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.

Graduate medical education, postgraduate medical education and continuing medi-cal education between China and the United States were compared in order to explore a better physi-cian training system of China. The physician training system of the United States has a series of ad-vantages such as strict access system, uniform training standard and closely linked among each stage, etc. We should make clear medical education standards and strengthen the cohesion between each stage, standardize the management mode and perfect the management system and promote regular as-sessment system.

Soluble ST2 (sST2) is a decoy receptor of IL-33 in blood.sST2and ST2L (receptor on cell membrane) seem to be markedly induced in mechanically overloaded cardiac myocytes,especially the expression of sST2.A large number of sST2 bind IL-33 thus subtracting IL-33 from the interaction with ST2L,potentially attenuating the cardioprotective effects of IL-33/ST2L pathway.Recently,sST2 has emerged as a novel for heart failure biomarker.Though sST2 was a less robust marker for the diagnosis of heart failure than NT-proBNP,it has been implicated in the prognostication of patients with acute dyspnea,acute or chronic heart failure and myocardial infarction,with particular value for mid-and long-term prognosis.However,further studies are needed in order to better point out the evidence for a routine use of sST2 evaluation in patients suffering from cardiovascular diseases.

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 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 investigate the relation between omentin and coronary artery disease.Methods Eighty-eight eases were divided into 2 groups, coronary artery disease group (56 cases, includingacute coronary syndrome 28 cases and stable angina 28 cases), and non-coronary artery disease group (32cases). The plasma omentin levels were assayed by ELISA, and height, weight, blood pressure, totalcholesterol high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C),lriglyeeride (TG), high-sensitivity C-reactive protein were detected. Results The plasma omentin level incoronary artery disease group [(33.4 + 6.4) μg/L] was lower than that in non-coronary artery disease group [(51.8 + 7.7) μg/L](P= 0.034). Logistic analysis showed that the decline of omentin was an independent risk factor of coronary artery disease (P=0.012). Conclusions The decline of omentin is an independent risk factor of coronary artery disease. The plasma omentin may contribute, in part, to the pathogenesis of coronary artery disease.

Objective To investigate the relation between plasma omentin and glycometabolism.Methods Eighty-five cases were divided into 3 groups by glucose tolerance test:diabetes mellitus group (42cases), impaired glucose regulation group (17 cases) and normal glucose regulation group (26 cases). The level of plasma omentin was assayed by ELISA. Results The level of plasma omentin was (53.7 ± 7.7),(40.7 ±9.9) and (30.6 ±5.3) μg/L in diabetes mellitus group, impaired glucose regulation group and normal glucose regulation group. There was significant difference among three groups (P= 0.049) and there was significant difference between diabetes mellitus group and normal glucose regulation group (P= 0.014).The level of plasma omentin in normal glycometabolism was (53.7 ± 7.7) μ g/L , and the level of plasma omentin in abnormal glycometabolism was (33.5 ± 6.0) μ g/L. There was significant difference between them(P = 0.023 ). Logistic analysis showed that the decline of plasma omentin was the independent risk factor ofglycometabolic disturbance (P= 0.027). Conclusion Omentin may play important roles in glycometabolic disturbance.

BACKGROUND: PI3K is a family of enzymes involved in insulin signal transductlon pathway, the abnormal expression of which would affect synthesis, secretion, and migration of GLUT4, therefore, results In increased blood sugar, eventually, leads to diabetes.OBJECTIVE: To discuss the effects of insulin combined with selenium on PI3K and GLUT4 expression in cellular signal transduction of skeletal musde in diabetic rats.METHODS: Sprague Dawley (SD) rats were randomly divided into the control, diabetic, insulin-treated diabetic, selenium-treated diabetic and combination administration groups. All rats were prepared for diabetic models by injecting 50 mg/kg Streptozocin exception of the control group. Rats in the control and diabetic groups ware free to food and water; in the insulin treatment group,rats were subcutaneous injected 1 U/(kg·d) insulin. Rats in the selenium treatment group ware treated with a dose of 180 pg/kg per day of sodium selenite dissolved in redistilled water by gavage; and in the combination administration were given both treatments for 4 successive weeks. The levels PI3K end GLUT4 in skeletal muscle were estimated using Western blotting and immunohistochemistry techniques.RESULTS AND CONCLUSION: Immunohietochemistral results were accordance to Western blotting results, which showed the combination of insulin and selenium can remarkable Increase the levels of PI3K in skeletal muscle and GLUT4 in skeletal muscle membrane fraction, therefore, enhance the insulin signal transduction pathway.

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.