OBJECTIVE:To provide experience and reference for the reform ofintegration of medicine and nursingunder the strategy ofHealth China 2030. METHODS:By literature analysis,the demand characteristics and supply situation ofinte-gration of medicine and nursingservice model in China were analyzed. The development bottleneck ofintegration of medicine and nursingservice model in China was discussed to put forward countermeasures and suggestions. RESULTS&CONCLUSIONS:Integration of medicine and nursingis a new model of the development of pension services in China. Throughout whole country, it is still in the stage of exploration and practice. There are some problems,such as serious inadequate beds,low participation of private pension institutions,pension service quality ofintegration of medicine and nursinghaving to be improved,weak market competition of pension institutions,social forces participation having to be improved,big demand gap of medical and nursing staff,inadequate high-quality medical and nursing talent. A clear positioning ofintegration of medicine and nursingservice model in China should be put forward andintegration of medicine and nursingmonitoring system should be improved. It is suggested to establish service complaint mechanism of pension institutions,encourage the active participation of diverse social forces,broaden the financing channels ofintegration of medicine and nursing,build service information sharing platform ofintegration of medi-cine and nursing,establish electronic health records for the elderly and set up maintenance personnel training mechanism so as to promote the rapid development of the reform ofintegration of medicine and nursing.

Objective To investigate the related factors and preventive measures of nasopharyngeal massive hemorrhage in patients with nasopharyngeal carcinoma after radiotherapy. Methods Clinical data of 43 nasopharyngeal massive hemorrhage patients with nasopharyngeal carcinoma after radiotherapy were analyzed retrospectively. Results Thirty-nine cases(90.7 %) had abroad skull base invasion due to tumor, 36 cases (83.7%) received high dose of radiation, and 13 cases (30.2 %) were accompanied by diabetes. Conclusion Tumor location is the major factor for nasopharyngeal massive hemorrhage, while radiation dosage, fractionation patterns and diabetes are the secondary factors. The measures in cluding hyperfractionation, overall dose control and blood sugar regulation should be taken for the high risk patients. Prevention is more important than salvage.

Objective To study pathological diagnostic value of forceps and brush biopsy cytological examination by percutaneous transhepatic cholangiodrainage(PTCD) for malignant obstructive jaundice.Methods From April 2005 to April 2006,24 cases of obstructive jaundice underwent PTCD and stent insertion in biliary tract.Tissue pathological examination by forceps and brush was done during PTCD.Results 24 cases received forceps biopsy,of whom,14 cases received brush cytological examination at the same time.All of the 24 cases of forceps biopsy obtained pathological tissue and the pathological results as follows: adencarcinoma in 15 cases,4 cases had allotype cells,regarded as positive results;inflammation tissue in 1 case,which was restenosis after stent insertion;fibrous tissue in 1 case;tissue obtained was cholangioepithelia in 3 cases,in which 1 case was diagnosed as lymph node metastasis of peripheral head of pancreas after gastric cancer operation,2 cases were diagnosed as cholangiocarcinoma,the positive rate of forceps biopsy being 79.2%(19/24).4 cases of cytological examinations by brush showed tumor cells in 2 cases,allotype cells in 2 cases,regarded as positive results,the positive rate being 28.6%(4/14),and others were negative results.Conclusions Intracholangio-biopsy by PTCD offers the advantages of simplicity,safety,higher accuracy and less complications.Pathological diagnosis can be obtained at the same time during reducing-jaundice therapy by PTCD.

ncing analysis validated that all four-type base-quenched probes could provide unbiased genotyping results ( Kappa =1, P=0.00), although. Conclusion This method is simple, economic and suitable for large-scale genotyping studies.

Objective To investigate the effects of arginine combined with leptin in treatment of rats with a-cute pancreatitis. Methods Sixty Wister rats were randomly divided into sham operation group (group A), acute pancreatitis group (group B),arginine group (group C),leptin group (group D),arginine plus leptin group (group E),with 12 rats in each group. Acute panereatitis model was developed by retrograde injection of 5% sodium tauro-cholate into cholangiopancreatography in rats. After 6 hours, medicine were given by intraperitoneal injection, ab-dominal aortic blood and pancreatic specimens were taken for measurement of tumor necrosis factor-α(TNF-α), ser-um amylase,nuclear factor-κB (NF-κB) activity of pancreatic tissue, and pathological damage score of pancreatic tissue. Results TNF-α,Amylase,NF-κB activity, pathologic scores were(1.206±0.446)μg/L, (1617.2±18.8) U/L,0.174±0.013,0.6±0. 2 in group A;(3.201±0.321) μg/L, (4643.8±303.4) U/L,0.397±0. 025,7.8±1.3 in group B;(1.845±0.404) μg/L,(3370.9±173.2)U/L,0.255±0.026,3.9±1.1 in group C;(1.996±0.374) μg/L, (3693.7±208.0)U/L,0.274±0.062,4.2±1.2 in group D;(1.440±0.287)μg/L, (2501.0±771.4)U/L,0.211±0.027,2.3±1.0 in group E. Compared with group A, the indicators were significantly in-creased in group B (P < 0.05). Compared with group B, these indicators were reduced in group C and D (P <0.05). There was no significant difference between group C and group D. These indicators in group E were signifi-cantly lower than those in group C and D (P < 0.05). NF-κB in pancreatic tissue were positively correlated with other indicators(P <0.01). Conclusions In treatment of acme pancreatitis in rats, arginine combined with leptin has idenditfied effect, and the effect of combination therapy is better than that of separate medicine.

Objective To discuss the expressions and clinicopathologic significances of insulin-like growth factor Ⅱ mRNA binding protein 3 (IMP3)in squamous intraepithelial lesion (SIL)and cervical squa-mous cell carcinoma (CSCC)before and after the therapy of radiation and chemotherapy.Methods The expressions of IMP3 in 80 cases of CSCC,90 cases of SIL (60 cases of HSIL,30 cases of LSIL)and 30 cases of cervicitis were detected by immunobistochemistry.The relations between IMP3 and clinicopathological cha-racteristics of CSCC were analyzed.Results The expression rates of IMP3 in CSCC,HSIL,LSIL and cervici-tis were 86.3%(69 /80),78.3%(47 /60),33.3%(10 /30)and 0(0 /30),and the difference among the four groups was statistically signicant (χ2 =87.01,P <0.01).The positive expression rate of IMP3 declined by radiation or chemotherapy (60.0% vs.85.0%,χ2 =5.79,P =0.013).The expression of IMP3 was related with lymph node metastasis (χ2 =3.97,P =0.046),differentiated degree (χ2 =5.95,P =0.018),clinical stage (χ2 =5.82,P =0.016)and invasion depth (χ2 =5.73,P =0.017).There was nothing to do with age (χ2 =0.11,P =0.745).Conclusion IMP3 expresses excessively in CSCC,and is associated with pathologi-cal grade and invasion progress.Radio-chemotherapy can reduce the expression of IMP3.

Objective To observe the operation process implementation and the therapeutic effect of interventional therapy for the superior mesenteric artery thrombosis.Methods 21 cases with superior mesenteric arterial thrombosis who had the diagnosis and clinical treatment in our hospital from January 2005 to December 2013 were retrospectively analyzed.Results Among 21 cases,19 cases had obvious risk factors,and their early symptoms and signs were not consistent.The artery angiography showed that 17 cases had superior mesenteric artery thrombosis,2 cases had ileum arterial thrombosis,2 cases had inferior mesenteric arterial thrombosis.All surgeries were performed successfully.The length of hospital stay was 10 14 days with an average of 11 days.After interventional treatment,the symptom of abdominal pain had obvious remission.The follow-up period was 12 to 36 months and no recurrence was found.Conclusions The diagnosis of mesenteric arterial thrombosis is difficult.Mesenteric arterial thrombosis needs the early diagnosis and timely interventional treatment.

Objective To investigate the pharmacological action of Shuanglong Prescription on cardiac function in dogs and to study its mechanism. Methods The changes of the parameters such as coronary blood flow, myocardial oxygen consumption and heart rates were observed in normal anesthetic dogs. Results Compared to those in the normal group, the coronary blood flow increased and the heart rates decreased in Shuanglong Prescription group. Conclusion Shuanglong Prescription can regulate and improve the cardiac function of dogs.

Objective To investigate the long-term effects and risk factors of arterial polyvinyl alcohol resin (PVA) embolization for ⅢB and IV non-small cell lung cancer(NSCLC) patient.Methods 126 patients with 1 B or V NSCLC were performed the perfusion with 5-FU,THP,DDP by PVA grain embolization under fluoroscopic control.All patients were followed up.Kaplan-Meier was used to calculate the survival rate and the median survival time,and Cox regression model was adopted to analyze related risk factors which affected curative effect.Results The median survival time was( 11.78 ± 3.24) months and 1 -,2-year survival rate was 39.1 ％,25.59％ in 126 patients with NSCLC.Cox model analysis showed that of the tumor staging,tumor size,location and combination chemotherapy were all independent risk factors of prognosis (all P ＜ 0.01 ).Conclusion Arterial embolization of PVA for treatment of NSCLC is effective.Tumor size,stage,location and combination chemotherapy are associated with prognosis of NSCLC.

Objective To investigate the expression of MTSS1 in cholangiocarcinoma tissue and its relationship with the prognosis of patients.Methods The specimens of bile duct of 49 patients with hilar cholangiocarcinoma who received surgical excision at the Eastern Hepatobiliary Surgery Hospital from January 2003 to December 2005 were collected.Tissue microarrays of the 49 samples of hilar cholangiocarcinomas and the 10samples of adjancent normal bile duct epithelial tissue were constructed.The expression of MTSS1 was detected by the immunohistochemical staining.The pcDNA3.1-MTSS1 was transferred into the RBE cells and the abilities of proliferation of REB cells were measured by MTT assay.The patients were followed up via out-patient examination and telephone till May 2012.The measurement data were analyzed using the t test,and the count data were analyzed using the chi-square test,the survival curve was drawn by the Kaplan-Meier method,the survival was analyzed using the Log-rank test,and multivariate analysis was done using the COX regression model.Results The results of immunohistochemical staining showed that the expression rate of MTSS1 was 10/10 in the adjacent normal epithelial tissue of bile duct,while 59.2％ (29/49) in the cholangiocarcinoma tissues.The proliferative rate of cholangiocarcinoma cells transfected with MTSS1 was 1.55 ±0.05,which was significantly lower than 2.32 ±0.08 of cholangiocarcinoma cells without transfection of MTSS1 (t =4.454,P ＜ 0.05).Gender,age,TNM stage,T stage,differentiation,neural invasion and diameter of tumor did not influence the expression of MTSS1 (x2=0.211,3.471,0.507,0.507,0.368,0.882,0.660,P ＜ 0.05),while lymph node metastasis influenced the expression of MTSS1 (x2=10.436,P ＜ 0.05).All the patients were followed up for 1-59 months,and the median time for follow-up was 16 months.The median tumor-free survival time was 17.9 months in patients with positive expression of MTSSI,and 11.3 months of patients with negative expression of MTSS1,with no significant difference (Log-rank value =3.707,P ＞ 0.05).The median survival time was 34.9 months in patients with positive expression of MTSS1,which was significantly longer than 18.7 months of patients with negative expression of MTSS1 (Log-rank value =5.671,P ＜0.05).Multivariate analysis showed that MTSS1 was not the independent risk factor influencing the prognosis of patients (x2 =0.406,P ＞ 0.05).Conclusions The expression of MTSS1 is decreased in cholangiocarcinoma tissue,which negatively correlates with lymph node metastasis.MTSS1 could be used as a biomarker in predicting the prognosis of patients with cholangiocarcinoma.