Objective:To analyze the current situation of fear, discharge preparation, family function and quality of life of breast cancer patients during chemotherapy, and to explore the influence of fear, discharge preparation and family function on their quality of life by constructing structural equation model.Methods:A total of 274 patients with breast cancer undergoing chemotherapy in Shanxi Cancer Hospital from January to July in 2019 were investigated with Quality of Life Instruments for Cancer Patients-Breast Cancer(QLICP-BR), Fear of Progression Questionnaire-Short Form(FoP-Q-SF), Readiness for Hospital Discharge Scale(RHDS) and Family APGAR Index(APGAR).Results:The total score of the quality of life was 137.78 ± 21.66, the total score of recurrence fear was 34.61±12.36, the total score of discharge preparation was 95.57±18.83, and the total score of family function was 7.53 ± 2.66. The structural model showed that fear, family function and discharge preparation had a direct predictive effect on quality of life, the direct effects were -0.468, 0.331 and 0.509, respectively ( P<0.01); fear had an indirect negative predictive effect on quality of life through the mediation of discharge readiness ( β value was -0.127, P<0.01), and family function had an indirect positive effect on quality of life through the mediation of discharge preparation. The predictive effect was ( β value was 0.124, P<0.01). Conclusions:Fear, discharge preparation and family function are important factors affecting the quality of life of breast cancer patients undergoing chemotherapy. Fear and family function can also indirectly affect the quality of life through discharge preparation.

Objective To discussion the clinical study of milrinone injectionon on acute heart failure with poor effect of digitalis and diuretics.Metheds 90 cases of acute heart failure with poor effect of digitalis and diuretics patients from September 2014 to May 2016 in our hospital were selected,according to the random number table method is divided into control group and study group,45 cases in each groups,the control group was treated with conventional heart failure intervention program,the study group given milrinone injectionon on the basis of control group,two groups were treated for seven days.Serum neurohormonal factors,inflammatory factors and blood pressure were measured before and after treatment,and the clinical efficacy and complications were compared between two groups.Results Compared with before treatment,serum NT-proBNP,NE and ET-1 levels were decreased in two groups,NO content increased,the levels of serum TNF-α,IL-6 and Hs-CRP were decreased,the levels of LVEF and CI were increased,the levels of LVEDD and CTR were decreased,the differences were statistically significant(P<0.05).Compared with the control group,the levels of serum NT-proBNP,NE and ET-1 in the study group were lower,NO were higher,the levels of TNF-α,IL-6 and Hs-CRP in serum were lower,LVEF and CI were higher,LVEDD and CTR were lower,the differences were statistically significant(P<0.05).The effective rate of the study group was 86.67％,which was significantly higher than that of the control group(66.67％,P<0.05).All the patients were followed up and no cases were reported.There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Milrinone injectionon has a significant effect on acute heart failure with poor effect of digitalis and diuretics,can significantly reduce the neurotrophic factor and inflammatory factors,improve heart function,promote prognosis.

Objective To explore the influence of carvedilol combined with diuretics on BNP and cardiac function of patients with mild to moderate cardiac insufficiency.Methods87 cases of patients with mild to moderate cardiac insufficiency treated in Zhejiang Greentown Cardiovascular Hospital from June 2014 to June 2016 were divided into the groups randomly.The control group of 44 cases were given carvedilol treatment, and the study group were combined with spironolactone treatment on the basis of the control group, with the total course for a month.Clinical effects were contrasted after a month of treatment in the two groups, in order to explore the influence of carvedilol combined with diuretics on BNP and cardiac function of patients with mild to moderate cardiac insufficiency.ResultsBefore treatment, there was no significant difference in serum BNP level between the control group and the study group.After treatment, serum BNP level significantly decreased when compared with those before treatment in the two groups (P< 0.05), which of the study group was significantly lower than that in the control group(P< 0.05).Before treatment, there were no significant differences in the levels of cardiac function indexes, and after treatment, heart rate, EF (%), FS (%), LVEDD (mm) the four indicators significantly improved when compared with those before treatment, and heart rate, LVEDD (mm) levels were significantly lower than those in the control group(P<0.05), and EF (%), FS (%) levels were significantly higher thatn those in the control group(P<0.05).After treatment, the significant effective rate (73.91%) and total effective rate (95.35%) in the study group were significantly higher than that of (56.82%) and(86.36%) in the control group (P<0.05).After treatment, body function, life satisfaction, mental health, social adjustment the four parts of quality of life index scores were significantly higher than those in the control group(P<0.05).ConclusionIt has obvious improvement effect of carvedilol combined with diuretics on BNP and cardiac function of patients with mild to moderate cardiac insufficiency.It is worthy of clinical application.

Marine actinomyces LYG-1 was isolated from marine mud flats in Lianyungang,China.Strain LYG-1 was identified using the methods of morphology,physiological and ehemotaxonomic characterization and 16S rRNA gene sequence analysis.The results showed that strain LYG-1 was a marine variable species of Streptomyces roseosporus.The fermentation broth of strain LYG-1 exhibited conspicuous antitumor activity against HepG2,MCF-7,HCT116 and MDA-MB-231 cell lines,and the IC50 values were defined by MTT method respectively.

Objective Toinvestigatethehemodynamicchangesofthegraymatterandwhitematterinpatientswithchronicmountain sickness(CMS).Methods 14CMSpatientsand12healthyvolunteerswererecruitedinthisstudy.Allofthem wereperformedbyroutineMRI andperfusionweightedimaging(PWI)scans.Aftertheappropriatepost-processing,therelevanthemodynamicparametersofdifferent graymatternucleiandwhitematteroffrontallobewereobtained,andthedifferenceofeachvaluebetweenthetwogroupswascompared.Results Therelativecerebralbloodflow (rCBF)decreasedinthebraingraymatterandwhitematterinCMSpatientswhencomparedwith normalgroup(P<0.05)[rCBFofthespleniumofthecorpuscallosum was(40.57±18.89)mL·100g-1·min-1forCMSpatients, and (64.56±18.55)mL·100g-1·min-1fornormalgroup],andatthesametime,meantransittime (MTT)andtimetopeak (TTP)werebothprolonged(P<00.5)[MTTofthespleniumofthecorpuscallosumwas(66.3±19.5)sforCMSpatients,and(48.0±2.17)sfor normalgroup;TTPofthespleniumofthecorpuscallosum was(26.86±4.67)sforCMSpatients,and (23.17±3.01)sfornormal group].Conclusion Collateralcirculation mayexistinCMSpatients’brain.Therearecerebralhemodynamicdifferencesbetween CMSpatientsandhealthyvolunteers.MRPWIisanimportantwayfordiagnosisofCMS.

Objective To investigate the nutritional management level of Department of Clinical Nutrition in elderly inpatients through analyzing the actual hospital dietary intakes in elderly inpatients in Peking Union Medical College Hospital from 2013-2015.Methods Using continuous sampling, the nutrients contents and the eating rates of hospital meals ordered by the elderly inpatients on the 1st, 15th, 29th of every month from May 2013 to October 2015 were selected.The intake levels of energy, protein, calcium, vitamin A, vitamin B1 , and vitamin C were calculated and compared with the Chinese dietary reference intakes (DRIs).The nutritional in-take differences between diabetes diet and the basic hospital diet were also compared.Results A total of 90 days of hospital dietary data from 8 402 elderly inpatients were included in the study.The average eating rate was (50.1 ±4.2)%, which was lower than the general eating rate of the hospital [ (59.0 ±4.0)%, P<0.001]. Only protein intake from hospital diet reached the requirement target [male (103.1 ±47.3)%, femal (98.3 ± 33.8)%].Individual compliance rates were 63.2%and 59.8%, respectively, while the other kinds of nutrients were lower.The compliance rates of energy [ (73.3 ±26.3)%vs.(62.1 ±38.2)%, P<0.001] and ma-jor nutrient intake [ protein: ( 119.1 ±41.2 )% vs.( 93.3 ±65.1 )%, P <0.001; calcium: ( 55.5 ± 26.7)% vs.(34.3 ±34.2)%, P <0.001; vitamin A: (75.2 ±48.3)% vs.(57.4 ±97.1)%, P<0.001;vitamin B1:(76.4 ±38.2)%vs.(52.1 ±46.6)%, P<0.001;vitamin C:(92.2 ±51.4)%vs. (49.3 ±55.0)%, P<0.001) in diabetes diet group were significantly higher than those in the basic hospi-tal diet group.Conclusions The nutritional intakes from hospital diets may not meet the nutritional require-ments based on DRIs in elderly inpatients.Medical diet designed by physicians and dietitians should be ex-panded to improve the nutritional management level for these patients.

Objective To investigate the effect of subclinical hypothyroidism during pregnancy on hippocampus insulin-like growth factor Ⅰ (IGF-Ⅰ) signaling pathway in rat offspring.Methods A total of 60 female Wistar rats were evenly divided into control(CON),subclinical hypothyroidism(SCH),and clinical hypothyroidism (CH) groups.The hippocampus of progenies were collected on the postnatal day 3,postnatal day 7 to measure protein kinase B (Akt) and phosphorylated-Akt (p-Akt) by Western blot,IGF-Ⅰ and insulin-like growth factor Ⅰ receptor (IGF-Ⅰ R) by Elisa.Morris water maze and field excitatory postsynaptic potential long-term potentiation were measured at the postnatal 40 day.Results Western blot and Elisa revealed that levels of IGF-Ⅰ,IGF-Ⅰ R,and p-Akt of pups from SCH group were lower than that of CON group and were higher than CH group on day 3 (P ＜ 0.05).On day 7,the levels of IGF-Ⅰ,IGF Ⅰ R,and p-Akt of pups from SCH group were lower than CON group (P＜ 0.05),but no difference was observed in p-Akt and IGF-Ⅰ R level between SCH group and CH group (P ＞ 0.05).Latencies of all groups had shortened in Morris water maze test with increasing of training trials.The slope of field excitatory postsynaptic potenial was increased in all groups after Theta burst stimulation.The amplification percentage of slope of field excitatory postsynaptic potenial in SCH group's was lower than control group's but was higher than CH group's(all P values＜0.05).Conclusions Maternal subclinical hypothyroidism impairs long-term potentiation induction in hippocampus of rat might be associated with the levels of IGF-Ⅰ,IGF-Ⅰ R,and p-Akt.

Objective To study the correlation between blood glucose variability and TOAST type of patients with acute ischemic stroke and provide new evidence which can improve the prognosis of ischemic stroke.Methods One hundred and forty-three hospitalized patients with acute ischemic stroke from August 2013 to August 2014 were included.All patients were estimated about the general state of health and performed laboratory examinations and other auxiliary examinations.Then the TOAST type of all cases was classified.The 24-hour blood glucose monitoring was done to the patients to calculate the blood glucose variability.One hundred and forty-three cases were divided into blood glucose variability group ( standard deviation of glucose ( GluSD )≥1.4 mmol/L, 85 cases ) and control group ( GluSD <1.4 mmol/L, 58 cases) according to glucose variability.We estimated the neurologic impairment of the patients with the US National Institutes of Health Stroke Scale ( NIHSS) and the activities of daily living with Barthel index.The relation between blood glucose variability and the prognosis of ischemic stroke was analysed with multivariate analysis.Results Differences were significant in age, history of diabetes and NIHSS score between blood glucose variability group and control group.The degree of neurologic impairment of large artery atherosclerosis (LAA) group (moderate and severe neurologic impairment:43/53(81.0%)) and cardio-aortic embolism ( CE) group ( moderate and severe neurologic impairment:15/17 ) was more serious than that in small artery occlusion ( SAO) group ( moderate and severe neurologic impairment:6/71 ( 8.5%) ) , especially in CE group.The differences were significant (χ2 =7.043,P<0.05).Blood glucose variability in patients with LAA was more obviously than that in other patients.NIHSS score and activities of daily living of the patients estimated on admission and after 2 weeks were not different in the blood glucose variability group, but the difference was significant in control group.The poor prognosis in blood glucose variability group was 2.821 times that in control group ( 95% CI 1.880 -4.233 ).Conclusions The people sufferd ischemic stroke with old age, diabetes or severe case are more vulnerable to abnormal blood glucose variability.Abnormal blood glucose variability is an independent risk factor for acute ischemic stroke and induces difficulty to recovery and poor prognosis.

Objective To investigate the factors influencing positive and negative affects ot orthodontic patients.Methods 145 orthodontic patients were selected and finished questionnaire survey.The questionnaires included demographic data,psychosocial impact of dental aesthetic questionnaire (PIDAQ),aesthetic content of index of orthodontic treatment need (IOTN-AC),perception of occlusion scale (POS),and positive affect and negative affect scale (PANAS).Mann-Whitney U-test,Kruskal-Walis H-test,and Spearman correlation analysis were used to analyze the relation between impact of dental aesthetics and positive and negative affects in orthodontic patients.Results The scores of adolescent patients were higher than adult patients in negative affect (U =1886.500,P＜0.05).The patients under orthodontic treatment scored higher than those before treatment (U=2228.000,P＜0.05).The subdomains of PIDAQ,such as social impact (x2=ll.794,P＜0.05),aesthetic attitude (x2 =45.853,P＜0.05),and dental confidence (x2 =33.551,P＜0.05) were related with negative affect.The scores of IOTN-AC,PIDAQ,POS demonstrated positive correlation with negative affect (P＜0.05).The scores of social impact showed negative correlation with positive affect (P＜0.05).Conclusions Adult orthodontic patients suffer more negative affect than adolescent patients.Orthodontic treatment could promote patients' positive affect.However,the negative psychosocial impact in dental aesthetics would strengthen the negative affect.

OBJECTIVE To investigate the distribution of pathogenic bacteria and the status of drug resistance in intensive care unit(ICU) of Anhui Provinceical Hospital,to provide reference for rational use of the antibiotics in clinical practice and effective control of hospital infection.METHODS From Jan 2007 to Dec 2008,a total of 873 clinical isolates were collected from different samples of infective patients in ICU,drug sensitivity test was conducted based on disk diffusion testing(K-B),to analyze the drug resistance of the pathogenic bacteria.RESULTS The highest isolating rate came from the sample of respiratory tract,which was 68.96%.Among 873 clinical isolates,Gram-negative bacilli and Gram-positive cocci accounted for 65.95% and 19.22%,respectively.Gram positive cocci rised obviously in 2008 compared to 2007.The rate of bacterial drug resistance was relatively high,meticillin-resistant Staphylococcus aureus(MRSA) detection rate was 56.58%;The detection rates Escherichia coli and Klebsiella ESBLs were 75.00% and 57.41%.CONCLUSIONS There is a higher rate of infection for ICU patients,and the condition of drug resistance is serious.To strengthen the pathogen distribution and drug resistance monitoring is of great guiding significance for rational clinical use of drug,reducing multi-drug resistance and nosocomial infection control.