Objective Quadratic regression universal rotary combination design was used to optimize the fluorescence labeling condition of lycium barbarum polysaccharide (LBP).Methods The fluorescence labeling condition of LBP presented, when the covalent coupling of LBP and tyramine was reacted with fluorescein isothiocyanate (FITC). Filter the best labeling condition via using quadratic regression universal rotary combination design experiment on the relationship of labeling efficiency among pH value of buffer solution, reaction time, temperature and the dose of tyramine.Results The regression equation was:Y=0.085 41 - 0.002 82X1 - 0.015 68X2 + 0.008 11X3 + 0.005 01X4 + 0.008 75X1X2 - 0.005 75X1X3 - 0.001 75X1X4 + 0.010 63X2X3 + 0.000 125X2X4 + 0.000 25X3X4 - 0.021 44X12 - 0.008 89X22 - 0.001 984X32 + 0.003 66 X42, and the variables fromX1 toX4 represented pH value, reaction time, temperature and dose of tyramine, respectively. The goodness of fitting of regression equation was statistically significant. The condition of labling LBP was optimized when the temperature was at 50℃, timing of labling at the fourth day and pH value was 8.5.Conclusion The condition of labling LBP was optimized with suitable temperature, pH value and extended timing.

Objective To explore the application of transitional care based on the Omaha system in postoperative rehabilitation of patients with breast cancer.Methods Seventy-two patients after radical mastectomy were assigned into two groups according to admission time,patients from June to December 2011 were set as the control group,patients from February to December 2012 were assigned to the intervention group,each group contained 36 patients.The patients in the control group received routine nursing,while patients in the intervention group were implemented transitional care program with Omaha system as framework from before discharge to 6-week follow-up after discharge from hospital.Nursing effect was compared between two groups from three aspects such as cognition,behavior and status.Results Twenty-three problems were found in the 6-week follow-up for the intervention group,including environmental domain,psychosocial domain,physiological domain and health-related behavior domain.Knowledge,behavior and status scores of the intervention group 6 weeks after discharge were significantly higher than those of the control group [(3.92 ± 0.48) scores vs.(2.41 ± 0.17) scores,(4.11 ± 0.49) scores vs.(2.83 ± 0.25) scores,(3.09 ±0.52) scores vs.(2.32 ±0.39) scores,t=14.81,15.36,9.42,P＜0.01 or 0.05].Conclusions Transitional care based on the Omaha system shows common problems in rehabilitation of patients with breast cancer after operation,and provides standardized program for rehabilitation nursing.It can achieve better nursing effect.

Objective: Full expression of class I HLA molecules on tumor cells is pivotal in priming the tumor antigen-specific CTLs for effective iramunotherapies. Tumor cells display abnonnal expression of HLA class I molecules in human ovarian carcinoma. Methods: In this study, the expression of class I molecules in human ovarian cancer cells was determined by using Western bloting, immunohistochemistry testing and flow cytometry. The mRNA of TAP (transporter associated with antigen processing) and LMP(low molecular weight polypeptide) were exannined at the same time by RT-PCR. Results: It has been shown that class I molecules were unable to be, or only weakly, expressed in five of eight ovarian cancer cell lines. On these cell lines abnormal in class I expression, no or only little mRNA were detected for TAP1, TAP2, LMP2 and(or) LMP7 genes. Class I expression, however, could be partially recovered by incubating the tumor cells at 25℃ when compared with those at 37℃ . Conclusion: The results suggested that the dysfunction of TAP and IMP genes, following by a defective expression of class I molecules, might be one of the mechanisms enable ovarian cancer cells to escape from immune surveillance.

Objective To analyze the characteristics of atherosclerosis in elderly patients with isolated systolic hypertension (ISH) combined with low diastolic blood pressure and risk factors related to low diastolic blood pressure (DBP).Methods A total of 447 elderly patients with untreated ISH were divided into the low DBP (DBP＜70 mmHg, 1 mmHg=0.133 kPa) group (n=206) and the non-low DBP (DBP＞ 70 mmHg) group (n=241) according the DBP level.Clinical data including brachial-ankle pulse wave velocity (baPWV), carotid artery ultrasonography, blood lipids, blood glucose, plasma homocysteine were collected and determined.baPWV, carotid intimal-medial thickness (IMT) and the incidence of carotid plaques were compared between the two groups.Risk factors for low DBP were analyzed.Results There were no significant difference in systolic pressure levels between the low DBP group and the non-low DBP group [(160.8±10.1) mmHg vs.(161.1-±-10.9) mmHg, P＞0.05].Pulse pressure, baPWV levels, IMT and the incidence of carotid artery plaque were higher in the low DBP group than in the non-low DBP group [(98.4 ±11.7) vs.(77.4±12.0) mmHg, (1 785.3±175.0) vs.(1 436.5±114.4), (1.2±0.2) mm vs.(1.1±0.3)mm and 78.2％ (161/206) vs.67.2％ (162/241), each P＜0.05].Stepwise logistic analysis showed that age, gender (female) and diabetes were independent risk factors for low DBP (OR=1.62, 2.07, 1.38, all P＜0.05).Conclusions Atherosclerosis is more serious in elderly patents with ISH combined with low diastolic blood pressure than those without low DBP.Age, gender (female) and diabetes are independent risk factors for low DBP.

Objective To explore the surgical extent and to improve the surgical techniques of the Piver class Ⅲ hysterectomy on invasivc cervical cancer,so as to reduce the urinary tract complications,shorten the surgical duration,decrease the hemorrhage and blood transfusion.Methods The study group,196 cases with stages Ⅰ b and Ⅱ a carcinoma of the cervix underwent the modified Piver class Ⅲ hysterectomy from June 2000 to May 2005.The control group,176 cases of the same stages underwent the Pivet class Ⅲ hysterectomy between June 1994 and May 1999.The modified Piver class Ⅲ hysterectomy mainly include the surgical extent and some surgical techniques as follows.The cervicovesical and vesicovaginal space are separated with assistance of electrotome.Half of the uterosacral ligaments are removed with electrotome.The tunnel of the ureters is separated and penetrated or not. The anterior leaf of the cervicovesical ligaments is removed and the uterine artery are removed at the same time.while the ureter branch from the uterine artery are preserved.When the ureters aIe drawn to the lateral side of the body with an "S" hook and the urocyst lateral recessus are expanded.the cardinal ligaments can be exposed and be removed of 3/4.But part of the inferior of these ligaments should be preserved.The paracolpium are resected about 2 cm.2-3 cm tissue of the vagina is removed.Results Compare with the control group,the urinary tract complications of the study group were significantly reduced(51.1%versus 23.0%,P<0.01).There were a shorter surgical duration[(132±20)min],less of the hemorrhage[(322±100) ml]and blood transfusion[(154±79)ml] in the study group than those in the control group(all P<0.05).While,there was no significant difference at the survival rates of 5 years between the two groups (87.8% versus 88.6%.P=0.793).Conclusion The modified Piver class Ⅲ hysterectomy is effective and applicable for patients with cervical cancer.

Objective To observe the effect of medication compliance and self-efficacy of schizophrenia patients with diabetes by continuing self-management education. Methods A total of 60 patients with schizophrenia with diabetes diagnostic criteria were divided into experimental group (30 cases) and control group (30 cases) by the admission number, 2 groups received conventional drug treatment, the control group received general preaching health education pattern, were each issued a health education manual, with schizophrenia and diabetes health knowledge division, the test group on the basis of the continuation of the implementation of self-management education, followed up 12 months after discharge, compared 2 groups of patients with medication compliance and recurrence rate, with General Perceived Self-Efficacy Scale (GSES) assessment level of 2 groups of patients with self-efficacy, fasting blood glucose (FPG) was determined by automatic biochemical analyzer, 2 hours postprandial blood glucose (2 hPBG). Results Six months after discharge, 82.1%(23/28) cases were complete compliance, 14.3%(4/28) cases of partial compliance, 3.6%(1/28) cases of non-compliance, 55.2%(16/29)cases of the control group complete compliance, 27.6%(8/29) cases of partial compliance, 17.2%(5/29) cases of non-compliance, the differences between two groups were statistically significant (χ2=37.41, P<0.05). The 12 month test group of full compliance discharged 75.0%(21/28) cases, 14.3%(4/28) cases of partial compliance, 10.7%(3/28) cases of non-compliance, 31.0%(9/29) cases of the control group complete compliance, 31.0%(9/29) cases of partial compliance, 37.9%(11/29) cases of non-compliance, the test group compliance was higher than the control group (χ2=11.27, P<0.05). The score after 6 months and 12 months respectively for the test group general self-efficacy scored 35.32 ± 2.02, 34.18 ± 1.77, control group scored 24.03 ± 3.04, 22.48 ± 2.01, the differences between two groups were statistically significant (t=16.445, 23.304, P<0.01). After 6 months in test group FPG and 2 hPBG were (5.71 ± 1.05), (9.46 ± 1.37) mmol/L, control group were (7.79 ± 1.05),(12.28 ± 2.07) mmol/L, the differences between two groups were statistically significant (t=7.483, 6.023, P<0.01). 12 months after discharge in test group FPG and 2 hPBG respectively (5.89±1.13), (9.68±1.09) mmol/L, control group (9.14±1.19), (13.17±1.42) mmol/L, test group FPG and 2 hPBG were lower than the control group (t=10.550, 7.431, P<0.01). After 6 months and 12 months, the recurrence rate of experimental group were 7.1% (2/28) and 24.1% (7/29) respectively, and control group were 14.3%(4/28) and 44.8%(13/29), the recurrence rate of experimental group was lower than the control group, there was significant difference between 2 groups (χ2=4.326, 6.225, P< 0.05 or 0.01). Conclusions Self-management education can improve the medication compliance and self-efficacy, improve mental symptoms and sugar metabolism, and reduce the recurrence rate.

Objective To understand the pathway of iodine intaking among Tibetan, and provide basic data for prevention and control of iodine deficiency disorders (IDD). Methods Through the method of random sampling, the boarding and day student aged 8 - 10 and women of childbearing age were conducted dietary survey to understand the condition of food intaking via the 24 h review method in 2015. Samples of urine, drinking water, dried beef, milk, Qula and fried noodles were collected and tested iodine level. Results Due to taking iodized salt three times a day with meals, the median of urinary iodine among 492 investigated boarding students was 179.2 μg/L;differently, the median of urinary iodine among 298 day students in this investigation was 79.6 μg/L who taking iodized salt only at lunch at school;and in the study, the median of urinary iodine among 158 women of childbearing age who took iodine-free salt daily was 33.7 μg/L. The iodine contents in 51 drinking water samples, 66 dried beef samples, 48 milk samples, 20 Qula samples and 37 fried noodle samples were quantified respectively, and the average iodine contents of each food were 0.8 μg/L in drinking water, 59.1 μg/kg in dried beef, 61.5 μg/kg in milk, 226.4 μg/kg in Qula and 17.0 μg/kg in fried noodles. The acceptable daily intake (ADI) of iodine of the boarding and day students aged from 8 to 10 and women of child bearing age were 234.0, 126.4 and 76.7 μg/d, respectively, among which the ADI of iodine with iodized salt were 208.0, 78.0 and 0.0 μg/d. Conclusion Consuming iodized salt is a main method to get iodine among Tibetans in Nangqian County, so that it is significant to carried out this measure for a long time for free to let them have iodized salt every day instead of iodine-free one.

Objective To study the effect and safety of ticagrelor on platelet in ＞75 years old patients undergoing PCI.Methods One hundred and twenty ＞75 years old patients with acute coronary syndrome undergoing PCI were randomly divided into observation group treated with aspirin+ticagrelor (n =60) and control group treated with aspirin+ clopidogrel (n =60).They were followed up for 1 year after PCI.The major adverse cardiovascular events (MACE),bleeding events,drug-related side effects and all-cause mortality were compared between the two groups.Results No instent thrombosis occurred in any patients,myocardial infarction occurred in 2 patients,angina pectoris occurred in 5 patients and 3 patients died in observation group after 1 year of PCI.Instent thrombosis occurred in 4 patients,myocardial infarction occurred in 3 patients,angina pectoris occurred in 6 patients,and 4 patients died in control group after 1 year of PCI.The incidence of instent thrombosis was significantly lower while that of mild dyspnea was significantly higher in observation group than in control group (0％ vs 6.7％,10.0％ vs 0％,P＜0.05).Conclusion Ticagrelor can effectively prevent instent thrombosis and does not increase the risk of bleeding in ＞75 years old patients after PCI.

Objective:To investigate the dietary iodine intake of people in different areas of Qinghai Province, and to provide the basis for scientific iodine supplementation and continuous elimination of iodine deficiency hazards.Methods:From 2018 to 2019, according to administrative division, natural geographical regions, population distribution and economic development level of Qinghai Province, a total of 14 survey sites were selected. One village was selected from each survey site, and 20 households were selected from each village, the salt samples and 24 h urine samples of all family members were collected to detect salt iodine and urinary iodine. One drinking water sample was collected at the five directions of east, west, south, north and middle of each village to detect water iodine. Salt iodine was detected by direct titration, urinary iodine and water iodine were detected by arsenic-cerium catalytic spectrophotometry. At the same time, the 3-day weighing method was used to investigate the diet, the daily dietary iodine intake per capita (the result was expressed as average) and the proportion of dietary iodine in urinary iodine were calculated, the daily dietary iodine intake per capita of different production modes (agricultural region and pastoral region), different geographical environment (Hehuang Valley, Qaidam Basin, Qilian Mountain and Qingnan Plateau), different nationalities (Han, Tibetan, Hui, Mongolian, Tu, Salar) and different economic levels (< 8 000, 8 000 -, 10 000 -, ≥12 000 Yuan) were compared.Results:A total of 999 people from 280 families were surveyed, including 511 males and 488 females. The median water iodine of each survey site was less than 10 μg/L, all of which were environmentally iodine-deficient areas. A total of 280 salt samples were collected, the median salt iodine was 26.0 mg/kg, and the consumption rate of qualified iodized salt was 100% (280/280). A total of 999 urine samples were tested, and the median urinary iodine of people was 192.5 μg/L, which was at an appropriate level of iodine. There was no statistically significant difference ( t =-1.599, P > 0.05) in the daily dietary iodine intake per capita (28.53, 33.44 μg) of people in agricultural region ( n = 643) and pastoral region ( n = 356). The daily dietary iodine intake per capita (25.38, 33.30, 32.98, 34.79 μg) of people in Hehuang Valley ( n = 448), Qaidam Basin ( n = 125), Qilian Mountain ( n = 157), and Qingnan Plateau ( n = 269) were compared, the difference was statistically significant ( F = 2.883, P < 0.05); among them, the daily dietary iodine intake per capita in Hehuang Valley was lower than that in Qingnan Plateau ( P < 0.05). The daily dietary iodine intake per capita of different nationalities were compared, the difference was statistically significant ( F = 3.647, P < 0.05), Salar ( n = 68) and Tibetan ( n = 239) were higher (37.21 and 32.21 μg). The daily dietary iodine intake per capita (38.97, 17.01, 30.86, 33.14 μg) of annual per capita disposable income < 8 000 ( n = 194), 8 000-( n = 221), 10 000-( n = 302), ≥12 000 Yuan ( n = 282) were compared, the difference was statistically significant ( F = 9.407, P < 0.05). The proportions of dietary iodine in urinary iodine of various population ranged from 5.35% to 15.54%. Conclusions:The iodine nutrition of people in Qinghai Province is suitable, the dietary iodine intake of people is closely related to geographical environment, nationality and economic level. But the proportion of dietary iodine in urinary iodine is relatively low, the consumption of iodized salt is still the main way for people to intake iodine, and it is also the main measure to continuously eliminate the harm of iodine deficiency in Qinghai Province.

Objective To investigate the relationship between thyroid volume and multiple body indexes such as urinary iodine level,height,and weight,respectively,in order to provide a theoretical basis for evaluation of goiter disease in the future. Methods The height and weight were measured, and urine samples were collected from children aged 8 to 10 years old from 10 township schools of Nangqian County in Qinghai Province in 2014 and urinary iodine was tested via the As (Ⅲ)-Ce4+catalytic spectrophotometry method. Meanwhile, the thyroid volume was immediately measured via the B-ultrasound method. Statistical analyses were employed finally to assess the difference and correlation between thyroid volume and multiple physiological indexes including urinary iodine level, height, weight, gender and age. Results The thyroid volume of 773 children aged 8 to 10 years old showed skewed distribution (W = 0.088, P < 0.05), with median of 3.53 ml and quartile of 3.05, 4.15 ml. The thyroid volume was not significantly different between different urinary iodine levels (H = 1.644, P > 0.05). There were significant differences of the thyroid volume among different height groups, weight groups and age groups (H=59.845,64.888,28.590,P<0.05),and the thyroid volume was positively correlated with height weight and age,respectively(r = 0.389, 0.359, 0.155, P < 0.05). Conclusions The thyroid volume is related to the level of children's physiological parameters, such as age, height, weight. Therefore, the diagnosis of thyroid volume via the B-ultrasound method for a individual child should not only take age,but also height and weight into account, to reduce the diagnostic error of goiter disease.