Objective To summarize the nursing experiences of patients who have received liver transplantation. Method Through the analysis 3 forms of preoperative nursing care and 6 forms postoperative nursing care methods of two cases of patients who have received liver transplantation, the important point and method of nursing care was made out. Result There were no complications were found, and the two cases were fully recovered and discharge from the hospital. Conclusion Sufficient preoperative preparation, earlier period vital sign monitoring,proper using of immunosuppressive agent,protecting complication protection, diet guidance, proper activity and resting, were the keys for the success of liver transplantation.

Objective:To assess the efficacy of trastuzumab combined with neoadjuvant chemotherapy in the treatment of human epidermal growth factor receptor-2 (Her-2)positive breast cancer patients,and to explore its influencing factors of prognosis of breast cancer.Methods:The clinical materials of 112 Her-2 positive breast cancer patients were collected and they were divided into combined treatment group (trastuzumab + neoadj uvant chemotherapy)and single chemotherapy group (without trastuzumab ). SPSS 1 9.0 software was employed to calculate and analyze their clinical characteristics.The survival rate and prognosis were analyzed by Kaplan-Meier method,Log-rank test, and Cox regression. Results:Among the 112 Her-2 positive breast cancer patients, 23 cases were treated with trastuzumab,89 cases were treated without trastuzumab.The disease-free survival (DFS)in combined treatment group and single chemotherapy group had significant difference (P=0.012).And there was no significant difference of overall survival (OS)between two groups (P=0.064).The HR negative group had 18 (32.7%)patients with 5-level of Miller and Payne (MP)classification which was higher than HR positive group (5/46,10.9%)(P=0.009).In univariate analysis,the tumor size,node status at diagnosis and node status after operation were the influencing factors of DFS in the Her-2 positive breast cancer patients;the tumor size,node status at diagnosis,MP classification and node status after operation were the influencing factors of OS in the Her-2 positive breast cancer patients.The result of multivariate analysis indicated that the tumor size, node status at diagnosis,and with or without radiotherapy were the independent influencing factors of DFS and OS in the Her-2 positive breast cancer patients. Conclusion:The breast lesions in the Her-2 positive breast cancer patients with negative HR are relieved after treated with trastuzumab combined with neoadjuvant chemotherapy. The combination of trastuzumab and neoadj uvant chemotherapy can significantly improve the DFS and has a positive influence in the prognosis of Her-2 positive breast cancer patients.

ObjectiveTo investigate the efficiency of autologous transplantation of peripheral blood stem cells for treatment of patients with diabetic lower limb ischemia.MethodsEighteen patients of type 2 diabetes with diabetic lower limb ischemia (30 legs) were treated by autologous transplantation of peripheral blood stem cells.ResultsThe limb pain, cool feeling and numbness feeling improved significantly after PBSC transplantation,the improvement rate were 96.7％, 100.0％ and 95.8％ respectively.Intermittent claudication was also relieved significantly, total remission rate was 76.9％.The ABI and TcPO2 of patients increased significantly at 3 months after transplantation.After the transplantation ABI raised from 0.60 ± 0.11 to 0.71 ±0.12(t =-6.882, P ＜ 0.01) .93.3％ of patients' TcPO2 raised in different degrees.The foot infections were well controlled.Ulcer or toes gangrene got better or healed.No obvious complications or adverse reaction were observed after the transplantation.ConclusionAutologous transplantation of peripheral blood stem cells shows to be a simple, safe and effective method in treating patients with diabetic lower limb ischemia.

Objective To detect the DMD gene mutation sites and the regions of breakpoints in Duchenne/Becker muscular dystrophy (DMD/BMD) patients in northern China. Methods Multiplex amplifiable probe hybridization (MLPA) was used to detect the mutation in 59 cases (51 cases with DMD and 8 with BMD) from northern China and dystrophin gene mutations in their parents. Results From northern China and dystrophin gene mutations 59 families found gene deletions in 33 cases of 59 DMD/BMD patients (55.9%), duplications in 6 cases (10. 2%) and point mutation in one case (1.7%). Intron 44 was most frequently affected (n = 13, 33.3%), followed by intron 50 (n = 11, 28.2%) and intron 45 (n=8, 20.5%). The novel mutations were identified, in two patients including two independent duplications carried by patient D1 149 and a point mutation [5208del(A)] carried by patient D1 65, which were not included in Leiden database. In addition, an exon 22 deletion was found in one patient, which was the first reported case in Chinese patients. Conclusions Deletions are mostly located in the hotspot between exon 45 and 50. Duplications mostly occurred in the 5' end of the gene. Intron 44 is the most frequently affected breakpoint in northern Chinese population.

Objective To investigate the safety and efficiency of robot-assisted partial nephrectomy (RAPN) for totally intrarenal tumors (TITs).Methods Thirty-eight patients who underwent RAPN for treating TITs by one experienced surgeon were included between August 2012 and December 2017.There were 25 males and 13 females,aged 26-72 years(mean 51.6 years).Tumors of 24 cases were in right kidney,and 14 cases in left kidney.The diameter of tumor was(3.12 ± 0.92) cm,the R.E.N.A.L.score was(9.76 ± 1.00),and the Scr was (74.82 ± 20.32) μmol/L.Patients' peri-operative and oncological outcomes were analyzed.Results All the tumors were successfully resected without conversion to open surgery or radical nephrectomy.Mean operative time and ischemia time were (188.47 ± 46.75) min and (24.32 ± 7.69) min.Mean blood loss was (115.79 ± 43.66) rrd.One-week postoperative Scr was (85.97 ± 28.33) μmol/L.Postoperative hemorrhage was successfully treated by DSA or drug therapy in 3 patients.The pathological examination showed 28 clear cell renal cell carcinomas,3 chromophobe renal cell carcinomas,3 TFE-3 infusion related renal cell carcinomas,2 metanephric adenomas,1 acidophile adenoma and 2 angioleiomyolipomas.One positive surgical margin occurred in RAPN group for cystic components.No evidence of tumor progression observed during follow-up.Conclusions RAPN is safe and effective in treating TITs when performed by an experienced surgeon at a high-volume institution.Further prospective and large-scale study was warranted to evaluate the long-term outcomes.

Objective To compare genomic copy number variations (CNVs) among different subtypes of breast cancer and analyze specific CNVs in each subtype. Methods AIMS software was used for genotype breast cancer (BasL, Her2, LumA and LumB), and GISTIC2.0 software was used to analyze genome-wide CNVs in tumor tissues from TCGA. We collected and analyzed the information and samples of 324 cases of invasive breast cancer admitted to Jiangmen Central Hospital(JMCH). Fluorescence quantitative PCR was used to detect the CNV of ERBB2, TFDP1, MIR148B, CCND1, MDM2 and MIR139 genes in the tumor tissues, to verify TCGA analysis. Results 13q34 was specifically amplified and 12q13.13 was specifically deleted in BasL-type breast cancer. The 17q12 was specifically amplified in Her2 type. The 12q15 was specifically amplified and 11q13.4 was specifically deleted in LumB type, but LumA type had no specific amplification or deletion of chromosome region. The proportion of TFDP1 amplification or MIR148B deletion in BasL type were 57.8% (TCGA) and 71.4% (JMCH), which were significantly higher than other subtypes (P < 0.001). The proportion of ERBB2 amplification of Her2 type were 55.2% (TCGA) and 86.7% (JMCH), which were significantly higher than other subtypes (P < 0.001). The proportion of LumB type with CCND1 or MDM2 amplification or MIR139 deletion were 47.6% (TCGA) and 61.8% (JMCH), which were significantly higher than other subtypes (P < 0.05). Conclusion At the CNV level of breast cancer, Her2 type is characterized by the amplification of ERBB2, BasL type is characterized by the amplification of TFDP1 or the deletion of MIR148B, LumB type is characterized by the amplification of CCND1 or MDM2 or the deletion of MIR139, but LumA type lacks specific CNV characteristics.

Malaria is one of the major diseases threatening the lives of people in Africa. Over the past decade, China has provided anti-malaria assistance to Africa. In November 2007, fast control malaria team of Guangzhou University of Chinese Medicine cooperated with the Comoros health authority. In Moheli Island of the Comoros, the anti-malaria team adopted a new strategy of Mass Drug Administration (MDA) and active intervention. They established an effective anti-malaria system and reporting system, as well as a local anti-malaria team. Furthermore, they treated patients with malaria in Moheli Island and implemended health education in local people. In a very short time, they have achieved remarkable results. This paper summarized the experiences of the project in order to provide useful reference for China to better carry out anti-malaria action in Africa and expand foreign health assistance.

Objective To apply PDCA(plan,do,check and action)cycle to optimize management and shorten the turnaround time(TAT)of five sex hormone tests for improving clinical efficiency and patient satisfaction.Methods A PDCA management team was established to retrospectively analyze the current status of sex hormone TAT in 2021.In 2022,PDCA tools were utilized,including fishbone diagrams for cause analysis,Pareto charts for root cause identification,formulation and implementation of corresponding im-provement measures and monitoring of TAT changes before and after PDCA.Results Through the corrective measures,such as staff personnel training,increasing testing equipment,optimization process and other improvement measures,the median TAT of sex hor-mone samples in 2022(post-PDCA improvement)was 54 minutes which was significantly lower than 61 minutes in 2021(pre-PDCA)(P＜0.05).Conclusion PDCA cycle management effectively shortened the TAT of sex hormone samples,enhanced clinical diagnostic efficiency and patient experience,improved doctor-patient relationships,while also elevated the quality management standards of labo-ratories.

Objective To explore the compensatory effect of exercise on brain activation abnormalities caused by sleep disorders.Methods Brain imaging meta-analysis was conducted using activation likelihood estimation(ALE)to investigate brain activation abnormalities caused by sleep disorders and changes in brain activation related to exercise.Results A total of 119 studies were included,and it was found that there was widespread activation in the bilateral frontal areas,hippocampus,superior and middle temporal gyri,and some regions of the thalamus in abnormal brain regions related to sleep disorders and brain regions after exercise intervention.Conclusion Exercise may play an important role in alleviating brain activation abnormalities caused by sleep disorders.

Objective To understand the correlation of constitutional type of Traditional Chinese Medicine between undergraduate nursing students and their agnate grandparents, so as to provide references for disease prevention and health guidance. Methods A total 800 undergraduate nursing students and their agnate grandparents were investigated with constitution in Chinese medicine questionnaire ( CCMQ ) designed by professor Wang Qi. Results A total of 784 questionnaires were collected. There were 569 effective questionnaires for nursing students which indicated that their agnate grandparents were living. There were 296 questionnaires for grandfather and 353 questionnaires for grandmother. Among the population, there were 389 persons ( 31. 94%) belong to Gentleness constitution, 769 persons ( 63. 14%) belong to lopsided constitutions. The most common constitutions types were gentleness type, Yang-deficiency type, Qi-deficiency type in nursing students (44. 46%) and their grandmothers (26. 62%). Nevertheless, the first three types of constitutions were Yang-deficiency type, Qi-deficiency type, Gentleness type in grandfather. Correlation analysis of constitutional type between nursing students and their grandparents indicated that there was no correlation in Gentleness constitution (r= -0. 09,0. 09;P>0. 05), but there were correlations in other constitutional types between nursing students and their grandparents (r=0. 20 0. 43;P<0. 01). Conclusions The correlation is not significant in constitutional type of traditional Chinese medicine between nursing students and their agnate grandparents, but it still has a certain directive significance for disease prevention and control in some family.