Evidence-based medicine,personalization,standardization are the three common sense of cancer care in the 21st century.The model of cancer treatment has changed from experience-guided treatment into gene guided personalized treatment.Recently,personalized treatment of cancer develops fast,particularly in molecular profile for prognosis,molecular marker for efficiency of target drug and so on.

Objective:To explore the relationship between glycosylated hemoglobin (HbA1c)and carotid artery atheroscle-rosis in aged patients with normal glucose tolerance.Methods:A total of 100 aged patients with normal glucose tolerance were selected.Their bilateral carotid arteries were measured by color Doppler ultrasonography.They were grouped accord-ing to carotid intima-media thickness (C-IMT,normal,thicken and atherosclerosis)and plaque form (no plaque,hard plaque and soft plaque);blood pressure,blood lipids and HbA1c etc.were compared among groups.Results: (1)Along with CIMT rose,there was significant increase in HbA1c level [(4.98 ± 0.55)% vs.(5.51 ± 0.42)% vs.(5.92 ± 0.39)%],and there was significant difference between any two groups (P<0.01 all);(2)HbA1c level was (5.36±0.51)%,(5.89±0.44)% and (5.97±0.2)% in no plaque group,hard plaque group and soft plaque group respectively,and there was significant difference among hard plaque group,soft plaque group and no plaque group (P <0.01 all).Conclu-sion:Glycosylated hemoglobin may become an important index assessing carotid atherosclerosis in aged people.

Objective To investigate the nalaxone treating first acute right heart failure.Methods52 patients with FARHF were divided into the naloxone group(30cases)and control group(20cases)at random.Patients in control group were given general comprehensively treating.Patients in naloxone group were given naloxone as well as comprehensively treating,were given intravenously 0.8 mg of first dose,if it was necessary,repeated 0.8 mg of dose,and continuously dropped for 1.2 mg was added into liquid 500 mL.After treatment of 24 hours,were compared the changes of HR、SBP、SV and heart function.ResultsIn the naloxone group,the total effective rates were 84.4%,the mortality rates were 6.6%;in control group.The total effective rates were 60%,the mortality rates were 18.3%.The difference of the effective rate of the naloxone group be treatment was statistically significant(P

Physical activity is limited in maintenance hemodialysis (MHD) patients, and higher level of physical activity may result in less risk of death, milder depression or ahypnosis, less fatigue and better quality of life. Physical activity may relate with many factors. MHD patients may be benefited from exercise to improve the physical activity, mainly with aerobic exercise and resistance training during hemodialysis. Nurses can do more in health education and direction of exercise for MHD patients.

?AlM: To discuss the artificial tears on the tear film of diabetic patients with dry eye preoperatively, and the influence on the tear film’s fuctional after phacoemulsification.
?METHODS: Fifty-four diabetic patients with dry eye (60 eyes) were followed up before phacoemulsification. Preoperatively, group A ( 30 eyes in 28 cases ) was treated with Hydroxyl lndican eye drops and group B (30 eyes in 26 cases) was not treated. Postoperatively, both group A and B were treated with Tobramycin Dexamethasone eye drops, Oprah Winfrey lbuprofen eye drops and Hydroxyl lndican eye drops. Dry eye symptoms, break up time (BUT), SchirmerItest (SIt), fluorescein stain test ( Fl ) were measured at 3d preoperatively, and 1, 7, 30, 90d postoperatively.
? RESULTS: At 3d preoperatively, there was no statistical differences between the two groups for dry eye symptoms, BUT, S I t, Fl ( P>0. 05 ). At 1 and 7d postoperatively, there were significant statistical differents between the two groups for dry eye symptoms (P<0. 05). And dry eye symptoms scores of group A were less than that of group B. At 1, 7, 30d postoperatively, BUT was longer, FL was less, Slt was increased in group A, with significant statistical differences (all P<0. 05). At 90d postoperatively, two groups of dry eye symptoms, BUT, S I t, Fl had no statistical significance (P>0. 05).
? CONCLUSlON: Using artificial tears before phacoemulsification can improve symptoms of the diabetic patients with dry eye and accelerate the recovery of the tear film.

Objective To investigate the effect of melatonin on oxidative stress and inflammatory reaction in patients with moderate to severe chronic obstructive pulmonary disease and to explore its mechanisms. Methods 42 patients with moderate to severity chronic obstructive pulmonary disease in stable stage were random-ly divided into melatonin group and control group,and 21 patients in each group treated with melatonin(3 mg/d) or placebo for 3 months respectively. The plasma levels of 8- isoprotane,IL-8,TNF-α,h-CRP pulmonary func-tion,six minutes walking test and MRC dyspnea score before treatment,2 months and 3 months after the treatment were analyzed. Results After 2 months of treatment,compared to placebo groups,melatonin could significantly decrease the concentration of 8-isoprotane(10.40 ± 5.4 vs. 16.92 ± 4.33,P<0.05),and the concentration of IL-8 (6.88 ± 2.37 vs. 11.33 ± 3.39,P < 0.05). After 3 months of treatment,compared to placebo groups,melatonin could significantly decrease the concentration of 8-isoprotane(9.40 ± 4.0 vs. 17.92 ± 3.33,P < 0.01),and IL-8 (5.67 ± 3.22 vs. 9.31 ± 3.23,P < 0.05). Compared with before treatment,melatonin could significantly de-creased the concentration of 8-isoprotane(9.40 ± 4.0 vs. 20.40 ± 8.4,P<0.01 )and IL-8(5.67 ± 3.22 vs. 12.33 ± 3.88,P<0.05)after 3 months. Meanwhile,the concentration of the TNF-α(25.83 ± 9.18 vs. 35.83 ± 12.18,P<0.05)and hypersensitive C(1.76 ± 1.18 vs. 3.09 ± 1.79,P < 0.05)reactive protein in the melatonin group was greatly lower than the placebo group. After 3 months,compared to the placebo group,MRC dyspnea score of pa-tients in the group of melatonin was improved significantly(1.56 ± 1.38 vs. 2.09 ± 1.16,P<0.05 ),and lung func-tion and six minutes walk test showed no significant difference between patients in the two groups. Conclusions Exogenous melatonin administration can decrease the concentration of 8-isoprotane,IL-8,TNF-αand h-CRP in the blood of patients with moderate to severe COPD ,and improve the MRC dyspnea score. Melatonin has a significant effect on reducing oxidative stress and inhibiting inflammatory reaction in patients with moderate and severe stage stable COPD,which demonstrates its potential therapeutic value with broad clinical application prospects.

In order to promote rehabilitation exercises for breast cancer patients and to improve their quality of life,as well as to promote the development of nursing profession, our hospital has estab-lished a specialistnursing clinic for breast cancer since January 2016. We standardized nurses' qualification and training requirements, and performed management in patients'symptom assessment, nursingtechniqueguidance for breast cancer, sleep guidance, health education, long-term follow up, etc. After one year of implementation, symptom assessment was conducted 1283 times, rehabilitationexerciseguidance was 329 times, lymphatic drainage guidance was 297 times, sleep guidance was 159 times, health education was 591 times, sexual life with spouse guidance was 107 times, in-hospital nursing consultation was 48 times, family on-site demonstration was 29 times. The satis-faction rate was 98.4% which was higher than average level of the hospital according to outpatient investigation.

Aberrant promoter methylation in special genes such as tumor suppressor genes is early eventin carcinogenesis of lung cancer. Aberrant methylation, resulting in corresponding mRNA silence or overexpression , closely relates to carcinogenesis, development, treatment response and prognosis of lung cancer and it may become a potential biomarker. Methylation of special genes may provide evidences for individual treatment of lung cancers.

Forty-eight patients with essential hypertension or coronary disease in cardiac function NYHA class I underwent a routine electrocardiography and a cotour Dopper echocardiography were studied,and by multiple stepwise regression analysis irwas found that significant partial correlations exist between PTFVl and left atrial dimensionas wee as E peak,Macruz index and A peak.Macruz index≥1.6 gave a sensitivity of 71%VS accuracy 64% for A peak increase(>70 cm/s),of 61% vs 58% for A/E>1 respectively,.These results suggest that electrocardiographlic indexes of abnormality of left atriun combined with Colour Doppler echocardiograpby may be more helpful to predict wkether the latent left ventricutar diastolic dysfunction or decrease of diastolic reserve was present or absent in patients with essential hypertension or coronary artery disease in normal clinical cardiac function.

OBJECTIVE:To provide reference for rational application of tigecyclinet and alert to the occurrence of severe ADR.METHODS:Fifity patients receiving tigecycline in a level 3 general hospital during 2013-2015 were analyzed retrospectively to observe the change of symptom,sign and lab indexes after using Tigecyclinet injfection.Possible ADR of tigecycline,processing and outcomes were summarized.RESULTS:Among 50 patients,there were 24 cases of ADR,including 10 cases of inducing or aggravating blood coagulation abnormality (41.67％),9 cases of liver function injury (37.50％),4 cases of vomiting and other gastrointestinal discomfort (16.67％),1 case of red erythra with itching (4.17％).ADR of digestive system were mild and recovered after symptomatic treatment as inhibiting acid,antiemetic.Severe ADR as Liver function injury could not be recovered after symptomatic treatment as protecting liver,reducing enzyme.Nine cases of liver function injury mainly manifested as the elevation of TBIL,DBIL,ALP,LDH;8 of which suffered from liver function injury before medication and the symptom was aggravated after medication;liver function injury appeared in 3 cases on 10th day after medication and in 2 cases on 9th day after medication.Ten cases suffered from coagulation function disorder before medication and the symptom was aggravated after medication,which mainly manifested as the prolongation of APTT and TT and the elevation of INR,PT,D-dimer,etc.The coagulation function disorder was aggravated abnormally on 2nd-22th day after using tigecycline,mainly appearing on 2nd-5th day (70.00％).CONCLUSIONS:Great importance should be attached to severe ADR as coagulation function disorder,liver function injury when using tigecycline,in order to ensure the safety of drug use.