Objective We used the method ot Meta analysis to evaluate the effect of the comfort care in Chinese patients with breast cancer in peri-operative period.Methods The randomized controlled trials on the comfort care in patients with breast cancer in peri-operative period were collected using the databases of China National Knowledge Infrastructure (CNKI),Wanfang Periodical Databases and Chinese Science Technology Periodical Databases which were analyzed by RevMan 5.3 software.Results Twelve randomized controlled trials were included in the study.The results of Meta-analysis revealed that the comfort care were effectively on anxiety condition,the degree of pain,the incidence rate of complicating diseases after surgery and degree of satisfaction on nursing than the conventional nursing,OR value and 95％CI were 0.26(0.13-0.50),9.98(6.00-16.61),0.24(0.13-0.42) and 4.74(2.84-7.90).Conclusions The comfort care can improve the state of anxiety,relieve the pain,reduce the postoperative complications and improve the degree of satisfaction of the patients.

Objective To investigate the application value of the ratio of lactic acid(LAC)divided by central venous oxygen saturation (ScvO2 ) to judge the illness severity and prognosis in shock patients. Methods Sixty-four shock patients were divided into two groups:survival group (n=35) and death group (n=29) based on death in 28-d admission. The gender, age, LAC/ScvO2, LAC, 6 h-lactate clearance rate (6 h-LCR), ScvO2 and acute physiology and chronic health Ⅱ(APACHEⅡ) score were compared between two groups. The correlation of LAC/ScvO2 with APACHEⅡscore was analysised in two groups. The receiver operating characteristic (ROC) curve was used to analyse the values of LAC/ScvO 2, LAC, 6 h-LCR, ScvO2 and APACHEⅡscore in the treatment and prognosis of shock. Results There were significant differences in LAC, ScvO2, 6h-LCR and APACHEⅡbetween two groups. There was a lower LAC/ScvO2 in survival group compared with that of death group (P<0.01). LAC/ScvO2 was positively correlated with APACHEⅡscore (rs=0.706,P<0.01). The sensitivity and speciality of LAC/ScvO2 were the highest compared with those of LAC, ScvO2, 6 h-LCR and APACHEⅡ score, the best threshold was 13.92. Conclusion LAC/ScvO2 is a better indicator for shock patients to evaluate the severity degree and prognosis.

555 medical vocational students were surveyed with questionnaire to data regarding their employment intentions. The study showed that the employment rate in basic-level medical organizations and the degree of job satisfaction of college students were low. The main factors were economic benefits, living environment, hospital equipment status, self-awareness. Therefore, in order to encourage medical vocational students to choose basic-level medical organizations, it is important to train health talents which is suitable for the grass-roots level, develop basic-level medical organization service qualities and pays more attention to the employment guidance in higher vocational schools, which can help medical vocational students cultivate proper views of employment.

Objective:To investigate the Value of Wavelet Analysis to Ultrasonic Diagnosis for liver neoplasms. Methods: The tissue images of Liver Neoplasms by ultrasonic examination experienced color conversion with Photoshop software, and the corresponding relationship among wavelet coefficient, spacial distribution and local image characteristic after conversion were analyzed, i.e.the row details were arrayed in line sequence,the line details in row sequence and the diagonal details in Zsequence. Results: The frequency spectral data and the image texture information were provided via imaging detection and wavelet analysis of, as well as the quantitative data description of the texture of the foci or the normal tissue. Conclusion:Wavelet analysis provided with a reliable basis for the early clinical diagnosis and treatment for liver neoplasms, by which the focal character and degree can be differentiated or analyzed.

Objective To evaluate the effect of evidence based nursing on the prevention of the complications of PICC .Meth‐ods The randomised controlled trials (RCT) on the evidence based nursing in reducing or preventing the complications of patients with PICC were collected using the databases of PubMed ,CNKI ,WanFang ,CBM and VIP;the data were analyzed by RevMan5 .0 software .Results 17 studies involving 3 092 patients were included in total .The results of Meta analyses showed that compared with the control group ,the complication (Phlebitis ,puncture point infection ,catheter prolapse or ectopic and catheter obstruction) rates of evidence based nursing group with PICC were lower (P<0 .05) than that of the control group .Conclusion Evidence based nursing can effectively prevent the complication of PICC ,improve the quality of nursing and worth of clinical application .

Objective To study the diagnosis and trea tm ent of urolithiasis in patients after renal transplantation. Methods 5 cases of urinary tract stone in patients after renal transplantat ion were diagnosed and treated.In 1 case,the stone was a remnant of the stone in the donor kidney,in 3 cases,the stone was secondary to a sternotic ureterocysto stomy stoma,in the other case,a stent in the urinary tract was complicated by st one formation.Surgical removal of the stone with ureter-bladder reanastomosis w as carried out for 3,in one of which ESWL has failed.Conventional nonsurgical meas ures was adopted for 2. Results The patients have been f ollowed up for 1～13 years with all the patients and the transplants surviving.I n one of the patients with nonsurgical management,the transplanted kidney has al ready survived for 13 years. Conclusions The treatment o f urinary tract stone in a transplanted kidney is similar to the conventional pr inciples,relieving the block and removal of the stone.Risk factors of uric acid stone formation should be taken care of.

Objective To observe the effect of comprehensive rehabilitation on the recovery of knee joint function in old patients severe burned in lower extremity. Methods 49 patients severe burned in lower extremity were randomly divided into observation group (n=25) and control group (n=24). The control group accepted routine rehabilitation, while the observation group accepted comprehensive rehabilitation. They were assessed with the range of motion (ROM) of knee flexion/extension, 45 m-walking, stair activity, Functional Independence Measure (FIM) and muscle strength 3 months after rehabilitation. Results The active and passive ROM of knee, stair activity, FIM score and muscle strength improved more in the observation group than in the control group (P<0.05). Conclusion Comprehensive rehabilitation promotes the recovery of knee function of old patients with severe burn in lower extremity.

ObjectiveTo evaluate the efffects dexamethasone (DEX) administration at different times on intestinal ischemia-reperfusion(I/R) injury and inducible nitric oxide synthase(iNOS) activity in mice.Methods Tirty-five healthy male Kunming mice weighing 20-24 g were randomly divided into 5 groups( n =7 each): Sham operation group (group Ⅰ ); intestinal I/R group (group Ⅱ ); DEX administration before ischemia group (group Ⅲ ); DEX administration during ischemia group ( group Ⅳ) and DEX administration at the begining of reperfusion group (group Ⅴ ).Intestinal I/R injury was induced by clamping the superior mesenteric artery for 30 min.Normal saline10 mg/kg,DEX 10 mg/kg was injected iv at 30 min before ischemia in groups Ⅱ and Ⅲ respectively.DEX 10 mg/kg was injected iv at 5 min of ischemia in groupⅣ and immediately at the begining of reperfusion in group Ⅴ.The mice were sacrificed at 3 h of reperfusion,and then the small intestinal tissues were taken for determination of intestinal pathological score( Chiu score),iNOS activity and nitric oxide (NO) content.ResultsChiu score was significantly higher in groups Ⅱ - Ⅴ,and iNOS activity and NO content were sinificantly higher in groups Ⅱ,Ⅳ and Ⅴ than in group Ⅰ ( P ＜ 0.05).Chiu score,iNOS activity and NO content were sinificantly lower in group Ⅲ,and were higher in group Ⅴ than in group Ⅱ ( P ＜ 0.05).There was no significant difference in the indexes mentioned above between groups Ⅱ and Ⅳ ( P ＞ 0.05).ConclusionDEX administration before ischemia can reduce intestinal I/R injury by inhibiting iNOS activity; DEX administration during ischemia has no effcet on intestinal I/R injury and iNOS activity; DEX administration at the begining of reperfusion aggravates intestinal I/R injury by enhancing iNOS activity.

Objective To analyze the difference of the venous port access (VPA) and peripherally inserted central catheter (PICC) in cancer chemotherapy.Methods All eligible studies on VPA and PICC were searched in the databases of PubMed,China National Knowledge Internet (CNKI),Chinese Biomedical Database (CBM),WANFANG Database and VIP Database.Literatures screening,quality evaluation and data extraction were conducted according to Cochrane Handbook;Meta-analysis was calculated by using RevMan 5.2.Results Twenty-nine studies with a total of 4 449 cases of patients were included in this Meta-analysis,with 1 912 cases in experimental group which adopted VPA and 2 537 cases in controlled group which adopted PICC.Experimental group had advantages in the average catheter retention time (SMD=3.36,95％CI 2.51-4.21) and quality of life (RR=1.61,95％CI 1.15-2.24) compared with controlled group.The overall complication rate (RR=0.26,95％CI 0.20-0.34,P＜0.01),phlebitis incidence (RR=0.08,95％CI 0.04-0.16,P＜0.01),catheter infection incidence (RR=0.32,95％CI 0.23-0.44,P＜0.01),catheter obstruction incidence (RR=0.32,95％CI 0.22-0.48,P＜0.01),catheter dystopy incidence (RR=0.18,95％CI 0.09-0.37,P＜0.01) in experimental group were remarkably lower than that in controlled group.However,no significant difference was found between the two groups in the incidence of the puncture success rate for the first time,errhysis or hematoncus,thrombus and catheter leakage (P ＞0.05).Conclusions Compared with PICC,VPA had advantages in a long retention time,fewer complications and few influence on quality of life.Therefore,VPA should be widely used in cancer chemotherapy.

Objective To clone ORF of DcR3 gene and insert it into eukaryotic expression vector and express it in COS-7 cells. Methods Encoding sequence of human DcR3 gene was cloned by PCR and sequenced. The sequenced ORF was cloned into eukaryotic expression vector pAAV-IRES-hrGFP to construct recombinant plasmid. COS-7 cells were transfected with recombinant plasmid by lipofectamine2000. Expression of recombinant DcR3 gene was verified by Western blotting and confocal microscopy. Results A 1 000-bp gene segment was obtained by PCR and inserted into pAAV-IRES-hrGFP to construct recombinant plasmid. The gene segment was proved to be encoding sequence of human DcR3 gene by sequencing. DcR3 expression in COS-7 cells was verified by Western blotting and confocal microscopy. Conclusion DcR3 gene was successfully cloned and expressed in COS-7 cells.