Objective To discuss the promoting effect of clinical pathway in the standard and reasonable medication by the application of clinical pathway in the anticoagulation treatment of warfarin and health education for patients with atrial fibrilation.Methods Sixty eight patients with atrial fibrilation and receiving anticoagulation treatment of warfarin were divided randomly into the intervention group(36 cases)and the control group(32 cases).The control group received routine nursing while the intervention group underwent nursing intervention with clinical pathway based upon routine nursing intervention.The time cost to achieve the aims,compliance,incidence rate of complications and satisfaction degree were compared between the two groups.Results All the items in the intervention group were superior to those of the control group except for the items of satisfaction degree and health knowledge score(P<0.05).Conclusion Application of clinical pathway in the anticoagulation treatment of warfarin for patients with atrial fibrilation could ensure standard and reasonable medication in order to decrease medical cost,lower the incidence rate of complications,improve patients compliance and increase nursing quality.

Overexpression of epidermal growth factor receptor (EGFR) in esophageal cancer has been related to tumor grade, vascular invasion and metastasis. The level of EGFR expression may be a predictive marker of esophageal caneer's sensitivity to chemoradiotherapy. EGFR inhibitors have been indicated as an effective targeted therapy, and promising results have been observed in phase Ⅱ and Ⅲ clinical trials.

Thirty-four patients with chronic lingual tonsillar hypertrophy were treated in our department from 1994 to 2000. There were 18 males and 16 females ranging in age from 21 to 60 years old. The clinical feature of lingual tonsillar hypertrophy usually appeared a series of pharyngeal symptoms, such as foreign-body sensation, sore throat, speech change, difficulty in swallowing, dysapnea and obstructive sleep apnea. The CO2 laser surgical lingual tonsillectomy was used for these patients. Result showed that the cure rate was 100% without any serious complications by following up 2 months to 3 years. The variety of presentations of lingual tonsillar hypertrophy and methods of surgical treament were discussed.

Objective:In the medical cooperation, in order to realize the homogeneity of the medical, teaching, research, management, avoid to the waste of resources and the low benefit of patients with traditional cooperative mode. So combining the Internet and cloud computing technology to realize the reconstruction of the traditional mode of cooperation.Methods: Because of the need for equivalent cooperation, Beijing Friendship Hospital set up The Tiered Medical Work Platform Based on Medical image and Cloud Computing which between Beijing Friendship Hospital and Beijing Pinggu Hospital. The Work Platform was able to provides applications such as remote reading, remote diagnosis, remote consultation, remote difficult case discussion, remote teaching, training and so on.Results: The Work Platform solved the problem of wasting of human resource cost in our hospital, and improved the allocation of medical resources, improved the level of medical service of Beijing Pinggu Hospital, made people get benefits.Conclusion: Telemedicine technology can realize the reconstruction of traditional medical cooperation mode, establish standardized information sharing platform, increase the efficiency of medical resources allocation, improve the ability of primary diagnosis and treatment services, provide assist in forming the pattern of Tiered Medical.

Objective To investigate the expression and distribution of cyclooxygenase-2(COX-2) in periodontal tissues during experimental tooth movement in rats,and study the relationship between COX-2 and vesscular reconstruction in experimental tooth movement process.Methods Thirty-five healthy Wistar rats were divided randomly into 7 groups on average:normal group and experimental groups for 1,3,5,7,14 and 21 d.A NiTi coil spring with 0.294 N mesial force was connected between first molars of maxillary and the upper incisors.The histological sections were stained with goat anti rat COX-2 antibody,and computer image analysis was used to study the expression of COX-2 in the periodontal tissues of rats.Results Pressure area:compared with normal group(134.75?5.25) the COX-2 expression in 1 d group (147.73?3.27)increased(P0.05).Conclusion The expression of COX-2 in periodontal tissues during experimental tooth movement increase,suggesting that COX-2 can promote the vascular reconstruction in periodontal tissues during orthodontic tooth movement.

Objective:To explore risk factors for slow coronary flow (SCF) phenomenon in male patients .Methods:A total of 123 male patients ,who were suspecting coronary heart disease because of chest pain ,then coronary angiography indica‐ted there was no significant lesion in epicardial coronary arteries ,were selected .According to presence of SCF or not ,they were divided into SCF group (n=69) and normal group (n=54) .Case data of two groups were retrospectively analyzed , and Logistic regression analysis was use to analyze risk factors for male SCF .Results:Compared with normal group ,there were significant rise in body mass index [BMI , (24. 01 ± 1. 57 ) kg/m2 vs . (27. 06 ± 3. 40 ) kg/m2 ] , hemoglobin level [ (145.79 ± 9.63) g/L vs .(150.00 ± 11.84) g/L] and hematocrit [ (0.43 ± 0.03) L/L vs .(0.45 ± 0.06) L/L] in SCF group ,P<0.05 all .Logistic regression analysis indicated that BMI (OR= 1.373 ,95% CI 1.146~1.645 ,P=0.001) and hemoglobin (OR=1.037 ,95% CI 1.000~1.176 ,P=0.048) were independent risk factors for male SCF .Conclusion:El‐evated body mass index and hemoglobin level are independent risk factors for slow coronary flow in male patients ,so corre‐sponding preventive measures must be carried out to improve prognosis .

Thirty-one children suffered from speech retardation were found to have normal hearing level through ABR and/or acoustic immittance tests. Some of them were further checked by psychiatrists and pediatricians. The results demonstrate that among reasons for speech retardation in children,autism and mental retardation are important factors that can not be ignored. A-mong children with unclear diagnosis .some harmful factors were found on themselves and in surroundings. We emphasize that for children with speech retardation,not only hearing disorders,but also other factors should be considered.

Objective To investigate the effect of Ruin nutrient solution combined with dietary education on the postoperative patients with gastrointestinal neoplasms.Methods 88 patients with gastrointestinal neoplasms in Hangzhou tumor hospital from January 2016 to January 2017 were randomly divided into the control group(44 cases) and the observation group(44 cases).The control group were given the early stage total parenteral nutrition.The observation group were received the early stage enteral nutrition and dietary education.The recovery time, the occurrence of complications and the hospitalization time and hospitalization expenses were compared in the two groups.Results After the intervention, the recovery time of bowel sounds and recovery time of anal in the observation group were less than those in the control group, the difference was statistically significant(P<0.05);the incidence of complications in the observation group was lower than that in the control group(P<0.05).The hospitalization time and hospitalization cost in the observation group were better than those in the control group, the difference was statistically significant(P<0.05).Conclusion The combination of Ruin nutrient solution and dietary education is effective on the treatment of the postoperative patients with gastrointestinal neoplasms, which can effectively promote the recovery of intestinal function and reduce the incidence of complications, accelerate the rehabilitation of patients and deserve to be further promoted in clinic application.

Objective To investigate the risk factors of vagus nerve invasion of advanced adenocarcinoma of esophagogastric junction (AEG).Methods The specimens from 98 patients with advanced AEG who underwent radical total gastrectomy and esophagogastric Roux-en-Y anastomosis from January 2011 to August 2012 at the First Affiliated Hospital of Anhui Medical University were collected.Serial section cutting was done and the upper and bottom incisional edges of every section were marked.The specimens were stained by hematoxylin-eosin solution,S-100 and CK immunohistochemistry.Vagus nerve invasion could be affirmed if cancer cells were observed in the peripheral space of vagus nerve and vagus nerve parenchyma or cancer cells infiltrated along the peripheral space of vagus nerve.Relationship between nerve invasion and clinicopathological factors was analyzed using chi-square test or Fisher exact probability.Factors related to vagus nerve invasion were analyzed using one-way analysis of variance and multi-factor logistic regression analysis.Results The incidence of vagus nerve invasion was 28.6％ (28/98),and the tumor only invaded the vagus nerve which had the same altitude as the upper incisional edge.The results of one-way analysis of variance showed that Siewert classification,intravascular cancer emboli,lymph node metastasis,the degree of lymph node metastasis,clinical staging,the degree of tumor differentiation were correlated with the vagus nerve invasion (x2 =14.156,14.552,5.454,10.706,6.919,14.767,P ＜ 0.05).The results of multi-factor logistic regression analysis showed that Siewert classification,intravascular cancer emboli and degree of tumor differentiation were the independent influencing factors of vague nerve invasion (OR =3.667,10.368,0.249,P ＜ 0.05).Conclusion Vagus nerve invasion is correlated with Siewert classification,intravascular cancer emboli and degree of tumor differentiation.The range of vagus nerve invasion is restricted under the upper incisional edge of tumor section.

As the third generation platinum antitumor drug with independent intellectual property rights,a number of basic and clinical research shows lobaplatin can effectively inhibit the proliferation of human breast cancer cell lines including triple-negative breast cancer in vivo.Compared with the cisplatinbased regimens,lobaplatin-based regimens have similar efficacy,and better safety profile.It becomes the new treatment option of metastatic breast cancer,and remains to be further study to optimize clinical rational drug use.