Objective To investigate the relationship between coronary artery disease, other vascular risk factors and mild cognitive impairment in elderly patients. Methods A total of 196 inpatients were collected from the departments of cardiovascular internal medicine from April to September 2015.The unified questionnaires of cognitive status and standardized survey were developed. The patients were divided into 133 cases of mild cognitive impairment and 63 cases of cognitively normal by Montreal Cognitive Assessment Scale. The patients were divided into 79 cases of coronary heart disease and 117 cases of negative control by coronary angiography. Coronary artery disease and other vascular risk factors for mild cognitive impairment were analyzed. Results The levels of education and proportion of coronary heart disease were (9.23 ± 4.34) years and 45.9%(61/133) in mild cognitive impairment patients, and (12.27 ± 3.79) years and 28.6%(18/63) in cognitively normal patients. There were significant differences between the two(t=4.77, P<0.05,χ2=5.31, P<0.05). Multivariate Logistic regression analysis showed that degree of education was a protective factor for mild cognitive impairment with odds ratio ( OR) 0.86, 95%confidence interval (CI) 0.77 to 0.91 and P=0.00. Coronary heart disease was an independent risk factor for mild cognitive impairment (OR=2.02, 95%CI 1.03 to 4.00; P = 0.04) . The total scores of Montreal Cognitive Assessment Scale and delayed memory were (20.9±4.8), (22.4±5.6) points and (2.1± 1.6), (2.6 ± 1.8) points in coronary heart disease and negative control patients. There were significant differences between the two (t=1.98, 4.77, all P<0.05). Conclusions The degree of education is a protective factor for mild cognitive impairment. Coronary heart disease is an independent risk factor for mild cognitive impairment, and it mainly impairs delayed memory ability.

OBJECTIVE:To analyze the characteristics and rules of pediatric adverse drug reaction (ADR) in our hospital, and provide reference for clinical safe drug use. METHODS:Retrospective study was adopted to statistically analyze the ADR re-ports in our hospital from Mar. 2012 to Jun. 2016. RESULTS:In the 176 ADR reports,102 were male(57.95%)and 74 were fe-male (42.05%);children younger than 6 years old had the highest incidence of ADR (81.26%);intravenous administration in-duced 153 cases(86.93%),the top one was antibiotics,which involving 20 antibiotics,totally 106 cases(60.23%);skin and its appendages damage were the main manifestations, totally 127 cases (50.60%). CONCLUSIONS:Pediatric ADR monitoring should be strengthened,dinical rational drug use should be promoted by cooperation in many ways to reduce and prevent the incid-erle of pediatric ADR.

There is a close relationship between osteoporosis and osteoarthritis .The joints of bearing weight often suffer the osteoarthristis with osteoporosis .There are some symptoms in the disease ,such as pain and motion disorder ,and joint abnormality in late＋ stage .The principle of rehabilitation is to improve osteoporosis , release pain and increase the function if motion .The treatment includes medicament ,acupuncture ,injection ,rehabilitation ,psychology and surgery therapies .The injection can release pain effectiverly .The methods of rehabilitation include physical therapy,exercise ,massage ,and occupational therapy.These therapies can release pain ,improve motion and increase the quality of life .The article reveiws the clinical symptoms ,diagnosis and treatment ,especially the rehabilitation therrapy.

Histone acetylation and deacetylation is an important regulatory way of gene expression in eukaryotic cells. As a key regulatory enzyme, histone deacetylase is overexpressed in many malignant tumors, including hepa- tocellular carcinoma. In addition, it has been suggested to be a potential therapeutic target for solid tumors. In this study, we review the classification, mechanisms, as well as the expression and regulation of histone deactylases in hepatocelhlar carcinoma.

Acute massive pulmonary thromboembolism after pneumonectomy usually results in death if not diagnosed early and treated aggressively.It was a case of acute embolism in the main pulmonary ar-tery with thrombus following right pulmonary wedge resection.Diagnosis was made clinically and with computerized tomography before emergency surgery.Thromboembolectomy was successfully performed on cardiopulmonary bypass and the patient was subsequently discharged home after uneventful recovery.Al-though the patient had no previous history of thrombosis,he took high dose of warfarin for anticoagulating postoperatively,which suggested that the patient with pulmonary embolism attack may be associated with the hypercoagulable state of his own.

Objective To evaluate the efficacy of endovascular stent-graft placement for the treatment of Debakey Ⅲ type aortic dissection. Methods From June 2001 to July 2006, 31 patients with Debakey Ⅲ type aortic dissection were diagnosed by contrast-enhanced CT scan. Vascular access was obtained through the right or left femoral artery after arteriotomy and stent-graft was deployed into the true lumen to occlude the primary entry tear. Immediate aortography was performed after the procedure and the follow-up data of CT scan were evaluated. Results Stent-graft deployment was successfully performed in all the patients. Immediate aortography after the procedure showed no leakage in 27 patients and minor leakage in 4. After the operation, one patient showed paraplegia, and one developed left arm ischemia. No stent movement or organ ischemia was found at the early postoperative stage in the other patients. Six months after the operation, in all the 31 patients, contrast-enhanced CT scan showed the disappearance of the false lumen and thrombosis at the level of the stent; and the minor leakage of was improved in the 4 patients. Four years after the operation, one patient developed severe internal leakage at the approximal end of the stent, and was treated by thoracotomy. Conclusions Endovascular stent-graft placement is effective for the treatment of Debakey Ⅲ type aortic dissection. However, further studies are needed to evaluate its long-term outcomes.

The preventive maintenance of medical instruments is very important in field hospital. Because of effective preventive maintenance,the ultrasonic instrument ran normally and efficiently in field hospital. The method of preventive maintenance are introduced,including quakeproof,power supply,hot & moist resistance,dustproof,antijam,probe maintenance,etc. These maintenance methods can provide reference for diversified military affairs.

BACKGROUND:The immature disc nucleus pulposus is composed of notochordal cels, but there is no notochordal cel in the mature human intervertebral disc, in which the notochordal cels are replaced by chondrocyte-like cels. It is very important to comprehend the disappearance of the notochordal cels; however, it is stil unknown at present. OBJECTIVE: To elaborate the feasibility of notochordal cels to maintain the proliferation and phenotype of chondrocyte-like cels and to induce the cartilage-like differentiation of bone marrow mesenchymal stem cels. METHODS: The first author used the computer to retrieve PubMed and Wanfang databases using the key words of “notochord cels; nucleus pulposus cels; identify” in English and Chinese, respectively. Totaly 9 896 relevant articles published from January 1999 to August 2015 were retrieved. Repetitive studies were excluded, and finaly 36 articles were in accordance with the inclusion criteria. RESULTS AND CONCLUSION:Now, the main functions of notochordal cels are to promote synthesis of extracelular matrix in the nucleus pulposus, induce directional differentiation of mesenchymal cels into nucleus pulposus cels or act as “seed cels” to form the nucleus pulposus cels. The presence and disappearance of notochordal cels is related to intervertebral disc degeneration. Cel apoptosis is involved in static compressionviadeath receptor signals, and then leads to intervertebral disc degeneration. fas ligand can mediate the reduction of notochordal cels, and hypoxia-inducible factor can induce spinal cord injury thereby triggering cel death and complete disappearance of nucleus pulposus. The measurement and verification of immune makers of notochordal cels, CK-8, CK-18 and galectin-3, can benefit to the identification and isolation of notochordal cels, and thereby help the studies on cel growth and differentiation, function and its mechanism of apoptosis.

Background and purpose:Radical surgery remains the main treatment for patients with resectable gastric cancer.However,the majority of patients have advanced gastric cancer with either extensive invasion of tumor into the adjacent organs,lymph nodes or metastases when diagnosed.The advantage of neoadjuvant chemotherapy prior to surgery includes the shrinking of the cancer so that surgery becomes feasible for the patients with inoperable cancer and ultimately improve their long-term outcome.We conducted a clinical trial to evaluate the efficacy and toxicity of docetaxel(TAX),cisplatin(CDDP) and fluorouracil(5-FU) plus leucovorin(CF)as the neoadjuvant chemotherapy in the treatment of non-resectable advanced gastric cancer.Methods:From June 2003 to June 2005,12 patients with non-resectable advanced gastric cancer were treated with docetaxel/cisplatin/5-FU/CF before operation.Neoadjuvant chemotherapy regimens consisted of docetaxel(D),75mg/m~(2)(days 1),cisplatin(C),75mg/m~(2)(days 1),fluorouracil(F),500mg/m~(2)(days 1 to 5) plus leucovorin(CF),200mg/m~(2)(days 1 to 5) and were administered every 3 weeks for 2～3 cycles before operation.The immediate response and toxicity were documented for each patient.Results:9 of the 12 patients were downstaged and 8 were radically operated 4-6 weeks after the end of the neoadjuvant chemotherapy.The overall response rate was 75% with 8.3% CR and 66.7% PR,25% NC,and the ascites disappeared in 63.6%(7/11).Pathological complete response was found in 1 case.Histopathogical responses were scaled as mild,moderate and marked in 3,4 and 1 cases,respectively.The most common toxicities were bone marrow suppression,nausea,vomiting,alopecia and heptoses.The toxicities were recoverable after symptomatic treatment.Conclusions:The combination of docetaxel,cisplatin,fluorouracil plus leucovorin(CF) is a very effective and well-tolerated regimen as neoadjvant chemotherapy for the patients with non-resectable advanced gastric cancer.

Traditional Chinese medicine emphasizes the overall state of health, pays attention to individual health condition, highlights maintaining health rather than diseases, shows the clinical effectiveness with flexible treatment. It is the unique resource of health service in our country. Currently, the qualification and certification of traditional Chinese medicinewere only applied in medical practitioners of traditional Chinese medicine and Gua sha.This led to the status quo of vacuum to the traditional Chinese medicine in the fields of access system and standardization. Thus, it is urgent to unify and standardize the access and qualification traditional Chinese medicine, in order to TCM inheritance and development. The establishment of the system should be based on clinical effect and difference among the clinical application. The system can be divided into easy, middle and senior level TCM therapist. TCM therapist with different levels can apply the qualification and certification based on their own levels.