Clinical practice guidelines play an important role in practitioner and patient decisions regarding appropriate clinical health care and in health policy formation. In the guideline development process, inappropriate methodologies and development strategies significantly influence the quality of guidelines; therefore, research and evaluation of guidelines have great significance. The original Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was published in 2003 by a group of international guideline developers and researchers. AGREE has important significance for the quality guarantee and successful implementation of guidelines, and has extensively achieved endorsement since 2003. In 2009, The AGREE Collaboration has developed the AGREE II by refining the original AGREE instrument. At present, the AGREE II has already replaced the original AGREE instrument; however, related introduction regarding AGREE II has not been found in China. The authors of this article briefly introduce the AGREE II, and believe that it will add value to research and evaluation of the guidelines as a whole.

Skin toxicities are the most common adverse effects of epidermal growth factor receptor inhibitors(EGFRI).It can result in significant physical and psyehological discomfort,and even leads to interruption or dose modification,and consequently affect the curative effect. Nowadays this adverse effect has attracted lot of attention.It is proposed that clinical management and treatment measures for skin toxicities should be further studied to improve the patients life quality,and guarantee the continuity and best curative effect of the treatment.But more researches on the pathogenesis and its prognostic significance are still expected.

Ceramide (Cer),as the center molecular of sphingolipids metabolism,functions as a bioactive mediator of different cellular processes,such as cell growth,differentiation,senescence and apoptosis,besides being structural component of cellular membrane.It can inhibit cell proliferation and promote cell apoptosis via multiple signal pathawys.Chemicals anti-cancer properties based on Cer metabolism that upregulate its level are confirmed in plenty of experimental researches,and parts of research productions are applied in anticancer clinic experiments.

The check methods of thyroid nodules include palpation,serum thyroid hormone and high-frequency ultrasound.When the diagnosis is difficult,fine-needle aspiration (FNA) is carried to differentiate benign and malignant nodules.In clinical practice,approximately 20％ of FNA-derived cytology reports can not meet the standard of benign or malignant.Some specific molecular biomarkers are applied to the derivative detection of FNA,which achieve considerable progress and improve the preoperative diagnostic rate.

ObjectiveTo revise the Chinese version of the screening for somatofonn symptoms-7( SOMS-7).Methods——( 1 )306 patients with somatoform disorder were selected in Psychiatry Clinic of Shengjing Hospital of China Medical University.(2) With convenient sampling,207 residents were selected in Xian village of Xintang town of Zengcheng district in Guangzhou and 288 in Tongji Road community of Chancheng district in Foshan.Besides,283 residents were selected in Changnan Community of Huanggu District and Jixiang Community of Dadong District in Shenyang.After 10 to 14 days,63 female and 73 male of the community subjects were selected randomly to fill in the scale again.All of the subjects filled in the Chinese version of the SOMS-7.Results ( 1 ) The internal consistency of the Chinese version of the SOMS-7 was 0.944 for female and 0.945 for male.The test-retest reliability was 0.869 for symptom count and 0.823 for severity index.The correlation with somatization subscale of SCL-90 was 0.805 for symptom count and 0.824 for severity index.(2) Based on the diagnostic criteria of somatoform disorder in DSM-Ⅳ,ROC curves were drawn.The AUC was 0.935 for symptom count and 0.942 for severity index in female,while 0.916 for symptom count and 0.926 for severity index in male.When 2.5 (female) or 1.5 (male) was chosen for symptom count and 15.5 (female) or 14.5 (male) for severity index,the youden in-dex reached a maximum.ConclusionThe Chinese version of the SOMS-7 showed a good reliability and validity,being reliable and valid as a tool to screen patients with somatoform disorder.

Objective To study the knowledge,attitude and behavior of six-step hand-washing procedure in the infectious department.Methods Questionnaires were used to investigate the knowledge,acceptability and compliance of six-step hand-washing procedure in the clinical workers in four class a tertiary hospitals of Guangdong province.Results 168 medical staff all knew the six-step hand-washing procedure(100%).However,the rates of acceptability and compliance varied from one occasion to another.The knowledge about hand-washing scored(4.36±2.08),(26.08±6.14)for attitude,The correlation coefficient was 0.358.Conclusions Though the importance of hand-washing has been confirmed and accepted by the medical staff,their compliance of hand-washing during work is not very optimistic.

Objective To study the significance of acute pancreatitis AP complications by acid-base distur-bance. Methods The arterial blood gas, serum electrolytes parameter and clinical data of 85 patients were analyzed.Results Acid-base disturbance of different types commonly existed in the early stage of AP patients. There are sig-nificant statistical differences in the indices of PaO2, PaCO2, SaO2 between group MAP and group SAP( P < 0.05 or P < 0.01 ). Conclusion Acid-base disturbance are very common in the AP patients and this-will make the condition worse,they should be treated promptly.

Objective To investigate the potential complications of renal transplant patients, to develop appropriate treatment programs to reduce the incidence. Methods Clinical data of 42 patients with renal transplantation were retrospectively analyzed. Blood type of the donors and recipients were same in 32 cases; Blood type of the donors was 0 and recipients blood type was A,3 cases;Donors blood type was 0 and recipients blood type was B,2 cases; Donors blood type was O and recipients blood type was AB,4 cases; Donors blood type was B and recipients blood type was AB,lease. Results In alll cases, there were acute rejection in 2 cases,pulmonary infection in 2 cases, wound infection in 1 case,urinary leakage in 1 case,urinary tract infection in 2 cases.42 cases were all cured up. One patient lost kidney function and required dialysis therapy 4 years after kidney transplantation, the remaining 40 patients were good. Conclusion Early detection and timely management of complications of renal transplantation played a very important role in improving the survival rate.

High mobility group box 1 protein (HMGB1), a damage-associated molecular pattern, exists ubiquitously in the cells of mammals. It contributes to maintaining the structure of nucleosome and modulating transcription of gene in nuclei. Extracellular HMGB1 plays two-way roles in promoting inflammatory and tissue repair. Released actively as well as passively following cytokine stimulation during cell death, HMGB1 may act as a late inflammatory factor and an endogenous damage-associated molecular pattern recognized by its receptors. And it may mediate the occurrence, development and outcome of the inflammatory injury of digestive system diseases, such as gastric mucosal injury, inflammatory bowel-disease, liver injury, pancreatitis, and so on. This review mainly concerns the research progresses of HMGB1 in the inflammatory injury of digestive system diseases. At the same time, HMGB1 itself, or as a therapeutic target, can promote tissue repair.
Animals ; Digestive System Diseases ; pathology ; HMGB1 Protein ; metabolism ; Humans ; Inflammation ; pathology