Objective:To explore the influence of fuyuan capsule treatment on patients with qi deficiency and blood stasis. Methods:40 cases with qi deficiency and blood stasis were divided into two groups,the fuyuan capsule group and the control group. Besides basic diseases were treated in two groups, the patients in control group were treated with xinxuekang capsule, while patients in fuyuan capsule group were treated with fuyuan capsule instead of xinxuekang capsule. Scores of symptom and indexes of Hemorheology and heart function were tested after 8 weeks.The data were compared with those of pretherapy. Results:Scores of symptom and indexes of Hemorheology in the fuyuan capsule group were significantly lower than those in the control group(P

Objective To describe status of cancer-related fatigue (CRF) and its trajectory during three different time node for the operation, chemotherapy, and radiotherapy among breast cancer patients. Methods The convenience sampling method was used for 242 cases diagnosed with breast cancer which prepared for breast cancer resection, prepared to be treated with adjuvant chemotherapy and radiotherapy, and conformed to the sample standard from a tumor hospital and two affiliated hospital of medical college from February 2014 to November 2015 in a city. The follow-up survey of CRF was conducted respectively in the three different point-in-time for one week after the operation, at the end of chemotherapy and radiotherapy. Results After the operation mean rating for general fatigue was mild (2.59±2.41) points, and approximately 76.0% (184/242) patients experienced fatigue to low- grade degree; After the chemotherapy fatigue was significantly increased (6.57 ± 2.43) points, and 75.2% (182/242) patients accounted for severe fatigue; After the radiotherapy mean rating for fatigue was moderate (4.38 ± 2.46) points, and 57.0%(138/242) patients suffered to moderate fatigue. During the whole treatment period the level for general fatigue and four dimensions of fatigue were in the unstable state ofwaveof fluctuations with mild, severe, moderate, and fatigue were statistically different in three different stages of treatment ( F= 43.16,P=0.000). The age and operation method were associated with CRF in thephaseofoperation(age t=7.365, P=0.003; operation method t=5.166, P=0.009), chemotherapy (age t=9.835, P=0.000; operation method t=3.313, P=0.025) and radiotherapy (age t=9.014, P=0.000;operation method t=10.392, P=0.000). Conclusions There is a certain difference with CRF of breast cancer patients at different stage of rehabilitation treatment. There are two factors that could affect CRF such as age and operation method in the whole rehabilitation treatmentperiod.

Objective To understand the short-term effect of practice skill training for general practitioners in Guangdong province and to provide scientific basis for improving the training strategy. Methods According to the training outline (Outline of job-transfer training for general practitioner in primary health institutions (trial))of the Ministry of Health,job-transfer training was provided for a total of 451 primary care doctors in economically undeveloped cities for one year. All trainees were investigated before and after training by questionnaire,which were designed by ourselves and included practical skill level and satisfaction degree.SPSS 13.0 software was used to do statistical analysis and data were processed by description analysis,t test,ANOVA and correlation analysis. Results Average self-evaluation scores of practical skills were 136.37 ±21.74 and 169.39 ±17.12 before and after training with significant differences (t=29.028,P=0.000). Scores of all types of practical skills after training were significantly higher than those before training (P<0.000 1). Total satisfaction rate was 91.6%and students were not well satis-fied with training environment and training guarantee. Fac-tors influencing the effect of training included educational background,professional title,doctors' de-sire of training,whether taking part in the general practitioner training or not. The effect of practical training was positively correlated with total satisfaction (r=0.162,P=0.037). Conclusions Remark-able results of practice skill training have been achieved. In the future,more chances for practice should be provided for trainees and contents of skill training should be designed according to the need of community health service,and more attention should be paid to the training project management.

Objective To explore how to establish and safeguard the peripherally inserted central catheters(PICC) maintenance network for the management and practical activity of PICC,so as to provide continuous high-quality PICC maintenance for discharged patients with PICC. Methods 40 nurses each year from 10 cities and 100 country hospitals affiliated with Shanxi Quality Control Center to train in the 1st and 2nd affiliated hospital of Xi`an Jiaotong University were choosen as 214 PICC maintainers. These maintainers were taken into the inner-net of 1st affiliated hospital of Xi`an Jiaotong University management system complete the PICC maintenance net of Shanxi province. Results After the establishment of maintenance network, the number of patients with PICC increased (from 610 cases in 2008 to 1 434 cases in 2014);A large number of PICC management had been down by the qualified nurses in primary hospitals; Duration of PICC in patients days was prolonged; The PICC related complications including thrombophlebitis, catheter infection,occlusion or dislodgment and unplanned extubate were significantly decreased (P < 0.05 respectively). Conclusions Establishment of PICC maintenance network can provide patients with standardized and convenient PICC maintenance service,decrease the incidence of catheter which related complications and ensure patient safety. The application of PICC maintenance network should be used more and more.

Objective To obtain recombinant human granulysin using prokaryotic expression system. Methods Total RNA was extracted from cultured PBMC. Granulysin gene segments were obtained with granulysin-specific primers by RT-PCR and then inserted into pET32a(+) plasmid. After identification by DNA sequence, pET-GN-LY9K and pET-GNLY15K were transferred to E. Coli Rosetta (DE3). The fusion protein was identified by SDS-PAGE and Western blot. The bioactivity of granulysin fusion protein was measured by MTT assay. Results The prokaryotic expression vectors pET-GNLY9K and pET-GNLY15K were successfully constructed. The corresponding protein was highly expressed in E. Coli. Recombinant protein was specifically bound by anti-granulysin antibody. GNLY9K fusion protein significantly inhibited the growth of A549 cells in a dose-dependent manner, while GN-LY15K had little effect on the growth of A549. Conclusion Granulysins with different mw were successfully expressed using prokaryotic expression system, which might be helpful for the further study of granulysin.

Objective To obtain recombinant human granulysin using prokaryotic expression system.MethodsTotal RNA was extracted from cultured PBMC. Granulysin gene segments were obtained with granulysin-specific primers by RT-PCR and then inserted into pET32a(+) plasmid. After identification by DNA sequence,pET-GNLY9K and pET-GNLY15K were transferred to E. coli Rosetta (DE3). The fusion protein was identified by SDS-PAGE and Western blot.The bioactivity of granulysin fusion protein was measured by MTT assay.Results The prokaryotic expression vectors pET-GNLY9K and pET-GNLY15K were successfully constructed.The corresponding protein was highly expressed in E.coli. Recombinant protein was specifically bound by anti-granulysin antibody. GNLY9K fusion protein significantly inhibited the growth of A549 cells in a dose-dependent manner,while GNLY15K had little effect on the growth of A549.Conclusion Granulysins with different mw were successfully expressed using prokaryotic expression system,which might be helpful for the further study of granulysin.

Objective To know the masons of delaying to receive medical treatment among patients with breast cancer, and then reference to related health education. Methods 13 patients with breast cancer were selected in this research, interviewed them by phenomenological method to know their reasons of delaying to receive medical treatment, analized the results of interview by Clolaizzi method. Results The were five themes for patients with breast cancer about delaying to receive medical treatment, they were not understand breast cancer-related knowledge, shortage of method of self-examination, psychological factors, working pressure and family factors, social environment factors. Conclusions We should strengthen breast cancer-related health education when changed women's traditional ideas and ameliorated their family and social environment.

Objective To investigate the effects of dynamic ventilatory factors on inflammatory response and function of extrapulmonary organs in acute respiratory distress syndrome (ARDS) dogs. Method Thirty-six healthy dogs were randomly divided into 6 groups: normal control group (N group), ARDS group ( M group) and ventilation groups (A～D groups)hased on a series of random number. The ARDS dog model was replicated by iutrawacheal instillation of hydrochloric acid and mechanical ventilation was carried out according to the following protocols. Group A:low VT, low inspiratory flow and high respiratory rate. Group B: large VT, high inspiratory flow and high respiratory rate. Group C: large VT, high inspiratory flow and low respiratory rate. Group D: large VT, low inspiratory flow and low respiratory rate. After 4 hours of mechanical ventilation, animals were sacrificed.Tumor necrosis factor (TNF)-α and intefleukin (IL)-8 levels in blood serum were measured by radioimmunoassay.Histopathological changes of liver and kidney were observed under light microscope. Results The level of IL-8 and TNF-u of group B and C were much higher than those of group D, A and M ( P<0.05), but there was no significant difference among group D, A and M ( P>0.05). The level of IL-8 and TNF-α of group N were much lower than other groups ( P<0.05). The change of histopathology was the most significant in group B and C while the change of histopathology on group C was better than group B. The change of histopathology on group A and D was better than group B and C. The change of group A was similar to group M. All the data were analyzed by statistical F test. There was statistical difference with P<0.05. Comclusions Large tidal volumes with high inspiratory flow and high respiratory rate may increase mediators of inflammation in blood sennn, and aggravate the irflamnnmtory response of extrapulmonary organs. Beducfion of inspiratory flow and respiratory rate ventilation may prevent the occurrence d multiple organ dysfunction syndrome.

Objective To evaluate the prophylactic effect of abdominal breathing exercises on radiation pneumonitis in patients with chest malignant tumors.Methods 100 patients with chest malignant tumors were given radiotherapy and divided with random digit table into the exercise group and the control group with 50 patients in each group.The incidence rate of radiation pneumonitis in both groups was compared.The prophylactic effect of abdominal breathing exercises on radiation pneumonitis was evaluated.Results The incidence of radiation pneumonitis in abdominal breathing exercise group was significantly reduced [34％ (17/50) vs.56％ (28/50),Z=2.397,P＜0.05],the incidences of grade Ⅰ [22％ (11/50) vs.30％ (15/50)] and grade Ⅱ [12％ (6/50) vs.18％ (9/50)] radiation pneumonitis decreased,and no grade Ⅲ and Ⅳ radiation pneumonitis occurred.Conclusions The incidence of radiation pneumonitis in patients with chest malignant tumors treated with radiation therapy may be decreased by abdominal breathing exercises,which may be widely applied in patients treated with radiation therapy.

Objective To investigate the effect of Omaha system intervention on social psychology of the elderly,and to provide evidence for effective intervention in elderly with homebound state.Methods 218 cases with homebound conditions were divided into intervention group and control group by random digits table with each group 109 cases.The intervention group accepted intervention including health education,treatment procedures,case management,supervision of the four aspects of 1-3 times a week according to Omaha intervention system for a period of 3 months.The control group was the blank control.And Omaha evaluation form was used to evaluate social psychological and physical effect before and after the intervention.Results 3 months after the intervention,except physiology in the field of neuromusculo-skeletal function of two groups had no significant difference (t=2.03,P＞0.05),scores in the intervention group in the field of physiology (like the circulation) were higher than the control group,the difference was statistically significant [(1 1.20±2.03) vs.(8.72±1.36),P＜0.05].As for psychology (like mental health),scores of intervention group were higher than that of the control group [(12.53±1.42) vs.(8.63±1.33),t=20.12,P＜ 0.05].Conclusions Omaha system can effectively improve the quality of life of elderly with homebound state and maintain their physiological,social and psychological function.