@@

Objective To explore the training model of nurse specialists in geriatric and study its practical effect. Methods Forty-two nurse specialist participating in the training courses in geriatrics were enrolled in the study. The training was divided into 2 stages: the first one was for 1 month theoretical study together with 2 months clinical practice; the second was for 9 months clinical research on a specific topic. The examinations were done both at the two stages. They were interviewed on their views on theoretical study and internship at the end of first stage. Results The degree of satisfaction with the theoretical course was 91.6%, and the satisfaction degree of internship was 92.9%. The average scores at the end of the final examination and graduation examination were more than 85 points. Toally they were funded with 4 muncipal scientific research programs and 3 municipal patents, and published 9 academic papers. Conclusions The standardized training model is accessible for the nursing because of the training content and form. This model is feasible and effective, and it is worth applying and popularizing in the training of nurse specialist in the future.

Objective To investigate the correlation between retraction phenomenon on the coronal planes obtained by an automated breast volume scanner ABVS and biological behaviors of breast cancer Methods Two hundred and eighty-eight female patients with 293 pathologically proven breast cancers were included in this study All of them underwent ABVS examinations before surgery Retraction phenomenon on the coronal planes was evaluated retrospectively Correlation between retraction phenomenon and hormone receptor HR human epidermal growth factor receptor 2 HER-2 Ki-67 molecular subtypes histologic type histologic grade lymph node status lesion size and patient age were evaluated by univariate logistic regression analysis Above significant variables were then enrolled in multivariate logistic regression analysis to select independent risk factors for retraction phenomenon Results By univariate logistic regression analysis Luminal A subtype odds radio OR =8 395 P <0 001 HR positive OR=4 876 P <0 001 HER-2 negative OR = 4 407 P < 0 001 lower expression of Ki-67 OR = 3 716 P <0 001 lower grade OR=3 574 P <0 001 lymph node invasion OR=2 053 P =0 004 and smaller lesion OR=1 762 P =0 033 were risk factors for retraction phenomenon while histologic type P =0 3 1 8 and patient age P = 0 612 were not By multivariate logistic regression analysis Luminal A subtype OR=9 877 P <0 001 lower grade OR=3 573 P <0 001 and lymph node invasion OR=2 730 P = 0 004 were independent risk factors for retraction phenomenon among which Luminal A subtype was the strongest one Conclusions Retraction phenomenon on the coronal planes obtained by ABVS is closely related with Luminal A subtype and may be an imaging feature of less aggressive behaviors of breast cancer.

Objective To explore the effect of competency based education (CBE) in the nursing training of GNS (gerontological nurse specialist).Method The CBE was used in the nursing training of GNS and the differences in knowledge and nursing skills,ability in nursing training,and aiblity in organization and scienticific research.Result After the training,the GSN was above 80 in knowledge and skills,ability in nursing training,ability in organization and scientific research and self-assessment better than that before training (P＜0.05).Conclusion The CBE for the nursing training can upgrade the abilities in the GSN in the aspects of knowledge and skills,nursing training,organization and scientific research so that they become more competent in the gerontological nursing.

Objective To investigate the expressions of NBS1 mRNA and protein in the salivary gland of irradiated rats and explore the role of NBS1 in the repair of radiation injury of salivary gland epithelial cells.Methods Eighty rats were randomly divided into two groups for radiation and control (n =40 each).The rats were fractionally exposed to 3 Gy of 60Co γ-rays once in two days,leading to an accumulation dose of 3,6,9,12,15 Gy.The sham-irradiated controls were anesthetized in parallel but without irradiation.After 2-4 h of irradiation,the rats were sacrificed,IHC and RT-PCR were used to detect the expressions of NBS1 protein and mRNA in parotid and submandibular glands,and the ultra-structural changes in the glands were observed by a transmission electron microscopy.Results After irradiation,the salivary glands became atrophy and the parotid gland cells were damaged more serious than the submandibular gland cells.Compared with the controls,with the groups of dose,at 9,12,15 Gy in parotid gland (t =7.10,17.93,20.86,P ＜ 0.05),at 12,15 Gy in the submandibular gland (t =3.13,7.53,P ＜0.05),the expression of NBS1 mRNA was reduced.With the groups of dose at 9,12,15 Gy in paretid gland (t =4.29,17.91,91.29,P ＜ 0.05 ),the dose at 12,15 Gy in submandibular gland ( t =4.61,11.84,P＜0.05),the expression of NBS1 protein in serous cells,and the dose at 12,15 Gy in parotid gland ductal epithelial cell ( t =3.09,5.62,P ＜ 0.05) were reduced.But in the ductal epithelial cells as well as muoass cells in the submandibualr gland were steadily.Conclusions After irradiation,NBS1 at both protein and mRNA levels was dropped in the salivary gland of rats,which might contribute to the repair of radiation injury of salivary gland.

Objective To investigate the expression of MUC-1 and CD44v6 in breast carcinoma and its diagnostic value.Methods 93 cases of breast carcinoma were examined by immunohistochemical method for MUC-1 and CD44v6.Results The positive rates of MUC-1 and CD44v6 were 71.0 ％ (66/93) and 63.4 ％ (59/93),respectively.The expression of MUC-1 in breast carcinoma was correlated with histologic differentiation (14.3 ％,69.4 ％,100.0 ％) and lymph node metastasis (22.9 ％,100.0 ％) (x2 =36.147,63.047,both P ＜ 0.0001),but had no relationship with the type of breast carcinoma,tumor clinical stages,and tumor size (all P ＞ 0.05).The expression of CD44v6 in breast carcinoma was correlated with tumor clinical stages (6.3 ％,64.6 ％,93.1％) and lymphnode metastasis (20.0 ％,89.7 ％) (x2 =9.507,45.662,both P＜0.05),but had no relationship with tumor type,tumor clinical stages and tumor size (all P ＞ 0.05).Conclusion MUC-1 and CD44v6 may play important roles in the development of breast carcinoma and the biologic behavior of breast carcinoma may be closely related with over expression of MUC-1 and CD44v6 protein.MUC-1 and CD44v6 can be used to predict the prognosis and direct the treatment of breast carcinoma.

This article brieves the significance of the quality of medical records in the mode of basic medical insurance and argues that five aspects concerning quality control should be brought into focus on coordination with the auditing requirements on the medical records put forward by the medical insurance department.The faculty should be educated to become quality-conscious and legality-conscious and the awareness of medical records quality-profit should be imbedded into their minds.The quality control standards of medical records should be set up and the system of quality control,feedback,rewards and punishment should be improved.The monitoring and evaluation by the medical insurance department should be treasured and mutual communication should be enforced to further improve the quality of medical records.

Objective:To investigate the diagnostic value of pelvic floor ultrasound combined with electromyography physiological parameters for postpartum stress urinary incontinence(SUI)of different degrees and pelvic floor function of primipara.Methods:A total of 160 SUI patients who admitted to Yan'an hospital of Kunming City from January 2019 to January 2022 were selected,and they were divided into abnormal group(110 cases)and normal group(50 cases)according to pelvic floor function(the muscle voltage values of different muscle fibers).The SUI was graded according to the Chinese Guidelines for Diagnosis of Urological Diseases and the International Incontinence Advisory Committee's Incontinence Questionnaire(ICI-Q-SF).The posterior horn(α)of bladder and urethra at rest,the displacements of the bladder neck on y-axis(△y)and x-axis(△x)after the rest to the fatigue action,the proximal urethral rotation angle after the rest to the fatigue action(γ),the posterior horn of bladder and urethra(β)after the fatigue action were observed.The electromyography was used to draw and record the pelvic floor myoelectric activity signals of the patients of two groups at five stages(pre baseline rest period,class II muscle fiber systole period,class II and I muscle fiber systole period,class I muscle fiber systole period and post baseline rest period).And then,the muscle voltage values of different muscle fibers on the surface of pelvic floor were quantified.Results:There was no statistically significant difference in Δ x between patients with postpartum SUI of different degrees.There were significant differences in △y,α,β and γ between patients with postpartum SUI of different degrees(F=7.162,7.655,14.998,2.758,P<0.05).The differences of the means of muscle voltages of pre and post baseline rest period,and class I muscle fiber systole period among patients with postpartum SUI of different degrees were not significant.The differences of the means of muscle voltages of class II,and the class II and I muscle fiber systole period among patients with postpartum SUI of different degrees were significant(F=12.062,24.501,P<0.05),respectively.There was no statistically significant difference in △x between the two groups.The △y,α,β and γ of abnormal group were significantly higher than those of normal group(t=8.991,8.691,9.389,27.552,P<0.05),respectively.There were no statistically significant differences in the means of muscle voltage values of the pre and post baseline rest period,and class I muscle fibers systole period between the two groups.The means of muscle voltage values of class II,and class II and I muscle fibers systole period in the abnormal group was significantly higher than them in the normal group(t=9.613,14.452,P<0.05),respectively.The sensitivities of △y,α,β,γ,the means of class II muscle fibers systole period,and the means of class II and I muscle fibers systole period of pelvic floor ultrasound and electromyography physiological parameters were respectively 71.60%,79.40%,81.40%,91.20%,83.30%and 82.40%,and the specificities of them were respectively 41.40%,37.90%,37.90%,60.30%,41.40%,and 44.80%in diagnosing postpartum SUI of different degrees of primipara.The sensitivity and specificity of the combined diagnosis of them were respectively 92.20%and 82.80%in diagnosing postpartum SUI of different degrees of primipara.The sensitivities of △y,α,β,γ,the means of class II muscle fibers systole period,and the means of class II and I muscle fibers systole period of pelvic floor ultrasound and electromyography physiological parameters were respectively 79.10%,77.30%,88.20%,89.10%,77.30%,87.30%,and the specificities of them were respectively 64.00%,64.00%,52.00%,46.00%,70.00%and 66.00%in diagnosing pelvic floor function of primipara.The sensitivity and specificity of the combined diagnosis were respectively 98.20%and 80.00%in diagnosing pelvic floor function of primipara.Conclusion:Pelvic floor electromyography physiological parameters and pelvic floor ultrasonic parameters have a certain value in diagnosing postpartum SUI of different degrees and pelvic floor function,and the value of the combined diagnosis of them is higher.

Objective To evaluate the effectiveness of automated breast volume scanner(ABVS) and magnetic resonance imaging(MRI) in the detection and diagnosis of breast cancer and to assess the value of these modalities as well as the joint use of the two.Methods In this study,a total of 50 breast lesions in 37 patients proved by surgery and pathology were included.Before operation,all patients were underwent both ABVS and dynamic contrast-enhanced (DCE-MRI) examinations,and classified into groups according to BI-RADS classification.Then the effectiveness of the two examinations were contrasted,the image features on the two techniques were analyzed,and their differential diagnosis in benign and malignant breast lesions were compared.Results The sensitivity,specificity,accuracy,positive predictive value (PPV) and negative predictive value(NPV) of ABVS and MRI for the diagnosis of breast cancer were 91.67％ and 95.83％,88.46％ and 80.77％,90.00％ and 88.00％,88.00％ and 82.14％,92.00％ and 95.45％,respectively,and there was no statistical difference between ABVS and MRI(P ＞0.05);The sensitivity and specificity of the combination of the two were 99.65％ and 97.78％,respectively.The difference of the ABVS coronal features and MRI dynamic enhancement curve types between malignant breast lesions and the benign were statistically significant (P ＜ 0.05).Conclusions Both ABVS and MRI are effective to diagnose breast cancer well,while the combination of the two can improve the diagnosis more accurately.

Objective To explore the image performance of mucinous breast carcinoma( MBC) on automated breast volume scanner ( ABVS ) and its pathologic features ,for the purpose of improving the recognition of this disease on ABVS ,as well as diagnostic ability . Methods Retrospectively analyzed the sonogram and pathological data of 17 patients with 18 MBC lesions that included 9 PMBC ( pure mucinous breast carcinoma) and 9 MMBC( mixed mucinous breast carcinoma) ,all patients were examined by ABVS before operation and confirmed by pathology . Results Luminal A was the main molecular subtype of MBC ,as well as rarely lymph node metastases;The image of the MBC on ABVS mainly showed a round like or irregular mass ,isoechoic or slightly lower with posterior acoustic enhancement ,and clearly edge with microlobulated or angular ;While on the coronal plane ,it might presented unsmoothed contour ,retraction phenomenon and expansive growth pattern like a spherical nodular;The image characteristics of the PMBC and MMBC lesions on ABVS had no statistical difference( P > 0 .05) ,but the PMBC often performed isoechoic mass with clearly marge ,in contrast , the MMBC usually performed hypoechoic mass with indistinct and angular edge ,and the malignant image features on the coronal plane . Conclusions The three vertical sections of ABVS are beneficial to observe the morphological features of MBC completely ,which can help to identify it from the benign lesions ,reduce misdiagnosis ,and provide some guidance for MBC surgical treatment in the early stage .