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To explore nurses' experiences and perceptions of career growth and its influencing factors, as career growth is more closely associated with individual attitudes and behaviours in the new career era.A qualitative descriptive design was used.Thirty-one nurses from 10 secondary and 8 tertiary hospitals in Sichuan Province of China were purposively selected to participate in this study. The data were collected using individual semi-structured face-to-face interviews. Two researchers independently reviewed the transcripts and emergent coding. The data were analysed using qualitative content analysis.The nurses' perceptions of career growth fully described the nurses' experience and occurred in five dimensions: career promotion, career goal progress, professional ability and quality improvement, professional identity development and increase in personal prestige. The factors influencing career growth were identified at the organizational, individual and social levels. Career growth in nursing was complex, changed over time and showed several specific characteristics compared with other careers. The nurse-specific symbol of career growth was professional identity development, which reflected career progression characteristics.Career growth is a multi-dimensional concept with varying influencing factors. The meaning of career growth for nurses is distinct from that for employees in other careers.Nursing managers should guide nurses to comprehensively assess their career growth from multiple perspectives, and professional identity development deserves more attention. Both organizations and individuals should take responsibility for career management to pursue career growth.

Low anterior resection syndrome (LARS) is a common postoperative complication in patients with colorectal cancer, which seriously affects their postoperative quality of life. At present, the aetiology of LARS is still unclear, but some risk factors have been studied. Accurate prediction and early management of medical intervention are keys to improving the quality of life of such high-risk patients.Based on machine-learning methods, this study used the follow-up results of postoperative patients with colorectal cancer to develop prediction models for LARS and conducted a comparative analysis between the different models.A total of 382 patients diagnosed with colorectal cancer and undergoing surgery at West China Hospital from April 2017 to December 2020 were retrospectively selected as the development cohort. Logistic regression, support vector machine, decision tree, random forest and artificial neural network algorithms were used to construct the prediction models of the obtained dataset. The models were internally validated using cross-validation. The area under the curve and Brier score measures were used to evaluate and compare the differentiation and calibration degrees of the models. The sensitivity, specificity, positive predictive value and negative predictive value of the different models were described for clinical use.A total of 342 patients were included, the incidence of LARS being 47.4% (162/342) during the six-month follow-up. After feature selection, the factors influencing the occurrence of LARS were found to be location, distance, diverting stoma, exsufflation and surgical type. The prediction models based on five machine-learning methods all showed acceptable performance.The five models developed based on the machine-learning methods showed good prediction performance. However, considering the simplicity of clinical use of the model results, the logistic regression model is most recommended. The clinical applicability of these models will also need to be evaluated with external cohort data.

Glioblastoma is an aggressive malignant tumor of the brain and spinal cord. Due to the blood–brain barrier, the accessibility of its treatments still remains significantly challenging. Unfortunately, the recurrence rates of glioblastoma upon surgery are very high too. Hence, understanding the molecular drivers of disease progression is valuable. In this study, we aimed to investigate the molecular drivers responsible for glioblastoma progression and identify valid biomarkers. Three microarray expression profiles GSE90604, GSE50601, and GSE134470 containing healthy and glioblastoma-affected samples revealed overlapping differentially expressed genes (DEGs). The interrelational pathway enrichment analysis elucidated the halt of cell cycle checkpoints and activation of signaling pathways and led to the identification of 6 predominant hub genes. Validation of hub genes in comparison with The Cancer Genome Atlas datasets identified the potential biomarkers of glioblastoma. The study evaluated two significantly upregulated genes, SPARC (secreted protein acidic and rich in cysteine) and VIM (vimentin) for glioblastoma. The genes CACNA1E (calcium voltage-gated channel subunit alpha1 e), SH3GL2 (SH3 domain-containing GRB2-like 2, endophilin A1), and DDN (dendrin) were identified as under-expressed genes as compared to the normal and pan-cancer tissues along with prominent putative prognostic biomarker potentials. The genes DDN and SH3GL2 were found to be upregulated in the proneural subtype, while CACNA1E in the mesenchymal subtype of glioblastoma exhibits good prognostic potential. The mutational analysis also revealed the benign, possibly, and probably damaging substitution mutations. The correlation between the DEG and survival in glioblastoma was evaluated using the Kaplan–Meier plots, and VIM had a greater life expectancy of 60.25 months. Overall, this study identified key candidate genes that might serve as predictive biomarkers for glioblastoma.

Objectives The purpose of this paper is to ascertain the effect and mechanism of Radix Isatidis polysaccharide (RIP) on obesity. Methods High fat diet (HFD)-induced obese rats and the MDI-induced 3T3-L1 adipocyte cells were established to evaluate the ameliorated obesity effect and mechanism from RIP. Key findings Experiments in vivo show that oral administration of RIP has significant preventive effects on HFD-induced obesity and metabolic disorders in rats. With treatment of RIP (20, 40 and 80 mg/kg BW), the body weight, fat accumulation, adipocyte cell size, serum lipid levels and antioxidant enzyme activity were progressively improved. On the other hand, the treatment of 3T3-L1 cells with RIP (25, 50 and 100 mg/L) led to a decrease in lipid accumulation and glucose consumption. In addition, during adipogenesis in 3T3-L1 cells, RIP remarkably down-regulated mRNA levels of peroxisome proliferator-activated receptor-γ (PPARγ), CCAAT/enhancer binding protein-α (C/EBPα), sterol regulatory element-binding protein-1c (SREBP-1c), fatty acid synthase (FAS), acetyl-CoA carboxylase and glycerol-3-phosphate dehydrogenase. Furthermore, after RIP treatment, the protein expression of PPARγ, C/EBPα, FAS, HMG-CoA reductase and acetyl-CoA synthetase-1 (AceCS1) were significantly decreased and the expression of p-AMPK was increased. Conclusion These results highlight the potential of RIP for obesity interventions and suggest that RIP inhibited adipocyte differentiation and lipid synthesis by activating adenosine 5ʹ-monophosphate (AMP)-activated protein kinase (AMPK) signalling pathway and down-regulating the expression of major adipogenic transcription factors, PPARγ, C/EBPα, etc.

Traditional Iterative Closest Point (ICP) algorithm registration is slow, especially when the scale of the point cloud is relatively large. This paper proposes a new algorithm which is the iterative closest registration based on the normal distribution transform (NDT-ICP). The algorithm uses NDT as the coarse registration algorithm, because the NDT algorithm does not use the features of the corresponding points to calculate and match during the registration process, and does not need to consume a large price to find the nearest neighbor matching points, which speeds up the registration speed. The ICP algorithm is used as fine registration to further improve the accuracy of the overall registration. The results show that the NDT-ICP algorithm has obvious speed advantage while ensuring considerable accuracy. Especially for large-scale point cloud registration with few features, the accuracy of this algorithm is about twice that of SAC-IA-NDT algorithm, and slightly improved compared to SAC-IA-ICP algorithm. In terms of registration speed, the registration time of the NDT-ICP algorithm is about 10% and 11% of the SAC-IA-NDT algorithm and the SAC-IA-ICP algorithm, respectively. The experimental results show that the algorithm is efficient and effective.

PURPOSE The purpose of this study was to determine the effectiveness of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) on depression, quality of life (QoL), and glycosylated hemoglobin (HbA1c) in people with diabetes. DESIGN A systematic literature review and meta-analysis was conducted. METHODS Eight databases (PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature [CINAHL], Cochrane, PsycINFO, and three Chinese databases) were searched for relevant studies from inception to December 2019. Only randomized controlled trials (RCTs) of MBSR and MBCT interventions for people with type 1 and type 2 diabetes were included. FINDINGS Nine studies described in 11 articles were included in the review. Meta-analysis showed a significant effect favoring MBSR and MBCT on depression (standardized mean difference -0.84; 95% confidence interval [CI] -1.16 to -0.51; p < .0001), the mental health composite score of QoL (mean difference [MD] 7.06; 95% CI 5.09 to 9.03; p < .00001), and HbA1c (MD -0.28; 95% CI -0.47 to -0.09; p = .004). However, effects on the physical health composite score of QoL have not been found. CONCLUSIONS MBSR and MBCT are beneficial in improving depression, the mental health composite score of QoL, and HbA1c in people with diabetes. More well-designed trials using longer follow-up measurements are needed. CLINICAL RELEVANCE MBSR and MBCT could be considered as effective complementary treatment alternatives for people with diabetes.

Objectives The objective of this paper was to explore the effects of Radix isatidis polysaccharide (RIP) extracted from Radix isatis on alleviating insulin resistance. Methods The insulin resistance models of 3T3-L1 preadipocytes and type 2 diabetic rats were established to evaluate the insulin resistance activity of RIP. Key findings Radix isatidis polysaccharide within the concentration range of 25–100 μg/ml could reduce cell supernatant glucose and TNF-α levels (P < 0.01) and increase the expression of PI-3K P85, Glut4, IRS-1 and Akt protein in symptoms of IR 3T3-L1 preadipocytes. In the meantime, RIP contributed to relieve the weight loss of diabetic rats whose liver weight and liver index were decreased due to the effects of RIP. Experiments in rats also showed that RIP had capacity in reduced serum TC, TG, LDL-C, FFA, FBG, FINS, MDA, ALT, AST activities and increased serum HDL-C, SOD, ISI (P < 0.05 or 0.01). In addition, the oral glucose tolerance in rats was improved (P < 0.05) and liver damage was restored due to RIP. Conclusions Radix isatidis polysaccharide significantly alleviates insulin resistance in 3T3-L1 preadipocytes and type 2 diabetic rats. These beneficial effects of RIP may associate with their roles in improving the glucose metabolism, lipid metabolism and oxidative stress.

Background Lack of adequate self-care, frequent admissions, and poor quality of life are common and serious problems in adult patients with systemic lupus erythematosus (SLE). Some studies have revealed that transitional care is effective in improving self-care and quality of life as well as reducing rehospitalization rates. However, limited studies explored its effects in adult patients with SLE. Therefore, we performed a study to examine the effects of transitional care on self-care, readmission rates, and quality of life in adult patients with SLE. Methods This study was a single-center, single-blind, and parallel-group randomized controlled trial comparing transitional care with usual care in SLE patients from a university hospital in China. Evaluations were conducted at baseline before discharge and at 3 months after discharge by using hospital readmission rate, the Exercise of Self-Care Agency Scale, and the Medical Outcomes Study Short Form 36-item Health Survey for self-care and quality of life. Data were collected between June and December 2016. Results Compared with the usual care group, the transitional care group reported significantly greater improvement in self-care and quality of life. Additionally, the 30-day readmission rate for the patients in the transitional care group was significantly lower than in the usual care group, and this effect remained significant at 60 and 90 days after patient discharge. Conclusion This study shows that transitional care improves self-care and quality of life in adult patients with SLE and reduces readmissions. However, further studies are needed. Trial registration China clinical trial registry, ChiCTR-IPR-16007708. Registered January 5, 2016. Electronic supplementary material The online version of this article (10.1186/s13075-018-1670-4) contains supplementary material, which is available to authorized users.

Objective To study the association between the serum creatine kinase (CK) level and aggressive behavior in patients with schizophrenia. Method This retrospective study recruited 2780 Chinese patients with schizophrenia from January 2009 to December 2013 at the psychiatric inpatient units of West China Hospital. The diagnosis was made according to the DSM-IV criteria. The serum level of CK was checked. Results Aggressive behavior was positively correlated with the serum CK level (r = 0.262, p = 0.000). The OR value is 8.084 when comparing the high CK group and normal CK group prior to admission. The aggressive behavior rate in the 5 times group (serum level ≥ 1130 U/L) after admission (28.2%) is higher than the rate prior to admission (16.5%). Conclusion The aggressive patients with schizophrenia displayed increased serum CK level. It may be useful to include a lab test of CK level in patients with schizophrenia and history of aggression. It would help the staff to take precautions to protect the patients and others.

A new flavonoid glycoside 1 was isolated from Schizonepeta annua (Pall.) Schischk. by column chromatography. Its structure was determined to be acacetin 7-O-α-L-rhamnopyranosyl-(1→2)-[β-D-xylopyranosyl-(1→6)]-β-D-glucopyranoside (1) by spectroscopic data (1H NMR, 13C NMR, 1H−1H COSY, HSQC, and HMBC) and chemical methods. In addition, the α-glucosidase inhibitory activity of compound 1 was evaluated.

This study investigates the anti-angiogenic effect of 3β, 12β, 20(S)-trihydroxy dammarane-3-O-β- d -glucopyranosyl(1–2)-β- d -glucopyranoside(HRG), a new chemical compound obtained by structure modification on Ginseng saponins Rg3, associated with the regulation of matrix metalloproteinases(MMPs) and its upstream signal-regulated molecule of vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(b-FGF) in vitro, which plays an critical role in angiogenesis during the process of carcinoma. In our study, to investigate the anti-angiogenesis effect of HRG in HUVECs, we utilized cell proliferation assay, tube formation assay, wound-healing assay, Semi-quantitative reverse transcription PCR, and Western blot assay. Our results demonstrated that HRG plays a major role in the regulation of proliferation, migration and tube formation of HUVECs by suppressing the expression of VEGF and b-FGF in both transcriptional and post-transcriptional levels. In addition, the expression of MMP-2 and MMP-9, which were related to the ECM degradation, were down-regulated after administration of HRG as well. Overall, our results revealed that HRG strongly inhibited the process of angiogenesis and shows better effectiveness than Rg3.

// An Hu 1 , Jing-Juan Huang 2 , Jing-Fei Zhang 1 , Wei-Jun Dai 1 , Rui-Lin Li 3 , Zhao-Yang Lu 3 , Jun-Li Duan 3 , Ji-Ping Li 4 , Xiao-Ping Chen 1 , Jing-Ping Fan 1, 5 , Wei-Hua Xu 1 and Hong-Liang Zheng 6 1 Department of Otolaryngology, Gongli Hospital, Second Military Medical University, Pudong New Area, Shanghai, 200135, China 2 Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China 3 Department of Gerontology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China 4 Department of Otolaryngology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Pudong New Area, Shanghai, 200127, China 5 Department of Otolaryngology-Head and Neck Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China 6 Department of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China Correspondence to: Jing-Juan Huang, email: hjjxinhua@163.com Keywords: cell cycle arrest, apoptosis, ATM/Chk2/p53 signal pathway, head and neck squamous cell carcinoma, curcumin Received: March 20, 2016 Accepted: March 31, 2017 Published: April 13, 2017 ABSTRACT Studies have demonstrated that curcumin (CUR) exerts its tumor suppressor function in a variety of human cancers including head and neck squamous cell carcinoma (HNSCC). However, the exact underlying molecular mechanisms remain obscure. Here, we aim to test whether CUR affects ATM/Chk2/p53 signaling pathway, leading to the induction of cell cycle arrest, inhibition of angiogenesis of HNSCC in vitro and in vivo . To this end, we conducted multiple methods such as MTT assay, Invasion assay, Flow cytometry, Western blotting, RT-PCR, and transfection to explore the functions and molecular insights of CUR in HNSCC. We observed that CUR significantly induced apoptosis and cell cycle arrest, inhibited angiogenesis in HNSCC. Mechanistically, we demonstrated that CUR markedly up-regulated ATM expression and subsequently down-regulated HIF-1α expression. Blockage of ATM production totally reversed CUR induced cell cycle arrest as well as anti-angiogenesis in HNSCC. Moreover, our results demonstrated that CUR exerts its antitumor activity through targeting ATM/Chk2/p53 signal pathway. In addition, the results of xenograft experiments in mice were highly consistent with in vitro studies. Collectively, our findings suggest that targeting ATM/Chk2/p53 signal pathway by CUR could be a promising therapeutic approach for HNSCC prevention and therapy.

Xia Xie, Hui Yang, Anliu Nie, Hong Chen,* Jiping Li* West China School of Nursing and Department of Nursing, West China Hospital, Sichuan University, Chengdu, China *These authors contributed equally to this work Purpose: The aim of this study was to determine the prevalence and predictors of medication nonadherence among patients with systemic lupus erythematosus (SLE) in Sichuan.Patients and methods: A cross-sectional investigation was performed. Participants were recruited by consecutive sampling from the Rheumatic Clinic of a university hospital between June and September 2016. Patients’ self-reported medication adherence was assessed by the eight-item Morisky Medication Adherence Scale. Additional surveys included patients’ demographics, and clinical and treatment characteristics. Logistic regression analysis was used to identify the predictors of medication nonadherence.Results: A total of 140 patients were included in analysis. The percentage of patients classified as nonadherent to medication was 75%. Low education, rural residency, childlessness, limited comprehension of medication instructions, side effects experienced, dissatisfaction with treatment and better physical health were associated with an increased risk of nonadherence.Conclusion: This study demonstrated a high prevalence of medication nonadherence among SLE patients in Sichuan, and factors associated with the nonadherence are multifaceted. Interventions for these factors, such as appropriate adjustment of the service resources for patients with rheumatic disease in rural communities and improved communication between the health care providers and the patients, may contribute to improve the medication adherence of this cohort. Keywords: systemic lupus erythematosus, medication management, adherence, predictors

An HPLC method was established for the determination of adenosine, γ-aminobutyric acid (GABA) and six flavonoids (calycosin-7-glucoside, ononin, calycosin, isoliquiritigenin, formononetin and medicarpin） in Radix Hedysari. The samples were extracted with methanol by refluxing for 4 h. The HPLC-DAD was performed on a Diamonsil C(18) column (250 mm × 4.6 mm, 5 μm) with acetonitrile-water as the mobile phase. The column temperature was at 40 ℃ and the flow rate was 1.0 m L·min(-1), while the temperature of drift tube was 110.5 ℃ and the nebulizing gas flow was 3.1 L·min-1 for the ELSD system. The results showed all the eight components had good linear relationships (r(2) =0.992 8-1.000 0) in the range of the test concentration. The RSD of precision, stability and repeatability were less than 2%.The average recovery rates were 96.78%-103.45%, and RSD were 0.29%-1.61%.The index component contents of Radix Hedysari form 24 different origins were determined and used as variable factors in clustering analysis. The results were classified into 2 groups basically in accordance with the regional cluster. And the consequence was in consistent with the results of principal component analysis. This HPLC method is simple, shows good sensitive and accurate, and provides the experimental basis for multi-index control of Radix Hedysari. Clustering analysis for Radix Hedysari quality control has a certain reliability and objectivity.

To analyze and summarize Professor LIU Feng-bin's clinical experience and academic thoughts on gastroesophageal reflux disease (GERD), the study group adopted the retrospective study for case series and expert interview, extracted the retrospective data, including the herbs, diseases, syndrome type, medical expense and quantity of herbs of GERD patients attended the First Affiliated Hospital of Guangzhou University of Chinese Medicine. Statistical description and binary Logistic regression were used for the identification and modification of syndrome type and initial core herbs. After expert interviews were performed for the syndrome type and herbs, the final scheme were formed. A total of 112 GERD patients ages（48.97±13.13）y; male: 35 (31.3%), female: 77(68.7%) were enrolled. The numbers of patients with liver and stomach incoordination syndrome, heat stagnation of liver and stomach syndrome, syndrome of dual deficiency of Qi and Yin, syndrome of spleen deficiency and dampness-heat, spleen-stomach disharmony syndrome were 40, 26, 19, 17 and 10, respectively. The patients used totally 80 herbs, and 26 of them had significant differences among different syndrome groups. According to the logistic regression analysis on the 23 herbs used by 112 patients, the herbs scheme was modified for the second time. After the expert interviews and modification, the final consensus was reached. The main causes for GERD were dietary irregularities, moodiness, and weak constitution. The basic mechanism of GERD was spleen deficiency with Qi adverseness. The spleen-stomach disharmony syndrome was deleted by expert interviews. The 10 core herbs for GERD treatment were Taizishen(Pseudostellariae Radix), Fuling(Poria), Baizhu(Atractylodismacrocephalae Rhizoma), Gancao(Glycyrrhizae Radix Et Rhizoma), Zhebeimu(Fritillariae Thunbergii Bulbus), Haipiaoxiao(Sepiae Endoconcha), Zhiqiao(Aurantii Fructus), Chenxiang(Alosewood), Pugongying(Taraxaci Herba), Zhizitan(Cape Jasmine Fruit). The modification and psychological and diet interventions were also identified. This study summarized Professor LIU Feng-bin's clinical experience and academic thoughts of chronic atrophic gastritis based on data mining of case series and expert interviews. The quality of methodologies and report were both well. The results provide a foundation and ideas for further study on the complex intervention for GERD, and can be directly applied in clinical practice.

Managing increasing numbers of diabetic patients is placing increasing pressure on healthcare providers, especially general practitioners, who usually serve in multiple roles. This situation has caused generally poor results in terms of diabetes management. However, community nurses in some countries have successfully and effectively controlled chronic diseases among their patients. Therefore, the effects of nurse-led management is worth further exploration in order to better understand and promote this mode of care.To explore the effects of community-nurse-led team management on diabetes patients.An experimental research design was adopted. Patients with type 2 diabetes were recruited from two community health centers (the first for the intervention group, the second for the control group) in Wuhou District, Chengdu City, China. The intervention group received nurse-led team management care for 2 years, while the control group received standard care. The evaluations were conducted before the intervention and at 6, 12, and 24 months into the intervention. Outcomes included glycosylated hemoglobin (HbA1c) level, body mass index, waist circumference, visual acuity, ankle brachial index, kidney function index, urinary protein level, and electrocardiogram.The 179 participants included 88 in the intervention group and 91 in the control group. After the intervention, HbA1c level, ankle brachial index, and waist circumference were all significantly better in the intervention group than in the control group (F = 28.894, p.01; F = 4.065, p.01; F = 5.540, p.01). The other outcome variables remained statistically similar between both groups throughout the study period.Community nurse-led team management is an effective mode of care in terms of controlling blood glucose control and preventing diabetes-related complications.探討護理人員引領社區第二型糖尿病照護之管理團隊模式成效.糖尿病患者人數不斷增長，給社區糖尿病管理帶來巨大壓力，在中國全科醫師常常身兼數職，以致糖尿病管理不佳，然而國際上已證實社區護理人員在慢性病管理中的的角色功能十分有效，因此，在中國推動護理人員主導的社區糖尿病管理模式，並且評價其成效日益重要。.探討社區護理人員引領的團隊管理對糖尿病患者的疾病改善效果。.採用試驗性研究設計，選取成都市武侯區2家社區衛生服務機構分別為試驗組和對照組，並於所在社區納入2型糖尿病患者作為研究對象。試驗組患者接受社區護理人員引領的團隊管理服務2年；對照組維持現有的管理服務。分別在介入前、介入後半年、1年及2年評價患者的糖化血色素（HbA1c）、身體質量指數、腰圍、視力、踝肱指數、腎病指數、尿蛋白及心電圖。.兩社區共納入研究對象179例，其中試驗組88例，對照組91例。通過介入，試驗組患者糖化血色素、踝肱指數、腰圍較對照組明顯改善（F = 28.894，p.01；F = 4.065，p.01；F = 5.540，p.01）；身體質量指數、視力、腎病指數、尿蛋白及心電圖與對照組差異無統計學意義，但維持了上述指標的穩定。.社區護理人員引領的團隊管理，可以改善患者的血糖控制，改善或維持併發症相關指標，在一定程度上起到了預防相關併發症的作用。.

We develop a reduced-complexity approach to the detection of SOQPSK-TG, a highly bandwidth-efficient constant-envelope waveform. The optimal detector for SOQPSK-TG requires of a bank of 2784 matched filters and 512 states, which is impractical and highly complex. In this paper, a practical detector was developed based on Laurent decomposition and frequency pulse truncation (PT) technology, with the number of correlators reduced to only 2 and states reduced to 4 at the expanse of less than 0.2dB at BER of 10-4.

A new kind of combined finite element named three-dimensional virtual laminated element and its deduce process is introduced. The new finite element was proved to be convenient, accurate and efficient in the calculation of bridge structures by a modal test and corresponding numerical example. Then some research and discussion were done, which show that with small modal construction scale being comparative with beam element, the static and dynamic spatial behavior of complicated structures can be simulated precisely. Furthermore, it is sensitive to structural damages, and more damage information can be obtained than corresponding spatial beam element, which means it is highly promising in the application of structural damage detection.

The electrochemical behaviors of shikonin at a poly(diallyldimethylammonium chloride) functionalized graphene sheets modified glass carbon electrode(PDDA-GS/GCE) have been investigated. Shikonin could exhibit a pair of well-defined redox peaks at the PDDA-GS/GCE located at 0.681 V(E pa) and 0.662 V(E pc)[vs. saturated calomel electrode(SCE)] in 0.1 mol/L phosphate buffer solution(pH=2.0) with a peak-to-peak separation of about 20 mV, revealing a fast electron-transfer process. Moreover, the current response was remarkably increased at PDDA-GS/GCE compared with that at the bare GCE. The electrochemical behaviors of shikonin at the modified electrode were investigated. And the results indicate that the reaction involves the transfer of two electrons, accompanied by two protons and the electrochemical process is a diffusional-controlled electrode process. The electrochemical parameters of shikonin at the modified electrode, the electron-transfer coefficient(α), the electron-transfer number(n) and the electrode reaction rate constant(k s) were calculated to be as 0.53, 2.18 and 3.6 s−1, respectively. Under the optimal conditions, the peak current of differential pulse voltammetry(DPV) increased linearly with the shikonin concentration in a range from 9.472×10-8 mol/L to 3.789×10-6 mol/L with a detection limit of 3.157×10−8 mol/L. The linear regression equation was I p=0.7366c+0.7855(R=0.9978; I p: 10−7 A, c: 10−8 mol/L). In addition, the modified glass carbon electrode also exhibited good stability, selectivity and acceptable reproducibility that could be used for the sensitive, simple and rapid determination of shikonin in real samples. Therefore, the present work offers a new way to broaden the analytical application of graphene in pharmaceutical analysis.

Survival and germination of overwintering oospores of two strains from Gansu,China compared with two standard from Wageningen, the Netherlands of Phytophthora infestans were determined in 2010-2011. It was found that compatible mating strains of P. infestans A1 and A2 produce oospores abundantly in paired cultures on tomato-rye agar medium.The survival rate of overwintering was ranged from19.57% to 24.59%.The germination rate of overwintering was ranged from 3.58% to 8.49%, and there were no significant differences in germination rate of oospores between alternating light at day/night and whole darkness at day/night. Furthermore, the soil extract liquid was more suitable for oospore germination than distilled water.

Non-line-of-sight (NLOS) propagation is a major source of error for accurate time-of-arrival (TOA) location estimation. The two-step least square (LS) method, which does not need any information about the distribution of the NLOS error, has been studied in related researches to provide efficient location estimation of the mobile terminal (MT). By observing the estimation of the error covariance matrix in the two-step LS method, this paper finds that the measured distances are more suitable than the initial estimated distances by maximum likelihood (ML) algorithm in NLOS environments. Moreover, by making use of the geometry relations among fixed terminals (FTs), some measured distances which are corrupted by big NLOS errors may be reduced. Further, an iteration method can be adopted to further improve the performance of the algorithm. Accordingly, an improved algorithm based on the two-step LS method is proposed. Simulation results demonstrate that the improved algorithm has better performance than the two-step LS method and converges more quickly. Meanwhile, it is robust in different NLOS environments.

The present study reports a rare case of a renal clear cell carcinoma with thyroid and parotid metastases. A 56-year-old female, with a painless, right preauricular mass present for 6 months was referred to Renji Hospital (Shanghai, China). Physical examination revealed a mass of 3×3 cm, which was smooth, firm, immobile and non-tender. There was no accompanying facial weakness. Parotid ultrasonography revealed a hypoechoic mass within the right parotid gland, which was potentially a parotid mixed tumor. In July 2011, the patient underwent a superficial parotidectomy with preservation of the facial nerve. Pathology confirmed as right parotid clear cell carcinoma (metastasis). The patient's relevant medical history included a right radical nephrectomy for renal clear cell carcinoma (clinical stage III) in 2004. Additionally, in 2009, the patient underwent a resection of thyroid metastatic renal cell carcinoma. To the best of our knowledge, no similar case has previously been reported in English-language literature. The present study discusses a case report, and investigates the clinical features and treatment strategy.

According to existing problems in polysaccharide determination methods in new Chinese drug applications, the method suitability, chemical reference selection, components interference and method research were introduced. The author suggests that suitable determination method should be selected according to the structure and property of the polysaccharide, and validated. Some influent factors should be examined to assure the accuracy of the method, such as the stability and using amount of the visualizing reagent, visualizing time, maximum detection wavelength etc. Monosaccharide and other water soluble components should be removed from polysaccharide sample, and suitable reference substance and detection wavelength should be selected. It should pay attention to mutual interference of neutral and acidic saccharide, and use inhibitor to eliminate the interference. Because the slopes of the standard curves are different for different monosaccharide, it is proposed that the types and ratios of the monosaccharide in heteroglycan should be understood, and mixed reference substance solution in the ratio is prepared for determination.

We sought to identify microRNAs that exhibit altered expression in laryngeal squamous cell carcinoma (SCC) and to determine whether microRNA expression is predictive of disease. This study was divided into three steps: (1) The expression of six miRNAs, such as up-regulated miR-223, miR-142-3p, miR-21, miR-16, miR-23a and down-regulated miR-375, was evaluated using total RNA isolated from freshly-frozen primary tumors and non-cancerous laryngeal squamous epithelial tissues and analyzed using quantitative real-time polymerase chain reaction (qRT-PCR). (2) We also investigated the mRNA expression levels of processing elements (RNASEN, DGCR8, and DICER1) that participate in miRNA-biogenesis pathway. (3) We analyzed the relationships between the expression levels of these miRNAs and the clinicopathologic parameters of laryngeal SCC patients. In this study, we found that: (1) A marked difference in the microRNA expression pattern was observed between tumors and non-cancerous tissue. With regard to miRNA-processing elements, the expression level of RNASEN was higher in laryngeal SCC than in normal epithelium (P

To determine the role of JAK-2/STAT-3 signaling pathway in invasion and vasculogenic mimicry of laryngeal squamous cell carcinoma. HEp-2 cells were treated with 1 or 10 μmol/L curcumin and AG490 (the inhibitor of JAK-2) for 48 h, the invasion and vasculogenic mimicry of tumor cells were tested with Transwell chamber test and tube formation experiment. RT-PCR was used to measure the expression of MMP-2 and VEGF. Western blot assay was employed to determine the expression of JAK-2, STAT3, p-STAT3, MMP-2 and VEGF. Compared to control group，there were less tumor cells permeating membrane and less formed tubes after curcumin or AG490 treatment, RT-PCR showed that the expression of MMP-2 and VEGF at mRNA level were decreased (P < 0.01). Western blotting indicated that the expression of JAK-2, p-STAT3, MMP-2 and VEGF at protein levels were decreased (P < 0.01), while that of STAT-3 protein had no difference among each group (P > 0.05). Immunofluorescence staining demonstrated that the expression of eNOS was down-regulated (P < 0.01). Curcumin and AG490 significantly inhibits invasion and vasculogenic mimicry of laryngeal squamous cell carcinoma in vitro, and JAK-2/STAT-3 signaling pathway promotes above processes.

Learning is the major human activity which can make people to accommodate the environment or the society better. The effectiveness of learning is one important research issue in orange technology. The learning effectiveness of nurse education is more important than the other types of educations. In this paper, we proposed a work which develops a simulation-based digital courseware for intramuscular injection training in nurse education, to improve the learning effectiveness of practical nursing care training. The design of courseware is guided by the constructivism. In addition, the scenario simulation and game are involved to enhance the learning motivation. Moreover, the course has been successfully applied on the nursing students in Taiwan.

The dismal outcome of laryngeal squamous cell carcinoma (SCC) patients highlights the need for novel prognostic biomarkers. The involvement of microRNAs in cancer and their potential as biomarkers of diagnosis and prognosis are becoming increasingly appreciated. We sought to identify microRNAs that exhibit altered expression in laryngeal SCC and to determine whether microRNA (miRNA) expression is predictive of disease progression and/or patient survival. The expression of two miRNAs, miR-21 and miR-375, was evaluated using total RNA isolated from freshly-frozen primary tumors and non-cancerous laryngeal squamous epithelial tissues and quantitative real-time polymerase chain reaction (qRT-PCR) analysis. We further analyzed the association between the expression of miRNAs and the clinicopathological features. A marked difference in the microRNA expression pattern was observed between tumors and non-cancerous tissue. MiR-21 and miR-375 were expressed at higher and lower levels, respectively, in the laryngeal SCC samples, compared to the normal samples (p < 0.01 and p < 0.001, respectively). There was no correlation between characteristics such as age, sex, clinical stage, and alcohol use, and the expression level of mir-21. The relative expression of mir-375 in laryngeal SCC was shown to be associated with localization of the tumor in these patients (p = 0.037) and with alcohol use (p < 0.05). Patients with high miR-21 or low miR-375 expression in tumor tissues had poorer prognoses compared to patients with lower miR-21 or higher miR-375 expression. Furthermore, the miR-21/miR-375 expression ratio was highly sensitive (0.94) and specific (0.94) for disease prediction. These data suggest that the pattern of microRNA expression in primary laryngeal SCC tissues is reflective of the disease status and that miR-21 and miR-375 expression levels, in particular, may serve as potential biomarkers with applications in the clinical setting.

Fast-track (FT) has been shown to enhance post-operative recovery. The aim of this study was to compare the effects of FT and traditional nutrition on post-operative rehabilitation, as well as evaluate the feasibility of applying FT in nutrition management of colorectal surgery. A prospective and randomized controlled trial was performed. This study included 464 patients who underwent colorectal surgery. The patients were randomly assigned into an FT group and a traditional group. The nutritional risk screening (NRS 2002) score, post-operative recovery index and surgical complications were compared between the FT and traditional groups. The NRS 2002 score in the FT group was better than the traditional group (p0.05). Serum indicators for nutrition (HGB, ALB, A/G) and immune function (lymphocyte rate [LYMPH%], IgA, and CD4+) in the FT group were superior to those in the traditional group (p0.05) on post-operative day 5. The first time to aerofluxus, defecation, oral intake and ambulation in the FT group was shorter when compared to the traditional group (p0.05). The complication incidence was significantly lower in the FT group than in the traditional group (p0.05). In particular, the occurrence rate of anastomotic leakage was higher in the traditional group than in the FT group (0.5% vs 2.8%, p0.05). Taken together, these data suggest that FT management can improve the nutritional condition and outcomes of colorectal surgical patients.研究证明加速康复外科能够促进手术患者康复。本研究的目的是比较加速康复 外科流程与传统流程下的营养支持对患者术后康复的影响，同时探究加速康复 外科流程在结直肠手术患者营养支持方案中的临床适用性。本研究前瞻性地纳 入464 例结直肠癌手术患者，随机分为加速康复外科流程组(FT 组)和传统流程 组。终点指标为NRS2002，术后康复指标，术后并发症。FT 组NRS2002 评分 低于传统流程组(p0.05)；FT 组血红蛋白，白蛋白，白球比及淋巴细胞比率、 IgA、CD4+等指标在术后第5 天均优于传统流程组(p0.05)；FT 组首次排气、排 便、经口进食及下床活动时间短于传统流程组(p0.05)；FT 组的并发症发生率低 于传统流程组(p0.05)；传统流程组的吻合口瘘发生率高于FT 组(2.8%比上 0.5%，p0.05) 。综上所述，本研究表明加速康复外科能够改善结直肠癌术后患 者的营养状态及临床效果。

A key issue in physical-layer network coding (PLNC) is how to recover the network-coded packet by the relay from the superimposed signals transmitted simultaneously by multiple transmitters. In order to decode correctly, the asynchrony between signals must be perfectly dealt with. That is, symbols transmitted by different transmitters could arrive at the receiver with relative carrier frequency offset (CFO), relative carrier phase offset and different channel fading. In this paper, we propose an algorithm to estimate the relative carrier offset from the PLNC signals, and investigate two decoding schemes, JCNC and M-JCNC, to construct the XORed packet. As shown in the simulation results, the algorithm can efficiently estimate the relative carrier offsets and significantly reduce the SNR penalty due to asynchrony.

To assess the QOL in rectal cancer patients after preventative anal operation and to discuss the influence of age on perceived quality of life.A prospective study of 342 patients with rectal cancer from May 2011 to January 2012 in the gastrointestinal surgery department was randomly selected and divided into the elderly group and the young group, and the differences in their QOL assessed by the questionnaire QLQ-C30, after preventative anal surgery (7 days) were compared.A total of 207 patients met the study criteria and were divided into the elderly group (≥60 years, 107 cases) and the young group (60 years, 100 cases). The incidences of complication with pneumonia (p=0.030), wound infection (p=0.024) and ileus (p=0.036) were higher in the elderly group. In the QLQ-C30 assessment, the physical function in the elderly group was worse (p=0.004). Additionally, the fatigue of symptom, sleep disturbance and poor appetite (p0.001), and global quality of life (p=0.002) were worse in the elderly group too. However, the role and emotional function were better in the elderly group (p0.001).The QOL in elderly patients is generally worse than young patients, and a targeted approach should be used.

To apply peripherally inserted central catheter (PICC) in critically ill neonates who require long-term parenteral nutrition.A retrospective review of 98 critically ill neonates who had a PICC inserted and received long-term parenteral nutrition from March to December 2011 was performed.The PICC insertion succeeded in 74.5% (73/98) of the cases at the first attempt. The catheter remained for an average of (19.7 +/- 2.0) days. Of the 98 cases, 92 underwent planned extubation after enteral nutrition was fully established; 10 developed complications within the follow-up period of 956 days. The PICC-associated complications occurred at a rate of 10. 5 per 1000 catheter-days, including infection (n=0), phlebitis (n=1), accidental dislodgement (n=3), catheter occlusion (n=3), and hemorrhage in puncture point (n=3).PICC can be used as a safe venous access for critically ill neonates for long-term parenteral nutrition. PICC-associated complications can be reduced through improving nursing skills, especially for catheter-related infection.

The genetic diversity of 85 isolates of Phytophthora infestans collected in 2007 from Gansu province in China was determined and compared with 21 isolates collected before 2004. Among them, 70 belonged to the A1 mating type and 15 were self-fertile (SF). The mitochondrial DNA haplotypes revealed both Ia (25%) and IIa (75%) haplotypes. Metalaxyl resistance occurred with high frequency (54%) in Gansu. Simple sequence repeat (SSR) genotyping revealed 26 genotypes (13 from the Tianshui region) among the 85 isolates, and 18 genotypes among the 21 isolates collected before 2004, without overlap in genotypes detected in the two groups. Cluster analysis showed clear subdivisions within the different mating type isolates. Among Gansu's isolates, Nei's and Shannon's diversity indices were highest in isolates collected in Tianshui where both A1 and SF isolates were found. Analysis of molecular variance of isolates from Gansu indicated that 51% and 49% of the variance was explained by within-area and among-area variance, respectively. The results suggest that the occurrence of SF isolates increases the risk of sexual reproduction, the formation of oospore as initial inocula in the field, and affects the genotypic diversity in the population.