Inflammatory breast carcinoma (IBC) is a particularly local advanced breast cancer,which has characters of high invasion,high metastasis and high human mortality.Because of high malignancy and rapid development,extensive body metastasis often happens in early stage and the prognosis is very poor.Currently,the therapy strategy of operation,chemotherapy combined with radiotherapy is used to treat IBC.However,the effect is always very limited.Now,the advances in researches of molecular biology and cancer immunology bring hope.Some recent progresses of therapy in IBC are reviewed in the article.

The price adjustment in medical service system is a quite complex systematic engineering,this paper proposed the implement steps for the price adjustment in medical care system and correlative information technological support in Nanjing Jinling Hospital in details.The application results showed that the steps for the price adjustment in medical service system could insure the adjustment process steadyand effective,and it could also make the new price list software system and the whole information system run stably and reliably.

BACKGROUND: Family factor is the main reason for children's psychological and behavioral problems. Seen from the view of systemic family theory, in any circumstances, children's behavioral problems reflect various interpersonal systemic networks among society, school, family, relatives and friends and the relationship of complicated interactions among individuals.Family therapy is an important way to cure children's behavioral problems.OBJECTIVE: To observe whether systemic family rehabilitation is adequate for intervening in children's behavioral problems.DESIGN: Cluster sampling; Contrast observationSETTING: Department of Psychiatry, Kunming Medical College.PARTICIPANTS: A total of 276 students in grade four from Mingtong primary school of Kunming City were selected along with their parents from May 2004 to March 2005. A survey was conducted on students and their parents according to the principle of cluster sampling.METHODS: Self-rating family dynamics scale was used to investigate the characteristics of family dynamics of 276 students in grade four. Achenbach child behavior checklist for parents was adopted to investigate the situation of their children' s behaviors. 57 cases of children with behavioral problems were detected out, and took the families in which the whole family members voluntarily participated in the intervention as interventional group and the families in which any one of the family members did not want to participate in the intervention as abnormal control group. The students and their parents in interventional group were treated with 4-month systemic therapy. 4 months later, resent the above rating scales.MAIN OUTCOME MEASURES: Comparison of family dynamics and children's behaviors between interventional group and abnormal control group before and after intervention.RESULTS: After intervention, changes of family dynamics and children's behaviors in interventional group had taken place, which had statistical difference. The changes as follows: family atmosphere changed from "depressive and hostile" to "harmonious, pleasant, equal and exoteric"; the degree of individuation of family members changed from low level to high; disease concept changed from "regarding the patients as helpless victims" to "regarding them as helpful doers", which realize "softening of disease concept". The total scores of Achenbach child behavior checklist for parents decreased [The scores of questionnaire for fathers before and after intervention were (42.20±22.58) and (28.95±21.90) respectively, and scores of questionnaire for mothers before and after intervention were (50.95±14.60) and (36.40-±15.36) respectively, P ＜ 0.05]. There was no significant difference between the changes of children's behaviors assessed by fathers and mothers in abnormal control group [The scores of questionnaire for fathers before and after intervention were (38.32±17.30) and (37.57±16.45) respectively, and scores of questionnaire for mothers before and after intervention were (45.54±16.02) and (40.14±17.95) respectively, P ＞ 0.05].CONCLUSION: Using the idea and technique of systemic family therapy ,it is feasible and effective to intervene in children's behavioral problems by family therapy.

Objective To explore stimulative of posttraumatic growth(PTG) of head-injured patients associated with limb movement disorder,in order to provide reference for psychological nursing intervention.Methods Phenomenological methodology was used in the study.A semi-structured interview was conducted on seven head-injured patients with limb movement disorder recruited by purposive sampling method.Data were analyzed by Colaizzi's analysis procedure.Results Through interview,the following four themes were summarized:positive state of mind and coping style of patients; patients' high level of self-efficacy; social support; high quality of medical services.Conclusions In order to promote PTG of head-injured associated with limb movement disorder patients,nurses should strive to adjust the patient mentality and coping strategies,improve their self-efficacy levels,help patients get support from the community,at the same time should also focus on quality of medical services.

Objective To observe the analgesia effect of combination of continuous femoral nerve block and oral analgesics after total knee arthroplasty and the impact on early rehabilitation of knee.Methods Sixty patients scheduled for unilateral total knee arthroplasty were randomly divided into two groups.One group was the multimodal analgesia group (group M)and the other was patient controlled intravenous analgesia group (PCIA)(group Ⅰ),30 patients in each group.In group M, patients were given celecoxib (200 mg,bid)and oxycodone (10 mg,bid)two days before operation, then received continuous femoral nerve block followed by oral acetaminophen (100 mg,tid)and oxyc-odone (20 mg,bid)three days after operation.In group I,patients took no medicine before operation and only received PCIA after operation.The two groups were compared with postoperative visual ana-logue scale(VAS)scores at 6,12,24,48 h at rest,during active training and continuous passive movement,range of motion of the knee joint during active training and continuous passive movement, the first time of ambulation,length of hospital stay,range of motion of the knee joint at hospital dis-charge and the incidence of complications.Intravenous dezocine 5 mg was given when VAS score was higher than 5,which was recorded.Results Compared with group Ⅰ,the VAS scores at rest,during active and continuous passive movement at postoperative 6,12,24,48 and 72 h in group M were de-creased significantly (P <0.05).The range of motion of the knee joint during active training and con-tinuous passive movement at postoperative 24,48 and 72 h in group M was increased significantly(P<0.05).The first time of ambulation(2.5±0.8)d and length of hospital stay(9.1±2.3)d in group M were shorter significantly than the first time of ambulation (3.3 ±0.7)d and length of hospital stay (10.8±2.0)d in group I (P <0.05 ).The range of motion of the knee joint(95.6 ± 1 7.2)°in group M at hospital discharge was greater significantly than the range of motion of the knee joint (82.5± 1 5.2 )° in group I (P < 0.05 ).The incidence of nausea and vomiting (3.3%),uroschesis (6.7%)in group M was lower significantly than the incidence of nausea and vomiting (30.0%), uroschesis (26.7%)(P < 0.05 ).Additional use dezocine (3.3%)was lower significantly than additional use dezocine (40.0%)(P <0.05).Conclusion Compared to patient controlled intravenous analgesia,combination of continuous femoral nerve block and oral analgesics can effectively alleviate postoperative pain in patients undergoing total knee arthroplasty,which is beneficial to early postop-erative knee function recovery.

Objective To investigate the effects of Huaier Granule combined with TAC chemotherapy on immunologic function and prognosis in triple negative breast cancer patients after operation.Methods Ninty-two cases of Ⅰ-ⅢA stage triple negative breast cancer patients entered the study.They were randomly divided into control group and research group.Only TAC chemotherapy was affected in control group of 42 cases, while Huaier Granule combined with TAC chemotherapy was applied in research group of 50 cases.And we gave Huaier Granule to patients in the first day of chemotherapy.The changes of T cell subset, NK cell were detected in the patients respectively in the first day before therapy and after therapy.The five-year disease-free survival rate and overall survival rate were also observed in two groups.Results Compared with control group, the changes of T cell subset, NK cell had no significant differences in research group in the first day before therapy(P ＞0.05).In the first day after therapy, the level of CD4 + (38.16 ± 5.71) ％ in control group was significantly lower than that (44.67 ± 6.47) ％ in research group(P ＜ 0.05).However, the percentage of CD8 + T cells (28.68 ± 4.06) ％ in control group was markedly higher than that (22.85 ± 3.22) ％ in research group (P ＜ 0.05).The level of NK cell (15.75 ± 3.47) ％ in control group was obviously lower than that (19.46 ± 4.22) ％ in research group(P ＜ 0.05).The five-year disease-free survival rate is 28.6％ in control group, however the five-year disease-free survival rate is 42.0％ in research group, there were significant differences between two groups(P ＜ 0.05).Furthermore, the five-year overall survival rate in research group was obviously higher than that in control group(P ＜ 0.01).Conclusions Huaier Granule combined with TAC chemotherapy not only enhances immune function but also improves prognosis and quality of life in triple negative breast cancer patients after operation.It provides a positive exploration for anti-cancer research by integration of traditional and western medicine.

Objective: To raise the all-round informational level through analyzing the necessity of constructing compound medical library.Methods: Through aiming at the fundamental characters of compound medical library,so as to carry out the practices of theoretical researches,the development and optimization of network environments,the integration of informational resources,the enhancement and innovation of information service quality.Results: To provide some helpful references from the traditional to the compound state.Conclusion: Constructing compound medical library by combining the traditional with the digital base is the only way to accelerate the development of medical library.

The current situation of the satellite-based distant medical education, the distant hygienic education was introduced. We analysed the characteristic and advantage and indicated the importance and necessity of the satellite-based distant medical education.

This paper introduces the overall strategy of routing,the organization and preparation as well as the implementation of VLAN division in Nanjing General Hospital of Nanjing Military Region.VLAN can control the broadcast storm and enhance the safety and management of local area network.

On the model of isoprenaline (ISO)-perinjured rat heart, the protctive effect of ischemic preconditioning (IPC) on ischemia reperfusion (I/R) damage was observed.It was found that compared with alone I/R group,IPC ameliorated I/R-induced reduced reduction of coronary blood flow (CBF) (8. 8 + 0. 6 vs 6. 6 + 0. 4mL/min,P