Objective To analyze the cases of malignant tumors found in health examination in our hospital, and to determine the prevalence and characteristics of malignant tumor, and to provide evidence for the development of effective early screening program. Methods A total of 468673 subjects were included from those who had health checkup from July 2009 to December 2014 at the physical examination center. The subjects were between 4 to 96 years of age, with average age of (56.0±12.5) years. Of them, there were 278484 men, 190189 women. All cases found in the examination were confirmed with pathological testing. Prevalence comparison was done withχ2 test, statistic significance level was set at P<0.05. Results Totally 753 cases of malignant tumors were found in 6 consecutive years, with an overall prevalence rate at 160.7/100000. The prevalence rate increased yearly from 50.0/100000 for the first year, and 100.6/100000, 146.1/100000, 149.1/100000, 188.9/100000, 221.6/100000 thereafter. The difference between each 2 years was statistically significant (P<0.01). The top ten malignant tumors were liver cancer, cervical cancer, lung cancer, renal cell carcinoma, esophageal cancer, gastric cancer, colon cancer, breast cancer, leukemia and thyroid cancer. The prevalence rates of malignant tumors in the top three were liver cancer, lung cancer and kidney cancer for man and cervical cancer, lung cancer and breast cancer for women respectively. With the increase of age, the incidence of malignant tumor showed a rising trend, especially for the group of over 80 years old. But women with cervical cancer in the 50-years age group was the highest. Conclusion The number of cases of malignant tumors found in the health checkup population was rising. It is important to include early screening for malignant tumor in physical examination. We should also pay attention to the relevant departments, in order to improve the early cancer detection rate and decrease the morbidity and mortality of malignant tumors.

Objective To explore X-ray measurement of the subacromial space and to determine the normal range of it.Methods Shoulder joints in 188 healthy adults were examined with routine X-ray on the anterior-posterior position and the anterior lateral part of acromion to the intercondylar line of humerus(h1),as well as the most lateral part of acromion to intertubercular sulcus of humeral head(h2) were measured and observed.Results The 95% reference ranges in h1,h2 were 6.4～10.4 mm and 11.0～17.6 mm,respectively.Conclusion Both h1 and h2 can correctly reflect the bony distance of subacromial space,which is of significant meaning for guiding clinical diagnosis and therapy.

Objective To improve the clinical efficacy of angina pectoris with dyslipidemia patients, analysis of the combined use of trimetazidine, atorvastatin calcium, the clinical value of psychological intervention.Methods 86 cases of patients with coronary heart disease and angina pectoris with dyslipidemia were selected, according to the random number table method is divided into control group and study group, each group of 43 cases. The control group were given routine symptomatic angina pectoris of coronary heart disease with abnormal blood lipid therapy plus trimetazidine hydrochloride oral Sibutramine, study group on the basis of the control group given oral atorvastatin calcium plus psychological intervention of statin treatment. Results After treatment, the clinical efficiency of the study group and the control group was 95.34％ and 81.4％, the difference between the two groups was statistically significant (P<0.05); patients in the study group SDS, SAS score than the control group, the difference between the two groups was statistically significant (P<0.05); patients in the study group, TC, TG, LDL and C levels were significantly lower than the control group, the HDL level of C higher than that of control group, the difference between the two groups was statistically significant (P<0.05); study on patients with angina pectoris attack times less than the control group, the seizure duration shorter than the control group, the difference between the two groups was statistically significant (P<0.05). Conclusion Psychological intervention combined with the treatment of angina pectoris of coronary heart disease with abnormal blood lipid, clinical efficiency increased from 81.4％ to 95.34％, reduced in patients with depression, anxiety and other negative emotions, so that the blood has been effectively controlled, improve clinical symptoms, reduce the pain of patients, with high clinical value.

Objective To understand the differences between sexes in the clinical and pathological features of patients with mesangial proliferative glomerulonephritis(MPGS).MethodsOne hundred and five patients with MPGS admitted to our hospital were retrospectively studied in clinical and pathological aspects.Results( 1 ) The proportion of male patients were 75 of 105 ( 71.43 ％ ) and that of females were 30 of 105 ( 28.57％ ) ; ( 2 ) The average age of the male patients was ( 40.25 ± 15.50 ) and that of the females was (36.23 ± 15.26) in year.There was no significant difference between the two groups( t =1.206,P =0.231 ) ;(3) There was no significant difference in duration of disease,hematuria,edema,hypertension prevalence and mean blood pressure( P ＞ 0.05 ).The proportion of patients with hematuria was 56.19％ (59/105).The males accounted for 69.33％ ( 52/75 ) and the females were 63.33％ ( 19/30 ) in the main clinical manifestations of nephrotic syndrome.There was no significant difference( x2 =0.352,P ＞ 0.05 ) between the proportion of males and females; (4)Males and females groups had no significant difference( P ＞ 0.05 )on levels of urinary protein,serum albumin,immunoglobulin,complement,urea nitrogen and serum creatinine.Complement decreased in 53 cases,accounting for 53％ of all the participants.The proportion of male patients with renal insufficiency was 24.00％ (18/75),and the proportion of females with renal insufficiency was 13.33％ (4/30).There was no significant difference ( x2 =1.472,P ＞ 0.05 )on the percentage of males and females with renal insufficiency.The mean value of urea nitrogen was higher than the normal levels ; (5) The proportion of male cases with different deposition of immune complexes was 93.06％ (67/72),and the proportion in females were 92.86％ (26/28) in the exception of 5 cases ( male 3 and female 2 ) with no glomeruli in immunofluorescence examination.No significant difference was found between the two groups( x2 =0.001,P ＞ 0.05 ) ; ( 6 ) There was no significant gender differences( x2 =1.696,P ＞ 0.05 ) found in risk assessment.ConclusionThe prevalence of MPGS is higher in male patients than in females,the main clinical manifestations of which were nephrotic syndrome.Patients were found to have a higher rate of hematuria,decreased complement C3,and renal dysfunction than the normal levels.There was no significant difference in gender on the clinical and pathological aspects of MPGS.

Objective:To explore the correlation of nurses ’ organizational commitment and their professional identity status.Methods:Using Chinese employee organizational commitment scale and nurses professional identity evaluation scale questionnaire survey was conducted in 400 cases of clinical nurses , nurse compare different characteristics of organi-zational commitment and professional identity level , and USES the Pearson correlation analysis to investigate the correla-tion of both.ResultsNurses organizational commitment and professional identity total score , respectively (2.16-0.45) and (3.49 +0.84);Different cultural degree , job title, working years and the way of hiring nurses ’ professional identi-ty score comparison, the difference was statistically significant (P <0.05);Different ways of title, working years, and hire nurses’ organizational commitment score comparison , the difference was statistically significant (P <0.05);Pear-son correlation analysis showed that organizational commitment and the scores of each dimension career cognitive apprais -al, professional social skills , professional setback coping , social support and total scores of professional identity were sig -nificantly positive correlation (P <0.05).Conclusions:The nurse was significantly positively related to organizational commitment and their professional identity , and both have big room to improve .

OBJECTIVE:To explore the clinical efficacy and safety of nedaplatin combined with docetaxel in the treatment of advanced cervical cancer. METHODS:A total of 53 patients with advanced cervical cancer selected from our hospital during Apr. 2014-Apr. 2016 were divided into observation group(31 cases)and control group(22 cases)according to chemotherapy plan. Con-trol group was given Docetaxel injection 60 mg/m2,ivgtt,qw. Observation group was additionally given Nedaplatin for injection 35 mg/m2+0.9% Sodium chloride injection diluted into 500 mL,ivgtt (≥60 min),qw. A chemotherapy cycle lased for 21 d,and both groups received 2 cycles of chemotherapy. Clinical efficacies of 2 groups were evaluated 2 weeks after treatment,and the level of PCNA integal was detected before and 2 weeks after treatment. The occurrence of ADR was recorded. RESULTS:The total re-sponse rate of observation group (77.42%) was significantly higher than that of control group (63.64%),with statistical signifi-cance(P<0.05). Before treatment,there was no statistical significance in PCNA integval between 2 groups(P>0.05). After treat-ment,PCNA integval of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). ADR were concentrated in grade I,and there was no statistical significance in the in-cidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Docetaxel combined with nedaplatin can significantly improve the clinical efficacy of patients with advanced cervical cancer,and does not increase the adverse reactions compared to docetaxel alone.

Objective: To explore the diagnostic value of brachial-ankle artery pulse wave velocity (baPWv) in patients of heart failure with preserved ejection fraction (HFpEF). Methods: A total of 86 consecutive dyspnoea patients without coronary artery diseases (CAD) were studied and they were divided into 2 groups: HFpEF group,n=46 and Control group, the patients had no organic heart disease,n=40. The incremental diagnostic value of HFpEF by baPWv improving the echocardiographic index and plasma BNP level was assessed by logistic regression model, receiver operation curve (ROC) of multi-parameter combination and net reclassiifcation index analysis. Results: Multiple stepwise logistic regression analysis presented that the ratio of early mitral inlfow velocity to tissue Doppler velocity at the lateral mitral annulus, BNP level and baPWv had the independent predictive value for HFpEF diagnosis, P<0.05. The ROC for baPWv with the combination of 2 or 3 parameters was better than the ROC for a single parameter, P<0.05. The baPWv added with 2007 ESC consensus statement signiifcantly improved HFpEF diagnosis, NRI = 0.127,P<0.05. Conclusion: The baPWv combining with current diagnostic criteria could increase the diagnostic value in patients of HFpEF.

Shanghai East Hospital has built a general practice residency training information system based on "Internet +" technology since 2017. This training system effectively promoted the training quality, improved the clinical and research ability of general practitioners, and strengthened the supervision of the training. It has improved the training satisfaction, increased passing rate of national medical licensing examination and graduation comprehensive examination of trainees. This training system can largely break the time and space limitations, and has strong replicability. It may provide reference to optimize the general practice standardized residency training for other institutions.

Objective To investigate the effects of 13-hexyl-berbefine hydroehlofide (HB-13) and 13-hexyl-paimatine hydrochloride (HP-13) on the activation of nuclear factor-kappa B (NF-kB) and phosphorylation of p38 mitogen-activated protein kinase (MAPK) in a human keratinocyte cell line, HaCaT stimulated by tumor necrosis factor alpha (TNF-α). Methods HaCaT cells were cultured in the presence of various concentrations (0.39, 0.78, 1.56 μg/mL) of HB-13 or HP-13 for 120 minutes followed by the stimulation with recombinant human TNF-α for 120 minutes (in phosphorylatEd-IkB-α test) or 15 minutes (in phosphorylated-p38 test). Then, HaCaT cells were disrupted, total protein was extracted, and the expressions of phosphorylated I B-α and phosphorylated p38 were detected with Western blot. HaCaT cells receiving neither pretreatment nor stimulation served as blank control, untreated HaCaT cells stimulated by rhTNF-α as stimulator control, and HaCaT cells pretreated with turmeric root tuber and stimulated by rhTNF-α as positive control. Results From 0.39 to 1.56 μg/mL, both HB-13 and HP-13 significantly inhibited the expression of p-IkB-α in HaCaT cells stimulated by rhTNF-α, and a nonsignificant dose-dependent trend was observed for their inhibitory effect, with the ICo value being 0.441 μg/mL for I-IB-13 (r = -0.990, n = 3, P > 0.05) and 0.832 μg/mL for HP-13 (r = -0.992, n = 3, P > 0.05). In contrast, neither 1-113-13 nor HP-13 within the experiment concentration range had a significant effect on the expression of p-p38 in HaCaT cells stimulated by rhTNF-α (P > 0.05). Conclusions Within the experimental concentration range, both HB-13 and HP-13 can inhibit the activation of NF-kB in HaCaT cells induced by TNF-α signal, but neither of them suppress the phosphorylation of p38MAPK induced by TNF-α signal in HaCaT cells.

Objective To investigate the effects of triptolide on the expression of a series of proteins associated with interferon-γ (IFN-γ)signaling in HaCaT keratinocytes.Methods After pretreatment with difrerent dosages of triptolide(10-10-10-7 mol/L),HaCaT cells were stimulated by recombinant human IFN-γ(rhIFN-γ,500 U/mL)for various periods followed by the collection of cells.Then,total protein was extracted from these cells and subjected to Western blotting for the detection of expression of interferon-γ receptor α(IFN-γRα),phosphorylated Janus kinase 2(pJAK2)and suppressor of cytokine signaling (SOCS1).Results Triptolide at the concentrations of 10-8 mol/L and 10-7 mol/L significantly inhibited the IFN-γRα expression upregulated by rhIFN-γ(both P＜0.05).The expression of pJAK2 induced bv rhIFN-γ was also suppressed by triptolide at the concentrations of 10-9 moI/L and 10-8 mol/L(both P＜0.05).The inhibition of triptolide on IFN-γRα and pJAK2 expression was dose-dependent and the 50%inhibitory concentrations(IC50 value)were 1.37×10-8 mol/L and 2.83×10-9 mol/L,respectively.On the contrary,triptolide upregulated the expression of SOCS1 stimulated by rhIFN-γ at the concentrations of 10-10,10-9 and 10-8 mol/L(P＜0.05,0.05,0.01,respectively)with the 50%effective dosage(ED50 value)at 3.32 × 10-11 mol/L.Conclusions By inhibiting the expression of IFN-γRα as well as phosphorylation of JAK2 and upregulating the expression of SOCS1,triptolide inhibits the phosphorylation of STAT-1,resulting in the inhibition of genetic transcription of multiple inflammatory factors induced by IFN-γ signaling in HaCaT keratinocytes,and the inhibition probably contributes to the efficacy of triptolide in the treatment of IFN-γ-dependent inflammatory skin disorders,such as psoriasis.