Objective To explore the modern communication tools urged by effect of patients with cor pulmonale discharge rehabilitation program. Methods A retrospective analysis was carried out from February 2014 to October 2016 in 46 cases of patients who suffered heart disease from lung disorders, they were given implementation of rehabilitation nursing through modern communication tools after discharge by the nursing staff. Another 46 cases of cor pulmonale patients were selected as the control group from January 2012 to January 2014, who were given routine rehabilitation treatment after discharge. The treatment effect, lung function and satisfaction degree were compared between the two groups after rehabilitation. SF-36 scale was adopted to assess the patients quality of life. Results The total efficiency was 97.83%(45/46) in the observation group, higher than that of the control group , 86.96%(40/46), the difference was statistically significant (χ2=3.8655,P<0.05). The indexes of pulmonary function of tidal volume, vital capacity, vital capacity, forced expiratory volume in one second of the observation group was (837.47±211.35), (3689.56 ± 174.63), (3788.43 ± 735.34), (1761.24 ± 510.35) ml, the control group were (678.34 ± 184.56), (3089.35 ± 215.35), (2916.36 ± 457.35), (1394.24 ± 394.34) ml, there were significant differences between two groups (t=3.8464-14.6825, P<0.01). The SF-36 scale physiological function, physiological function, mental health, emotional function, body pain, vitality, social function, general health scores of the control group were 77.46 ± 3.46, 74.32 ± 4.25, 72.13 ± 3.46, 77.46 ± 3.67, 75.78 ± 2.74, 79.53 ± 2.15, 80.46 ± 3.15, 78.94 ± 3.47, while they were 87.43 ± 5.23, 88.43 ± 3.47, 85.36 ± 2.36, 89.65 ± 5.36, 88.53 ± 3.48, 90.43 ± 4.36, 90.43 ± 2.35, 89.64 ± 3.27 in the observation group, there was significant difference between two groups (t=10.7831-21.4244, P<0.01). The satisfaction rate of the observation group was 97.83%(45/46), which was significantly higher than that of the control group 82.61% (38/46), and the difference was statistically significant (χ2=6.0348, P<0.05). Conclusions Rehabilitation treatment by the nursing staff through modern communication tools has a very good effect on pulmonary heart disease patients. It can help the pulmonary function of patients recover well, improve the quality of life and satisfaction degree significantly , which should be popularized in clinic.

Background and purpose: The morbidity of colorectal cancer in China increased year by year. This study aimed to explore the signiifcance of ADAMTS9 protein levels and promoter methylation in colorectal cancer onset and progression. Methods:ADAMTS9 promoter methylation status was detected by methylation speciifc PCR method in 162 colorectal cancer patients’ peripheral blood DNA samples; Plasmatic ADAMTS9 protein levels was detected by enzyme-linked immunosorbent assay method in 162 colorectal cancer patients and 150 healthy subjects. Results: Compared with healthy people, patients with colorectal cancer had a significant lower ADAMTS9 protein level in plasma [(65.25±9.70)μg vs (50.28±9.66)μg, P<0.001];ADAMTS9 gene promoter methylation was observed in 66 among 162 colorectal cancer patients (40.7%);The plasma level of ADAMTS9 protein in patients with methylated ADAMTS9 gene had signiifcantly reduced (P<0.001), while the plasma level of ADAMTS9 protein in patients with low ADAMTS9 protein had signiifcantly increased (P=0.007);ADAMTS9 methylation is closely related to tumor size (larger, P=0.017) and tumor differentiation degree (P=0.029), ADAMTS9 protein low expression is closely related to invasion depth (P=0.020), lymph node metastasis (P=0.019) and Dukes staging (P=0.002).Conclusion: ADAMTS9 protein downregulation induced by DNA promoter methylation may be involved in the pathogenesis, invasion and metastasis, and promote the progression in colorectal cancer.

Objective To investigate the relationship between programmed death receptor ligand 1 (PD-L1) and regulatory T cell(Treg) in non-small cell lung cancer.Methods Seventy-nine patients with non-small cell lung cancer who were treated in Hainan Provincial People's Hospital from December 2013 to December 2015 were selected.The levels of PD-L1 and Treg in cancer tissues and adjacent tissues were detected,observed the relationship with clinical pathological features,and analyzed the correlation of PD-L1 level and Treg infiltration.Results High expression of PD-L1 (53.2％,42/79) and Treg (50.6％,40/79) in cancer tissues were significantly higher than those in adjacent tissues (3.8％ (3/79),5.1％ (4/79)),the difference was significant (x2 =9.761,9.002,P＜0.05).High expression of PD-L1 (87.5％,28/32) and Treg(84.4％,27/32)were significantly higher in stage]Ⅲ and Ⅳ cancer tissues than those in stage Ⅰ and Ⅱ cancer tissues(29.8％(14/47),27.7％ (13/47)),the difference was significant (x2 =8.958,7.274,P ＜ 0.05).High expression of PD-L1 (85.3％,29/34) and Treg (88.2％,30/34) were significantly higher in lymph node metastasis cancer tissues than those in non-lymph node metastasis cancer tissues (28.9％ (13/45),22.2％ (10/45)),the difference was significant(x2=8.146,9.056,P＜0.05).The high level of PD-L1 in cancer tissues was positively correlated with high Treg infiltration (r =0.762,P＜0.05).Conclusion The expression of PD-L1 and Treg in non-small cell lung cancer tissues is related to the lymph node metastasis and stage,and the high expression of PD-L1 is positively correlated with the high infiltration of Treg.

Objective:To study the feasibility of electronic gingivoplasty on the subjects suffering from high blood sugar or blood coagulating dysfunction on rat model.Methods:Electronic gingivoplasty was performed in 10 SD rats with high blood sugar and 10 with blood coagulating dysfunction on the right side of mandible and scalpel gingivoplasty on the left.For each group of diseased rats 10 healthy rats were used as the controls. Gingival tissue slices of the rats with high blood sugar and the controls were obtained 1,24, 72 hours, one and two weeks after operation respectively, and processed for histological observation. The bleeding condition were evaluated with paper tips during the operations on the rats with blood coagulating dysfunction and the controls.Results:The process of histological reaction in the tissues of operation area after electronic gingivoplasty was basically similar to that after scalpel gingivoplasty. Electronic surgery caused more slight inflammatary reaction than scalpel surgery in high blood sugar group. The amount of bleeding during electronic surgery was significantly smaller than that during scalpel surgery in blood coagulating dysfunction group.Conclusion:Electronic surgery is feasible for gingivoplasty on the subjects with high blood sugar or blood coagulating dysfunction.

Liquid biopsy of circulating free DNA has become an auxiliary method to evaluate cancer.Because of the advantages of minimally invasive and simple, it plays an increasingly important role in the screening, diagnosis, monitoring treatment, prognosis and drug resistance detection of breast cancer.This article reviews the clinical application and related research progress of circulating free DNA (cfdna) in breast cancer.

Objective To discuss change the platelet counts by microscope rule by the platelet of Chinese people biological refer‐ence range in this laboratory blood analysis requirement .Methods Retrospectively analyzed according to the platelet of Chinese people biological reference range change the lab Sysmex XE‐5000 automatic blood cell analyzer platelet review rules .Change the platelet counts by microscope rules ,the differences between the microscopy rate and the microscopic examination of the platelet ag‐gregation rate .Results Before change the platelet counts by microscope rules the microscopy rate was 1 .94% .After change the platelet counts by microscope rules the microscopy rate was 3 .99% ,after change the platelet counts by microscope rules pushing blood piece rate increased significantly ,the difference was statistically significant(P<0 .05) .Conclusion According to the platelet of Chinese people biological reference range change the lab platelet review rules .We can increase the rate of microscopy ,and effec‐tively avoid the pseudothrombocytopenia and accurately guide clinical treatment .

Objective To explore the clinical features of sentinel polyps (rectal polyps with proximal colon carcinoma), and the correlation between sentinel polyps and proximal colon carcinoma. Methods The clinical data of 331 patients with rectal polyps were retrospectively analyzed. According to the combination condition of proximal colon carcinoma, the patients were divided into sentinel polyps group (observation group, 37 cases) and pure rectal polyps group (control group, 294 cases). The family history, laboratory examination, colonoscopy, clinical pathological features, treatment, sequelae and short-term prognosis were compared between 2 groups. Results The family history rate, positive rate of tumor marker and the incidences of polyps maximum diameter>1 cm, polyps>5 pieces, adenomatous polyp in observation group were significantly higher than those in control group:35.1%(13/37) vs. 4.8%(14/294), 67.6%(25/37) vs. 6.8%(20/294), 62.2%(23/37) vs. 46.6%(137/294), 43.2%(16/37) vs. 11.9%(35/294) and 83.8%(31/37) vs. 35.4%(104/294), and there were statistical differences (P<0.01). The patients in control group did not have special find in colonoscopy. The majority patients in observation group had new organisms around the lumen growth in colonoscopy, but the intestinal canal between rectal polyps and proximal colon carcinoma did not have special find. The majority pathologic type of proximal colon carcinoma patients in observation group was papillary adenoearcinoma and tubular adenocarcinoma, 75.7%(28/37). Duke stage:A stage was in 11 cases (29.7%, 11/37), B stage in 11 cases (29.7%, 11/37), C stage in 9 cases (24.3%, 9/37), and D stage in 6 cases (16.2%, 6/37). In control group, 282 patients (95.9%, 282/294) were treated by endoscope, and they were cured and discharged. In observation group, 15 patients (40.5%, 15/37) were treated with radical operation, 9 patients (24.3%, 9/37) by endoscope, 7 patients (18.9%, 7/37) with palliative surgery, 4 patients (10.8%, 4/37) with chemotherapy, and 2 patients (5.4%, 2/37) with symptomatic treatment;the patients were followed up for 6-12 months, the 23 patients with complete tumor resection did not relapse, 12 patients showed tumor reduction or symptomatic relief, and the other 2 patients died. Conclusions If maximum diameter over 1 cm, multiple and adenomatous polyps exist, the possibility of carcinogenesis of the polyps or the proximal colon should be awared. The patients should be followed up in short-term and complete the whole colon examination.

OBJECTIVE:To explore the method and approach for traditional Chinese pharmacists to play an active role in case of emergent epidemic situation. METHODS:Taking the opportunity of H1N1 flu treatment,the traditional Chinese pharmacists carried out pharmaceutical services such as drug counseling,establishing medication history for typical cases,offering guidance and advice on medication,retrospectively analyzing prescription and consulting records. RESULTS & CONCLUSION:In the differential treatment,pharmacists of traditional Chinese medicine should take full account of patients' individual differences,actively participate in the design of individualized dose scheme and offer medication guidance so as to enhance patients' medication compliance meanwhile enhancing the status of pharmacists of traditional Chinese medicine.

AIM:To study the electrophysiological effects of amiodarone on the pacemaker cells in guinea-pig left ventricular outflow tract under the conditions of hypoxia,acidosis and treatment with epinephrine.METHODS:The action potentials of the pacemaker cells in guinea-pig left ventricular outflow tract were recorded by conventional intracellular microelectrode technique.The effects of amiodarone on the spontaneous slow response potentials were investigated under the conditions of hypoxia,acidosis and treatment with epinephrine.RESULTS:(1) Amiodarone at concentration of 0.1 ?mol/L markedly decreased the rate of pacemaker firing (RPF) and maximal diastolic potential (MDP),lengthened 80% of the duration of action potential (APD80).Amiodarone at concentration of 1 ?mol/L significantly decreased the velocity of diastolic depolarization (VDD) and RPF,the maximal rate of depolarization (Vmax),MDP and amplitude of action potential (APA),lengthened 50% of the duration of action potential (APD50) and APD80.Amiodarone at concentration of 10 ?mol/L led to a significant decrease in VDD and RPF,Vmax,MDP and APA,a notable lengthening in APD50 and APD80 was also observed.(2) Under the condition of hypoxia and perfusion with deprived glucose content for 15 min,VDD,RPF,MDP,Vmax and APA decreased significantly,APD50 was shortened notably.Under the condition of hypoxia,amiodarone at concentration of 1 ?mol/L significantly decreased VDD,RPF and Vmax,increased MDP,lengthened APD50 and APD80 as compared to the cells treated with hypoxia only.(3) Perfusion with pH 6.8 solution for 10 min,VDD and RPF significantly decreased,Vmax and APA notably reduced,APD80 was markedly shortened.Under the condition of acidosis for 10 min,amiodarone significantly decreased VDD,RPF,MDP and APA,lengthened APD50 and APD80 as compared to the cells under the condition of acidosis only.(4) Perfusion of epinephrine at concentration of 10 ?mol/L for 10 min resulted in a significant increase in VDD,RPF,Vmax,MDP and APA,a notable shorting in APD50 and APD80 was also observed.Compared to 10 ?mol/L epinephrine group,1 ?mol/L amiodarone+ 10 ?mol/L epinephrine significantly reduced VDD,RPF,Vmax,MDP and APA,lengthened APD50 and APD80.CONCLUSION:Amiodarone markedly decreases the autorhythmicity of the pacemaker cells in guinea-pig left ventricular outflow tract.This electrophysiological effects were significantly influenced by hypoxia,acidosis and epinephrine.