Objective Through researching the name,etiology,pathogenesis and therapeutic methods and prescriptions of the breast cancer in ancient medical documents to provide the theoretical basis and syndrome differentiation thinking for the treatment of breast cancer clinically.Methods By disease name searching,content analysis was used to screening the ancient literature that associated with breast cancer.The pathogenesis,treatment and medicine used of breast cancer in these ancient literatures were summarized.Results The stagnation of Qi and phlegm,blood stasis,and vital deficiency are important factors for breast cancer formation,while the deficiency of vital qi and viscera deficiency are important pathogenesis of breast cancer.Prevention before the onset of disease,eliminating pathogenic factors at the early period of the disease,supplement vital qi and eliminating pathogenic vital qi in the middle stage,and supplementing vital qi at the late stage of the disease should be emphasized.Meanwhile soothing liver to regulate mode and depression should also be paid attention.Conclusion The recognition of breast cancerby TCM and advantage of TCM in treating this disease need further literature researches.

Objective: To investigate the rifampicin resistance status and its influencing factors among elderly patients with pulmonary tuberculosis in Changzhou City, Jiangsu Province, so as to provide the basis for improving drug-resistant pulmonary tuberculosis prevention and control strategies. Methods: Patients aged over 60 years with pulmonary tuberculosis treated in tuberculosis designated hospital was selected. Demographic information, history of previous disease, history of diagnosis and treatment and drug sensitivity test were collected. Rifampicin resistance among elderly patients with pulmonary tuberculosis and its influencing factors was analyzed. Results: Totally 249 elderly patients with pulmonary tuberculosis were included, with an average of (69.75±4.36) years. There were 147 males and 102 females, with a gender ratio of 1.44∶1. There were 183 treatment-naïve patients (73.49%) and 66 retreated patients (26.51%). Rifampicin resistance was found in 21 cases, with a drug resistance rate of 8.43%. Among them, there were 7 treatment-naïve patients (3.83%), and 14 retreated patients (21.21%). Multivariable logistic regression analysis showed that retreated elderly patients with pulmonary tuberculosis had a higher risk of rifampicin resistance (OR=10.551, 95%CI: 1.344-82.857). Conclusion The rifampicin resistance rate of 249 elderly patients with pulmonary tuberculosis was 8.43% and was associated with the type of treatment.

Objective To study the biocompatibility of carboxymethyl chitosan (CMCS) membrane with melanocytes from healthy human skin,and to investigate the feasibility to transport and carry melanocytes by using CMCS membrane.Methods CMCS membrane was prepared by a casting method combined with a glutaraldehydebased cross-linking method.Melanocytes were isolated from the foreskin of healthy men,and subjected to primary culture and subculture.The third-passage melanocytes were classified into two groups to be cultured on the CMCS membrane (test group) or traditional culture plates (control group).Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferative activity of melanocytes,and a sodium hydroxide-based lysis method to determine melanin content.HMB45 staining was conducted,and tyrosinase activity was estimated for melanocytes.Results Inverted microscopy showed that melanocytes were evenly distributed on the CMCS membrane with a normal shape.The melanocytes adherent to the CMCS membrane stained positive for anti-HMB45 monoclonal antibody.The growth curve of the melanocytes on the CMCS membrane,which was obtained from MTT assay,demonstrated that CMCS membrane could support the normal growth of melanocytes.No significant difference was observed between the test group and control group in melanin content (0.083 ± 0.015 vs.0.066 ± 0.008,t =2.38,P ＞ 0.01) or tyrosinase activity (0.234 ± 0.083 vs.0.241 ± 0.061,t =0.23,P ＞ 0.05).Conclusion CMCS membrane can maintain the normal biological activity of melanocytes and have good biocompatibility with skin melanocytes.

[Summary] The high-risk subjects of type 2 diabetes mellitus ( T2DM) in normal glucose tolerance ( NGT) were screened. The subjects with NGT at baseline were divided into high-risk and low-risk groups according to the diagnostic threshold of insulin area under the curve ( AUCINS ) 108. 43 mU/L. The incidence of prediabetes and/or T2DM was significantly increased in high risk group in comparison with low risk group ( 29. 41 vs 2. 21%, P<0. 01). The result suggests that the diagnosis threshold for AUCINS≥108. 43 mU/L can be used to screen the high-risk subjects of T2DM in NGT.

As an effective implant for bone fracture, bone screws are widely used in clinic. Based on the clinical application of bone screws, this study summarized different kinds of bone screws according to their structures and materials, analyzed 3 kinds of common screw failure (loosening, breaking, corrosion) and the influencing factors. The common testing methods of screws were summarized, especially the key points and difficulties during the testing process for bone screws were analyzed, which was important for improving the design of product, selection of materials and development of in vitro testing technology. The development trend for testing method of bone screws was prospected as well.

Objective To explore the relationship between different blood glucose levels and new carotid artery plaques.Methods A total of 5 440 participants met the inclusion criteria were selected stratified randomly from the 101,510 serving and retired workers of Tangshan Kailuan Company who participated the health examination from 2006 to 2007.The follow-up health examination were respectively preformed from 2010 to 2011 and from 2012 to 2013 which included carotid ultrasound for these 5 440 participants.The 5 440 participants were divided into three groups (ideal blood glucose group,impaired fasting glucose group and diabetic group) according to their fasting glucose levels in 2010-2011 examination.Multivariate Logistic regression analysis was used to analyze the risk factors of new carotid artery plaques.Results Among 5 440 subjects,participants whose FPG,ultrasound data incomplete and ultrasound detection of carotid plaques during the 2010-2011 health examination were excluded,then 3 084 participants were included in this study,among them,175 participants who did not participate the 2012-2013 health examination and 561 participants whose carotid plaque ultrasound data incomplete were excluded.Thus,a total of 2 348 participants were included in the present analysis.The total detection of new carotid artery plaque rate was 15.0％ (352/2 348) after 2 years of follow-up.The detection of new carotid artery plaque rate in normal glucose group(n =1724),impaired fasting glucose group(n=464) and diabetic group(n=160) were 14.2％(245/1 724),14.9％(69/464) and 23.8％(38/160),respectively.The diabetic group was higher than that of the ideal blood glucose group and the impaired fasting glucose group,the difference was statistically significant(P＜0.05).Impaired fasting glucose group and diabetic group had an increased risk of new carotid artery plaque compared with those in ideal glucose group(OR =0.924,95％CI 0.691-1.235 and OR =1.733,95％CI 1.107-2.713,respectively),the difference was statistically significant(P＜0.05).After adjusted for the other risk factors,with the risk-adjusted ratio (OR =1.117,95％CI 0.824-1.513 and OR =1.393,95％CI 0.872-2.226).Conclusion The detection of new carotid artery plaque increase in the diabetic group.However,after adjustment for other risk factors associate with emerging danger of new carotid artery plaque is no significant difference.This requires more long-term follow-up study of a large sample to be further confirmed.

Objective To investigate the effect of folic acid intervention on plasma homocysteine (Hcy) metabolic changes and pulse wave velocity(PWV)in patients with type H hypertension. Methods Patients(hos-pitalized from March 2014 to December in our hospital)with H type hypertension were randomly divided into treat-ment group and control group randomly ,and were given routine antihypertensive drug therapy. Treatment group was given oral folic acid 0.8 mg,1 times a day,the control group was given placebo,1 times a day. All patient were treated for 12 months. Changes of plasma Hcy and PWV levels were observed. Results 432 patients(Han nationality)with type H hypertension were enrolled in this study with the age of 61.7 ± 13.6 years old and the ratio of men and women is 1.3:1. The most common diseases were coronary heart disease and type 2 diabetes mellitus. 2 groups were treated for a period of 12 months,with follow-up time from 6 to 10 months(average duration in 8 months). After treatment,the difference between plasma Hcy(Z=-7.63,P=0.000)and PWV(Z=-3.16,P=0.002)levels of the two groups were statistically significant. Conclusion Folic acid intervention can significantly reduce the level of plasma Hcy in patients with type H hypertension ,slow down the progression of atherosclerosis and reduce the risk factors of cardiovascular disease.

Objective: To investigate the changes of oxidative stress in kidney of type 2 diabetic rats after sleeve gastrectomy and its effect on renal function. Methods: Twenty male SD rats were fed with high-fat diet and injected with streptozotocin intraperitoneally to induce type 2 diabetes mellitus. Seventeen successful induction models were divided into sham operation group (n=7) and sleeve gastrectomy (SG) group (n=10) by random number table method, and were treated with sham operation and SG respectively. The body weight, 24-hour food intake, fasting blood glucose (FBG)and serum glucagon-like peptide-1 (GLP-1) were measured before and 1, 2, 3 and 4 weeks after operation. The activities of superoxide dismutase (SOD), catalase, glutathione peroxidase (GSH-Px) and malondialdehyde in renal tissue as well as blood urea nitrogen (BUN), creatinine levels and 24-hour urinary microalbumin (UALB) were measured 4 weeks after operation. Masurement data conforming to normal distribution were expressed as Mean±SD, and t-test was used for comparison between two groups. Results: At the 1st, 2nd, 3rd, 4th weeks after operation, the levels of FBG in SG group was lower than those in sham operation group [(11.13±3.27) mmol/L vs (16.74±4.10) mmol/L, (9.53±2.82) mmol/L vs (19.31±3.66) mmol/L, (6.69±2.44) mmol/L vs (20.84±2.71) mmol/L, (6.58±2.96) mmol/L vs (19.99±2.85) mmol/L, all P<0.05]. In the same period, the levels of serum GLP-1 in SG group was higher than those in sham operation group [(22.61±2.92) pg/mL vs (15.42±2.39) pg/mL, (24.72±3.02) pg/mL vs (16.20±2.26) pg/mL, (24.59±2.85) pg/mL vs (15.84±2.75) pg/mL, (26.15±3.23) pg/mL vs (15.77±2.79) pg/mL, all P<0.05]. At the 4th week after operation, BUN[(5.34±0.82) mmol/L], creatinine[(39.78±6.13)]μmol/L, UALB[(31.18±6.88) mg/24 h] and renal creatinine[(5.84±0.85) nmol/mg] in SG group were lower than those in sham operation group [BUN (9.08±1.54) mmol/L, creatinine (64.07±8.63) μmol/L, UALB (67.64±9.07) mg/24 h, creatinine (10.78±1.28) nmol/mg], and the differences were statistically significant (all P<0.05). Renal SOD[(620.05±55.98) U/mg], CAT[(24.72±2.28) U/mg] and GSH-Px[(281.53±27.99) U] in SG Group were lower than those in sham operation group [SOD(392.52±45.97) U/mg, catalase (15.62±2.46) U/mg, GSH-Px (164.71±21.83) U], and the differences were statistically significant (all P<0.05). Conclusion Sleeve gastrectomy may improve renal function through reducing oxidative stress in the kidney.

Objective:To provide reference for the development of a more intelligent and systematic nursing clinical decision support system based on the concept of precision nursing and data sharing, the nursing plan module of clinical decision support system.Methods:An evidence-based knowledge base was constructed based on the nursing process and the standardized nursing terminologies; the nursing plan module was designed according to clinical needs, and the logical reasoning rules were formulated from the generation, sequencing and stopping of nursing problems, objectives, measures and activities, and finally the nursing plan module of clinical decision support system was formed.Results:The nursing plan module of clinical decision support system included the basic information of patients, positive evaluation items and weight values, nursing problems, objectives, measures and activities, etc. the module could automatically deduce the nursing plan according to the patient's individual characteristic index (positive evaluation item), and sort the nursing problems and corresponding measures and activities according to the generation time, weight value and correlation degree. It could automatically distinguish nursing problems, goals, measures and the time of activity stop, and realize intelligent decision-making.Conclusion:The interface of nursing plan module of this system is clear and logical reasoning rules are rigorous. It breaks through the bottleneck of nursing decision-making based on personal professional knowledge and experience in clinical situation for a long time, which can ensure the homogeneity of nursing plan and improve the correctness of decision-making.

After the stratification of the normal glucose tolerance, the changes of insulin resistance and βcell function in the development of type 2 diabetes mellitus were investigated. A retrospective analysis on data of 275 cases with oral glucose insulin releasing tests. The area under the insulin curve (AUCINS ) 108. 43 mU/ L was taken as the critical value of diagnosis. Normal glucose tolerance subjects were divided into the NGT-a group(AUCINS<108. 43 mU/ L) and the NGT-b group(AUCINS≥108. 43 mU/ L). The plasma glucose, insulin, insulin sensitivity, and β cell function were compared among the 4 groups: NGT-a group (n=96), NGT-b group (n=49), prediabetes group (n=71), and type 2 diabetes mellitus group ( n = 59). Among the fasting insulin, 2 h insulin, AUCINS , early-phase insulin secretion index(△I30 / △G30), the ratio of total insulin area under curve, and total glucose area under curve, disposition index, homeostasis model assessment for insulin resistance, and Matsuda insulin sensitivity index, the relationship as follows: NGT-b group>prediabetes group>NGT-a group>type 2 diabetes mellitus group. The NGT-b group was always the highest, prediabetes group was lower, NGT-a group and type 2 diabetes mellitus group were the lowest, there were significant differences (all P<0. 05). Making the NGT-a group as the basic state, in the NGT-b group, β cell function has begun to appear compensation and insulin resistance, and β cell function compensation reached the peak, the β cell function in the prediabetes group was beginning to compensate for the deficiency, the function of β cell in type 2 diabetes mellitus group decreased further. These findings suggest that the development process of type 2 diabetes mellitus could be the following four stages according to the function of β cell: β cell function normal, β cell functional compensation, β cell function loss of compensation, and finally β cell function failure.