Objective:To provide the methodology reference for the gene expression data clustering.Methods:This paper proposed a fuzzy clustering ensemble algorithm based on wavelet de-noising.The new method is applied to the yeast cell's gene expression data,and the clustering results were compared with fuzzy ensemble clustering methods.Results:Apply micro-precision to evaluate the clustering results.The research indicated that the proposed method was superior to fuzzy ensemble clustering algotuthm.Conclusion:The proposed method has better clustering for the gene expression data clustering.

Objective:To inspect and improve physician professionalism effectively and preliminarily build eval-uation index system for physician professionalism. Methods:A sample of 240 physicians selected randomly from 8 Three-A hospitals in Shanghai were investigated using a self-designed questionnaire. Then the method of analyt-ic hierarchy process was performed in this study to construct the evaluation model of physician professionalism and determine every index weight. Results: An index system was initially built for physician professionalism evalua-tion. This system comprised three level-1 indexes namely moral quality characteristics, achievement action char-acteristics and vocational cognitive characteristics, as well as 14 level-2 indexes that drew from level-1 including responsibility etc. , at the same time determined their weight distribution. The judgment matrix had completely con-sistency through consistency check, indicating that the weight coefficient can reflect the relative importance of every index. Conclusion:Moral quality characteristics is one of the most important components of physician professional-ism evaluation; responsibility consciousness and vocational ideal are vital for the growth of physicians; lifelong learning and communication skills with high weight reflects needs of modern health care industry development;medical ethics consciousness has a trend of strengthening in physician groups, and enhancing evaluation index sys-tem for physician professionalism has the operability.

Objective To investigate the risk factors of Gallstone Disease ( GD) by a meta-analy-sis, which hopefully will help to develop a strategy for its prevention .Methods Thirty case-control studies on risk factors of GD in Chinese patients reported from 1987 to 2014 were included .A quantitative compre-hensive analysis and a heterogeneity test were conducted and the OR value and its 95% confidence interval (CI) were calculated by using Stata 12.0.Results A family history of GD [OR(95%CI):2.73(2.22~3.35)], alcohol drinking [OR(95%CI):1.53(1.20~1.97)], a history of biliary tract roundworm [OR (95%CI):5.28(3.10 ~9.00)], a history of biliary tract infection [OR(95%CI): 28.50(19.22 ~42.26 ) ] , a BMI≥25 kg/m2 [ OR ( 95%CI ):1.70 ( 1.51~1.92 ) ] , greasy food intake [ OR ( 95%CI ):3.27(1.76~6.07)], a non-vegetarian diet [OR(95%CI):2.03(1.48~2.77)], hyperlipidemia [OR (95%CI):2.26(1.88~2.71)], menopause [OR(95%CI):3.25(2.49~4.24)] and multiple preg-nancies [OR(95%CI):1.56(1.29~1.88)] were risk factors of GD in China.Besides, milk drinking [OR(95%CI):0.43(0.34~0.55)] and regular breakfast [OR(95%CI):0.19(0.06~0.64)] were protective factors of GD.Tea drinking [OR(95%CI): 0.43(0.34 ~0.55)], smoking [OR(95%CI):0.86(0.51~1.45)], and a vegetarian diet [OR(95%CI):0.24(0.05~1.13)] were possible GD’s protective factors as they were not statistically significant .Conclusion Having breakfast , drinking milk , keeping fit , less alcohol and avoiding Ascaris infection prevent the occurrence of GD in China .

Objective To analyze perioperative nursing methods of chest wall tumor removal and chest wall reconstruction. Methods 12 patients with chest wall tumor removal and chest wall revascularization were choosed as the research objects,and which were given prospective nursing intervention combined with high quality nursing intervention. Results 12 patients all cured without one case death occurred, and 4 cases complications. Followed up for 6 to 36 months, no local recurrence of alienation, chest wall deformity and rejection. Conclusions Proactive nursing intervention help to predict perioperative complications. High-quality nursing care including psychological nursing, skin nursing, pain nursing, function training etc, can promote patients recovery.

Objective To investigate the analgesic effect of epidural labor analgesia with contin-uous background infusion and its impact on obstetric outcome.Methods This was a retrospective co-hort study.In the two months of march 2014 and march 201 5,503 nulliparas women who had re-ceived epidural analgesia for labor were enrolled and assigned to two different study groups according to their analgesic protocol.Two hundred and fifty-eight nulliparas in group C received only patient-controlled analgesia while two hundred and forty-five nulliparas in group P received patient-controlled analgesia with continuous background infusion.The basic and perinatal data of all enrolled nulliparas women were collected and analyzed to compare the analgesic effect and the impact on obstetric risk of two different analgesic protocol.Results The NRS pain score during the second labor stage was lower in group P [3 (3-4)scores vs.5 (4-5)scores](P <0.001).The second stage prolonged [50 (29-82) min vs.38 (24-62)min](P =0.001)and intrapartum hemorrhage increased [200 (100-250)ml vs. 1 50 (100-200)ml](P =0.003)in group P.There were no significant differences between the two groups with regard to the delivery mode (P =0.656)and the morbidity of postpartum hemorrhage (9.8% vs.10.9%,P =0.697).Analgesic protocol with background infusion was not associated with postpartum hemorrhage,instrumental delivery risk and cesarean risk.Conclusion Epidural labor an-algesia with continuous background infusion provided more effective analgesia in nulliparas,without additional obstetric risk.

Objective To evaluate the characteristics of echocardiogram in senile degenerative heart valvular disease. Methods The cardiac structure and functional changes of the 166 cases of senile degenerative heart valvular diseases were studed with HP5500(USA) and En Visor color doppler(Philips). Results Simple aortic valve calcification was found in 93 cases(56.0%); simple mitral calcification, 18 cases(10.8%);aortic valve calcification combining mitral calcification, 55 cases,(33.1%);enlarged left atrium 116 cases(69.9%);left ventricular diastolic dysfunction 142 cases(85.5%).Within 136 cases of cardiac valve dysfunction, there was aortic valvular regurgitation in 70 cases(42.2%),stenosis of aortic valve in 23 cases(13.9%),mitral regurgitation in 20 cases(12.2%),mitral stenosis in 8 cases(4.8%),aortic valvular regurgitation combining stenosis in 10 cases(6.0%),mitral regurgitation combining stenosis in 5 cases(3.0%). The highest morbidity in valvular dysfunction was aortic valvular regurgitation(42.2%),the second was aortic valve stenosis(13.9%),the lowest morbidity was mitral stenosis combining insufficiency(3.0%). Enlarged left atrium was in 116 cases(69.9%). Conclusions The senile degenerative heart valvular disease have no specific clinical manifestation. With increasing age,the proportion of complex valve calcification is increased, and the highest is the aortic insufficiency in valvular dysfunction. The proportion of enlarged left atrium is also increased.

Bone remodeling is an ordered process of coupling of bone resorption and bone formation. Cytokines secreted by different bone cells and membrane molecules expressed by bone cells are involved in regulation of coupling of bone resorption and bone formation. To reveal the mechanism of bone coupling is of great significance in the study and diagnosis of osteoporosis and other metabolic bone diseases. In the present review, we summarize the progression of mechanisms by which cytokines and the related membrane molecules are regulating the coupling of bone resorption and bone formation.

Objective To research and develop an index system for training evaluation of national health emergency response.Methods A combinative approach was applied,including core expert group discussion,on-site investigation into parameters applied in Delphi assessment by field experts,national reviews by provincial health departments.Results Firstly,a framework of index system was constructed by core expert group based on literature;Secondly,the index was screened by mean score from field experts' investigation and suggestion of core experts,then an index system was formulated with 5 first level indexes,19 second level indexes and 46 third level indexes;Thirdly,index weight was determined according to the mean weight by field experts investigation and adjusted suggestion of core experts;Finally,the index system for training evaluation of national health emergency response was approved by Ministry of Health and applied to the whole nation.Conclusions The combinative approach is practical in research and developing index system.The index system covers a full range of related factors,and is applicable at provincial level.However,attention should be paid to improving training after evaluation.

Objective:To investigate and compare the influences of Ghrelin and growth hormone releasing peptide 6(GHRP-6) on the contractility of stomach smooth muscle in guinea pigs,and to study the related mechanism.Methods: The myenteric plexuses of gastric fundus and antrium in guinea pigs were stimulated with electrical field stimulation(EFS) to observe the influence of Ghrelin and GHRP-6 on the contractility of stomach smooth muscle.The influences of N-nitro-L-arginine(L-NNA) and L-Arginine(L-AA) on the effect of Ghrelin and GHRP-6 were studied to disclose the mechanism of the effects of Ghrelin and GHRP-6.Results: The circular muscle tissues of the gastric fundus generated on-relaxations and off-contractions when stimulating myenteric plexuses with 1-16 Hz electrical field;the on-responses induced relaxation could be reduced by L-NNA and the off-contractions induced contraction could be blocked by atropine and guanethidine.In fundic strips,ghrelin and GHRP-6 could decrease the on-response induced relaxation and increase off-response induced contraction of the muscle,with the effect of Ghrelin obviously stronger than that of GHRP-6.L-NNA could increase the effects of Ghrelin and GHRP-6-induced muscle contraction,and L-AA could decrease their effects.In the antral strips,electrical field stimulation of myenteric plexuses led to disappearance of relaxation wave,only leaving off-contractions.Both ghrelin and GHRP-6 could increase that contraction.Conclusion: Both ghrelin and GHRP-6 can promote the contractility of stomach smooth muscle in guinea pigs through stimulating myenteric plexuses of gastric fundus and antrium,which might be related to the NO pathway.

Atomoxetine as a nonstimulant medicine was approved by the Chinese Food an Drug Administration and provide a new selection of treatment drugs for attention deficit hyperactivity disorder (ADHD). Tomoxetine is a noradrenaline transmitter reuptake inhibitor which can selectively inhibit synapsis noradrenaline transport protein, strengthen noradrenaline's resupination effect, and increase noradrenaline's activity released by synaptic cleft to improve the symptoms of the ADHD patients. Compared with methylphenidate, atomoxetine does not affect the concentration of the neurotransmitter dopamine and does not induce or increase the Tourettes' syndrome, therefore atomoxetine is more suitable to treat ADHD together with Tourettes syndrome. In this article the treatment of atomoxetine for ADHD, including the indications, dosage as well as adverse reactions and efficacy assessment are reviewed.