Mammalian target of rapamycin(mTOR) inhibitors have the anti-tumor ettect,which have been known early.The traditional mTOR inhibitors include rapamycin and its derivatives,which have been applied in clinical use early.Nowadays,some new small molecule inhibitors such as the PI3K/mTOR duel inhibitor,Torinl,one after another are found to play a unique role in the tumor therapy.

Objective Investigation of satisfaction of clinical nurses and analysis of the influence factors.Methods The ERG theory of Clayton Alderfer is used as the framework to design the questionnaires,for questionnaire investigation of 249 nurses in the hospital in a stratified sampling,Results The score of general satisfaction of nurses for their work is 3.40±0.58;the satisfaction of nurses for the management of their leaders and teamwork is high,as the satisfaction scores are 4.01±0.76 and 3.60±0.71 respectively;their satisfaction for salary,welfare and social identity is low,as the scores are 2.46±0.86 and 2.50±1.02 respectively.Work satisfaction varies with departments,academic levels,monthly income,work shifts,age,seniority,and objectives for their choice of nursing as profession.Conclusion Managers are prompted to enhance their work in view of the satisfaction scores on survival,mutual relations and growth,as well as factors affecting satisfaction,and take various incentives to improve overall satisfaction of nurses.

Carcinoma, Adenoid Cystic ; etiology ; Ear Neoplasms ; etiology ; Humans ; Male ; Middle Aged ; Tympanoplasty ; adverse effects

[Objective] To gain more insight into the presentation,diagnosis of Bertolotti's syndrome and to investigate the indications,the procedure and the early clinical results of minimally invasive transverse process plasty.[Methods]Thirteen cases(Santavirta Type I)with Bertolotti's syndrome underwent minimally invasive transverse process plasty under MED X-tube(Medtronic Sofamor)from Apr.2006 to Dec.2008.The Visual Analogue Scale(VAS),Modified Oswestry Disability Index(ODI)score and subjective sensation of patients were recorded to evaluate the function.[Results]The operation blood loss was from 120 ml to 800 ml and operative time was from 60 to 280 minutes,average 115minutes.There was no severe complication.Nine cases were followed up for 10 to18 months,average 13.6 months.The VAS decreased from(6.7?2.2)before operation to(2.2?0.7)one week after operation and(2.8?0.9)three months after operation.ODI score decreased from(27.8?3.6)before operation to(5.9?2.2)three months after operation.The results were excellent in 10 case and good in 3 cases.[Conclusion]Minimally invasive transverse process plasty is an effective method for Bertolotti's syndrome,especially for Santavirta type I.It shows less blood loss and injury and deserves to be spreaded.Disectomy is recommended in one stage if the patient is complicated with disc herniation.

Objective:To design and prepare repaglinide and metformin hydrochloride tablets for pilot scale test and industrial pro-duction. Methods:Dissolution was applied to optimize the formula and preparation process. Results: The tablets were prepared ac-cording to the determined formula and process with poloxamer 188, meglumine, PVP K30, croscarmellose sodium, microcrystalline cellulose PH101, sorbitol, magnesium stearate and coating powder as the adjuvants. The dissolution behavior of the tablets in four media was similar to that of the reference. Conclusion:The preparation process of repaglinide and metformin hydrochloride tablets is simple and feasible, and the quality is controllable and stable.

Recent studies have found that autophagy was not only involved both in the occurrence and development of viral myocarditis (VMC),but also,it plays a key role in anti-viral infections by degradating the viral components,presenting viral antigens and activating the immune response.Meanwhile,the virus can also escape the protective antiviral activity and maintain their own survival and replication by inducing the autophagy of the host cells,becoming the accelerator of the viral infection.The interaction of the virus and the host cell autophagy in VMC is a complex process.Its detailed pathogenesis has yet to be further explored.

Objective To investgate the efficiency of autologous fat grafting for breast augmentation by improving low negative pressure mechanical liposuction.Methods A total of 37 cases of breast augmentation by autologous fat grafting were reviewed;group A included 19 cases of improved low pressure mechanical liposuction,and group B had 18 cases of traditional syringe liposuction.Respectively,the operating time of harvesting 800 ml fat granules (standing 30 mins) were recorded,and operative blood loss by testing the red blood cell count of lower mixed liquid was calculated,and then growth increment of nipple chest circumference of 6 months after operation were measured.The valid follow-up satisfaction scores were counted.Results The operating time of harvesting 800 ml fat granules were (53.32±4.73) mins for group A and (80.78±7.86) mins for group B,respectively;operative blood loss was (81.58±10.80) ml for group A and (72.94±13.45) ml for group B;All P＜0.05.The valid follow-up satisfaction scores were 78.9％ (15/19) for group A and 77.7％ (14/19) for group B.Growth increment of nipple chest circumference of 6 months after operation between groups were no statistical significance (P＞0.05);but the remarkable difference within both groups in internal comparison existed between 6 months and 1 month after operation (P＜0.05),also between 3 months and 1 month after operation (P＜0.05).Conclusions Improved low pressure mechanical liposuction in breast augmentation by autologous fat grafting is able to enhance the surgical efficiency evidently and shorten the operating time significantly.

In recent years,research on autoimmune pancreatitis (AIP) has gained significant progress.AIP is a special type of chronic pancreatitis which is mediated by an autoimmune mechanism.It is characterized by the infiltration of lymphocytes and plasma cells leading to pancreatic fibrosis and dysfunction.AIP can affect the bile ducts,salivary glands,kidneys and other organs outside the pancreas.The common manifestations include obstructive jaundice,abdominal pain,and weight loss,which are similar to pancreatic cancer.Steroid therapy is of significant effect.There is no consensus nowadays on the diagnostic criteria of AIP across the world.There are many studies on the pathological subtypes,imaging,serological markers and biopsy techniques on AIP,and research focuses on the differential diagnosis from pancreatic cancer.

Objective To investigate effect of urinary conditions and lower urinary tract symptoms (LUTS) in patients before and after the reconstructive pelvic surgery (RPS) for pelvic organ prolapse (POP) as well as effect of urinary conditions and LUTS by tension-free vaginal tape-obturator (TVT-O).Methods From Jan. 2007 to Dec. 2009, 213 patients with POP underwent RPS, the factors on preoperative, postoperative urinary conditions and qualities of life and postoperative urinary incontinence were studied prospectively. Results Totally 193 patients who was followed up for more than 3 months after surgery attend questionnaires, and 165 preoperative patients of 193 (85.5%) had LUTS, 105 postoperative patients of 193 (54.4%) had LUTS, which reached statistical difference (P ＜0. 01 ). The rate of LUTS before and after operation: urinary frequency ( 57.0% and 25.9% ), urinary urgency ( 51.8% and 28.0% ), urinary leakage due to cough ( 50. 3% and 15.0% ), dropping urinary leakage ( 44. 6% and 14. 5% ), dysuria (34. 7% and 23.3% ), vesicaltenesmus (49.2% and 19. 7% ) and hand assist urination (31.1% and 2.6% ). The incidence of LUTS after surgery is much lower than that of pre-operation ( P ＜0. 05 ). POP patients with stress urinary incontinence ( SUI ) before the operation, surgery without TVT-O simultaneously are the risk factors of unimproved symptom ( OR = 4. 933, 95% CI: 1. 353 - 17. 990, P=0. 016). Conclusions RPS have alleviated LUTS in patients with POP. RPS with TVT-O are more effective than traditional RPS in treatment of the urinary incontinence if the POP patient with SUI or occult SUI.

Objective　To study the value and limitation of CT in the damage to multiple organs in children with Langerhans cell histiocytosis (LCH). Methods　Analysis of CT manifestations was performed in 13 cases of LCH proved by clinical features, laboratory data, and pathologic changes. Localized LCH was found in 4 cases, and disseminated LCH in 9 cases. All cases were examined by plain scan in craniocerebral, chest, liver, and spleen, and four cases by contrast-enhanced CT scan. Results　The male outnumbered female in this group. Cranial bones were involved in the sequence of temporal bone(8 cases), parietal bone (3 cases), occipital bone (2 cases), and frontal bone (1 case). CT findings were very sensitive in showing the early destructions of the bones. The characteristic manifestation on CT was multiple lytic lesions of the flat bones at any sites, without reactive sclerosis and soft tissue mass accompanied with the bony lesion. Imaging findings presented later than the clinical manifestations for LCH involving the hypothalamus/pituitary axis. Involvement of the lung at various stages by LCH could be demonstrated by CT scan. Conclusion　Imaging manifestations had no characteristics in LCH involvement. The sites of predilection and related CT manifestations could be suggestive of the diagnosis. In addition, CT findings can be helpful in the classification and evaluation of the therapy and prognosis in LCH.