Objective To explore the effect of Orem self-care pattern on quality of life of patients undergoing radiotherapy after breast cancer operation.Methods One hundred patients undergoing radiotherapy after breast cancer operation were randomly divided into control group and treatment group in equal number.The control group was treated by conventional nursing.Orem self-control pattern was used in the treatment group besides conventional nursing.QOL scale was employed to observe their quality of life after radiotherapy.Result The self-care ability and quality of life of the treated group were improved significantly comparing with the control group(P<0.05,for both).Conclusion Orem self-care pattern can effectively improve the quality of life of patients undergoing radiotherapy after breast cancer operation by way of helping them actively completing function exercises on the diseased limbs and propelling their early rehabilitation.

Purpose　To study the proteins expression of genes related to apoptosis of retinal cells in development of human fetus．　Methods　Fifty cases of retinas of human fetus aged from 12 to 38 weeks were collected and paraffin embedded sections were made． Immunohistochemical method was used．　Results　Fas protein was expressed by cells of ganglion cell layer, inner and outer nuclear later, which were just formed on 16th week． It was not expressed until 38th week, Fas(+) staining appeared in layers of retina． Fas-L(+) staining was detected in cells of layers of retina on 26th week and the positive staining located in ganglion cell layer on 32th week． Neuronal fiber layer was Fas-L positive． Bax positive staining was detected on 8th week． Bax positive nucleus were observed mainly in GCL and ONL on 16th week． It was in INL on 24th week and in Müller cells inner terminates on 26th week． After this time, all cells of retina were bax immune negative staining． Bcl-2(+) staining appeared in differentiating neuroblastic layer on 16th week． Beginning on 24th week, bcl-2 (+) staining was observed in glial cells of GCL and inner terminates of Müller cell．　Conclusion　Apoptosis of developing retinal cell may be Fas/Fas-L independent and bax may be involved in apoptosis of the cells．

Objective To observe the expression of p53, bcl 2 genes, vascular endothelial cell growth factor (VEGF), basic fibroblast growth factor (bFGF), insulin like growth factor I (IGF I), and the receptors of these factors of retinal vascular endothelial cells (VECs) of 1 to 20 week diabetic rats, and the relationship between the expressions and cell cycle arrest. Methods Retinal sections of diabetic rats induced by alloxan were immunohistochemically stained and observed by light microscopy (LM) and electron microscopy (EM). Dot blotting and Western blotting were used to determine the expression of mRNA, proteins of p53 and bcl 2. Results Under LM, immunohistochemical positive expression of p53 and bcl 2 were found on the vessels of ganglion cell layer and inner nuclear layer of retinae of 8 to 20 week diabetic rats; under EM, these substances were observed depositing in VECs. The retinal VECs also expressed VEGF, bFGF, IGF I and their receptors. There was no positive expression of other cell types in these retinae, all cell types of retinae in control group, or all cells of retinae of diabetic rats with the course of disease of 1 to 6 weeks. The result of dot blotting revealed that retinal tissue of 20 week diabetic rat expressed p53 and bcl 2 mRNA, and the result of Western blotting revealed that they also expressed p53 and bcl 2 proteins. But retinal tissues of control group did not. Positive expression of bax was not found in the retinae in control group or 1 to 20 week diabetic rats. Conclusion p53, bcl 2 may introduce cell cycle arrest of VECs of retinae in 8 to 20 week diabetic rats. High glucose might stimulate the expression of VEGF, bFGF, IGF I and their receptors, and the growth factors may keep VECs surviving by self secretion.

Deer antlers are the unique mammalian organs that can be periodically regenerated,i.e.,they hold interest for researchers on stem cells and regenerative medicine,and have the potential to become an excellent biomedical research model.Deer antler regeneration may use stem cells.Antler growth appears to involve specific stimulation of the necessary stem cells present in the locality,and involves similar mechanisms to those used in limb development,unlike the regenerative process in the newt.Development regulation of antler and growth mechanism of antler stem cells have significance in limb regenerated medicine and stem cell research.Many scientists have carried out thorough research on the deer antlers development,thus,have drawn many concepts.This article reviews the field of deer antlers development such as antler regeneration and stem cells,and introduces research technique of antler development and relevant theories.

This guideline was published by the American Institute of Ultrasound in Medicine,which has been developed to assist physicians performing sonographic studies of the brain in neonates and infants.Neurosonography should be performed only when there is a valid medical reason,and gain the necessary diagnostic information.Although it is not possible to detect every abnormality,adherence to the following guideline will maximize the detection of most abnormalities of the brain in neonates and infants that can be imaged with ultrasound.

Objective:To explore the mechanism of the embolism and sclerotherapy of fibrin glue combined with bleomycin (FG/BLM) for the treatment of cervicofacial vascular malformations by color doppler ultrasound.Methods:10 patients with venous malformation(VM) and 10 patients with arterio-venous malformation(AVM) were included.All patients underwent embolism and sclerotherapy of FG/BLM guided by ultrasound.Color doppler ultrasound was used to record the real-time two-dimensional ultrasonography and color doppler image.The flow and distribution of FG/BLM after injection into the lesions were observed.Results:Two-dimensional ultrasonography showed clumps or flake strong echo after immediate injection of FG/BLM into the cavity of VMs,then floated in the abnormal venous lumen and diffused throughout the cavity.At the later stage the lesions were filled by a large number of flocculent and netted low echo,and patchy strong echo.The volume of VMs cavity expanded dramaticlly,and the blood flow signal was significantly decreased.After injection of FG/BLM into the lumen of AVMs,clumps or flake strong echo were observed,then most of the snowflake strong echo rapidly filled or scattered along with blood stream to the distal part of the vessels.The color doppler showed significantly decrease of blood flow signal.Conclusion:FG/BLM injection can embolize and block the draining vein of VM,and play a role on the storage of sclerozing agent.FG/BLM injection can embolize both the dilated blood vessels and capillary network of AVM.

ObjectiveTo explore the relationship among 25-hydroxyvitamin D,serum calcium,calcium-sensing receptor,and breast cancer. Methods The expressions of calcium-sensing receptor (CaSR) in primary breast cancer,breast benign tumors,and normal breast tissue beside tumors were determined by immunohistochemistry S-P method as well as the concentration of serum 25 (OH) D and serum calcium in breast cancer and breast benign tumors by Enzyme-linked immunosorbent assay (ELISA),Tribromoarsenazo Ⅲ method.ResultsSerum 25 (OH) D level of breast cancer was significantly lower than the breast benign tumors [ (34.13 ± 14.14) nmol/L vs (50.29 ± 25.65 ) nmol/L,t =2.870,P =0.001 ].Serum level of 25 ( OH ) D in lymph node metastasis positive patient was lower than that in negative group [ (30.8 ± 9.71 ) nmol/L vs (43.7 ± 23.59) nmol/L,t =2.467,P =0.021 ].The positive expression of CaSR in breast cancer(88.9％ )was higher than breast benign tumors(60％,x2 =6.717,P ＜ 0.01 ) and normal breast tissue beside tumors (60％,x2 =5.628,P ＜ 0.05 ).ConclusionsConcentration of serum 25 (OH)D and expression of calcium-sensing receptor in the tissues may be associated with occurrence,development and prognosis of breast cancer.

To investigate the regulatory effect of acupuncture on insulin resistance in simple obesity patients and its clinical effect. Methods: By the method to benefit qi, strengthen the spleen, dissolve phlegm and remove turbidity, eight periumbilical acupoints, Tianshu (ST 25), Huaroumen (ST 24), Wailing (ST 26), Yinjiao (CV 7) and Shuifen (CV 9), and Guanyuan (CV 4) and Zusanli (ST 36) were used, in cooperation with ear-points-embedding method, and together with 30 healthy persons for comparison, in order to observe the changes in FBG, INS,ISI, TC, TG, LDLC and HDLC and to observe the changes in the waist circumference, hip circumference, waist-hip ratio, body weight and BMI in simple obesity patients before and after acupuncture treatments, and to observe the differences of the therapeutic effects between grade Ⅰ and grade Ⅱ obesity. Results: Hyperinsulinemia (HI) existed in the patients with simple obesity before the treatment, and ISI significantly decreased (P＜0.01) in comparison with the healthy group, and waist circumference, hip circumference, waist-hip ratio, body weight and BMI significantly decreased (P＜0.05, P＜0.01), and FBG, INS, TC, TG and LDLC also significantly decreased (P＜0.01, P＜0.05), and ISI and HDLC significantly increased (P＜0.05) after the treatment. Conclusion: Acupuncturecan not only effectively improve the body fat parameters but also regulate the abnormal fat metabolism and improve insulin resistance status in simple obesity patients.

Objective To explore relationship of the anesthetic risks and intraoperative complications.Methods Preoperative anesthetic risks were assessed with Hussman's method from May 2015 to May 2016 in 2 494 surgical patients, including 1 462 males and 1 032 females.Intraoperative data and complications were tracked and recorded.Results Three hundred and thirty-six intraoperative complications occurred, accounting for 13.47% of total patients.The cardiovascular complications were a major intraoperative complications, accounting for 80.7%.2 494 patients were graded respectively into risk grade 1 with 1 540 (61.75%), grade 2 with 660 (26.46%), grade 3 with 202 (8.10%), grade 4 with 80 (3.21%) and grade 5 with 12 (0.48%).The incidence of complications were 112 (7.28%), 82 (12.42%), 82 (40.59%), 50 (62.50%) and 10 (83.33%) respectively.The sensitivity of prediction was 33.33%, 24.40%, 24.40%, 14.88% and 2.78%;the specificity 33.76%, 73.26%, 94.44%, 98.61% and 99.91%;and the accuracy 33.76%, 66.64%, 85.01%, 87.33% and 86.85%, respectively, in patients with risk grade 1, 2, 3, 4 and 5.Conclusion Hussman's method of anesthetic risks well predicts the intraoperative complications.

Objective:To understand the genotyping and molecular epidemiological characteristics of Norovirus (NoV) GⅡ in adult acute gastroenteritis outpatients in Shanghai from 2015 to 2016.Methods:A total of 912 stool specimens from adult patients with acute diarrhea from March 2015 to December 2016 (431 in 2015 and 481 in 2016) were collected. The Norovirus GⅡ type was detected by one-step quantitative reverse transcription PCR assay and the RdRp region of open reading frame (ORF) 1 and 5′end of ORF2 were amplified. The region was sequenced and classified.Results:From March 2015 to December 2016, NoV GⅡ were detected in 17.76% (162/912) of the samples, 15.08% (65 /431) in 2015 and 20.17% (97/481) in 2016. Based on sequence analysis of the RdRp and capsid sequences, 145 identified NoV strains were divided into 10 genotypes: GⅡ.Pe_GⅡ.4 Sydney 2012 (60), GⅡ.P17_GⅡ.17 (45), GⅡ.P16_GⅡ.13 (10), GⅡ.P12_GⅡ.3 (10), GⅡ.P7_GⅡ.6 (9), GⅡ.P21_GⅡ.21 (5), GⅡ.P16_GⅡ.4 Sydney 2012 (2), GⅡ.Pe_GⅡ.17 (2), GⅡ.P2_GⅡ.2 (1), and GⅡ.P7_GⅡ.14 (1).Conclusions:The main epidemic NoV GⅡ genotype in Shanghai was GⅡ.P17_GⅡ.17 in the spring of 2015. GⅡ.Pe_GⅡ.4 Sydney 2012 and GⅡ.P17_GⅡ.17 were identified as predominant genotypes during the winter of 2015 and spring of 2016. The most common genotype was GⅡ.Pe_GⅡ.4 Sydney 2012 in autumn of 2016. Continuous NoV outbreak surveillance is important for identifying changing trends in genotype distribution and emerging new strains.