Objective To evaluate the nursing effect of wenjing moxibustion with ginger in zhuang medicine to knee osteoarthritis (KOA), which can provide an effective nursing intervention for KOA. Methods Totally 80 cases were divided into two groups by random number table. There were 40 cases in zhuang moxibution group and 40 in traditional moxibution group. These two groups were taken the same nursing intervention and exercise. However zhuang group were spend 20 minutes and covered by ginger mud on zhuang xiguan point, and fire moxa on the ginger mud. Xuehai, Liangqiu, Neixiyan, and Waixiyan were chosen and fired moxa cone with ginger in traditional group that spent 20 minutes. It was observed the knee pain and swelling before and after 1 week during the treatment. 2 groups were compared with the cost of treatment. Results There was no different in pain and swilling before treatment (P>0.05), but there was significantly difference after 1 week in two groups (t=14.72、12.90;7.04, 2.73, P﹤0.01). It was significantly different in two groups after 1 week treatment (t=-5.06,-3.64, P﹤0.01). There was no significantly difference in the cost of treatment (F=0.041 6, P>0.05). Conclusions these two nursing intervention can release pain and swelling. However it is effective and no different in the cost of treatment when using wenjing moxibustion with ginger in zhuang medicine.

AIM:To detect the changes of active status of bypass signaling pathways in EML4-ALK positive lung cancer cell line H3122 treated with alectinib, hepatocyte growth factor (HGF), epidermal growth factor (EGF) and transforming growth factor-α (TGF-α), and to explore the potential mechanisms.METHODS:EML4-ALK positive cell line H3122 was treated with increasing concentrations of alectinib or/and induced by HGF, EGF and TGF-α.The cell viability was measured by CCK-8 assay.The cell apoptosis was analyzed by flow cytometry.The protein levels and phosphorylation status of ALK, c-Met and EGFR, and the downstream molecules AKT, ERK, p-AKT and p-ERK were examined by Western blot.RESULTS:The viability of the H3122 cells was inhibited by alectinib in a dose-dependent manner after administrated for 72 h, and the IC50 value was 0.042 μmol/L.The concentration-growth curves of the H3122 cells shifted to the right after induced by HGF, EGF and TGF-α.After treatment with alectinib at 0.05 μmol/L for 48 h, the apoptotic rate of H3122 cells was (20.12±1.36)%, while the apoptotic rates of the cells in the groups of alectinib combined with HGF, EGF or TGF-α were (7.85±1.03)%, (5.60±0.79)% and (4.58±1.00)%, respectively.Those values were remarkably lower than those in alectinib single treatment group (P<0.05).Alectinib inhibited the protein levels of p-ALK and its downstream signaling pathway molecules, while HGF significantly up-regulated the protein levels of p-Met and its downstream p-AKT and p-ERK.Besides, EGF and TGF-α remarkablely up-regulated the protein levels of p-EGFR and its downstream p-AKT and p-ERK.Combined treatment with crizotinib and 17-DMAG successfully inhibited the viability of the H3122 cells even in the presence of the HGF and EGFR ligands, respectively.CONCLUSION:Bypass signaling pathways are activated by HGF, EGF and TGF-α in EML4-ALK positive lung cancer cell line H3122, which may be linked to alectinib resistance.

ABSTRACT:Strongyloides stercoralis is an opportunistic parasitic nematode ,whose larvae can invade the lung ,brain ,liv‐er ,kidney and other organs of hosts and cause strongyloidiasis .The infection opportunity of strongyloidiasis increased with raised living standard ,changed lifestyle and family pets .So far ,the relevant domestic researches of strongyloidiasis are limited in case reports and epidemiological investigation ,but researches involving biological characteristics ,immune phenomenon and protective immune response in humans are still very little .Based on the references ,this review summarizes recent findings in morphology ,life cycle ,pathogenicity ,epidemiology ,immunology ,diagnosis and prevention of S .stercoralis for raising the awareness of strongyloidiasis .

In 2013 Shanghai took the lead to carry out the specialist standardized training which is common in the international medical education. This paper first gives a picture of the general condition of the standardized training on specialists of obstetrics and gynecology in Shanghai. Then from the perspectives of strategic deployment, department management, clinical skill training and the training of examiners, the paper explores the assessment model in which both the assessment of train-ing process and the scores of the final examination are considered whereas the process assessment is given more weight. This paper is aimed to provide experience and suggestions for the further advance of the specialists standardized training in the field of obstetrics and gynecology.

Objective To explore the relationships among attachment,parental attachment and parental rearing style of adolescent depression.Methods 36 outpatients and hospital patients in Anhui Mental Health Center with depression and their parents were involved as the case group,33 age-,gender-,and education-matched high school students and their parents as the normal controls.The case group and control group were assessed with Experiences in Close Relationships Inventory (ECR) and Parental Rearing Pattern Questionnaire (EMBU).Results ① The score of attachment avoidance and anxiety dimension in the depression group were obviously higher than that of the control group(73.19 ± 16.63 vs 66.25 ± 12.91,62.76 ± 13.90 vs 51.97 ± 13.69,P ＜ 0.01) ;the score of mother's attachment anxiety in the depression group were significantly higher than that of the control group (72.06 ± 14.23 vs 57.42 ± 12.81),and there were significant differences between two groups (P ＜ 0.01).②The attachment avoidance was positively correlated with parental attachment avoidance in the depression group (r =0.534,r=0.488 ; P＜ 0.01).The attachment anxiety dimension was positively correlated with mother's attachment anxiety in depression group (r =0.532,P ＜ 0.01).Attachment avoidance was negatively correlated with parental warmness(r =-0.406,r =-0.462,P ＜ 0.01),however attachment avoidance had positive correlation with father's punishment and mother's rejection in depression group (r=0.395,r=0.468; P＜0.05).Father's attachment avoidance was negatively correlated with father's warmness(r =-0.527,P＜ 0.01),and mother's attachment avoidance was negatively correlated with mother's warmness (r =-0.491,P ＜ 0.01),which was positively correlated with mother's rejection (r =0.392,P ＜ 0.05).③ Regression analysis showed that mother's warmness rearing style had full mediating effect on the relationship between mother's attachment avoidance and attachment avoidance in depression group,and then mother's refused rearing style partly mediated the relationship between them.But father's warmness didn(t) have mediating effect on the relationship between father's attachment avoidance and attachment avoidance in depression group.Conclusion The attachment pattern is insecure in the depression group.Parenting attachment and rearing style significantly influence on adolescent depression attachment patterns,and mother's rearing style has mediating effect on the relationship between mother's attachment and depression attachment.

To analyze the potential limitations of hospital-level research projects management by summarizing its performance status from 2008 to 2011,including but not limited to lack of time for conducting research,insufficient financial funds,inadequate funding application,inadequate supervision.Thus,since 2014,our hospital has adopted some new measurements for projects management,including full-time research,hierarchical management,full mobilization,the establishment of reward and punishment measures,which significantly improved the quality of hospital-level research projects,and the rate of longitudinal follow-up project,research enthusiasm of medical staff,and sustainable development of hospital science and technology.

Objective:To explore the effect of digital rehabilitation system on the recovery of infants with cerebral palsy.Methods:Twenty-one children with cerebral palsy were treated with residual cerebral palsy in Putuo District,and 21 children with cerebral palsy were followed up.The patients were divided into two groups (n =21).The control group was treated by routine OT training by the parents,and the treatment group was treated with the digital rehabilitation system.Three months later,the efficacy was evaluated and compared.Results:After 3 months of treatment,the total effective rate (effective rate and effective rate) of the two groups was 90.5％ and 81％,respectively,and the treatment group was significantly higher than the control group (P ＜0.05).The PROM of the two groups was improved (P ＜0.01),and the PROM in the treatment group was significantly higher than that in the control group (P ＜0.05).FMFM was significantly higher than that before treatment (P ＜0.01),and FMFM was significantly higher in the treatment group than in the control group (P ＜0.01).Conclusion:Family (community) digital rehabilitation system can effectively improve the rehabilitation of children with cerebral palsy.

ObjectiveTo explore the relationship among dream threat level,life events and childhood trauma in obsessive-compulsive patients.Methods 59 obsessive-compulsive patients and 57 healthy controls were tested with Dream Threat Questionnaire (DTQ),Childhood Trauma Questionnaire ( CTQ ) and Life Events Scale (LES).The dream threat level were compared between the two groups,and correlation and regression analysis were used to research the relationship of the variables for patients’ data.ResultsCompared with the healthy controls,patients had significantly higher DTQ score ( 1.40 ± 2.23 vs 3.31 ± 3.04,P ＜ 0.01 ),CTQ total score (34.21 ± 8.47 vs 43.02 ± 10.78,P ＜ 0.01 ),LES total score ( 16.88 ± 16.42 vs 45.39 ± 46.01,P ＜ 0.01 ) and its negtive life events subscore ( 14.14 ± 14.61 vs 39.56 ± 42.94,P ＜ 0.01 ).Correlation analysis showed that dream threat level,negative life events and childhood trauma were significantly positively correlated each other( r =0.326 ～0.402,P ＜ 0.05 ～0.01 ).Regression analysis indicated that childhood trauma directly predicted dream threat level (β =0.104,P ＜ 0.05 ) and completely mediated the relationship between negative life events and dream threat level.ConclusionObsessive-compulsive patients have higher dream threat level,more childhood trauma experience and life events.Childhood trauma experience is a significant factor influencing dream threat level,and as a complete mediation by which life events influence dream threat level.

Objective To explore the management model of scientific research projects based on the application of the National Natural Science Foundation of China (NSFC).Methods We retrospectively analyzed the NSFC funding of our hospital during 2009-2017.Results Our hospital sets up the pre—experiment special project of NSFC and "full—time" policy,development translational medicine research center platform,introduce and train scientific talents,strength the delicacy management of scientific research and so on.Through the above measurements,NSFC funding in our hospital was significantly improved.The number of projects approved increased from 1 to 23,and the amount approved increased from 300 thousand to 21 million 350 thousand yuan during the eight yesrs.Conclusions The policy,platform,personnel and delicacy management have effectively improved the quality and quantity of NSFC,and promote the sustainable development of the hospital science and technology.

Objective To explore the value of cytokines and procalcitonin (PCT) in predicting the potential pathogen and the severity of infection in children with hematological malignancies.Methods This was a prospective cohort study.A total of 1 543 children (3 912 episodes) with hematological malignancies admitted to the Department of Hematology/Oncology in Children's Hospital of Zhejiang University School of Medicine from November 2010 to June 2018 were prospectively enrolled in this study.According to the pathogen,the patients were divided into sepsis group with positive blood culture (380 patients/608 episodes),sepsis group with negative blood culture (539/1 484),non-septic infection group (549/1 709),viral infection group (18/21) and fungal infection group (57/90).The patients were also divided into two groups in either shock group (171/187) or non-shock group (1372/3725).Meanwhile,89 children (112 episodes) with matched hematological malignancies without fever were enrolled as the control group.The levels of PCT and cytokines were measured for detecting the potential relationship between these markers and infection severity.Mann-Whitney U test or Kruskal-Wallis H test was used to compare the differences between groups.The Receiver Operator Characteristic curve analysis was used to explore the predictive value.Results (1) There were significantly higher levels of interleukin (IL) 6 (H=210.002,P＜0.01),IL-10 (H=223.045,P＜0.01),and PCT (H=76.799,P＜0.01) in the infection group,with area under curre (AUC) of 0.67 (95％CI 0.64-0.69),0.69 (95％CI 0.66-0.71) and 0.59 (95％CI 0.56-0.61),respectively.(2) Among the patients in the shock group,IL-6 (Z=11.460,P＜0.01),IL-10 (Z=14.242,P＜0.01) and PCT (Z=10.813,P＜0.01) were significantly higher than those in the non-shock group,with the AUC of 0.75 (95％CI 0.70-0.79),0.81 (95％CI 0.77-0.84) and 0.73 (95％CI 0.69-0.77),respectively.(3) In patients with septic shock,the incidence of Gram negative bacteria (GNB) infection (60 episodes) was significantly higher than Gram positive bacteria (GPB) infection (22 episodes) (x2=29.665,P＜0.01).The AUC of IL-6,IL-10 and PCT for predicting GNB infection were 0.75 (95％CI 0.72-0.78),0.82 (95％CI 0.79-0.85) and 0.67 (95％CI 0.63-0.70),respectively.(4) The predictive power of IL-6,IL-10 and PCT combination (AUC=0.994) was superior to IL-10 alone (AUC=0.810) in predicting septic shock (Z=10.211,P＜0.01).Conclusions IL-6and IL-10 are better predictors of GNB infection than PCT in hematology-oncology children.Furthermore,the combination of these two cytokines and PCT is more valuable in predicting the severity of infection.