Objective To investigate the clinical values of postoperative aerobic exercise and psychological intervention in patients with breast cancer after operation.Methods One hundred patients with breast cancer admitted to our hospital were prospectively studied.All patients underwent modified radical mastectomy and were randomly assigned into observation group (50 cases)and control group (50 cases).The patients in the observation group were treated with aerobic exercise and psychological intervention,and the health education was given in the control group. The 3 -month postoperative self -rating anxiety scale score,self -rating depression scale score,shoulder mobility, degree of limb edema and 6 -month postoperative health related quality of life (SF -36)of the two groups were observed.Results There were no significant differences between the two groups in preoperative self -rating anxiety scale score,self -rating depression scale score,degree of limb edema and health related quality of life (all P >0.05).However,the self -rating anxiety scale score of the observation group three months after operation significantly decreased compared with the control group[(40.94 ±9.20)points vs.(45.84 ±8.79)points,t =2.722,P =0.008];self -rating anxiety scale score significantly decreased[(40.18 ±9.96)points vs.(45.28 ±8.67)points,t =2.730, P =0.008];the degree of limb edema was significantly reduced[(10.00 ±6.27)mL vs.(18.52 ±7.20)mL,t =6.313,P =0.000].The health related quality of life 6 months after operation was significantly improved[(78.70 ± 8.85)points vs.(72.02 ±9.76)points,t =3.584,P =0.001 ].Compared with the control group,the shoulder flexion,extension,abduction,external rotation and internal rotation of the observational group were significantly increased at 3 months after operation (all P <0.05 ).Conclusion Postoperative rehabilitation and psychological intervention contribute to the rapid recovery in patients with breast cancer after operation.

Objective To investigate the effect of postoperatively early stage-function-exercise on the recovery of upper limb function of diseased side after breast cancer modified radical mastectomy.Methods One hundred patients with breast cancer admitted to our hospital from January 2013 to June 2016 were collected.All patients underwent modified radical mastectomy.The patients were divided into the observation group and control group after operation,50 cases in each group.The observation group was given the early stage-function-exercise,while the control group received the routine nursing care.The shoulder joint mobility,affected limb edema degree,self-rating anxiety scale (SAS)score,self-rating depression scale (SDS) score and 36-item short-form health survey (SF-36) score were observed in the both groups.Results When compared with the control group,the patients in the observation group got a significant increase in the shoulder joint activity such as antexion,abduction,internal rotation,external rotation,adduction and rear protraction at postoperative 3,6-months (P<0.05).There was no statistically significant difference between the two groups in upper limb volume,SAS score and SDS score before the operation (P>0.05).However,when compared with the control group,the patients in the observation group got a significant decrease of upper limb volume at postoperative 3 months[(1 543.38±414.93) mL vs.(1 635.58±401.58) mL,P=0.000)],a significantly decrease of SAS score[(37.87±6.90) points vs.(44.07±12.32) points,P=0.000)] and SDS score[(38.32±6.65) points vs.(45.02±11.07) points,P=0.000)] at postoperative 6 months,and a significant increase of SF-36 score at postoperative 6 months [(77.52±7.28) points vs.(70.28±7.55) points,P=0.000)].Conclusion Postoperatively early stage-function-exercise can help to improve the shoulder joint activity degree and quality of life,and reduce the limb edema degree after modified radical mastectomy in the patients with breast cancer.

Objective:To investigate the effects of different lymph node dissection methods in radical resection of intrahepatic cholangiocarcinoma (ICC) on the number of harvested lymph nodes and prognosis of patients.Methods:The retrospective cohort study was conducted. The clinicopathological data of 57 patients with ICC who underwent radical resection in the Second Affiliated Hospital of Nanchang University from January 2011 to January 2016 were collected. There were 25 males and 32 females, aged from 45 to 72 years, with an average age of 59 years. Of the 57 patients, 36 undergoing en bloc fusion lymph node dissection and 21 undergoing conventional lymph node dissection were allocated into observation group and control group, respectively. Observation indicators: (1) intraoperative situations; (2) results of postoperative pathological examination; (3) postoperative complications; (4) follow-up. Follow-up using outpatient examination or telephone interview was performed once every six months after hospital discharge to detect survival of patients up to January 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was done using the t test. Measurement data with skewed distribution were described as M (range), and comparison between groups was analyzed by the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact propability. Comparison of ordinal data between groups was analyzed using the Mann-Whitney U test. The survival curve and rate were drawn and calculated using the Kaplan-Meier method, and survival of patients was analyzed by the Log-rank test. Results:(1) Intraoperative situations: operation time, volume of intraoperative blood loss, hepatic portal occlusion time, cases with <3 segments of hepatectomy and ≥3 segments of hepatectomy for the observation group were (218±53)minutes, (266±24)mL, (21±9)minutes, 5, 31, respectively, versus (207±45)minutes, (270±23)mL, (19±8)minutes, 2, 19 for the control group, showing no significant difference in the above indicators between the two groups ( t=-0.530, 0.774, 0.590, χ2=0.004, P>0.05). (2) Results of postoperative pathological examination: the number of harvested lymph nodes and percentage of positive lymph nodes of the observation group were 11±3 and 16.58%(66/398), respectively, versus 5±2 and 6.80%(7/103) of the control group, showing significant differences in the above indicators between the two groups ( t=-9.454, 2.148, P<0.05). (3) Postoperative complications: cases with Clavien-Dindo grade Ⅰ-Ⅱ complications or Clavien-Dindo grade Ⅲ-Ⅳ complications, cases with bile leakage, cases with postoperative hemorrhage, cases with incision infection, cases with gastroparesis were respectively 35, 1, 6, 1, 8, 0 in the observation group and 19, 2, 3, 1, 1, 2 in the control group. There was no significant difference in the cases with complications of Clavien-Dindo classification, cases with bile leakage, cases with incision infection between the two groups ( χ2=0.236, 0.000, 1.870, P>0.05) and no significant difference in the cases with postoperative hemorrhage, cases with gastroparesis between the two groups ( P>0.05). (4) Follow-up: 57 patients were followed up for 5-42 months, with a median time of 36 months. The survival time and postoperative 3-year survival rate were respectively 36 months (range, 8-42 months) and 66.7% of the observation group, versus 23 months (range, 5-39 months) and 38.1% of the control group, showing significant differences in the above indicators between the two groups ( Z=-2.253, χ2=5.317, P<0.05). Conclusion:For radical resection of ICC, the en bloc fusion lymph node dissection is beneficial to increase the number of harvested lymph nodes and improve survival rate of patients.