technical Information Service (NTIS), CNKI, VIP database (VlP), Wanfang Data and Chinese biomedical literature database (CBM) were searched for the randomized control ed trials addressing bone marrow stem celltransplantation for heart function in patients with myocardial infarction. The bibliographies of the included studies were also searched. The time span was from database establishment to November 2012. The extracted data were analyzed by RevMan5.1. RESULTS AND CONCLUSION:A total of 14 randomized control ed trials were included. Results from the meta-analysis showed that the ejection fraction and cardiac output of patients undergoing bone marrow stem celltransplantation was significantly different from those of patients without celltransplantation (WMD=5.23, 95%CI (0.73, 9.72), P<0.01;WMD=1.69, 95%CI (1.23, 2.16), P<0.000 01). Current evidence has demonstrated that bone marrow stem celltransplantation can remarkably improve the ejection fraction and cardiac output of myocardial infarction patients, which can be clinical y recommended for improvement of heart function. Due to the limitations of the included studies, more large-sample, multi-center high-quality randomized control ed trials are required to further verify the therapeutic methods and effectiveness.

Objective To determine postoperative resting energy expenditure ( REE) in children with congenital heart disease ( CHD) requiring open heart surgery , to compare measured resting energy expenditure (MREE) with current predictive equations (PEE), and to investigate the possible influencing factors on the metabolic status of the postoperative CHD children .Methods From February 2015 to June 2015 , 150 ventila-ted children admitted to the cardiac intensive care unit after surgery for congenital heart disease in Shanghai Children's Medical Center were enrolled consecutively .Indirect calorimetry ( IC) measurements were performed using metabolic cart 4 hours after surgery .General clinical data were recorded .Results Totally 104 male and 46 female patients were enrolled, with a median age of 14 months (8.3-36.0 months).The non-protein re-spiratory quotient of patient was 0.79 ±0.20, MREE was (264.76 ±61.74) kJ/(kg· d), and PEE using Schofield equations was (278.51 ±93.42) kJ/(kg· d).Although there was no significant differences (P=0.096 ) between MREE and PEE , the agreement was poor between them ( R2 =0.119 ) .Multivariate stepwise regression analysis showed that MREE had significant positive correlation with risk adjustment in congenital heart surgery (RACHS-1) score (P=0.012) and negative correlation with age (P=0.010).Up to 97.33%of children (146/150) had lower energy intake compared with MREE on the 1st postoperative day .Conclu-sions MREE does not increase after surgery in CHD children;however , the substrate utilization is influenced . Factors influencing the postoperative REE include RACHS-1 score and age.The energy intake at 1st day after surgery is generally lower than REE in these children .

Objective To evaluate the effect of Jian Pi Bu Shen prescription on inflammatory factors and iron metabolism in the brain of T2DM model mice.Methods A total number of 30 healthy 12-week-old male mice were used in the present study.The groups were randomly assigned to one of the following experimental groups:(1) control group:n=5,the mice were maintained on a normal diet for 4 weeks;(2) model group:n=25,the mice were maintained a high fat diet for 4 weeks.Then,the mice were deprived of food for 12 hours before a single intraperitoneal injection of streptozotocin (STZ,30 mg/kg).Then,the blood glucose levels were measured randomly 3 times within 24 hours after injection.The mice whose blood glucose was less than 16.7 mmol/l would receive another single intraperitoneal injection of STZ.Finally,we got a total number of 19 mice meeting the criteria of animal model we described above.The final 19 mice were randomized to 2 groups:diabetes group (n=10)and Jian Pi Bu Shen (JPBS) group(n=9).JPBS group received gavage administration of JPBS Prescription 7.4 g/kg/d(8weeks).Diabetes group and control group were maintained treated with saline for 8 weeks.Mice were decapitated 24 hours after the last drug treatment.The mice brain tissue slices were prepared for pathological observation.To examine the effects of JPBS prescription on neuroinflammation and iron metabolism in cerebrum and hippocampi,the relative mRNA levels of IL-6,IL-1β,DMT1,FPN1 and CP were tested by RT-PCR.Results mRNA levels of IL-6,IL-1β and DMT1 in the brains of diabetes group were higher while the levels of FPN1 and CP were lower than that of the control group (P＜0.01).Compared with diabetes group,in JPBS group,mRNA levels of IL-6,IL-1β and DMTl in cerebrum and hippocampi were decreased while the levels of FPN1 and CP were increased (P＜0.01).The brain tissue slices of diabetes group showed neuron loss and signs of neurodegeneration.But JPBS group attenuated neurodegenerative change.Conclusion JPBS prescription can protect neuron from apoptosis,suppress neuroinflammation and attenuate iron metabolism,which may be one of the mechanisms of traditional Chinese medicine in treating cognitive dysfunction.

A cadmium column reduction-azo dyes spectrophotometric method based on micro sequential injection lab-on-valve was established for the determination of total nitrogen in seawater. The experimental parameters were optimized, and the interference experiment was carried out. The results showed that the interference of the main components and salinity in sea water could be eliminated by using a series of standard solution prepared by national standard seawater with certain salinity. The concentration of total nitrogen in seawater was linear with the absorbance in the range of 0 . 03-1 . 00 mg/L with a correlation coefficient of 0. 9993. When determining the national standard seawater at nitrogen concentration of 0. 20 mg/L, the relative standard deviation (RSD) was 4. 9%, the detection limit was 0. 010 mg/L, and the recoveries were 99. 5%-101 . 1%. There were not significance differences between the results of this method and national standard method in the t-test analysis. The method is suitable for the determination of total nitrogen in seawater.