Comprehensive geriatric assessment conducts comprehensive assessments of many aspects of health and well-being of an older patient including medical, functional, nutritional, psychiatric and behavioral issues, as well as family and social support. Comprehensive geriatric assessment is put into using widely in common geriatric syndromes and problems. This paper introduced the concept, content,objects, and implementation of comprehensive geriatric assessment, as well as the application in geriatric rehabilitation.

We here systematically summarize our practice and its effectiveness in the creation and development of the discipline proteomics in Academy of Military Medical Sciences,and the establishment of a system for identifying and training talented researchers in proteomics.The methods we used to train the researchers and to develop a vigorous team are discussed.These practices contributed much to the development of proteomics in China.

Objective To discuss spinal fusion effect of lumbar intertransverse process in rabbits by using bone marrow stromal stem cells(MSCs)in conjunction with bone morphogenetic protein(BMP)and freeze-dried demineralized bone matrix(FDBM)as scaffold.Methods To separate and cultivate MSCs in vitro,with FDBM as scaffold,osteogenesis was induced by BMP.Sixty Japan white rabbits were randomly divided into three groups.Group A was MSCs+FDBM+BMP,group B was FDBM,group C was autogenous ilium cancellous bone(AIB).Lumbar intertransverse process was fused in lumbar five to six.Rabbits were killed at 8 weeks after operation.The general observation and imageology were used to assess the fusion condition.To estimate the implantation using DR image.Gray scale analysis of DR image caculated the osteogenic density and acreage.The CT scan and three-dimensional reconstruction was used to observe the fusion configuration of lumbar intertransverse process.Results The fusion mass character in group A and C was hard,the morphology was not regulation.The fusion mass was almost absorbed in group B beside little tissue approach transverse process.There were high density image between intertransverse processes,osteogenic density were nonuniform in group A and C.There were nonunion in group B.Consistent callus were existed between intertransverse process in group A and C.There were not consistent callus in group B.Group A was similar to group C in osteogenesis density and acreage.Group B was the worst.There were cartilage and newly born bone trabecular formation in group A and group C.Between transverse process were mainly fiber tissue in group B.Conclusion MSCs in conjunction with BMP and FDBM has the similar osteogenic capability to the AIB and better osteogenic capability than that of FDBM alone when spinal fusion of lumbar intertransverse process is performed in rabbits.

Objective To evaluate the clinical effect of group cognitive behavioral therapy on blood glucose levels,anxiety and depression in patients with type2 diabetes mellitus.Methods Ninety three patients with type 2 diabetes mellitus were recruited and randomly divided into intervention group (n =48) and control group (n =45).Both groups received diabetes health education,patients in intervention group received additional group cognitive behavioral therapy.The glucose tolerance,glycosylated hemoglobin A1c were measured; the HAMA(Hamilton Anxiety Scale)scores,HAMD(Hamilton Depression Scale)scores and CSQ (Coping Styles Questionnaire) scores in patients were analyzed before and 6 months after treatment.Results After 6-month treatment the fasting blood glucose (6.33 mmol/L vs.5.94 mmol/L),1 h postprandial plasma glucose(12.40 mmol/L vs.11.46 rmool/L),2 h postprandial plasma glucose (10.24 mmol/L vs.9.13 mmol/L),A1 c (6.31％ vs.6.07％) in intervention group were decreased significantly,compared to baseline values (all P ＜ 0.05).The HAMA total score (9.98 vs.8.14),somatic anxiety (3.98 vs.3.48),psychic anxiety(6.00 vs.4.67),HAMD total score(10.74 vs.6.93),anxiety somatic(5.02 vs.3.26),block(2.24 vs.1.38)and sleep disorders(2.40 vs.1.40)in intervention group were all decreased significantly(P ＜ 0.01 or 0.05).There were significant differences in HAMA total score (8.14 vs.9.15),HAMD total score(6.93 vs.9.33),anxiety somatic(3.26 vs.4.38),block(1.38 vs.1.98)and sleep disorders(1.40 vs.2.03)between the intervention group and control group(P ＜ 0.01 or 0.05).And the negative coping style scores in intervention group was also lower than that of the baseline (26.74 vs..29.43).Conclusion The group cognitive behavioral therapy combined with diabetes health education for patients with type 2 diabetes mellitus may improve the glucose metabolism and depression and anxiety status of patients.

Objective:To explore how coping style and social support influence the quality of life in patients with impaired glucose tolerance, which act respectively as the internal and external mediating ways. Methods:A total of 283 patients with impaired glucose tolerance from 6 Three-A hospitals in China were surveyed with self-rating anxiety scale, self-rating depression scale, trait coping style questionnaire, social support scale, and WHOQOL-BREF.
Results:Biographic data failed to predict the quality of life in patients with impaired glucose tolerance, while anxiety, depression, social support and coping style significantly influenced their quality of life.
Conclusion:The fact that emotional disorder, social support and coping style influence the quality of life in patients with type 2 diabetes also exists in patients with impaired glucose tolerance.

Objective To explore the clinical effects of S-1 single agent chemotherapy for the patients undergoing radical resection of cholangiocarcinoma.Methods The clinical data of 51 patients receiving radical resection of cholangiocarcinoma who were admitted to the Second Affiliated Hospital of Zhejiang University from November 2011 to December 2013 were retrospectively analyzed.After radical resection of cholangiocarcinoma,25 patients receiving non-special treatment and 26 patients receiving S-1 single agent chemotherapy were divided into the operation group and chemotherapy group,respectively.S-1 was taken orally twice per day.Forty mg/once of S-1 was applied to patients with the body surface area ＜ 1.25 m2,50 mg/once of S-1 was applied to patients with the body surface area ≥ 1.25 m2 and ＜ 1.50 m2,and 60 mg/once of S-1 was applied to patients with the body surface area ≥ 1.50 m2.The 14 days usage and 7 days withdrawal of S-1 were used as one course of treatment.The standard usage of S-1 was 6-8 courses of treatment.All the patients were followed up by outpatient examination and telephone interview till December 1,2014.Count data were analyzed using the chi-square test.Measurement data with normal distribution were presented as (x) ± s and analyzed using the t test.Survival curve was drawn by the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Results Twenty-six patients in the chemotherapy group finished the courses of chemotherapy without chemotherapy-related death,and 14 patients had chemotherapy adverse reactions with remission after discontinuation of S-1.All the 51 patients were followed up for 5-37 months with a median time of 19 months.The median overall survival time,1-,3-year overall survival rates,tumor-free median survival time and 1-,3-year tumor-free survival rates were 22 months (range,18-27 months),72.3％,42.9％,21 months (range,16-26 months),60.0％,55.0％ in the operation group and 32 months (range,29-35 months),84.6％,44.4％,26 months (range,21-31 months),76.9％,61.9％ in the chemotherapy group,respectively.There was a significant difference in the overall survival between the 2 groups (x2=6.032,P ＜ 0.05).There was no significant difference in the tumor-free survival between the 2 groups (x2=0.498,P ＞ 0.05).Conclusion S-1 single agent chemotherapy after radical resection of cholangiocarcinoma could improve the survival of patients,while no obvious advantages of inhibiting tumor recurrence is observed.

Objective:To explore the correlation among serum levels of resistin ,oxidized low density lipoprotein (ox‐LDL) ,high sensitive C reactive protein (hsCRP) and severity of acute ischemic cerebrovascular diseases .Methods :A total of 92 patients with acute ischemic cerebrovascular diseases ,who were treated in our hospital from Nov 2013 to Nov 2014 ,were selected ,including 36 cases with transient ischemic attack (TIA ,TIA group) ,29 cases with re‐versible ischemic brain damage (RIBD ,RIBD group) and 27 cases with focal cerebral infarction (FCI ,FCI group) . Another 70 healthy volunteers were regarded as normal control group .Serum levels of resistin ,ox‐LDL and hsCRP were measured and compared among all groups .Pearson correlation analysis was used to analyze the correlation a‐mong serum levels of resistin , ox‐LDL , hsCRP and severity of acute ischemic cerebrovascular diseases . Results:Compared with normal control group ,there were significant rise in serum levels of resistin [ (0.26 ± 0.42)μg/L vs . (0.63 ± 0.38)μg/L vs .(0.91 ± 0.45)μg/L ,(0.89 ± 0.42)μg/L] ,ox‐LDL [ (334.3 ± 142.5) mg/L vs .(451.7 ± 15.8) mg/L vs .(518.3 ± 205.7) mg/L ,(520.7 ± 198.9) mg/L] and hsCRP [ (5.8 ± 4.9) mg/L vs .(8.7 ± 7.6) mg/L vs .(13.5± 9.1) mg/L ,(13.6 ± 7.4) mg/L] in TIA group ,RIBD group and FCI group (P< 0.01 all);those of RIBD group and FCI group were higher than that of TIA group (P<0.01 all) ,and there were no signifi‐cant difference in above indexes between RIBD group and FCI group (P>0.05 all) .Pearson correlation analysis in‐dicated that serum levels of resistin , ox‐LDL and hsCRP were significant positively correlated with severity of acute ischemic cerebovascular disease (r=0.473~0.902 , P<0.01 all) .Conclusion:Serum levels of resistin ,ox‐LDL and hsCRP can reflect severity of acute ischemic cerebrovascular diseases ,which is worth extending .

Objective To evaluate the consistency of estradiol kits between E2-Ⅲ and the upgraded Enhanced Estradiol(eE2)kit with chemiluminescence immunoassay analyzer Siemens ADVIA Centaur.Methods Used duplicate samples and removed outliers to test the two reagents′stability;document EP9-A2 were used as reference to do the methodological comparison and bias estimation. Results There was good correlation between the two reagents with different concentrations,the correlation coefficients were grea-ter than 0.975;the percentage of bias was varied among different groups.Conclusion It is effective to reduce the interference of up-dated estradiol kits on the assisted reproduction treatment cycles by assessing the bias through comparison tests of the two kits in advance.

The establishment of a scientific salary system is a key measure to improve the incentive and re-straint mechanisms, adjust and optimize the relations of the production, release the reform “bonus”, and is also an important health care reform today. In order to establish a scientific salary system of medical personnel adapting to the health industry characteristics, the paper makes an investigation on the salary level in the years of 2010—2012 in Shanghai, and analyzes the main problems of the present performance pay policy. On this basis, starting from the point of the health industry characteristics, the paper builds the salary system of medical personnel containing the comprehensive budget management, theoretical workload for approval, authorized personnel, performance appraisal and distribution, structural proportion within the industry, fund distribution management through the establishment of the salary level’s average wage and social linkage mechanism, and builds a theoretical framework on salary system of medical personnel in Shanghai.

Objective To investigate the influence of the lymph node micrometastasis and its clinicopathological features on postoperative disease-free survival rate for patients with gastric cancer.Methods The study included 120 patients with pT1-3NoMo gastric cancer. The relationships between clinicopathological features or carcinoembryonic antigen (CEA) positive expression and postoperative disease-free survival rate were analyzed. Results In clinicopathological factors, multivariate analysis identified CEA positive expression was significantly correlated with tumor diameter (P = 0.011 ),depth of tumor invasion (P= 0.027) and lymphatic vessel invasion (P= 0.001 ) in lymph node positively. The average postoperative follow-up was (53.14 ± 16.75) months. There was statistical correlation between the tumor diameter( P = 0.018 ) or depth of tumor invasion ( P = 0.015 ) and postoperative disease-free survival rate. The disease-free survival rate was 90.91% ( 80/88 ), 86.36% ( 19/22 )and 40.00% (4/10) for the lymph node CEA negative,isolated tumor cells (IT Cs) and micrometastasis,respectively. There was significant difference between micrometastasis and the lymph node CEA negative (P= 0.000) or ITCs (P = 0.009), however, the lymph node CEA negative and ITCs was no significant difference (P = 0.438 ). Lymph node micrometastssis of gastric cancer was detected in 10 patients who should belong to stage pN1,the restage rate was 8.33%(10/120). Conclusions If the patients were found micrometastasis in lymph node with high-risk stage pT1-3NoMo gastric cancer for whom chemotherapy may be recommended,because of its high recurrence and poor prognosis.