Objectives:To evaluate serum ?-HCG and VEGF concentrations in women with rupture of tubal pregnancy(rTP),tubal abortion(TA) and spontaneous abortion(SA) at about 6 weeks of gestation.Methods:This was a prospective,case-control study evaluating serum ?-HCG and VEGF concentrations among 63 women with the symptom of abdominal pain or vaginal bleeding who subsequently were confirmed rTPs(n=21),TAs(n=14),SAs(n=27).One suspected TP proved to be normal intrauterine pregnancy and was excluded.?-HCG,and VEGF were measured by RIA and ELISA methods respectively.Results:The median ?-HCG concentrations in rTPs and TAs were statistically higher than that in SAs(3070.70?1069.68,2632.21?840.60,1674.05?727.88mIU/ml respectively,P1 880 mIU/ml,serum ?-HCG could discriminate TPs from SAs with a sensitivity of 88.6%,a specificity of 66.7% and a positive predictive value of 77.5%.The median VEGF concentration in rTPs was statistically higher than that in TAs and SAs(254.87?78.52,105.81?38.11,118.32?52.94 pg/ml respectively,P179pg/ml,serum VEGF could discriminate rTPs from TAs with a sensitivity of 85.7%,a specificity of 100% and a positive predictive value of 100%.Conclusion:It is a useful marker that the combined measurement of serum ?-HCG and VEGF predicts the rupture of tubal pregnancy at about 6 weeks of gestation.

Objective To systematically evaluate the effectiveness of using gargle solution Chlorhexidine Gluconate for patients with mechanical ventilation in ICU.Methods The randomized controlled trials (RCTs) on the application of gargle solution Chlorhexidine Gluconate for patients with mechanical ventilation in ICU were collected through the databases such as the China National Knowledge Infrastructure (CNKI),China Scientific Journal Database by VIP (VIP) and Wanfang Database.The quality of studies was critically appraised and data were extracted by two reviewers independently.Meta-analysis was conducted for the included studies.Results Eleven RCTs involving 1 337 patients were included.Meta-analysis showed that the application of gargle solution Chlorhexidine Gluconate for patients with mechanical ventilation in ICU could reduce ventilator-associated pneumonia (VAP) incidence rate[RR=0.54,95％CI(0.44-0.65),P ＜ 0.01],shorten the duration of mechanical ventilation [mean differences(MD)=-2.38,95％CI(-2.69--2.07),P ＜ 0.01] and length of ICU [MD=-3.66,95％CI (-5.45--1.87),P ＜ 0.01],but the mortality rate was not statistically significant [RR=0.37,95％CI (0.11-1.26),P ＞ 0.05].Conclusions The application of gargle solution Chlorhexidine Gluconate for patients with mechanical ventilation in ICU is safe and effective.

Given the unlimited proliferation and aerobic glycolysis in tumor cells, these cells require more glucose, glutamine, and other nutrients compared with normal cells. Tumor cells are often affected by insufficient nutrient supply. However, by sensing changes in the nutrient supply in tumor microenvironment and by regulating signal-transduction pathways, some specific proteins can help tumor cells in blocking the cell cycle, reprogramming metabolism, and regulating autophagy to progress and survive against nutri-ent stress. Exciting innovations have been made to elucidate the mechanisms relevant to this process. This review aims to highlight re-cent studies on the mechanisms of sensing the low nutrient supply in microenvironments, as well as the downstream effect factors in cancer cells.

Objective To study the half quantitative diagnostic method of the high-risk gastrointestinal stromal tumors (GISTs) with analyzing the characteristic of high-risk and lower risk GISTs with multi-slice spiral CT (MSCT). Methods CT findings of 46 patients with 51 GIST lesions were retrospectively analyzed. The location, size, shape, boundary, growth pattern and other specialties of the tumors in high-risk and lower risk GISTs were studied, moreover statistical analysis was conducted, logistic regression equation was obtained. Results Significant difference was found in tumors' location, size, shape, boundary and distant metastasis between the two types of GISTs. There were obvious correlation between the risk level and tumors' size and boundary which could be used to build the diagnostic equation of high-risk GISTs. Conclusion The equation ln [P/(1-P)]=-2.612X_3+0.371X_5 (X_3:tumors' boundary, X_5:tumors' size) is valuable in the diagnosis of high-risk GISTs.

This article elaborated on the importance of collecting archives of drug clinical trails. Taking the drug clinical trial archives into account, the first value is the effort of clinical researchers. Sec-ond, the archives of drug clinical trials are the requirement to obtaining the evaluation before the new drug projects are approved. Third, the archives are the important evidence as getting professional certification from relevant drug research organizations and governmental officials. Making good drug clinical archive man-agement depends on the system and relevant regulations. A system should clarify the responsibilities of the collectors and managers for the archival materials. It also should make clear what are needs for collection, the rule of project numbering, and the rule of transferring. A good system also establishes the functionalities of monitoring and controlling. Last, the article pointed out the usual problem appeared in archive manage-ment of drug clinical trials.

This paper discussed the deviation of the intellectual property strategy applied in hospitals. The deviation, which is reflected on excessive enthusiasm and over-evaluation on research publication on the one hand, and negligence and insufficiency in the protection of whereas relevant patents and technique (commercial) secrets on the other hand. This deviation in the management can impede the hospital development in the long run. Measures should be taken to tackle this problem, which includesis, increasing the awareness, building up stimulation system, improving hospital cultural atmosphere, and training specialized administrators.

Objective To explore the pathological and imaging features of adenosquamous carcinoma (ASC) of pancreas.Methods Both clinical data and imaging findings in seven cases with pathologically proved ASC of pancreas were analyzed retrospectively.Imaging features were compared with pathological results.Results 1 )The disease mainly occurred in people around 55 years, among the 7 cases ,5 located in the pancreatic head, 2 in the body and tail, with abdominal pain and jaundice as the chief complaint.2)Pathologically, the solid part of the tumor was made up of ductal adenocarcinoma and squamous carcinoma components, with a different rate, while the cystic part was made up of necrosis, liquefaction.3) the imaging of 5 cases with ASC of pancreas in which squamous carcinoma components predominate shows solid and cystic tumors of pancreas, furthermore the ratio of central cystic diameter and the whole tumor diameter increase with the the volum of the tumor.4) There is no partitioning in the cystic part of the tumor, with a few irregular microcyst around it.5 ) The tumor shows a pattern of infiltrative growth, associated dilatation of the common bileduct or pancreatic duct in all cases, pancreatic atrophy in part.6) Squamous carcinoma components of the tumor was the pathologic basis for the formation of the solid and cystic structure in imaging.Conclusions ASC of pancreas is a rare aggressive subtype of pancreatic adenocarcinoma with a worse prognosis than the usual type of ductal adenocarcinoma, although symptoms similar to pancreatic ductal carcinoma.Cases of ASC of pancreas in which squamous carcinoma components predominate have certain characteristic imaging and pathologic features,which is important to early diagnosis.

In October 2020, the American Heart Association(AHA) published the 2020 guidelines for cardio-pulmonary resuscitation and emergency cardiopulmonary resuscitatio, it is a comprehensive revision for adult, pediatric, neonatal, resuscitation education science, and systems of care topics.This article mainly interprets the most important updates of pediatric and neonatal basic and advanced life support.

0.05).Conclusions This study shows that in severe acute biliary pancreatitis patiens with biliary tract obstruction, emergency endoscopic therapy should be performed within 48 hours from the onset of symptoms; patients with mild acute biliary pancreatitis shoud also undergo prompt endoscopic therapy after ineffective conservative management or appearance of symptoms of acute biliary tract infection.

0.05). The average total medical expense and the cost of hormone drugs in dexamethasone-treated group vs. budesonide-treated group were(1 258.73?131.04)yuan and(8.94?1.45)yuan, respectively vs.(1 385.39?175.61)and (167.28?24.86)yuan, respectively, showing significant differences between the two groups(P