Objective: To discover molecular markers associated with lung adenocarcinoma diagnosis/prognosis and drug resistance through screening of differentially expressed genes based on published chip data in gene expression databases using bioinformatics methods. Methods: Comprehensive analysis was performed in available mRNA microarray datasets including lung adenocarcinoma tissues dataset GSE32863 and lung adenocarcinoma taxane-platin resistance dataset GSE77209 from the gene expression omnibus(GEO) database. Gene ontology enrichment analysis, gene pathway enrichment analysis and protein interaction network analysis were performed based on significantly correlated genes. The expression level of genes was validated in the cancer genome atlas(TCGA) dataset. Survival differences were assessed by the log-rank test in TCGA lung adenocarcinoma dataset. Based on the publications genomics of drug sensitivity in cancer(GDSC) database in CellMiner cross database(CellMiner CDB), Pearson correlation analysis was used to analyze the correlation between differentially expressed genes and the half-maximal inhibitory concentration(IC50) of anticancer drugs. Results : There were a total of 77 genes which had a different expression in resistance lung adenocarcinoma cells and lung adenocarcinoma cancer tissues. The functional enrichment analysis showed that these co-different expression genes were mainly enriched in microtubule, extracellular exosome, cell cycle and signaling by nuclear receptors. Protein-protein interactions(PPI) network screened 6 most connected genes as molecular complex(MCODE). Among the MCODE, overexpressed ubiquitin conjugating enzyme E2 T(UBE2T), kinesin family member 20A(KIF20A), PCNA clamp associated factor(KIAA0101), pituitary tumor-transforming gene 1(PTTG1) and NIMA related kinase 2(NEK2) were associated with poor outcomes. Survival analysis results showed that these five genes were upregulated in lung adenocarcinoma tissues and drug-resistant cells and were significantly associated with poor prognosis in lung adenocarcinoma patients. Drug sensitivity analysis results suggested that high expression of PTTG1 and UBE2T was significantly associated with sensitivity to multiple anticancer drugs, including paclitaxel and docetaxel. RT-PCR validation showed that PTTG1 andUBE2T were highly expressed in docetaxel-resistant cells A549-TXR and H358-TXR. Conclusion PTTG1 andUBE2T holds the potential to be chemoresistance markers in lung adenocarcinoma.

Five universities with health policy and management ranked top level worldwide, including Harvard University, John Hopkins University, Stanford University, University of North Carolina at Chapel Hill and National University of Singapore were selected in our study. From above universities, we found that the curriculum of PHD students was focused on research concentration, methodology courses, and numerous elective courses. Hence, in China, the curriculum of PHD students should be improved with emphasis on course studying, management courses and highlighting curriculum content according to research area to enhance the quality of doctoral education.

Objective: To compare the effect of two different methods of "3-PR" participatory health education and traditional distribution of publicity materials on health literacy improvement of medical students, to provide a reference for making more effective measure to improve health literacy. Methods: 173 Second-grade students in nursing major were selected in a secondary vocational school in Datong City. Two different intervention methods were used to intervene for 8 weeks. The experimental group (92 students) received "3-PR" participatory health education; the traditional health education intervention in the control group(81 students). The "National Residents’ Health Literacy Monitoring Questionnaire 2015" was used to conduct a questionnaire survey on the experimental group and the control group before and after the intervention, and to compare the effects before and after the intervention. Results: The average score of health literacy was (36.04±9.43) points and (36.01±10.17) points before and after intervention in the control group; (35.78±8.91) points and (49.53±13.53) points before and after intervention in the experimental group; No statistical difference between experimental and control group was found before intervention(t=0.18, P=0.86); There was no significant difference in health literacy score before and after intervention for the control group(t=0.03, P=0.98); Health literacy significantly increased in the experimental group after intervention(t=-11.36, P=0.00). Adequate health literacy accounted for 3.70% and 4.94% before and after intervention in the control group and 4.35% and 45.65% in the experimental group before and after intervention. No significant difference was found in adequate health literacy proportion between the two groups before intervention(χ2=0.00, P=1.00). However, the difference showed statistically significant after intervention(χ2=36.58, P=0.00). The change of health literacy score in the control group and the experimental group was (-0.02±7.52) and (12.75±10.77), respectively, accounting for 1.24% decrement and 41.30% increment. The difference between the two groups was statistically significant (t=-8.93, P=0.00). The dimension-and type-specific score of health literacy showed similar pattern. Conclusion The "3-PR" participatory health education model is more effective than the traditional health education method in improving health literacy, and it could be carried out by multi-disciplinary students.

Based on participatory idea, we constructed a novelty model of participatory health edu-cation, which was based on participatory research as the module, participatory role-playing as the core mod-ule, participatory review as enhanced module (abbreviation to as "3-PR"). We applied it to pre-selected health officer health promotion activities, and randomized controlled trials were designed. The results showed that "3-PR" model of participatory health education might be more effective in promoting health literacy than conventional health education methods. "3-PR" health education model has the advantages of participation, practicality, fun and flexibility, integration and education, which has certain reference signifi-cance for exploring health education methods and improving the health of the whole people.

Objective To investigate the loss of motor unit and it's influencing factors in the lower motor neurons after middle cerebral artery infarction. Method Forty patients with first onset and unilateral middle cerebral artery infarction were divided into cortical-basal ganglia(26)and basal ganglia(14)groups and 10 healthy controls were served as control group.All included patients were scored by National Institute of Health stroke scale(NIHSS),modified Rankin scale (mRS), Fugl-Meyer Assessment (FMA) at 48 hours of admission. Nerve conduction study on the limb and motor unit number estimation (MUNE) on abductor pollicis brevis were performed at 2-4 weeks after onset, and the data of single motor action potential (SMUAP) were collected. SPSS 20.0 software was used to statistical analysis. Result The MUNE on were significantly lower and the amplitude and area of SMUAP were significantly increased in ipsilateral than contralateral sides (cortical-basal ganglia group:95.85±26.82 vs. 143.65±38.86, P<0.001; basal ganglia group: 126.71± 44.13 vs. 157.36±56.72, P=0.001). The affected MUNE was significantly decreased in the cortex-basal ganglia than in basal ganglia groups (95.85±26.82 vs.161.40±48.90,P=0.027). The MUNE was negatively correlated with NIHSS score (r=-0.362,P=0.022)and mRS score(r=-0.339,P=0.032).NIHSS score(β=-1.603,P=0.032,95%CI:-3.064~-0.142)and mRS score(OR=2.885,P=0.025,95%CI:1.139~7.158)on admission could predict the loss of MUNE on the affected side. Conclusion This study reveals the loss of motor unit and the compensation of remained motor unit on the affected side after middle cerebral artery infarction,NIHSS score and mRS score on admission may predict the loss of MUNE after stroke.

Objective To understand the loneliness of elderly people,and to analyze the correlation between frailty,family social support and loneliness.Methods The elderly people aged 75 and over from 10 community health service centers in Tangshan were selected and evaluated with the CFAI comprehensive e-valuation tool and the loneliness scale.Results The frailty rate was 100% in 3 448 elderly people.The score of the frailty of elderly was(47.27±0.77),and the degree of frailty was increased with the increase of age. The social support level of general and below accounted for 95.92%.The total average score of social support for the elderly was(32.72±6.21);and the medium or above loneliness accounted for 68.94%.The total aver-age score of loneliness in the elderly was(40.24± 10.23).The most needed caregiver was the children and their daughters. Multivariate analysis showed that the degree of education,the degree of frailty,family support (the relationship with children,with the children who do not support the elderly,communicating with chil-dren,taking the views of the elderly,importance of being at home and the visiting frequency of the children), community support(received the services provided by the neighborhood committee,often keep up with rela-tives and friends,the frequency of neighborhood interaction,have received community psychological counse-ling and have received volunteer service)and social support entered the regression equation.The regression coefficient were -0.084,1.167,1.016,1.212,0.914,1.029,1.025,1.264,1.400,0.889,1.053,1.307,1.466, 1.332,-0.405,respectively.Conclusion Frailty,family function and community social support are important factors of loneliness among the elderly.The support system construction should be strengthened to reduce the loneliness of the elderly,and improve the quality of life.

Objective To translate the English version of Comprehensive Frailty Assessment Instrument (CFAI) into Chinese and evalu-ate its reliability and validity. Methods CFAI was translated into Chinese with the Brislin's translation mode. From May to July, 2015, 200 community aged people in Shijiazhuang, China were assessed with the Chinese version of CFAI and World Health Organization Quality of Life-BREF (WHOQOL-BREF), and 30 of them were assessed with CFAI again after a week. The content validity was rated by six experts of gereology. The total scores of CFAI and WHOQOL-BREF were analyzed with Pearson's correlation, as well as the scores of CFAI test and retest. The CFAI were analyzed with Factor Analysis. The Cronbach's α was tested. Results There were 23 items in 4 dimensions. The content validity index was 0.782. Six factors were extracted by Factor Analysis and the cumulated variance was 64.05%. The total score of CFAI correlated with the score of WHOQOL-BREF (r=-0.764, P<0.001). The Cronbach's α was 0.704~0.897 in dimensions (P<0.001), and the r= 0.604~0.941 (P<0.001) between test and retest. Conclusion The Chinese version of CFAI is reliable and valid, that can be applied to evaluate frailty in community aged people.

Objective To observe the intervention effect of Forbrain speech auditory feedback training on cognitive dysfunction in patients with stroke.methods 120 patients with cognitive dysfunction after stroke were divided into experimental group 1(n=40),experimental group 2 (n=40)and control group(n=40).The control group accepted conventional rehabilitation,while the experimental group 1 received Forbrain speech auditory feedback training additionally,and the experimental group 2 received the non-standard Forbrain speech auditory feedback training additionally.All the cases were assessed with Montreal cognitive assessment scale (MoCA)before and 10 weeks after intervention.Result sAfter 10-week intervention,the scores of structure skills(2.05±0.50),attention and concentration(2.15±0.36),memory(2.18±0.59) and the total score of MoCA(17.53±2.41) in experimental group 1 were higher than those in experimental group 2 (1.80±0.46,1.90±0.44,1.90±0.55,17.53±2.41) and control group(1.78±0.53),1.85±0.36,1.70±0.56,17.18±2.37) (all P<0.05).The Scores of language in experimental group 1(2.03±0.48)and experimental group 2(1.85±0.53) were higher than those in control group(1.70±0.46) (all P<0.05).Conclusion Forbrain speech auditory feedback training can improve cognitive function of patients with stroke.

Objective To investigate the efficacy of BrainHQ visual training in rehabilitating memory function among stroke survivors.Methods Sixty stroke patients with memory disorders were recruited from the rehabilitation center of Tangshan Workers' Hospital.They were randomly assigned to a control group or an intervention group,each of 30.Both groups accepted conventional rehabilitation,while the intervention group was additionally given BrainHQ visual training five times a week for 30 minutes,lasting four weeks.Before and after the treatment,both groups completed the Rivermead behavioral memory test.Results After the 4 weeks of treatment,the average scores in recalling full names,recalling hidden items,recalling appointments,recognizing pictures,recognizing faces,recalling a story immediately,delayed story recall,recalling a route promptly,delayed route recall and the average total score in both groups were all significantly higher than before the treatment.The treatment group scored significantly better than the control group except in recalling hidden items,and recognizing faces and pictures.Conclusion BrainHQ visual training can improve the memory of stroke survivors.

Objective To investigate the effect of obstructive sleep apnea hypoxia on learning memory capacity in rat after ischemia.Methods Eighty healthy male wister rats were randomly divided into:sham operation group (SO group,n =20),merely ischemia group (I/R group,n =20),and obstructive sleep apnea hypoxia for 7 days ischemia group (IH7 + I/R group,n =20),obstructive sleep apnea hypoxia for 21 days ischemia group (IH21 + I/R group,n =20).Obstructive sleep apnea hypoxia ischemia groups were respectively given obstructive sleep apnea hypoxia for 7 days and 21 days.Ischemia animals were prepared cerebral ischemia-reperfusion model by improved pulsinelli four vessels block (4-VO),the morphological changes of hippocampus nerve cells of rat brain were detected with HE,neuron pathology in hippocampal regin was observed using electron microscope,and learning memory capacity of rats were assessed by the Morris water maze test.Results Compared with the SO group,the I/R group demonstrated shortened escaping latency,increased frequency of crossing the platform in the water maze test,decreased survival rate of neurons,and increased apoptotic cells and ultrastructure damages (P ＜ 0.05).Compared with the I/R group,obstructive sleep apnea hypoxia ischemia groups showed shortened escaping latency,increased frequency of crossing the platform,decreased survival rate of neurons,and increased apoptotic cells and ultrastructure damages (P ＜ 0.05),especially in the IH21 + I/R group (P ＜ 0.05).Conclusions Obstructive sleep apnea hypoxia can increase the damage of learning memory capacity.This damage is related to hippocampus nerve loss and ultrastructure injury from obstructive sleep apnea hypoxia.