Objective　 To investigate the relationship between of serum bilirubin concentrations and risk of coronary heart drsease (CHD). Methods　 Serum bilirubin concentrations were determined in 12 cases with acute myocardial infarction(AMI)、37 cases with unstable angina pectoris (UAP) and 30 cases with UAP with arrhythmia. Results　 The serum total bilirubin(TB)、direct bilirubin(DB)、indirect bilirubin(IB) concentrations were lower in the three study groups of CHD than in the controls. There was significant difference between the patients with CHD and the controls. However, there was no significant difference among the three study groups of CHD. Conclusion　 Serum bilirubin concentrations was inversely and statistically significantly related to risk of CHD.

Objective To investigate the diagnostic value and clinical implications of low hemoglobin density(LHD%)in the pa-tients with cervical carcinoma complicating iron deficiency anemia(IDA).Methods The iron metabolism indexes and whole blood cell parameters were detected in 148 patients with cervical carcinomas.LHD% was calculated.The results were compared with that in the healthy group and the hysteromyoma complicating IDA group.Results LHD% was(63 ±30)% in the cervical carcinoma complicating IDA group and(32±15)% in the cervical carcinoma complicating iron deficient erythropoiesis(IDE)group,which were higher than(7±6)% in the healthy group,(22 ±21)% in the cervical carcinoma non-iron deficiency group and(16 ±10)% in the cervical carcinoma non-anemia group(P <0.05 ).And which had no statistical difference between the hysteromyoma complicating IDA group and the cervical carcinoma complicating IDA group(P >0.05 ).Conclusion The new RBC parameter LHD% has the reference value in the diagnosis of cervical carcinoma complicating IDA.The LHD% increase may prompt cervical carcinoma com-plicating IDA.

Objective To understand the status quo of medical graduates' professional faith and to evaluate the education methods. Methods Questionnaire survey combined with expert inter-view were conducted from two aspects: professional faith condition and educational methods. Medical graduates from an affiliated hospital of a university in Shanghai were investigated in this survey and 392 copies of effective questionnaires were analyzed comparatively. Results 92.6%(363/392) students regarded extreme events as the main factor that influence their further employment. 14.8%(58/392) students had career planning. 79.6%(312/392) students achieved self-improvement from strengthening learning and training. Salary was the main factor that affect medical graduates' career choice (4.47 points). 75.5%(296/392) students considered that the existing professional faith education was out of fashion. 85.5%(335/392) of students thought that education methods should be improved. Strengthen-ing relevant education career planning was considered as the most valuable content (4.22 points) and the most effective form was group learning (4.53 points). Conclusions The main reasons for devia-tion and dissatisfaction are:social factor, lack of professional faith, unique status and obsolete way of education. Professional faith education should take the above factors into consideration.

In China , some ophthalmic new drug clinical trials used placebo as control .Two principles should be con-sidered in ethical review when placebo was used in these ophthalmic new drug clinical trials .Firstly, using placebo couldn't lead to irreversible or permanent vision loss .Secondly , there should be proper risk management in protocol and risk dis-closure in consent process .There are several important factors , including effects of standard treatment , risks of using pla-cebo, risk management in protocol and risk information in informed consent form , which should be used to assess the ra-tionality of placebo in ethical review .

Based oncompetence-basedphilosophy of education, core competences of Master of Nursing Specialist (MNS) postgraduates serve as a benchmark for the education quality. Furthermore, the evaluation of core competences is a key link. Our research mainly summarizes the evaluation methods of core competences of MNS at home and abroad, thus providing suggestions to the improvement of domestic core competences evaluation methods of MNS.

Diastolic transmitral blood flow was measured by Doppler echocardiography in 66 patients with hypertension and 33 normal persons. The results showed that isovolumic ventricular relaxation time and peak. A velocity increased and E/A ratio decreased significantly in hypertensive patients without left ventricular (LV) hypertrophy. Patients with LV hypertrophy had not only significant change of these parameters, but also significant decrease of peak E velocity and deceleration of E velocity. Left atria was larger in hypertensive patients, especially in those with LV hypertrophy. It is suggested that LV diastolic dysfunction in patients with hypertension may occur before the development of LV hypertrophy, and LV hypertrophy may worsen the diastolic dysfunction.

Objective To explore the influencing factors for usage of the official App of a hospital, based on Unified Theory of Acceptance and Use of Technology (UTAUT).Methods 616 outpatients were randomly sampled from outpatient clinics of three tertiary hospitals in Hangzhou for questionnaire survey, to learn the usage and intention for hospital′s official App.Results It was found that women (0.134), high performance expectancy (0.321), facilitating conditions (0.256), high effort expectancy (0.224), and desirable social influence (0.100) all contributed positive influence (P<0.05) to usage of such App.Conclusions It is recommended to enhance service functions of such App and simplify its usage, in addition to better promotion and online security measures.

Objective To elucidate the relationship between quality of life (QOL) and disease activity of systemic lupus erythematosus (SLE),as well as to reveal the factors impacting disease activity and the QOL of SLE utilizing the combination of SLE-specific quality of life questionnaire (SLEQOL) and the medical outcomes survey short form 36 (SF-36).Methods SLEQOL and SF-36 health survey questionnaire were applied.Information on gender,disease duration,age,education level were collected.Serum complement (C3 and C4) level and erythrocyte sedimentation rate (ESR) were measured.Patients were divided into inactive,mild active,moderate active and severe active respectively according to SLE disease activity index (SLEDAI).Pearson's product moment correlation coefficient was used to analyze the correlation between the activity of disease and the QOL.Multiple linear regression was employed to explore the factors which could impact on SLEQOL.Results The physical function of SLEQOL was positively correlated with SLEDAI (r=0.36; P＜0.05).The association between reported health transition of SF-36 and SLEDAI was positive (r=0.19; P＜0.05).Physical functioning,role-physical,role-emotional,body pain and vitality were all negatively correlated with SLEDAI (r:-0.20,-0.19,-0.19,-0.19,-0.21 respectively; P＜0.05).The scores of patients with severe disease activity were significantly increased in the physical functioning of SLEQOL than other three groups (18±10 vs 11±5,12±6,13±7; P＜0.05).Scores on the Health transition of patients with moderate and severe disease activity were lower than those of whom with mild disease activity (23±28.14±17 vs 34±39,P＜0.05).Patients with mild or severe disease activity had lower score than those of patieuts in disease inactive (30±41,34±39 vs 44±44,P＜0.05).Multiple linear regression analyses showed that disease duration and education level might be the influencing factors of SLEQOL.Conclusion QOL of patients with SLE is related to the level of disease activity and is impacted by disease duration and education.

Objective To construct a prostate cancer specific oncolytic adenovirus armed with a fusion protein gene , PSA-IZ-CD40L, and to evaluate its oncolytic efficiency and immune activation ability in vitro.Methods Prostate Specific Antigen (PSA) gene, CD40L-N and CD40L-C genes were obtained from cDNA of LNCaP cells and Jurkat cells using poly-merase chain reaction (PCR) or nested-PCR, respectively.PSA,Linker,CD40L-N and CD40L-C were linked sequentially to generate fusion protein gene PSA-IZ-CD40L (PL) by overlapping PCR.Then, prostate specific oncolytic adenovirus PL-carrying gene, Ad-PL-PPT-E1A,was constructed using the oncolytic adenovirus system , which was based on Adeasy sys-tem.PC3M cells were infected by Ad-PL-PPT-E1A at serial multiplicity of infection (MOI), and the apoptosis was detec-ted by flow cytometry at several time points post-infection.For immune activation detection , PC3M cells were infected with Ad-PL-PPT-E1A at a MOI of 50, and the cell lysate was collected at 48 h post-infection.Peripheral blood mononuclear cells derived (PBMCs) from healthy donors were stimulated by the lysate from PC 3M cells or Ad-PL-PPT-E1A infected PC3M cells before proliferation was assayed using cell counting kit-8 (CCK8).Results Fusion protein gene, PSA-IZ-CD40L, was successfully constructed and cloned into the prostate cancer specific adenovirus to generate Ad -PL-PPT-PL. The expression of E1A and PL protein could be detected by reverse transcription PCR and Western-blotting.Cytopathic effect was observed in PC3M cells infected with Ad-PL-PPT-E1A.Furthermore, the apoptosis rate reached 70.67% ± 2.98%at 48 h post-infection with 200 MOI Ad-PL-PPT-E1A.Compared with the lysate of PC3M cells, that from Ad-PL-PPT-E1A infected cells could promote the proliferation of PBMCs .Conclusion We have constructed a prostate cancer spe-cific oncolytic adenovirus armed can fusion protein gene PL , Ad-PL-PPT-E1A, which could kill PC3M cells effectively and enhance the proliferation of PBMCs in vitro.

Objective To evaluate the risk of locoregional recurrence ( LRR ) and role of radiotherapy for patients with estrogen receptor?negative and human epidermal growth factor receptor 2?overexpressed ( Rec?/HER?2+) locally advanced breast cancer ( LABC ) . Methods A retrospective analysis was performed on the clinical data of 294 patients with Rec?/HER?2+LABC from 1999 to 2011. All patients were treated with modified radical mastectomy ( MRM ) . Of them, 239 patients received postmastectomy radiotherapy and 55 patients did not. Locoregional recurrence?free survival ( LRRFS) and overall survival ( OS) , as well as LRR, were compared between the two groups. The Kaplan?Meier method was used to estimate survival and recurrence rates, and the log?rank test was used for survival difference analysis and univariate prognostic analysis. Multivariate prognostic analysis was performed using the Cox regression model. Results The 5?year sample size was 162. Fifty?six patients developed LRR. The 5?year LRRFS and OS rates were 79. 7% and 70. 0%, respectively. Postmastectomy radiotherapy significantly increased the 5?year LRRFS rate ( 85. 1% vs. 56. 0%, P=0. 000) , but did not significantly increase the 5?year OS rate ( 71. 3% vs. 64. 2%, P= 0. 441 ) . Multivariate analysis indicated that postmastectomy radiotherapy was the only independent prognostic factor associated with increased LRRFS ( RR=0. 303, 95% CI:0. 166?0. 554, P=0. 000). Conclusions Patients with Rec?/HER?2+ LABC treated with MRM alone appear to be at a significantly increased risk of LRR compared with those treated with MRM followed by radiotherapy.