Objective To discuss the influence of systematic nursing on cancer related fatigue and life quality of patients with breast cancer during perioperative period.Methods 197 patients in our hospital with breast cancer were randomly divided into the experimental group (99 cases)and the control group (98 cases)from November 2010 to December 2011.The experimental group was given systematic nursing method and the control group received traditional nursing.After treatment,the influence of nursing intervention on cancer related fatigue and QOL were compared between two groups.Results The score of QOL was(92.1±1.6)after nursing in the experimental group,higher than before systematic nursing and the control group.The severity of cancer related fatigue in the experimental group was apparently lower than before nursing intervention and that in the control group.There was significant difference.Conclusions The systematic nursing can reduce the level of perioperative cancer related fatigue and improve the life quality for the patients with breast cancer,so it can be widely used in clinic.

Specific fusion genes of leukemia are currently the main biomakers for minimal residual disease (MRD)monitoring. Recent studys have found that the WT1, PRAME, ERG genes may be the potential acute leukemia related molecules, and can be used to monitor acute myeloid leukemia's MRD, directing clinical stratified therapy and estimating prognosis. This article reviews the pathogenesis, incidence of these genes and the relationship to the clinical prognosis.

Idiopathic thrombocytopenic purpura(ITP),which is the most common acquired hemorrhagic disease in childhood period,is also called immune thrombocytopenia because it is an immune-mediated disorder characterized by isolated thrombocytopehia.In recent years,the diagnosis and treatment of ITP has been dramatically improved,and some consensuses concerning the staging,symptom scoring,treatment indications and prognosis have been achieved.This article reviews the pathogenesis,epidemiology,symptom scoring,staging,grading of severity,treatment and prognosis evaluation of ITP in children.

Objective:To study the clinical characteristics of retinoblastoma in children.Methods:To analyze the age,sexuality,symptom,the accompaniment of symptom and the diagnostic feature of 53 retinoblastoma cases.Results:The average diagnostic age was two years and three months.There was no obvious sex difference.The principal first symptom of 24 cases was leukocoria,11 cases was strabismus,8 cases was big cornea or muddy cornea,6 cases was exophthalmos,1 case was nystagmus,2 cases was anterior chamber bleeding,and 1 case with health examination.It was significantly higher in single eye(85%) than in both eyes(15%).Conclusion:More and more people recognize the importance of eye health care,and the average diagnostic age becomes younger.The principal first symptom remains "galeamaurosis".The clinical characteristics of retinoblastoma in children are diversified?concealed?puzzling and easy to make missed diagnosis.

Thioredoxin(TRx) is a kind of endogenous protein which widely distributes in prokaryotic and eukaryotic cells.It possesses two vicinal cysteine residues at the active site and therefore can provide strong reducing activity and catalyze the reduction of protein-protein disulfides effectively.In addition,TRx plays a vital role in regulating intracellular redox homeostasis.Recent studies showed that TRx is muhifunctional and has a protective effect on the occurrence and development of a variety of human diseases including ocular diseases,such as age-related cataract,choroidal neovascularization,retinal diseases and optic nerve diseases,etc..Many researchers assessed the protective effect of TRx on ocular diseases in recent years.The progress in the relationship of TRx with eye diseases was reviewed in this article.

Based on the main body's definition of philosophy,the article points out that patients are the main body of clinic activities.It also analyzes patients'main status in the performance of clinic activities and in the medical countermeasure.The concluson is that a harmonious relationship between doctors and patients should be composed from bi-main bodies characteristic of the clinic activities.

The elderly patients with diabetes often have a high prevalence of hypertension.Meanwhile,hypertension is a major vascular risk factor in this population.The benefit of proper management of hypertension in elderly patients with diabetes has been well recognized.According to the IDF Global Guideline for Managing Old People with Type 2 Diabetes,lifestyle interventions are recommended to form the first step in managing hypertension in elderly patients with diabetes.Pharmacological therapy should be initiated in addition to lifestyle interventions after 6 weeks during which non-pharmacological therapy has failed to achieve blood pressure targets.ACE-inhibitors are the first choice for initial medication,especially in the presence of diabetic nephropathy.ARBs can be used in people who cannot tolerate ACE-inhibitors.Diuretics or calcium channel blockers can be used as the first add-on therapy to ACE-inhibitors or ARBs if they fail to achieve target blood pressure.β-blockers should be considered for combination therapy in people with tachycardia or coronary artery disease.The generally recommended blood pressure target for older people with diabetes should be less than 140/90 mmHg(1 mmHg=0.133 kPa).

The expansion of high-containment bio-defense laboratory in USA is introduced in such aspects as the increase of laboratory magnitude,amplification of laboratory area and the funding growth of the United States National Institutes of Health(NIH).In addition,a series of problems caused by the expansion are analyzed in the perspective of the biosafety training,information exchange of laboratory and public participation.

Objective Discuss and analyze Staphylococcusaureus in isolation and drug resistance in patients with pediatric re-spiratory infection,providing guidelines for clinical treatment on the control of infection.Approaches collect 5 413 cases of respiratory tract infection from Jan.2013 to Dec.2014 in patients (including pediatrics neonatology)with sputum specimens, applying MicroScan-As4 automated Microbes Identification analyzer to identify and test drug sensitiveness of the separated strains,using Whonet 5.6 for statistical analysis.Results 1 540 strains of 29 different pathogenic bacteria were isolate from pediatric patients with respiratory tract infection,among which there were 336 strains (21.82%,336/1540)of Staphylococ-cus aureus (SAU,S.aureus),more than 1/5 of the total of pathogenic bacteria.And the isolation rate of pediatric respiratory tract infection accounted for 6.2 1%,significantly higher than that of other pathogenic bacteria isolation rate (with the excep-tion of Haemophilus influenzae>5%,the rest all<5%).In all detected SAU,methicillin-resistant Staphylococcus aureus (MRSA)occpied 59 strains (17.56%,59/336),which indicated that SAU played a leading place in patients with pediatric respiratory infection.The antimicrobial drug resistance rate of SAU against vancomycin,Nai thiazoleamine,daptomycin,and Quinupristin was 0,whereas to other antibiotics it showed different degrees of resistance.The drug resistance rate of MRSA to penicillin and ampicillin,oxacillin,ampicillin/sulbactam,amoxicillin/clavulanic acid and cefazolin,ceftriaxone was 100%,to erythromycin,clindamycin over 50%,to other antimicrobial resistance in low resistance.Conclusion There were more SAU in children with respiratory infection;especially MRSA bears multi drug resistance.Therefore,the monitoring of drug resist-ance of Staphylococcus aureus should be strengthened,and antimicrobial drugs should be rationally chosen according to the results of drug sensitive test for individuals,so that resistant strains can be under effective control and kept being reduced from emergence.

Objective To summarize and analyse the clinical data of death cases in the department of emergency internal medicine. Methods The clinical data of patients presenting at the department of emergency internal medicine from January 2005 to July 2010 were analyzed retrospectively. Results Among 13 211 patients of department of emergency internal medicine, 145 died. More cases died in winter( 32.0% , 39/122 ).More than half of deaths occurred within 6 hours after admission( 54.5% ,79/145 ). The top six death causes were sudden death, pulmonary infection, cerebrovascular accident, advanced cancer, gastrointestinal bleeding,cardiovascular diseases and the occurrence rates were 18. 6%, 13.8%, 13.8%, 10.3%, 9. 7% and 9.0%respectively. Conclusion The first three death causes in department of emergency internal medicine were sudden death, cerebrovascular accident, pulmonary infection. Prevention of these diseases, cooperation between emergency department and other departments and special training on standardized treatment of critically ill patients should be enhanced.