Transforming growth factor β1 (TGF-β1) is a member of cytokine superfamily.Recent studies reveal that the abnormality of TGF-β1 and its receptors is strongly related to genesis,progression and prognosis of lung cancer.It plays an important role in early diagnosis,stage and assessment of treatment and prognosis of lung cancer.

General practitioners from community health service institutions in Shijingshan,Mentougou,Haidian,Chaoyang,Fengtai and Dongcheng Districts of Beijing were selected to take the examination of chronic wounds management.Questionnaire survey was also performed on the status of community chronic wounds management,medical service motivation,influencing factors and their demand for training.Among 204 general practitioners,55 (27.0％) had mastered basic knowledge,98 (48.0％) passed the examination and 51 (25.0％) failed.The results showed that 179 (87.7％) had changing dressing service,36.8％ offered out-patient consulting service,17.6％ performed surgical debridement,only 10 (4.9％) provided home chronic wounds care service and 2 (0.9％) of them carried out long-term follow-up.According to the motivation survey,all the practitioners expressed the willingness to help the patients and win their trust.Most of the practitioners claimed no supporting from their institutions(91.7％) and chronic wounds management was excluded from daily routine.Furthermore,heavy work load(82.8％) and lack of professional knowledge(80.9％)were also considered to be main obstructive factors.The survey showed that the majority of physicians required classroom teaching (90.1％),case analysis (86.8％),operating video (92.6％) and other teaching forms.More low level doctors(97.1％)had the desire to pursue further specialist training than higher level physicians (56.7％).The results of our investigation indicate that general practitioners in community heath service institutions have strong learning motivation for chronic wounds management and systematic training of knowledge and practical skills in this field should be provided.

[Objective]To assess whether calcitonin exerts an chondroprotective action in unstable knees which induce experimental osteoarthritis and its effect to MMP-1.[Method]Twenty 6-month New Zealand rabbits underwent anterior cruciate ligament transaction(ACLT) and were divided into two groups (ACLT group and ACLT+CT group) randomly after transaction on day 7 postsurgery. ACLT+CT group rabbits received a daily subcutaneous injection of salmon calcitonin at a dose of 5 IU per kg of body weight for six weeks.ACLT group were treated with the normal saline at the same dose. All animals were sacrificed 7 weeks postsurgery. The articular cartilage degeneration of medial femoral condyle was evaluated at mascroscopically and microscopically. The mRNA expression and tissue level of MMP 1 was detected by RT-PCR and immunohistochemistry.[Result]Cartilage degradation in ACLT group was significantly more severe than that in ACLT+CT group both in microscopic grading scale and in Mankin's grading scale (P

Objective To explore the clinical value of heart-type fatty acid binding protein testing (H-FABP) in the diagnosis of early myocardial ischemia injury.Methods One hundred and eighty cases diagnosed with myocardial ischemia from January 2016 to December 2016 were selected as the experimental group,then according to the disease time,the subjects were divided into the earlier group(≤3 h),middle group(3~6 h)and later group(≥6 h),each group 60 cases.180 cases with healthy physical examination results were enrolled in the control group.The concentration of serum H-FABP and IMA were detected in order to analyze the clinical value comprehensively.Results Compared with the control group,the concentration of serum H-FABP ((11.54±4.31) μg/L) and IMA ((92.72±5.31)U/ml) in the experimental group increased greatly,the differences were statistically significant(t=2.305,3.001,P<0.05).Among the subgroups in the experimental group,the concentration of IMA was the highest in the early stage and decreased in the middle and later stages,and there were significant difference between the earlier group and later group(t=2.326,P<0.05).The concentration of serum H-FABP and IMA in the experimental group and control group were positively correlated (r=0.9237,P<0.05).Positive detection rate analysis showed that the positive rates of H-FABP and IMA among the subgroups were above 80.00%,and the positive rate of combined detection was obviously improved (P<0.05).The clinical diagnosis was used as the gold standard,the Kappa of the results of H-FABP detection and clinical diagnosis was 0.85 (P<0.05).Conclusion H-FABP has a positive clinical significance in the diagnosis of early myocardial ischemia,as IMA has high positive detection rate,and has high consistency with clinical diagnosis results,it can effectively reduce the misdiagnosis rate and combined detection can reduce the rate of missed diagnosis.

Objective To explore the effect of laparoscopy and laparotomy surgery on immune function related indicators in ovarian benign tumor patients. Methods From January 2015 to January 2016, 86 cases of ovarian benign tumor patients were set as study objects. All the patients were randomly divided into control group and observation group, 43 cases in each. Patients in control group were given traditional laparotomy surgery, while patients in observation group were given laparoscopic surgery. The changes of immune function related indexes before and after operation were recorded, before operation, day 1 and day 3 postoperative, number of peripheral white blood cells (WBC), neutrophil ratio (NGR), immunoglobulin (IgA, IgG, IgM) levels, C reactive protein (CRP) content and the distribution of T lymphocyte subsets (CD3+, CD4+ and CD3+/CD4+ ratio) distribution were respectively determined, and the incidence of postoperative complications was recorded, and were further statistical analyzed. Results There was no significant difference in immunoglobulin IgA, IgG and IgM between the twogroups before operation (P > 0.05). Postoperative, only the IgG content of the two groups was significantly lower than that before the operation (P < 0.05 ); The levels of WBC, NGR and CRP in the control group patients in the昀rst day and the third day after surgery were significantly increased compared with preoperative period, while CRP in the observation group was higher than that before the operation, there was significant difference between the two groups (P < 0.05). There was no significant difference in CD3+, CD4+ and CD3+/CD4+ ratios between the two groups before operation (P > 0.05), the difference between the two groups was significant (P < 0.05). The complication rate of the observation group after operation was 6.98%, the control group was 16.28%. Conclusion Clinical use of laparoscopic treatment of benign ovarian tumors relative to the traditional laparotomy can effectively reduce the immune system of patients with immune function, with high safety, contribute to the recovery of patients, it is worthy of clinical promoting.

Parkinson disease (PD) is a common neurodegenerative disease,of which clinical symptoms give priority to movement disorders,accompanied by a series of non-motor symptoms,such as pain.Studies suggest that 40％ to 85％ of PD patients combined with pain,of more nature is related to muscleskeletal and dystonia.PD combined with pain severely reduces the quality of life of patients.However,it is still lack of uniform clinical evaluation and effective treatment.This paper makes a brief overview about the status and research progress of the evaluation and treatment of PD combined with pain.

Objective Early identification of deep vein thrombosis(DVT) risk in patients with joint arthroplasty helps to reduce the incidence of DVT.The study aimed to investigate the effectiveness of Autar risk assessment model in assessing DVT risk in patients with joint arthroplasty.Methods 72 patients with DVT from 10 hospitals from November 2014 to February 2016 were selected as the case group, and 144 non-DVP patients who hospitalized during the same period served as the control group.The medical history, laboratory tests and other related clinical data of the patients were collected, and Autar risk assessment scale was used to evaluate the patients.Multiple logistic regression was applied to analyze the relationship between the risk scale of DVT and the risk of DVT formation.Results 216 patients were included in the research.The Autar score of DVT patients (17.09±2.83) in case group was higher than that of control group (14.25±2.46) and the difference is of statistical significance(P<0.05).The area under the ROC curve of Autar scale in case group was 0.789 (95％CI: 0.719, 0.858,P<0.05).When the ROC curve cutoff point was 15, the sensitivity and the specificity of Autar scale were 88.57％ and 57.90％ respectively.In Autar scale, the main risk factors of DVT incidence were age≥70 years old, BMI≥30, strict bed rest, varicose veins, lower limb injuries and orthopedic surgery.The result of logistic regression analysis showed the difference of Autar risk rating between these two groups was of statistical significance(P<0.05).In comparison with low risk group, the DVT risk of patients with joint arthroplasty at medium risk was of no significant difference (OR=1.178, 95％ CI: 0.733-1.490, P=0.053) while that of patients with joint arthroplasty at high risk was of significant difference (OR=5.536, 95％ CI:3.577-7.132, P<0.001).Conclusion Autar DVT risk assessment scale assessed patients with joint arthroplasty at high risk are high risk group of DVT.The risk of DVT increases with the risk rating in patients with joint arthroplasty.Therefore, Autar risk assessment scale can be applied in the assessment of DVT risk in patients with joint arthroplasty.

Objective To investigate the expression of Alzheimer′s disease(AD) patients with serum CRP,IL-6,and analyze its clinical significance.Methods The clinical data of 85 patients with AD (AD group)treated in our hospital from March 2015 to June 2016 were retrospectively analyzed,and the data of 85 healthy adults were selected as control group.The differences of serum CRP,IL-6 levels,the mini mental state rating scale(MMSE) and the daily living ability rating scale(BI) score of the two groups were observed,and the correlation between CRP,IL-6 and MMSE and BI scores in patients with AD was analyzed.Results The levels of CRP and IL-6 in the AD group were significantly higher than those in the control group,the difference was statistically significant(P<0.05);The scores of directional function,instantaneous memory,attention and computational power were significantly lower in the AD group than those in the control group,the difference was statistically significant(P<0.05);The daily living ability scores of patients in AD group were lower than those in the control group,such as eating,bathing and dressing,and the difference was statistically significant(P<0.05);Serum CRP and IL-6 levels in patients with AD were negative correlation with MMSE and BI scores(P<0.05).Conclusion The levels of CRP and IL-6 in serum of patients with AD are high,and are closely related to the patients′ mental symptoms and daily living ability.

Objective To analyze the occurrence of sharp injuries among health care workers(HCWs),and put forward suggestions for safety management of sharp inj uries.Methods Recorded form of sharp inj uries reported in a hospital in August 2006-July 2015 were analyzed retrospectively,relevant data were analyzed statistically.Results A total of 211 sharp injuries occurred among HCWs were reported,sharp injuries mainly occurred among nurses(n=118,55.92%)and doctors(n=83,39.34%);117(55.45%)sharp injuries occurred in HCWS whose length of service was≤5 years;the main occurrence locations of sharp injuries were surgical ward(n=67,31.75%),internal medicine ward(n=65,30.81%),and outpatient as well as emergency departments(n=33,15.64%);the main de-vices causing sharp injuries were syringe needle(n=91,43.13%),suture needle(n=34,16.11%),and scalp nee-dle/transfusion needle(n=27,12.80%);the main injury-related manipulations were all types of injection(n=40, 18.95%),intravenous transfusion (n=38,18.00%),and surgical suturing/cutting (n=36,17.06%).The main opportunities of injuries was during manipulation(treatment,examination,operation,n=109,51.66%).Among bloodborne pathogens contaminated devices,contaminated by HBV,HCV,and HIV were 95 (76.61%),25 (20.16%),and 4 cases(3.23%)respectively.There was no bloodborne pathogen infection occurred.155(73.46%) of 211 HCWs were inoculated hepatitis B vaccine.Conclusion Prevention of sharp injuries should be focused on nurses and doctors who work for≤5 years,HCWs in surgical ward,internal medicine ward,and outpatient as well as emergency departments.Prevention of sharp inj uries during manipulations such as inj ection,intravenous transfu-sion,suturing/cutting should be intensified.Related hospital departments should improve the reporting process and intensify follow-up.

Objective To explore the effect of setting up standardized treatment demonstration ward for cancer pain on the management of narcotic drugs. Methods The study group (from 2015 to 2016 to create the standardized treatment of cancer pain ward) and control group (from 2013 to 2014 to create a standardized pain treatment demonstration unit ) all kinds of narcotic drugs dosage and medication frequency (DDDs), a monthly 30 prescriptions from tumor anesthesia, analysis of prescription writing quality qualified the rate and the rate of unreasonable use. Results The study group of patients with cancer pain drug usage and DDDs, oxycodone dosage rises fast, DDDs way ahead, dosage of morphine increased gradually, morphine dosage gradually decreased, transdermal fentanyl DDDs decreased, pethidine dosage remains low. The research group for the passing rate of prescription writing quality 99.3％, the control group of prescription writing quality qualified rate is 81.1％, the research group of narcotic drug use rate was only 4％, reasonable utilization rate is as high as 96％ is not reasonable, unreasonable use of narcotic drugs control group was as high as 18.5％, reasonable utilization rate is only 81.5％ (P<0.05). Conclusion The creation of standardized pain treatment demonstration unit narcotic drugs more reasonable structure, can improve the quality of narcotic drugs prescription writing qualified rate, reduce the rate of unreasonable use, reasonable use of pain medicine has positive significance to ensure patient safety and efficacy of.