Objective To investigate the incidence of anxiety in patients with breast cancer,and further explore the surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI) technology' s clinical value in the diagnosis of anxiety.Methods 121 breast cancer patients were selected as research objects by using convenience sampling method.Self-rating anxiety scale (SAS) was used to evaluate the anxiety on the first day of admission and SELDI was used on the next day to detect the serum from patients' fasting venous blood sample got in the morning after their consent,then anxiety-related protein fingerprints spectrums were selected.The SAS score and SELDI result were finally compared and analyzed.Results SAS score in 121 patients was 53.45±9.78,anxiety occurred in 63 cases (52.07 ％).Established the diagnostic model between 15 000+H and 16 800+H protein fingerprints abundance ≥5 ％,that was to say,abundance ≥5 ％ was judged as positive,otherwise negative.On this basis,patients can accurately be distinguished between anxious group and non-anxious group.Correct rate (total coincidence rate) was 91.74 ％,specificity and sensitivity respectively were 89.66 ％ (52/58) and 93.65 ％ (59/63),the positive predictive value was 90.77 ％ (59/65),and negative predictive value was 92.86 ％ (52/56).Conclusions Breast cancer patients have a high incidence of anxiety.SELDI technology has showed high sensitivity and specificity in anxiety detecting.As an objective assessment tool,it could have better prospects for clinical use.

Objective To investigate the relationship of glycosylated hemoglobin A1C(HBA1c) and 2 hour postprandial blood glucose(2hPBG) with 12-hour urinary albumin excretion rate(UAE).Methods One hundred and thirteen patients with type 2 diabetes mellitus(T2DM),whose fast blood glucose(FBG) levels after treatment were less than 7.0 mmol/L,and 54 healthy subjects were the control group in this study.The level of HBA1c was detected by high performance liquid chromatography(HPLC).The level of 2hPBG was measured by glucose oxidase assay and the level of UAE was detected by radioimmunoassay.According to the level of HBA1c and 2hPBG,the patients were divided into 4 groups: group A(HBA1c7% and PBG

Objective To study the occurrence of anxiety in patients with malignant tumor, and in further explore the scientificity and clinical application value of surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI) technology in anxiety detection. Methods 1 000 patients with malignant tumor were selected as research objects, the self-rating anxiety scale (SAS) was used to evaluate the anxiety on the first day of admission, the fasting venous blood of patients was taken on the next day morning. The SAS score and SELDI result were compared and analyzed. Results The effective sample number was 988. The SAS score was 56.32± 9.665, there were 454 cases of anxiety, the incidence rate of anxiety was 45.95 %. 470 cases were SELDI test positive, and the incidence rate of anxiety was 47.57 %. SAS was used as the gold standard to judge anxiety, the sensitivity and specificity of SELDI technology were 93.17 % and 91.20 %, the positive predictive value and negative predictive value were 90.00 % and 94.02 %, the total coincidence rate was 92.11 %. SAS score highly correlated with the abundance of SELDI, the fitting curve showed an up trend, and the correlation coefficient was 0.837. Conclusions The incidence of malignant tumor patients ' anxiety is relatively high. SELDI technique shows high sensitivity, specificity, total coincidence rate and correlation in anxiety detection, it can be used as an objective evaluation of anxiety.

Objective: To survey on the home blood pressure measurement and blood pressure control rate among patients with hypertension in Beijing Yuetan community. Methods: A questionnaire survey was conducted among 504 hypertensive patients, who were visiting Beijing Yuetan Community Health Service Center and selected by convenience-sampling method during June 2018 to January 2019. The status of home blood pressure measurement, the awareness of hypertension, the blood pressure control rate and factors related to not regularly measuring were surveyed. Results: Of the 504 patients, 93.7% (472/504) took regular medication, but only 61.5% (310/504) had regular blood pressure measurements; 92.5% (466/504) had sphygmomanometers at home with electronic type mainly; 89.9% (453/504) patients knew the method of blood pressure measurement, but only 11.5% (52/453) had their sphygmomanometer calibrated. Among those who measured blood pressure, 77.4% (240/310) measured per week. The main reason for not measuring blood pressure regularly was that there was no need to measure blood pressure without any discomfort, accounting for 50.0% (97/194). The office blood pressure control rate (with desktop mercury sphygmomanometer) was 62.3% (314/504); the blood pressure control rate both in the morning and at bed time was 61.3% (73/119), that in the morning was 68.1% (81/119) and at bed time was 75.6% (90/119). The control rates of systolic blood pressure and heart rate by home measurement at morning and bedtime were significantly higher than those by office measurement (χ²=5.02, 9.97, 15.51, 13.72; all P<0.05). Conclusions The home blood pressure monitoring rate and knowledge level of hypertension among patients with hypertension in Yuetan community are relatively low. There are some differences in blood pressure control rate between office measurement and home measurement. Comprehensive evaluation is needed in the management process, and the treatment plan should be adjusted according to the specific condition of patients.

Objective:To explore the effects of competency-based diversified training on the bedside nursing comprehensive ability aand transition shock of newly recruited nurses.Methods:A total of 62 newly recruited nurses from the Second Affiliated Hospital of Zhengzhou University in June 2018 were selected as the control group, and 70 newly recruited nurses from June 2019 were selected as the experimental group by cluster sampling. The control group received routine pre-job training, and the experimental group received diversified training based on the control group. After one year of training, the differences in the scores of bedside nursing comprehensive ability, post competency and transition shock between the two groups of nurses were analyzed.Results:After 1 year of training, the total scores and the scores of nursing problems, nursing evaluation, nursing plan, nursing theory, nursing operation and bedside nursing comprehensive ability in the experimental group were 12.20±1.76, 24.29±2.38, 13.54±1.88, 9.77±1.35, 15.14±2.30 and 79.24±6.59, which were all higher than those of the control group (10.26±1.55,22.31±1.84,10.45±1.58, 8.56±1.80, 13.27±2.38 and 69.82±4.09), the differences were statistically significant ( t value was 4.582-13.679, P<0.05). The total scores and the scores of each dimension of the Post-competency the experimental group were 31.46 ±4.32, 51.03± 4.64, 20.27± 3.78, 17.86±3.99, 58.43± 4.44, 179.37±9.97, which were all higher than those of the control group 24.76±4.12, 40.56±5.55, 16.61±2.88, 15.15± 2.96, 49.74±3.07, 146.66±17.98, the differences were statistically significant ( t value was 4.466-13.197, P<0.05). The scores of psychological knowledge, skills, social culture and development and the total scores of Transition shock in the experimental group were 30.90±3.15, 19.69±2.74, 32.17±3.06, 103.81±12.24, which were all higher than those in the control group (25.69±2.76, 15.92±3.24, 27.50±4.15, 88.32±11.54), the differences were statistically significant ( t value was 7.237-10.040, P<0.05). Conclusions:competency-based diversified training can effectively improve the bedside nursing comprehensive ability and post competency, reduce their transition shock, and has strong clinical reference significance.

ObjectiveTo explore the underlying mechanism of modified Zhenwutang in delaying renal interstitial fibrosis in chronic renal failure （CRF） by observing the effects of modified Zhenwutang on the expression of angiotensin Ⅱ （Ang Ⅱ）， angiotensin Ⅱ type 1 receptor （AT1R）， nicotinamide adenine dinucleotide phosphate （NADPH） oxidase 4 （NOX4）， transforming growth factor-β₁ （TGF-β₁）， type I collagen （COL1A1）， and type Ⅲ collagen （COL3A1） in the serum and renal tissues of adenine-induced CRF rats. MethodFifty male SPF-grade SD rats were randomly divided into a normal group （n=10） and an experimental group （n=40） using a random number table. After one week of adaptive feeding， the experimental CRF model was established in rats by administering adenine at 150 mg·kg^-1·d^-1 orally. Three rats from each group were randomly selected to evaluate the model induction. After successful modeling， rats in the experimental group were randomly divided into a model group， low-， medium， and high-dose modified Zhenwutang groups， and a benazepril hydrochloride group， with six rats in each group. The rats were orally administered the corresponding drugs once daily for four weeks. At the end of the first week， 13^th week， and 17^th week of the experiment， 24 hour urinary protein quantification （24 h-UTP） was measured. At the end of the 17th week， the rats were euthanized， and blood samples were collected from the abdominal aorta for the measurement of total protein （TP）， albumin （ALB）， creatinine （Cr）， and blood urea nitrogen （BUN） in the serum. Enzyme-linked immunosorbent assay （ELISA） was used to measure the expression levels of serum Ang Ⅱ. Hematoxylin-eosin （HE） staining and Masson's trichrome staining were performed to observe the pathological changes in renal tissues. Immunohistochemistry （IHC） was performed to observe the expression of AT1R， NOX4， TGF-β₁， COL1A1， and COL3A1. Real-time fluorescence-based quantitative polymerase chain reaction （Real-time PCR） was used to observe the mRNA expression levels of AT1R， NOX4， and TGF-β₁. Western blot was conducted to measure the protein expression levels of AT1R， NOX4， and TGF-β₁. Result① Compared with the normal group， the model group showed a significant increase in 24 h-UTP （P<0.01）. The levels of Cr and BUN in the model group were significantly higher （P<0.01）， while the levels of TP and ALB were significantly lower （P<0.01）. The serum Ang Ⅱ level in the model group was significantly elevated （P<0.01）. The model group exhibited widening of the renal glomerular mesangial space， necrotic glomeruli， increased interstitial width with extensive inflammatory cell infiltration， brownish precipitates blocking the renal tubular lumens， irregular renal tubules， and significant deposition of collagen fibers in the renal interstitium. Additionally， the collagen fibers around the renal vessels， outside the parietal layer of the renal sacs， glomerular basement membrane， and tubular basement membrane increased significantly. The expression of AT1R and NOX4 in the glomeruli and renal tubules of the model group was significantly enhanced， and TGF-β₁ expression also significantly increased in the renal tubules. The expression of COL1A1 and COL3A1 in the renal interstitium significantly increased. The mRNA expression of AT1R and TGF-β₁ in the model group significantly increased （P<0.01）， while NOX4 mRNA expression significantly decreased （P<0.01）. The protein expression of AT1R， NOX4， and TGF-β₁ was significantly enhanced （P<0.01）. ② Compared with the model group， modified Zhenwutang significantly reduced 24h-UTP （P<0.01）， decreased levels of Cr and BUN （P<0.01）， increased levels of TP and ALB （P<0.01）， reduced serum Ang Ⅱ level （P<0.01）， alleviated renal pathological damage， reduced expression of AT1R， NOX4， TGF-β₁， COL1A1， and COL3A1 in the glomeruli， renal tubules， and renal interstitium， reduced mRNA expression of AT1R and TGF-β₁ （P<0.01）， increased NOX4 mRNA expression （P<0.01）， and weakened protein expression of AT1R， NOX4， and TGF-β₁ （P<0.01）. The modified Zhenwutang groups showed a significant dose-effect trend. ConclusionModified Zhenwutang may delay renal interstitial fibrosis in CRF rats by reducing the expression of Ang Ⅱ， AT1R， NOX4， and TGF-β₁ in the serum and renal tissues， thereby alleviating renal pathological damage， reducing proteinuria， protecting renal function， and delaying the progression of CRF. The modified Zhenwutang group exhibited a dose-effect trend.

Multiple plant lineages have independently evolved sex chromosomes and variable kary-otypes to maintain their sessile lifestyles through constant biological innovation.Morus notabilis,a dioecious mulberry species,has the fewest chromosomes among Morus spp.,but the genetic basis of sex determination and karyotype evolution in this species has not been identified.In this study,three high-quality genome assemblies were generated for Morus spp.[including dioecious M.notabilis(male and female)and Morus yunnanensis(female)]with genome sizes of 301-329 Mb and were grouped into six pseudochromosomes.Using a combination of genomic approaches,we found that the putative ancestral karyotype of Morus species was close to 14 protochromosomes,and that sev-eral chromosome fusion events resulted in descending dysploidy(2n=2x=12).We also charac-terized a～6.2-Mb sex-determining region on chromosome 3.Four potential male-specific genes,a partially duplicated DNA helicase gene(named MSDH)and three Ty3_Gypsy long terminal repeat retrotransposons(named MSTG1/2/3),were identified in the Y-linked area and considered to be strong candidate genes for sex determination or differentiation.Population genomic analysis showed that Guangdong accessions in China were genetically similar to Japanese accessions of mul-berry.In addition,genomic areas containing selective sweeps that distinguish domesticated mul-berry from wild populations in terms of flowering and disease resistance were identified.Our study provides an important genetic resource for sex identification research and molecular breeding in mulberry.