Objective To explore the application of clinical pathway in the management of single disease cost. Methods Inpatients with breast cancer from June 2006 to June 2007 were divided into the test group and the control group according to different payment models.Patients in the test group had medical insurance while patients in the control group did not.The general data in the two groups had no statistical difference.The test group were given nursing intervention by clinical pathway while the control group received routine nursing measures. Results The mean inhospital days,mean days waiting for operations and mean inhospital expenses in the test group were shorter or lower than those in the control group (P ＜ 0.05).The mastering degree of health knowledge and the satisfaction degree of patients in the test group were higher than those in the control group (P ＜ 0.05). Conclusions The application of chnical pathway in the single disease cost patients with medical insurance could effectively control the medical expenses and guarantee the quality.So we consider that the application of clinical pathway in single disease cost is applicable.

Objective:To establish a method for the determination of asperosaponinⅥin Dieda Cuyu tablets by HPLC. Methods:A Hypersil C18(250 mm ×4.6 mm,5 μm)column was used. The mobile phase was acetonitrile-water(30∶70) with a flow rate of 1.0 ml·min-1 . The detection wavelength was 212 nm, the column temperature was room temperature,and the injection volume was 10μl. Results:AsperosaponinⅥ showed a good linear relationship within the range of 0. 04-0. 32 μg(r=0. 999 6). The average recovery was 97. 84%(RSD=1. 70%, n=6). Conclusion:The method is simple,accurate and reproducible, which can be used in the deter-mination of asperosaponinⅥ in Dieda Cuyu tablets.

OBJECTIVE: To explore the association between the cancer related fatigue and social support in breast cancer patients after chemotherapy. METHODS: According to the uniform inclusive and exclusive criteria, 396 breast cancer patients after chemotherapy were sampled randomly from 4 hospitals in Changsha and investigated on the spot by cancer fatigue scale and social support scale. RESULTS: The levels of social support, subjective support, Objective support, and utilization of support of the breast cancer patients after chemotherapy were 36.63±7.80, 21.05±4.67, 8.45±3.06, and 7.13±2.10, respectively, which were lower than the normal level, with significant difference(P<0.001). There was a negative correlation between each fatigue dimension and social support, subjective support, Objective support, and utilization of support (P<0.05 or P<0.001). CONCLUSION The social support system in patients with breast cancer after chemotherapy is poor. There is a negative correlation between the social support system and cancer related fatigue.
Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Breast Neoplasms ; complications ; drug therapy ; Carcinoma, Ductal, Breast ; drug therapy ; psychology ; China ; Fatigue ; etiology ; psychology ; Female ; Humans ; Middle Aged ; Social Support

OBJECTIVE: To study the relevance between cancer related fatigue and coping styles in breast cancer patients after chemotherapy. METHODS: A survey was conducted in 396 patients with breast cancer after chemotherapy on cancer related fatigue scale and Jalowiec coping scale, and the relation was analyzed. RESULTS: The rate of overall fatigue in breast cancer patients was 96.97%, mostly moderate fatigue. The rate of fatigue dimensions from high to low was physical fatigue, feeling fatigue and cognitive fatigue, respectively. The score of coping styles in patients with breast cancer after chemotherapy from high to low was optimistic coping, facing bravely, support seeking, self-reliance, emotional catharsis, avoidance, fatalism, and conservation. The most widely used coping style was optimistic coping style, and the least was emotional catharisis. There was a positive correlation between coping style of emotional catharsis and cancer related fatigue of all dimensions (P<0.01). There was a negative correlation between emotional fatigue and optimistic,facing bravely, support seeking, self-reliance, or conservation (P<0.05). There was also a negative correlation between physical fatigue and optimistic or support seeking (P<0.05), but there was a positive correlation between avoidance or fatalism and the dimensions of general fatigue, physical fatigue, and cognitive fatigue (P<0.05). CONCLUSION There is prevalent cancer related fatigue in patients with breast cancer after chemotherapy. We should guide the patients to more active coping styles, to enhance the ability of psychological adaption in patients, reduce cancer related fatigue, and improve the quality of life.
Adaptation, Psychological ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Breast Neoplasms ; complications ; drug therapy ; Chemotherapy, Adjuvant ; Fatigue ; chemically induced ; Female ; Humans ; Middle Aged ; Quality of Life ; psychology ; Sampling Studies ; Surveys and Questionnaires

OBJECTIVE: To evaluate the condition of cancer-related fatigue (CRF) in breast cancer patients with chemotherapy and to explore the effect of Yoga on it. METHODS: After the completion of Yoga, 100 breast cancer patients with CRF (CFS>0) were selected and were randomly divided into the Yoga group and the control group (n=50). Patients in the control group only received routine cure and care while patients in the Yoga group received extra Yoga exercise, lasting for 4 months. Cancer fatigue scale (CFS) was evaluated in the 2nd, 4th and 6th round of chemotherapy. RESULTS: At the end, 82 cases qualified for the study, 42 cases for the control group and 40 for the Yoga group. The mean score of body fatigue was 12.67±3.46. There was no significant difference in CRF between the Yago group and the control group before the Yoga intervention (P>0.05). After the 4th round of chemotherapy, the mean scores of CFS and body fatigue in the Yoga group were significantly lower than that in the control group (P<0.05). After the 6th round of chemotherapy, the mean scores of CFS, body fatigue and cognitive fatigue in the Yoga group were lower than that in the control group (P<0.05). Repeated analysis of variance showed that the difference in the overall fatigue, body fatigue and cognitive fatigue between the Yoga group and the control group was significant (P<0.05); the time influence on the overall fatigue, body fatigue and emotional fatigue was significant difference between the 2 groups (P<0.05); there were interactions between the effect of Yago and time on the overall fatigue, body fatigue and cognitive fatigue (P<0.05). CONCLUSION The body fatigue was more serious in breast cancer patients with chemotherapy. Yoga intervention could significantly reduce body fatigue, cognitive fatigue, thus reduce the overall fatigue in breast cancer patients with chemotherapy.
Breast Neoplasms ; rehabilitation ; Emotions ; Fatigue ; prevention & control ; Female ; Humans ; Yoga

OBJECTIVE: To determine the clinical effect of standardized training and management of peripherally inserted central catheter (PICC) and catheter-related complications. METHODS: A total of 610 patients were divided into a control group and an observation group, the control group (n=300) were catheterized by trainees who received "short-term intensive training", the observation group (n=310) by "system standardized training and management". The clinical efficacy of catheterization and the rate of catheter-related complications were compared. RESULTS: There was significant difference in the one-time puncture success rate, one-time cannulation success rate, the time for operation and the pain score between the 2 groups (all P<0.01), and there was also significant difference in the occurrence of catheter extrusion, plug, arrhythmia, catheter-related thrombosis, phlebitis, puncture point effusion and catheter-related infection between the 2 groups (all P<0.05). CONCLUSION Standardized PICC training and management can improve the effect of catheterization and reduce the incidence of PICC-related complication.
Catheter-Related Infections ; prevention & control ; Catheterization, Peripheral ; methods ; Humans ; Incidence ; Inservice Training ; Thrombosis

OBJECTIVE: To investigate the profile and potential significance of PTEN and NBS1 mutations among patients with familial or at early onset breast cancer in Hunan province.
 METHODS: A total of 131 breast cancer patients with familial history or suffered from breast cancer at the age of less than 35 years old were included in this study. A comprehensive phosphatase and tensin homolog (PTEN) and nibrin (NBS1) mutation analysis was performed through denaturing high performance liquid chromatography (DHPLC) and subsequent DNA direct sequencing.
 RESULTS: Among 131 patients, a reported mutation IVS4+109insTCTTA in PTEN gene were identified in two patients. The mutation frequency of IVS4+109insTCTTA was 1.15%. Two mutations in PTEN gene, 225 A>C (Thr 160 Pro) and IVS5+13T>C, was firstly discovered. Another reported missense mutation was rs121909229 G>A (Arg 130 Gln). Three mutations were detected in NBS1 gene, of which IVS6+43A>G and IVS6+127A>G were firstly discovered and another reported synonymous mutations was rs1805794 G>C (Glu 185 Gln).
 CONCLUSION The novel mutations in PTEN and NBS1 might be specific to the familial and early-onset breast cancer of Chinese Hunan population.
Adult ; Asian Continental Ancestry Group ; Breast Neoplasms ; genetics ; Cell Cycle Proteins ; genetics ; China ; DNA Mutational Analysis ; Female ; Humans ; Mutation ; Nuclear Proteins ; genetics ; PTEN Phosphohydrolase ; genetics