Colorectal cancer is one of the most commonly seen malignant tumors,and the metastatic colorectal cancer is of poor prognosis. The median overall survival for chemotherapy is only 1-1. 5 years. Recently,molecular targeted therapy targeting at vascular endothelial growth factor and epidermal growth factor receptor was used widely for metastatic colorectal cancer and becoming a hot spot of related researches. This article focused on the strategy and hypothesis of molecular targeted therapy for treatment of metastatic colorectal cancer.

This paper summarizes the observation and nursing of patients with postoperative complications following percuta-neous transhepatic cholangogrphic drainage(PTCD) and biliary tract stent implantation for malignant obstructive jaundice. A-mong thirty-two patients,eight had postoperative complications,including two with biliary tract hemorrhage,four with biliary tract infection,one with pneumothorax and one with bile leakage. All the thirty-two patients recovered well in clinical symptoms and quality of life. To attach importance to psychological nursing and postoperative health education are the key points in nursing care of patients with PTCD,which play important roles in alleviating clinical symptoms,improving treatment outcome and pro-moting the patients' quality of life.

Purpose To investigate the chest CT features of lung injury caused by oral paraquat,and deepen the understanding of paraquat poisoning.Materials and Methods The chest CT features of 74 patients with lung injury caused by oral paraquat were analyzed retrospectively and comparatively.74 patients were divided into 3 groups according to toxic dose:28 cases in the low dose group (paraquat dose less than 10 ml),34 cases in the medium dose group (paraquat dose among 11 to 50 ml),and 12 cases in the large dose group (paraquat dose more than 50 ml).74 patients were also divided into 3 groups according to course of disease:The course of disease among 1 to 7 days were in the early period,8 to 14 days in the medium period,and 14 days later in the later period.The image features were summarized by comparing the chest CT features,with toxic dose,course of disease,and the scope of lung injury.Results Poisoned patient's chest CT features,related with toxic dose (P＜0.05),appeared from increased bronchovascular shadows,ground glass opacity,to effusion and consolidation,and to pulmonary fibrosis along with time.The effusion and consolidation majorly located in the lateral lungs,which showed a characteristic disease extent.Conclusion The chest CT features of lung injury,caused by oral paraquat,have a certain characteristic.It relates to toxic dose and course of disease,which has a certain guiding significance to clinical diagnosis and treatment.

Objective:To observe the inhibition of Chinese gallnut on bacteria in plaque biofilms by the use of artificial mouth.Methods:Water extract of Chinese Gallnut was prepared and liquid media two-fold dilution method was used to determine the minimal inhibition concentration(MIC)of the drug on S.mutans,A.viscosus,S.sanguis and S.oralis.Individual bacteria plaque biofilms in artificial mouth were created.The inhibition of Chinese gallnut on the bacteria in plaque biofilms was studied by colony counting.Results:In bacteria suspension gallnut water extract inhibited the growth of the four kinds of bacteria.The MIC of the extract on S.mutans,A.viscous and S.sanguis was 64 mg/ml,that on S.oralis 8 mg/ml.The plaque biofilms formed by the four kinds of bacteria could be inhibited by 2 mg/ml-128 mg/ml of the extract dose-dependently.At the highest tested conentration(128 mg/ml)the gallnut water extract could not completely clear up the colonyforming unite(CFU)of the becteria.Conclusion:Chinese gallnut water extract can inhibit the growth of bacteria in suspension and in plaque biofilms,the bacteria in biofilms may have stronger resistance to the extract.

Background and purpose:Patients with colorectal cancer are often accompanied by the increase of plasma ifbrinogen concentration. This study aimed to investigate the distribution characteristics of beta-ifbrinogen gene-448G/A, -148C/T, -1420G/A and -854G/A polymorphism and plasma ifbrinogen (Fg) concentration in patients with colorectal cancer. Furthermore, we analyzed their effects on the occurrence and development of cancer.Methods:The level of plasma Fg was quantiifed by using Clauss clotting method.FGBβ gene polymorphisms were identiifed by re-al-time lfuorescence quantitative PCR (RTFQ-PCR) in 194 colorectal cancer patients and 74 healthy controls.Results:The plasma Fg levels in tumor metastasis group and non-metastasis group were signiifcantly higher than that in control group, respectively (P<0.05). Compared with control group, the frequencies of -148T allele and mutation genotype were notably higher in disease group (P<0.05). In all the groups, the plasma Fg levels of those with -148T allele were higher than those without -148T allele (P<0.05). In stageⅣ patients, there was no difference in PFS between -148T wild gen-otype group and mutation genotype group (P>0.05).Conclusion:Plasma Fg concentration in patients with colorectal cancer was signiifcantly raised, which suggests that Fg may play a role in the occurrence and development of colorectal cancer. The beta-ifbrinogen gene -148C/T polymorphism is one of the reasons that cause plasma Fg elevation, but has no correlation with prognosis of patients with stageⅣ colorectal cancer.

0.05].In 48 patients without lymph node metastasis,there was no significant difference between the OPN-positive and OPN-negative patients in survival times.Multivariate analysis revealed that survival times was associated with patients′sex(P=0.032)and TNM stage(P

OBJECTIVE:To strengthen the supervision of drug stocktaking,and to improve drug management. METHODS:The data of drug stocktaking were extracted from our hospital from 2011 to 2014,and was analyzed in respects of accounts coinci-dence rate,drug profit and loss account rate,the entry and exit account between departments and original record,etc. A series of supervision strategies were established,and the data of drug stocktaking was analyzed during Jan.-Jun. in 2015 statistically to evalu-ated supervision effects. RESULTS:The supervision of drug stocktaking was strengthened through limiting the right of drug profit and loss on stocktaking,strengthening original stocktaking record management,establishing Key Drug List,setting up drug stock-taking supervision institutions,etc. During Jan.-Jun. in 2015,there was obvious improvement in the drug supervision skills,in terms of account coincidence rate,profit and loss account,material safety,cash flow rate,staff responsibility and stocktaking dura-tion,etc. More specially,the accounts coincidence rate had rose from about 82.8% to more than 95%;both the key drug accounts coincidence rate and the entry and exit account between departments coincidence rate had reached to 100%;the profit and loss ac-count rate had reduced from about 7.6% to less than 0.3%;the stocktaking time had reduced from 10 h to 3 h. CONCLUSIONS:Strengthening drug stocktaking supervision can not only improve the stocktaking efficiency and quality markedly,but also contrib-utes to the development of other pharmacy work in hospital.

Objective: To understand the medical staff' cognition of medicalethics.Method: Descriptive study and various analysis were performed. Results: Four aspects including the understanding of hospital Ethic Review Committee, the status of medical ethics education, the understanding of medical ethics in clinic and research, the requirement of medical ethics training were surveyed among the medical staff in five hospitals. Conclusion: The influence of medical ethics in clinical practice and medical research were greatly improved. The hospital Ethic Review Committee should be strengthened and a lot of works was needed for medical ethics education.

Objective To study the diagnostic value of spectral CT in atypical tuberculosis ball and lung cancer.Methods 45 cases of pulmonary nodule or mass received unenhanced and two phase enhanced scan in gemstone spectral imaging mode,and all pulmonary nodule or mass were confirmed by pathology.Selecting unenhanced,arterial phase and venous phases of spectrum image,atypical tuberculosis ball group and lung cancer group were analyzed.Normalized iodine concentration (NIC), the spectral curve slope (λHU),CT value of unenhanced and two phase enhanced spectrum image were measured and calculated.Two independent samples t-test was used for the statistic analysis of each spectrum parameters between the two groups.The receiver operating characteristic (ROC) curve was obtained for comparing the sensitivity and specificity of each spectral parameter.Results Among the 45 patients,11 were atypical tuberculosis ball, and 34 were lung cancer.Comparison NIC,two phase enhanced λHU and the net enhanced CT values of 70 keV monoenergetic image of the two groups, lung cancer group was higher than atypical tuberculosis ball group,and the difference was statistically significant(P<0.05);However, the unenhanced CT value of 70 keV monoenergetic image of the two groups was not statistically significant (P>0.05).When the NIC diagnostic threshold was 0.105, the maximum Youden index (0.733), the area under the ROC curve was 0.89, and sensitivity and specificity was 82.4% and 90.9%, respectively.Conclusion The quantitative parameters of spectral CT is helpful in the diagnosis of atypical tuberculosis ball and lung cancer,especially the NIC with high value.

Based on a study of children’s behavior and psychological characteristics,the article introduced Maslow’s hierarchy of needs to discuss children’s special needs for medical environment.Hence the authors proposed to meet children’s physiological needs,security needs,social needs,esteem needs,and self-realization needs.Shanghai Children’s Hospital was cited as an example,to present the humanistic expression practices in designing children’s medical environment.