Objective To develop a Chinese version of Death Attitude Proevaluate its reliability and validity by applying it in the Chinese Christians.Methods After undergoing forward and backward translation of the DAP-R by expert consultation and in-depth interview,150 Christians over 40 years old were recruited to complete the Chinese version of DAP-R,And then factor analysis,correlation analysis and reliability analysis were applied to establish the scale's construct validity and reliability.Results The final scale consisted of five dimensions with 25 items; the varimax rotation factor analysis of the scale identified seven principal factors and explained for 67.075% variances; the correlation coefficient between each item and its domain was 0.432～0.850; Cronbach's α coefficient of five domains were 0.585～0.853,the Cronbach's α and split-half coefficient for the whole scale were 0.840 and 0.843 respectively.Conclusions The Chinese version of DAP-R possesses acceptable validity and reliability in the setting of Christians,and more in-depth study on the scale needs to be done in a wider population.

Objective To investigate the efficacy,toxicity and cosmetic outcome of short-course radiotherapy with concomitant tumor bed boost after breast-conserving surgery for early stage breast cancer.Methods A total of 306 patients with T1-2 N0-1 M0 breast cancer after breast-conserving surgery were included.160 patients received whole-breast radiation to 45 Gy in 25 fractions followed by tumor bed boost of 14 Gy in 7 fractions (C group).146 patients received whole-breast radiation to 46 Gy in 23 fractions with concomitant tumor bed boost to 60 Gy in 23 fractions (S group).Kaplan-Meier method was used to calculate the local recurrence and overall survival rates and the differences were compared by Logrank test.Chi-square test was used to compared the differences of the clinical characteristics,toxicity and cosmetic outcome between the two groups.Results The follow-up rate was 100％.After a median follow up of 26 months,the 1-,2-and 3-year overall survival rates were 100％.No patient developed local recurrence.In C and S group,the incidence of grade 1 acute skin toxicity was 46.9％ and 45.1％ (x2 =0.73,P =0.695),grade 2was 16.3％ and 13.7％ (x2 =0.73,P =0.695).Grade 1 late skin and subcutaneous tissue toxicity developed in 16.9％ and 17.1％ of patients in C and S group (x2 =0.00,P =0.954).Grade 1 neutropenia occurred in 11.9％ and 13.7％ of patients in C and S group (x2 =0.23,P =0.633).In C and S group,66.2％ and 65.5％ of patients had excellent and good cosmetic outcome (x2 =0.01,P =0.927).Conclusions Short-course radiotherapy with concomitant tumor bed boost provides similar results to conventional radiotherapy in local control,toxicity and cosmetic outcome.Long-term follow up is warranted to confirm this finding.

ObjectiveTo design the scale of death attitude for Chinese nurses and evaluate its validity and reliability.MethodsThe scale draft was formed through the literature review,the formal scale was got via expert consultation and interview survey of 20 cases of small sample.120 clinical nurses were selected for investigation.Then item analysis,factor analysis,correlation analysis and reliability analysis were applied to establish the scale′s validity and reliability.ResultsThe nursing staff death attitude scale consisted of 25 items,the varimax rotation factor analysis of the scale identified seven principal factors and explained for 63.732％ variances.The correlation coefficient between each item and its domain was 0.498～0.808,the Cronbach′s α coefficient of five domains was 0.595～0.774,the Cronbach′s α and split-half coefficient for the whole scale were 0.824 and 0.868 respectively.ConclusionsThe scale has high reliability and validity,and it can be the effective test instrument for death attitude of nurses in China.

Objective To investigate the adjuvant therapeutic efficacy of three-dimensional conformal radiotherapy (3D-CRT) in treating patients who underwent surgical operation for biliary drainage.Methods Clinical data on 88 clinically diagnosed advanced pancreatic head carcinoma patients who received palliative biliary drainage surgery in Tanshan Gongren Hospital from Jan 2006 to Jan 2010 were retrospectively reviewed. The cases were categorized according to the treatment into control group ( n=34 ) , chemotherapy group ( n=23 ) and radiotherapy group ( n=31 ) . The patients in control group received no chemotherapy or radiotherapy after biliary drainage surgery.The patients in chemotherapy group received chemotherapy of 1 000 mg/m2 gemcitabine intravenous infusion on day 1 and day 8, 80 mg/m2 cisplatin intravenous infusion on day 1 for each treatment cycle.Each cycle lasted for 21 days and was repeated for 3 cycles at an interval of 7 days in a treatment course.Patients in radiotherapy group received 3D-CRT for 6 successive days followed by an interval on the 7th day.The treatment course was completed within 10~15 days with the total dosage of 3 000~4 800 cGy.The therapeutic effects and survival time were analyzed.Results The incidence of cancer associated pain was 52.9%, 39.1%and 9.7%in control group, chemotherapy group and radiotherapy group, respectively, which was significantly lower in radiotherapy than that in the other two groups (both P<0.05). The incidence of mild gastrointestinal symptoms was 8.8%, 73.9% and 16.1%, respectively, and that of bone marrow suppression was 0%, 82.6% and 9.7%, respectively, which were both significantly lower in radiotherapy group than in chemotherapy group (both P<0.05).The 1-year, 2-year and 3-year survival rate was 30.1%, 8.3%, 0% in control group, 35.3%, 14.8%, 0% in chemotherapy group and 46.4%, 21.1%, 3.6%in radiotherapy group, which in radiotherapy group was significantly higher than that in control group and chemotherapy group (all P<0.05).Conclusions 3D-CRT was a palliative strategy for advanced pancreatic head cancer, which could prolong the survival of patients.

Objective:To test a model in which self-esteem mediated the effects of behavior on exposure to violence(victimization) in a sample of rural middle school students.Methods:A cross-section study was conducted in 3620 middle school students randomly selected from rural areas.A questionnaire of violence(WHO) and Achenbach Children Behavior Checklist(CBCL) and Rosenberg self-esteem scale were used to measure the exposure to violence behavior,and self-esteem respectively.Results:Hierarchical regression analyses provided evidence that the addition of self-esteem reduced the links between behavior and exposure to violence(? from 0.232 to 0.226).Sobel Z-test predicted that self-esteem partially mediated the effects of behavior on exposure to violence(victimization) with significant difference(? from 0.232 to 0.226,Sobel-Z value=2.340,P=0.019).Speech violence,physical violence,and sexual violence were tested by the same model respectively,and the results showed that self-esteem partially mediated the effects of behavior on speech violence with significant difference(? from 0.225 to 0.200,Sobel-Z value=1.992,P=0.046),but not on physical or sexual violence.Conclusion:Self-esteem partially mediates the effects of behavior on exposure to violence(emotion violence).

Background and purpose:The prognosis in patients with early breast cancer(EBC) was poorly defined by clinical and histopathological features.There were more than 200 genes that might be correlated with development,progression,recurrence and prognosis of breast cancer in the published literature.This study evaluated the prognosis of patients with EBC at molecule level according to the protein expressions of 16 selecting genes(HER2,ER,PR,BCL2,Ki-67,BMYB,Cyclin B1,STK15,MMP11,BAG1,NM23,PTEN,P53,P27,VEGF,PCN A).Methods:The immunohistochemical method was used to detect the protein expressions of these genes in 76 patients with EBC and the statistical analysis was performed by COX proportional hazards model.Results:COX proportional hazard model revealed that BCL2,VEGF and STK15 were independent prognostic factors for patients with EBC.A formula of PI was set up according the three genes.The predictive outcomes with PI were compared with the actual follow-up outcomes in 48 patients with EBC.As a result,the predictive accuracy of good and bad prognosis was 86.67% and 91.67%,respectively.Conclusion:A formula of PI derived from protein expressions of the 16 genes correlated with breast cancer was ultimately set up and might be used to predict the outcomes of the patients with EBC.

Objective To prepare stable aqueous dispersions of chitosan/multi-walled carbon nanotubes (CS/MWCNTs) composites,and observe the effects of CS/MWCNTs on the growth of human umbilical vein endothelial cells (HUVEC).Methods CS/MWCNTs composites were prepared by electrostatic interactions between negatively charged MWCNTs and positively charged low-molecular-weight CS.The prepared CS/MWCNTs were characterized by transmission electron microscopy and Zetasizer nano-analyser.The cellular uptake of the fluorescently labeled CS/MWCNTs was observed by laser confocal microscopy after incubating with HUVEC for 24 h at different concentrations.In vitro cytotoxicity and cellular reactive oxygen were also detected.Results When the mass ratio of low-molecular-weight CS to MWCNTs was equal or greater than 10∶1,the CS/MWCNTs can be stabilized in solution.Cellular uptake experiments showed that the CS/MWCNTs could enter into the cells and locate mainly in the cytoplasm.Cytotoxicity study showed that the CS/MWCNTs composites was less toxic than MWCNTs alone at high concentration (10 and 20 μg/ml).However,there was no significant differencein the level of cellular reactive oxygen between the two groups (P＜0.05).Conclusions CS/MWCNTs composites showed low cytotoxicity and high stability,which would be a promising carrier for drug delivery.

Objective To investigate the influence of prepubertal exposure to estradiol benzoate (EB)in the male reproductive system of the rats and the natural process of tissue repair,and to clarify the possible mechanism of the reproductive toxicity of exogenous estrogen.Methods Ninety 2 1-day-old male Wistar rats were randomly divided into 2 experimental groups (low dose of EB group and high dose of EB group,n=30)and control group (n=30). The rats in the experimental groups were injected with EB dissolved in peanut oil at 15(low dose of EB group)and 15 000μg·kg-1 (high dose of EB group)respectively,the rats in control group received equal vehicle injection only,once every other day for two weeks from postnatal day(PND)21 to 34.All of them were normally fed after the drug usage was stopped.The testes were harvested at the stages of PND 60 and PND 125(n=15 at each stage).The serum levels testosterone of (T),follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin (PRL)and estradiol(E2)of the rats in various groups were detected with radioimmunology method and the weights of the rats in various groups were recorded;the histological changes of the testes tissue were observed with light microscope.Results On PND60,compared with control group,the T levels in low dose of EB group and high dose of EB group were decreased(P<0.05 or P<0.01);the FSH,LH and E2 levels were increased (P<0.05 or P<0.01),and the PRL levels had no change(P>0.05);the weights of testes were decreased(P<0.01);the histological changes of the testes of the rats in experimental groups included seminiferous tubules maldevelopment, decreased cell number of seminiferous epithelia.Compared with low dose of EB group,the T and FSH levels in high dose of EB group were decreased (P<0.05 or P<0.01),the E2 and LH levels were increased(P<0.01),the PRL level had no change (P>0.05 ), and the weight of testes was decreased (P<0.01 );the diameters of seminiferous tubules were smaller,there was no sperm in high dose of EB group while there were a few sperms in low dose of EB group.On PND125,compared with control group,the T,FSH and PRL levels in low dose of EB group and high dose of EB group were decreased(P<0.01),the E2 levels were increased (P<0.01);the LH level in low dose of EB group was increased(P<0.05),the LH level in high dose of EB group was decreased(P<0.01), and the weights of testes in high dose of EB group were decreased(P<0.01);the diameters of seminiferous tubules and the cell number of seminiferous epithelia were increased but not apparent change.Compared with low dose of EB group,the T,LH levels in high dose of EB group were decreased (P<0.01),the E2 and FSH levels were increased(P<0.01),the PRL level had no change(P>0.05),and the weight of testes was decreased(P<0.01);there was still no sperm in high dose of EB group, the number of sperms was increased in low dose of EB group, but it was still lower than that in control group.Conclusion EB is harmful to the reproductive system and can change the normal serum sex hormone levels,even induces the irreversible injury.

Background and purpose: Reports showed that berbefine not only had an effect ofdetoxification and inflammation but also could induce the cell to apoptosis. Berberine may also inhibit the migration and metastasis of tumor. To investigate the effects and mechanism of berberine on migration and metastasis of A549 cells, the proliferation, mobility and adhesion of A549 cells were observed after incubation with berberine. Methods: The proliferation was determined by MTT. Wound healing assay and adhesion test were used to observe the mobility and adhesion rate. The mRNA and protein expressions of MMP2 and MMP9 were assessed by semi-quantitive RT-PCR and gelatin zymography, respectively. Results: Berberine could significantly inhibit the proliferation ofA549 within a certain range of treating time and dose (P<0.05). The mRNA and protein expression of MMP2 and MMP9 gene were decreased slightly by the treatment ofberberine (P<0.05), especially at dose of 100 μg/ml. Conclusion: Berberine can inhibit the migration and adhesion abilities of A549 cells, probably by down-regulating the expression and activation of MMP2 and MMP9.

Objective To detect biofilm formation and biofilm-associated genes of methicillin-resistant Staphylococcus aureus (MRSA) in clinical isolates. Methods The biofilm were determined by microtiter plate assay (MPA) and congo red agar (CRA) and the biofilm-associated genes icaA,sarA,fnbA,fnbB were detected by PCR in 33 strains of MRSA in clinical isolates. Results Of the 33 MRSA isolates, 29(87.9%) were MPA positive, 16(48.5%) were CRA positive; The icaA gene was present in 39.4% of isolated strains. Furthermore, 69.7% of strains harboured the sarA gene, 39.4% were fnbA positive and 75.8% were fnbB positive. As many as 87.9% strains had the ability to form biofilm in vitro. 44.8% of MRSA formed biofilm in ica-dependent mechanism and 55.2% of MRSA isolates formed biofilm in ica-independent mechanism. Of the biofilm positive MRSA, 75.9% were sarA positive, 37.9% were fnbA positive and 79.3% were fnbB positive. Conclusion Most of the MRSA strains formed biofilm in ica-independent mechanism. fnbB and sarA gene shows higher frequency among the biofilm-associated genes of MRSA, it may infer that most of the MRSA strains biofilm formation are fnbB-mediated. Meanwhile, sarA may be a positive regulator of fnbB, and thus drives the biofilm formation.