Objective To investigate the relationship between evidence-based nursing tactics and quality of life of breast cancer patients so as to provide the reference for the best nursing strategy .Methods 87 patients who were diagnosed with breast cancer received surgical treatment were randomly divided into experimental group (44 cases) and control group (43 cases) .Patients in control group were given general nursing ,while those in experimental group were given evidence-based nursing tactics on the ba-sis of general nursing .Both groups were asked to fill in the quality of life questionnaire after 4 months breast cancer treatment and before treatment .Results The quality of life in experimental group was significantly improved after treatment compared with that of before treatment(P< 0 .05) ,the quality of life in the experimental group received evidence-based nursing tactics is significantly better than that of in control group (P< 0 .05) .Conclusion Evidence-based nursing tactics can improve the quality of life in breast cancer patients .

Objective To study the effect of continuing flushing with heparin on the prevention of tube obstruction after vacuum sealing drainage(VSD).Methods Seventy-four patients with large area of skin defects treated by VSD were randomly divided into experiment group and control group. The experiment group were managed by continuous infusion with saline at 250 mL and heparin at 12500 U (50 U/mL)in 24 h after operation,with 20 to 30 drops per minute and two times a day. The control group included 33 cases was injected with 20 mL saline when the drainage tube blocked until the VSD tube was unobstructed. The two groups were compared in terms of drainage time, drainage tube,wound healing time,rate of un-obstruction of tubes and histopathological scores.Results The drainage time and wound healing time of experiment group were significantly shorter than that of control group(P<0.05). The rate of un-obstruction of tubes was higher than the control group and so it was with the score in histopathology.Conclusion Continuous flushing with heparin can effectively reduce the incidence of VSD obstruction and promote wound healing.

Objective To compare the ultrasonographic manifestations of ligamenta patella and their entheses of healthy volunteers with those of professional athletes. Methods Sonography was performed using a GE Logiq 700 MR Expert Series ultrasound equipment and a 5-10 MHz multifrequency linear array transducer. Fifty-two healthy volunteers and 20 professional athletes underwent sonography on ligamentum patella of both sides. Results The normal ligamenta patella′s contour was regular and sharply defined, appearing as tightly packed echoic structures with fine parallel internal linear echoes with a synovial sheath to a thickness of 0.02 cm. The attaching bone surface was smooth and continuous. The ligamenta patella of male was longer than that of the female(P

Objective:To investigate the number and distribution of macrophages (Mφ) and natural killer(NK) cells in hepatocellular carcinoma (HCC), paraneoplastic,cirrhosis and normal liver tissues and their relationship with the prognosis of HCC patients.　Methods:Surgical specimens from 60 cases of HCC, 62 cases of cirrhosis and 23 cases of normal liver tissues were investigated by immunohistochemical staining of CD68 and CD57 with a streptavidin-horseradish peroxidase detective system.The correlation of the number of Mφ and NK cells in different tissues with the clinical tumor parameters was also studied.　Results:①The order of the number of Mφ from the highest to the lowest was:paraneoplastic,cirrhosis, normal, HCC(P<0.05)；and the number of NK cells from the highest to the lowest was:HCC, paraneoplastic, normal, cirrhosis(P<0.05).②The number of Mφ decreased successively with the decrease of the HCC differentiation(P<0.05)；There was no relationship between the number of NK cells in HCC and histological grade. ③There was no relationship between the number of Mφ in HCC and clinical TNM stage ；The number of NK cells in HCC had degressive tendency with the clinical TNM stage(P<0.05). ④The number of Mφ and NK cells in HCC in the cases with metastasis in 15 months was significantly lower than that without metastasis(P<0.05, 0.01）.⑤There was a linear positive correlation between the number of Mφ and NK cells in HCC (r＝0.344, P<0.05).　Conclusion:The number of Mφ and NK cells in HCC in the cases with metastasis is significantly lower than that without metastasis；The number of Mφ has a close correlation with the HCC differentiation, and positive correlation with the number of NK cells；The number of Mφ and NK cells might be important markers to estimate the immune status and useful factors to predict the prognosis of HCC patients.

Objective To investigate the correlation between the expression of peripheral blood CD8 + T lymphocytes and the severity degree of hand,foot and mouth disease( HFMD)in children infected by enterovirus( EV)71 at different ages,and further to predict the role of the expression of CD8+ T lympho-cytes played in the occurrence of neurological complications infected by EV71. Methods A total of 138 pe-ripheral blood samples derived from the confirmed HFMD cases were collected in the department of infectious disease at Kunming Children′s Hospital between March and September in 2014,including 33 mild cases,45 severe cases,and 60 critical cases. Patient ages were 9 months to 5 years old. Flow cytometry was used to detect the expression of peripheral blood CD8 + T lymphocytes in all of above patients. Results Compared to the reference value of CD8 + T lymphocytes in normal healthy children at different age groups,the percentage of peripheral blood CD8 + T lymphocytes elevated or increased slightly in patients of all ages,except the obvi-ously increasing expression in the age group of ~2 years and decreasing expression in critical cases of the age group of ~5 years. The expression of peripheral blood CD8+ T lymphocytes significantly increased in mild and severe patients but slightly increased in critical patients of the age group of 9 to 15 months,gradually de-creased in the age group of ~2 years and slightly increased in mild and severe cases but decreased in critical patients of the age group of ~5 years. There were significant differences between the patients in mild condi-tion and in severe condition or critical condition respectively within the age group of ~2 years( P﹤0. 05 ), and there were no significant differences in other age groups between different severity of disease. Conclusion
There are correlations between the expression of CD8+ T cells and the severity of HFMD in patients at different ages. Especially,the patient′s condition developing into severe degree is associated with the rapid decreasing of CD8 + T cells in HFMD patients of the age group of ~2 years. CD8+T cells play an important role in antiviral immune response in HFMD patients of ~2 years old.

Objective To explore the incidence and clinical treatment of related complications caused by implantable venous access port(IVAP) in patients with breast cancer during chemotherapy.Methods The data of 755 patients with breast cancer recieved chemotherapy by which caused some related complications in our hospital from January 2014 to March 2016 were retrospectively analyzed.Results 753 patients IVAPs were implanted succussfully.The total placement time of implantable venous access port was from 110 days to 940 days,with median placement 147.33 days.The related complications of IVAP were catheter malposition(0.79％,6/755),catheter-related thrombosis(27.81％,210/755),catheter fracture(0.13％,1/755),port exposure(0.93％,7/755) and IVAP-related bloodstream infection(0.13％,1/755).The IVAP-related complications and thrombosis rate were significant higher when IVAPs implanted in the left internal jugular veincompared with that in right internal jugular vein(34.88％ vs.25.74％,33.10％ vs.24.68％).Conclusion Application of IVAP in patients with breast cancer during chemotherapy is a safe and effective operation.The most common complication is asymptomatic mural thrombus formation around the catheter,which should be paid attention to.

Objective To investigate the clinical features and treatment strategy of brain arteriovenous malforma-tions(AVM) associated with arterial aneurysms. Methods The clinical manifestation, imaging data, treatment and out-come of the patients with AVM were retrospectively analyzed in 38(10.4%) of these 364 patients. Results Hemorrhage was the most common clinical manifestation (60.5%). The hemorrhage risk was higher in AVM associated with arterial an-eurysms than in single AVM(χ2=5.956,P<0.05). The most common type of associated aneurysms was feeding artery an-eurysm (69.4%). Hemorrhage more frequently occurred within the aneurysm.(χ2=8.869,P<0.05). The bleeding lesions and 43 associated aneurysms of the 37 patients were treated effectively by endovascular treatment and/or craniotomy. Thirty-four patients had excellent or good outcomes, six patients had complications, 3 patients had neurological deficits. Postoperative digital subtraction angiography (DSA) examination showed the complete disappearance of arteriovenous malformation and aneurysm in sixteen cases. Conclusions The AVM associated with aneurysms is common in patients with AVM. AVM associated with aneurysms has a higher risk of hemorrhage than single AVM. The aneurysm within AVM has a higher rate of hemorrhage. The treatment priority should be given to the bleeding lesions and aneurysms.

Abdominal Cavity ; Adult ; Anemia, Aplastic ; therapy ; Antigens, CD34 ; metabolism ; Carcinoma ; metabolism ; pathology ; Dendritic Cell Sarcoma, Follicular ; metabolism ; pathology ; Diagnosis, Differential ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Ki-67 Antigen ; metabolism ; Lymph Nodes ; pathology ; Male ; Neoplasms, Muscle Tissue ; metabolism ; pathology ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Sarcoma, Kaposi ; etiology ; metabolism ; pathology ; Viral Proteins ; metabolism

OBJECTIVETo explore the clinical effects of Dynesys system for the treatment of multiple segment lumbar degenerative disease.

METHODSA total of 28 patients with lumbar degenerative disc disease treated with Dynesys system from December 2008 to May 2011 were retrospectively reviewed. There were 16 males and 12 females, aged from 27 to 75 years old with an average of 49.1 years. Thirteen patients with multiple segmental lumbar intervertebral disc protrusion, including L3-L5 in 7 cases, L2-L4 in 1 case and L4-S1 in 5 cases. Fifteen patients with multiple segmental lumbar spinal stenosis, including L3-L5 in 10 cases, L4-L5 in 4 cases and L2-S1 in 1 case. The symptoms of lumbago and (or) intermittent claudication in all patients were treated with conservative treatments for more than 6 months and these methods did not work. Visual analogue scale (VAS) was used to analyze the lumbar and leg pain, imaging data were used to measure the intervertebral space height and intervertebral motion of fixed segment and upper adjacent segment, Oswestry Disability Index (ODI) was used to evaluate the clinical effect.

RESULTSAll operations were successful and the patients were followed up from 38 to 65 months with an average 50.6 months. At final follow-up, ODI and VAS of the low back pain and leg pain were (25.10±6.52)%, (1.25±0.70) points and (1.29±0.89) points, respectively and were decreased compared with preoperative (P<0.05). Postoperative intervertebral space heights were increased and intervertebral motions were decreased in fixed segment compared with preoperative (P<0.05). There were no significant differences in intervertebral space heights and intervertebral motions of upper adjacent segment between preoperative and postoperative (P>0.05).

CONCLUSIONDynesys system may obtain long-term clinical curative effect in treating multiple lumbar degenerative disease. It can partially preserve the intervertebral motions of the fixed segments, have little effect on adjacent segments. The long-term clinical effect of Dynesys still need longer time follow-up observation.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; pathology ; surgery ; Joint Instability ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Visual Analog Scale