Objective To develop an evidence-based community extended care model for patients with asthma.Methods Mixed research methods were applied to integrate best evidences:80 literatures were included in systemic review; 394 medical records were analyzed; 112 nurses admitted a test and a questionnaire to assess their competence on asthma care; clinical observation to both hospital and community centers were conducted; 6 multidisciplinary experts were consulted; and 100 patients admitted a questionnaire on patient needs and 17 of them were further interviewed.Results The nursing care model with the feature of hospital and community health service center collaborating to provide extended care for patients with asthma was established.Conclusions The development of a nursing care model for practice should be based on the current best evidence generating from the best research evidence,professional judgment on clinical practice requirement and patients' needs.

Objective Ultrasonongraphy and mammography were employed to estimate the pathological response of patients with breast cancer ,who had been accepted neoadjuvant chemotherapy .According to the pres-ent study ,we can provide additional evidence on therapeutic effect on evaluation of neoadjuvant chemotherapy and better selection of regime for breast cancer .Methods One hundred Thirty-six patients who were previously dia-gosed diagnosed with primary breast cancer were included in this study .All subjects were female with clearly pathological detection and accepted neoadjuvant chemotherapy about 4 to 6 cycles regardless of regime .The resid-ual tumor size was evaluated by mammography and /or ultrasonography before operation .Tumor size measured by image were compared with pathological size to predicting the accuracy of two types of imaging .Results Forty one of 116 records were undetectable imaging by mammogram and 19 of 106 records were undetectable by ultrasound which were considered a pathologic complete response .Sixty one(62.24%)of 98 patients who were accepted de-tection of mammogram and ultrasound would be predicted the tumor size by mammogram .Eighty three(84.69%) of 98 patients would be predicted the residual tumor by ultrasound .31 and 59 were accurately evaluated by mam-mogram and ultrasound , respectively .The result indicated that ultrasound was more accurate than mammogram (60.20%vs.31.63%,χ2 =16.11,P<0.001).The correctly rate was 92.85%(91/98)for ultrasound and 68. 37%(67/98) for mammogram.The diagnosis efficiency of ultrasound was more higher than mammogram ,even though there was no different significance between the two methods (χ2 =2.028,P=0.164).Conclusion Ultra-sonongraphy in estimating the residual tumor size after neoadjuvant chemotherapy of patients with breast cancer displays more accurately than mammography .

Objective We reported the rehabilitative nursing points of patients with pectoralis minor muscle transplantation for recovery of thumb oppositional function. Methods We selected 10 patients who underwent pectoralis minor muscle transplantation for recovery of thumb oppositional function and gave them perfect preoperative examination and psychological nursing. We also implemented rigorous monitoring postoperation and auxiliary electric stimulation and functional exercises. The emphasis was put on the exercise of thumb oppositional function. Results The thumb oppositional function of all the ten patients recovered. The myodynamia reached level 4 and the shape of thenar was satisfying after 6 to 12 months of follow-up visit. Conclusions Sufficient preoperative psychological nursing and effective postoperative rehabilitative treatment had pivotal significance for the success of operation and the recovery of thumb oppositional function.

Objective To observe the influence of the short effect antihypertension drugs- nifedipine and medial effect antihypertension drugs- extended release nifedipine on the blood pressure variability (BPV) in essential hypertension(EH). Methods Twenty-five EH patients were underwent 24-hour noninvasive ambulatory blood pressure monitoring (ABPM) and observed their BPV respectively before taking drugs, after taking nifedipine and extended release nifedipine. Meantime,25 normotensive controls (NC) were observed. Results (1)BPV in EH group was higher than that in controlled group and the severer the rise of blood pressure, the more obvious the increase of BPV (P 0.05). Conclusions Nifedipine could increase BPV but extended release nifedipine did not change BPV while they decreased blood pressure. Effect of extended release nifedipine was better than nifedipine in decreasing blood pressure.

BACKGROUNDTo evaluate the relationship between the CT signs and p53 protein abnormal expression in peripheral lung cancer.

METHODSFifty-two patients with pulmonary masses underwent CT scanning before operation. Immunohistochemistry was used to detect p53 protein expression in pulmonary specimens obtained by operation.

RESULTSThere were significant differences among p53 protein expression and differentiation of lung cancer cell, size of the cancer, tumor appearance, pleura excavation and lymphatic metastasis.

CONCLUSIONSp53 gene mutation indicates the biological behavior of lung cancer and might influence the morphological feature of lung cancer, which remarkably relates to CT signs of lung cancer.

Objective:To explore the effect of a new teaching mode, which includes bridge-in, outcome, pre-test, participation, post-test and summary (BOPPPS), on the online teaching of radiobiology related knowledge for cancer radiotherapy practitioners.Methods:Taking the cell survival curve, cell cycle and radiosensitivity as examples, the radiotherapy practitioners in multiple university-affiliated hospitals were organized to carry out a multicenter prospective randomized control study. All practitioners were randomly divided into BOPPPS group and control group. The courses for BOPPPS group were designed as an online classroom, consisting of pre-class preparation, online teaching and post-class stages. The online teaching stage included video viewing, basic knowledge learning, literature discussion, group discussion and others. The control group employed the traditional teaching mode. The χ2 test was used to compare the consistency of general conditions between the two groups, and nonparametric test was used to compare the differences in scores between two or more groups. Results:The score of the pre-class test was 58.56 ± 0.99. Post-class average score for BOPPPS group was 85.48±0.85 and for control group 77.79±1.10, with the former being higher 7.69 ( Z=5.31, P<0.001) than the latter. The average answer time was (296.62±15.40) s for BOPPPS group and (386.41±21.27) s for control group, with the former being shorter 89.79 s ( Z=3.34, P=0.001) than latter. Subgroup analysis shown that the scores of BOPPPS group were significantly rising, regardless of whether or not the students had studied radiobiology courses. Among the students who have not studied these courses, the scores were rising greatly. Moreover, From the analysis of different positions, it was found that both the scores of BOPPPS group and control group have risen, especially for doctors, deputy chief doctors, physicists and technicians. There were also statistically differences between different degrees, with significantly rise in scores for undergraduate and doctoral students ( Z=3.64, 4.18, P<0.001). Conclusions:The flexible application of BOPPPS teaching mode to the online education of such boring disciplines, like radiobiology, is of great significance to raise the theoretical basis of radiotherapy practitioners.