Objective To investigate the expressions and significances of Bcl-2 and Bax in basal-like breast carcinoma (BLBC).Methods The expressions of Bcl-2 and Bax were detected in 43 cases of BLBC, 57 cases of non-BLBC and 60 cases of normal breast tissues by immunohistochemistry,and their relationships with physiological and pathological characteristics of patients were analysized.Results The positive rate of Bcl-2 in BLBC was 69.77%,higher than 43.86% in non-BLBC (χ2 =6.647,P =0.01 0)and 21 .67% in normal breast tissues (χ2 =23.831 ,P =0.001 ).The positive rate of Bax in BLBC was 20.93%,lower than 45.61 % in non-BLBC (χ2 =6.564,P =0.01 0)and 76.67% in normal breast tissues (χ2 =31 .270,P =0.001 ).The expressions of Bcl-2 and Bax were correlated with lymphnode metastasis (χ2 =6.927,P =0.008;χ2 =6.203,P =0.01 3)and pTNMstaging of BLBC (χ2 =6.331 ,P =0.01 2;χ2 =5.972,P =0.01 5).There was negative correlation between the expression of Bcl-2 and Bax in BLBC (r = -0.408,P <0.01 0). Conclusion High expression of Bcl-2 and low expression of Bax interact with each other leading to unbalance of cell deferation and apoptosis,resulting in promoting genesis and progress of BLBC.

Purpose To study the expression of HIF-1αand Glut-1 in the molecular subtypes of breast carcinoma and their correlation with basal-like breast carcinoma. Methods 803 cases of invasive breast carcinoma from our database were identified. The clinicopath-ologic findings and the biologic markers including estrogen receptor ( ER) , progesterone receptor ( PR) , and human epidermal growth factor receptor-2 (HER-2) status were reviewed. Immunohistochemical MaxVision stains for cytokeratin 5/6 (CK5/6) and epidermal growth factor receptor ( EGFR) were performed. All breast carcinomas were subclassified into Luminal A, Lumincal B, HER-2 over-expression, normal-like, and basal-like subtypes according to Nielsen criteria. Immunohistochemical stain was also used to detect the expression of HIF-1αand Glut-1. Results Positive expression rates of HIF-1αprotein in basal-like, HER-2 over-expression, normal-like, Luminal A and Luminal B substypes were 77. 89% (74/95), 56. 06% (37/66), 55. 76% (92/165), 31. 97% (141/441), 25. 00% (9/36), respectively. The positive expression rates of Glut-1 protein were 80. 00% (76/95), 57. 58% (38/66), 58. 18%(96/165), 34. 01% (150/441), 25. 00% (9/36), respectively. The positive expression rates of HIF-1α and Glut-1 in the basal-like, HER-2 over-expressing and normal-like subtypes were remarkably higher than that in Luminal A and Luminal B subtypes ( P<0. 004 5) and the expression of HIF-1a and Glut-1 was negatively correlated with the expression of ER (P<0. 01). In the ER-negative breast cancers, the positive expression rates of HIF-1a and Glut-1 in basal-like substype were much higher than that in the other sub-types (P<0. 004 5), and the expression of HIF-1α was positively correlated with expression of Glut-1 in basal-like breast carcinoma (P<0. 01). Conclusion The overexpression of HIF-1αand Glut-1 may be closely related to the ER-negative breast cancer and HIF-1α and Glut-1 might play an important role in the development of basal-like breast carcinoma.

Objective To investigate the effect of sevoflurane anesthesia on learning and memory in mice and the relationship with histone acetylation. Methods Thirty-six adult male C57BL/6 mice were ran-domly divided into control group(mice inhaled 95％ O2 for 6 h), sevoflurane (Sevo) group (1. 5％ Sevo group, 2％ Sevo group, 3％ Sevo group:mice inhaled 1. 5％, 2％ and 3％ sevoflurane for 6 h respectively) , sevoflurane + SAHA (Sevo + SAHA) group (mice were intraperitoneally injected with histone deacetylase inhibitor SAHA ( 25 mg/kg) . And 1 h later, 3％ Sevo was inhaled continuously for 6 hours. ) and SAHA group(mice were intraperitoneally injected with histone deacetylase inhibitor SAHA (25 mg/kg)). The abil-ity of learning and memory in mice was estimated by Morris water maze. The expression levels of Ac-H3, BDNF and Syt-I protein in the hippocampus were detected by Western blot. Results In Morris water maze, 3％ sevoflurane anesthesia significantly prolonged the escape latency((46. 91±1. 84)s),and significantly decreased the ratio of target time((35. 84±5. 40)％) compared with that of control group((23. 46±2. 67)s, (49. 74±4. 91)％,P<0. 05). Compared with 3％ Sevo group,the ratio of target time in Sevot+SAHA group ((46. 86±4. 37)％) was increased(P<0. 05). Moreover,3％ sevoflurane anesthesia significantly decreased the expression levels of Ac-H3 (10. 23±2. 45),BDNF (6. 72±1. 21) and Syt-I (8. 25±2. 11) in the hippo-campus compared with that of control group((15. 45±2. 58),(10. 17±1. 45) and (15. 02±3. 38),P<0. 05) . However,pre-administration of the histone deacetylase inhibitor SAHA significantly increased the ra-tio of target time in Morris water maze,and improved the expression levels of Ac-H3 (14. 06±2. 79),BDNF (10. 13±1. 06) and Syt-I (14. 16±3. 66) in Sevo+SAHA group compared with that of Sevo group (P<0. 05) . Conclusion The high dose of sevoflurane anesthesia can induce learning and memory impairment through the inhibitation of histone acetylation in the hippocampus.

Objective:To evaluate EEG biofeedback therapy on clinical efficacy of children with different subtypes of attention deficit hyperactivity disorder (ADHD) using the integrated visual and auditory integration continuous performance test (IVA-CPT).Methods:Children with ADHD who completed more than 60 times of EEG biofeedback training in Hangzhou Seventh People's Hospital from July 2018 to September 2020 were selected as the research subjects. According to the results of IAV-CPT before treatment, all the children were divided into three subtypes: attention deficit type ( n=21), impulse hyperactivity type ( n=11), and mixed type ( n=30). The differences of symptom improvement between the three subtypes before and after training were compared by SPSS 23.0 software. Results:(1) In terms of response control (a total of 9 items), there was no statistical significance in the attention deficit group before and after treatment (all P>0.05). In the hyperactivity group, the scores of visual and auditory response control, full scale response control, auditory prudence and auditory consistency, visual focus quotient and visual consistency before treatment were significantly lower than those after treatment(all P<0.05). In the mixed group, the scores of visual and auditory response control, full scale response control, auditory prudence, visual consistency, and visual prudence before treatment were significantly lower than those after treatment(all P<0.05). In terms of attention (a total of 9 items), the scores of auditory vigilance, auditory attention, visual attention, full scale attention, visual vigilance and visual speed in the attention deficit group before treatment were significantly lower than those after treatment(all P<0.05). The scores of visual attention, full scale attention, visual focus quotient (all P<0.01), auditory attention and visual speed (all P<0.05) in hyperactivity group before treatment were significantly lower than those after treatment. In the mixed group, the scores of the other 8 items before treatment were significantly lower than those after treatment (all P<0.01, auditory focus quotient were P<0.05), except that the auditory speed had no statistical significance before and after treatment.(2)After EEG biofeedback training, the changes of IVA-CPT scores of the three groups before and after treatment(visual response control (-2.76±24.39), (19.55±19.94), (12.93±25.30), F=3.932, P=0.025), (full scale response control (2.38±20.77), (21.27±15.86), (15.43±25.69), F=3.158, P=0.050), (full scale attention (18.43±27.44), (11.36±11.40), (26.23±18.41), F=4.692, P=0.016), (auditory vigilance (20.23±42.65), (6.55±10.20), (33.63±36.30), F=7.160, P=0.002), (visual vigilance (19.48±28.55), (5.27±10.62), (33.27±28.26), F=10.876, P<0.001), (visual focus quotient (-2.24±23.67), (14.45±13.79), (12.83±21.91), F=3.669, P=0.031) were statistically significant. After LSD comparison, the changes of visual control and total control scores in the attention deficit group before and after treatment were significantly lower than those in the impulse hyperactivity group (all P<0.05) and the mixed group (all P<0.05). In the three items of total attention score, auditory vigilance and visual vigilance, the changes of impulsivity hyperactivity group before and after treatment were significantly lower than those of mixed group ( P=0.050, P<0.05, P<0.01, respectively). The changes of visual attention quotient in the attention deficit group before and after treatment were significantly lower than those in the impulse hyperactivity group and the mixed group (all P<0.05). Conclusion:EEG biofeedback has clinical efficacy in the three groups of subtypes of ADHD, but the efficacy is different, and individualized EEG training programs should be developed for different subtypes of children on the basis of standard TBR therapy protocol.

Objective To explore the effects of continuing health education by establishing virtual social networking platform on treatment compliance of patients with cerebral infarction.Methods A total of 100 patients with cerebral infarction discharged from our hospital between April 2010 and June 2010 were included and randomly divided into control group (50 cases) and observation group (50 cases).The patients of two groups received routine health education,while the patients of observation group additionally received continuing health education by establishing virtual social networking platform.The treatment compliance and rehabilitation of patients in two groups were compared after 6 months.Results After 6 months,the Barthel index and FAM scores of patients in observation group were (79.13 ±21.08) and (66.17 ±2.13) respectively,and those in control group were (51.86 ± 15.72) and (50.53 ± 1.32) respectively.The Barthel index and FAM scores in observation group were significantly higher than those in control group,so the differences between two groups were statistically significant (P ＜ 0.05).There were 22 patients (44.0％) with complete compliance in observation group,and it was significantly more than that of control group (20.0％,10/50) (P ＜ 0.05).Conclusions The continuing health education by establishing virtual social networking platform can increase the awareness and importance of knowledge about cerebral infarction,improve the patient's treatment compliance,and help to ensure the therapeutic effects and promote the prognosis.

Objective:To investigate the core competence of newly recruited nurses in ClassⅢ hospitals in Shanxi Province so as to provide a basis for the training of core competence of newly recruited nurses.Methods:From August 15 to 21, 2019, cluster sampling was used to select 2 913 newly recruited nurses and their real-time teachers from 46 Class Ⅲ general hospitals and 13 specialized hospitals in 11 cities in Shanxi Province. The Core Competency Self-rating Questionnaire of Newly Recruited Nurses and the Core Competency Observer Rating Questionnaire of Newly Recruited Nurses were used to investigate newly recruited nurses and evaluate the real-time teaching teachers of newly recruited nurses respectively.Results:In the end, 2 575 valid self-rating questionnaires and 2 400 valid observer rating questionnaires were recovered. Among 2 575 newly recruited nurses, the total score of self-rating core competence was (154.22±17.15) , and the scores of each dimension from high to low were quality accomplishment, personal traits, management ability, professional ability and professional development. Among 2 400 teachers of newly recruited nurses, the total score of the core competence evaluated by teachers in real-time teaching was (155.60±20.71) , and the scores in each dimension from high to low were quality cultivation, personal traits, professional ability, management ability and professional development. There was a statistically significant difference between the self-rating of the core competency scores of newly recruited nurses and the evaluation of teaching teachers ( P<0.05) . Conclusions:The core competence of newly recruited nurses in Shanxi Province is at the upper -middle level, and the professional development ability needs to be strengthened. There is a difference between the self -rating of the core competence of newly recruited nurses and the evaluation by teaching teachers. Therefore, the selection and training of newly recruited nurse teachers should be emphasized.