Objective To acknowledge the present status of clinical use of nonsteroidal antiinflammatory drugs(NSAIDs) in China. Methods Five hundred and seventy-five valid questionnaires were collected from 50 hospitals in different areas of China including Shanghai, Beijing, Tianjin, Shenyang and Guangzhou. Results 54.7% of doctors used cyclooxygenase-2 (COX-2) selective inhibitors. The ratio of the doctors prescribing loxoprofen, diclofenac, meloxicam were 22.6%, 23.3%, 14.60%, respectively. The ratio of the doctors who prescribe uncoated routine-dose aspirin, uncoated low-dose aspirin, enteric-coated routine-dose aspirin, enteric-coated low-dose aspirin and others were 17.0%, 14.7%, 36.8%, 28.5% and 3.0%, respectively. The ratio of doctors who only "some-times" prescribed co-medicine to prevent gastrointestinal damages when they prescribed aspirin, conventional NSAID and COX-2 selective inhibitors were 41.10%, 40.70% and 45.1%, respectively, while the most commomly used co-medicine were H2 receptor antagonist (H2 RA) and proton pump inhibitor respectively. 37.1% of doctors examined H. pylori infection status, and 76.3% of doctors would eradicate H. pylori if positive. Conclusions The most commonly used conventional NSAID is diclofe-nac. The most commonly used formulation of aspirin is enteric-coated aspirin. Most doctors only "sometimes" prescribe co-medicine together with aspirin, conventional NSAID and COX-2 selective inhibitors to prevent gastrointestinal damages, and the most commonly used co-medicine is acid inhibitor. Only a few doctors examine H. pylori infection prior to the administration of NSAID.

Objective To investigate the clinical efficacy of intravitreal ranibizumab injection combined with complex trabeculectomy in treatment of neovascular glaucoma. Methods Totally 38 patients(38 eyes) of neovascular glaucoma were divided into two groups of 19 cases in each randomly. Patients in treatment group were treateded with complex trabeculectomy after intravitreal injection 0. 05 mL ( 0.5 mg ) ranibizumab 4 - 7 days. Patients in control group were treateded with cyclocryotherapy. Visual acuity, intraocular pressure, iris neovascularization and complications were observed. Results The average intraocular pressure of preoperation and postoperation 1 month in treatment group were (6.5±1.7) kPa and (2.1±1.2) kPa.The difference of intraocular pressure before and after operation was significant. The average preoperative and postoperative intraocular pressure in control group were (6.7±1.9) kPa and (2.5±1.2) kPa . The postoprative intraocular pressure of treatment group was lower than that of control group, the difference was statistically significant( P< 0.05). Visual acuity and operative reaction after operation in treatment group were superior to those in control group. Conclusion Intravitreal injection of ranibizumab combined with complex trabeculectomy in treatment of neovascular glaucoma is safe and effective and worth in clinical application.

0.05. No marked side effects and complication were found. The obliterate rate of needles for D-TH direct injection is lower than that of Histoacryl sandwich method. Conclusion Tissue adhesive D-TH injection for hemostasis of acute esophagogastric varices bleeding was an effective treatment and was easy to perform without side effects, and could be served as a recommended application in clinics.

Object To investigate the features of health related quality of life ( HRQOL) among elderly hypertensive patients with different body mass index (BMI) so s to provide evidence for the health promotion of hypertensive. Methods A cross-sectional survey of health status data from a population of 1281 elderly hypertensive patients from Beijing and 8 provinces of China ( Jiangsu, Anhui, Gansu, Qinghai, Fujian, Jilin, Jiangxi, and Henan) was made in the study. Analysis of variance was applied to compare the differences in HRQOL of elderly hypertensive patients in different BMI categories. Results For the elderly hypertensive patients with low body mass index, the scores of 8 dimensions and scores in physical component summary (PCS) and mental component summary( MCS) of SF-36 were the lowest;except the role-emotional(RE) dimension,the scores of other 7 dimensions,PCS and MCS were significantly different(PF,RP,BP,GH,VT,MH, P<0.01; SF,PCS,MCS, P<0.01). Comparing the scores between any two groups in PCS, the scores of patients with low body mass index were significantly lower than normal weight group (62.30 ± 22. 12 vs72.40 ±20.86, P<0.05) .overweight group (62.30 ± 22.12 vs 74.97 ± 19.20, P<0.05 ) and obese group (62.30 ± 22.12 vs 74.57 ± 19. 22, P < 0.05 ). Comparing the scores between any two groups in MCS,the scores of patients with low body mass index were significantly lower than normal weight group (68. 81 ± 20. 48 vs 74. 70 ± 20.41, P < 0. 05), overweight group (68. 81 ± 20. 48 vs 78.08 ±18.23, P<0.05) and obese group (68.81 ±20.48 vs 78. 69 ± 17.77, P<0.05); the score of normal weight group was significantly lower than the overweight group (74. 70 ±20. 41vs 78. 08 ±18.23, P<0.05). Gender Stratification showed that females with low body mass index had worse HRQOL than males. Conclusion The HRQOL of elderly hypertensive patients with low body mass index is significantly lower than normal weight patients, overweight patients and obese patients, the health promotion of elderly hypertensive patients with low body mass index should be paid more attentions, especially females with low body mass index.

Objective To evaluate the clinical toxicity and efficacy of S-1 combined with γ-ray body stereotactic radiation therapy in treatment of locally advanced pancreatic cancer.Methods Forty-five patients with locally advanced pancreatic cancer were randomly divided into two groups.The combination group received γ-ray stereotactic body radiation therapy which was given isodose curve of 50 ％-60 ％,tumor encircling dose of 3.0-4.5 Gy per fraction depended on dimension of tumors,9-12 fractions.Combined with S-1 40 mg/m2,2 times/d,for consecutive twenty-one days for four courses.The control group was given γ-ray stereotactic body radiation therapy only.Toxicities and effects were evaluated according to the criteria of WHO and RTOG.Results The CR rates in combination group and control group were 30.4 ％ (7/23) and 13.6 ％ (3/22),the response rates were 91.3 ％ (21/23) and 63.6 ％ (14/22) (x2 =4.980,P =0.026).The rates of gastrointestinal tract side reaction in combination group and control group were 82.6 ％ and 68.2 ％ (x2 =1.267,P =0.260),myelosuppression in combination group and control group were 78.3 ％ and 63.6 ％ (x2 =1.171,P =0.279).The rate of Ⅲ-Ⅳ grade myelosuppression in combination group were higher than that in control group (x2 =4.874,P =0.027).The median progression-free survival (PFS) rates of two groups were 8 months and 6 months respectively (x2 =1.357,P ＞ 0.05),the median survival period were 17 months and 14 months (x2 =1.017,P ＞ 0.05),1 year survival rates were 60.9 ％ and 54.5 ％ respectively (x2 =0.184,P ＞ 0.05).Conclusions S-1 combined with body gamma system treatment can improve local control rate and effective rate for inoperable patients with local advanced pancreatic carcinoma,and the adverse reactions are well tolerated.This method can be used as locally advanced pancreatic cancer chemoradiation safe and effective choice.

Ulcerative colitis( UC)is a disease difficult to cure and easy to relapse. Although the pathogenic and recurrent factors for UC are not clear,dietary factors are thought to be associated with both of them and becoming the hot topic of UC-related studies. Traditionally,dietary fiber is considered beneficial to UC,however,some of the latest overseas studies raised doubts about it. In this article,the dietary fiber and its role in UC were reviewed.

Oxidative damage theory is currently one of the predominant theories on the mechanisms of aging. Previous research has shown that antioxidants can extend the lifespan in the model organism by scavenging free radicals,inducing the expression of stress related genes and hormesis. However, recent studies have suggested that these pharmaceuticals may cause serious side effects,such as promoting oxidation,increasing the risk of cancer,and destroying the metabolic balance. The low absorption and targeting property also limit the efficiency of most antioxidants. As a result ,the correlation between antioxidants and lifespan extension remains to be demonstrated. We reviewed the research progress in the field of lifespan extension by antioxidants in recent years and provided references for future research in related areas.

Objective To evaluate systematically the long-term efficacy and prognostic factors of surgical treatment for gastric carcinoma with liver metastases (GCLM).Methods Database including Chinese Journal Full Text Database,Wan Fang Database,VIP database,Chinese Database of Literature on Biomedicine,Pubmed,EMBASE,Cochrane Library,Medline,Springerlink and Wiley Online Library were searched with“胃癌,胃月中瘤,肝转移,手术治疗,外科手术,肝切除术,生存率,预后因素,gastric cancer,gastric carcinoma,hepatic,resection,hepatic resection,hepatectomy,liver metastases,hepatic metastases,surgery,surgical,survival,prognostic factors.The time for retrieving was from January 1995 to August 2015.Literatures on longterm efficacy and prognostic factors of radical resection of gastric carcinoma combined with hepatectomy for GCLM were retrieved,and data were analyzed and evaluated by 2 independent researchers.The count data were presented by the relative risk (RR) and 95％ confidence interval (95％ CI).The group rate was merged by the formula RR/(1 + RR),corresponding 95％ CI upper limit values were transferred by the formula RR/(1 + upper limit value RR),and the lower limit values were transferred by the formula RR/(1 + lower limit value RR).The comparison of group rates was done by indirect comparison,Z =difference between group rate/√∑ni=1 (standard error of group rate)2.The heterogeneity was analyzed by I2.Results Eighteen literatures of cross-sectional studies were retrieved and the total sample size was 410 patients.The results of Meta analysis:(1) the summary RR of 3-year overall survival of surgical patients with GCLM was 0.47 (95％ CI:0.37-0.60) while the summary 3-year overall survival rate was 32.0％ (95 ％ CI:0.27-0.38).(2) The summary RR of 5-year overall survival of surgical patients with GCLM was 0.35 (95％ CI:0.27-0.45),summary RR of 5-year overall survival rate was 25.9％ (95％ CI:0.21-0.31).(3)The summary RR of overall recurrence of surgical patients with GCLM was 2.95 (95％CI:2.23-3.88) while the summary overall recurrence rate was 74.7％ (95％CI:0.69-0.80).(4)The summary RR of remnant liver recurrence of surgical patients with GCLM was 1.39 (95％ CI:0.91-2.15) while the summary RR of remnant liver recurrence rate was 58.2％ (95％ CI:0.48-0.68).(5)The summary 3-year survival rate of surgical patients with GCLM and primary carcinoma serosal invasion was 32.9％ (95％ CI:0.23-0.44),and summary 5-year survival rate was 25.9％ (95％ CI:0.16-0.40).The summary 3-year survival rate of surgical patients with GCLM and without primary carcinoma serosal invasion was 47.9％ (95％ CI:0.38-0.58),and summary 5-year survival rate was 38.3％ (95％ CI:0.29-0.49).The summary 3-year survival rate of surgical patients with synchronous hepatic metastases was 30.6％ (95 ％ CI:0.24-0.38),and summary 5-year survival rate was 24.2％ (95％ CI:0.18-0.32).The summary 3-year survival rate of surgical patients with metachronous hepatic metastases was 40.1％ (95％ CI:0.32 0.48),and summary 5-year survival rate was 32.9％ (95％ CI:0.25-0.41).The summary 3-year survival rate of surgical patients with solitary metastatic hepatic carcinoma was 47.6％ (95％ CI:0.40-0.56),and summary 5-year survival rate was 37.1％ (95 ％ CI:0.26-0.48).The summary 3-year survival rate of surgical patients with multiple metastatic hepatic carcinoma was 28.6％ (95％ CI:0.18-0.42),and summary 5-year survival rate was 15.3％ (95％ CI:0.07-0.30).The summary 3-year survival rate of surgical patients with GCLM and R0 resection was 28.6％ (95 ％ CI:0.19-0.40),and summary 5-year survival rate was 20.0％ (95％ CI:0.12-0.32).The summary 3-year survival rate of surgical patients with GCLM and without R0 resection was 0.0,and summary 5-year survival rate was 9.1％ (95 ％ CI:0.03-0.25).The summary 3-year survival rate of surgical patients with GCLM and resection margin ＜ 10 mm was 13.0％ (95 ％ CI:0.05-0.30),and summary 5-year survival rate was 8.3 ％ (95 ％ CI:0.02-0.28).The summary 3-year survival rate of surgical patients with GCLM and resection margin ≥ 10 mm was 34.6％ (95 ％ CI:0.21-0.52),and summary 5-year survival rate was 34.6％ (95％ CI:0.21-0.52).The summary 3-year survival rate of surgical patients with GCLM and chemotherapy was 45.9％ (95％ CI:0.29-0.64),and summary 5-year survival rate was 29.1％ (95 ％ CI:0.19-0.42).The summary 3-year survival rate of surgical patients with GCLM and without chemotherapy was 38.7％ (95 ％ CI:0.26-0.53),and the summary 5-year survival rate was 25.4％ (95％ CI:0.18-0.35).The 3-year survival rate of surgical patients without primary carcinoma serosal invasion and with metachronous hepatic metastases,solitary metastatic hepatic carcinoma,R0 resection and resection margin ≥10 mm was statistically significantly higher than that of surgical patients with primary carcinoma serosal invasion,synchronous hepatic metastases,multiple metastatic hepatic carcinoma and resection margin ＜ 10 mm and without R0 resection (Z =2.118,1.999,3.01 8,5.295,2.183,P ＜ 0.05).The 5-year survival rate of surgical patients with solitary metastatic hepatic carcinoma and resection margin ≥ 10 mm was statistically significantly higher than that of surgical patients with multiple metastatic hepatic carcinoma and resection margin ＜ 10 mm (Z =4.528,2.819,P ＜ 0.05).Conclusion Overall long-term efficacy of surgical patients with GCLM is not good enough,and there is the better prognosis in the surgical patients without primary carcinoma serosal invasion and with metachronous hepatic metastases,solitary metastatic hepatic carcinoma,R0 resection and resection margin≥ 10 mm.

Objective To explore the extent of agreement between measurements of temporal and spatial gait parameters made with portable gait analysis equipment and in the laboratory.Methods Fifteen healthy young people submitted to laboratory gait analysis using 3D motion analysis apparatus and then on the same day to analysis using the Gait Watch portable apparatus.Cadence,stride length,walking speed and step length were recorded.Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to evaluate the agreement between the two gait analyses.Results Test-retest comparisons with the Gait Watch apparatus generated ICCs for the temporal and spatial parameters ranging between 0.80 and 0.98,indicating good test-retest reliability.Bland-Altman plots comparing the two measurement systems also showed good agreement.According to paired simple t tests,the stride length,walking speed,and step length assessments with the two systems showed significant differences.All exceeded the minimum detection threshold (stride length =0.05 m,walking speed =0.12 m/s,left step length =0.03 m,right step length =0.04 m).Conclusions Measurements of cadence,stride length,walking speed and step length with the two systems yield acceptable agreement,and either can be used in clinical walking assessment.

There were some problems in the seven-year pediatric clinical Teaching of Learning on the job in the past.It is insufficient that the teaching mode and teaching form raised the clinical diathesis and competence of medical students.Aimed at these problems,countermeasures are proposed from the following aspects.First of all,let the students learn how to be on good behaviour.Using"students'simulation diagnose and treatment method" enables the students to assimilate the knowledge learned by themselves,use the evidence based medicine(EBM)to give directions to paediatric clinical practice,so as to make the clinical medicine change from the experience type to the science type.