Objective　To investigate the biological significance of p185 and p16 in breast cancer. Methods　Immunohistochemical S-P method was used to detect the expression of p185 and p16 proteins in 59 breast carcinomas，and their relations to clinicopathologic features were analyzed. Results　The positive rates of p185 and p16 were 47% and 34% respectively. No significant association was evident between the two proteins. There was also no significant relation between p16 expression and clinicopathologic features. p185 positive rate was 64% in the group of lymph-node involvement that was higher than that being 32% lymph-node negative one (P<0.05). Conclusion　p185 and p16 may play important roles independently in the development of breast cancer through different pathways. p185 detection is of important value in breast cancer.

OBJECTIVE: To investigate the relationship between single nucleotide polymorphism of gene and ischemic stroke and search for predisposing genes of ischemic stroke.DATA SOURCES: The Medline database was searched for articles of gene polymorphism of fibrinogen and ischemic stroke published from 1980 to 2005 with the key words of "stroke, plasma fibrinogen, polymorphism"in English. Meanwhile, Vip Information Database was also searched for literatures of gene polymorphism of fibrinogen and schemic stroke published between 1995 and 2005 with the key terms of "ischemic stroke, fibrinogen,gene polymorphism" in Chinese. Full-texts were gotten by correspondence with the authors.STUDY SELECTION: Included literatures were only case control study literatures. Literatures of contrast study, experience summary, individual case and so on were excluded.DATA EXTRACTION: Totally 50 articles of gene polymorphism of fibrinogen and ischemic stroke were retrieved. Twenty articles were accorded with inclusive criteria, and thirty articles were excluded.DATA SYNTHESIS: Level of plasma fibrinogen was co-affected by heredity and environment. Gene polymorphism of fibrinogen has important regulatory effects on the level of plasma fibrinogen. The fibrinogen accelerates thrombotic formation. As a result, the incidence rate of ischemic stroke increased by participating atherosclerosis, helping thrombocytic aggregation and changing the status of hemorheology. But definite mechanism and molecular function of gene polymorphism of fibrinogen deserved further research.CONCLUSION: The relationship between single nucleotide polymorphism of fibrinogen and ischemic stroke remains obscure. It also needs further study.

Objective To analyze the complications of pregnant secondary cesarean in scar uterus,to provide theoretical guidance for cesarean section.Methods 160 pregnant women of secondary cesarean uterine scar were chosen as the study group.80 pregnant women of non-scar uterine were chosen as the control group.Results The bleeding volume during operation,operation time,operation fee,postoperative bleeding,uterine resection rate,neonatal asphyxia in study group were (432 ± 331) mL,(64 ± 21) min,(0.91 ± 0.11) million,(262 ± 187) mL,4.4％,11.9％,which in the control group were (361 ± 209) mL,(44 ± 16) min,(0.63 ± 0) million,(184 ± 132) mL,1.3％,6.3％ respectively,the differences were significant (t =2.52,8.19,26.10,4,4.76,x2 =3.98,all P ＜ 0.05).The two groups had no statistically significant difference in organ damage situation (P ＞ 0.05).Conclusion Secondary cesarean uterine scar easily lead to maternal blood loss and increased postoperative bleeding,prolonged surgery,increased hysterectomy rate,increased incidence of neonatal asphyxia and other complications.Pregnant uterine scar pregnancy is a high-risk pregnancy,pregnancy for maternal uterine scar secondary surgical indications should be strictly controlled.

Objective To explore the relationship between critical thinking disposition and mental self-supporting and provide reference for educators in an attempt to improve undergraduate nursing students' positive psychological qualities and critical thinking disposition.Methods A total of 406 nursing undergraduates were investigated by using the California Critical Thinking Disposition Inventory-Chinese Version (CCTDI-CV) and Mental Self-supporting Questionnaire of University students.Results Undergraduate nursing students scored (280.91± 28.43) points averagely in critical thinking disposition,and the dimensions of analyticity (42.17±5.31) and truth seeking(37.56±6.42) got the highest and lowest score respectively.The total score of mental self-supporting was 76.40±8.47 points; among the seven subscales,opening and containing(11.90± 1.72) scored the highest and self-conviction(8.87±2.28) scored the lowest.A positive association was found between critical thinking disposition and mental self-supporting(r=0.583,P＜0.01).The regression analysis showed that students' self-decision,self-cognition,self-confidence and self-charge played a significant role in students' critical thinking disposition (R2=0.435,P＜0.01).Conclusion Undergraduate nursing students' disposition of critical thinking and mental self-supporting were on medium level.The subscales of self-decision,self-cognition,self-confidence and self-charge have huge influence on critical thinking disposition.Nursing educators should make an effort in the above 4 aspects so as to improve undergraduate nursing students' critical thinking disposition.

Objective To evaluate Meta-analysis in assessing the overall diagnostic value of adenosine stress echocardiography (ASE) in patients with coronary heart disease (CHD). Methods Relevant English and Chinese articles about ASE for assessing diagnostic accuracy of CHD were collected from the literatures published from 1994 to 2007 in China and abroad. Meta-analysis was conducted with the method recommended by the Cochrane Collaboration. Results Twelve papers were included. The reported sensitivity of ASE for the diagnosis of CHD ranged from 0.69 to 0.94, and the specificity ranged from 0.71 to 1.00. The pooled weighted sensitivity and specificity was 0.81 (95%CI 0.77-0.85) and 0.83 (95%CI 0.78-0.87), respectively;and the pooled positive and negative likelihood ratio was 4.81 (95%CI 3.65-6.33) and 0.22 (95%CI 0.18-0.28), respectively. The area under the curve of the summary receiver operating characteristic was 0.8968±0.0151. Conclusion ASE is medium to highly accurate in the diagnosis of CHD.

Objective To investigate the efficacy and safety of HCPT combined with 5-fluorouracil(5-Fu) in treatment of bladder cancer .Methods Selected 92 patients with advanced bladder cancer in our hospi-tal from February 2011 to August 2015 , equally divided into observation group and control group of 46 patients based on the random number table ,the control group were received 5-Fu intravesical chemotherapy ,The obser-vation group were given the HCPT combined with 5-Fu chemotherapy ,the chemotherapy infusion were once a week,continuous perfusion were observed for 3 months.Results The response rates in the observation group was 95.7%and the control group was 76.1%,the observation group were significantly higher than the control group (P<0.05).The occurrence of bladder irritation adverse reaction ,blood abnormalities,liver and kidney dysfunc-tion,bone marrow suppression in the observation group during chemotherapy compared with the control group were no significant difference(P>0.05),all adverse reactions after symptomatic treatment were improved .All patients were followed up for 1 year,The mortality and recurrence rates in the observation group were 8.7%and 4.3%re-spectively,while the control group were 30.4%and 17.4%,the mortality and recurrence rates of the observation group were significantly lower than the control group (P<0.05).Conclusion HCPT combined with 5 -Fu chemotherapy for bladder cancer has strong anti -cancer effect and without increase the incidence of adverse re-actions,it can promote the improvement of the long -term prognosis,so it is a safe and effective topical bladder chemotherapy drugs .

OBJECTIVE:To investigate penetrative effects of a penetration enhancer and multiple penetration enhancers combi-nation with different proportions on Euodia rutaecarpa superfines cataplasm,so as to optimize enhancer and their concentrations. METHODS:Modified Franz diffusion cell was employed with isolated mice abdominal skin as barrier. HPLC method was adopted to detect the effects of a penetration enhancer (propanediol, azone, oleic acid), multiple penetration enhancers (propanedi-ol-azone,propanediol-oleic acid,propanediol-azone-oleic acid),their proportion and amount on accumulative permeation quantity (Qn) of evodiamine and rutaecarpin in Euodia rutaecarpa superfines cataplasm. RESULTS:The penetrative effect of a penetration enhancer propanediol was significantly better than that of other one penetration enhancers and multiple penetration enhancers;the higher proportion of propanediol in multiple penetration enhancer system was,the better penetrative effects of evodiamine and rutae-carpin had. Using 3%,5 % and 7 % propanediol as enhancer,Q36 h of evodiamine were 11.290,14.332 and 13.537 μg/cm2,and those of rutaecarpin were 11.965,14.856 and 13.901 μg/cm2. CONCLUSIONS:The penetrative effect of 5% propanediol is the best,and can be used as enhancer for E. rutaecarpa superfines cataplasm.

OBJECTIVE:To establish a method for the simultaneous determination of chlorogenic acid,evodiamine,rutecar-pine in different places of Evodia rutaecarpa. METHODS:UPLC was performed on the column of ACQUITY UPLC BEH C18 with mobile phase of acetonitrile-0.1% Phosphoric acid aqueous solution(gradient elution)at a flow rate of 0.40 ml/min,the detection wavelength was 326 nm and 220 nm,column temperature was 30 ℃,and the volume injection was 2 μl. RESULTS:The linear range was 7.67-76.67 μg/ml for chlorogenic acid(r=0.999 2),13.33-133.33 μg/ml for evodiamine(r=0.999 7)and 13.33-133.33μg/ml for rutecarpine(r=0.999 8);the limits of quantitation were 0.11 ng,0.05 ng and 0.05 ng,the limits of detection were 0.03 ng,0.01 ng and 0.01 ng,respectively;RSDs of precision,stability and reproducibility tests were lower than 3%;recoveries were 96.19%-101.90%(RSD=2.19%,n=6),95.35%-101.16%(RSD=2.27%,n=6)and 95.92%-98.98%(RSD=1.33%,n=6),re-spectively. CONCLUSIONS:The method is rapid and accurate,and suitable for the simultaneous determination of chlorogenic ac-id,evodiamine,rutecarpine in different places of E. rutaecarpa.

Objective To study the expression of cytokeratin(CK)20 in exfoliated urothelial cells and to evaluate its clinical significance. Methods The expression of CK20 in exfoliated urothelial cells in 40 patients with bladder cancer and 20 subjects with normal urothelium was observed with immunohistochemical methods. Results The positive staining of CK20 in patients with bladder cancer was 52.5%, the expression of CK20 was negative in all controls, the positive rate of expression of CK20 combining with HE staining in patients with bladder cancer was 90%. The expression of CK20 was significantly higher in recurrent cases(80%) than in primary cases(43.3%). CK20 was not related to the tumor grade or stage. Conclusions The results suggested that the method had a higher specificity and therefore CK20 would be a good diagnostic marker.