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.

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.

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 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.

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 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 analyze the relation between ischemic mitral regurgitation (IMR)and the changes of left ventricular systolic synchrony and volume parameters before and after percutaneous coronary intervention (PCI)in patients with subacute myocardial infarction and to evaluate the impact of PCI on IMR by measuring such changes with three-dimensional echocardiography volume quantitation technology. Methods Eighty-seven patients were enrolled and echo data were acquired before and 6 months after PCI. Patients were classified into alleviation group (group Ⅰ)and non-alleviation group (group Ⅱ)according to the change of mitral regurgitation volume (MRvol).The systolic synchrony indexes (Tmsv 1 6-SD%,Tmsv 1 6-Dif%)and left ventricle volume parameters (LVEDVI and LVESVI)before and after PCI for patients of two groups were measured and contrasted.Results Systolic synchrony indexes of all patients of two groups were improved after PCI.Left ventricular volume parameters were decreased after PCI in group Ⅰ,and the remodeling was reduced.Correlation analysis of the parameters variations showed that,there was significant positive correlation between variations of left ventricular volume and MRvol in all patients and no significant correlation between variation of systolic synchrony index and MRvol.Conclusions PCI can improve left ventricular systolic dyssynchrony for submyocardial infarct patients.Left ventricular volume index that reflects the remodeling process is closely related to IMR.

Activated microglia function after pathologic event has been extensively investigated .In recent decades , it has be-come evident that resting microglia cells are highly dynamic surveillants .Microglia could influence synaptic development and connectiv-ity in the normal and developing brain .Microglia dysfunction results in behavioral deficits , indicating that microglia are essential for normal brain function .Here we summarize the functions of microglia in the physiological conditions , its effects on neural development , the formation of synapses and the regulation of the human′s behavior .

Objective To investigate the comparison of clinical curative effect and inflammation factors between irbesartan hydrochlorothiazide and candesartan cilexetil in the treatment of patients with hypertension.Methods A total of 86 patients with hypertension in our hospital from June 2014 to October 2015 were collected and randomly divided into two groups, 43 cases in the control group were treated by candesartan cilexetil,43 cases in the experimental group were treated by irbesartan hydrochlorothiazide.The blood pressure, CRP, IL-6 and NO indexes were detected in the two groups and the clinical curative effect of the two groups was compared.Results The systolic pressure and diastolic pressure levels in the experimental group were significantly lower than the control group ( P <0.05 ); the serum CRP, IL -6 levels in experimental group were significantly lower than the control group, the NO level was significantly higher than the control group (P<0.05).Conclusion Irbesartan hydrochlorothiazide in the treatment of patients with hypertension has a better clinical curative effect, and higher security.