Objective To evaluate the clinical efficacy of gemcitabine plus cisplatin (GP) regimen and paclitaxel plus cisplatin (TP) regimen in the treatment of recurrent or metastatic nasopharyngeal carcinoma.Methods One hundred and thirty patients with recurrent or metastatic nasopharyngeal carcinoma of Qinhuangdao Harbor Hospital,Hebei Province between September 2012 and December 2017 were chosen,and were divided into GP group (68 cases) and TP group (62 cases)according to the selection of treatment.GP group was treated with GP regimen,and TP group was treated with TP regimen.The clinical efficacy and adverse reactions of the two groups were observed,and the serum epithelial cadherin (SE-CAD) and platelet-derived growth factor (PDGF-BB) were measured before and after chemotherapy.Results There was no significant difference in short-term efficacy between GP group and TP group (P＞0.05),and the total effective rates were 88.24％ (60/68) and 79.03％ (49/62) respectively;1 month after treatment,SE-CAD in GP group and TP group were (2.57 ± 0.81) and (2.50 ± 0.96) g/L,PDGF-BB were (102.22 ± 31.18) and (110.15 ± 37.21) ng/L,and the difference was not statistically significant (P＞0.05);progression-free survival (PFS) in GP group and TP group were 13 and 12 months,and overall survival (OS) were 17 and 16 months,and the difference was not statistically significant (P＞0.05);there were no significant difference in leucopenia,hemoglobin,thrombocytopenia and abnormal liver and kidney function between GP group and TP group (P＞0.05);the incidence of gastrointestinal reactions in GP group was 16.18％ (11/68),which was significantly lower than that in TP group was 38.71％(24/62),and the difference was statistically significant (P＜0.01).Conclusions GP and TP regimens are effective in the treatment of recurrent or metastatic nasopharyngeal carcinoma.There is no significant difference in SE-CAD and PDGF-BB levels between the two regimens after treatment,but GP regimen has a lower incidence of gastrointestinal reactions.

Aneurysmal subarachnoid hemorrhage (aSAH) isa cerebrovascular event with serious health consequences and is characterized by a high incidence,high morbidity,high mortality and high recurrence rate.As global population aging intensifies,the prognosis of aSAH among the elderly has become a focus for researchers in various specialties.Consequently,the identification of risk factors for the prognosis of aSAH in the elderly carries enormous importance.In this article,we review the recent advances in factors and the genetics related to the prognosis of aSAHin elderly patients.

Preeclampsia(PE) is a unique disease to pregnancy women,and women who had a history of preeclampsia significantly increased the risk of cardiovascular disease.Preeclampsia etiology and pathogenesis is not clear yet,it may have common pathophysiology with cardiovascular disease(CVD),such as oxidative stress,endothelial injury,insulin resistance,lipid metabolic disorder and so on.The article reviewed the relationship between preeclampsia and long-term cardiovascular disease among women,especially discussed the disease such as coronary heart disease,hypertension and stroke,to find the association and to explore the potential risk management options for these high-risk women.To block,intervene,and prevent cardiovascular disease starting with preeclampsia,it is of significance to the cardiovascular health of over 300 million women worldwide.

This article reviewed the measures taken by the hospital against a catastrophic fire hazard and exploration in its response and work organization of nursing care of the wounded.Proposed in this paper are development of such five systems as the pre-plan,exercises,personnel,quality control and incentives,which are expected to improve the nursing capacity of the hospital in emergency rescue,for sustainable development of nursing emergency rescue work.

Retrospectively analyzed in the paper are such clinical data as disease category,inj ury part,severity and outcomes for 322 victims of the catastrophic fire and explosion accident at a tertiary hospital.The authors summarized the disease spectrum,and treatment and nursing strategy,in order to improve the emergency plan against fire and explosion accidents,to raise the accuracy of pre-hospital and in-hospital inj ury examination,and to ensure efficient and scientific treatment and nursing,with minimized deaths.

Objective To explore the effects of Clark comfortable nursing mode on self efficacy and quality of life in hospitalized patients with stroke .Methods This research selected 100 hospitalized patients with stroke in recovery period in department of neurology at a hospital where the author was .They were divided into control group (50 cases, usual nursing) and observation group (50 cases, Clark comfortable nursing mode ) according to nursing mode .The self efficacy , quality of life , and degree of satisfaction was compared in patients of two groups on admission and 6 months after nursing care .Results The score of self efficacy (33.04 ±5.09) of patients in observation group was higher than that ( 26 .73 ±4 .75 ) in control group with a significant difference (t=3.726, P=0.015);the score of quality of life (40.80 ±5.72) of patients in observation group was higher than that (35.41 ±5.53) in control group with a significant difference (t=4.210, P<0.001);the degree of satisfaction (96.00%) of patients in observation group was higher than that (74.00%) in control group with a significant difference (P=0.007).Conclusions The Clark comfortable nursing mode applied to the nursing care of hospitalized patients with stroke not only can improve patients ′self efficacy and quality of life, but also can increase the degree of satisfaction of patients .

Objective To investigate the role of silent mating type information regulation 2 homologue 1(SIRT1) in renal ischemia-reperfusion(IR) injury and its effect on NF-κBp65-peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC-1α) signal pathway in mice.Methods Seventy-two healthy C57BL/6 male mice were randomly divided into four groups:control group(n=18),sham-operated group(n=18),IR group(n=18),resveratrol group(n=18).Bilateral renal pedicle were clamped for 45 min was adopted to establish the model of acute ischemic renal injury,to give 2％ dimethyl sulfoxide or resveratrol by intraperitoneal injection for 7 days before modeling.Determination techniques included routine biochemical methods for the the levels of Scr and BUN,spectrophotometry for the level of superoxide dismutase (SOD),HE staining for the histological changes as well as immunohistochemical method and Western blotting for the expressions of SIRT1,NF-κBp65 and PGC-1α,respectively.Results Compared with that in control and sham-operated groups,the levels of serum Scr and BUN were higher and SOD levels in renal tissues were lower at 12 h and 24 h after operation in IR groups(P ＜ 0.05).HE staining revealed evident pathological lesions including necrosis of renal tubular epithelial cells in IR group.Compared with that in IR group,resveratrol attenuated the above-mentioned changes.Western blotting revealed the up-regulated SIRT1 expression and the activated NF-κB signal pathway,the up-regulated p65 expression and the down-regulated PGC-1αexpression subsequent to IR(P ＜ 0.05).Both Western blotting and immunohistochemistry showed that the expressions of SIRT1 and PGC-1α in resveratrol group were up-regulated compared to that in IRgroup(P ＜ 0.05),while the NF-κBp65 expression in resveratrol group was down-regulated(P ＜ 0.05).Conclusions In mouse model of renal ischemia-reperfusion injury,the activation of SIRT1 can inhibit the NF-κBp65 expression and accordingly up-regulated PGC-1α level,contributing to inhibiting inflammatory reactions and attenuating oxidative stress-induced injury in the protection of the kidneys.

Spontaneous intracerebral hemorrhage (SICH) refers the primary, non-traumatic parenchymal hemorrhage. In China, SICH accounts for about 20%-30%of total strokes. SICH is a kind of disease affected by multiple factors includ?ing environmental and genetic factors. The high morbidity and mortality cause serious damage to human health. Therefore, it is important to find etiology and risk factors of SICH. The article reviewed the progress of SICH pathogenesis in the perspec?tive of genetics and molecular biology.

Objective To investigate the significance of test of receptor activator of nuclear factor?kappa B(NF?κB)ligand(RANKL)in serum and urine for the diagnosis of osteoporosis. Methods A total of 53 patients with osteoporosis(the experimental group)and 45 healthy controls(the normal control group)were recruited in this study. The expression levels of RANKL in serum and urine was measured and compared by enzyme?linked immunosorbent assay. Results The serum and urine levels of RANKL in the experimental group were significantly higher than those in the normal control group(P<0.01). The areas under receiver operating characteristic(ROC)curve of serum and urine RANKL were 0.898 and 0.734, respectively. The combined detection of serum and urine RANKL and Ca2+reached a high sensitivity of 89.5%and a specificity of 86.1%for diagno?sis of osteoporosis. Conclusion RANKL may be closely associated with the progression of osteoporosis. Serum and urine RANKL test may be help?ful in the diagnosis of osteoporosis.

Objective To explore the relationship between the size and location of the aneurysm after subarachnoid hemorrhage (aSAH) and its clinical classification. Methods A retrospective study was performed in patients with aSAH from January 1, 2008 to December 31, 2014. The relevant clinical data were collected including age, gender, aneurysm size, location, and Hunt-Hess (H-H) classification. The aneurysms were classified by size (A group d<5.00 mm, B group 5.00 mm≤d<10.00 mm, C group d≥10.00 mm), location and H-H classification according to the results of CT, digital subtrac?tion angiography (DSA), and magnetic resonance angiography (MRA). The relationship between size, position of aneurysm and H-H classification was observed and analyzed. Results There were 750 cases included in this study, with average age (56.14 ± 11.88), male 292 and female 458. The total number of aneurysms was 903, and the number of multiple aneurysms was 91 (12.13%). There was one case with multiple aneurysms that can be included in A, B and C groups. There were two cases with multiple aneurysms that can be included in A and B groups, two cases can be included in A and C groups, and three cases can be included in B and C groups. The number of aneurysms and the ratios of groups A, B and C were 20(3.9%), 12 (3.8%), 5 (7.5%), 70 (13.6%), 39 (12.2%), 10(14.9%), 2 (0.4%), 4 (1.3%), 2 (3.0%), 165 (32.0%), 94 (29.4%), 6 (9.0%), 130 (25.2%), 90 (28.1%), 6 (9.0%), 17 (3.3%), 11 (3.4%) and 2 (3.0%) for the location in the anterior cerebral artery, the middle cerebral artery, the posterior cerebral artery, the internal carotid artery, the anterior communicating artery, the posterior communicating artery, and the vertebral basilar artery, respectively. The number of aneurysms and the ratios of H-H classificationⅠ,Ⅱ,Ⅲ,ⅣandⅤin groups A, B and C were 48 (9.3%), 45 (14.1%), 12 (17.9%), 228 (44.2%), 150 (46.9%), 14 (20.9%), 68 (13.2%), 54 (16.9%), 30 (44.8%), 142 (27.5%), 43 (13.4%), 9 (13.4%), 30 (5.8%), 28 (8.8%) and 2 (3.0%). There was a negative correlation between the size of aneurysm and the H-H grade (rs=-0.075, P=0.024). Conclusion The anterior communicating artery and posterior communicating artery are high-risk areas for smaller aneurysms. The internal ca?rotid artery is high-risk areas for larger aneurysms. The size of aneurysm is negatively correlated with H-H classification.