Livin is the inhibitor of apoptosis proteins (IAPs), a new member, in most malignant tissues of high expression, and its main function is to inhibit cell apoptosis. Apoptosis and tumor cells is closely related to the occurrence and development, more on which the survival of tumor angiogenesis. Vascular endothelial growth factor (VEGF) is one of the strongest of vascular growth factor, and almost all human tumors and tumor cell lines have over-expression of it. Livin and VEGF protein expression in tumor was summarized.

ObjectiveTo explore the nursing students'puzzles about career planning,and provide a basis for the training.MethodsA qualitative research was conducted on 14 university nursing interns by in-depth interview and observing.The whole interview was noted.The data was analyzed according to Colaizzi's phenomenological procedure.ResultsThe experience could be classified into four aspects,including hazy understanding of career planning,lack of understanding of themselves,limited ca reer identity and lack of social cognition.ConclusionNursing educators should enhance the training against the nursing students'puzzles and make sure they can make a good career planning.

Objective:To investigate the sleep quality of the people aged over 18-years-old in Hebei province and the impact of relative factors on it.Methods:Sum total of 20 716 random samples at ages over 18 were selected among the general population.The tools were Pittsburgh Sleep Quality Index(PSQI),Simplified Coping style Questionnaire(SCSQ).Results:The total prevalence of low sleep quality was 11.6 %(2411/20716).Female had higher standardized prevalence rate than male(6.8% vs.4.8%).Logistic analysis showed that risk factors to low sleep quality were ages over 70-years-old,remarriage,divorce,bereft,negative coping style(OR=1.776,1.515,2.046,1.254,1.097).On the other hand,factors to good sleep were the Han nationality,male,farmer,the family average annual income ranged 5001-10000 RMB,10001-20000 RMB,20001-40000 RMB,positive coping style(OR=0.839,0.703,0.732,0.750,0.660,0.573,0.936).Conclusion:Low sleep quality had high prevalence in Hebei.It should be recognized by medical workers.

Objective To research the risk factors of new-onset atrial fibrillation (AF) during hospitalization in patients with acute myocardial infarction.Methods Five hundred and one patients first diagnosed with acute ST-segment elevation myocardial infarction who accepted primary coronary intervention from January 2012 to May 2014 in the Second Hospital of Tianjin Medical University were selected.These patients were divided into non-AF group and new-onset AF group depending on whether happened new-onset AF during hospitalization.Data of the patients in acute myocardial infarction complicated with new-onset atrial fibrillation were collected.Univariate and multivariate logistic regression analysis were used to determine the predictors of new-onset AF.Results AF occurred in 49 cases of the 501 (9.8％) patients diagnosed as acute myocardial infarction.Logistic regression analysis showed that admission heart rate(OR =1.019,95％CI:1.004-1.034,P =0.012),left atrial diameter (OR =1.086,95％ CI:1.021-1.156,P =0.009),previous stroke (OR =2.060,95％ CI:1.029-4.123,P =0.041) were independent risk factors for new-onset AF in acute myocardial infarction.Use of β-blockers before coronary intervention treatment can reduce the risk of new-onset atrial fibrillation(OR=0.222,95％CI:0.064-0.768,P=0.017).Conclusion Admission heart rate and left atrial diameter are independent predictors of new-onset atrial fibrillation,and β-blockers in early stage can effectively reduce the incidence of atrial fibrillation.

Purpose:To study the relationship between expression of TGF-?_(1) and invasion and metastasis of bladder cancer.Methods:ELISA was used to examine TGF-?_(1) in serum of patients with bladder cancer.Results:Compared to the control group,TGF-?_(1) level in patients serum was higher(P

Objective To study the effect and safety of Shugan Jieyu capsules combined with olanzapine tablets in the treatment of schizophrenia,and to analyze its effects on the patients’ depressive symptoms.Methods According to the digital table,80 patients with schizophrenia were randomly divided into control group and observation group,40 cases in each group.The control group was treated with olanzapine,while the observation group was given olanzapine combined with Shugan Jieyu capsules.During the treatment,the other antidepressants,antipsychotics and mood stabilizers were prohibited.Results After treatment,the scores of CDSS,PANSS,PSQI and SQLS in the two groups were improved,and the differences were statistically significant(all P ＜ 0.05).The CDSS score was (3.4 ± 2.5) points,PANSS score was (36.2 ± 7.5) points,PSQI score was (3.4 ± 2.5) points and SQLS total score was (79.1 ± 16.2)points in the observation group,which were all better than those in the control group[CDSS score was (2.8 ± 2.0) points,PANSS score was (40.5 ± 8.7) points,PSQI score was (5.8 ± 3.3) points and SQLS total score was (59.4 ± 19.1) points],the differences were statistically significant (t =5.942,2.368,3.666,4.975,all P ＜ 0.05).After treatment,TCHO,TG,SBP,DBP and GLU were decreased in both two groups,but no significant differences were shown compared with before treatment(t =1.265,0.425,1.224,1.236,0.670,all P＞ 0.05),and there were no significant differences between the two groups (all P ＞ 0.05).After treatment,the total effective rate of the control group(67.5％) was lower than 85.0％ of the observation group,the difference was statistically significant (x2 =4.267,P ＜ 0.05).There were no significant difference in the incidence of complications between the two groups(x2 =0.139,0.164,0.105,0.263,0.263,0.180,all P ＞0.05).Conclusion For the treatment of schizophrenia,combined therapy of olanzapine tablets and Shugan Jieyu capsules has significant effect and higher safety,it can improve the patients'depressive symptoms,regulate the body's metabolism and improve their sleep and life quality.

Objective To investigate the predictive value of CHADS2 and CHA2DS2-VASc score in left atrial (LA) or left atrial appendage (LAA) thrombus in patients with non-valvular atrial fibrillation (AF). Methods A total of 164 consecu?tive non-valvular AF patients confirmed by transesophageal echocardiography (TEE) were included in this study, and were divided into two groups, LA/LAA thrombus group and non LA/LAA thrombus group. The previous history was recorded in two groups of patients. Their CHADS2 and CHA2DS2-VASC scores were calculated based on the general data of two groups. The laboratory examinations and TEE indexes were compared between two gropes. Results Of all patients, the rate of LA/LAA thrombus was 19.5%. The CHADS2 and CHA2DS2-VASC scores were significantly higher in LA/LAA thrombus group than those of non LA/LAA thrombus group (2.1±1.3 vs 1.0±0.9, 3.4±1.8 vs 1.9±1.4,P<0.01). There were 13(11.9%) and 5 (8.8%) patients showed LA/LAA thrombus under low-moderate risk in the two score systems, respectively. Multivariate logis?tic regression analysis showed that CHADS2 score≥2 points(OR=3.735, 95%CI:1.508-9.251, P=0.004) and CHA2DS2-VASc score ≥2 points (OR=5.104, 95%CI:1.586-16.425, P=0.006) were independent risk factors of LA/LAA thrombus. ROC curve showed that AUC of CHADS2 and CHA2DS2-VASc scores to predict LA/LAA thrombus were 0.731 (95%CI:0.630-0.832, P<0.001) and 0.742 (95%CI:0.640-0.843, P<0.001), respectively. Conclusion CHADS2 and CHA2DS2-VASC score ≥2 points are independent risk factors of LA/LAA thrombus in patients with non-valvular atrial fibrillation. The pre?dictive values of both score systems are moderate. There are also LA/LAA thrombus in low-moderate risk patients when us?ing the two score systems, and with the increased risk stratification, the rate of LA/LAA thrombus is increased.

ObjectiveTo study the mechanism of infection-related reactive thrombocytosis.MethodsSeventy-five infectious disease patients were selected including 42 cases with acute infections phase thrombocytosis (acute infectious phase thrombocytosis group),18 cases with acute infectious phase normal platelet count (acute infectious phase normal platelet count group),15 cases with recovered phase (infectious recovered phase group) and 16 cases with healthy controls(control group).The serum thrombopoietin (TPO),intefleukin-6 (IL-6),white blood cell,platelet was determined and compared among 4 groups.Results The serum TPO in acute infectious phase thrombocytosis group [( 159.1 ± 65.9) ng/L]was higher than that in acute infectious phase normal platelet count group,infectious recovered phase group,and control group [(43.5 ± 14.4),(40.3 ± 15.2),(41.8 ± 18.9) ng/L](P＜ 0.05).There was no significant difference in the serum IL-6 between acute infectious phase thrombocytosis group [(542.7 ± 247.0) ng/L]and acute infectious phase normal platelet count group [(598.5 ± 250.4) ng/L] (P ＞ 0.05 ),but which was higher than that in infectious recovered phase group [(43.5 ± 20.7 ) ng/L] and control group [( 38.3 ± 17.6 )ng/L] respectively (P ＜ 0.05 ).The serum IL-6,TPO was positively correlated with platelet,white blood cell.The serum TPO was positively correlated with IL-6.ConclusionElevated TPO leads to the thrombocytosis,which is the possible mechanism of infection-related reactive thrombocytosis.

Objective To investigate the association of serum angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) with myocardial reperfusion in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). Methods A total of 103 consecutive STEMI patients who received primary PCI were enrolled in this study. The patients were divided into two groups according to ST-segment resolution (STR) at 2 h after PCI:STR ≥ 50%group (n=69) and STR<50%group (n=34). Serum concentrations of Ang-1, Ang-2 and Ang-2 to Ang-1 ratios (Ang-2/Ang-1) before and immediately after PCI, 2 h, 6 h, 24 h after PCI were compared. Predictors of poor STR were identiifed by multivariable logistic regression analysis. Results The patients with STR≥50%had significant higher serum Ang-1 levels (P < 0.05) and lower Ang-2/Ang-1 ratios (P < 0.01) from before PCI to 6 h after PCI than those with STR < 50%;Ang-1 and Ang-2/Ang-1 at 24 h after PCI, and Ang-2 at all time points were not signiifcantly different between the two groups (P>0.05). In multivariable logistic regression analysis, Ang-2/Ang-1 before PCI was independently associated with STR < 50%;Other independent predictors were pain to balloon time, infarct related artery (LAD), and TIMI flow grade<Ⅲafter PCI. Conclusions Higher Ang-2/Ang-1 is an independent predictor of poor myocardial reperfusion in STEMI patients after PCI.

Objective To report a case of primary breast T-cell lymphoblastic lymphoma/leukemia (T-LBL/ALL) and study its clinico-pathological features and treatment,to improve the recognition of T-LBL/ ALL.Methods A case of primary breast T-LBL/ALL was reported and reviewed the literatures.Results The female patient was 17 years old,was diagnosed as primary breast T-LBL/ALL who presented with multiple bilateral breast masses and left axillary lymph node enlargement for two months.The patient was treated with modified BFM-90 and achieved complete remission.The patient was in complete remission 12 months after diagnosis at present and till in follow-up.Conclusion Primary breast T-LBL/ALL is very rare and highly aggressive with bad prognosis.T-cell lymphoblastic leukemia chemotherapy regimens is often effective.