Objective To investigate uncertainty in illness of family members of patients with malignant tumor,to explore the factors that affect uncertainty in illness of family members of patients with malignant tumor,and to provide clinical basis for clinical doctors and nurses implementing effective interventions for their patients.Methods Questionnaires were conduted to investigate uncertainty in illness of family members of patients with malignant tumor and explore the related factors.The measurements included three parts,Chinese version of Mishel uncertainty in illness scale for family member,self-designed questionnaire about family general condition,patients disease information.Results The total score of uncertainty in illness was 82.71±9.93,more than 50 ％ (75 score) of the highest PPUS-FM score.There were statistical significances of uncertainty in illness in education (F =8.06,P ＜ 0.05),family income (F=3.14,P ＜ 0.05),residence place (F =3.99,P ＜ 0.05) and frequency of hospitalization (F =4.85,P ＜ 0.05).Conclusion Family members of patients with malignant tumor have a higher level of uncertainty in illness.Education,family income,residence place and frequency of hospitalization have a certain effect on uncertainty in illness of family members of patients with malignant tumor.

This article introduces the definition of quality of Life.How do the quality of life questionnaires apply in the clinical situations.This paper provides an overview of the factors that influence cancer patients quality of life.These research will give inspirations to our nurses and provide some reference for nursing interfere measurement.In order to improve quality of life of cancer patients,the clinical nurses should pay attention to these influencing factors.

Objective To investigate the incidence of anxiety in patients with breast cancer,and further explore the surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI) technology' s clinical value in the diagnosis of anxiety.Methods 121 breast cancer patients were selected as research objects by using convenience sampling method.Self-rating anxiety scale (SAS) was used to evaluate the anxiety on the first day of admission and SELDI was used on the next day to detect the serum from patients' fasting venous blood sample got in the morning after their consent,then anxiety-related protein fingerprints spectrums were selected.The SAS score and SELDI result were finally compared and analyzed.Results SAS score in 121 patients was 53.45±9.78,anxiety occurred in 63 cases (52.07 ％).Established the diagnostic model between 15 000+H and 16 800+H protein fingerprints abundance ≥5 ％,that was to say,abundance ≥5 ％ was judged as positive,otherwise negative.On this basis,patients can accurately be distinguished between anxious group and non-anxious group.Correct rate (total coincidence rate) was 91.74 ％,specificity and sensitivity respectively were 89.66 ％ (52/58) and 93.65 ％ (59/63),the positive predictive value was 90.77 ％ (59/65),and negative predictive value was 92.86 ％ (52/56).Conclusions Breast cancer patients have a high incidence of anxiety.SELDI technology has showed high sensitivity and specificity in anxiety detecting.As an objective assessment tool,it could have better prospects for clinical use.

Objective To observe the effects of the different serum uric acid levels on expression of Alzheimer’s disease biomarkers (APP and BACE1) in rats. Methods Intraperitoneal injection of oxygen of oxazine acid potassium was used to produce HUA models in rats. H&E staining was used to detect the morphological changes of the hippocampus. Western blot was used to detect the protein levels of APP and BACE1 of the hippocampus. Results Compared with nor-mal control group, the serum uric acid and the protein levels of APP and BACE1 in the hippocampus was obviously in-creased at OAPS treatment group (P<0.01). Compared with low dose OAPS treatment group, the serum uric acid level was significantly increased whereas the protein levels of APP and BACE1 in the hippocampus were significantly decreased at the middle and high dose group (P<0.01). Compared with middle dose group, the serum uric acid level was increased at high dose group (P<0.05) and the expression of APP were decreased in the hippocampus rats but the expression of BACE1 remained unchanged (P>0.05). Conclusion The higher level of serum uric acid may be a protective factor of AD. The higher serum uric acid levels, the lower the risk of AD.

Objective To observe clinical efficacy of laparoscopy combined with gonadotropin-releasing hormone agonist (GnRH-a ) in the treatment of endometriosis (EMs).Methods 158 patients who underwent laparoscopic surgery and were diagnosed endometriosis in our hospital during Sep.2010 to Dec.2010 were chosen and divided into three groups:control group were treated with pure laparoscopic surgery,group A were treated with laparoscopic surgery and follow-up GnRH-a medication,and group B were treated with laparoscopic surgery,follow-up GnTH-a medication and add-back therapy.The total effective rates,recurrence rates,the changes of hormone levels before and after the treatment and adverse reaction rates after treatment were compared and analyzed to evaluate the efficacy of different treatments.Results The total effective rates of group A and group B (84.6%,86.2%) were significantly higher than that of control group (58.3%),and the difference was statistically significant (P=0.032,P=0.032).The recurrence rates of group A and group B (15.4%,13.8%)were significantly reduced compared with that of control group (41.6%)(P=0.012,P=0.012).The hormone levels decreased dramatically after treatment in three groups.The adverse reaction rate of group B was apparently reduced compared with that of group A,and the difference was statistically significant (P=0.001 ).Conclusion Laparoscopy combined with GnRH-a medication was a safe and effective treatment for endometriosis.The application of GnRH-a after laparoscopy can significantly increase the total effective rate of the operation and reduce the postoperative recurrence rate.For the patients who need to take long-term GnRH-a treatment,add-back therapy need to be given to decrease its adverse reaction and recurrence rate,or to delay its recurrence,thus could improve patients' living qualities significantly.

Objective To study the occurrence of anxiety in patients with malignant tumor, and in further explore the scientificity and clinical application value of surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI) technology in anxiety detection. Methods 1 000 patients with malignant tumor were selected as research objects, the self-rating anxiety scale (SAS) was used to evaluate the anxiety on the first day of admission, the fasting venous blood of patients was taken on the next day morning. The SAS score and SELDI result were compared and analyzed. Results The effective sample number was 988. The SAS score was 56.32± 9.665, there were 454 cases of anxiety, the incidence rate of anxiety was 45.95 %. 470 cases were SELDI test positive, and the incidence rate of anxiety was 47.57 %. SAS was used as the gold standard to judge anxiety, the sensitivity and specificity of SELDI technology were 93.17 % and 91.20 %, the positive predictive value and negative predictive value were 90.00 % and 94.02 %, the total coincidence rate was 92.11 %. SAS score highly correlated with the abundance of SELDI, the fitting curve showed an up trend, and the correlation coefficient was 0.837. Conclusions The incidence of malignant tumor patients ' anxiety is relatively high. SELDI technique shows high sensitivity, specificity, total coincidence rate and correlation in anxiety detection, it can be used as an objective evaluation of anxiety.

Objective To evaluate the sensitivity of patient-specific volumetric-modulated arc therapy (VMAT) quality assurance (QA) to minor multileaf collimator (M LC) positioning errors.Methods Systematic multileaf collimator (MLC) positioning errors (+0.5 mm,+ 1 mm and +2 mm) were introduced into the clinical VMAT patient plans with 2 types of MLC positioning errors:systematic MLC gap width errors and systematic MLC shift errors for 6 cases,including 3 cases with prostatic cancer and 3 cases with nasopharyngeal cancer.The planar dose distributions of the original and modified plans were measured using ArcCheck array.The coincidence between the measured results and the calculated results was evaluated using both absolute distance-to-agreement (AD-DTA) analysis with 3％/3 mm and 2％/2 mm criteria.Results The average passing rate of the 6 original VMAT plans was 96.0％ with the ADDTA criteria of 3％/3 mm which was commonly adopted in clinical practice.For the MLC gap width errors of + 1 mm,+2 mm,and-2 mm and the MLC shift errors of 2 mm,the drop levels in average passing rate with the AD-DTA criteria of 3％/3 mm were 8.8％,15.5％,6.1％ and 7.9％,respectively.The + 2 mm MLC positioning errors and + 1 mm MLC gap width errors could be detected by the patient-specific VMAT QA procedure.The AD-DTA criteria of 2％/2 mm was more sensitive compared with the criteria of 3％/3 mm.Conclusions Patient-specific VMAT QA is not sensitive enough to detect the systematic MLC positioning errors within 1 mm.Additional MLC QA is needed to guarantee the accuracy of VMAT delivery.

Objective To explore the influence of core competence evaluation on continuing education of training nurses in operation room.Methods Questionnaires were administered to 42 training nurses by using the registered nurse core competence scale (CIRN) in operation room.Results The level of core competence of training nurses in operation room was medium (3.25 ± 0.45).Legal and ethical practice dimension of scores was the highest (3.55 ± 0.63).The single average of clinical nursing dimension was the advanced lowest (3.11 ± 0.54).The nurses self identity was the core influencing factors by multiple stepwise regression analysis in regression.Conclusions The core competence of training nurses in operation room is on the middle level,The focus is to improve the ability of clinical nursing in continuing education.To give more attention and support in self identity of the operation room training nurses,and to provide the scientific basis for the training plan and specialist training for them,in order to promote the continuing education projects of training nurses.

Objective To report the preliminary results of placing metallic stent and ~(125)Ⅰ seed strand combined with transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC) with inferior vena cava (IVC) obstruction. Methods From March 2009 to June 2009, implantation of radioactive ~(125)Ⅰ seed strand and metallic stent combined with TACE treatment was performed in 8 cases of HCC with malignant IVC obstruction. All patients were males with a mean age of (60.6 ± 9.6) years, ~(125)Ⅰ seed strand and Z-type soft-expandable metallic stent were placed in the obstructive segment of IVC, which was followed by TACE. Before and after the treatment, the diameter of the obstructive segment of IVC, the pressure gradient between right atrium and distal end of obstructive segment of IVC, and the symptoms related to the obstruction were estimated and recorded, the results were compared individually. Clinical follow-up was conducted in all patients. Results A total of 8 stents and 10 ~(125)Ⅰ seed strands were placed in the obstructive segment of IVC. Altogether 138 ~(125)Ⅰ seeds were implanted in 8 patients. Obvious clinical improvements were obtained after therapy. No complications occurred in all patients except one patient who experienced acute renal dysfunction at the second day after therapy. During a mean of (2.1 ± 0.6) months follow-up, occlusion of IVC stent was detected in 1 patient. The remaining stents remained patent. Conclusion Our initial results indicate that placement of ~(125)Ⅰ seed strand and metallic stent combined with TACE is a safe and feasible therapeutic option for advanced HCC with malignant IVC obstruction.

Objective To evaluate Satoh typing for tumor thrombi in the bile duct in patients of hepatocellular carcinoma.Methods A retrospective analysis was made on clinical data of 51 hepatocellular carcinoma patients with tumor thrombi in the bile duct undergoing hepatectomy in Eastern Hepatobiliary Surgery Hospital from Jan 2004 to Dec 2005.The cumulative disease-free survival by the three Satoh types were compared by Kaplain-Meire analysis.and log-rank test.Results There was no operationrelated motality and the postoperative complication rate was 22%(11/5 1).The overall survival rates at 1-and 2-years were respectively 76%(39/51)and 55%(28/51).The overall disease-free survival rates at 1-and 2-years were respectively 53%(27/51)and 22%(11/51).The disease-free survival rates at 1-and 2-years in type Ⅰ patients were respectively 61%(19/31)and 29%(19/31).The disease-free survival rates at 1-and 2-years in type Ⅱ and Ⅲ patients were respectively 35%(7/20)and 10%(2/20).The cumulative disease-free survival rates at 2-years was statistically different between type Ⅰ,type Ⅱ and Ⅲ (v=7.489,P=0.006)).Conclusions Satoh typing of tumor thrombi helps to determine the surgery plan and assess the prognosis of hepatocellular carcinoma with tumor thrombi in the bile duct.