Objective:To investigate the relationship between narcissism and entrepreneurial intention and roles of achievement motive and risk aversion in college students.Methods:In this study,375 college students were selected from Henan University.Their narcissism,entrepreneurial intention,achievement motive and risk aversion were assessed with the Narcissism Scale,Entrepreneurial Intentions,The Achievement Motive Scale,and General Risk Aversion Scale.Results:The scores of overt narcissism positively predicted the scores of entrepreneurial intention (3 =0.37,P ＜ 0.001),the predictive effect of covert narcissism on entrepreneurial intention was not significant (β =-0.05,P ＞ 0.05).The scores of achievement motive partly mediated the relationship between the scores of overt narcissism and entrepreneurial intention (95％ CI:0.06-0.22),and this mediation effect was moderated by the scores of risk aversion (β =0.09,P ＜ 0.05).Only when the score of risk aversion was higher (above one standard deviation),achievement motive was a mediator between narcissism and entrepreneurial intention.When the score of risk aversion was lower,the mediate effect was not valid.Therefore,the moderated mediation model was confirmed.Conclusion:It suggest that the moderated mediation model is feasible,that is,achievement motive is a mediator between narcissism and entrepreneurial intention,but this mediation is moderated by risk aversion.

High incidence of liver metastases from colorectal cancer was found. To the patients with liver metastases from colorectal cancer, regardless of whether the liver metastases could be resected or not, hepatectomy after neoadjuvant chemotherapy was recommended. The combination of cetuximab and chemotherapy based on irinotecan and oxaliplatin as the second-line and first-line for the liver metastases from colorectal cancer could get higher response and longer survival, and more patients got the chance of hepatectomy. However, cetuximab was only good for the colorectal cancer patients with wild-type k-ras.

Objective Diagnosis of GDM during the early period and treatment in time can improve motherchild prognosis.Methods 805 pregnant women with gestational age of 24～28 weeks were screened by the 50g 1hour glucose challenge test(GET).75g oral glrcose tolerance test(OGTT)were further performed in the abnormal pregnant women,and the normal or abnormal pregnant outcomes were followed.Results The morbidity of pregnant women and neonates were higher in-group of gestational impaired glucose tolerence(GIGT)and geztational diabetes mellittts(GDM)(P＜0.05 or P＜0.01).Conclusion The research suggests that all pregnant women must be screened for detecting diabetes mettitus.The abnormality of glucose tolerance test need to be further treated and monitored.

Objective: A cross-sectional study was conducted to determine the general symptom clusters and study its influence on life quality of cancer patients in community. The association between the symptom clusters and life qualities was analyzed to provide guidance for targeted intervention. Methods: We randomly selected 200 cancer patients living in Pengpu Community from "Shanghai Cancer Patients Database". They filled in the Chinese version of Functional Assessment of Cancer Therapy-General (FACT-G) selfrating scale. Partial correlation and multiple linear regression analysis were used for statistical analysis. Results: Partial correlation analysis showed that symptom clusters had no apparent correlation with the score of social/family well-being in FACT-G scale. The symptom clusters including anorexia, insomnia, fatigue, pain, and diarrhea mainly correlated with the scores of FACT-G self-rating scale. Multiple linear regression analysis explained 13.2% of the variance in FACT-G score, explained 41.8% of the variance in physical well-being, explained 27.0% of the variance in emotional well-being, and explained 4.2% of the variance in functional well-being, respectively. Conclusion: The life qualities of tumor patients in Shanghai community were associated with anorexia, pain, and insomnia named as QOL-related symptom clusters. Paying attentiation to QOL-related symptom clusters may help health care professionals to increase the intervention efficacy and improve the life quality of tumor patients.

The lymphatic vessel is a crucial pathway for tumor metastasis. The discovery of more lymphatic growth factors and lymphatic vessel markers signifies the significant progress of studies on the role of vascular endothelial growth factor-C/D (VEGF-C/D) and one of its specific receptors in the mechanisms of tumor lymph-angiogenesis and lymph node metastasis. VEGF-C/D expression is related to the clinicopathologic features of gastric cancer, including lymph metastasis, micro-lymphatic vessel density in the paraneo-plastic tissues, survival rate, and prognosis. Experimental animal models and in vitro experiments show that suppression of VEGF-C/D expression is beneficial in gastric cancer treatment. This article provides an overview of the association between VEGF-C/D and lymph node metastasis in gastric cancer.

BACKGROUND:Nuclear transcription factor(NTF) ?B is a transcription factor,which exists universally in eukaryocyte.It has been identified that its overacting is correlated to the ongoing and development of many diseases.Among the pathomechanism of rheumatoid arthritis,the abnormal activation of NTF ?B has a lot to do with the inflammatory hyperplasia of synovium and the erosion of tissue around articulation.OBJECTIVE:To review the recent progress of NTF ?B,pathogenesis and treatment of rheumatoid arthritis.RETRIEVAL STRATEGY:A computer-based online search of PubMed database was undertaken to identify the articles published in English from January 2000 to July 2007,with the Key words of "nuclear transcription factor ?B,rheumatoid arthritis,pathogenesis,treatment".Meanwhile,Wanfang database was searched for the related Chinese articles published between January 2000 and July 2007,with the same key words in Chinese.A total of 72 articles were finally selected for the first trial.Inclusive criteria:the articles focus on the NTF ?B,the pathogenesis and treatment of rheumatoid arthritis.Exclusive criteria:repeated experiments.LITERATURE EVALUATION:Among the 30 inclusive literatures,7 were related to reviews while the others were clinical or basic researches.DATA SYNTHESIS:①NTF ?B is a significant transcription factor,which participates in regulating many genes related to immune function and inflammation reaction.The promoters of many genes have the binding sites of NTF ?B.②It is indicated that the abnormal activation of NTF ?B plays an important role in the pathogenesis of rheumatoid arthritis.In recent years,many researches inhibiting its activation through different components of signaling pathways have been doing,which become very hot in anti-inflammatory and anti-rheumatism treatment.③In recent years,people have been making great progress in the therapy of rheumatoid arthritis aiming at cytokine and its receptor,however,interfering NTF ?B to treat rheumatoid arthritis is still in study stage.CONCLUSION:NTF ?B target therapy provides a new therapeutic strategy for the treatment of rheumatoid arthritis,which is a very exciting prospect indeed.

Objective To investigate the complications of laparoscopic exploration of the common bile duct,and its prevention.Methods From June 2003 to June 2007,a total of 124 patients received laparoscopic exploration of the common bile duct in our department,13 of them developed complications.The data of these 13 patient were analyzed retrospectively.Results Among the 13 cases,3 had intraoperative perforation of the common bile duct(one of them was complicated with perforation of the duodenum),2 had intraoperative hemorrhage;1 had postoperative perforation of the duodenum,2 had biliary leakage(treated by primary suture),1 had postoperative intra-abdominal hemorrhage,and 4 had residual stones in the bile duct.All the complications were cured.Conclusions Strict indications and high-level techniques are important factors for laparoscopic exploration of the common bile duct.The prognosis of the patients can be good as long as open surgery is carried out at proper time and the complications are treated appropriately.

Objective To compare the long-term survival rate and safety of laparoscopic surgery(LS)with those of open surgery(OS)in the treatment of colorectal cancer by using Meta-analysis.Methods Randomized controlled trails reported between January 1991 and July 2007 comparing the outcomes of LS and OS in patients with colorectal cancer were collected and analyzed by using RevMan4.2.Results Totally,14 reports involving 4989 colorectal cancer patients were enrolled in this study.Significant difference was found in the morbidity rate of bowel adhesion between the two groups(P=0.002).The long-term outcomes,including the 3-and 5-year survival rates,and the rates of local recurrence and distant metastasis,were not significantly different between the two groups.Conclusions Laparoscopic surgery is effective and safe for colorectal cancer with a similar long-term survival rate as that of the open surgery.

Objective To investigate the clinical effect of high dose of calcitriol on end-stage renal disease (ESRD) in patients with secondary hyperparathyroidism (SHPT). Methods The clinical data of patients with ESRDcomplicated with SHPT were retrospectively analyzed. According to the treatment method were divided into control group and observation group, the control group were given conventional dose of calcitriol treatment, the observation group were treated with high dose of calcitriol. The differences of calcium and phosphorus levels, parathyroid hormone (PTH) level and quality of life were observed between the two groups before and after treatment. Results The serum phosphorus, calcium and calcium-phosphorus product in two groups of patients before treatment had no significant difference. After treatment, the above indicators decreased in two groups of patients compared with those before treatment, and the observation group was significantly lower (P<0.05). Before treatment, there was no difference in the levels of PTH between the two groups. After treatment, the level of PTH in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in quality of life between the two groups before treatment. After treatment, the quality of life in the two groups were higher than before treatment, and the observation group was significantly higher (P<0.05). Conclusion High dose of calcitriol has good therapeutic effect for ESRD patients with SHPT and can significantly improve the patient's calcium and phosphorus and PTH levels, improve the quality of life of patients.

Clinician-scientists are doctors who perform laboratory-based or clinically oriented research and have direct patient contact.Not only do they play a critical role in the research and practice of translational medicine,but also they are the educators of the next generation of clinician-scientists.However,clinician-scientists are vanishing.It is urgent to train new clinician-scientists who can be engaged in clinic work,research,and also education.Thus,in order to correct understand the importance of the work of clinical scientists,from multi angle analysis of clinical scientists training problems that may be encountered in the process,the active improvement of the education system and condition,and sustained and efficient guidance to the outstanding seedlings are advocated.Besides,aspiring candidates are also encouraged to seek ideal guidance and support through their career,arrange their work reasonably,strengthen their cooperation and the management ability,and strive to grow into excellent clinician-scientists.