Objective To explore the application of transitional care based on the Omaha system in postoperative rehabilitation of patients with breast cancer.Methods Seventy-two patients after radical mastectomy were assigned into two groups according to admission time,patients from June to December 2011 were set as the control group,patients from February to December 2012 were assigned to the intervention group,each group contained 36 patients.The patients in the control group received routine nursing,while patients in the intervention group were implemented transitional care program with Omaha system as framework from before discharge to 6-week follow-up after discharge from hospital.Nursing effect was compared between two groups from three aspects such as cognition,behavior and status.Results Twenty-three problems were found in the 6-week follow-up for the intervention group,including environmental domain,psychosocial domain,physiological domain and health-related behavior domain.Knowledge,behavior and status scores of the intervention group 6 weeks after discharge were significantly higher than those of the control group [(3.92 ± 0.48) scores vs.(2.41 ± 0.17) scores,(4.11 ± 0.49) scores vs.(2.83 ± 0.25) scores,(3.09 ±0.52) scores vs.(2.32 ±0.39) scores,t=14.81,15.36,9.42,P＜0.01 or 0.05].Conclusions Transitional care based on the Omaha system shows common problems in rehabilitation of patients with breast cancer after operation,and provides standardized program for rehabilitation nursing.It can achieve better nursing effect.

OBJECTIVE To investigate the distribution of clinical commonly encountered pathogens and their drug resistance in our hospital,and provide reference for reasonable choices of the clinical antibiotics.METHODS The K-B method was used to test the sensitivity to antibiotics of 859 strains pathogens isolated from all kinds of infected samples during from Jan to Dec 2006 in our hospital,at the same time the ESBLs of Escherichia coli and Klebsiella and the MRS were detected.RESULTS The more pathogens isolated from our hospital were E.coli,Staphylococcus,Pseudomonas aeruginosa,Klebsiella,Acinetobacter and Enterococcus.The ESBLs isolating rate was 32.8% in E.coli and 29.4% in Klebsiella,and the sensitivity to antibiotics was degraded obviously in those ESBLs producing strains.Imipenem was the most effective antibiotic to Gram-negative bacilli,cefoperazone/sulbactam and piperacillin/tazobactam also had better antibacterial activity.The isolating rate of MRSA and MRCNS was 32.6% and 40.7% in S.aureus and MRCNS.Gram-positive cocci had the best sensitivity to vancomycin.There was no drug-resistant Enterococcus strain to vancomycin being found.CONCLUSIONS We should think highly of the bacterial drug resistance and use antibiotics reasonably.

A novel method for quantification of astragaloside IV in Radix Astragli was developed by using online SPE liquid chromatography coupled with corona charged aerosol detection( CAD) . The sample solution
was loaded into Acclaim Polar AdvantageⅡC18(50 mm×4. 6 mm, 3 μm) which was selected as online SPE column. Then the cleaning process was done by using the Right one of dual gradient pumps with Methanol-water as mobile phase. Acclaim C18(150 mm×4. 6 mm, 5 μm) was selected as analytical column with acetonitrile-water as mobile phase at a flow rate of 1. 0 mL/min. The eluate containing the target from SPE column was transferred into the analytical column by heart-cutting mode. The temperature of nebulizer of corona CAD was set at 30 ℃ and the nitrogen pressure was 241. 3 kPa. The baseline separation of astragaloside IV from matrix components has been achieved. There was a good linear correlation in the range of 4 . 0-80 mg/L for astragaloside IV and the correlation coefficient was 0 . 9998 . The standard addition average recovery of astragaloside IV in Radix Astragli was 97 . 6%. It has been validated that astragaloside IV in Radix Astragli and its preparations can be quantified rapidly and accurately with this method.

The ubiquitin-proteasome system is composed by multiple enzymes which are ubiquitously expressed in mammalian cells and plays an essential role in a variety of biological processes. As key members of the protein degradation enzymatic system, the function of E3 ubiquitin ligases has been extensively investigated. BMP and TGF-? are critical molecules that regulate proliferation, differentiation and apoptosis of osteoblasts and chondrocytes through different signaling pathways. Resent findings indicate that the ubiquitin-proteasome system functions as a key regulator in bone cells and the E3 ligase mediates the proteolytic degradation of critical molecules in BMP and TGF-? signaling pathways. Recent progress on studies of HECT domain E3 ligase, Smurf, in osteoblasts and chondrocytes were summarized. The regulatory role of Smurf1 and Smurf2 in BMP and TGF-? signaling and osteoblast and chondrocyte function has been reviewed.

OBJECTIVE To explore the protective effect of polysaccharides from Salvia Chinensis Benth. (PSSC) on lipopolysaccharide (LPS) and D- galactosamine (GalN)- provoked mouse acute liver failure (ALF) and the possible molecular mechanism. METHODS Kunming mice were randomly divided into four groups: normal control, model, model+PSSC 30 and 100 mg·kg- 1 groups. PSCC was given once a day and for a week. To establish an ALF model, mice of model and PSSC groups were ip injected with LPS 10 μg·kg-1 and GalN 700 mg·kg-1 at the end of PSSC treatment. The microscopic structure of the liver was detected by HE staining. Serum and hepatic biochemical parameters of glutamic-oxalacetic transaminase (GOT), glutamic- pyruvic transaminase (GPT), catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), malondialdehyde (MDA), and glutathione (GSH) were detected by colorimetric methods. The relative content of hepatic reactive oxygen species (ROS) was measured by DCFH-DA fluorescent probes. Levels of cytokines tumor necrosis factor-α (TNF-α), interleukin 1β(IL-1β) and IL- 6 in the serum and liver were detected by ELISA. Activity of caspase 3 in liver homogenates was detected by aspase 3 activity assay kit. RESULTS Compared with normal control group, in the liver of model group, hepatocytes were arrayed in disorder, cytoplasm of hepatocytes shrank, and boundaries between cells were fuzzy, the infiltration of a large number of inflammatory cells and tissue hemorrhage could be detected, pathological scores were elevated significantly (P<0.01), levels of MDA and ROS in the liver of ALF model mice were elevated to 2.2 and 4.3 times that of the normal control, respectively (P<0.01), the level of GSH decreased to 51% (P<0.01), and the activities of SOD, CAT and GSH- Px declined to 74%, 36% and 42%, respectively (P<0.01). Levels of TNF- α, IL- 1β and IL- 6 in the serum and liver of model group were increased (P<0.01), and caspase 3 activity was increased to 5.3 times that of the normal control (P<0.01). Compared with the model group, the number of surviving mice in PSSC groups increased, liver pathological scores declined (P<0.01), levels of MDA and ROS increased (P<0.01), levels of GSH, TNF-α, IL-1β and IL-6 in the liver and serum declined (P<0.01), and caspase 3 activity decreased (P<0.01). CONCLUSION PSSC is able to alleviate LPS and GalN-induced ALF in mice. Inhibition of hepatic oxidative stress, inflammatory response, and cell apoptosis is possibly implicated in the protective effect of PSSC.

With patch clamp method,the effects of taurine (Tau) on slow inward calcium current (Ica) were investigated in single ventricular cells of guinea pigs. Tau decreased Ica in a dose- and voltage-dependent mode,but had little effect on reversal potential. Tau 0. 1 umol - L-1 decreased Ica by 17% and its maximal effective concentration was near 100 umol -L '. The initial block of Tau had already reached by 47% after a rest out of stimulation. Tau facilitated the reduction of lea through increasing clamp pulse frequency. The obtained results suggested that it decreased Ica in a use-dependent manner.

Objective:To differentiate the methamphetamine users according to the developmental stages of addictive behavior, and explore the characteristics of different stages in order to provid a theoretical reference for our clinical intervention.Methods:Take the male methamphetamine users in compulsory detoxification institute whom were admitted from September 2018 to December 2019 as research objects.All the objects were asked to complete clinical diagnosis, interview and questionnaire evaluation in one week.According to the developmental stages of addictive behavior, the subjects were divided into occasional use group ( n=51), regular use group ( n=95) and compulsive use group ( n=157).All subjects were evaluated using visual analogue scale(VAS), Barrett impulsiveness scale(BIS)and CogState scale.SPSS 20.0 software was used for statistical analysis, AVOVA or Kruskal-Wallis H test was used for group comparison.Multiple Logistic regression analysis was used to explore the factors associated with the development of addictive behavior. Results:(1)The compulsive use group had higher cumulative duration(24(8, 48), 12(4, 24), 22(10, 36)), average dose(6.6±3.8, 2.8±1.4, 4.5±3.4) and craving score(1(0, 5), 0(0, 1), 1(0, 3)) than the other two groups(all P<0.05).And individuals in compulsive use group had more previous heroin use experience(20.4%, 9.8%, 14.8%, P<0.05).The regular use group had more withdrawal times than the other two groups(1(1, 3), 1(0, 1), 1(1, 2), P<0.05).The total scores of Barrett impulsiveness scale(42.8±13.3, 34.5±13.6, 36.1±14.9) and the scores in all dimensions in the compulsive use group were significantly higher than those in the other two groups(motor impulsiveness: 37.5±15.8, 27.8±13.4, 29.2±17.8; attentional impulsiveness: 43.2±18.0, 39.4±17.0, 37.2±18.1; non-planning impulsiveness: 47.2±19.8, 38.8±18.7, 40.7±20.8; P<0.05) .In the compulsive use users, the ISL(16.50±4.87, 19.30±4.78, 18.33±4.91) and SEC(0.76±0.21, 0.89±0.22, 0.81±0.21) scores about cognitive assessment were significantly lower than other two groups(both P<0.05).(2)The results of multiple Logistic regression analysis showed that cumulative duration ( β=0.022, OR=1.022, 95% CI: 1.003-1.042), dosage( β=0.625, OR=1.869, 95% CI: 1.196-2.921), craving ( β=0.194, OR=1.214, 95% CI: 1.002-1.215), the total scores of Barrett impulse scale( β=0.036, OR=1.037, 95% CI: 1.013-1.061), scores of non-planning impulsiveness( β=0.040, OR=1.041, 95% CI: 1.004-1.038), scores of motor impulsiveness( β=0.033, OR=1.214, 95% CI: 1.001-1.068) were associated with the periodic grouping of addictions. Conclusions:Addictive behavior is a progressive process and methamphetamine users at different stages have different characteristics in substance use, impulsiveness and cognitive function.The development of addictive behavior is associated with the time, dosage and craving of substance use, as well as the personality impulsivity of users.And the compulsive users suffered more cognitive impairment than the other two groups. The methamphetamine users should be identified dynamically and targeted therapeutic intervention measures should be carried out to block the addictive process to achieve the goal of harm reduction.

Objective To compare the diagnostic values of US-guided optical imaging system (OPTIMUS) and full-field digital mammography (FFDM) in breast neoplasms. Methods Sixty-four patients suspected of breast neoplasms underwent OPTIMUS and FFDM before surgery. All patients were proved histopathologically. The accuracy of diagnosis was compared with chi-square test. Results Sixty-five masses were delineated by OPTIMUS and FFDM. The diagnostic accuracy, sensitivity and specificity of OPTIMUS were 86. 2% ( 56/65 ), 87.0% ( 20/23 ) and 85.7% ( 36/42 ), respectively. The positive likelihood ratio was 6. 09 and the negative likelihood ratio was 0. 175. The diagnostic accuracy, sensitivity and specificity of FFDM were 73.8% (48/65), 82. 6% ( 19/23 ) and 71.4% (30/42), respectively. The positive likelihood ratio was 2. 892 and the negative likelihood ratio was 0. 243. There were no significant differences between OPTIMUS and FFDM ( x2 = 3. 077 ,P ＞ 0. 05). Conclusion OPTIMUS is similar and supplementary to FFDM for the diagnosis of breast neoplasms.

In recent years, antiangiogenic drugs based on VEGF and VEGFRs signaling pathway have been widely used in the treatment of malignant tumors. Apatinib is an orally bioavailable small-molecule antiangiogenic agent and can specifically inhibit the tyrosine kinase activity of VEGFR, thereby inhibiting tumor angiogenesis. Apatinib is the first-level recommendation of third-line treatment of gastric cancer in CSCO Guidelines for the Diagnosis and Treatment of Gastric Cancer published in 2018. Apatinib has been proved to be effective and safe in gastric, lung and breast cancers. In addition, the drug shows great potential in the treatment of a variety of solid tumors. This article reviews the recent progress on the mechanism, clinical efficacy, related efficacy predictors of apatinib and its combination with other antitumor drugs.

Objective To understand the application status and users' demands of the chronic disease management application in Guangzhou. Methods From June to October 2017, 794 patients with chronic disease (hypertension as an example) and 25 community health workers were investigated and analyzed by questionnaire and personal interview in Guangzhou. Results The utilization rate of hypertension management type APP was 71. 7％ in Guangzhou, and that of community health service staff was 25. 0％. The demand of this kind of APP users lies in perfecting the basic function of chronic disease management, stressing market norms and technological innovation, emphasizing the health education of patients with chronic disease and continuous education of medical staff. Conclusion Currently, the chronic disease management applications can not meet the most practical and urgent needs of its users, so it is necessary to continuously evaluate the market and adjust the development strategy.