Selective COX-2 inhibitors can promote the apoptosis of tumor cells and block the growth of new blood vessels through the inhibition of ring oxidase,vascular endothelial growth factor,microvessel and so on. Research shows that COX-2 is overexpressed in vascular and endothelial cells of lung cancer,select COX-2 inhibitors to adjuvant chemotherapy,not only can directly inhibit the tumor proliferation,but also can reduce the adverse reaction of chemotherapy drugs,and enhance the curative effect. To investigate the effects of selec-tive COX-2 inhibitors and cisplatin in lung cancer angiogenesis and its mechanism,will be a hope for the clini-cal treatment of tumor.

Objective To know the situation of nurses obtaining osteoporotic fractures related knowledge ,and provid guiding basis for further education and relevant training on target people .Methods Questionnaire survey and semi -structured interviews methods were used to investigate 595 nurses ,9 clinical nurse workers and nurse managers who come from a tertiary comprehensive teaching hospital were interviewed personally .Results The scores of the related knowledge in nurses were 35 .70 ± 6 .36 ,score rate was 67 .36% ;Interview data analysis showed that lack of professional training ,training was not systematic ,the approach obtain knowledge was simple were result in lack of the related knowledge in nurses ;By the multiple liner stepwise regression ,The educa‐tion level and professional title were main factors which affect nurses acquired osteoporosis knowledge .Conclusion It is necessary to focus on improving the strengthen of related knowledge education for the nurses with low education background and low profes‐sional title ,At the same time ,related departments of the hospital should strengthen the training of professional knowledge .

Objective To observe the effectiveness of the percutaneous transluminal angioplasty (PTA) and percutaneous transluminal stenting (PTS) for central vein occlusion in maintenance hemodialysis patients.Methods From January 2010 to August 2015,a total of 42 patients with center vein occlusion of arteriovenous fistula were treated with maintenance hemodialysis,and the surgery and postoperative conditions,revascularization and improvement of vascular stenosis were observed.Results Among the 42 patients,38 cases were successfully carried out with PTA,and the patency rate was 90.5%(38/42).A total of 32 intravascular stents were placed in 30 patients whose vein stenosis were still greater than 30% after PTA.After surgery,the swelling of the patient receded rapidly and the internal fistula went back to normal.Conclusion PTA and PTS are effective methods for maintenance hemodialysis patients with central vein occlusion,and they could help protecting functional access in patients with autogenous fistulas with smaller wounds and faster effects.

Biomarkers ; Cerebral Hemorrhage ; etiology ; prevention & control ; Humans ; Infant, Newborn ; Protein Precursors ; Prothrombin ; Vitamin K Deficiency ; complications ; diagnosis ; Vitamin K Deficiency Bleeding ; etiology ; pathology ; prevention & control

Diagnostic Errors ; Humans ; Pneumoconiosis ; diagnosis ; Scleroderma, Systemic ; diagnosis

The field of integrative medicine (IM) has grown tremendously in the United States over last two decades, in terms of clinical practice, research, and education. Its growing popularity among patients has led to increased need for physicians with appropriate counseling skills and a knowledge base of the efficacy and safety of complementary and alternative medicine (CAM) therapies. Family medicine is the first specialty as a whole to embrace IM, which encounters similar ailing conditions and emphasizes similar core values-person centered, evidence based, proactive, and continuous in nature. As integrative family medicine emerges, family medicine educators have developed suggested curriculum guidelines and approved measurable competencies to implement the best of evidence-based CAM and principles of IM. There are currently over 40 family medicine residencies that officially advertise CAM/IM in their programs. Meanwhile, IM centers have also been developing their own primary care programs based on their unique characteristics. This physician-led IM workforce is similar to that of China's IM in the early 1960s. As the Chinese government embarks on repeating its efforts to educate more Western medicine trained physicians in Chinese medicine in primary care training programs, the process and insights related to implementation of their practice in the United States would provide useful food for thought.
China ; Complementary Therapies ; Curriculum ; Education, Medical ; Humans ; Integrative Medicine ; education ; Internship and Residency ; Physicians ; Primary Health Care ; United States

Objective To explore the diagnostic value of barium meal in gastroesophageal reflux disease(GERD).Methods The data of patients who performed barium meal from January 2003 to December 2012 were retrospectively analyzed,and the GERD detection rate and its relationship with gender and age were calculated and compared.The degree and position of reflux during barium meal in 454 patients in 2012 and the relationship between age and degree and symptom of reflux were studied.Results The GERD detection rate was 13.48％(2 743/20 353) from January 2003 to December 2012,and increased by years.The GERD detection rate in male and female were 13.73％(1 312/9 554) and 13.25％(1 431/10 799) respectively,and there was no significant difference (P ＞ 0.05).With the increase of age,the GERD detection rate increased aslo.In patients of age ≤30 years,31-60 years and ≥61 years,the GERD detection rate were 6.87％ (197/2 866),11.63％(1 096/9 421) and 17.98％(1 450/8 066) respectively,and there was significant difference (P ＜ 0.05).The mild reflux accounted for 242 cases,the moderate reflux accounted for 110 cases,and the severe reflux accounted for 102 cases in patients with GERD in 2012,and there was also an aggravating reflux degree with the increase of age.In patients ≤30 years,31-60 years and ≥61 years,the reflux degree were 10.26％(4/39),17.92％(38/212) and 29.56％(60/203) respectively (P ＜ 0.05).The position with left anterior oblique was most often,accounting for 95.37％(433/454).Conclusions Barium meal can be directly observed,and evaluate the degree of reflux and position.Barium meal is simple and intuitive,and can be used as one of GERD diagnostic methods.

Background To construct and analyze the differentially expressed gene library in the SD rat's brain of Parkinson's disease.Methods The lateralization Parkinson's disease model of SD rat was established by stereotaxis injection of 6-OHDA in lateralization corpora striatum. Suppression subtractive hybridization was utilized to isolate the cDNA fragments in both control and experimental groups. Then the cDNA fragments were directly bound to pMD18-T to set up the subtractive library. Amplification of the library was carried out by transformation of E. coli with high voltage electroperforation. Ninety five positive bacteria clones were randomly picked up and identified by colony PCR.Results The amplified library contained more than 1500 positive bacteria clones. Ninety-five clones were analyzed randomly by colony PCR. And there were 81% clones contained 100 ～600 bp DNA fragments. They might be the cDNA fragments of differentially expressed genes of Parkinson's disease.Conclusions A differentially expressed genes subtracted cDNA library of Parkinson's disease of SD rat was constructed successfully with SSH and T/A cloning techniques. The library is efficient and it was useful in screening and cloning new and specific differential expression genes of Parkinson's disease.

AIM: To adopt the foam separation to get the best condition of the process about separation-purification sapindus-saponin. METHODS: The orthogonal experiments was used to analyse the results of the process. RESULTS: The best condition of the process was 2.5 g/L feed concentration,0.9 L/min gas flow rate,pH 4.8 and the temperature of 30 ℃.Under this condition,the yield,concentration ratio and purity of sapindus-saponin was 69.42%,2.48,and 67.78%,respectively. CONCLUSION: The process is very simple and practical,which provides a base for the application of natural sapindus-saponin.

3 d in 16)were converted to open surgery because of massive adhesion at the Calot's triangle(13 cases),severe wound hemorrhage(4),common bile duct stones(4),gallbladder-duodenum fistula(2),gallbladder-colon fistula(1),or Mirizzi syndrome(1).During the operation,no bile duct injury occurred.None of the patients had intra-abdominal haemorrhage,biliary leak,or subhepatic abscess after the operation.The 279 patients were followed up for 5 to 24 months with a mean of 12 months,during which no patients complained of abdominal pain or jaundice.Conclusions The success of LC depends on early treatment and strict selection of patients.Intraoperative hemorrhage and bile duct injury can be avoided by sufficiently exposing the Calot's triangle and using the technique of flush-suction blunt dissection.Conversion to open surgery is necessary when LC is difficult.