Objective:To evaluate the effects and safety of adjuvant chemotherapy for adults with malignant glioma. Method:PubMed,EMBASE,Cochrane Library,CNKI,Chinese Biomedical Database and VIP were reviewed and randomized controlled trials of adjuvant chemotherapy for adults with malignant glioma were identified.The quality of the included trials was evaluated by two reviewers.A meta-analysis was conducted in homogeneous studies.Result:13 controlled trials were involved in 3639 patients.The meta-analysis results showed that compared with radiotherapy alone,the adjuvant chemotherapy might increase 1 year survival,2 years survival,2 years progression free survival,and their OR and 95%CI were 0.61(0.43,0.87),0.52(0.33,0.81),and 0.42(0.19,0.90),respectively,but 1 year progression free survival and 5 years survival had no statistical significance.Their OR and 95%CI were 0.52(0.26,1.04) and 0.75(0.54, 1.04) respectively.5 studies(2418 cases) reported that the toxicity rates increased in patients who received radiotherapy plus adjuvant chemotherapy compared with those in patients who received radiotherapy alone.Conclusion:The adjuvant chemotherapy may increase one year survival and two years survival,and have advandage impact on 2 years and 5 years progression free survival.Owing to the high possibility of attrition bias and measurement bias in the included studies,there must be a negative impact on evidence intensity of our results and therefore,some randomized controlled trials with high quality have to be expected to obtain the best evidence.

For thyroid microcarcinoma(TMC),the incidence is not obvious,the lesion is small,the symptoms are not distinctive and the progression is slow. Studies suggest that patients with the age over 45 years or below 15 years old,male,lesion over 5 mm and lymph node metastasis have poor prognosis and active opera-tion treatment is needed. When in operation,the excision extension should take clinical data into consideration, and complete resection of the lesions and preservation of the normal tissue as much as possible should be done. For the patients with lymph node metastasis,lymph node dissection is feasible,and the central lymph node dis-section is applicable for the negative lymph nodes. Reduce the risk of recurrence and metastasis,increase the survival rate of patients with tumor and improve the quality of life,become the prime target of the follow up,in which the standardized treatment of TMC plays a vital role.

Objective:To explore whether there is mood congruency effect of involuntary autobiographical memories among different mood undergraduates.Methods:Totally 60 college students were induced to generate positive,negative or neutral mood by emotional pictures and music.Vigilance task paradigm was used to induce involuntary autobiographical memory in the present experiment.All participants were asked to rate the pleasantness of involuntary autobiographical memories,then the memory proportion of different valence was calculated.Two raters who had not taken part in the experiment were instructed to divide the objective memory contents into positive,negative and neutral three types.Furthermore,the number of involuntary autobiographical memories recalled was evaluated according to the valence of objective memory contents.Besides,all participants were asked to rate the mood state at the end of the experiment.Results:There was no significant difference in pleasantness ratings among different mood college students (P ＞ 0.05).There was a significant interaction between mood state and the valence of objective memory contents (P ＜ 0.01).Further examination of the interaction suggested the number of positive memory contents recalled was greater in positive state compared with neutral state [(6.3 ±5.5) vs.(2.8 ±2.2),P ＜0.01].However,there was no difference in the number of negative memory contents and neutral memory contents among different mood states (Ps ＞ 0.05).Additionally,no matter the pleasantness ratings was positive or negative,there was no significant correlation between the proportion of memories and mood state rated at the end of the experiment (r =0.29,-0.13,Ps ＞ 0.05).Conclusion:It suggests that there does not exist mood congruency effect of involuntary autobiographical memories among college students in different mood states.Even in negative mood state,their involuntary autobiographical memories would still display a kind of optimistic bias.

Objective To observe the preventive effect of dexmedetomidine on penile erection(PE) after general anesthesia induction and urinary bladder irritation during recovery(UBIR) with urethral catheterization in male patients.Methods A total of 1000 male patients with ASA grade Ⅰ ～ Ⅱ were randomly divided into control group(group C) and dexmedetomidine group (group D,n =500).Dexmedetomidine (1 μg/kg) was intravenous pumped in group D and saline was given in group C 15 minutes before anesthesia induction.Both groups started catheterization within 10 minutes after endotracheal intubation.The incidence and grade of PE before infusion(To),before induction(T1),before catheterization(T2) and during catheterization (T3) were observed.The degree and extent of UBIR were observed and recorded.Results The incidence and grade of PE at T3 time-point in group C were highest (Compared with T2 and other time-points,P ＜ 0.05),but there was no statistically differences in incidence and grade of PE in group D between at T3 and T2time points (P ＞ 0.05).The incidence of PE at T2 and T3 time-points were 4.0％ and 5.6％ in group D,which was significantly lower than those in group C (15.4％,77.8％,P＜0.05).The incidence of PE at grade 1,2 and3 was 4.4％,1.0％ and0.2％ respectively in group D,which was significantly lower than those in group C (62.6％,11.4％,3.8％,P ＜ 0.05).The incidence of UBIR was significantly lower (28.4％ vs 63.0％,P ＜ 0.05),among which the incidence of UBIR at grade 1,2 and 3 were 15.6％,10.4％ and 2.4％,which was significantly lower in group D than those in group C (22.0％,21.0％,20.0％,P ＜ 0.05).Conclusion 1μg/kg dexmedetomidine pumped before anesthesia induction could prevent the occurrence of PE during catheterization and UBIR,which can improve patients' comfort.

Better governance of private hospitals is key to deepening the health reform.In view of the present development of private hospitals in Hubei province,this paper expounded the characteristics development of private hospitals and the governance of specific measures in the province and analyzed the defects found in the legal system and mechanism.The authors also raised such recommendations as perfecting the legal system and improving the mechanism of information disclosure and evaluation.

Objective To investigate the relationship between serum nesfatin-1 and gestational diabetes mellitus (GDM). Methods The serum nesfatin-1 concentrations were measured in 45 GDM patients and 44 NGT pregnant women , as well as 47 non-pregnant healthy women served as control. Serum nesfatin-1 were measured by sandwich enzyme linked immunosorbent assay (ELISA). Meanwhile FPG、 lipoid、 FFA、 FINS、 C-tide were also measured. Result Serum nesfatin-1 level in GDM were significantly higher in GDM patients than in NGT and control (P < 0.01), while serum nesfatin-1 in NGT was significantly lower than in control (P < 0.01). Correlation analysis showed that serum nesfatin-1 was positively correlated with FINS , C-tide , HOMA-IR , triglycerides FBG and OGTT 1 hour glucose, HbA1c (P < 0.05). Conclusion Serum nesfatin-1 level in pregnant women significantly decreas, while in GDM patients significantly increase. Serum nesfatin-1 level in pregnant women is positively correlated with Insulin resistance (IR) and triglycerides level.

Objective To investigate the level and influencing factors of subjective well-being of nurses and establish a model of the relationship of job stress, self-efficacy and subjective well-being. Methods Totally 438 nurses from 5 hospitals in Changchun city were investigated with the self-designed demographic questionnaire, General Well-Being Scale, Nurse Job Stressors Scale and Self-Efficacy Scale. Results The total score of subjective well-being was (71.36 ± 18.83) points. Single factor analysis found that age (F=1.759, P<0.01), department (F=1.712, P<0.01), professional title (F=1.364, P<0.05), years of working (F=1.420, P<0.05) and monthly income (F=1.632, P<0.01) were statistically significant. Multiple linear regression analysis showed that sex (t=-2.447, P<0.05), the first factor of job stress (t=-5.033, P<0.01), the second factor (t=-2.478, P<0.05), the third factor (t=-2.315, P<0.05), the fifth factor (t=-5.862, P<0.01) and self-efficacy (t=10.705, P<0.01) were the predictive effectton of subjective well-being. The result of path analysis shows that self-efficacy has a significant effect of adjustment on job stress and subjective well-being (direct effects=-0.62, indirect effects=-0.24, P<0.01). Conclusions The nurse subjective well-being is in the medium level. Hospitals and all related departments should take effective measures to reduce or eliminate unfavorable factors and increase the protective factors, and then improve the level of nurses′subjective well-being and nursing quality.

Ob jectiev Oxidized low-density lipoprotein ( ox-LDL) induces vascular endothelial cell injury , which is one of the factors initiating atherosclerosis .This study aimed to investigate the protective effect of Tongxinluo ( TXL ) on vascular endothelial cells with ox-LDL-induced injury . Methods Human umbilical vein endothelial cells ( HUVEC ) were cultured in vitro and divided into five groups:normal control, oxidative stress injury (OSI) model, and high, medium and low dose TXL.The HUVECs were incubated with ox-LDL at the concentration of 30 mg/L for 24 hours to induce oxidative stress injury and then treated with TXL at 50, 100 and 150 mg/L for 4 hours, followed by 24 hour incubation with 30 mg/L ox-LDL added to the culture medium .The viability of the cells was detected by MTS assay, the nitric oxide (NO) content, superoxide dismutase (SOD) activity and mitochondrial membrane poten-tial ( MMP) in the cell culture supernatant were measured with respective kits , and the expressions of iNOS , MMP9, and NF-κBp65 proteins were determined by Western blot . Results The HUVECs of the OSI model group showed a significant decrease in cell via-bility compared with the normal control , ([73 .89 ±0.67] vs [100.00 ±2.23]%, P<0.01) but a remarkably increase after treated with medium and high dose TXL ([92.15 ±0.76]%and [ 97.19 ±1.45]%, P<0.01).The MMP, NO content, and SOD activity were markedly reduced in the model group (P<0.01) but elevated in the low, medium, and high dose TXL groups (P<0 .01).The expressions of the iNOS, MMP9, and NF-κBp65proteins were significantly up -regulated in the model group (P<0.01) but down reg-ulated in the low, medium, and high dose TXL groups (P<0.05).C on clusion TXL has the effects of anti-oxidation and anti-in-flammation and can protect vascular endothelial cells against ox-LDL-induced injury .

Objective The establishment of the model of myocardial ischemia-reperfusion injury (MIRI) in SD rats involves lengthy time, severe damage, and death of the rats.We aimed at an efficient and rapid method for establishing an MIRI model in rats to ensure a high success rate of modeling and survival of the animals.Methods Using the trachea intubation-assisted breathing machine, we fully exposed the hearts of 80 adult SD rats (8-10 weeks old and weighing 250-300 mg) by mutilating the 2-3 intercostal muscles.Then, we rapidly positioned and ligated the left anterior descending (LAD) coronary artery for an hour, and established the model of MIRI at 48 hours after releasing the slipknot.We performed electrocardiography (ECG) before, during, and at 1 and 48 hours after operation, ligated the same part again at 48 hours postoperatively, and measured the size of the myocardial ischemia and infarction areas using Evans-TTC double staining.Results The survival rate of the 80 rats was 90% and the success rate of MIRI modeling was 86.25%.After ligation of the LAD coronary artery, ECG showed the ST segment and T wave elevation, followed by gradual decrease of the ST segment and R wave voltage, the myocardium and cardiac apex muscle grey or dark grey below the ligation slipknot.The heart rate myocardial motion amplitude were obviously reduced after ligation.Evans-TTC double staining revealed an evident myocardial infarction area at 48 hours after modeling and the ratio of the ischemia area + infarction area to the total myocardial area of the left ventricle was 0.43 to 0.55 (P>0.05) and that of the infarction area to the ischemia area + infarction area was 0.35 to 0.45 (P>0.05).Conclusion The modified rat model of MIRI can be fast and efficiently established, with a high success rate of modeling and a low mortality of the animals.

Objective To explore advantage of RNA guiding activity in vitro cleavage assay and intracellular antivi-ral effects for hepatitis C, basing on one external guide sequence (EGS)sequence of the conserved region of 5′UTR of HCV genome .Methods We analyzed the sequence and structure of the conserved region of 5′UTR of HCV ge-nome with computer software and designed one EGS which was direct at the potential targeting site ( C67-G68 ) .We tested the gene expression of HCV in Northern blot and Western blot and its antiviral activity by fluorescence quan -titative PCR in the Huh7.5.1 cell which was transfected by EGS-C67 .Results EGS-C67 had obvious advantage of RNA guiding activity in vitro cleavage assay .EGS-C67 obviously inhibited the gene expression of HCV and inhibit the proliferation of HCV and down-regulate the titer of HCV about 150 times( P<0.01 ) .Conclusions EGS-C67 , the new antiviral RNA has notably antiviral activity in cultured cells , thus could provide a new promising approach for development of anti-HCV strategy .