Research on the relationship between obesity and breast cancer has been deepened in recent years.Obese breast cancer patients have poorer prognosis than normal-weight patients.Weight variation is correlated with relapse in breast cancer survivors.The role of adipokines in this process can not be ignored.The correlations between adipokines,estrogen,cell proliferation,angiogenesis and breast cancer prognosis are reviewed in this article.

Objective To investigate the risks and anesthetic management of scar uterus undergoing cesarean section.MethodsOne hundred pregnant women(aged 24-43 years old)with scar uterus underwent cesarean section.Epidural anesthesia was used in 90 cases(group A)and general anesthesia in 10 cases(group B).The monitorings included ECG,BP,HR and SpO_2.CVP was measured in the high risk cases.The time from skin incision tO neonatal delivery(I-D).the time from uterine incision to delivery(U-D),and Apgar scores of neonates were recorded.Results Incomplete blockade was seen in 20 cases(22％).The I-D time was shorter in group B than that in group A[(7.5±2.0)min vs.(12.3±2.6)min](P<0.01).Intraoperative hypotension occurred in 32 cases (32％).Neonatal asphyxia happened in 21 cases(21%).Apgar scores of 11 neonatals werc less than 3,of whom 5 neonates died.Apgar scores were 4 to 7 in 10 cases,8 to 10 in 79 cases.Subtotal uterectomy was performed in 2 cases.Repair of injuried bladder had to be done in one case.Intraoperative huge bleeding took place in 15 cases.Conclusion The scar uterus undergoing cesarean section has a high risk for mothers and neonates.The incidence of incomplete epidural blockade is higher.Effectively preventing and managing the risk factors are the keys for reducing maternal and neonatal complications and mortality.

The process of late lung development is disturbed in bronchopulmonary dysplasia (BPD).One of the keys in late lung development is secondary septation, in which secondary septa arise from primary septa, producing plenty of small alveoli, which significantly increase the surface area of gas exchange.Secondary septation,together with architectural changes to the vascular structure of the lung which minimize the distance between the blood and the inspired air, are the targets of late lung development.BPD is a disease of premature infants in which development of the alveoli is stunted caused by many factors including volutrauma,inflammation,and oxygen toxicity.Compared with early lung development, the later development of the immature lung remains unclear.This paper is to emphasize remarkable latest research of arrested late lung development and BPD.

Objective To study the clinical effect of escitalopram oxalate in treating patients with depression accompanied with anxiety disorder.Methods Sixty-four patients with depression accompanied with anxiety disorder (met DSM-IV diagnostic criteria)were randomly divided into study group (n =32)who were treated with escitalo-pram oxalate 5-20mg/d and control group (n =32)with mirtazapine 15-45 for eight weeks.Clinical effect was evalua-ted with the Hamilton Depression Scale (HAMD)and the Hamilton Anxiety Scale (HAMA)as well as the adverse reactions with the Treatment Emergent Symptom Scale (TESS).Results There were no statistically significant differ-ences (P >0.05)in HAMD and HAMA scores between the study group and control group before treatment,but after treatment for 8 weeks,HAMD score showed statistically significant difference (P =0.000)and the difference of HAMA score was statistically significant (P =0.010).The total effective rate of the study group was 93.8%,which of the control group was 87.5%,the clinical effect had no statistically significant difference (P =0.391 ).The study group and the control group had equal effect,and there were no serious adverse reactions.Conclusion Escitalopram oxalate has high anti-depressant and anxiolytic effect,fewer adverse reactions,good tolerability and compliance,there-fore,escitalopram oxalate can be popularized in treating patients with depression accompanied with anxiety disorder.

AIM: To study the effectiveness of urapidil and nitroglycerine on controlling the cardiovascular responses to tracheal intubation/extubation in patients with essential hypertension. METHODS: 45 patients with essential hypertension undergoing general anesthesia were divided randomly into control (C, without depressor, n=15), urapidil (U, 0.5 mg?kg -1 , n=15), and nitroglycerine (N, 1 ?g?kg -1 , n=15) groups. The SBP, DBP, MAP, HR and RPP were measured during intubation and extubation and at the induction of anesthesia and the end of operation respectively. RESULTS: The SBP, DBP, MAP, HR and RPP increased markedly (P

0.05).SF-36 data revealed significant postoperative improvement(P0.05).Main complications included deep infection in one case,deterioration of spondylolisthesis in two cases,conjunctional stenosis in one case,and broken pedicle screws in two cases.Six patients received revision surgery.[Conclusion]Surgical treatment of DLSS may result in satisfactory outcome.Transpedicular screw fixation may not improve the clinical outcomes and posterior instrumentation should be adopted cautiously and properly.

Immune checkpoint is one of the most effective research targets for tumor immunotherapy. Immune checkpoint inhibitors, mainly programmed death receptor 1 and its ligand 1, have achieved good response rates in various tumor treatments, but some tumors still have low response rates. In recent years, bispecific antibodies have developed rapidly in the field of tumor research, because they can target multiple targets and play a combined role in tumor therapy, and can effectively inhibit tumor immune escape. This article reviews the research progress and clinical status of bispecific antibodies targeting immune checkpoints.

Objective To investigate the effect of flurbiprofen axetil(FA)on the acute lung injury(ALI)induced by LPS in rats.Methods Forty male SD rats weighing 190-220 g were nmdomly divided into 3 groups:group Ⅰ control(C,n=8);groupⅡ LPS(n=16)and group Ⅲ FA+LPS(n=16).In group Ⅱ and Ⅲ LPS 5 mg/kg in 1 ml of normal saline(NS)w88 given iv.In group Ⅲ FA 6 mg/kg in NS 1 ml was given Ⅳ 0.5 hbefore LPS administration.In group Ⅱ and Ⅲ 8 animals were killed at 2 h(T1)and 4 h(T2)after LPS administration respectively.Blood samples were obtained at T1 and T2 for blood gas analysis and determination of serum TXB2,6-keto PGF1α(by radio-immuno assay),TNF-α,IL-1β,IL-6 and IL-10 concentrations(by ELISA).Lungs were removed for determination of W/D lung weight ratio,lung water content(LC)and microscopic examination.ResultsCompared with group C,LPS signitlcanfly decreased PaO2,PaO2/FiO2 and increased PaCO2,W/D lung weight ratio,LC,serum TXB2,6-keto-PGF1α concentrations,TXB2/6-keto-PGF1α ratio and serum IL-1β,TNF-α,and IL-6 concentrations in LPS group.Pulmonary edema and hemorrhage were observed in LPS group.FA pretreatment significantly attenuated LPS-induced blood gas,bio-chemical and pulmonary histological changes in group Ⅲ.Conclusion Flurbiprofen axetil pretreatment can protect the lungs against LPS-induced acute injury by down-regulating TXB2/6-keto-PGF1α ratio and inhibiting inflammatory response.

Objective To study the influence of health behavior intervention on coping style and hope level in lung cancer patients undergoing chemotherapy. Methods 60 lung cancer patients undergoing chemotherapy were divided into the intervention group and the control group with 30 patients in each group. Two groups all had an operation, carried on the normal nursing care and health education. After operation, the intervention group accepted health behavior intervention from the beginning of the first period chemotherapy. After the third period chemotherapy, coping style and hope level of the two groups were measured. Results After intervention, positive coping style "confrontation" had a higher score. Negative coping style such as obviation and acception got lower scores in the intervention group compared with the control group. In addition to "keep an intimate relation(I)",the rest dimensions of hope level showed significant differences as well. Conclusions Applying the related theories of health behavior to build up mental nursing intervention mode has a significant meaning on lung cancer patients undergoing chemotherapy. It can increase patients' positive coping style and reduce negative aspects. At the same time, hope levels of lung cancer patients also have an improvement.

Objective To know the relationship of self-efficacy and quality of life of patients with breast cancer after postoperative chemotherapy, and then carry out reference to clinical nursing cares. Methods Interviewed 115 patients with breast cancer after postoperative chemotherapy by questionnaire to know their conditon about self-efficacy and quality of life, and then analysis the relationship between them. Results The general score of quality of life of patients with breast cancer was 105.62±6.68, which was significant lower than the normal model. There was significant correlation of self-effi-cacy and quality of life of patients with breast cancer. Conchusions Related experts should emphasis the postoperative management of patients with breast cancer, and then promote their self-efflcacy and quality of life.