Objective To examine cardiotoxicity of anthracyclines and trastuzumab in patients with breast cancer by two dimensional speckle tracking imaging. Methods Fifty-eight human epidermal growth factor receptors-2 (HER2) positive patients with breast cancer treated by anthracyclines and trastuzumab were monitored by echocardiography before treatment (Group A), after completion of anthracyclines (Group B), and at follow-up of 3 months (Group C) and 12months (Group D) after using trastuzumab. LVEDD, IVSTD, PWTD, LVEDV, LVESV were measured in the apical four- and two-chamber views. Left ventricular ejection fraction (LVEF) was measured using a modified Simpson's biplane method. Global longitudinal strain (GLS) and longitudinal strain rate (LSR) were calculated via Qlab8.0 analysis software off-line. Results LVEDDs in A-D groups were (47.95 ±4.12), (48.45 ±4.02), (48.91 ±3.83) and (49.98 ±3.72) mm, respectively, and LVEDVs were (108.70 ±21.26), (111.90 ±20.91), (113.50 ±20.25) and (119.20 ±20.02) ml, respectively. LVEDD, PWTD [(9.14 ±0.76) mm vs. (9.00 ±0.82)mm], LVEDV, LVESV [(54.60 ±14.58) ml vs. (50.97 ±14.35) ml] were increased in group B compared with those in A group (all P<0.05). LVEDD and LVEDV were increased in group C(P<0.05) compared with those in group B. CLVEDD, LVEDV, LVESV [(59.18±13.88) ml vs. (55.23± 13.81) ml] were increased in group D compared with group (P<0.05). Differences of LVEF between group C and group D were statistically significant[(59.48±2.62) % vs. (62.00±1.40) %, P<0.001]. Differences of GLS [(-21.16±2.33)%, (-19.76±1.98) %, (-19.22±1.89) % and (-18.74±1.79) %, respectively, P<0.001] and LSR [(-1.27±0.11), (-1.22±0.09), (-1.17±0.07) and (-1.14±0.06) /s, respectively, P<0.001] among four groups had all statistically significant. Conclusions Longitudinal left ventricle systolic function are impaired in patients with breast cancer treated by anthracyclines and trastuzumab. GLS and LSR of myocardium traced by two dimensional speckle tracking imaging would be useful for early evaluation of the severity.

Objective:To explore the clinical characteristics, possible causes and treatment methods of anaphylactoid reactions related to PICC catheterization.Methods:A retrospective analysis of the data of 27 patients with anaphylactoid reactions in 3 933 PICC catheters from October 2018 to February 2020.Results:The incidence of anaphylactoid reactions was 0.69%(27/3 933), its clinical symptoms were mainly skin reactions, some of which were complicated with respiratory, digestive, cardiovascular system and other symptoms. There was no difference in the incidence of different genders, diagnosis, and history of allergy ( χ2 value was 2.233, 0.839, 0.027, P>0.05). The incidence of patients younger than 60 years old was higher than that of patients older than 60 ( χ2 value was 12.821, P<0.01); the incidence of two catheters with different coatings was higher than that of uncoated catheters ( χ2 value was 27.195, 84.203, P<0.01). Twenty six patients continued the catheterization after the symptoms relieved, and one patient stopped the catheterization. Conclusion:The incidence of anaphylactoid reactions related to PICC, which is more common in catheters or the stylet wire is coated. It is recommended to use a large amount of saline to flush the catheter to reduce or avoid coating materials into the blood, so as to effectively control the occurrence and severity of such complications.

OBJECTIVETo detect the mutation sites of exons 2, 20, 11A and 11B in Chinese patients with breast cancer.

METHODSA total of 86 patients with breast cancer without blood relationship were randomly selected. Polymerase chain reaction (PCR) and double-strand DNA direct sequencing were applied.

RESULTSNo mutations, especially deletions were found in exons 2, 20 and 11 with carefully checking the sequencing results, although they were reported frequently in Europe populations with breast cancer. We found one polymorphism in exon 11, with high frequency, and in the test of chi-square, the frequencies of two alleles had no significant difference between the patients and controls.

CONCLUSIONThe above results suggest this SNP may not be associated with the breast cancer in Chinese population, and indicates that the gene sequence of what we have studied doesn't account much for occurrence of the breast cancer in the population of China.

Asian Continental Ancestry Group ; genetics ; BRCA1 Protein ; genetics ; Breast Neoplasms ; genetics ; Exons ; Female ; Gene Frequency ; Humans ; Mutation ; Polymorphism, Genetic

Objective To compare the effects of mini-midline catheters that were placed in different sites.Methods The inpatients of a tertiary general hospital in Zhejiang Province from October 2023 to January 2024 were selected as the study subjects using a fixed point continuous convenience sampling method.The patients were divided into 2 groups by simple random grouping method.The experimental group had a mini-midline catheter placed in the upper arm,and the control group had a mini-midline catheter placed in the forearm.The incidence of catheter-related complications,the puncture success rate with one-attempt,the total procedure time,the time of the first occurrence of catheter-related complications,the rate of removal due to complications,and the indwelling catheter duration were compared between the 2 groups.Results A total of 121 patients were included,including 64 in the experimental group and 57 in the control group.The incidence rates of catheter-related complications in the experimental group and the control group were 29.69％and 66.67％;the times of the first occurrence of catheter-related complications were 167(122,220)h and 104(73,168)h;the rates of removal due to complications were 17.19％and 42.11％;the indwelling catheter duration was 171(124,258)h and 120(92,187)h;the differences between the 2 groups of these outcomes were statistically significant(P＜0.05).The puncture success rates with one-attempt in the experimental group and the control group were 96.88％and 96.49％;the total procedure times were 352(296,446)s and 370(295,430)s;the differences between the 2 groups of these outcomes were not statistically significant(P＞0.05).Conclusion Mini-midline catheters inserted in the upper arm can reduce the incidence of catheter complications and the rate of removal due to complications,prolong the time of the first occurrence of catheter-related complications and the indwelling catheter duration.

Objective:To explore the current status of physical frailty in elderly patients with chronic obstructive pulmonary disease (COPD) and analyze its influencing factors.Methods:A total of 278 COPD patients who were admitted to Geriatric Medicine Center of Xinjiang Uygur Autonomous Region People's Hospital from February 2018 to February 2020 were selected as the research objects by the convenient sampling method. FRAIL Scale was used to assess frailty status of the patients. General information questionnaire and clinical questionnaires were used to investigate. Ordinal Logistic regression model was used to analyze the influencing factors of frailty in elderly COPD patients.Results:A total of 278 questionnaires were issued and 260 valid questionnaires were returned, including 120 cases without frailty, 97 cases in early frailty and 43 cases in frailty. The results of ordinal logistic regression analysis showed that age [ OR=1.324, 95% CI: (1.011-1.632) ], whether exercise regularly [ OR=0.265, 95% CI: (0.004-0.765) ], whether lack of nutrition [ OR=1.335, 95% CI: (0.258-1.985) ], with or without comorbidities [ OR=1.654, 95% CI: (0.521-1.865) ], lung function classification [ OR=2.356, 95% CI: (1.520-3.690) ], whether inflammation [ OR=1.258, 95% CI: (0.024-1.821) ] and prolonged length of stay in hospital due to exacerbation of COPD in the past 1 year [ OR=0.854, 95% CI: (0.214-1.662) ]were influencing factors of frailty in elderly COPD patients (all P<0.05) . Conclusions:The frailty of elderly patients with COPD is affected by factors such as age, exercise, nutritional status, length of stay in hospital, lung function, inflammation and complications. Nursing staff should prevent frailty and delay the progression of frailty in COPD patients through effective intervention.