Objective This study aimed at retrospective analysis of some metastatic breast cancer cases,investigated the recurrence of brain metastases of metastatic breast cancer in patients with risk factors,and provided a reference for the implementation of prevention strategies in the treatment plan and a reasonable choice.Methods A total of 796 breast cancer cases was visited,of whom 456 patients with recurrent metastatic breast cancer,in which 61 patients were with brain metastasis.The follow-up data were analyzed with SPSS13.0 software.x2 was used to test the age,estrogen receptor (ER),progesterone receptor (PR),cerbB-2 expression,lymph node metastasis,and brain metastasis.The COX proportional hazard model was used to analyze the recurrence and metastasis in patients with single-factor,multi-factor analysis,in order to obtain the independent prognostic factors.Results The x2 tests that group age ≤ 35 years,hormone receptor-negative,CerbB-2 (2 +)/(3 +) has a higher risk than another group (x2 =24.92,8.28,4.02,P ＜0.01 orP ＜0.05).COX univariate analysis showed that patient age,tumor size,ER and PR expression,CerbB-2 expression,lung metastases were looked.as the first metastatic site and hormone therapy.Those were significant factors whether the patient suffered from brain metastasis (P ＜ 0.05).COX multivariate analysis showed that age,ER and PR expression,CerbB-2 expression,and lung metastases were looked as the first metastatic site acted as an independent prognostic factor for brain metastasis (P ＜0.05).Conclusions Age,ER and PR expression,CerbB-2 expression,lung metastases as the first metastatic site are the independent prognostic factors for brain metastasis.

ObjectiveTo analyze the effect of empowerment management for nursing risk in blood purification center.Methods16 nurses were chosen and nursing risk were authorized to six management groups,each group was respectively responsible for their share of nursing work.Before the implementation of empowerment management for nursing risk,100 patients undergoing maintenance hemodialysis were chosen,and after the implementation another 100 patients were also selected.The nursing effect was compared before and after the implementation.ResultsAfter the implementation,the score of nursing quality and patients' satisfaction degree were significantly improved.ConclusionsThe effective empowerment management for nursing risk can raise management effect of nurses continuously,and stir up the initiative and creativity of nursing staff,lower nursing risk occurrence.It is an effective management method that promotes nursing quality comprehensively.

In the load capacity test of CT diagnosis table top, by analyzing the easy destroy area and related test data for the table top, using a simple mechanical auxiliary support structure in local area of the table top to solve the insufficient loading strength problem of table top and obtain significant results during the actual product usage.
Tomography, X-Ray Computed ; instrumentation ; methods

Objective To study the correlation between blood uric acid level and blood pressure among general population.Methods 1 694 healthy cases exclusion of hypertension,hyperuricemia and related diseases were enrolled in the study.The levels of blood uric acid,blood pressure,body mass index,fasting glucose,triglycerides,cholesterol were detected and compared.Results In prehypertension group,the levels of uric acid (344.5 ± 41.37)μ mol/L,shrink blood pressure (124.85 ± 7.52) mmHg,diastolic blood pressure (79.46 ± 6.62) mmHg,cholesterol (1.66 ± 1.10) mmol/L,triglycerides (4.69 ± 0.87) mmol/L,fasting plasma glucose (4.98 ± 1.01) mmol/L were significantly higher than those in the normal blood pressure group [(304.09 ± 63.75) μ mol/L,(106.12 ± 8.10) mmHg,(68.53 ± 6.26) mmHg,(1.30 ± 0.87) mmol/L,(4.52 ± 1.02) mmol/L,(4.78 ± 0.70) mmol/L] (t =15.32,49.14,34.81,7.48,3.57,4.67,all P ＜ 0.01).With the increase of uric acid,the levels of shrink blood pressure andthe diastolic blood pressure had an increasing trend(P ＜ 0.01).In prehypertension group,the uric acid level of men was (363.16 ± 32.05) μmol/L,which was significantly higher than female (311.35 ± 34.81) μmol/L (t =22.39,P ＜ 0.05).Conclusion Blood uric acid level and blood pressure level are closely related among general population,the serum uric acid increased in prehypertensive patients.The serum uric acid can provide useful prognostic information in subjects with the hypertension and the cardiovascular disease.

Objective To investigate the infection status of hepatitis virus among the perinatal women in Nanjing.Methods 523 samples of perinatal women's serum were selected.The hepatitis virus markers were detected by the ELISA kit,the quantitive detection of HBV surface-antibody was detected by electrochemiluminescence immunoassay.Results The positive rate of anti-HAV IgM was 0.19％,47 cases were HBV surface antigen-positive,accounted for 8.99％,183 cases were HBV surface antibody-positive,accounted for 35.00％,224 cases were all negative HBV markers,accounted for 42.83％.The quantitive detection of HBV surface-antibody in high concentration was significant higher than middle concentration and low concentration (all P ＜ 0.05).The positive rate of anti-HCV IgG was 1.34％,anti-HDV IgG was all negative.The positive rate of anti-HEV IgM was 0.57％.The positive rate of anti-HEV IgG was 24.28％.With the advance of age,the positive rate of anti-HEV IgG had an increasing trend,with significant difference among groups (P ＜ 0.05).Conclusion There are important significances in the detection of hepatitis virus markers in pregnancy monitoring,it can improve the quality of the population.

Objective To explore the effect of double cypress powder (DCP) combined with TDP irradiation on lumbar intervertebral disc protrusion and summarize nursing experience.Methods One hundred and twenty-five patients with lumbar intervertebral disc protrusion were randomized into the observation group and control group.The control group was treated with massage and electro-acupuncture and the observation group received DCP fumigation combined with TDP irradiation besides treatments the controls received.The two groups were compared in terms of pain level and curative effect after two courses of treatment.Result The score on pains by VAS in the treatment group was significantly lower than that in the control group and the curative effect was better than that in the control group (P<0.05).Conclusion On the basis of the massage,electro-acupuncture and moxibustion therapy,DCP combined with TDP irradiation is therapeutically effective in the reduction of the pains from lumbar disc protrusion.

[Objective] To observe the clinical effect of Shenfu Decoction and Compound Red Sage Injection on new infants respiratory distress syndrome.[Method] Randomly divide 42 cases into 2 groups,control group(1)take the integrated therapy:CPAP,oxgen,warming,keeping wet and anti-bacterial;the treatment group(1)take the Shenfu Decoction and Compound Red Sage Injection.Compare their cure rates after 7d.[Result] In group 1,survivable rate was 95.23%,cure rate 71.4%;and 80.95% and 47.62% respectively for other group;the clinical symptoms,signs,blood-gas analysis and X-ray result were all better in group 1 than group 2.[Conclusion] Oral taking Shenfu Decoction and Compound Red Sage Injection for vein drip can help relieve infants clinical symptoms and pass alveolus superficial active substance lack period.

Objective To investigate the therapeutic methods for hypertrophy of nasal tip so as to create an aesthetic shape of nasal tip. Methods The “seagull-wing incision”was used in all patients. According to various nasal tip contours, trimming of soft tissues and reconstruction of alar cartilage were preformed simultaneously. Excessive soft tissue between skin and alar cartilage was removed; after exposing the domal segment of the alar cartilage, cartilage was resected from lateral crus to middle crus with a width of 0.2 cm marginal lateral crus was left. The shape of nasal tip was recontoured by middle crus suture technique. Others deformities of nose were corrected then: 10 patients with flat and low nasal tip were operated for nasal augmentation; 9 patients with thickening nasal wing were operated for thinning rim; 3 patients with wide bases of nasal wing were operated for shortening width through intraoral approach and one patient with broad nasal bone was operated with osteotome, infractured and displaced in the midline. An exteral splint was placed over the tape for 5-7 days postoperatively. Results Since 1995, follow-up for 3 to 24 months showed that 25 cases had achieved satisfactory cosmetic effects without secondary deformity except 3 early cases. Conclusion Trimming of soft tissues and reconstruction of alar cartilage are effective methods for correction of hypertrophy of nasal tip.

Objective To explore the diagnostic value of bronchoscopy combined materials drawn in multiply methods in patients with bacteriological negative pulmonary tuberculosis.Methods The clinical data of 74 patients with pulmonary tuberculosis were retrospectively analyzed.All the patients had sputum acid-fast staining more than three times,25 patients were sputum bacteriological positive and 49 patients were bacteriological negative or had no sputum.Bronchoscopy was performd in 28 cases,including biopsy examining,brush examining,bronchoalveolar lavage fluid(BALF) smear and sputum spear acid-fast stain test.Results In 28 patients undergoing examination,microscopic abnormalities were found in 14 cases,taken 50.0％.15 cases performed lesion biopsy or transbronchiallung biopsy(TBLB) were diagnosed tuberculosis,taken 53.6％.Brush acid-fast staining was positive in 7 cases,taken 25.0％.BALF smear postive in 10 cases,taken 35.7％.And phlegm test after bronchoscope positive in 6 cases,taken 21.4％.Combined multiply index,23 cases finally diagnosed as pulmonary tuberculosis,taken 82.1％.Conclusion Bronchoscopy with materials drawn in multiply methods has a high value in diagnosing bacteriological negative pulmonary tuberculosis,we should take advantage of it as soon as possible.

Objective To investigate the role of p38MAPK in the differentiation of murine osteoblasts, and to observe the expressions of receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG). Methods The calvarial osteoblasts of newborn BALB/c mice were cultured in MEM medium containing 10% NCS. Raloxifene (10~(-7) mol/L) and 17β-estradiol (10~(-8) mol/L) were added respectively when cells reached 70%-80% confluence combined with or without 5 μmol/L SB202190, an inhibitor of p38MAPK. The osteoblasts alkaline phosphatase activity assays were performed 72 hours later using PNPP method, and mRNA levels of alkaliphosphatase (ALP), OPG and RANKL were determined by RT-PCR. Results 17β-estradiol and raloxifene increased ALP activity and ALP mRNA level in osteoblasts in vitro which were blocked by p38MAPK inhibitor.The mRNA levels of RANKL and OPG were up-regulated by 17β-estradiol and raloxifene while the ratio of OPG/RANKL kept constant. SB202190 (5 μmol/L) inhibited the highly expressed RANKL and OPG in osteoblasts, and obviously decreased the ratio of OPG/RANKL. Conclusions p38MAPK inhibition blocked the differentiation of osteoblasts and decreased the up-regulated OPG and RANKL expressions in osteoblasts significantly (P<0.05).