Objective To investigate the current situation of nursing research based on Omaha system in China. Methods All the nursing research based on Omaha System were retrieved and collected by using China National Knowledge Infrastructure, Wanfang database and VIP database, NoteExpress software for the management of documents was used. Based on the classification of nursing research literature, a content analysis of system analysis model analyzed the documents had been retrieved. Results Sixty-four pieces of literature were included, and thirteen categories system were formed. The transverse reliability coefficient of all kinds of system were 0.940-1.000, the longitudinal reliability coefficient were 0.658-1.000. Conclusions The study of nursing research based on Omaha system in China is booming, which is also facing challenges, and has a broad space for exploration.

Objective This study assessed whether the best overall response rate(ORR) of cetuximab combined with oxaliplatin,leucovorin and fluorouracil/Xeloda was superior to that of this method alone as first-line treatment for metastatic colorectal cancer.The influence of KRAS mutation status was investigated.Methods Patients received cetuximab(400mg/m2 initial dose followed by 250mg/m2,wk thereafter)less than 2 times plus chemotherapy(oxaliplatin 130mg/m2 on day 1,plus leucovorin 200mg/m2 and fluorouracil as a 400mg/m2 bolus followed by a 600mg/m2 infusion during 22 hours on days 1 and 2) or chemotherapy alone.Treatment was continued until disease progression or unacceptable toxicity.KRAS mutation status was assessed in the subset of patients with assessable tumor samples.Results The confirmed ORR for cetuximab plus oxaliplatin,leucovorin and fluorouracil/Xeloda was higher than that with alone(42.86% vs 21.74%).A statistically significant increase in the odds for a response with the addition of cetuximab to oxaliplatin,leucovorin and fluorouracil/Xeloda could be established.In patients with KRAS wild-type tumors,the addition of cetuximab to oxaliplatin,leucovorin and fluorouracil/Xeloda was associated with a clinically significant increased chance of response(ORR 54.55% vs 21.74%) and a lower risk as compared with chemothrapy alone.Cetuximab plus oxaliplatin,leucovorin and fluorouracil/Xeloda was generally well tolerated.Conclusion The clinical effcacy of chemothrapy(oxaliplatin,leucovorin and fluorouracil/Xeloda) plus cetuximab is better than only chemothrapy.KRAS mutational status was shown to be a highly predictive selection criterion in the treatment decision regarding the addition of cetuximab to oxaliplatin,leucovorin and fluorouracil/Xeloda for previously untreated patients with metastatic colorectal cancer.

Objective To investigate the complex effect of soman and hypoxia on PC12 cell line as shown by the expression changes in IL-6/GP130, JAK1 and STAT1. Methods A cell model of intoxication by combining effect of hypoxia and soman was reproduced, and it was divided into four groups: control, soman intoxication, hypoxia combined with soman intoxication, and Genistein inhibition groups. PC12 cells were cultured in RPMI 1640 and were treated with NGF (50ng/ml) for seven days. The differentiated PC12 cells were then exposed to hypoxia in an incubator containing 5% CO2, 95% N2 and (or) incubated with soman (20?mol/L) for 2, 6, 12 or 24 hours. The expression levels of IL-6/GP130, JAK1, STAT1 mRNA and protein were assessed by RT-PCR and Western blot in PC12 cells. The products were sequenced by Sanger's double strand DNA sequence determination. Results In soman intoxicated group, the expression levels of IL-6/GP130, JAK1, STAT1 mRNA and protein were elevated in PC12 cell, reaching the peak level at 12 hours, and then lowered at 24 hours, but remaining higher than that of control group. In combined soman intoxicated and hypoxia group, the expression levels of IL-6/GP130, JAK1, STAT1 mRNA and protein reached the peak value at 6 hours, being higher than that of control group, soman intoxicated group and Genistein inhibition group. It was shown that the sequences of the products as amplified by RT-PCR were the same as that found in the GenBank. Conclusion Soman intoxication or (and) hypoxia up-regulate the expression of IL-6/GP130. Both hypoxic condition and soman treatment can up-regulate the expression of JAK1/STAT1 mRNA and protein in PC12 cells. JAK-STAT pathway may play a role in the mechanisms of brain injury resulted from hypoxia and soman poisoning.

Objective To explore the functionalternation of human cholangiocarcinoma cell line HUCCA-1 by silenc?ing Gab1 expression;to detect its effect on PI3KCA and Akt1 expression at protein and mRNA levels and to explore the role of Gab1,PI3KCA and Akt1 expressions in the malignant behavior of cholangiocarcinoma. Methods Gab1 siRNA was trans? fected into cholangiocarcinoma cell line HUCCA-1. Proliferation, apoptosis, migration/invasion of cells were examined by MTT, flow cytometry and Transwell assay respectively after transfection. PI3KCA and Akt1 expressions were detected by Western blotting and qPCR. Results Transfection efficiency was satisfactory and reaches 65%~70%;PI3KCA and Akt1 expressions were down-regulated at both protein and mRNA levels upon silencing of Gab1. Meanwhile, proliferations of HUCCA-1 cells were inhibited (P<0.01);apoptosis rate increases(P<0.05);and migration and invasion were both inhibit?ed upon Gab1 silencing(P<0.05). Conclusion The proliferation, migration and invasion are all inhibited while apoptosis is attenuated after Gab1 was down-regulated by Gab1 siRNA transfection. PI3KCA and Akt1 expressions are up-regulated with down-regulation of Gab1. Therefore, Gab1 may enhance the maglinant behavior of cholangiocarcinoma cells through up-regulating PI3KCA and Akt1 expression and it can be used as a candidate for cholangiocarcinoma therapy.

ObjectiveTo evaluate central nervous system function of patients with coronary cardiac diease by short latency somatosensory evoked potentials (SSEP).MethodsThe cerebral and spinal somatosensory evoked potentials were recorded by stimulating median nerve in 43 patients with coronary cardiac disease but without apparent nervous symptoms and 14 healthy control subjects.ResultsThe lactency periods and central conductive time of N13, N20 and P25 wave were significantly prolonged in patients with myocardial infarction (MI) or angina pectoris (AP) when compared with normal controls (P<0.05～0.001). The lactency periods and central conductive time of N20 and P25 wave recorded in MI patients were longer than those recorded in AP patients (P<0.01～0.001).ConclusionThe subclinical nervous damages in the central somatosensory pathway from spinal cord to cerebral cortex is present in patients with coronary cardiac disease especially myocardial infarction.

Objective To study the pharmacokinetics of aristolochic acid A in Radix Aristolochiae and the compound preparation of Guanxinsuhe Capsule in mice in vivo after single-dose oral administration and observe the difference of aristolochic acid A absorption and distribution. Methods Aristolochic acid A assay was performed by RP-HPLC on a Waters apparatus with a DiamonsilTM C18 column (250 mm × 4.6mm, 5 μm), a mobil phase: a mixture of methanol-water-acetic acid (72: 27 : 1), flow rate: 1.0 mL/min, detection wavelength: 315 nm, and column temperature: 20 ℃. Results Mice were given Radix Aristolochiae and Guanxinsuhe Capsule by ig at the same level of 2. 5 mg/kg of aristolochic acid A, respectively, which were suspended in 0. 3% CMC-Na solution. Plasma concentrations were determined by RPHPLC. After single-dose ig administration of Radix Aristolochiae or Guanxinsuhe Capsule to mice, the mean plasma concentration-time courses of aristolochic acid A obtained fitted the one-compartment model.The main pharmacokinetic parameters of aristolochic acid A in Radix Aristolochiae, t1/2ka, t1/2 ke, tmax,AUC, Cmax are 5. 103 min, 43. 63 min, 17.89 min, 80. 45 (μg · min)/mL, and 0. 916 8 μg/mL; the rela tive pharmacokinetic parameters in Guanxinsuhe Capsule are 5. 294 min, 43.50 min, 18. 32 min, 33.08(μg · min)/mL, and 0. 381 8 μg/mL. Conclusion The Cmax of aristolochic acid A in Guanxinsuhe Capsule is significantly less than that in Radix Aristolochiae, which indicates that the compound compability could decrease the absorption of aristolochiae acid A.

Objective To evaluate two kinds of anterior screw fixations in the treatment of odontoid fractures. Methods A total of 36 patients with D' Alonzo type Ⅱ odontoid process fractures were treated with anterior screw fixation in our department from 1999 to July 2009. There were 28 males and 8 females at mean age of 42.3 years (rang 17-59 years). According to time and surgery procedures, the patients were divided into Group A ( from 1999 to June 2005, n = 11 ) and Group B ( from June 2005 to July 2009, n = 25 ). Patients in Group A received anterior hollow screw fixation of the odontoid process monitored under G-arm or C-arm, while those in Group B received anterior screw fixation of the odontoid process assisted by Iso-C 3D navigation system. The operation time and blood loss in two groups were compared by Student' s t test and analyzed with SPSS 13.0 statistical software. X-ray examination was performed in all patients 3, 6 and 12 months after operation to observe fracture union and stability of the upper cervical spine. Results The operation time was ( 102 ± 12) min ( range, 77-148 min) in Group A and ( 104 ± 14) min ( range, 71-150 min) in Group B, with no statistical difference ( P =0.21 ). The blood loss was (465 ± 5) ml (range, 20-130 ml) in Group A and (42 ± 6) ml (range, 26-150 ml) inGroup B, with no statistical difference (P = 0.16). All patients received reexamination three months after operation, which showed no bony union or dislocation but average 40% restriction of neck rotation. One year after operation, 30 patients (83%) got fracture union and six ( 17% ) got fiber healing, with average 24% restriction of neck rotation. Conclusions There is no statistical significant differences between two groups in aspects of operation time, blood loss and fracture healing. But anterior screw fixation of the odontoid process assisted by Iso-C 3D navigation system can reduce exposure to radiation of both patients and surgeons. Furthermore, solid screws can be applied to augment the fixation intensity and thereby reduce the complications caused by non - union.

Objective To determine the effects of intrauterine growth retardation(IUGR) caused by malnutrition during pregnancy on the lung structure and expression of Clara cell protein (CCSP) and interferon (IFN)-γ in the fetal lungs,and to explore their relation ship with pulmonary disease.Methods Fetal rats from maternal protein-malnutrition dams were studied on day 20(term 21.5 day).The lung pathology was examined by means of Hematoxylin and eosin(HE) stain.Plasma was collected to determine the CCSP and IFN-γ concentration.Lungs were harvested to measure the expression of CCSP and IFN-γ mRNA by using fluorescent quantization reverse transcription (RT)-PCR and the levels of CCSP and IFN-γ protein were assessed by using enzyme-linked immunosorbent assay.Results Malnutrition fetus body weight significantly less compared to control group,so did the lung weight.However,lung weight,expressed as a percentage of body weight between the 2 groups was not different.The IUGR group had significantly decreased alveolar number manifested by lower radial alveolar count,and significantly increased mean linear intercept of alveoli.Both the CCSP mRNA expression and protein level in lung of IUGR rats were decreased compared with control rats (all P ＜ 0.05).A decline in plasma CCSP protein concentration was also noted compared with control group (P ＜0.05).Furthermore,IUGR group fetus showed lower IFN-γ levels both in circulation and in the lung tissue (all P ＜ 0.05).Conclusions Intrauterine malnutrition significantly alters lung structure and cytokine IFN-γ level,and the latter may further inhibit the transcription of CCSP gene.These alterations may contribute to both early and late postnatal respiratory morbidity.

Objective To investigate the clinical characteristics of elderly-onset inflammatory bowel disease (IBD) and its treatment options.Methods Clinical data of IBD in-patients treated in Peking University First Hospital from January 1995 to December 2014 were reviewed and the subsequent information in the follow-up was also collected.Based on the onset age, patients were divided into the elderly-onset group (≥60 years old) and the control group (＜60 years old).The general situation, clinical characteristics and treatment options were retrospectively analyzed and compared between the two groups.Results There were 37 patients (9.3％) with IBD in the elderly-onset group, with 25 cases with ulcerative colitis (UC) and 12 cases with Crohn disease (CD).The ratio of gender, smoking, family history of IBD and colon cancer in the elderly-onset and control groups were 1 : 0.9 and 1 : 1.3, 32.4％ and 21.7％, 0.0％ and 6.1％, 0.0％ and 1.9％, respectively, with no significant differences between the two group (P=0.597, 0.139, 0.247 and 0.840).The attack frequency and the percentages of patients with persistent symptoms and severe disease had no statistical differences between the elderly onset and the control groups.Compared with the control group, the elderly-onset group showed that the percentage of UC patients with extensive colitis (E3) was decreased [16.0％ (4/25) vs.41.2％ (117/289) respectively (x2 =6.123, P=0.013)], and the percentage of CD patients with colonic type (L2) was increased [58.3％ (7/12)vs.21.3％ (16/75) respectively (x2=6.447, P=0.011)].For treatment options, the number of patients receiving 5-Aminosalicylic Acid (5-ASA)/sulfasalazine(SASP) as maintenance treatment for more than 1 years were 274 cases (96.9％) in the control group and 22 cases (86.5％) in the elderlyonset group (x2 =6.382, P=0.011).And the number of patients receiving systemic corticosteroids during induction period were 5 cases (19.4％) in the elderly-onset group and 122 case (43.2％) in the control group (x2 =7.617, P=0.006).There were no statistically significances in the number of patients with immunosuppressant, biologics and operation treatment between the two groups.Conclusions The elderly-onset IBD patients are not rare.The inflammation involvement is more limited in the elderly-onset patients than in the young-onset patients.The treatment option for elderlyonset IBD should be more cautious, especially for the treatment with 5-ASA/SASP long-term maintenance and systemic corticosteroids usage.

Objective To investigate the status of Helicobacter pylori(Hp)infection with subclinical hepatic encephalopathy (SHE) and the level of blood ammonia. Methods Sixty-five SHE patients and healthy volunteer were selected. In all subjects Hp was assessed by rapid urease test (RUT) and histological examination. It would be regarded as Hp infection if both the RUT and histological examination were positive. The level of blood ammonia was detected and number connection test (NCT), digit symbol test (DST)and electroencephalogram (EEG)was performed. The patients could be diagnosed with SHE whichever of the three tests was abnormal. The patients with Hp infection were randomized received one-week standard treatment. Bacterial eradication was assessed with <'14>C-urea breath test after the treatment of 6-8 weeks, meanwhile above mentioned examinations were reassessed. Results The ratio of Hp infection in SHE patients (46.2%, 30/65 )was higher than that in healthy controls ( 33.3 % ,20/60), but there was no significant difference(P> 0.05).The blood ammonia level before and after eradication had no significant difference(P> 0.05 ). No improvement was observed in above mentioned examinations after treatment. Conclusion There is no relationship between the level of blood ammonia and Hp infection in SHE.