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.

A retrospective analysis was made on clinical data of 230 cases of metabolic syndrome (MS) and 239 cases of non-MS admitted to department of cardiology and endocrinology of Huashan Hospital from July 2005 to August 2009.Multiple linear regression analysis was performed to assess the association between levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and potential influencing factors.Covariance analysis was used for group comparison.Multiple linear regression analysis demonstrated that age,body mass index,systolic blood pressure,diastolic blood pressure,insulin resistance index,triglyceride,low density lipoprotein-cholesterol,creatine,left atrial diameter,left ventricular posterior wall dimensions,left ventricular ejection fraction were independent predictors for plasma levels of NT-proBNP in those subjects(P ＜ 0.05).Covariance analysis showed that plasma levels of NT-proBNP in MS group were significantly lower than those in non-MS group ( P ＜ 0.05).Further analysis found that plasma levels of NT-proBNP in MS patients with high triglyceride and body mass index,but normal systolic and diastolic blood pressure,normal fasting plasma glucose were significantly lower than those in non-MS group ( P ＜ 0.05 ).The results indicate that decreased plasma levels of NT-proBNP might be related to lipids disorder and obesity of MS patients.

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 explore the related factors that might had effect on orthodontic patients' esthetic evaluation of axial dental midline angulation from three aspects which are ideal value,detectable value and tolerable value.Methods Photographs of a smiling woman was digitally manipulated to produce models with left or right maxillary axial dental midline angulations in 2° increments.These digital photographs models were used to develop an electronic questionnaire in combination with corresponding guidance for each question.The electronic questionnaire was applied to investigate the esthetic evaluation of axial dental midline angulation from 222 orthodontic patients who complied with the inclusion criteria.Esthetic evaluation included three aspects,the ideal value,the detectable value and the tolerable value,which represented the degrees of maxillary axial dental midline angulations the patients considered to be ideal,detectable and tolerable,respectively.The patients' personal information and clinical orthodontic examination results were collected as well.Results The mean detectable value and tolerable value were 4.9° and 9.7°,the median of detectable value and tolerable value were 5°and 9.5°.Logistic regression analysis was applied to explore the influence of seven factors on each evaluator's ideal value,detectable value and tolerable value.The seven factors were gender,marriage condition,education level,orthodontic treatment condition,malocclusion index,dental esthetic rating from others and from themselves.The statistical analysis indicated education level and orthodontic treatment condition were the influential factors of detectable values,while the tolerable values were influenced by the education level and gender.The ideal value converged to 0° and none of the factors had effect on it.Conclusions The education level,orthodontic treatment condition and gender are considered to be the influential factors of the esthetic evaluation of axial dental midline angulation.

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 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.