Many medical journals have already digitalized their publishing procedure,but not achieved digital publishing yet.Utilizing digital technology,digital publishing can achieve the functions that paper media cannot,such as information storage,fast search,real-time publishing,individualized information and interaction with readers.These functions entail digitalization of medical journals,and involve a range of macro- and micro-modifications,including laws,industry policies,personnel training,and culture development.There is a long way to go for Chinese medical journals to enter the stage of digital publishing.

Objective To explore the diagnostic and differential diagnostic value of Ki-67,Arg-1,HepPar-1 and Glypican-3 in primary hepatocellular carcinoma and benign hepatocellular lesions.Methods A total of 118 cases of primary hepatocellular carcinomas,100 cases of benign hepatocellular lesions and 263 cases malignant carcinomas originated from other organs were adopted in this study.Immunohistochemistry of Ki-67,Arg-1,HepPar-1 and Gly-3 were performed and evaluated in all specimens.Results The expressions of Ki-67 were concordant with the differentiation of hepatocellular carcinomas and the difference between primary hepatocellular carcinomas and benign hepatocellular lesions were statistically significant (P ＜0.01).The combination of Arg-1 + HepPar-1 + Glypican-3 had the most sensitivity and specificity in differential diagnosis between primary hepatocellular and metastatic malignant cancers,while the combination of Ki-67 + Glypican-3 + Arg-1 showed the better diagnostic value in primary hepatocellular carcinomas and benign lesions.Conclusions The application of different immunohistochemical antibody spectra in primary liver cancers could efficiently improve diagnostic accuracy and reliability.

Objective To investigate the effect of Cimetidine on the adhesion between colorectal cancer LOVO cells and endothelial ECV304 cells;and study whether Cimetidine can inhibit the expression of E-selectin in ECV304 cells. Methods Cellular uptake of rose Bengal stain was used to measure the adhesion between LOVO cells and ECV304 cells. Enzyme-linked immunosorbent assay(ELISA)and flow cytometry (FCM, indirect fluorescence staining and labeling)were used to detect the expression of E-selectin. Results ECV304 cells were exposed to different concentrations of Cimetidine. Both the adhesion between LOVO cells and ECV304 cells and the levels of E-selectin significantly decreased with increasing concentration of Cimetidine(P =0. 001 and 0. 001 respectively). Conclusion Cimetidine can inhibit the adhesion of human colorectal cancer LOVO cells on endothelial ECV304 cells by blocking E-selectin expression. Our observations indicated a potential of anti-adhesion therapy using Cimetidine in cancer treatment.

Objective To identify the clinical risk factors of refractory Mycoplasma pneumoniae pneumonia (RMPP) and their values in early diagnosis. Methods The retrospective analysis of clinical data was conducted in 142 children with Myco-plasma pneumoniae pneumonia (MPP) admitted to Changhai Hospital of Second Military Medical University from Jan. 2012 to Jan. 2014. All children were divided into two groups, RMPP group (n=112) and MPP group (n=30). The comparison was made between two groups in clinical data. The factors were analyzed by the multifactor logistic regression. Results As compared to MPP, RMPP had longer fever duration, the higher ratios of large consolidation shadows, extrapulmonary complications and in-creased CRP level (P<0.05). The results of logistic regression indicated that the clinical risk factors included large consolidation shadows (OR=6.57, 95%CI:2.10-20.56), extrapulmonary complications (OR=11.66, 95%CI:2.42-56.08) and CRP (OR=14.87, 95%CI:2.67-82.79) (P<0.01). Conclusions Large consolidation shadows, extrapulmonary complications and CRP are clinical risk factors of RMPP. CRP elevation and lung imaging changes are valuable in early diagnosis of RMPP.

Objective:To explore the clinical effect of Pingchuan Decoction combined with routine western medicine therapy in the treatment of acute attack of bronchial asthma in children. Methods:From January 2017 to June 2019, 118 children with acute attack of bronchial asthma were selected from the Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and they were randomly divided into control group (59 cases) and observation group (59 cases) according to the random number table. The control group was treated with routine western medicine therapy, and the observation group was treated with Pingchuan Decoction on the base of control group, and both groups were treated for 14 days. The main symptom scores before and after treatment were evaluated. The percentage of forced vital capacity expressed as percent predicted (FVC% pred) and the forced expiratory volume in 1 second expressed as percent predicted (FEV1% pred) were measured by pulmonary function meter. The levels of CD3 +, CD4 + and CD4 +/CD8 + in peripheral blood were detected by flow cytometry. The adverse reactions during the treatment were recorded and the clinical efficacy was evaluated. Results:The total clinical effective rate was 93.2% (55/59) in the observation group and 71.2% (42/59) in the control group, where the difference between the two groups was statistically significant ( χ2=9.790, P=0.002). After treatment, the scores of cough, wheezing and wheezing rale in the observation group were significantly lower than those in the control group ( t=27.695, 17.573, 32.827, P<0.001). After treatment, FVC% pred [(80.21 ± 4.06)% vs. (71.71 ± 3.95)%, t=11.526], FEV1% pred [(78.84±3.92)% vs. (72.26 ± 3.59)%, t=9.508] in the observation group were significantly higher than those in the control group ( P<0.01). The levels of CD3 + [(74.05 ± 5.13)% vs. (67.44 ± 4.98)%, t=7.101], CD4 + [(48.43 ± 4.31)% vs. (42.20 ± 4.06)%, t=8.082] and the ratio of CD4 +/CD8 + (1.67 ± 0.29 vs. 1.34 ± 0.25, t=6.620) in the observation group were significantly higher than those in the control group ( P<0.01). During the treatment, the incidence of adverse reactions was 10.2% (6/59) in the observation group and 6.8% (4/59) in the control group, and there was no significant difference between the two groups ( χ2=0.437, P=0.509). Conclusion:The Pingchuan Decoction combined with routine western medicine therapy can reduce the clinical symptoms of children with acute attack of bronchial asthma, improve lung function, improve organism immunity and clinical effect with safety.

Objective To investigate the current situation of nurses' practice environment in tertiary general hospitals in Anhui Province,and to provide references for improving it.Methods The Nursing Work Index-Revised was used to investigate nurses from 35 tertiary general hospitals in Anhui Province.Results The mean score of Nursing Work Index-Revised was 64.79±26.07.The entry of hospital has a training program for newly recruited nurses,nurses in the work team are qualified for care received the highest score;the entry of the level of remuneration of nurses is appropriate in all sectors of society,nurses have the opportunity to participate in hospital internal management and nurses have the opportunity to participate in hospital management decisions got the lowest score.Whether a teaching hospital,the number of years of work,gender,education,department,title,age and whether recruited with authorized strength played important roles in nurses' practice environment.Conclusion The score for nurses practice environmental in Anhui Province was not high,and there were differences between regions.Hospital management mode and nurse salary distribution system need to be improved.Nursing managers should take appropriate measures to address existing problems and improve the nurses' practice environment according to different characteristics.

Objective To explore the effect of the prevention and treatment of unstable bladder after suprapubic prostaectomy by capsaicin instilled into the bladder preoperatively combined with patient-controlled epidural analgesia(PCEA)for benign prostatic hyperplasia(BPH).Methods Sixty patients with BPH underwent suprapubic prostatectomy under epidural anesthesia were randomly divided into control group (30 cases)and treatment group(30 cases),100 ml of 100 μmol/L capsaicin was instilled into the bladder preoperatively for 30 minutes combined with PCEA after operation in treatment group,the control group was only given PCEA.Observed the incidence and continuous time of unstable bladder after operation in two groups.Results Unstable bladder was found in 3 cases of treatment group and they were Ⅰdegree,12 cases happened unstable bladder in control group,3 cases Ⅰdegree,5 cases Ⅱdegree,3 cases Ⅲ degree,1 case Ⅳ degree.There was obvious significance between two groups (P＜0.05).Conclusion Capsaicin instilled into the bladder combined with PCEA can cut off the reflex arc of detrusor contraction more completely and has obvious effect of decrease the incidence of unstable bladder after suprapubic prostatectomy and can be used widely.

Objective To evaluate the effective of weight loss on blood glucose,lipid profile,and blood pressure in over-weight or obesity patients combined with impaired glucose tolerance(IGT).Methods Body weight of 91 over-weight or obesity IGT patients were managed by doctors and nurses.Body weight,waist circumference,blood glucose,lipid profile,blood pressure and liver function of the patients were compared at 3 months with baseline.Results After 3 months' intervention,the levels of body weight,waist circumference,fasting plasma glucose,postprandial glucose,systolic blood pressure,diastolic blood pressure,and glutamie oxalacetie transaminase (COT),instead of triglyeeride and hish-density lipoprotein cholesterol (HDL-C),were significantly reduced.Over weight or obesity IGT patients saw a 1.8 and 2.3 kg body weight loss,respectively.Decreased plasma glucose and blood pressure were found both in the over-weight group and in the obesity groups,but decreased waist circumference and GOT were found only in the over-weight patients.Conclusions Body-weight control may improve the blood glucose,blood pressure,central obesity,or fatty liver in over weight or obesity IGT patients.For those obesity patients,longer and stronger body weight control should be needed.

Objective To investigate the relationship between heart rate variability ( HRV) and chronic complications in pa-tients with type 2 diabetes mellitus (T2DM).Methods A total of 96 patients with T2DM was given chronic complication assessment . Demographic data were obtained .Diabetic retinopathy , diabetic kidney disease , diabetic peripheral neuropathy ( DPN) , and peripher-al artery disease ( PAD) were diagnosed according to international clinical classification .The parameters of HRV in the patients with diabetes and non-diabetes were examined with24 h Holter recorder .Results The HRV parameters of type 2 diabetic patients were significantly lower than those of non-diabetes ( P <0.05 ) .HRV time domain parameters [ standard deviation of normal RR intervals (SDNN), standard deviation of 5-minute mean RR intervals (SDANN), root mean square difference among successive RR normal in-tervals ( RMSSD) ] were especially impaired in diabetic patients with retinopathy compared to those without retinopathy .HRV parame-ters except low-to-high frequency ratio ( LF/HF) and MNN were lower in diabetic patients with kidney disease than those without kid-ney disease .HRV parameters were no significant difference between patients with or without PAD .Conclusions HRV of diabetic pa-tient is lower.Diabetic retinopathy and kidney disease impact on the HRV .

BACKGROUND:Previous studies have suggested that the risks for coronary atherosclerotic plaque progression and in-stent restenosis are increased in patients with coronary heart disease combined with type 2 diabetes. OBJECTIVE:To explore the predictive factors for in-stent late loss and non-culprit coronary lesion progression in patients with type 2 diabetes mel itus. METHODS:A total of 399 stenting patients were enrol ed, including 179 diabetic patients and 220 non-diabetic patients. The clinical materials, angiography parameters and biochemical markers were col ected. The difference between the two groups was compared, and also we conducted subgroup analysis in the diabetic patients. Low-density lipoprotein cholesterol, hemoglobin A1c, fibrinogen and high-sensitivity C-reactive protein were detected at days 3, 120, 210 and 360 after stenting. RESULTS AND CONCLUSION:Compared with non-diabetic patients, the stent length (P=0.18) was longer and the stent diameter (P=0.002) was smal er in the diabetic patients. The minimal lumen diameters of post-procedure and fol ow-up angiography in the diabetic group were significantly decreased (P=0.001, P=0), and the diabetic patients also showed severe coronary artery stenosis instantly and within the fol ow-up after stenting (P=0.038, P=0.004). The fol ow-up angiography showed that the diabetic patients had more late loss and restenosis (P=0, P=0.097). Furthermore, in the subgroup analysis of diabetic patients, the levels of hemoglobin A1c, fibrinogen and high-sensitivity C-reactive protein were significantly increased in the patients with restenosis and non-culprit lesion progression. These findings indicate that diabetic patients appear to have the higher incidence of restenosis and non-culprit lesion progression. Moreover, hemoglobin A1c, fibrinogen and high-sensitivity C-reactive protein are effective predictors for in-stent late loss and non-culprit coronary lesion progression.