Objective To investigate knowledge, attitude, and practice of exercise for post-operative breast cancer. Methods 110 postoperative breast cancers were investigated using a self-designed questionnaire which included general condition of patients, knowledge, attitude and practice of exercise after breast surgery. Results The rate of effective response was 98%. The average rate of awareness about postoperative exercise for breast cancers was 87%, and the score of knowledge of intensity and forms of exercise was the lowest, while the announcements of post-operative exercise was the highest. All of the patients presented positive attitude toward exercise, however, some of them indicated that they couldn't insist on it. 41% exercised only in one form, 78% at a low intensity, 41% less than 3 times per week, and 74% at least 30 minutes per session. Only 7% did traditional Chinese medical exercise. Time after surgery correlated positively to general scores (r=0.40, P<0.01), kinds of exercise (r=0.41, P<0.05) and intensity of exercise (r=0.43, P<0.05). Phase of cancer correlated negatively to general scores (r=-0.37, P<0.05) and exercise time (r=-0.38, P<0.05). Conclusion The knowledge on intensity and form of exercise after operation is not popular in post-operative breast cancers.

Objective To explore the relationship of content of plasma endothelin(ET)-1 with the change of pulmonary function in patients with chronic obstructive pulmonary disease(COPD).Method Thirty cases of the normal people were as group A ,34 cases of the patients with COPD with acute exacerbation before treatment were as group B and the patients with remission period after treatment were as group C,the plasma ET-1,arterial blood gas and pulmonary function parameters were determined from the patients before and after treatment.Results The plasma ET-1 in group B and group C were significantly higher than that in group A,the content of the plasma ET-1 had negatively correlated with PaO2,and that had positively correlated with PaCO2,P＜0.01.The pulmonary function parameters (VC,FEV1/FVC,MVV,V50 V25)in group B were significantly lower than those in group A and group C[(55.3±24.5)%,(54.8±19.3)%,(54.2±16.2)%,(54,8±9,9)%,(58.7±14.5)%;(114.8±24.1)%,(84.9±21.6)%,(86.4±17.2)%,(78.5±14.8)%,(90.3±15.4)% and (110.1±19.4)%,(85.8±15.5)%,(85.9±16.7)%,(74.5±13.4)%,(89.4±18.6)%,respectively],P＜0.01.Conclusion Pathophysiological effects of patients with COPD can be commonly adjusted by the plasma ET-1,oxygen and carbon dioxide retention,which affect pulmonary function.

BACKGROUND:Adipose-derived stem cels under osteogenic induction can be combined with biodegradable silk fibroin/hydroxyapatite scaffold, which is expected to develop a new biocompatible and osteogenic bone fusion material. OBJECTIVE:To study the effect of silk fibroin/hydroxyapatite composite on the viability and osteogenic properties of adipose-derived stem cels after osteogenic induction. METHODS:Adipose-derived stem cels were obtained from rat’s fat tissue, then adherently cultured, proliferated and passaged in vitro. Passage 3 cels were cultured in conditioned medium for osteogenic induction, and then seeded onto silk fibroin/hydroxyapatite scaffold as experimental group. Adipose-derived stem cels cultured on the cover glasses at the same condition acted as control group. The celular morphology, proliferation and differentiation were assessed respectively by means of phase contrast microscope, MTT assay and alkaline phosphatase activity measurement. RESULTS AND CONCLUSION:After osteogenic induction, adipose-derived stem cels could adhere to the scaffold material and proliferate on the surface of silk fibroin/hydroxyapatite scaffold normaly. No significant difference was found in cel proliferation and alkaline phosphatase activity between the experimental and control groups (P > 0.05), suggesting the celular activity and function were not affected by the material. These findings indicate that silk fibroin/hydroxyapatite composite material has good cytocompatibility. Subject headings: Silk; Hydroxyapatites; Stem Cels; Adipose Tissue; Biocompatible Materials; Tissue Engineering.

Objective To investigate the differences of curriculum designs for undergraduate nursing majors among different TCM colleges and universities;To provide evidence for the development of the accreditation standards for academic quality of baccalaureate degree program in TCM colleges and universities which can be used as the standards for teaching reform. Methods Cultivating plans of 20 TCM colleges and universities for undergraduate nursing majors were collected. Current status and deficiency in curriculum design were obtained through comparative study and statistical analysis.Results The course names were lack of standardization;proportion of Chinese and Western medicine related courses were unreasonable;theoretical and practice teaching were irrelevant;optional courses were greatly inconsistent and irrational. Conclusion The further reform of the curriculum design for the undergraduate nursing majors in TCM colleges and universities is in urgent need, which can be standardized by developing the accreditation standards for academic quality of baccalaureate degree program in universities of Chinese Medicine.

Objective: This study aims to analyze the effects of catastrophic disease insurance (CDI), especially to evaluate the influences of CDI on the discrepancy of benefits between the patients covered by the Employee's Medical Insurance (EMI) and the Resident's Medical Insurance (RMI).Methods: The data used in the study are collected from the health insurance database of Zhuhai City in the years of 2012 and 2014.A descriptive analysis is made to depict the general situation of CDI in the city, and a logistic regression model is used to analyze the factors that affect the probability to get the benefits of CDI.Moreover, a triple difference model is built up to probe into the CDI's effects on the discrepancy of reimbursement ratio between patients covered by EMI and RMI.Results: The benefits of CDI favor the patients with old age, high medical expenditures and chronic diseases.When other factors are controlled, patients covered by EMI have lower probability to get CDI benefits than those covered by RMI.Within the patients with high medical expenditures who have gotten the CDI benefits, those covered by EMI enjoy higher reimbursement ratio than those covered by RMI, but CDI decreases the discrepancy by 3.2%.Conclusions: Since the CDI gives more favor to the vulnerable population and narrows the gap of the benefits between EMI and RMI, the policy improves the equity of health security.

Objective To analyze the treatment effects of cervical disc herniation treated by ozone combined with radiofrequency ther-mocoagulation. Methods Ninety cases of cervical intervertebral disc herniation were collected from our hospital in July 2009 to December 2013,who were treated by ozone combined with radiofrequency thermocoagulation. The patients were followed up for at least 3~6 months and the improvement rate was calculated according to the Macnab improved standard. Results All the patients were followed up for at least 3~6 months,according to the Macnab standard improved,50 cases were excellent,good in 25 cases,in 10 cases and poor in 5 cases,the improve-ment rate was 94. 4%. Conclusion The treatment of cervical disc herniation by ozone combined with radiofrequency thermocoagulation is one of the interventional therapy methods,which is minimally invasive and relatively safe. The treatment method has the following advantages, such as,satisfactory effect,accurate operation safety,less complications and without destroying the stability of the spinal structure.

OBJECTIVE:To investigate the improvement effects of Zhuanggushenjin capsules on osteoporosis induced by reti-noic acid in mice. METHODS:84 mice were randomly divided into normal control group,model control group,positive control group [Gushukang granules,5 g(crude drug)/kg] and Zhuanggushenjin capsules high-dose,medium-dose and low-dose groups [7.80,3.90,1.95 g(crude drug)/kg]. Except for normal control group,those groups were given retinoic acid(90 mg/kg)to induce osteoporosis model. 7 days after modeling,all drug groups were given relevant medicine intragastrically,normal control group and model control group given normal saline intragastrically ,once a day,for consecutive 14 days. ALP activity and the contents of cal-cium and phosphorus in serum and thigh-bone were determined. The body weight, the dry weight, length and diameter of thigh-bone were determined,and organ coefficients (spleen,testicle,ovarium and uterus) were calculated. RESULTS:Compared with normal control group,the activity of ALP in serum of mice increased in model control group,while the contents of calcium and phosphorus,body weight,length and diameter of thigh-bone decreased significantly;spleen coefficients increased,while testi-cle and uterus coefficients decreased(P<0.05 or P<0.01). Compared with model control group,the contents of calcium and phos-phorus increased in Zhuanggushenjin capsules groups,while spleen coefficient decreased;the activity of ALP in serum of mice de-creased in high-dose and medium-dose groups,while body weight,the length of thigh-bone,testicle and uterus coefficients in-creased;diameter of thigh-bone increased in high-dose group (P<0.05 or P<0.01). CONCLUSIONS:Zhuanggushenjin capsules can improve retinoic acid-induced osteoporosis in mice to certain extent.

Objective To observe the efficacy ofvitrectomy combined with internal limiting membrane (ILM) peeling and scleral shortening for myopic foveoschisis (MF).Methods Prospective and non-randomized concurrent control study.A total of 35 MF patients (35 eyes) were enrolled in this study.The patients were divided into 2 groups according to surgery,including group A (18 eyes) and group B (17 eyes),all received vitrectomy combined with ILM peeling,but group A also received scleral shortening.The best corrective visual acuity (BCVA) examination using the Snellen vision chart was converted to the minimum resolution logarithm (logMAR).Ocular axis length (AL) was measured by Zeiss IOL-Master or A-scan ultrasound (Quantel Medical,France).The maximal value of retinal foveoschisis (MxFT) was measured by frequency-domain optical coherence tomography (Heidelberg,Germany).Multifocal electroretinogram (mfERG) responses were obtained with the RETIscan system (Roland Consult,Gemany).There was no statistically significant difference between the two groups (P＞0.05) in age (t=0.460),AL (t=1.520),diopter (t=0.020),logMAR BCVA (t=-2.280),MxFT (Z=-4.179) and b-wave ERG amplitude (Z=-0.198).The changes of BCVA,AL,MxFT and b wave amplitude were followed-up for 3-12 months.Results At the last follow-up,the height of MF was decreased in 18 eyes of group A,and MF was completely disappeared in 4 eyes.The logMAR BCVA (t=7.272,5.951),MxFT (Z=-3.724,-3.622) and b-wave ERG amplitude (Z=-3.223,-3.243) in both groups A and B were statistically improved (P=0.000,0.000,0.000,0.000,0.001,0.001) compared to pre-operational results.There was significant difference of logMAR BCVA (t=-2.280) and MxFT (Z=-4.179) between the two groups (P=0.029,0.000).But there was no significant difference in the amplitude of b-wave (Z=-0.198,P=0.843).The AL in group A was shortened after surgery,the difference was statistically significant (t=10.017,P=0.000).During the follow-up,there was no ocular hemorrhage,endophthalmitis and other complications.Conclusion PPV combined with ILM peeling and scleral shortening can shorten AL significantly for MF patients,and gain relative normal anatomical structure of the fovea,thus improve the vision.

Objective:To evaluate the role of nuclear factor E2-related factor 2 (Nrf2)/heme oxidase-1 (HO-1) in reduction of renal ischemia-reperfusion (I/R) injury by the human umbilical cord mesenchymal stem cells (hucMSCs)-derived exosomes (hucMSCs-exo) in mice.Methods:The hucMSCs were cultured, and exosomes were extracted and identified by transmission electron microscopy, nanoparticle tracking analysis and Western blot. Thirty-six male SPF-grade C57BL/6 mice, weighing 20-25 g, were used. Thirty mice were selected and divided into 5 groups ( n=6 each) by a random number table method: sham operation group (Sham group), sham operation + Nrf2 inhibitor ML385 group (Sham + ML385 group), renal I/R group (I/R group), renal I/R + exosome group (I/R+ EXO group), and renal I/R + exosome + Nrf2 inhibitor ML385 group (I/R+ EXO+ ML385 group). A model of renal I/R injury was prepared by clamping the bilateral renal pedicles for 45 min followed by perfusion in anesthetized animals. ML385 30 mg/kg was intraperitoneally injected at 45 min before preparing the model in Sham+ ML385 group and I/R+ EXO+ ML385 group, and hucMSCs-exo 100 μg was injected via the tail vein at 15 min before reperfusion in I/R+ EXO group and I/R+ EXO+ ML385 group. Serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations were detected at 24 h of reperfusion. The renal tissues were obtained for examination of the pathological changes and for determination of contents of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and malondialdehyde (MDA), superoxide dismutase (SOD) activity and reactive oxygen species (ROS) levels and expression of Nrf2 and HO-1 protein and mRNA (by Western blot and quantitative real-time polymerase chain reaction). The left 6 mice were allocated to sham operation group (Sham-IM group, n=3) and renal I/R group (I/R-IM group, n=3) by a random number table method for VISQUE in living imaging observation. Results:The exosomes showed a typical cup-shaped morphology with a transmission electron microscope, the nanoparticles tracked and analyzed the average diameter of the exosome, with an average diameter of 96.7 nm, and the positive expression of surface markers CD9, CD63 and TSG101 was detected using Western blot. The renal fluorescence intensity value was significantly increased in I/R-IM group as compared with Sham-IM group ( P<0.05). Compared with Sham group, the serum BUN and Cr concentrations were significantly increased, the contents of IL-6, TNF-α and MDA and ROS levels were increased, the activity of SOD was decreased, the expression of Nrf2 and HO-1 protein and mRNA was down-regulated ( P<0.05), and the pathological changes of renal tissues were aggravated in I/R group, and no significant change was found in serum BUN and Cr concentrations in Sham+ ML385 group ( P>0.05). Compared with I/R group, the serum BUN and Cr concentrations were significantly decreased, the contents of IL-6, TNF-α and MDA and ROS levels were decreased, the activity of SOD was increased, the expression of Nrf2 and HO-1 protein and mRNA was up-regulated ( P<0.05), and the pathological changes of renal tissues were significantly attenuated in I/R+ EXO group. Compared with I/R+ EXO group, the serum BUN and Cr concentrations were significantly increased, the contents of IL-6, TNF-α and MDA and ROS levels were increased, the activity of SOD was decreased, the expression of Nrf2 and HO-1 protein and mRNA was down-regulated ( P<0.05), and the pathological changes of renal tissues were aggravated in I/R+ EXO+ ML385 group. Conclusions:The mechanism by which hucMSCs-exo reduces renal I/R injury may be related to activation of the Nrf2/HO-1 signaling pathway in mice.

Objective In order to understand the chondrogenesis differentiation of mesenchymal stem cells in either hydrogel or pellet culture,we applied the two methods and reveal the possible mechanism and for further investigation.Methods In C3H10T1/2 chondrogenic differentiation,we apply extracellular matrix hydrogel mixed the cell suspensions of freshly prepared (including scaling chondroitin sulfate,sodium hyaluronate synthesis and cross-linking agent) co-culture system and high cell density pellet formed by centrifugation.Chondrogenic differentiation of C3H10T1/2 was induced by treatment with TGF-β3 (10 ng/ml),dexamethasone (100 nmol/L),ascorbic acid (50 ug/ml),1 ∶ 100 dilution ITS+Premix and high glucose-DMEM medium with 0.2 volume fraction fetal bovine serum.And high glucose-DMEM medium with 0.2 volume fraction fetal bovine serum is for control group.Histochemistry staining was utilized to identify extracellular proteoglycan and real-time PCR was performed to assess gene expression of SOX9,collagen Ⅱa1/Ⅹa1 and aggrecan for the 1st,2nd and 3rd week respectively.Results In the hydrogel model for 3 weeks chondrogenic differentiation,the expression of master transcription factor SOX9 was upregulated in both culture models.While the marker genes of collagen Ⅱa1 and collagen Ⅹa1 were all promoted in hydrogel culture,the aggrecan gene expression was peaked in pellet culture.In addition,immunocytochemistry analysis of the hydrogel and pellet for 3 week illustrated the expression of extracellular matrix and more obviously in the hydrogel model.Conclusion In compared with pellet culture,the MSCs in the hydrogel were more likely promoted chondrogenesis leading to the eventual expression of marker genes.And the hydrogel would be applied in regeneration of cartilage injury.