Objective To investigate knowledge, attitude, and practice of exercise for post-operative breast cancer. Methods 110 postoperative breast cancers were investigated using a self-designed questionnaire which included general condition of patients, knowledge, attitude and practice of exercise after breast surgery. Results The rate of effective response was 98%. The average rate of awareness about postoperative exercise for breast cancers was 87%, and the score of knowledge of intensity and forms of exercise was the lowest, while the announcements of post-operative exercise was the highest. All of the patients presented positive attitude toward exercise, however, some of them indicated that they couldn't insist on it. 41% exercised only in one form, 78% at a low intensity, 41% less than 3 times per week, and 74% at least 30 minutes per session. Only 7% did traditional Chinese medical exercise. Time after surgery correlated positively to general scores (r=0.40, P<0.01), kinds of exercise (r=0.41, P<0.05) and intensity of exercise (r=0.43, P<0.05). Phase of cancer correlated negatively to general scores (r=-0.37, P<0.05) and exercise time (r=-0.38, P<0.05). Conclusion The knowledge on intensity and form of exercise after operation is not popular in post-operative breast cancers.

Objective To evaluate the effectiveness of Tai chi on quality of life of breast cancer patients. Methods Articles from 10 English and Chinese Databases from inception to March 2012 were recalled. 2 researchers independently screened titles and abstracts for eligible trials, methodological quality was assessed according to risk of bias items. Meta-analysis would be used if data available. Results 4 randomized trials with 169 participants were included. All trials had high risk of bias. 2 studies demonstrated significant improvement in Tai chi group for improving shoulder functional capacity which caused by breast cancer. The meta-analysis failed to demonstrate significant effects of Tai chi compared with control interventions (psychological support therapy, standard health care, routine rehabilitation training) in improving quality of life (SMD 0.03, 95%CI: -0.85, 0.91, P=0.94). Conclusion Tai chi is effective on shoulder functional capacity of breast cancer, but not significantly on quality of life.

Objective To investigate the differences of curriculum designs for undergraduate nursing majors among different TCM colleges and universities;To provide evidence for the development of the accreditation standards for academic quality of baccalaureate degree program in TCM colleges and universities which can be used as the standards for teaching reform. Methods Cultivating plans of 20 TCM colleges and universities for undergraduate nursing majors were collected. Current status and deficiency in curriculum design were obtained through comparative study and statistical analysis.Results The course names were lack of standardization;proportion of Chinese and Western medicine related courses were unreasonable;theoretical and practice teaching were irrelevant;optional courses were greatly inconsistent and irrational. Conclusion The further reform of the curriculum design for the undergraduate nursing majors in TCM colleges and universities is in urgent need, which can be standardized by developing the accreditation standards for academic quality of baccalaureate degree program in universities of Chinese Medicine.

Objective To investigate the effect of the optimal prescription of huiru yizeng on rats with hyperplasia of mammary gland and hyperprolactinemia. Methods Fifty-six female Wistar rats were randomly divided into 7 groups (n=8), including normal control group, model control group, sodium chloride group, bromocriptin group, rupi sanjie group, the original prescription group and optimizing prescription group. Rat model of mammary gland hyperplasia with hyperprolactinemia was replicated in 6 groups but not the normal control group. The successfully established experimental rats were given corresponding drugs by intragastric gavage. After 30 days, the levels of the estradiol, progesterone, and prolactin were detected, and the pathomrphology of glandular tissue was observed. Results Prolactin levels of model control group, the original prescription group and optimize prescription group were (69.47 ±6.08), (53.13 ±10.59), and (28.41 ±6.37) pg·mL-1, respectively . Compared with that in the model control group, the contents of prolactin in both the optimal prescription group and the original prescription group were reduced, but the optimal prescription group was better (P<0. 01). In the original prescription group, the lobules of mammary gland showed a few of hyperplasia, the individual alveoli and duct showed a slight hyperplasia, and a small amount of secretions was found in the duct. The degree of the hyperplasia was alleviated in the optimal prescription group similar to that observed in the normal control group, which showed that there was no hyperplasia in the lobules of mammary gland or no secretions in the duct. Conclusion The therapeutic effects of the optimal prescription are much better than the original prescription, which can effectively lower the level of prolactin, adjust the balance among the prolactin , estrogen and progesterone, and alleviate the pathological hyperplasia of mammary glands in the model rats.

Objective: To determine the impact and mechanism of HIV derived microRNA99 (miRNA99) on macrophages pyroptosis. Methods: THP-1 cells were stimulated by phorbol ester (PMA) and then were cultured and differentiated into sidewall attached macrophages; the morphology and phenotype of CD11b were measured by microscopy and flow cytometry. TLR8 RNAi plasmid was transfected to macrophages and were detected by confocal fluorescence microscopy. The levels of IL-18 and IL-1β released by macrophages were measured by ELISA. Western blot(WB) was employed to examine TLR8 and cleaved caspase-1 protein expression in macrophages. Results: THP-1 cells that were challenged with PMA (100 ng/ml) for 24 h became smooth and adherent. In addition, the expression of CD11b in macrophages was up to 99%. TLR8 protein expression in macrophages transfected with TLR8 plasmids was significantly lower than that in macrophages transfected with control plasmids. Levels of IL-18 and IL-1β secreted by macrophages were elevated in LPS+ ATP group, miRNA99 group and control plasmid group, but not in control group and TLR8 RNAi plasmid group. Cleaved caspase-1 protein from macrophages of miRNA99 experimental group/ LPS+ ATP group and control plasmid group was significantly higher than that of control group and TLR8 RNAi plasmid group. Conclusions The present study demonstrates that HIV-derived miRNA99 could induce pyroptosis of macrophages via TLR8-dependent pathway.

Objective To survey the prevalence of greenhouse farmer's lung and related risk factors in part of rural areas of Liaoning Province.Methods Using uniform scheme,procedures and questionnaire,a survey for 5420 farmers(2660 men and 2760 women)with complete data who work inside greenhouses was performed in Shenyang,Xinmin,Chaoyang,and Jinzhou between August 2006 and June 2009.Pulmonary function tests was performed for every active farmer.Results Greenhouse farmer's lung was diagnosed in 308 cases,205 men(66.55%,205/308)and 103 women(33.44%,103/308),a prevalence of 5.7%(308/5420).The prevalence rate of greenhouse farmer's lung in males was significantly higher than that in females(?2=39.93,P0.05).In the 308 cases,the number of patiernts presented with fever chill,cough/sputum,chest tightness/shortness of breath were 180(58.44%),192(62.34%),160(51.95%)respectively,and the number of crepitations,radiological changes,spirometry abnormalities and serum IgE antibodies(+)was 164(53.25%),153(49.68%),147(47.73%)and 136(44.16%)at the time of the study.62.34%(192/308)of patients with greenhouse farmer's lung were mild and 38.66%(116/308)were severe.Conclusion The total prevalence rate of greenhouse farmer's lung in part of rural areas of Liaoning Province was 5.7% and multiple risk factors were associated with the disease.

Standardized reporting is a crucial factor affecting the use of patient guidelines （PGs）， particularly in the reporting and presentation of recommendations. This paper introduced the current status of PG reporting， including the research on PG content and presentation formats， and provided comprehensive recommendations for PG reporting from aspects such as overall framework， recommendations， presentation format， and readability. First， the presentation of PG recommendations should include clearly defined clinical questions， recommendations and their rationale， and guidance on how patients should implement the interventions； for specific content in the PG， such as level of evidence， level of recommendation， it is recommended to explain in text the reasons for giving different levels of recommendation， i.e.， to present the logic behind giving the level of recommendation to the patient； additional information needed in the recommendation framework should be supplemented by tracing references or authoritative textbooks and literature that support the recommendations. Subsequently， the PG text should be written based on the Reporting Checklist for Public Versions of Guidelines （RIGHT-PVG） reporting framework. Finally， to enhance readability and comprehension， it is recommended to refer to the Patient Education Materials Assessment Tool （PEMAT） for translating PG content. To enhance the readability of PGs， it is suggested to present the PG content in a persona-lized and layered manner.

Since the concept of patient versions of guidelines （PVGs） was introduced into China， several PVGs have been published in China， but we found that there is a big difference between the concept of PVG at home and abroad， and the reason for this difference has not been reasonably explained， which has led to ambiguity and even misapplication of the PVG concept by guideline developers. By analyzing the background and purpose of PVGs， and the understanding of the PVG concept by domestic scholars， we proposed the term patient guidelines （PGs）. This refers to guidelines developed under the principles of evidence-based medicine， centered on health issues that concern patients， and based on the best available evidence， intended for patient use. Except for the general attribute of providing information or education， which is typical of common health education materials， PGs also provide recommendations and assist in decision-making， so PGs include both the patient versions of guidelines （PVG） as defined by the Guidelines International Network （GIN） and "patient-directed guidelines"， i.e. clinical practice guidelines resulting from the adaptation or reformulation of recommendations through clinical practice guidelines.

At present， the process and methodology of patient guidelines （PGs） development varies greatly and lacks systematic and standardised guidance. In addition to the interviews with PG developers， we have sorted out the relevant methodology for the adaptation and development of existing clinical practice guideline recommendations and facilitated expert deliberations to achieve a consensus， so as to finally put forward a proposal for guidance on the process and methodology for the development of PGs. The development of PGs can be divided into the preparation stage， the construction stage， and the completion stage in general， but the specific steps vary according to the different modes of development of PGs. The development process of Model 1 is basically the same as the patient version of the guideline development process provided by the International Guidelines Network， i.e.， team formation， screening of recommendations， guideline drafing， user testing and feedback， approval and dissemination. The developer should also first determine the need for and scope of translating the clinical practice guideline into a patient version during the preparation phase. Model 2 adds user experience and feedback to the conventional clinical practice guideline development process （forming a team， determining the scope of the PG， searching， evaluating and integrating evidence， forming recommendations， writing the guideline， and expert review）. Based on the different models， we sort out the process and methods of PG development and introduce the specific methods of PG development， including how to identify the clinical problem and how to form recommendations based on the existing clinical practice guidelines， with a view to providing reference for guideline developers and related researchers.