Based on the performance status quo of the deficiency of medical informing duty,this paper analyzed the causes,from the respects of system,management,medical side,patient side,legal,cultural and ethical factors.

Objective To explore the coping styles and family environment in patients with depression.Methods 90 patients with depression were evaluated with CSQ and FES-CV.Results There were significant differences in the family environment between depression group and normal control group(P＜0.01).The factor scores of seeking-help and solving question in depression group positively correlated with the factor scores of family intimacy and success(r=0.29,0.32,0.27,0.31,P＜0.05).The factor score of self-accusation in depression group negatively correlated with the factor score of affection expression(r=-0.27,P＜0.05).Conclusion The coping styles are associated to family environment in patients with depression.

Nurses play an important role in promoting asthma control. In order to improve the quality of nursing practice for adult asthma controlling, Registered Nurse' s Association of Ontario (RNAO) integrated the latest evidence and published the best practice guideline of Adult Asthma Care: Promoting Control of Asthma (Second Edition) in 2017. This article mainly introduces the development, application scope, main content, quality evaluation and subsidiary information of the guide.

High density lipoprotein cholesterol ( HDL-C) has received extensive attention because of its cardiovascular protective effects.Recent studies showed that HDL could promote reverse cholesterol transport ( RCT ) , be anti-inflammatory and antioxidant, and induce angiogenesis. Apolipoptrotein A-I (apoA-I), the most abundant protein of HDL, plays a pivotal role in the HDL mediated-functional activities.Short peptides based on the amphiphilic alpha helix structure of apoA-I have been designed and aimed at imitating the function of apoA-I.The function and metabolism of these mimetic peptides depend on their amino acids component and sequence , and have been proved to exert protection in against cardiovascular disease , infection, inflammation and oxidative damage, metabolic syndrome and tumor.Clinical trials confirmed their benefits, but high cost put them out of the practical applications..

A novel fluorescence homogeneous biosensing strategy was developed for simple, rapid and sensitive detection of melamine in milk by using the polythymine oligonucleotide T24 and SYBR Green Ⅰ. In the absence of melamine, the fluorescence of SYBR Green Ⅰ was weak. The interactions between the single strand oligonucleotide T24 and SYBR Green Ⅰ were weak. In contrast, the presence of melamine drove the formation of T-melamine-T folded structure and enabled the SYBR Green Ⅰ to intercalate into double-strand DNA, resulting in the enhancement of fluorescence intensity. The results revealed that the method allowed a sensitive, simple, and rapid assay of melamine with a linear response range from 0. 1 μmol/L to 10 μmol/L and a detection limit of 35 nmol/L.

0.05). All of the indexes in control group were lower on post-operative day 7 than those of pre-operation. The levels of pre-albumin,transferrin, fibronectin, IgG,IgM, CD~+_3, CD~+_4 T cells and nitrogen balance in the study group were significantly higher than those of control group.Negative nitrogen balance began to be positive in the study group on the post-operative day 7. However, the nitrogen balance in the control group was still negative on the post-operative day 10. The duration of hospitalization in the r-hGH group was shorter than that of the control group. The 1-year, 2-year and 3-year survival rates and recurrence rate were not different between two groups.(Conclusions) The post-operative short-term use of the r-hGH plus HPN in patients with excisable gastrointestinal cancer is safe, effective and benefit for the post-operative recovery.

Objective To investigate the effect of treatment with transplanted bone marrow mononuclear cells under different transplant paths on neovascularization in ischemic cerebral infarction rats. Methods The MCAO models were established by intraluminal vascular suture method. All the successful models were randomly divided into control group, intravenous transplantation group and subarachnoid transplantation group according to the random number table. The Extraction,isolation and culture of bone marrow mononuclear cells were extracted,i?solated and cultured. The models in the control group were injected 200μl PBS through the femoral vein. The mod?els in the intravenous transplantation group were injected 200μl containing 2×107 bone marrow mononuclear cells through the femoral vein. The models in the subarachnoid transplantation group were injected 200μl containing 2× 107 bone marrow mononuclear cells through the subarachnoid. The VEGF levels in cerebrospinal fluid of rats were detected using quantitative ELISA method. The vascular regenerations in the infarct area were observed by using quantitative immunofluorescence. Results After transplantation of bone marrow mononuclear cells 7 d,14 d and 28 d,the VEGF levels of rat cerebrospinal fluid in subarachnoid transplantation group were (207.4±8.9)pg/ml, (171.2±10.3)pg/ml and (143.8±13.8)pg/ml,respectively,which were all higher than the VEGF levels in intra?venous transplantation group,the differences were all statistically significant (P<0.05). After transplantation 14 d and 28 d,the BrdU?positive cells in subarachnoid transplantation group were ( 2043. 8 ± 514. 2) and ( 1834. 8 ± 307.4) ,respectively,which were higher than the intravenous transplantation group,the differences were all statisti?cally significant (P<0.05). The microvessel counts in subarachnoid transplantation group were (384.6±45.1) and (514.8±51.3),respectively,which were higher than that in the intravenous transplantation group,and the differ?ences were all statistically significant (P<0.05) . Conclusions Bone marrow mononuclear cells transplantation can increase VEGF secretion,and promote angiogenesis infarct. The effect of subarachnoid transplantation is better.

Objective To observe the effect of different doses of propofol injection and propofol medium/long-chain fat emulsion injection in short time infusion on plasma ketone body ratio,to eva-lute its effecton hepatic energy metabolism.Methods Forty patients,aged 18-50 years old,ASA Ⅰ orⅡ undergoing selective surgery were randomly divided into 4 groups with 10 cases in each;propofol injection 4 mg·kg-1·h-1 maintain anesthesia (group L4 ),propofol injection 6 mg·kg-1·h-1 maintain anesthesia (group L6 ),propofol medium/long-chain fat emulsion injection 4 mg·kg-1·h-1 maintain anesthesia (group M4 ),propofol medium/long-chain fat emulsion injection 6 mg·kg-1·h-1 maintain anesthesia (group M6 ).MAP,HR,SpO2 and PET CO2 were recorded before anesthesia induction (T0 ),after tracheal intubation (T1 ),after 2 hours infusion of propofol (T2 )and operation completed (T3 ).The blood samples were collected at T1 and T2 to detect the level of acetoacetate,β-hydroxybu-tyrate and to calculate the blood ketone body ratio (the ratio of acetoacetate andβ-hydroxybutyrate). Results MAP,HR,SpO2 ,PET CO2 at T0-T3 and acetoacetate,β-hydroxybutyrate,blood ketone body ratio at T1 ,T2 showed no significant statistic difference.Conclusion Different doses of propofol and different doses of propofol medium/long-chain fat emulsion injection in short time continuous in-fusion has no obvious effect on hepatic energy metabolism;same dose of propofol injection and propo-fol medium/long-chain fat emulsion injection in short time continuous infusion has no obvious effect on hepatic energy metabolism.

Objective To evaluate the effectiveness of EEG bispectral index (BIS) as the feedback control variable of target-controlled infusion (TCI) of propofol for sedation in patients undergoing laparoscopic hysterectomy under epidural anesthesia. Methods A total of 60 patients for selective operation of laparoscopic hysterectomy under epidural anesthesia were randomly divided into two groups: the feedback TCI group (FTCI) and the TCI group (TCI),with 30 patients in each group.The target blood concentration of propofol was set up at a level of 2 mg/L.It was maintained unchanged in the TCI group throughout the surgery.The BIS value,as the control variable,was set up at 70 in the FTCI group.The highest and lowest BIS values,mean arterial pressure (MAP) and HR during the operation,the standardized unit dose of propofol,time for orientation recovery,the degree of amnesia during the operation and patient's satisfaction were recorded and compared between the two groups. Results Of the two groups: the maximum of BIS values were 76 1?6 4 and 86 0?8 6,respectively,with statistically significant difference ( t = -5 058, P =0 000),and the minimal values were 69 0?4 5 and 60 9?11 8,respectively,with significant difference ( t =-3 513, P =0 000); the highest MAPs were (90 9?14 2) mm Hg and (100 4?11 6) mm Hg,respectively,with significant difference ( t =-2 838, P =0 006),and the lowest,(74 2?12 5) mm Hg and (63 8?13 8) mm Hg,respectively,with statistical significance ( t =-3 059, P = 0 003); the time for orientation recovery was (440 8?141 0)s and (576 4?120 5)s,respectively,with significant difference ( t = -4 004, P =0 000).Total dose of propofol in the FTCI group [(510 48?82 75)mg] was statistically lower than that in the TCI group [(620 65?76 79)mg; t =-5 345, P =0 000],the same was the standardized unit dose of propofol [FTCI: (5 08?1 26)mg,TCI:(6 02?0 86)mg; t =-3 375, P =0 001].No significant differences were seen between the two groups in the degree of amnesia during the operation and patient's satisfaction. Conclusions BIS is feasible to be used as a feedback control variable in propofol anesthesia.It offers less propofol consumption,appropriate sedation,rapid recovery of orientation and more stable blood pressure.

Background and purpose:Duffy blood group(DBG)system contains genotype system and phenotype system.DBG phenotype system is embodied by the protein carrying blood group antigens on the surface of red blood cells.Epidemiological evidence has shown that different races had definitely different DBG phenotype disuribution and there is a variation of morbidity and mortality of breast cancer among different race populations.Therefore,this study was to investigate whether DBG phenotype affects breast cancer occurrence and malignancy.Methods:We investigated DBG phenotypes of 253 female cases with breast diseases who were consecutively hospitalized in the Shanghai Cancer Hospital and analysis was done on its relationship with clinical pathological diagnosis.DBG phenotypes were examined by indirect antiglobulin-test with anti-Fya and anti-Fyb reagents,and were classified into Fya+Fyb-,Fya-Fyb+,Fya+Fyb+,Fya-Fyb-according agglutination.Results:Neither DBG phenotypes distribution difference existed in breast disease patients nor in breast cancer patients as observed in the general Chinese Han population.Fya-Fyb-and Fya-Fyb+ demonstrated more susceptibility to breast cancer than Fya+Fyb-and Fya+Fyb+,but there was no statistical significant difference.Fya-group(57.14%)had more malignant incidence than that of Fya+ group(39.02%),but there was also no statistical significance(P=0.28).No significant differences have been observed in ER,PR,Her-2 status and P53,PCNA,PS2,nm23,P450 status between every DBG phenotypes,nor in tumor grades in various DBG phenotypes.More patients were involved in axillary lymph nodes metastasis in Fya-than that in Fya+ group and reached statistical significance(100% and 39.13% respectively,P