Objective To investigate the expression level and clinical significance of hsa_circ_0005075 in serum extracellular vesicles(EVs)of patients with recurrent spontaneous abortion(RSA).Methods Fourteen RSA patients and 14 normal pregnant women from the Department of Obstetrics and Gynecology,Qilu Hospital of Shandong University were enrolled in a training set,and 64 RSA pa-tients and 48 normal pregnant women were enrolled in a validation set.The expression levels of hsa_circ_0005075 in serum EVs were detected by the quantitative real-time PCR(qRT-PCR),and their correlation with clinical pathological parameters of RSA patients were analyzed.Serum anti-thyroid globulin antibody(A-TG)and anti-thyroid peroxidase antibody(A-TPO)were detected by the elec-trochemiluminescence assay.Serum anticardiolipin(ACA)IgA,IgG,and IgM antibodies and anti-β2 glycoprotein 1(β2GP1)IgA,IgG,and IgM antibodies were determined by the chemiluminescence immunoassay.The correlation of these autoantibodies with the lev-els of hsa_circ_0005075 in serum EVs was analyzed by the Pearson correlation.The clinical application value of hsa_circ_0005075 in the diagnosis of RSA was evaluated by the receiver operating characteristic(ROC)curve.Results The detection results of the training set showed that the expression levels of hsa_circ_0005075 in serum EVs of RSA patients(7.69[4.74,42.15])were significantly high-er than that in normal pregnant women(1.02[0.51,4.23],U=28,P＜0.01].Similarly,in the validation set,the expression levels of hsa_circ_0005075 in RSA patients(4.96[1.73,8.89])were also significantly higher than that in normal pregnant women(1.00[0.24,2.96],U=693,P＜0.01).The ROC curve showed that hsa_circ_0005075 in serum EVs had good diagnostic value for RSA(AUCROC=0.774),with 70.3%of sensitivity and75.0%of specificity.In addition,the expression level of hsa_circ_0005075 in serum EVs was significantly correlated with A-TPO(r=0.298,P＜0.05).Conclusion The hsa_circ_0005075 in serum EVs is highly ex-pressed in RSA patients,which may have a potential differential diagnostic value for the diagnosis of RSA.

Nursing staff plays a crucial role in the end-stage of a patient′s life, and it is inevitable for nursing staff to face and handle problems about death. The ability to cope with death is of vital importance, which can reduce the risk of emotional distress in nurses, and assist nurses to better participate in patients' end-stage care, and improve the quality of care. This paper summarizes the definition, components, theoretical frameworks and models, assessment tools, status quo, influencing factors of the coping with death competence, and propose the corresponding intervention strategy according to the situation of our country, provide references for the future research.

Objective:To understand the needs of end-stage cancer patients for hospice care, so as to provide a basis for the development of human-centered quality nursing services in hospice care.Methods:13 patients with end-stage cancer in tumor ward were interviewed by personal in-depth interview, and the data were sorted and analyzed by Colaizzi's seven-step analysis method.Results:A total of four themes of hospice care needs of patients with end-stage cancer were extracted. The need to maintain self-subject: the desire to maintain self-efficacy and self-image of dignity in life; the need to relieve the symptoms of self-discomfort. The need to relieve the physical symptoms and psychological discomfort. Meet the needs of self-determination: participate in medical care decisions and choose comfortable social relationships. Express their own emotional needs: the past farewell and remembrance and future wish to achieve the expectationsConclusions:Patients with end-stage cancer have diverse needs for hospice care. In clinical work, medical staff should adhere to the people-oriented concept, explore patients' needs and preferences, and implement individualized quality nursing measures to meet patients' needs for hospice care.

Objective To assess the association between interleukin-10-1082 (IL-10-1082) gene polymorphisms and susceptibility of gastric cancer in the Chinese population.Methods Cochrane systematic evaluation was adopted for the analysis.Articles published in Medline,Embase,Cochrane library,CBM,CJFD and CSJD from 1966 to 2012 were retrieved.Case control studies on the correlation between the 1L-10-1082 polymorphism and gastric cancer in Chinese population were collected.Gastric cancer patients were in the gastric cancer group,and healthy individuals were in the control group.Two researchers extracted data and evaluated the quality of literatures independently.Meta analysis was performed to detect whether there were differences between the gastric cancer group and the control group about the distribution of genotypes of IL-10-1082 gene (GG,AA,AG,AA,alleles G and A).The heterogeneity was analyzed using the Q test or I2 test.Fixed effect model or random effect model was adopted,and the results of the meta analysis were presented with odds ratio (OR) and 95％ confidence interval (95％ CI).Results Thirteen literatures including 5252 patients were included in the analysis.There were 2077 patients in the gastric cancer group and 3175 patients in the control group.The results of meta analysis showed that population with the genotypes GG and AG have higher risk of having gastric cancer when compared with population with the genotype AA (OR =1.76,95％ CI 1.33-2.33 ; OR =2.08,95％ CI 1.62-2.66,P ＜0.05).Population with the allele G have higher risk of having gastric cancer when compared with population with allele A (OR =1.67,95％ CI 1.31-2.13,P ＜ 0.05).Conclusion The genotypes GG,AG and the allele G of IL-10-1082 gcne of the Chincse population are significantly associated with the increased risk of gastric cancer.