Nanomedicine offers great promise for early diagnosis and treatment of formidable diseases. The unique morphology and biology characteristics of bacteriophage provide unprecedented opportunity for such endeavor. The paper summarizes the application of bacteriophage in nanobiomaterials, nanomedicine, nanomedicine delivery and nanodiagnosis, especially the nano-imaging reagents and future direction concerning nanomedicine based on bacteriophage.

Objective To observe the developmental changes of projection and termination of proprioceptive afferent fibers in the mouse spinal cord. Methods Parvalbumin (PV) immunohistochemistry was used to label the proprioceptive afferents. Single and dual immunofluorescence histochemistry were used to examine the growth pattern of proprioceptive afferents and their relationships with motoneurons in the spinal ventral horn (VH). The stained sections were observed under a confocal laserscanning microscope. Results PV-like immunoreactive (LI) proprioceptive fibers first appeared in the dorsal column on embryonic (E) day 14, then entered the gray matter on El5 and reached the intermediate gray matter and VH more obviously on E16. The number and intensity of PV-LI proprioceptive afferent fibers and punctata increased in the VH with age and reached a maximum during earlier postnatal (P) period (P0-P7). After P14, the number and intensity of proprioceptive afferents gradually decreased. The proprioceptive terminals seemed to form close relationship with motoneurons from E17. Conclusion The present study indicates that the somatotopic organization of proprioceptive afferents in the spinal cord is established during the late embryonic and early postnatal stages. These results provide evidence for understanding the development of the reflex movements.

The present study was designed to examine the developmental changes in projection and termination of nociceptive and proprioceptive afferent fibers in the spinal cord by labeling those two fibers with calcitonion gene-related peptide (CGRP) and parvalbumin (PV)separately in mouse embryos and neonatal pups aged embryonic day 15 to posanatal day 3 (E15 -P3). CGRP-like immunoreactive (LI)nociceptive fibers first appeared in the superficial dorsal horn (DH) at E16. The afferent projections extended laterally to the DH and entered into the deep portions of the DH at E17 and E18. After birth, the projection pattern of CGRP-LI fibers remained unchanged but the intensity of afferent terminals increased in the superficial laminae and their branching patterns became more complicated. In addition,CGRP-LI collaterals that projected into the contralateral DH were also examined after E16. Around birth, the contralateral projections were also found originated from the lateral part of the DH. PV-LI proprioceptive afferents were first observed entering the gray matter at E15 and reached the intermediate gray matter (IG) and the ventral horn (VH) more obviously on E16. The number and intensity of PV-LI fibers increased in the the VH with age and reached a maximum during earlier postnatal period ( P0-P3 ). The proprioceptive terminals seemed to form close relationship with motoneurons in the VH from E17. Our results indicate that the somatotopic organization of nociceptive and proprioceptive afferents in the spinal cord both are established during the late embryonic and early postnatal stages. These results help to understand the development of the sensory transmission in more details.

Depending on the meaning and function of the liver in traditional Chinese medicine and modern medicine,this paper explores the important role of liver in the pathogenesis of DM (Diabetes Mellitus,DM).Combined with treatment based on syndrome differentiation and specific case report study,this paper has stressed the importance of treating DM from liver and so to set a sound basis for the systemic treatment based on syndrome differentiation from internal organs for DM.

Objective:Occult breast cancer (OBC) accounts for 0.3%-1.0%of all breast cancers. Because of the rarity of this dis-ease, its treatment and prognosis remain unclear. Our study evaluated the treatment outcomes and prognostic factors associated with OBC. Methods:A total of 82 patients diagnosed with OBC based on available criteria were treated at the Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China, between January 1968 and June 2014. Except for 16 patients who were treated by needle biopsy or excisional biopsy only and were subsequently excluded, all of the cases reported were included in the study. Of the remaining 66 patients, one was male. Patient data, tumor characteristics, and treatment and outcome variables were evaluated. Overall survival (OS) and disease-free survival (DFS) were analyzed. A unicentric retrospective review of 66 patients with OBC was performed. Re-sults:The median follow-up was 75.5 months (7.0-328.0). No significant differences in OS and DFS were observed between patients who underwent mastectomy plus axillary lymph node dissection (Mast+ALND) and those who underwent breast conservation surgery (P>0.05). Univariate analysis revealed that nodal status is a significant prognosis factor of DFS (P=0.031). Conclusion:No significant difference in treatment outcomes between mastectomy+ALND and breast conservation surgery was observed. Nodal status may be an independent predictor of poor outcomes in OBC patients.

Objective To observe the efficiency and safety of brachytherapy by CT-guided percutaneous paracentesis implantationof iodine-125 seed for lung cancer in elder patients.Methods 46 elder patients with lung cancer(65~81 years)were undergonebrachytherapy by CT-guided percutanepus paracentesis implantation of iodine-125 seeds with implanting needle(18-gauge). The effect of treatment according to observe the changes of tumors in size was evaluated after operation 1,2,3 and 6 months,respectively. Results There were totally 57 lesions in 46 cases,7 cases were undergone two times of implantation,and 1 case was undergone three times of implantation,totally the puncture accounted for 76. The effective rate (CR+PR) of treatment after one ,two, three, and six months was 8.77%(5/57), 40.35%(23/57),89.47%(51/57) and 96.49%(55/57),respectively. 5 patients(6.58%) accompanied by pneumathorax.Conclusion Brachytherapy by CT-guided percutaneous paracentesis implantation of iodine-125 seed is a safe, reliable and effective treatment for lung cancer, especially for elder patients.

Objective To analyze the reasons of non-planned decannulation (NPD) of peripheraly inserted central catheter (PICC) and explore the applicable prevention strategies.Methods We retrospectively analyzed the clinical data of 432 patients who underwent PICC cannulations maintenance between July 2005 and June 2008.The reasons of 26 cases of NPD were analyzed.Results The main reasons of NPD included cannulation occlusion,cannulation ectopia or translocation,cannulation exfoliation,cannulation-related infections,mechanical phlebitis,and thrombus formation.The complications usually were caused by the poor cannulation material,incorrect fixation,top of canuulation not reaching superior vena cava,lack of management measures for outpatients,accidents,and others.Effective measures for preventing NPD included:use silica gel cannulation;ensure the top of canuulation reach the superior vena cava;and improve the communications between outpatients and nurses.Conclusion NPD of PICC may be caused by various reasons and effective prevention measures should be taken.

Objective To investigate the level of the clinical nurses' critical thinking disposition and the competence about nursing ethical decision making,and analyze the relationship between them.Methods A total of 359 clinical nurses were recruited by stratified random sampling method.They were investigated with general situation questionnaire,critical thinking disposition inventory-Chinese version (CTDI-CV) and judgment about nursing decisiors(JAND).Results The total score of CTDI-CV was (285.06±26.79),the total score of JAND was(267.91±16.62).The influencing factors of clinical nurses' competence about nursing ethical decision making was education background,ways of obtaining occupational knowledge,training of nursing ethical decision.The clinical nurses' competence about nursing ethical decision making was positively correlated with critical thinking disposition.Conclusions The level of clinical nurses' critical thinking disposition and competence about nursing ethical decision making are medium,in order to improve the level of competence about nursing ethical decision making,both school education and the continue education among hospital should strengthen the training of nurses' critical thinking disposition.

Objective To evaluate the accuracy of the transcutaneous bilirubin (TcB) at different sites including the chest (covered and uncovered),forehead and scapula,compared with total serum bilirubin (TSB) before and after phototherapy.Method Neonates who underwent blood test of TSB together with the average TcB at chest over 6 mg/dl from September 2015 to July 2016 in our Hospital were enrolled in our study.TcB measurements were done by the transcutaneous bilirubinometer (JH20-1 C) at the sites of the chest,forehead and scapula within 30 minutes after venous or arterious blood sampling for testing TSB after admission.An area of 2 cm diameter over the left chest was covered during phototherpy.TSB was tested immediately and within 12 ～ 24 hours after phototherapy,while TcB was measured within 0.5 hour after blood sampling at the covered sites over the left chest,right chest,forehead and scapula.IBM SPSS 20.0 software was used for data analysis.Data were compared via Pearson correlation analysis,ANOVA of repeated measurement data,student's t test and Bland-Altman analysis.Result A total of 437 data were collected from 364 neonates were enrolled in our study.Before phototherapy,the values of TcB at different sites were highly correlated and consistent with TSB (P ＜ 0.05),especially taken from the chest (the difference value of TcB and TSB-1.2 ± 2.3 mg/dl).Immediately and within 12 ～ 24 hours after the phototherapy,the values of TSB and TcB taken from the covered left chest showed the highest consistency (-1.2±2.3 mg/dl and-0.5 ± 1.6 mg/dl).When TSB exceeded 15 mg/dl before phototherapy,the difference between TSB and TcB taken from chest was 1.5 ± 1.6 mg/dl,while if TSB was below 15 mg/dl,the difference was-1.9 ± 1.9 mg/dl.They were significantly different (P ＜ 0.001).And difference between TSB and TcB taken from chest was not affected by gender gestational age,birth weight,days of birth and different measurements.When TcB taken from the covered or uncovered chest was less than the TSB threshold value of 3.3 mg/dl for phototherapyl,or the TcB of the left covered sternum lower than the threshold value of 2.6 mg/ml for cessation of phototherapy,97.5％ of the TSB would not exceed the corresponding value.Conclusion The TcB values of both uncovered chest before phototherapy and covered chest after phototherapy were highly consistent with TSB,and could be applied in the replacement of TSB in the assessment and management of neonatal jaundice.

Objective To investigate the effect of intracoronary tirofiban bolus administration on platelet-derived microparticles (PMPs) and its correlation with the short term clinical benefit in patients with acute ST-segment elevation myocardial infarction (ASTEMI) undergoing emergency percutaneous coronary intervention (PCI).Methods A total of 90 patients with ASTEMI undergoing emergency PCI were selected and randomized into the intracoronary group (intracoronary tirofiban 10.00 μg/kg bolus within 1-3 min followed by intravenous continuous infusion at 0.15 μg· kg-1 · min-1 for 36 h,n＝ 30),intravenous group (intravenous tirofiban 10.00 μg/kg bolus within 1-3 min followed by intravenous continuous infusion at 0.15 μg· kg-1 · min-1 for 36 h,n＝30) and control group (without tirofiban administration,n＝ 30).The 3 ml blood samples from coronary artery were obtained before and 10 min after tirofiban infusion.The 3 ml blood samples from radial artery were collected 24 hours after tirofiban infusion and 12 hours after drug withdrawal.The counts of PMPs were analyzed by flow cytometry.The thrombolysis in myocardial infarction (TIMI) flow grade classification and TIMI Myocardial Perfusion Grade in the culprit blood vessel after PCI,and the incidences of bleeding and major adverse cardiac events (MACE) within 30 days after surgery were recorded.Results There was no significant difference in baseline of PMPs among intracoronary group,intravenous group and control group (all P＞0.05).The level of PMPs was decreased in the intracoronary and intravenous group as compared with the control group [(3.6 ±2.3)％,(5.1±2.7)％ vs.(6.7±3.2)％,P＜0.01 or 0.05] 10 min after tirofiban infusion.The PMPs were lower in intracoronary group than in intravenous group (P＜0.05).At 24 hours after tirofiban infusion,the levels of PMPs in intracoronary versus intravenous groups were similar (P＞0.05),and PMPs levels were lower in intracoronary and intravenous group than in control group (both P＜0.05).The levels of PMPs had no significant diferences among the 3 groups at 12 hours after drug withdrawal (P＞0.05).Immediately after PCI,the TIMI flow grade and TIMI myocardial perfusion grade in the culprit blood vessel in intracoronary group were superior to those in the intravenous group and control group (P＜ 0.05 or 0.01).There was no statistically significant difference in the total incidence of MACE among the three groups (P＞0.05).Conclusions The intracoronary versus intravenous tirofiban administration can effectively and immediately reduce the number of PMPs in patients with acute ST-segment elevation myocardial infarction undergoing emergency interventional treatment,quickly inhibit the activated platelets,and decrease the total major adverse cardiovascular events without increasing the risk of bleeding.