Objective To investigate the radiosensitization effect of the simultaneous silence of bcl-2 and XIAP on human head and neck cancer cell line in vitro.Methods Four groups of UMSCC12 cells were transfected with siRNA-bcl-2,siRNA-XIAP,siRNA-bcl-2 plus siRNA XIAP,and siRNA control,respectively.The silence efficiency was tested by Western blot assay. Apoptosis was evaluated with the activities of caspase-3 and caspase-9,and radiosensitization effect was evaluated with clonogenic assay.Results Bcl-2 and XIAP protein expressions were effectively eliminated in the cells simultaneously transfected with siRNA-bcl-2 and siRNA-XIAP.Transfection of cells with bcl-2 siRNA increased radiationinduced apoptosis ( t =5.32,6.27 ; P ＜ 0.05 ),but transfection with XIAP siRNA did not impact cell apoptosis.Since the simultaneous transfection of the above two siRNAs,the activities of caspase-3 and caspase-9 were increased by 1.36 and 1.34 times ( t =11.47,6.22 ; P ＜ 0.05 ) in nonirradiated cells and increased by 1.72 and 1.98 times ( t =12.02,20.14; P ＜ 0.05 ) in irradiated cells,respectively.The colonic assay showed that the SERs were 1.06,1.15 and 1.41 for the cells transfected with XIAP siRNA,bcl-2 siRNA and both siRNAs,respectively.Conclusions Compared to single silence of XIAP or bcl-2,simultaneous silence of XIAP and bcl-2 offers a potential approach to improving the radiosensitivity of the head and neck cancer cells,and apoptosis might contribute to the enhancement of radiosensitization.

Objective To evaluate the antibacterial activity in vitro of Galla Chinensis ethanol extractant(GCEE)against S.epidermidis,and the change of cell morphology of S.epidermidis.Methods Deterimination of antibacterial activity of GCEE against 124 strains S.epidermidis was performed by using agar dilution method,and the changes of cell merphalogy of S.epidermidis was examined by microscope.Results The MIC90 of GCEE against 43 strains of MRSE(methicillin-resistant staphylococcus epidermidis)and 81 strains of MSSE(methicillin-sensitive staphylococcus epidermidis)were 0.288 and 0.144 mg/mL respectively.Under microscope,the cells of S.epidermidis were expansion by degrees,with the edge of cell of S.epidermidis irregular.The substances in cells of S.epidermidis were disappear final.Conclusion Galla Chinensis ethanol extractant had strong antibacterial activity against 124 strains of S.epidermidis,and the cell morphology of S.epidermidis changed.

Objective To probe into the employment and turnover changes of health workers at township health centers,for analysis of the incentive preferences and methods characteristic of such people.Methods Questionnaire and interview investigations were made for 16 health centers to learn their personnel turnover from 2008 to 2010 in Junan county,Shandong province,and to learn their incentive preferences.Results Health workers of turnover tendency are mostly found among women,clinicians and nurses of college or above degree and those less than 39 years old.The top five incentive factors for such health workers are as follows:better working environment; better pay; better security for living; better hospital management; and better career development opportunities.Conclusion Township health centers should seize policy support of the health reform,by focusing on not only economic incentives such as the income and living conditions of health workers of turnover tendency,but also on non-economic factors such as career development opportunities.

Postoperative patients who underwent digestive tract reconstruction have a high risk of malnutrition and absorbing bar-rier. Enteral nutrition support can effectively maintain and improve the nutritional status of the human body, shorten hospital stay, and reduce complications. Therefore, the enteral approach is the preferred postoperative means of nutrition support. This article retrospec-tively summarizes the appropriate time to start enteral nutrition support therapy after digestive tract reconstruction, the proper selection of the mode of enteral nutrition support, the different enteral nutrition preparations, and the treatment of postoperative complications.

Objective:This article discusses the status of the health behaviors of rural people with diabetes, to explore effect of doctors’ home-visiting on the behavior of patients with diabetes in rural areas, and to promote chronic disease management and public health service equalization in rural areas . Methods:Junan, Liangshan, and Pingyin counties in Shandong province were sampled using a multi-stage stratified sampling method, and data was collected from 401 questionnaires issued to people with diabetes. A chi-square test and multivariate logistic regression were used to analyze the determinants. Results:Only 52. 0% of diabetes patients received home-visiting from doctors in the surveyed rural areas. Doctors’ visiting works on medication behavior on time and appropriate exercise of patients with diabetes in rural areas was statistically significant, but did not work on measuring blood glucose and periodic review and other health-related behaviors. Conclusion:The rate of doctor home-visiting is low, and the effect is not obvious. More attention should be paid to the content and quality of doctors’ home visiting, and strong policies should support and guide it. According to the characteristics of the rural and patients behavior changing, it is necessary to take flexi-ble modes of health service, improve the diabetes management in rural areas, and promote the equalization of public health service.

Objective: To investigate the expressions of programmed death ligand 1（PD-L1）in triple-negative breast cancer (TNBC) and its correlation with angiogenesis. Methods: 120 cases of TNBC patients who underwent surgery in the Fourth Hospital of Hebei Medical University from March 1, 2011 to June 1, 2012 were collected. The tumor tissues of patients were surgically resected and confirmed by pathology. PD-L1 protein expression in TNBC tissues of 120 patients was detected by tissue microarray combined with immunohistochemistry, and its relationship with various clinical indicators was analyzed. Blood vessels and lymphatic vessels were labeled withCD34andD2-40todetectmicrovesseldensity(MVD)andlymphaticvesseldensity(LVD)inTNBC.Results:Thepositiveexpression rate of PD-L1 in the tumor cells and interstitial infiltrating lymphocytes fromTNBC was 56.7% (68/120); No correlation was found between PD-L1 protein expression and the gender, age, histological grade, clinical stage, or tumor size of patients with TNBC (P>0.05), but related to the lymph node metastasis (P<0.05) and vascular thrombus (P<0.05). TNBC with high PD-L1 expression exhibited high incidence of lymph node metastasis and formation of vascular thrombus, and the expression of PD-L1 was positively correlated with MVD (r=0.500, P=0.02) as well as LVD (r=0.662, P=0.01). Log-Rank test showed that the survival time of TNBC patients with positive PD-L1 protein expression was significantly shorter than that of patients with negative expression (P<0.05). Cox multivariate analysis suggested that PD-L1 protein expression could be an independent prognostic factor for TNBC overall survival. Conclusion: PD-L1 plays an important role in TNBC angiogenesis and lymphangiogenesis, and is closely related to TNBC invasion and metastasis; blocking PD1/PD-L1 signal pathway is expected to be an effective new strategy for TNBC treatment.

The professional quality training ofthree orientedpersonnel training mode is one of the three core, which requires medical students to have lifelong learning ability. This study mainly describes the proposed concept of lifelong learning ability, expounds the necessity of lifelong learning ability, and analyzes the connotation, objective and strategies of improving the medical students'!lifelong learning ability under the framework of three oriented medical talents training mode. The training strategy has been discussed mainly from five aspects such as strengthening medical humanistic education, creating a lifelong learning atmosphere in campus, optimizing teaching methods, reform the course of career development and employ-ment guidance, reforming the course of career development and employment guidance, reforming the teaching of medical literature retrieval course and establishing the personal growth archives.

Objective Studying the status quo and constraints for rural healthcare service in grassroot rural healthcare units,for policy recommendations.Methods Using data from the fourth healthcare service investigation,by means of quantitative interview and qualitative interview,for an investigative interview of 348 township hospitals and 251 village clinics in 31 provinces in China.Results Deployment percentage of primary heahhcare services at township hospitals level is 49.1% (28.0/57),and that for village clinics is 60.6%(5.4/9).Conclusions The key to upgrading rural healthcare service system at grassroots level is to deploy better diagnostic equipments,upgrade the diagnostic competence of grassroots healthcare personnel and build a continuous service system for primary healthcare service.

Objective To survey the quality of life and mental health status of pre-post household service workers who held a high school graduation certificate or above and had been engaged in different work.Methods A total of 254 household service workers completed Symptom Checklist 90 (SCL-90) and World Health Organization Quality of Life-Brief (WHOQL-BREF).Statistical analyses of variance and correlation were carried out to evaluate mental health status and quality of life of the participants.Results Abnormal score of SCL-90 was found in 8％ of household service workers who had graduated from high school.The psychological score of household service workers who had worked as workers(60.59± 2.18)was lower than those who had worked as service workers (66.23 ± 12.13) or peasants (65.40 ± 12.24) (P ＜0.05).Almost all factors of SCL-90 were negatively correlated with WHOQL-BREF (correlation coefficient -0.140 to-0.376).Conclusions Our data suggest that mental health status can be well in pre-post household service workers who held a high school graduation certificate or above.Special training should be given to the household service workers in accordance with their working experience.

Objective To investigate the clinical effect of active immunotherapy combined with endometrial local injury in women with recurrent spontaneous abortion( RSA) caused by negative-blocking antibodies.Methods 112 patients diagnosed RSA with negative -blocking antibodies were randomly divided into the treatment group (62 patients) and control group (50 patients).The patients in treatment group were treated by active immunotherapy combined with endometrial local injury.The patients in the control group were treated by active immunotherapy.The pregnancy outcomes were observed.Results The rate of pregnancy was 93.54%in treatment group,and 80.00%in the control group.The success pregnancy rate in the treatment group was significant higher than that in the control group (χ2 =4.65,P<0.05).The rate of abortion was 3.44% in the treatment group and 12.50% in the control group.It was significant lower than the control group(χ2 =4.90,P<0.05).After active immunotherapy,the pregnan-cy rate was 90.58%in positive-blocking antibodies group and 77.77%in negative-blocking antibodies group.The success pregnancy rate in positive-blocking antibodies group was significant higher than that in negative-blocking antibodies group (χ2 =4.27,P<0.05).The abortion rate in positive-blocking antibodies group was 2.60% and 19.05%in negative-blocking antibodies group.It was significant lower than that in negative-blocking antibodies group (χ2 =6.14,P<0.05).Conclusion It can significantly improve pregnant outcome and reduce the abortion rate with active immunotherapy combined with endometrial local injury in women with recurrent spontaneous abortion ( RSA) caused by negative-blocking antibodies.