Objective To develop a pathway management system for nucleus-related special service recuperation to enhance efficiency and extend function in the pathway management.Methods The system was developed on the basis of military sanatorium information management platform,and constructed with modular and object-oriented method,B/S mode,Oracle 8 database and Java programming languages.Results The system solved the problems of paper pathway management in time consumption,supervision,statistics,regulation and etc.Conclusion The system contributes to the standardization,convenience and precision of the pathway management for nucleus-related special service recuperation,and thus is worthy promoting in the nucleus-related military sanatorium.

Objective: To evaluate the effect of Triangle hierarchical management among community patients with hypertension, so as to provide insights into the improvements of standardized hypertension management. Methods: Patients with newly diagnosed hypertension from 2 community health service centers in Qiantang District of Hangzhou City by the end of 2020 were randomly assigned to the conventional group and the Triangle group. Patients in the conventional group were given health management services according to the requirements of basic public health service standard for one year, while patients in the Triangle group were given Triangle hierarchical management. The blood pressure, self-management behaviors, treatment compliance, smoking, alcohol consumption and exercise were collected using the self-management behavior scale, treatment compliance scale and self-designed questionnaires, and were compared before and after intervention with analysis of covariance and generalized estimation equations. Results: Totally 200 patients with hypertension were recruited, including 100 patients in the conventional group and 100 patients in the Triangle group. There were no significant differences between the two groups before implementation of interventions in terms of gender, age, educational level or occupation (P>0.05). The reduction in blood pressure, increase in the score of treatment, diet, exercise and living habitat management and the total score of self-management behaviors, increase in the score of adherence to medication regimens, daily living management behaviors, smoking and alcohol consumption preference and the total score of treatment compliance, and increase in the number of patients with normal standard of quitting smoking, quitting alcohol consumption, exercise and blood pressure were significantly higher in the Triangle group than in the conventional group after intervention (P<0.05). Conclusions Triangle hierarchical management may increase the treatment compliance, improve the self-management behavior and facilitate hypertension control among hypertensive patients, which may be popularized for health management among community patients with hypertension.

Objective To investigate the expression and significance of P-glycoprotein in triple negative breast cancer (TNBC).Methods One hundred and seventy-one cases of breast invasive ductal carcinoma in our hospital were retrospectively analyzed.According to the expression of ER,PR,Her2,we categorized those paitents into triple negative breast cancer group (58 cases) and non triple negative breast cancer group (113 cases).The different expression of P-glycoprotein was detected by immunohistochemieal technology in two groups.We analyzed the relationship between the expression of P-glycoprotein and clinical and pathological features in TNBC,and investigated the effect of P-gp on the rate of recurrence and metastasis in 3 years.Results (1) The expression of P-gp in TN BC was significantly higher than that of NTNBC (53.45％ vs 37.17％) (P ＜ 0.05).(2) The expression of P-gp in TNBC was associated with TNM stage,histological grade,lymph node status and vascular invasion (P ＜ 0.05),but not with age and size of the tumor (P ＞ 0.05).(3) The rate of recurrence and metastasis in positive expression of P-gp in TNBC was 58.06％,which was significantly higher than negative expression of P-gp in TNBC (44.44％),but no statistically significant was found(P ＞ 0.05).Survival analysis showed that P-glycoprotein expression had no relationshiop to 3-year cumulative survival rate (P =0.161 ＞ 0.05).Conclusions The positive expression of P-gp in TNBC is associated with drug resistance and metastasis,but has no obvious significance to recurrence and metastasis,so as to 3-year cumulative survival rate.

OBJECTIVETo investigate the clinical significance of phosphorylated caspase-8 by Src in patients with operable non-small cell lung cancer.

METHODSSrc and caspase-8 expressions were tested using immunohistochemistry in non-small cell lung cancer tissues and control lung tissues. The expression of phosphorylated caspase-8 at 380 tyrosine by Src was detected using Western blotting. The disease-free survival (DFS) of patients positive and negative for phosphorylated caspase-8 was analyzed with Kaplan-Meire survival curve.

RESULTSNo significant difference was found in the positivity rate of caspase-8 or Src between the cancer tissues and control lung tissues (76.3% vs 83.3%, P>0.05; 70.1% vs 66.4%, P>0.05). All the patients with Casp8- and Src-positive cancers were positive for phosphoryalted caspase-8, whose expression rate was significantly higher in the cancer tissues than in the paired control lung tissues (52.4% vs 7.1%, P<0.05). The 2-year DFS was significantly higher in patients negative for phosphorylated caspase-8 than in the positive patients (32.0% vs 60.3%, P<0.05).

CONCLUSIONPhosphorylated caspase-8 may serve as a predictor for a poorer DFS in patients with operable non-small cell lung cancer.

Blotting, Western ; Carcinoma, Non-Small-Cell Lung ; metabolism ; Caspase 8 ; metabolism ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Lung Neoplasms ; metabolism ; Phosphorylation

To evaluate the sealing potential of self-designed root canal filling material made of calcium phosphate cement (alpha-TCP/TTCP, CPC), the apices of root canals of six adult dogs were purposely perforated and enlarged up to the No 40 instrument. Then CPC was used to fill the root canal. Mean while either calcium hydroxide (Ca(OH)2) paste or hydroxyapatite (HA) paste was used as control. The animals were killed at 4, 12, 20 weeks postoperatively. The different materials about ways of apical closure, restoration periapocal tissues and adaptability to the dentinal surface were observed by histomorphology and scanning electron microscopic. This study revealed that CPC had excellent biocompatibility and adaptability to the dentinal wall. Its osteoconduction can promote the formation of calcific barriers and healing of periapical tissue. The apex can be closed completely. Compared with the control pastes it has advantages of ease of manipulation and better sealing capability. The results showed that CPC could be used as a root canal filling material for pupless teeth with open apex and destructive periapical tissue.
Animals ; Calcium Phosphates ; pharmacology ; Dogs ; Root Canal Filling Materials ; pharmacology ; Root Canal Therapy

Objective To analyze of the effect of artificial lengthening femoral head replacement in elderly patients with stage Ⅰ of unstable femoral intertrochanteric fracture.Methods 203 patients with stage Ⅰ of unstable femoral intertrochanteric fracture were selected as the research object,and they were taken artificial lengthening femoral head replacement,among which 65caese were male,female in 138 cases.The Harris scoring,SF-36,VAS pain scores on admission,2 weeks after operation,postoperative follow-up limb were counted,and the pain of the affected limb and the hip scores were compared amond 3 time periods.Results All 203 cases of senile patients with follow-up,average operation time was 83.64 minutes,the intraoperative blood loss was 355.41mL.The curative effect was evaluated according to the Harris score,SF-36 and VAS pain scoring criteria,and the Harris scores of the affected limbs at admission,at 2 weeks after the operation and after the follow-up were (28.26 ± 5.50) points,(68.26 ±5.50) points,(93.13 ± 5.31) points,respectively,the differences were statistically significant (t =-71.27,-1 397.55,-46.07,all P ＜ 0.01);The VAS pain scores were (8.19 ± 0.48) points,(3.53 ± 0.71) points,(0.23 ± 0.42) points,respectively,the differences were statistically significant (t =88.06,324.17,60.84,all P ＜ 0.01).The sf-36 scores:physiological [(8.35 ± 1.24) points,(15.23 ± 2.17) points,(19.21 ± 2.12) points],social/family [(7.01 ±1.13) points,(14.12 ± 2.12) points,(19.85 ± 2.24) points],emotional [(4.83 ± 1.01) points,(10.12 ±1.22)points,(14.87 ± 1.32) points],function [(6.35 ± 1.21) points,(13.67 ± 1.87) points,(16.81 ±2.12) points],additional focus [(8.85 ± 1.45) points,(16.38 ± 2.12) points,(20.21 ± 2.42) points],total quality of life [(47.35 ± 4.76) points,(74.69 ± 5.87) points,(89.21 ± 6.12) points],the differences were statistically significant(-39.77,-62.92,-20.21,-44.87,-71.89,-26.79,-45.04,-89.01,-38.25,-45.79,-63.41,-15.29,-45.20,-60.39,-17.54,-52.12,-76.49,-22.58,all P＜0.O1).Conclusion Artificial lengthening femoral head replacement in elderly patients with stage Ⅰ of unstable femoral intertrochanteric fracture has good clinical effect,intraoperative high safety,less postoperative complications,postoperative limb functional recovery is good,and it is worthy of clinical promotion and application.

Abiraterone is commonly used as a targeted drug for the treatment of prostate cancer， which commonly causes adverse drug reactions （ADR）， including abnormal liver function， fatigue， nausea and edema， etc. This study reports a 78-year-old man with a history of hepatitis B and liver cirrhosis after prostate cancer resection who was admitted to the First Affiliated Hospital of Henan University of Chinese Medicine. The patient received abiraterone treatment 1 month before admission and developed gastrointestinal symptoms 3 weeks after the treatment and worsened at 4th week with yellowing of the skin， sclera and urine. Unfortunately， the patient died after 5 weeks of abiraterone treatment （1 week after admission）. Based on test and examination results， the patient was diagnosed with acute-on-chronic liver failure （ACLF）. This paper analyzes the patient’s medical history and the relevant treatment in detail. It is evaluated that ACLF and abiraterone are “probably” related based on Naranjo ADR Probability Scale， suggesting abiraterone may induce severe ADR of liver failure in patients with chronic liver diseases such as cirrhosis. These patients should be monitored dynamically for changes in liver function and treated prophylactically with liver-protective drugs if necessary.

Objective To prepare berberine hydrochloride nanoemulsion, optimize its formulation composition and preparation process, and investigate its in vitro characteristics. Methods BBR-NE was prepared by water drop addition and pseudo-ternary phase diagram was drawn. The formulation of NE was optimized by central composite design-response surface methodology to choose the optimal formulation composition. The particle size, potential and appearance of the prepared BBR-NE were characterized. Results The optimal prescription of BBR-NE was determined as the oil phase Capryol 90 accounted for 32.84% of the system, the surfactant Tween-80 accounted for 33.90%, the co-surfactant 1,2-propylene glycol accounted for 16.95%, and water relative system accounted for 15.25%. The prepared NE was clear and transparent in appearance, regular in shape and uniform in size, with an average particle diameter of (68.85±8) nm, polydiseperse index of (0.245±0.03) and drug loading of 0.83 mg/g. The in vitro drug release results of NE showed that the in vitro drug release behavior was passive diffusion, which had a certain slow releasing effect and met the first-order release equation. Conclusion The BBR-NE can provide a new dosage form for the clinical use of berberine.

BACKGROUND: Hepatectomy for hepatocellular carcinoma (HCC) beyond the Milan criteria is shown to be beneficial. However, a high rate of post-operative HCC recurrence hinders the long-term survival of the patients. This study aimed to investigate and compare the impacts of tenofovir (TDF) and entecavir (ETV) on the recurrence of hepatitis B viral (HBV)-related HCC beyond the Milan criteria. METHODS: Data pertaining to 1532 patients who underwent hepatectomy and received antiviral therapy between January 2014 and January 2019 were collected from five centers. Recurrence-free survival (RFS) analysis was performed using the Kaplan-Meier method. Cox proportional hazards regression analysis was performed to determine prognostic factors for HCC recurrence. RESULTS: The analysis incorporates 595 HBV-related HCC patients. The overall 5-year RFS was 21.3%. Among them, 533 and 62 patients received ETV and TDF treatment, respectively. The 1-, 3-, and 5-year RFS rates were 46.3%, 27.4%, and 19.6%, respectively, in the ETV group compared with 65.1%, 41.8%, and 37.2%, respectively, in the TDF group (P < 0.001). Multivariate analysis showed that TDF treatment (hazard ratio [HR]: 0.604, P = 0.005), cirrhosis (HR: 1.557, P = 0.004), tumor size (HR: 1.037, P = 0.008), microvascular invasion (MVI) (HR: 1.403, P = 0.002), portal vein tumor thrombus (PVTT) (HR: 1.358, P = 0.012), capsular invasion (HR: 1.228, P = 0.040), and creatinine levels (CREA) (HR: 0.993, P = 0.031) were statistically significant prognostic factors associated with RFS. CONCLUSIONS Patients with HCC beyond the Milan criteria exhibited a high rate of HCC recurrence after hepatectomy. Compared to the ETV therapy, TDF administration significantly lowered the risk of HCC recurrence.
Antiviral Agents/therapeutic use* ; Carcinoma, Hepatocellular/surgery* ; Guanine/analogs & derivatives* ; Hepatectomy ; Hepatitis B virus ; Hepatitis B, Chronic/drug therapy* ; Humans ; Liver Neoplasms/surgery* ; Retrospective Studies ; Tenofovir/therapeutic use*

OBJECTIVETo study the high risk factors of allergen sensitization among 1-16 years old children with allergic rhinitis (AR) symptoms.

METHODSMedical history was collected from 518 children with AR symptoms aged 1 to 16 years old between April 2011 and November 2012, including five aspects:basic information, disease characteristics, associated with other allergic diseases, growth and development history and genetic history and so on. The allergens were determined by UniCAP 100 system. The high risk factors of allergen sensitization (sIgE ≥ grade III) among 1-16 years old children with AR symptoms were analyzed. The data processing and statistical analysis were conducted by SPSS 17.0 software.

RESULTSThree hundred and thirty of 518 patients (63.7%) could be diagnosed as AR. The primary allergen was mixed fungal (52.4%). The highest percentage of allergen sIgE ≥ grade III accounted for the corresponding allergen positive cases was 71.1% (mixed fungal). Single factor analysis of clinical characteristics in the groups of AR and non AR showed that the history of months(χ(2) = -3.591), concomitant allergic conjunctivitis (χ(2) = 12.325) and cats or dogs at home (χ(2) = 5.615) were statistically significant between the two groups (all P < 0.05).In children with AR, single factor analysis of clinical characteristics in the groups of whether positive allergen level ≥ grade III showed that the concomitant asthma(χ(2) = 4.097), breastfeeding(χ(2) = 4.186), the housing situation (χ(2) = 4.360) and the bedroom toward (χ(2) = 4.656) were statistically significant between the two groups (all P < 0.05). In children with AR, single factor analysis of clinical characteristics in different age groups showed that the history of months(χ(2) = 64.999), concomitant eczema (χ(2) = 24.056), concomitant insect bite dermatitis (χ(2) = 9.148), cats or dogs at home (χ(2) = 8.529) and mother suffered from AR (χ(2) = 9.565) were statistically significant in different age groups (all P < 0.05).

CONCLUSIONThe study revealed that the longer of history, concomitant allergic conjunctivitis and cats or dogs at home are risk factors for AR;In children with AR, not breastfeeding and the bedroom toward back are risk factors for inhalation allergen sIgE ≥ gradeIII.

Adolescent ; Allergens ; immunology ; Animals ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulin E ; immunology ; Infant ; Male ; Pets ; Rhinitis, Allergic ; etiology ; immunology ; Risk Factors ; Skin Tests