Objective To investigate the subthreshold depression for long-term survivors after breast cancer surgery and its effect on their quality of life (QOL). Methods The self-made general questionnaire, Centre for Epidemiological Studies Depression Scale (CES- D), Hamihon Rating Scale for Depression and Functional Assessment of Cancer Therapy- Breast were used to investigate the subthreshold depression and its effect on their QOL for 210 long-term survivors after breast cancer surgery. The difference in general conditions and score of QOL between the subthreshold depression and non-subthreshold depression groups was also compared. Results The subthreshold depression with incidence rate of 46.67%(98/210) was observed for the log-term survivors after breast cancer surgery in this study. The results indicated that the age (≤50) (OR=5.627, 2.662,P<0.01), marriage (unmarried, divorced or widowed) (OR=5.087, P<0.01), employment (unemployed, sick leave or retired) (OR=2.077,P<0.05) and low income (<3000 RMB/month) (OR=3.375,P<0.01) were the key factors that led to the occurrence of subthreshold depression. The score of QOL for the subthreshold depression group were lower than those of the non-subthreshold depression group (t=-6.653--2.926,P<0.01), and had a significantly negative correlation with score of depression and QOL (β=-0.362--0.132). Conclusions A high incidence rate of subthreshold depression for long-term survivors after breast cancer surgery was observed. The incidence rate of subthreshold depression increased for the patients with younger age, low income,unmarried or unemployment. Due to their low QOL, attentions should be paid to the early detection and early prevention for the long-term survivors with subthreshold depression after breast cancer surgery.

Objective To study the clinical efficacy of platelet-rich plasma (PRP) in the treatment of knee osteoarthritis (KOA) and evaluate whether the age,body mass index and grade of KOA are associated with the treatment outcomes.Methods Using the prospective,randomized,controlled study,100 KOA patients hospitalized between December 2013 and November 2014 were enrolled.Twentyeight patients were men and 72 were women.Mean age was 58 years (range,35-85 years).Degenerative arthritis occurred in 68 patients and traumatic arthritis in 32 patients.Kellgren-Lawrence (K-L) score was grade Ⅱ in 35 patients,grade Ⅱ in 46 and grade Ⅲ in 19.The patients were assigned to receive hyaluronic acid (HA) (HA group,n =50) and PRP (PRP group,n =50) by an intraarticular route once weekly for 3 weeks,according to the random number table.Between-group differences were insignificant in age,gender,body mass index (BMI) and K-L grade.Western Ontario and McMaster Universities Arthritis Index (WOMAC),visual analog scale (VAS) and cartilage lesions score (CaLs) were used for clinical and MRI evaluations.At follow-up evaluation,the effective rate was defined at least 36％ improvement from the baseline WOMAC score.Results All patients were followed up for 6 months.The effective rate in PRP group was 84％ versus 68％ in HA group after the last treatment (P ＞0.05),and was 60％ versus 36％ in HA group at the final follow-up (P ＜ 0.05).WOMAC score in both groups had significant improvement after operation,while VAS improved only in PRP group (P ＜ 0.01).In PRP group patients with K-L grade I had better VAS and WOMAC scores than those with grade Ⅱ (P ＜0.05),and patients with grade Ⅱ had better WOAMC score than those with grade Ⅲ (P ＜ 0.05).MRI findings showed seven patients in PRP group had similar CaLs before and after operation (P ＞ 0.05),and the area of abnormal signal in subchondral bone and the depth of cartilage lesion gradually decreased in one of them.Follow-up study showed the outcomes had negative correlation with age and K-L grade (P ＜0.05),but no certain correlation with BMI in PRP group (P ＞ 0.05).Clinical effects in both groups were decreased over time.Conclusions Intraarticular injection of PRP benefits to pain relief,decreased inflammation and tissue repair,and has much better outcome in patients with younger age and lower K-L grade.However,BMI is not associated with the outcome.

Objective To investigate the expression and role of β-catenin in small-for-size liver grafts during early stage of liver regeneration after liver transplantation in rats.Method The livers of male Sprague-Dawley rats were reduced to 30％ or 50％ of their original sizes and transplanted.The experiment was divided into 3 groups:small-for-size graft group (SSG),half-size graft group (HSG) and sham-operated group.Liver samples were harvested at various time points after transplantation (n =6 per time point) for Western blotting and immunohistochemistry.Six rats in each group were sacrificed at 3rd day after liver transplantation for estimating liver regeneration rate.Result Liver regeneration rate in SSG group was lower than that in HSG group.The expression of β-catenin was down-regulated in liver graft of both groups after being stored in cold Ringer solution for 2 h.The expression of β-catenin was significant up-regulated in HSG group from 5 min to 12 h after operation,while the down-regulated expression of β-catenin was persisted in SSG group at 5 min after operation,and mildly increased expression of β-catenin occurred at 2 h and 6 h,which was significantly lower than that in HSG group at the corresponding time points.The expression of active-β-catenin was low in each group before transplantation.Significant expression of active-β-catenin was found at 5 min in HSG group and persisted until 12 h after operation,mildly increased expression of active-β-catenin in SSG group was only found at 2 h,which was lower than that in HSG group at the same time points.Immunohistochemical staining revealed that β-catenin was mainly expressed on the hepatocyte membrane and in cytoplasm in the sham-operative group,many hepatocytes exhibited nuclear localization of β-catenin in HSG group from 5 min to 24 h,while only some hepatocytes exhibited nuclear localization of β-catenin in SSG group.The expression of Cyclin D1 in SSG group was significantly lower than that in HSG group,which was similar to the expression of C-Myc.Conclusion Attenuated activation of Wnt/β-catenin signaling and down-regulated expression of target genes during early regeneration of small-for-size liver grafts may be involved in the inhibition of liver regeneration of small for size liver grafts.

Sexual health is an important part of the overall health of patients.The ability of nurses to carry out sexual health care directly affects the overall level of medical care. This article reviews the concepts of sexual health and sexual health care, the evaluation tools of sexual health care, the practical models and influencing factors of nurses' sexual health care, with a view to providing a reference for improving the practice level of nurses carrying out sexual health care.

In line with the worldwide trend in population aging, China has stepped into an aging society since 2000. The outstanding features of aging, including a large proportion of the older population, rapid growth, dramatic expansion of the oldest-old, and uneven aging distribution, have put China in a unique position. Besides, older population is expanding in parallel with the escalating burden of disease, high prevalence of disability, and low social involvement. However, China is not prepared to solve these problems in terms of the economy, awareness, geriatric care system, geriatric team, social security, or age-friendly environment. From the perspective of public health, we summarized the major challenges and proposed the following policy recommendations: (1) strengthening the top-level design and building a "government-leading, multi-sectoral-cooperating, and society-participating" pattern; (2) enhancing health services by implementing the "comprehensive health" strategy; (3) developing home and community care, coordinately enhance institutional care, promote integration of medical and care systems, and establish a multidimensional tailored care system; (4) optimizing geriatric the supporting system, included the construction of geriatric team and the long-term care insurance system; and (5) establishing a physical and socially age-friendly environment.

Objective To investigate the varying variances of the genetic components in birth cohorts.Methods Twin samples used in the current study were collected from the Chinese National Twin Registry and a two-wave study was conducted,in Qingdao and Lishui regions.Samples were broken down by birth cohort to create four subgroups:-1958,1959-1961,1962-1970 and 1970-.Structural equation models were fitted in each subgroup to estimate the genetic and environmental variances.Results From each birth cohort,weight and body mass index in 2012 appeared higher than those in 2001.Twins of 1971-cohort subgroup showed lower weight than in the other cohort subgroups.Except for the 1959-1961 cohort subgroup,the later birth cohorts were inversely related to the body mass indexes.Genetic factors might explain 54％-76％ of the total variations on the body mass index.Heritability of body mass index of twins born during 1959-1961 was increasing along with age.Conclusion Genetic factors might explain the main portion which related to the phenotypic variance of body mass index.Effects of genetic factors on body mass index of twins born during 1959-1961 might have increased along with age.

Objective: To explore the association between DNA methylation and body mass index (BMI) using Mendelian randomization analysis. Methods: A total of 469 participants were selected from the Chinese National Twin Registry in 2013, who were living in Shandong, Jiangsu, Zhejiang, and Sichuan provinces, and at least 18 years of age. A questionnaire survey and physical examination were conducted to collect demographic, clinical, and behavioral information. Peripheral blood cells were collected to detect genotype and methylation status. Association analyses between DNA methylation and BMI and between CpGs and cis-SNP were conducted. With rs748212 as the instrumental variable, the association between cg15053022 and BMI was explored using the Mendelian randomization method. Results: A total of 469 participants were selected. The mean age of participants was (44.8±13.2) years and the BMI was (25.0±3.8) kg/m². Nine BMI-related DNA methylation sites were found and DNA methylation site cg15053022 in the ATP4A gene was negatively associated with cis-SNP rs748212 (β=-0.020); the mean methylation level of AA, AC, and CC were 0.212±0.025, 0.242±0.024, and 0.264±0.028, respectively. rs748212 was associated with BMI (β=0.04, P=0.007) and closely related to cg15053022 (F=237.66, P=0.143). Mendelian randomization analysis showed lower methylation levels at cg15053022 were associated with higher BMI (β=-1.97, P<0.001). Conclusion This study supported the impact of cg15053022 methylation in the ATP4A gene on BMI using Mendelian randomization analysis and provided the basis for using Mendelian randomization analysis in methylation studies.

Transitional care refers to carrying out related health care services to make discharged patients′nursing activities orderly, coordinated and continuous, so as to meet their various rehabilitation needs. In recent years, it has become a research focus of breast cancer discharged patients. This article reviews the concept of continuous care and its practice and effect in discharged patients with breast cancer, and provides evidence for further improvement of breast cancer patients′continuity of care in China.

Objective: To investigate the posttraumatic growth and emotional regulation strategies of patients with moderate and severe burns at different time points in the rehabilitation period, and to explore the correlation between posttraumatic growth and emotional regulation strategies, so as to provide a basis for targeted nursing intervention. Methods: By convenience sampling method, 115 convalescent patients with moderate and severe burns in Linyi People′s Hospital burn plastic surgery center were investigated by General Information Questionnaire, Chinese Posttraumatic Growth Inventory (C-PTGI), Emotion Regulation Scale (ERQ) respectively on the day of discharge (T1), 3 months and 6 months after hospital discharge (T2, T3) from December 2017 to January 2019. Results: The post-traumatic growth scores of patients T1, T2 and T3 were 58.18±9.51, 48.65±9.31 and 47.43±8.76, respectively. The post-traumatic growth scores showed a downward trend at three time points, and the difference was statistically significant (F=339.732,P<0.01). The scores of T1, T2 and T3 in the cognitive reassessment dimensions of patients′emotion regulation strategies were respectively 27.10±4.13, 26.95±3.76, 26.11±3.60. The scores are going down and the differences were statistically significant (F=27.798, P<0.01). The expression inhibition scores were 14.42±4.39, 15.20±3.30, 15.21±3.56 respectively. The scores are the rise and the differences were statistically significant (F=13.675, P < 0.01). There were positive correlations between cognitive reassessment scores and posttraumatic growth scores、scores of all dimensions (r=0.230-0.555, P<0.05). The expression inhibition scores were negatively correlated with the total post-traumatic growth scores, personal strength, and scores of new possibility dimensions (r=-0.230--0.420, P<0.05). Conclusion Posttraumatic growth of patients with moderate to severe burns is not optimistic in the rehabilitation period. Therefore, it is necessary to pay attention to the guidance of emotional regulation strategies for patients with moderate to severe burns in the rehabilitation period, and carry out targeted interventions to promote the posttraumatic growth of patients.

With the accelerated urbanization process, there are growing interests in the potential impact of neighborhood built-environment on residents’ physical activity and dietary habits. In this paper, we introduced the concept of the built environment and the ways to assess the built-environment related to physical activity and dietary habits. We reviewed papers on the association of the built-environment with physical activity and dietary habits. Improvement of the built-environment is expected to reduce the health burden caused by insufficient physical activity and unhealthy dietary habits. As this field is still at its initial stage, there are many questions to be explored. We then discussed the challenges for this field and made some suggestions for future study.