Based on the discussion of the present English teaching in medical colleges and universities in China,this paper clarifies the mission and task of English teaching in medical colleges and universities and proposes that medical colleges and universities should attach importance to the education goals and needs of the department,major and students in the information age.It is believed that a scientific,reasonable and perfect English curriculum can be achieved by integrating IT into English curriculum,applying individualized teaching mode and expanding course connotation.

Objective To investigate the effects of Yindan-Xinnaotong combined with aspirin on lipidemia levels and hemorrheology in patients with stroke. Methods A total of 62 patients with stroke were randomized into a treatment group (31 cases) and a control group (31 cases). The patients in the control group were treated with aspirin and those in the treatment group were treated with aspirin and Yindan-Xinnaotong capsule (4 capsules each time, 3 times/d) for 30 days. The lipidemia levels and hemorrheology were evaluated before and after the treatment. Results After the treatment, whole blood viscosity (4.15 ± 0.14 mPa?s vs. 5.25 ± 0.40 mPa?s;t=14.452, P<0.01), plasma viscosity (1.70 ± 0.30 mPa?s vs. 2.70 ± 0.25 mPa?s;t=14.258, P<0.01), fibrinogen (3.71 ± 0.51 g/L vs. 5.80 ± 0.41 g/L;t=17.783, P<0.01) and thrombosis index (0.75 ± 0.31 vs. 1.30 ± 0.21;t=8.178, P<0.01) in the treatment group were significantly lower than those in the control group. After the treatment, the serum levels of total cholesterol (3.31 ± 1.19 mmol/L vs. 5.04 ± 1.30 mmol/L;t=5.465, P<0.01), triacylglycerol (0.63 ± 0.31 mmol/L vs. 1.34 ± 0.05 mmol/L;t=12.589. P<0.01) in the treatment were significantly lower than those in the control group, the serum level of high-density lipoprotein cholesterol in the treatment group was significantly higher than that in the control group (1.83 ± 0.49 mmol/L vs. 1.28 ± 0.45 mmol/L;t=4.603, P<0.01), and there was no significant difference in the serum level of low-density lipoprotein cholesterol between the two groups (2.22 ± 0.61 mmol/L vs. 2.11 ± 0.95 mmol/L; t=0.543, P>0.05). Conclusion Yindan-Xinnaotong combined with aspirin can improve the lipidemia and hemorrheology in stroke patients.

This paper first explains the contextual theory,then it analyses the contextual characteristics under network environment with multimedia.At last,according to systematic functional linguistics,it discusses the implications of how to take advantage of the contextual characteristics in College English teaching and learning.

Microglia are functionally principal immune effector cells widely spread in the central nervous system ( CNS) and physiological play a role in monitoring and stabilizing the internal environment. Very sensitive to external stimulation, microglia are eas-ily activated by slight pathological changes in the CNS. The activated microglia, on the one hand, phagocytize cellular debris and ex-crete growth factors to promote nerve repair and, on the other hand, also produce some inflammatory cytokines, glutamate, and nitric oxide, which may aggravate the inflammatory response and lead to secondary injury. This article summarizes the characteristics of mi-croglia and their involvement in CNS diseases and provides a new target for their treatment.

Objective To understand the current situation of neurology nurses′self-efficacy and quality of nursing services in Lanzhou area, and explore the relationship between self-efficacy and the quality of nursing services. Methods Using the method of questionnaire, one hundred and the neurology nurses and hospitalized patients in 5 Grade 3 Level hospitals of Lanzhou city were investigated by using self-efficacy scales and Servqual scales. Results Neurology nurses′ self-efficacy in Lanzhou area was lower than the general population ( U=-9.875,P=0.042);the scores of quality of care from high to low were at reliability, tangibles, assurance, responsiveness, cost acceptability and empathy, which were-(0.12 ± 0.05) points,-(0.23 ± 0.03) points,-(0.24 ± 0.06) points,-(0.25 ± 0.02) points,-(0.26 ± 0.05) points,-(0.66 ± 0.03)points.Satisfaction arranged from high to low were assurance (89.98%), reliability (89.69%), responsiveness (89.12%), tangibles (87.66%), cost acceptability (87.08%), empathy (86.67%).There were positive correlations between satisfaction and expectations and perceived service quality, and the correlation between satisfaction and perceived qualities of service was higher. Moreover, there might exist positive correlation between self-efficacy score and quality of nursing services (reliability, assurance, responsiveness, empathy) (P values were 0.002, 0.001,0.012 and 0.005). Conclusions Neurology nurses in Lanzhou area have lower self-efficacy, and the perceived qualities of care from patients never exceed their expectations. As results, hospital managers should take measures to improve general self-efficacy of nurses, and thus enhance the quality of care.

Objective To evaluate and compare the value of interleukin(IL)-6,IL-8,tumor necrosis factor(TNF)-α,and soluble form of triggering receptor expressed on myeloid cells (sTREM)-1 in neonatal infection and detect the relationship between them.Methods Eighty-five full-term newborns who were admitted to the neonatal ward of Shanghai Children's Hospital of Shanghai Jiaotong University were enrolled,according to the locations and severity of infection,the patients were divided into three groups:systemic infection group (n =27),local infection group(n =28),and non-infection group (n =30).The level of plasma sTREM-1 was measured by enzyme-linked immunosorbent assay,and the levels of IL-6,IL-8 and TNF-α were measured using cytometric bead array.Results (1) The levels of sTREM-1,IL-6,IL-8 and TNF-α were significantly higher in infants with systemic infection group than local infection group and non-infection group(P ＜0.05).(2) There were 17 survivors and 10 deaths in systemic infection group,and the level of sTREM-1 in the non-survivor [(121.64 ±49.31) pg/ml] was higher than the survivor[(73.13 ± 34.92) pg/ml,P =0.006].But the levels of IL-6,IL-8 and TNF-α were not statistically significant in the survivor and the death (P ＞ 0.05).(3) Based on the receiver operating characteristic analysis,cutoff values were identified for each variable that maximized both the sensitivity and specificity.These markers were considered positive if sTREM-1 ≥43.75 pg/ml,IL-6 ≥ 89.80 pg/ml,IL-8 ≥569.55 pg/ml and TNF-α ≥ 24.80 pg/ml.Among these indexes,the sensitivities were 85.5％,89.1％,70.1％ and 69.5％ respectively; the specificity were 80.0％,100％,100％ and 93.3％ respectively.Compared the area under curve(AUC) of them,IL-6(AUC =0.981)＞ sTREM-1 (AUC =0.868) ＞ TNF-α (AUC =0.864) ＞ IL-8 (AUC =0.852).sTREM-1 was correlated with IL-6,IL-8 and TNF-α(Spearman coefficient of rank r =0.532,P ＜0.01 ;r =0.420,P ＜0.01 ;r =0.531,P ＜0.01).Conclusion (1) The levels of plasma sTREM-1,IL-6,IL-8 and TNF-α were higher in neonatal infections;(2) sTREM-1 was associated with prognosis; (3) sTREM-1 was correlated with IL-6,IL-8 and TNF-α.

Objective To observe the changes of serum soluble form of triggering receptors expressed on myeloid cell-1 (sTREM-1) level in full-term newborns with infection and to investigate the relationship between serum sTREM-1 and neonatal bacterial infection.Methods Eighty-five full-term newborns admitted to the neonatal ward of Shanghai Children s Hospital of Shanghai Jiaotong University were selected into this study.According to the locations and severity of infection,patients were divided into 3 groups: severe infection group (n = 27),mild infection group (n = 28),non-infection group (n = 30).The samples of infection groups were collected before using antibiotics and within 48 h after infection symptom occurred; others were collected during hospitalization.For the neonates with organ dysfunction in the severe infection group,samples were also collected at the third and seventh day of infection.Serum sTREM-1 was measured by enzyme-linked immunosorbent assay.Analysis of variance was used to compare the difference between groups.Receiver operating characteristic (ROC) curve was used to calculate the sensitivity,specificity,positive and negative predictive value and Youden index.Results (1) Serum sTREM-1 level of severe infection group[(91.2±47.3) pg/ml] was significantly higher than that of mild infection group[(68.8 + 30.4) pg/ml] and non-infection group[(35.5±17.6) pg/ml],respectively (P＜0.05).(2) Serum sTREM-1 level of the survival newborns (n= 17) in the severe infection group was lower than that of dead ones[(73.1±34.9) pg/ml vs (121.6±49.3) pg/ml,t= - 2.995,P = 0.006].(3) For the survival patients,the serum sTREM-1 level decreased in the first week of infection,while that of dead patients increased,the cut-off value was 100.6 pg/ml.(4) Based on the ROC analysis,43.8 pg/ml was selected as the the cut-off value,area under the curve was 0.868,and sensitivity was 85.5%,specificity 80.0%,positive predictive value 0.887,negative predictive value 0.750,Youden index 0.655.Conclusions Serum sTREM-1 level increases in neonatal infection.The change of serum sTREM-1 level in patients with severe infection is correlated to the prognosis.

OBJECTIVE:To evaluate clinical efficacy and the effect of pharmacoeconomics of two chemotherapeutic regimens for the first line treatment of advanced gastric cancer. METHODS:98 patients with advanced gastric cancer receiving SOX or FLO regimen as first line chemotherapy in our hospital were enrolled. According to chemotherapy grouping,short-term efficacy,toxic re-action and pharmacoeconomics effect were analyzed and compared between 2 groups. RESULTS:There were a total of 55 patients in SOX group,with effective rate of 38.18%;43 patients in FLO group,with effective rate of 32.56%;there was no statistical sig-nificance in effective rate between 2 groups(P>0.05). There was no statistical significance in toxicities between 2 groups,includ-ing nausea and vomiting,neurotoxicity and neutropenia(P>0.05). The total cost of FLO regimen group was 9 136.98 yuan,while that of SOX regimen group was 12 345.97 yuan. Using minimum cost method,FLO regimen was superior to SOX regimen regard-ing the economical index. CONCLUSIONS:SOX and FLO regimen have no significant difference for the first-line treatment of ad-vanced gastric cancer in terms of response rate and toxicities. Taking into account the parmocyeconomics,FOL regimen is superior to SOX regimen.

Objective To investigate the basic perceptions, attitudes and needs towards delirium among ICU professionals in Shandong province, so that to help the ICU supervisors design target training for ICU professionals. Methods A survey was employed utilizing a self-designed questionnaire among 917 ICU professionals(doctors and nurses) from 62 hospitals in Shandong province. Results The score of ICU professionals′ basic perception and behavioral attitude concerning ICU delirium were (24.56 ± 6.36) and (19.00 ± 3.01) points respectively. The score had significant positive correlation and indicates statistic significance (r=0.53, P<0.01). Academic, work experience and title had influence on the score of basic perception (F=14.49, 26.25, 40.16, P<0.05), work experience, category of ICU, title and category of hospital were the effect on the score of behavior and attitude (F=11.87, 8.64, 6.55, P<0.05;t=4.81, P<0.05). The lower rate of correct responding to knowledge of ICU delirium were as follows:the correct rate of delirium in ICU of typing to 56.92%(522/917); the clinical manifestations of ICU delirium accuracy 65.32%(599/917); andrisk factors for delirium in ICU of the correct rate for 70.34%(645/917).ICU professionals acquire knowledge pertaining delirium mainly through lectures, conferences, knowledge brochure , exchange of experience. Conclusions The ICU professionals in Shandong province have less knowledge on ICU delirjum.ICU management should recognize the importance of ICU delirium to strengthen the training of relevant knowledge, enhance delirium management, ensure the patient's safety and improve the prognosis of patients.

Carcino-embryonic antigen related cellular adhesion molecule 1(CEACAM1),used to be called CD66a, biliar glyeoprotein(BGP) or C-CAM,is a glucoprotein expressed on the surface of cells, a member of the carcino-embryonic antigen family(CEA) and an adhesion molecule of immunoglobulin superfamily. It is widely expressed on the epithelial cells and vascular endothelial cells.CEACAM1 inhibits tumor growth and epithelial cell proliferation, induces apoptosis of epithelial cells, inhibits activation and proliferation of T lymphocytes, stimulates proliferation of B lymphocytes, inhibits the cytotoxic effects of T cells and NK cells, delays apoptosis of granulocytes and monocytes, inhibits the activity of tumor-infiltrating lymphocytes, stimulates invasion of tumor cells and motility of endothelial cells, promotes blood vessel angiogenesis, and modulates vascular remodeling, so it has many important biological functions.