Objective To study the expression of c-cbl protein in ovarian cancer and its effect on proliferation and invasion in ovarian cancer cell .Methods The expression of c-cbl protein in ovarian tissue were detected by immunohistochemical(S-P meth-od) ,the mRNA expression of c-cbl protein in ovarian cancer SKOV3 cells were detected .the proliferation ability and migration in o-varian cancer SKOV3 cells were detected by EdU assay and Transwell assay .Western blot was used to detect the expression of P21 and P53 protein .Results c-cbl was located in the cytoplasm in ovarian cancer tissues .c-cbl showed moderate or strong positive ex-pression in ovarian cancer .In contrast ,it showed weakly positive or negative expression in normal ovarian tissue .c-cbl expressed in-creased significantly in ovarian cancer compared with those of in normal ovarian tissue(P < 0 .05) ;c-cbl expressed was associated with FIGO stage in ovarian cancer(P< 0 .05) ;silence c-cbl expression in ovarian cancer SKOV3 cells decreased the proliferation and invasion(P< 0 .05) .Silence c-cbl expression increased the expression of P21 and P53 protein(P< 0 .05) .Conclusion c-cbl was in-creased expression in ovarian cancer tissues .Silence c-cbl expression may be related to increased expression of P21 and P53 .

Objective: To investigate the appropriateness of desflurane anesthesia used in patients undergoing intracranial operations. Methods: Sixteen patients were scheduled for removal of supratentorial mass. A radial artery catheter and a subarachanoid catheter were placed respectively prior to induetion of anesthesia. MAP, cerebrospinal pressure (CSFP), PETCO2 and HR were monitored. Anesthesia was induced with intravenous midazolan, fentanyl, propofol and vecuronium. After endotracheal intubation, anesthesia was maintained by desfurane inhalation in a concentration of 6 % (1MAC) throughout the operation. MAP, CSFP and PETCO2 were recorded before and during induction, at 20min, 30min, 40min and 50min during desflurane inhalation. Results: Compared with the baseline data recorded before anesthesia, CSFP and MAP were decreased significantly during induction. The CSFP tended to increase at 20 min after inhalation of 6 % desflurane, but remained below the baseline till 50min. MAP was decreased following inhalation of 6 % desflurane and kept relatively stable thereafter. No significnt change in HR was noted. Conclusion:Under the condition of PETCO2 28-30mmHg, 1MAC desflurane anesthesia can be used safely without any increase in ICP in patients undergoing intracranial operations.

OBJECTIVE To investigate the vocational safety protection in nurses in the clinic work,then to enhance the protection consciousness of nurse,and the usage of protection.METHODS The relative questions on the vocational protection were investigated in the nurses from one tiatiary care level hospital in China by the Questionnaire designed by ourselves.RESULTS Among the one hundred and fifty nurses investigated,one hundred and one(67.5%)of them just knew little about the vocational exposure,and one hundred and four thought they just accepted little education of vocational exposure.The average score of the usage of protection appliance was 54.89?14.70.The average score was increasing with the higher degree of the study and with the length of service.CONCLUSIONS The vocational safety protection should be emphasized,the protection appliance should be provided comprehensively,and clinic protection system of full efficiency with long time and ensuring system should be founded.

OBJECTIVE To understand the nurses′ awareness of specimen collection and explore the impact of acquisition-related factors and provide the basis for standardized training.METHODS A questionnaire was designed for specimen collection survey about microorganisms in level-3 hospital.RESULTS 90.38 percent of nurses consulted the laboratory,80.77 percent communicated with other nurses to solve the problom about microbiology specimen collection and 94.2% thought it necessary about continuing education.The ward nurses′ knowledge about microbiology specimen collection was better than these from surgical department.CONCLUSIONS It is urgent that stundard training of specimen collection should be implement in medintely due to lacking the awareness.

Objective To explore the relationship between self-efficacy and self-management behaviors of patients with chronic obstructive pulmonary disease (COPD).Methods A total of 350 COPD patients form 5 residents' committees in shanghai were recruited by using a convenient sampling method and were scored using Chinese Self-efficacy Scale (CSES)and the self-management behaviors scale.Spearman's correlation analysis was performed to detect the relation of self-efficacy with self-management behaviors.Results Three hundred and twenty adults were included in this investigation,and their average FEV1/FVC was (57.86 ± 7.06)％,average score of self-efficacy was 74.2 ± 9.5.In self-management behaviors,time spent on physical exercise was (16.2 ± 33.9) minutes per week,and endurance exercises accounted for (109.0±49.0) minutes per week.The score of cognitive symptom management practice was 0.9 ± 1.0 and communication with physicians was 0.7 ± 0.8.Total score of self-efficacy was positively correlated with self-management behavior in each dimension (r values were 0.522,0.407,0.330 and 0.044,respectively ; all P ＜ 0.01).Conclusions Self-efficacy and self-management behaviors of COPD patients need to be improved,and self-efficacy may be related to self-management behaviors.

Objective To investigate the prognositic factors of small intestine stromal tumors after radical resection.Methods The clinicopathological data of 41 patients with small intestine stromal tumors admitted between January 2005 and December 2010 in Henan Tumor Hospital were analyzed restrospectively.Kaplan-Meier survival rate and COX regression were used to evaluate the prognostic factors.Results There were 22 males and 19 females.The age ranged from 22 to 78 years old (median,55years).Location of tumor included duodenum (n =12),jejunum and ileum (n =29).The 3-year survival rate was 22％ in those 16 cases who reported preoperative gastrointestinal bleeding and 65％ in those without GIT bleeding,the difference was statistically significant (P =0.0012).COX model showed that tumor size,the tumor location,recurrence and metastasis were independent risk factors associated with the prognosis in small intestine stromal patients (P ＜ 0.05).Conclusions The most common clinical presentation of these tumors was gastrointestinal bleeding.The tumor location,recurrence and metastasis and gastrointestinal bleeding was independent risk factors associated with the prognosis of small intestine stromal tumor patients.

Objective To investigate the self-efficacy levels and its influencing factors of community-based patients with chronic obstructive pulmonary diseases (COPD).Methods From October 2008 to March 2009,320 community COPD patients were recruited from a Shanghai community.They undertook questionnaires,scale survey and pulmonary function testing so as to investigate the influencing factors of self-efficacy.Results The total scale of self-efficacy was 74.24 ± 9.50 and the level of selfefficacy in 286 cases( 89.4％ )was intermediate.The knowledge of COPD,social supports,forced expiratory volume at 1 second (FEV1)/forced vital capacity (FVC) and self-management level were entered into regression equation and could explain 57.1％ of the total variance of independent variables.Conclusions The knowledge of COPD,social supports,FEV1/FVC and self-management level are the major influencing factors of self-efficacy in the COPD patients.We should improve the knowledge of disease and strengthen the psychological care and social supports so as to improve their quality of life.

Objective To compare the difference of dosimetric results between 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) with 5-field for thoracic middle esophageal carcinoma.Methods Ten patients with thoracic middle esophageal carcinoma were involved in this study.Four treatment plans were designed for each patient,including one 3D-CRT plan and three IMRT plans with 5-field and all evaluation contents were compared.Results There were no significant differences of cord Dmax,total-lung mean dose (Dmean),L-lung Dmean and R-lung V25,V30.Significant differences of heart V30,V40 and Dmean were obtained among the plans,with the lowest of 5IMRT2 (V30:28.67±15.97,V40:13.04±7.28,Dmean:2097.76±718.26) and 5IM RT3(27.39±14.96,13.00±7.32,2096.16±718.85),the highest of 5CRT (43.27±18.69,26.83±19.18,2393.48±896.12) and 5IMRT1 (41.81±17.16,23.08±11.17,2403.77±834.73).There were significant differences of L-lung V5,V10,V15,V20 V25 and V30.All IMRT plans reduce V20,V25 and V30.5IMRT1 did not increase V5 (54.39±7.58) and V10 (44.76±6.30),but reducesd V15 (20.86±5.16),5IMRT2 (V5:70.89±7.95,V10:50.94±8.71,V15:34.20±6.62) and 5IMRT3 (V5:70.26±7.94,V10:49.80±7.62,V15:34.60±5.40)increased V5,V10 and V15.There were also significant differences of R-lung V5.V10,V10,V20 and Dmean.All IMRT plans reduced V20,but increased Vs and V10.5IMRT1 did not increase V15 (23.67±5.73) and Dmean (923.49±182.34); 5IMRT2 did not increases V15 (26.72±±6.79) but increases Dmean (1060.34±205.02); 5IMRT3 increased both V15 (32.40±6.59) and Dmean (1100.54±197.84).Significant differences were found in Dmean,homogeneity index (HI) and conformity index (CI) of PTV,with the best Dmean of 5IMRT1 (6219.80±37.90),the second of 5IMRT3 (6268.91±56.26); the best HI of 5IMRT1 (0.0870±0.0219) and 5IMRT3 (0.0990±0.0219);the best CI of 5IRT2 (0.8682±0.0172) and 5IMRT3 (0.8667±0.0183).Conclusion 5-field IMRT plans have the advantages in the treatment of thoracic middle esophageal carcinoma with better HI,CI of target volume and sparing of lung (V20,V25 and V30) compared to 3D-CRT.5IMRT1 plan has the advantages in reducing low-dose volume (V5,V10,V15 and Dmean) of lung.

AIM: To establish the quality control standard for Compound Dingfengzhitong Capsule (Radix Notoginseng, Radix Saposhnikoviae, Radix Angelicae Dahuricae). METHODS: Radix Saposhnikoviae, Radix Angelicae Dahuricae in capsule were identified by TLC, and the content of ginsenoside R g1 was determined by HPLC. RESULTS: Radix Saposhnikoviae, Radix Angelicae Dahuricae could be identified by TLC. The Ginsenoside R g1 showed a good linear relationship at a range of 0.5286?g～26.43?g, r=0.9999(n=6) , the average recovery was 99.94%, and RSD was 1.34%( n =9). CONCLUSION: The method is accurate with the good reproducibility and can be used for the quality control of Compound Dingfengzhitong Capsules.

Objective To study the distribution of glycosylated hemoglobin A1c (HbA1c) levels in Xiamen,and to investigate the relationship among HbA1c level and gender and age.Methods This was a cross-sectional study.10 487 cases of physical examination individuals in Zhongshan hospital from January 2013 to April 2014 were recruited.HbA1c was measured by ARKRAY HA-8180 automatic glycosylated hemoglobin analyzer (Japan).All data were collected for analyzing the HbA1c levels in different sex and age groups,exploring the rule between HbA1c and age,and comparing the different diagnostic criteria of diabetes mellitus(DM).Differences between the two groups were compared using the Independent Samples T Test.The measurement data of multiple group were compared with single factor analysis of variance (One way ANOVA),and the comparison between two groups was performed with LSD T test.Correlation between different variables was analyzed by Pearson correlation and linear regression.Results Focused on all the 10 487 cases and 9 436 cases with HbA1c ＜ 6.5％ physical examination population,the levels of HbA1c were positively correlated with age,the linear regression equations were HbA1c (％) =0.021 2 × age (years) + 4.811 9 (r =0.348 9,P=0.000) and HbA1c(％) =0.010 9 × age (years) + 5.0944 (r=0.4257,P =0.000)respectively; HbA1c levels in male physical examination population were significantly higher than those in females (P ＜ 0.001),moreover,in different gender groups,HbA1c level had gradually risen with increasing age.Patients at risk for diabetes (prediabetes,39.60％) diagnosed by the criteria of 2010 American Diabetes Association (ADA) were 2.55 times more than those diagnosed by the criteria of international expert committee (15.55％).Conclusions The HbA1c level is related to age and gender in Xiamen city.It is necessary to establish different reference intervals and DM diagnostic cut-off point.The criteria of 2010 ADA can identify more high-risk DM individuals,with is especially suitable for the physical examination screening.