Objective To explore the clinical effect of carbon nanoparticle in the axillary sentinel lymph node tracer of breast cancer.Methods Fifty-seven patients with breast cancer underwent lymphatic tracing with carbon nanoparticle.The carbon nanoparticle suspension was subcutaneously injected around the areola (points at 4 o'clock) and tumor surface skin at 30 min before operation.The first lymph nodes blacked were named sentinel lymph node.Then performed modified radical mastectomy,observing the application value of carbon nanoparticle.Results The detection rate of sentinel lymph node was 98.2％ (56/57).The correct,sensitive and false negative rates were 98.2％(55/56),95.2％(20/21) and 4.8％(1/21),respectively.The false positive rate was 0.Conclusions The carbon nanoparticle suspension injection subcutaneously around areola in sentinel lymph node biopsy is helpful for accurately evaluating the axillary lymph node condition.Being simple to operate,accurate positioning,dyeing time and is worth popularizing.

Objective To investigate the clinical significance of the antenatal detection of four indices of coagulation(PT,APTT, TT,FIB),D-dimer(DD)and platelet(PLT)in the judgment of parturient coagulation function and bleeding risk.Methods 795 pregnant women and childbearing age non-pregnant women with physical examination in this hospital from June 2012 to September 2013 were collected and divided into the normal pregnancy group(early pregnancy,middle pregnancy,late pregnancy,parturient pe-riod),obstetric accident group,pregnancy complicating other disease group and healthy control group.At the same time,PT, APTT,TT,FIB,DD and PLT were detected and the related statistical analysis was conducted.Results DD and FIB in the normal pregnancy group were significantly higher than those in the healthy control group(P<0.05),PT and APTT were significantly low-er than those in the healthy control group(P <0.05),TT had no statistically significant difference between these two groups(P >0.05 );DD and FIB in the obstetric accident group and the pregnancy complicating other disease group were significantly higher than those in the normal pregnancy group(P <0.05),while PT was significantly lower than that in the normal pregnancy group(P <0.05).PLT in the obstetric accident group and the pregnancy complicating other disease group was significantly lower than that in the normal pregnancy group(P <0.05).The sensitivity and specificity of the combined detection of 3 indices in diagnosing the ob-stetrical accidents were greatly superior to those of the single index detection or the combined detection of two indices.Conclusion The prenatal combination detection of four coagulation indices,DD and PLT can preliminarily judge the coagulation status of preg-nancy period in pregnant women,help to treat abnormal bleeding of pregnant women an possess the important guidance significance in formulating the labor scheme and preventing the occurrence of obstetric accidents.

Through the introduction of the gerontological nursing practice standards, the development course of practice, the scope of practice and gerontological nursing certification examination outline of American Nurses Credentialing Center in the US, the opinion about the development of gerontological nursing practice in our country is proposed. It is necessary to accelerate the cultivation of geriatric specialist nursing talent, and establishment of the scope and standards of gerontological nursing practice and geriatric specialized nurse certification system to cope with the development of aging society and improve gerontological nursing professional level in our country.

Objective To understand the research status and influence factors of endocrine nurses′oral health KAP in elderly diabetes patients in tertiary general hospital of Zhejiang province. Methods Using convenience sampling method, a total of 231 endocrine nurses of 18 tertiary general hospital were investigated by Oral health KAP questionnaire in elderly diabetes designed by ourselves.Results Standard scores of endocrine nurses′oral health knowledge, attitude and practice in elderly diabetes patients were (47.54±14.91), (75.78± 14.56) and (39.17±10.47). A number of 48 nurses(20.78% )had a standard scores no less than 60 points in knowledge;213( 92. 21%) had a standard scores no less than 60 points in attitude and 6 ( 2. 60%) had a standard scores no less than 60 points in practice. Work experience, age, hospital grade and technical post were the related factors. Conclusions Endocrine nurses′ attitude for oral heath in elderly diabetes patients was positive, while knowledge and practice were poor which should be improved by training of oral health knowledge and skills, thus to elevate the quality of oral health knowledge and behavior.

Objective: To evaluate the role of extracellular signal-regulated kinase (ERK) signaling pathway in intrathecal dexmedetomidine-induced reduction of spinal cord ischemia-reperfusion (I/R) injury in rats. Methods: Eighty clean-grade male Sprague-Dawley rats, aged 9-10 weeks, weighing 300-350 g, were divided into 4 groups (n=20 each) using a random number table method: sham operation group (group S), spinal cord I/R group (group I/R), dexmedetomidine group (group D), and dexmedetomidine plus ERK signaling pathway blocker PD98059 group (group P). Spinal cord ischemia was produced by cross-clamping of the abdominal aorta distal to the left renal artery for 25 min followed by reperfusion to establish the model of spinal cord I/R injury.Dexmedetomidine 1 μg/kg was intrathecally injected at 20 min before establishing the model in D and P groups, PD98059 2 mg/kg was given via the tail vein at the same time in group P, and the equal volume of normal saline was given instead in S and I/R groups.Five rats were selected at 6, 8, 10 and 12 h of reperfusion, and the modified Basso, Beattie, Bresnahan (BBB) scale was used to assess the hindlimb locomotor function.Five rats were sacrificed after assessing the locomotor function at 6 h of reperfusion, and the L_3-5 segments of the spinal cord were taken for determination of cell apoptosis (by TUNEL) and expression of phosphorylated ERK (p-ERK) (by Western blot). The apoptosis index was calculated. Results: Compared with group S, the BBB scores were significantly decreased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was up-regulated in the other three groups (P<0.05). Compared with I/R group, the BBB scores were significantly increased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was up-regulated in group D, and no significant change was found in the apoptosis index or p-ERK expression in group P (P>0.05). Compared with group D, the BBB scores were significantly decreased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was down-regulated in group P (P<0.05). Conclusion The mechanism by which intrathecal dexmedetomidine reduces spinal cord I/R injury is related to activating ERK signaling pathway in rats.

Objective To explore the effect of standing-sitting Baduanjin exercise in postoperative rehabilitation of breast cancer patients. Methods Totally 70 cases of patients with breast cancer postoperation were randomly assigned to the control group and the experimental group. Patients in the control group received routine postoperative nursing, while patients in the experimental group adopted standing-sitting Baduanjin exercise. Fatigue condition and functional recovery of ill limb were compared through evaluation by BFI and functional assessment of ill limb.Results The total BFI score of fatigue in the experimental group was (3.29± 0.42) points 1 month after operation, and was (3.28±0.45) points 3 months after operation. They were all superior than the score of control group (t=-4.007,-3.996;P<0.01). Limb function of 96.8% patients were completely recovered in the experimental group 1 month after operation, while just 75.8% patients in the control group. 3 months after operation, 100% patients were completely recovered in the experimental group, and in the control group, it was 81.8% (χ2=4.233,4.264;P<0.05).Conclusions Suitability standing-sitting Baduanjin exercise can relieve the fatigue symptom of patients with breast cancer postoperation, and delay the aggravation of symptoms during chemotherapy.

Returning to work is an important evaluation index for the recovery of physical function in patients with myocardial infarction. With the incidence of myocardial infarction in younger population and the prolongation of working age, young and middle-aged patients with myocardial infarction may become a population that needs to be paid attention to returning to work. This article reviews the status quo, influencing factors, evaluation tools and related intervention studies of young and middle-aged patients with myocardial infarction returning to work at home and abroad, aiming to provide a reference for the follow-up research of young and middle-aged patients with myocardial infarction returning to work.

Objective To evaluate the effect of hydrogen on blood brain barrier of mice with sepsisassociated encephalopathy (SAE).Methods A total of 100 adult male ICR mice,aged 6-8 weeks,weighing 20-25 g,were divided into 4 groups (n =25 each) using a random number table method:sham operation group (group Sham),sham operation plus hydrogen group (group Sham+H),group SAE and SAE plus hydrogen group (group SAE+ H).Sepsis was induced by cecal ligation and puncture (CLP).Sham+H and SAE+H groups inhaled 2％ hydrogen for 1 h starting from 1 and 6 h after CLP,respectively.At 24 h after CLP,Evans blue (EB) was injected via the caudal vein,and then the mice were sacrificed and brain tissues were removed for measuring the EB and water contents,for examining the pathological changes of hippocampi (with a light microscope) and for detecting the expression of occludin and VE-cadherin (by Western blot).Morris water maze test was performed at days 10-16 after CLP.Results Compared with group Sham,the contents of EB and water in brain tissues were significantly increased,the expression of occludin and VE-cadherin was down-regulated,the escape latency was prolonged,and the number of crossing the original platform was reduced in SAE and SAE+H groups (P＜0.05).Compared with group SAE,the contents of EB and water in brain tissues were significantly decreased,the expression of occludin and VE-cadherin was up-regulated,the escape latency was shortened,the number of crossing the original platform was increased (P＜0.05),and the pathological changes of hippocampi were significantly attenuated in group SAE+H.Conclusion The mechanism by which hydrogen mitigates SAE may be related to reducing the damage to blood brain barrier of mice.

Objective To evaluate the effect of dexmedetomidine on expression of hypoxia-inducible factor-1α (HIF-1α) during endotoxin-caused apoptosis in macrophages of mice.Methods Mouse macrophage cell line RAW264.7 cultured in vitro were seeded in 6-well or 96-well plates and divided into 4 groups (n=16 each) when cell confluence reached 60％-70％ using a random number table method:control group (group Con),dexmedetomidine group (group Dex),lipopolysaccharide (LPS) group,and LPS plus dexmedetomidine group (group LPS+Dex).Phosphate buffer solution was added in group Con.Dexmedetomidine 1 μmol/L was added in group Dex.LPS 1 μg/ml was added in LPS and LPS+Dex groups.Dexmedetomidine 1 μmol/L was added immediately after adding LPS in group LPS+Dex.Cells were then cultured for 24 h in each group.Cell apoptosis was measured using TUNEL,mitochondrial membrane potential using JC-1,reactive oxygen species (ROS) content by ROS kit,and ATP content by ATP kit.The apoptosis rate was calculated.The expression of HIF-1α,cytochrome C (Cyt-c),caspase-9 and cleaved caspase-3 was detected by Western blot.Results Compared with group Con,the apoptosis rate and ROS content were significantly increased,ATP content and mitochondrial membrane potential were decreased,the expression of HIF-1α,Cyt-c,caspase-9 and cleaved caspase-3 was up-regulated in group LPS (P＜ 0.05),and no significant change was found in the parameters mentioned above in group Dex (P＞0.05).Compared with group LPS,the apoptosis rate and ROS content were significantly decreased,ATP content and mitochondrial membrane potential were increased,the expression of HIF-1α was up-regulated,and the expression of Cyt-c,caspase-9 and cleaved caspase-3 was down-regulated in group LPS + Dex (P＜0.05).Conclusion Dexmedetomidine can reduce endotoxin-caused oxidative stress injury to macrophages,improve mitochondrial function and inhibit mitochondrial apoptosis,and the mechanism may be related to upregulating the expression of HIF-1α in mice.

Objective To investigate the changes in FUNDC1/microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ) signaling pathway during sepsis-induced liver injury in mice.Methods Tbirtytwo clean-grade healthy male C57BL/6 mice,aged 6 weeks,weighing 20-25 g,were divided into sham operation group (n =8) and sepsis group (n =24) using a random number table method.Sepsis was induced by cecal ligation and puncture.Blood samples were obtained at 24 h after operation in sham operation group and at 6,12 and 24 h after establishing the model in sepsis group for determination of concentrations of alanine aminotransferase and aspartate aminotransferase in serum.Mice were then sacrificed,and the right lobe of livers was removed for examination of the pathological changes and for determination of the expression of FUNDC1 and LC3 Ⅱ by Western blot.The mitochondria in the right lobe of livers were isolated to measure the respiratory function,and respiratory control rate was calculated.Results Compared with sham operation group,the concentrations of alanine aminotransferase and aspartate aminotransferase in serum and pathological scores were significantly increased,the respiratory control rate of mitochondria was decreased,the expression of FUNDC1 was down-regulated,and the expression of LC3 Ⅱ was up-regulated at each time point after establishing the model in sepsis group (P＜0.05).Conclusion The mechanism by which sepsis induces liver injury may be related to inhibiting activation of FUNDC1/LC3 Ⅱ signaling pathway in mice.