Inflammatory breast carcinoma (IBC) is a particularly local advanced breast cancer,which has characters of high invasion,high metastasis and high human mortality.Because of high malignancy and rapid development,extensive body metastasis often happens in early stage and the prognosis is very poor.Currently,the therapy strategy of operation,chemotherapy combined with radiotherapy is used to treat IBC.However,the effect is always very limited.Now,the advances in researches of molecular biology and cancer immunology bring hope.Some recent progresses of therapy in IBC are reviewed in the article.

Objective To observe the changes in the expression of renal tissue TNF-α , NF-κB and the interrelation to renal cell apoptosis, and their influences of Inula Britannica(an inhibitor of inflammatory signal pathway) in exhausted swimming rats, and to investigate the role of inflammatory signal pathway. Methods Forty-eight male Wistar rats were randomly divided into three groups: control group (CN, n=8), exhaustive swimming group (ES, n=24) and Inula Britannica group (IB, n=16). The rats of CN were quiet without swimming. The rats of ES swam to exhaustion and were sacrificed at immediately (ESI, n=8), 6 hour (ES 6 h, n=8) and 24 hour (ES 24 h, n=8) after exhanstiing swimming. The rats of IB group took orally Inula Britannica at the dose of 25 ml/kg body weight at 24 h before swimming and then swam to exhaustive state. The rats of IB group were sacrificed at 6 hour (IB 6 h, n=8) and 24 hour (IB 24 h, n=8) after exhaustiing swimming. The renal cell apoptosis was measured by the method of terminal-deoxynucleotidyl transferase mediated d-UTP nick end labeling (TUNEL). The expression of TNF-α in renal tissue was examined by immunohistochemistry. The changes of NF-κB in renal tissue were measured by flow cytometry and immunnhistochemistry. The interrelation between TNF-α and NF-κB was analyzed by Pearson method, and the interrelation between TNF-α, NF-κB and renal tissue cell apoptosis was analyzed by Spearman method. Resulls The number of renal tissue apoptotic cells was increased progressively from ESI to ES 24 h rats (P <0.05). Immunohistochemistry staining showed that the positive expressions of renal tissue TNF-α and NF-κB were increased progressively at 0 h (0.136±0.009, 0.129±0.011), 6 h (0.171±0.011, 0.166± 0.009) and 24 h (0.229±0.008, 0.218±0.019) after exhaustiing swimming in ES compared with control group (0.109±0.010, 0.095±0.010) ( all P<0.05). The similar changes of renal tissue NF-κB was also revcalved by flow cytometry. The expression of TNF-α was positively correldted with NF-κB (r=0.955, P<0.01 ), and renal cell apoptosis was also positively correlated with TNF-α and NF-κB (r =0.953, r=0.939, P<0.01) in ES rats. Pretreatment with Inula Britannica, inhibited the up-regulation of expressions of renal tissue TNF-α (6 h:0.142±0.012, 24 h:0.130±0.010) and NF-κB (6 h:0.138±0.010, 24 h:0.136±0.011 ) induced by exhausting swimming. Conclusion Overtraining can induce the up-regulating expressions of renal tissue TNF-α and NF-κB, and Inula Britannica can partly counter the above changes in exhaustied swimming rats, which may be one important mechanisms of overtraining-induced renal tissue cell apoptosis and the anti- apoptosis effect of Inula Britannica.

Objective To study the expressions of apoptosis related genes Bcl-2 and Bax proteins in rat's renal tissue and the relationship between the ratio of Bcl-2/Bax and renal cell apoptosis induced by overtraining,and observe the effect of anisodamine on the expression of genes Bcl-2 and Bax in exhausted rats.Methods The animal model of acute kidney injury induced by exhausting swimming was reproduced.Forty eight male Wistar rats were randomly assigned into sedentary control group(CN,n=8),exhausting swimming group(immediate,6 hours and 24 hours after exhausting swimming,ESI,ES6h and ES24h,8 each),Anisodamine group(6 hours and 24 hours after exhausting swimming,AD6h and AD24h,8 each).The expressions of Bcl-2 and Bax were detected by immunohistochemical staining and image analyzer.The correlation between the ratio of Bcl-2/Bax and renal cell apoptosis was analyzed.Results The analysis showed that the expression of Bax increased,and of Bcl-2 decreased,the ratio of Bax/Bcl-2 increased remarkably in ESI group compared with CN group(P

A new method based on the multiple locus variable number tandem repeat analysis (MLVA) was applied for the genotyping of combined HIV Mycobacterium tuberculosis in Dali to investigate the genotyping and distribution pattern of Myco‐bacterium tuberculosis clinical isolates with MLVA .Mycobacterium tuberculosis clinical isolates were selected from Dali area , and the polymorphism of VNTR locus was tested with PCR .The clustering of genotype was analyzed by BioNumerics (6 .6) . Result showed that 15 VNTR loci of 61 combined HIV Mycobacterium tuberculosis clinical isolates were analyzed respectively . There were obvious polymorphisms of VNTRs .The discrimination power of these loci appeared different from each other ,with the biggest Hunter‐Gaston index (0 .839) loci was MIRU26 ,and the smallest one (0 .341) loci was MIRU4 .The clustering of genotype showed that these strains could be categorized into 5 gene clusters and 61 genotype ,the proportions of cluster Ⅰ was the biggest one ,51 .6% were cluster Ⅰ which including 32 strains .The standard strain H37Rv was belongs to cluster Ⅱ .Its indicated that there are obvious polymorphisms of VNTRs of combined HIV Mycobacterium tuberculosis clinical isolates in Da‐li .The main genotype was Beijing family genotype .

Objective To observe the analgesia effect of combination of continuous femoral nerve block and oral analgesics after total knee arthroplasty and the impact on early rehabilitation of knee.Methods Sixty patients scheduled for unilateral total knee arthroplasty were randomly divided into two groups.One group was the multimodal analgesia group (group M)and the other was patient controlled intravenous analgesia group (PCIA)(group Ⅰ),30 patients in each group.In group M, patients were given celecoxib (200 mg,bid)and oxycodone (10 mg,bid)two days before operation, then received continuous femoral nerve block followed by oral acetaminophen (100 mg,tid)and oxyc-odone (20 mg,bid)three days after operation.In group I,patients took no medicine before operation and only received PCIA after operation.The two groups were compared with postoperative visual ana-logue scale(VAS)scores at 6,12,24,48 h at rest,during active training and continuous passive movement,range of motion of the knee joint during active training and continuous passive movement, the first time of ambulation,length of hospital stay,range of motion of the knee joint at hospital dis-charge and the incidence of complications.Intravenous dezocine 5 mg was given when VAS score was higher than 5,which was recorded.Results Compared with group Ⅰ,the VAS scores at rest,during active and continuous passive movement at postoperative 6,12,24,48 and 72 h in group M were de-creased significantly (P <0.05).The range of motion of the knee joint during active training and con-tinuous passive movement at postoperative 24,48 and 72 h in group M was increased significantly(P<0.05).The first time of ambulation(2.5±0.8)d and length of hospital stay(9.1±2.3)d in group M were shorter significantly than the first time of ambulation (3.3 ±0.7)d and length of hospital stay (10.8±2.0)d in group I (P <0.05 ).The range of motion of the knee joint(95.6 ± 1 7.2)°in group M at hospital discharge was greater significantly than the range of motion of the knee joint (82.5± 1 5.2 )° in group I (P < 0.05 ).The incidence of nausea and vomiting (3.3%),uroschesis (6.7%)in group M was lower significantly than the incidence of nausea and vomiting (30.0%), uroschesis (26.7%)(P < 0.05 ).Additional use dezocine (3.3%)was lower significantly than additional use dezocine (40.0%)(P <0.05).Conclusion Compared to patient controlled intravenous analgesia,combination of continuous femoral nerve block and oral analgesics can effectively alleviate postoperative pain in patients undergoing total knee arthroplasty,which is beneficial to early postop-erative knee function recovery.

Objective To explore the effect of combination application of preoperative carbohydrate loading and sequential enteral nutrition on the recovery of postoperative patients with stomach neoplasm.Methods Ninety-eight patients with stomach neoplasm were randomly divided into three groups.Those were Group A (preoperative fasting + sequential EN,n =33),group B (preoperative carbohydrate loading + postoperative TPN,n =33) and group C (preoperative carbohydrate loading + sequential EN,n =32).Insulin sensitivity (IS) ; Nutritional indicators including pre-albumin (PA) and transferrin (TRF) ; immunity parameters including IgG,IgM and IgA were measured in blood on the day before the operation,the 1st day,4th day and 8th day after the operation.Meanwhile,anal exhaust time after the operation,incidence of complications and postoperative hospitalizing time were also observed.Results The level of IS in group C at 4th day and 8th day after operation were 35.8 ± 3.2 and 36.1 ± 3.5,higher than those in A group and B group (A group:30.7 ±3.3,33.5 ±2.9;B group:33.7 ±3.1,34.0 ±2.2),and the differences were significant((F =20.88,7.28 ;P ＜0.05).At the 4th day after the operation,the levels of PA in group B and group C were (191 ± 11.6) mg/ and (193 ± 12.7) mg/L,significantly higher than those in group A ((176 ± 14.1) mg/L;F =17.15,P ＜ 0.01).At the 8th day after the operation,the levels of PA and TRF in group C were (221.3 ±30.81) mg/L and (86 ± 0.37) g/L,significantly higher than those in group A and group B (group A:(198.0 ± 30.6) mg/L,(1.60 ± ±0.33) g/L;group B:(202.0 ±28.6) mg/L,(1.61 ±0.34) g/L;F =5.42,5.83 ;P ＜0.01).At the 8th day after the operation,the levels of IgA,IgG and IgM in the group C were (2.74 ±0.69) g/L,(14.55 ±2.57) g/ L,(1.08 ± 0.33) g/L,significantly higher than that in group A and group B (group A:(2.30 ± 0.54) g/L,(12.71 ±2.94) g/L,(0.86 ±0.31) g/L;group B:(2.29 ±0.50) g/L,(12.06 ±3.33) g/L,(0.89 ±0.27)g/L;F =6.12,6.13,4.94;P ＜ 0.05).Conclusion The combination of preoperative carbohydrate loading and sequential enteral nutrition can reduce insulin resistance,improve postoperative nutritional status,improve the recovery of immune function and intestinal function,as well as reduce the incidence of postoperative complications.

Objective To explore stimulative of posttraumatic growth(PTG) of head-injured patients associated with limb movement disorder,in order to provide reference for psychological nursing intervention.Methods Phenomenological methodology was used in the study.A semi-structured interview was conducted on seven head-injured patients with limb movement disorder recruited by purposive sampling method.Data were analyzed by Colaizzi's analysis procedure.Results Through interview,the following four themes were summarized:positive state of mind and coping style of patients; patients' high level of self-efficacy; social support; high quality of medical services.Conclusions In order to promote PTG of head-injured associated with limb movement disorder patients,nurses should strive to adjust the patient mentality and coping strategies,improve their self-efficacy levels,help patients get support from the community,at the same time should also focus on quality of medical services.

Objective To observe the expression changes of renal tissue Bax,Bcl-2 and caspase-3,to wxamine the correlation between the ratio of Bax to Bcl-2,caspase-3 and renal tubular cells apoptosis,and to investigate the role of caspase-related signal pathway.Methods Forty-eight male Wistar rats were randomly divided into three groups: control (CN,n=8),exhaustive swimming (ES,n=24) and inula britannica (IB,n=16) group.The rats of CN were quiet without swimming.The rats of ES swam to exhaustive state and were sacrificed at immediately(ESI),6 hour (ES 6 h) and 24 hour (ES 24 h) after exhaustive swimming respectively.The rats of IB took orally inala britannica at the dose of 25 ml/kg body weight at 24 h before swimming and then swam to exhaustive state.The rats of IB group were sacrificed at 6 hour (IB 6 h) and 24 hour (IB 24 h)after exhaustive swimming.The animal model of overtraining-induced acute kidney injury was developed by exhaustive swimming.The renal cell apoptosis was measured by the method of TUNEL.The expressions of Bax,Bcl-2,caspase-3 in renal tissue were observed by immunohistochemistry.The expression of caspase-3 protein was examined by Western blotting.The correlation between the ratio of Bax to Bcl-2 and caspase-3 was analysed by Pearson method,and the correlation between the ratio of Bax to Bcl-2,caspase-3 and renal tubular cell apoptosis was analysed by Spearman method.Results The number of renal tubular apeptotic cells was increased progressively in ESI to ES 24 h rats by TUNEL (P＜0.05).Immunohistochemistry staining showed that the ratio of Bax to Bcl-2 and caspase-3 in renal tubular cells were increased progressively at 0 h,6 h and 24 h after exhaustive swimming compared with control group (P＜0.05).The change of renal tissue caspase-3 was also revealved by Western blotting analysis.The ratio of Bax to Bcl-2 and caspase-3 in renal tubular cell was correlated positively (r=0.865,P＜0.05),The ratio of Bax to Bcl-2,and caspase-3 was also correlated positively to renal tubular cell apoptosis (r=0.674,r=0.837,P＜0.05) in ES rats.Pretreatment with inula britannica inhibited the up-regulation of the ratio of Bax to Bcl-2,caspase-3 and cell apoptosis in renal tubular cell induced by exhaustive swimming.Conclusion Overtraining can induce renal tubular cells apoptosis through activating caspase-related signal pathway by impairing the balance of Bax and Bcl-2,which may be one of the important molecular mechanisms of overtraining-induceed renal tubular cells apoptosis.

Objective To observe the effect of SSRI and SNRI drugs combined with clinical nursing path of untreated depression in patients with executive function. Methods From October 2014 to April 2016, the third people's Hospital of Yuyao was admitted to the 4 people's Hospital, who met the criteria of diagnosis and inclusion criteria. 80 cases of untreated depressive patients were randomly divided into two groups, according to clinical medication and nursing methods were defined as SSRI group, SSRI group and SNRI group, SNRI group, SSRI group were treated with 8 cycles of Pa Rossi Dean oral treatment, during the treatment group were given routine clinical care, SNRI group were given venlafaxine 8 During the period of oral treatment, treatment group Ⅱ were given clinical nursing path on the basis of conventional nursing, treatment and nursing care of patients before and after the change of executive function evaluation. Results SSRI Ⅱ, SNRI Ⅱ group WCST scores were better than SSRI Ⅰ, SNRI Ⅰ group; SNRI group Ⅱ WCST scores were better than SSRI group; SSRI group, SNRI group Ⅱ TMT evaluation results is better than that of SSRI group, SNRI group; SNRI group Ⅱ TMT evaluation results is better than that of SSRI group; the SSRI Ⅱ SNRI Ⅱ group the experimental results of TOL is better than that of SSRI group, SNRI group; SNRI group Ⅱ TOL experimental results better than SSRI Ⅱ group. Conclusion SSRI and SNRI drug treatment untreated depression patients exactly, combined with clinical nursing path can effectively improve the patients with degree of functional recovery, is worthy of clinical application.

To investigate the cardioprotective effect of percutaneous transluminal myocardial laser revascularization (PTMR) and its mechanism, in the ischemia/reperfusion (I/R) model of in vivo porcine heart, the effect of PTMR on myocardial infarct size (IS) was observed using TTC method,and expression of heat shock protein (HSP) 70 and 86 in myocardium was detected with Western blotting. It was found that PTMR significantly limited the myocardial IS induced by I/R (32%?3% vs 56%?7% in control group, P