Objective: To develop a general module of self-administered quality of life instrument for Chinese patients with chronic disease. Methods: Using the structured group (nominal group and focus group) methods and the qualitative and quantitative theory and methodology in developing rating scales Items were preliminary screened, evaluated and modified, and the QoL data measuring from 201 cases of patients of 8 different chronic diseases were analyzed by the methods of coefficient of variation?factor analysis, clustering analysis and correlation analysis. Result: General module of quality of life instrument for patients with chronic disease (QLICD-GM) was developed and evaluated. It consists of three domains: physical function, psychological function and social function, 32 items. Conclusions: QLICD-GM possessed a reasonable good content validity for it reflect WHO 's definition and connotation of QoL, and also common issues of patients with chronic disease.

Objective To explore the professional identity of medical students with long education periods and its influencing factors.Methods Survey on professional identity was conducted through self-designed questionnaire among 665 medical students with long education periods of every grade.Single factor analysis of variance and t test were applied to do statistical analysis.Results There were significantly statistical differences in influencing factors of professional identity among every grade of long periodical medical students (P ＜ 0.05).There were significant statistical differences among influencing factors of sex,educational background of parents and residing(P ＜ 0.05).Conclusions Because of characteristics of medical education and psychological changes of students,professional identity of students shows a first decline and then an increase.Personal and environmental factors exert influences on professional identity at varying degrees.

Objective To investigate the inhibitory effect and associated mechanism of rapamycin on proliferation and extracellular matrix (ECM) secretion in myofibroblasts stimulated by connective tissue growth factor (CTGF). Methods Primary cultivated myofibroblasts were divided into 6 groups: control, CTGF (100 μg/L), rapamycin 20 μg/L+CTGF 100 μg/L, rapamycin 40 μg/L +CTGF 100 μg/L, rapamycin 20 μg/L, and rapamycin 40 μg/L alone. 5'-bromodeoxyuridine (BrdU) incorporation assay was used to detect the myofibroblast proliferation.Western blot was used to analysis the secretory FN protein in the supernatant medium of cultured myofibroblasts and the ERK1/2 phosphorylation in myofibroblasts. Results CTGF (100 μg/L)incubation significantly increased the number of Brdu positive myofibroblasts(P<0.01) and the level of FN protein secretory (P<0.05) in cell supernatant medium compared with control group,respectively. The number of Brdu positive myofibroblasts markedly decreased by 62% and 70% (P <0.05) in rapamycin 20 μg/L+CTGF 100 μg/L and rapamycin 40 μg/L+CTGF 100 μg/L groups, respectively. The FN protein levels in supernatant were decreased by 15% and 44% compared with CTGF 100 μg/L group, respectively; but the difference of FN protein levels was significant only in rapamycin 40 μg/L group (P<0.05). CTGF could activate ERK1/2 at 10 minutes; but as myofibroblasts were pretreated with rapamycin 40 μg/L for 30 min, it abolished CTGF-induced ERK1/2 phosphoralation. PD98059, the specific inhibitor of ERK1/2, could block the effect of CTGF-induced proliferation (7%±5% vs 85%±7%, P<0.01) and FN secretion (1.0±0.1 vs 1.6±0.3, P<0.05). Conclusions Rapamycin partially suppresses the proliferation and ECM secretion of myofibroblasts induced by CTGF. Its effect may be through inhibiting CTGF-induced activation of ERKI/2 signaling pathway.

Objective To analyze and discuss the expression of serum polymyositis‐scleroderma(PM‐Scl) antibody and its clinical significance in patients with systemic scleroderma(SSc) .Methods 315 hospitalized patients diagnosed with scleroderma by typical clinical manifestations or skin pathology from 2009 to 2012 were enrolled in the study .All patients were grouped into PM‐Scl antibody positive(PM‐Scl + ) group(90 cases) ,Scl‐70 antibody positive(Scl‐70+ ) group(70 cases) ,anti‐centromere antibody positive( ACA+ ) group(75 cases) and antibody negative group(80 cases) according to autoantibody spectrum .The severity of skin and visceral damage among all the groups were analyzed and compared .Results Patients in PM‐Scl+ group were characterized with different clinical manifestations .Compared with the other 3 groups ,the incidence of myositis in PM‐Scl+ group was significantly higher( all P< 0 .05) ;patients in Scl‐70+ group had higher incidence of visceral organ damage than PM‐Scl+ group(all P < 0 .05) .The incidence of skin lesions ,Raynaud′s phenomenon and capillary expansion in ACA+ group were higher than that of PM‐Scl+ ,while the incidence of interstitial lung disease ,heart disease and kidney disease were lower(all P< 0 .05) .Conclusion It is helpful for clinicists′ further understanding of common autoantibodies in Ssc patients and making correct assessment of the disease through analyzing the expression of PM‐Scl antibody .

Objective To investigate the effect of independent on duty assessment in the process of new nurse standardized training.Methods Totally 64 new nurses graduated in 2010 were set as the control group.Totally 68 new nurses graduated in 2011 were named as the observation group.The nurses in the control group received hospital standardized training,on the basis of the hospital standardized training,the observation group received independent on duty training.One year later,all nurses participate in the assessment of independent on duty organized by nursing department and the evaluation results were analyzed.Results The score of emergency response capacity of the observation group was significantly higher than that of the control group.Conclusions The implementation of the independent on duty assessment can strengthen the results of standardized training and promote emergency ability of new nurses,and effectively improve the ability of new nurses in clinical work.

Purpose To investigate effect of valsartan on expression of Notch pathway and production of extracellular matrix. Methods Urine protein and production of extracellular matrix were measured after diabetic mice were treated with valsartan. The levels of Jag-ged1, Notch1, Notch intracellular domain 1 (NICD1), transforming growth factor-β1 (TGF-β1), TypeⅣcollagen and Laminin were determinated by immunohistochemistry, Western blot and real-time PCR. Results Valsartan suppressed urine protein and production of extracellular matrix in diabetic mice (P<0. 05). Valsartan also inhibits overexpression of Jagged1, Notch1, NICD1, TGF-β1, Type Ⅳ collagen and Laminin in glomerular tissues of diabetic mice (P<0. 05 or P<0. 01). Conclusion Valsartan inhibits activa-tion of Notch pathway in glomerular tissues of diabetic mice, inhibits production of extracellular matrix in glomerulus and delays glomer-ulosclerosis.

Aim To investigate the expression of Notch pathway and Nephrin in angiotensin Ⅱ ( AngⅡ)-stimulated mice podocyte. Methods Mice podo-cyte was stimulated by AngⅡ, and then was treated with valsartan. The levels of Notch1, Notch intracellu-lar domain 1 ( NICD1 ) , Hes1 and Nephrin were deter-mined by immunofluorescence, Western blot and Real-time PCR. Results AngⅡincreased Notch1, NICD1 and Hes1 expression, and decreased Nephrin expres-sion in a time-dependent manner ( P<0. 01 ) . Valsar-tan inhibited AngⅡ-induced activation of Notch path-way and enhanced Nephrin level ( P <0. 01 ) . Con-clusion AngⅡdecreases Nephrin expression in podo-cyte by activating Notch pathway.

Thirty-five patients with perioperative pulmonary embolism during January 2000 and October 2006 were analyzed retrospectively.Disease diagnosis and treatment outcomes were assessed.Of the 35 patients,2 died without any management,and 33 received conventional anti-coagulation and thrombolysis.including 3 percutaneous catheterization.Disease improvement Was seen in 29.Four deaths occurred after no response to the treatment.Thus,early diagnosis and treatment,which miight depend on further understanding of pulmonary embolism,could play an important role in reduced adverse events.Prevention is crucial to avoid perioperative occurrence of pulmonary embolism.

Objective In this retrospective study, we analyzed the magnetic resonance imaging (MRI)and computed tomography(CT)scans of patients with prostate cancer to investigate the relationship between the apex of prostate and the anatomic structures visible in CT, and to provide evidence for localizing the prostatic apex in radiation treatment planning. Methods MRI and CT scans from 108 patients with prostate cancer were analyzed to measure the distance between the prostatic apex and the bottom of ischial tuberosities,the bottom of obturator foramen, the bottom of pubic symphysis and the bulb of the penis. The volume of prostate was calculated and the relationship between the size of the prostate and the localization of the prostatic apex was analyzed. Results The prostatic apex is located 13. 1 mm ±3. 3 mm superior to the bulb of the penis, 11.0 mm ± 5.4 mm superior to the bottom of obturator foramen, 31.3 mm ± 5.5 mm superior to the bottom of ischial tuberosities, and 7. 1 mm ± 4. 7 mm superior to the bottom of obturator foramen. There was no correlation between the size of prostate and the localization of the prostatic apex(R =0. 07、-0. 33, all P ＞ 0. 05). Conclusions Ninety-five percent of patients had a prostatic apex that is above the bulb of the penis 6 mm, and 100% of patients had a prostatic apex that is above the bottom of obturator foramen.

Objective To investigate the therapeutic effects and mechanism of Okam on asthmatic mice.Methods The mice model of asthma was established with the egg albumen sensitization, and were treated with low and large doses of Okam for four weeks.The pathological changes of lung tissues were observed.Immunohistochemistry was used to determine the contents of matrix metalloproteinases-9(MMP-9) and tissue inhibitor Metalloproteinase-1 (TIMP-1) in the lung tissues.Results Gasp and inflammation in the lung tissues were significantly relieved in the test groups than that in the model group.MMP-9,TIMP-1 and MMP- 9/TIMP-1 ratios were significantly lowered in the test group than that in the model group. Conclusion The marine drug of Okam shows therapeutic effects on mice with asthma,which may be the result of reduced contents of MMP-9 and TIMP-1 in the lung tissues and the correction of the imbalanced MMP-9/TIMP-1 ratio.Okam is likely to be a new choice for the treatment of asthma.