Objective To discuss changes of anxiety and adverse reaction before and after chemotherapy for patients with breast cancer, giving selective nursing intervention for coping with chemotherapy in order to reduce patients pain and increase life quality. Methods The changes of anxiety level and adverse reaction degree of 50 patients with breast cancer after modified radical mastectomy were investigated with questionnaires before the first, second and third time of chemotherapy. Results The postoperative patients showed significant difference in total score of Rotterdam symptom checklist, score of physiological domain, psychological domain and state anxiety, among which the adverse reactions such as lack of appetite, fatigue, lack of energy, nausea, acid ingestion, sore mouth, hair lost, irritability, depressed mood and tension increased after beginning chemotherapy. Conclusions Nurses should help patients to understand correctly chemotherapy and its possible adverse reaction, teach them correct coping method in order to reduce uncomfortable symptom, promote whole rehabilitation and increase life quality.

Objective To evaluate the effectiveness of music therapy on anxiety and adverse reactions induced by chemotherapy in breast cancer patients after modified radical mastectomy. Methods One hundred and ten breast cancer patients were divided into intervention group and control group. The patients in the intervention group received music therapy,progressive muscle relaxation and guided inner image in addition routine nursing care. State Anxiety Inventory and Rotterdam Symptom Checklist (RSCL) were administered before the 2nd chemo-cycle and before the 3rd chemo-cycle. Results There was trend of lower scores on the Rotterdam Symptom Checklist total score and the State Anxiety score in intervention group than in control group (P＜0.05). Conclusion Music relaxation therapy can alleviate chemotherapy related adverse reactions and anxious.Therefore,music relaxation therapy is a practical psychological behavioral intervention for the breast cancer patients during the chemotherapy after modified radical mastectomy.

Breast cancer is one of the most common malignant tumor in the world. medical delay always leads to more advanced stage, larger tumor and more metastasis. This literature review dealt about status, influencing factors and intervention related to medical delay of breast cancer, as a reference to promote health- seeking behavior of breast cancer.

At present,peripherally inserted central catheter (PICC) and totally implantable access port (TIAP) are most commonly used for the medium-term and long-term ccntral vcnous infusion in China,which is mainly adopted for long-term repeated chemotherapy,nutritional support and other clinical treatments.As an advanced infusion route,this technique needs to be further popularized in clinical practice to benifit the majority of patients.However,in aspect of the implantation,use,maintenance,and the diagnosis and treatment of complications of long-term central venous access,there are still a lot of problems,to which sufficient attention should be paid.Standard implantation and maintenance are of great importance for the safe implantation of central venous access and long-term safe use.This paper aims to make a comprehensive review concerning the problems of long-term indwelling of central venous access,the basic solutions,and the whole course management of central venous access.In order to promote the technique of central venous access to continually develop,the multidisciplinary collaborative team with tacit cooperation,standardized system and regulatory process should be emphasized.

Objective To evaluate the effect of a nurse-led case management intervention on arm function and uncertainty for women with breast cancer.Methods 90 women with breast cancer were divided into the intervention group and the control group according to their nurses,with 45 patients in each group.All participants were followed six months after surgery.The intervention group attended a 6-month nurse-led case management program,while the control group received the routine care and follow-up only.Questionnaires on arm function and uncertainty were administered 1 month,3 months and 6months after the surgery respectively.Score changes were compared by repeated-measure ANOVA and MANOVA.Results The arm function of the intervention group was better than the control group,except for the 10th day after the operation,there were significant differences at other three time points.The disease uncertainty level of the intervention group was better than that of the control group,except for the dimension of unpredictability,there were evident differences in other dimensions at other three time points.Conclusions The nurse-led case management intervention could improve arm function recovery and decrease the uncertainty to disease of breast cancer survivors.

AIM: The effect of low dose radiation (LDR) with different doses of X-rays on apoptosis and its related gene P53 expression were studied in spermatogenic cells of male Kunming mouse testis. METHODS: The different kinds of spermatogenic cells were separated using density gradient centrifugation and their apoptosis was measured by flow cytometry. At meantime, P53 protein and P53 mRNA was measured with immunohistochemical SABC and in situ hybridization, respectively. RESULTS: The apoptosis in all kinds of spermatogenic cells induced by LDR had a remarkable regularity. When the doses were 0 025 and 0 05 Gy, spermatogone apoptosis was domaint. With the increase in irradiation dose (0 075-0 2 Gy), spermatocytes also showed an apoptotic change, but the apoptotic percentage of spermatogonia was significantly higher than that of spermatocytes. Moreover, the apoptosis of spermatids and spermatozoa scarely occurred after LDR. P53 protein expressed in spermatogonia and spermatocytes in varying degrees, and the former was significantly higher than that of the latter after LDR. With the increase in irradiation dose, P53 protein expression showed a upregulated tendency, but that of spermatids and spermatozoa scarcely occurred. P53 mRNA primarily expressed in spermatids and spermatocytes when the dose was 0 025 Gy. With the increase in irradiation doses (0 05-0 2 Gy), that of spermatogonia also showed an enhancement. P53 mRNA expression in spermatogonia and spermatocytes showed a remarkable dose-effect relationship. CONCLUSION: The apoptosis of spermatogenic cells was selectively induced by LDR of X-rays, which had remarkable the dose-effect and time-effect relationships. The mechanism of the selective apoptosis in spermatogenic cells by LDR is closely related to the upregulation of P53 .

Objective:To promote evidence-based practice in the pre-chemotherapy nursing assessment among adult cancer patients.Methods:The Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit tools were used. The project was conducted in Shanghai Cancer Center of Fudan University from May to October 2018, 12 audit criteria were developed in the program including nursing training, patient medical and allergic history, medical diagnosis, lab data and so on.Results:A baseline audit of pre-chemotherapy nursing assessment among adult cancer patients was conducted, with a sample size of 68 patients and 36 nursing staff, during this stage, the compliance of audit 11 and 12 were 100%. After the implementation of systematic strategies, a follow-up audit involving similar sample as first audit was conducted using the same audit criteria. In the follow-up audit, except criterion 4 and 10, the compliance of the remaining 8 criteria had significantly improved, and χ2 value was 10.29-132.06, P<0.01. The result of history adverse reaction in the follow-up audit showed that among 68 patients, 3 had experienced chemotherapy infusion reactions in the past (The drugs were oxaliplatin, gemcitabine and paclitaxel), 39 had chemotherapy-related symptoms before admission (most of them were relieved at admission), of which the top five were loss of appetite, fatigue, nausea, neurotoxicity and vomiting. Conclusions:The aims of the project were fulfilled. We achieved increased compliance with evidence-based best practice recommended by JBI in most of audit criteria. Further audit will need to be carried out to improve the validity and quality of nursing assessment.

Objective To evaluate the efficiency and safety of exercise interventions on cancer related fatigue. Methods Cochrane Library, JBI Database of Systematic Reviews, MEDLINE, EMbase, CINAHL, Chinese Journal Full- text Database, Chinese Biomedical Literature Database, and Wanfang Databse were searched from the inception to November 2014 to screen the systematic review and Meta-analysis conforming to the inclusion criteria. Two authors independently appraised their methodological qualities with Overview Quality Assessment Questionnaire (OQAQ), and analyzed the data using descriptive analysis. The primary outcome included the scaling of cancer related fatigue, the secondary outcome included adherence to exercise intervention and the incidence of adverse events. Results Fourteen systematic review/Meta-analysis were identified, twelve of them had a high methodological quality (Scoring 5-7). Six systematic review/Meta-analysis found that aerobic exercise could effectively alleviate cancer related fatigue, especially for breast cancer patients;seven articles showed that exercise could modulate cancer related fatigue of patients under active treatments;seven articles reported the compliance to the exercise intervention, four articles reported adverse events occurring during the intervention, very few of them resulted directly from the exercise intervention. Conclusions Exercise intervention can modulate cancer related fatigue with good safety.

Objective To evaluate the effect of nurse-led follow-up on medication adherence and quality of life for breast cancer patients receiving adjuvant hormonal therapy.Methods A randomized controlled trial was conducted with 157 patients in the intervention group and 154 in the control group.A self-design web-database medication monitoring platform was designed for managing patients such as texting,reminding and mailing.Participants were randomized to follow-up care as usual(yearly outpatient clinic visits) or nurse-led telephone follow-up(monthly consultation with structured intervention).Telephone follow-up was performed by four trained breast care nurses (BCN) and consisted of a semi-structured interview including managing the side-effects of endocrine therapy,compliance with hormonal therapy and an open discussion of these issues.Patients' medication adherence and quality of life were evaluated by Morisky Medication Adherence Questionnaire(MAQ) and FACT-B at baseline and 3,6 18 and 24 months,respectively.Results The Nurse-led telephone follow-up did not significantly improve the quality of life(P＞0.05).MAQ score in the intervention group was significantly greater than that in the control group(P＜0.05) at 3,6,18 and 24 months.Conclusion Nurse-led follow-up using computer-based monitoring system can improve patients' medication adherence,but there is no obvious increase in quality of life.

AIM: To explore the effect of melatonin (MLT) on the apoptosis of thymocytes and splenocytes in mice induced by ionizing radiation and its mechanism. METHODS: The percentages of apoptotic bodies and the DNA lytic rates of thymocytes and splenocytes in mice in vitro and in vivo were detected with flow cytometry and fluorospectrophotometry, respectively. RESULTS: The apoptosis of mouse thymocytes and splenocytes in vitro increased with significant dose-dependence in 0 5-6 0 Gy X-irradiation. When MLT of 2 mmol?L -1 was added into thymocytes or splenocytes in vitro before irradiation with 0 5-6 0 Gy X-rays, the percentages of apoptotic bodies and the DNA lytic rates all decreased significantly as compared with those in the irradiation group. The percentages of apoptotic bodies in these two kinds of cells were 86 25% and 89 22% of those in the irradiation group, respectively, and the DNA lytic rates were 87 23% and 89 16%, respectively. When MLT was injected into intraperitonium in mice 60 min before whole-body irradiation with 2 Gy X-rays, the percentages of apoptotic bodies and the DNA lytic rates were significantly lower than those in the irradiation group, and near or lower than those in the sham-irradiation group. MLT of 0 1-2 5 mg/kg decreased the lymphocyte apoptosis, but without significant dose-dependence. CONCLUSION: The protective effects of MLT on mouse lymphocytes damaged by irradiation in vivo are obvious than those in vitro. [