Objective To investigate the effect of persistent concept based on strong concept on long-term hope of patients with breast cancer undergoing extended-concept nursing.Methods Two hundred and sixty-six patients with breast cancer were randomly divided into control group (n=62) and observation group (n=64) according to the discharge order.The routine health education and instruction were carried out plus strong concept of nursing intervention for three times during hospitalization.About 2 months after discharge the observation group was treated with the strong concept of nursing intervention (1 month,4 times) and the control group without strong concept of nursing intervention.The two groups were assessed with Hirth hope index (HHI) at discharge and six months after discharge.Results There was no significant difference in hope level between the two groups (P ＞ 0.05)at discharge.Six months after discharge,the scores of hope in the observation group were significantly higher than those in the control group (P ＜ 0.05) and with out statistical sigficance when comaparing to who at discharge(P ＞ 0.05).The HHI score of the control group 6 moths after discharge was significantly lower than that of the control group at discharge (P ＜ 0.05).Conclusion The strong concept nursing intervention during hospitalization can effectively improve the hope level of patients with breast cancer surgery.

Reliable data support, information technology and its products are needed to achieve the target of big data-based precision medicine.The mature clinical decision supporting products , such as seamless information product and nursing decision supporting products (my cancer genome and Watson) and studies on their related evi-dence in foreign countries were thus described in this paper with suggestions put forward for scientific achievements in genomes and in docking and integrating clinical electronic medical records, such as training learned bioinformatics professionals, sharing medical data, working out need-guided research strategies, constructing basic bioinformatics framework and cancer knowledge network.

After the characteristics and significance of domestic and foreign open access publication were analyzed, the open access publication environments in domestic and foreign academic journals were compared in aspects of open access policy, scientific research management evaluation system and awareness of open access publication in persons engaged in scientific research, journal management system and journal management model, open access publication journals and open access publication papers in order to know the advantages of open access publication and the difficulties it is faced.Certain suggestions were proposed for its future development.

Objective To evaluate the effect of isoflurane anesthesia on noise-induced hearing loss in guinea pigs.Methods Forty-eight healthy adult male guinea pigs,aged 3 months,weighing 400-500 g,were randomly divided into 4 groups (n =12 each) using a random number table:control group (C group),isoflurane group (I group),noise-induced hearing loss group (N group),and isoflurane + noise-induced hearing loss group (I + N group).Isoflurane was inhaled for 140 min at a concentration of 1％ in I and I + N groups.N and I + N groups were exposed to the noise of 4 kHz center frequency and 118-122 dB sound pressure level for 120 min starting from 20 min after administration.Mean arterial pressure (MAP) was recorded at 10,40,70,100 and 120 min of exposure to noise and cochlear blood flow (CoBF) was recorded before administration and at 10,40,70,100 and 120 min of exposure to noise.Auditory brainstem response (ABR) threshold was recorded before administration and at 1 h,72 h,and 10 days after the end of exposure to noise.Arterial blood samples were obtained and the plasma noradrenaline (NE) concentration was detected by HPLC before exposure to noise and immediately after the end of exposure to noise.Results Compared with group C,MAP and the change rate of CoBF were significantly decreased,and the plasma NE concentration was increased immediately after the end of exposure to noise in I group,and MAP was increased,the change rate of CoBF was decreased,and the plasma NE concentration immediately after the end of exposure,and ABR threshold after the end of exposure were increased in N and I + N groups.Compared with N group,MAP was significantly decreased,the change rate of CoBF was increased,the plasma NE concentration immediately after the end of exposure,and ABR threshold at 1 and 72 h after the end of exposure were increased,and no significant was found in ABR threshold at 10 days after the end of exposure in I + N group.Conclusion Isoflurane anesthesia exerts temporary but not permanent protective effects against noise-induced hearing loss in guinea pigs and partial inhibition of activation of sympathetic nerve and increased CoBF may be involved in the mechanism.

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Objective Self-management was adopted to intervene patients with breast cancer during chemotherapy in order to know about its effects on breast cancer patients′medical compliance behavior. Methods Samples were 154 breast cancer patients undergoing chemotherapy after surgery in breast surgery of the first affiliated hospital of Zhengzhou university. They accepted the docetaxel and cyclophosphamide (TC) program of chemotherapy. Patients were divided into two groups by random number table, one group as control group(80 patients) and the other group as experimental group (74 patients). Different nursing care were conducted during the two groups, the control group patients given routine nursing care, the experimental group patients given routine nursing care and self-management. The medical behavior compliance and upper extremities edema incidence for the two groups of patient were surveyed after the intervention and then evaluate the effect of the intervention. SPSS (version 17.0) was used to carry out statistical analysis. Results The total score of medical compliance behavior, the experimental group was (18.36±1.30) points, the control group was (16.70±1.57) points, the experimental group was higher than the control group, and there was statistically significant difference between two groups(t=7.093, P<0.05).The experimental group scores were higher than the control group in the functional exercise compliance (4.33±0.77 vs. 3.55±0.90), prevent or reduce the edema compliance (4.41± 0.61 vs. 3.84±0.88), PICC or venous access port of regular maintenance compliance (4.62±0.52 vs. 4.33± 0.57)(t=5.704,4.594,3.268,P<0.05);There were statistically significant differences between two groups (t=5.704,4.594,3.268,P < 0.05). There was no statistically significant difference between two groups (P >0.05) in scores of chemotherapy compliance on time.The influence of self-management on the incidence of upper extremities edema was as follow: The upper extremities edema incidence in control patients was 23.68% (18/76) which was higher than 11.11% (8/72) in the experimental group (χ2=4.036, P < 0.05). Conclusions Given self- management intervention for breast cancer patients with postoperative chemotherapy, the medical behavior compliance was increased, and the incidence of upper extremities edema was decreased.

OBJECTIVE: To investigate the value of each single and combined applications of ultrasound thyroid imaging reporting and data system (TI-RADS), ultrasonic shear wave elastography in the diagnosis of thyroid microcarcinoma (TMC). METHOD: 323 patients with thyroid tiny nodules confirmed by surgery and pathology were analyzed prospectively. Then their TI-RADS and shear wave elastography features were summarized. SWE elasticity indices (mean, minimum and maximum value of interest) of nodules were measured. The surgical pathology results were regarded as the gold standard to calculate the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TI-RADS, shear wave elastography and their combination in the diagnosis of TMC. The receiver operating characteristic (ROC) curve of TI-RADS, shear wave elastography and combined application of both were drawn. The area under the ROC curve were calculated. Furthermore, the value of combined application of both examinations in the diagnosis of thyroid microcarcinoma (TMC) was investigated. RESULT: From 323 nodules,253 were thyroid carcinomas and 70 were benign. Areas under the ROC curves (AUC) of SWE parameters were 0. 648,0. 629 and 0. 605. For SWE, the optimal cut-off value according to ROC curve was SWE_max = 65.50 kPa and SWE_mean = 37.50 kPa. Generally, the sensitivity, specificity, accuracy, PPV and NPV were 88.14%, 82.86%, 87.00%, 94.89% and 65.91% for TI-RADS, and 49.01%, 74.29%, 54.49%, 87.32% and 28. 73% for SWE. There were statistically significant differences in the sensitivity, accuracy, PPV and no statistically significant differences in the specificity, and NPV. The sensitivity,specificity, accuracy, PPV and NPV were 95.26%, 67.14%, 89.16%, 91.29% and 79.66% for combined application of both. The area under the ROC curve of TI-RADS, shear wave elastography and their combination were 0.763, 0.616, 0.804. For nodules ≤ 5 mm, the sensitivity, specificity, accuracy, PPV and NPV were 91.67%, 66.67%, 87.07%, 92.44% and 64.29%. However, for nodules 5-10 mm,the sensitivity,specificity, accuracy, PPV and NPV were 98.50%, 67.44%, 90.91%, 90.34% and 93.55%. CONCLUSION The diagnose of TMC can be further improved by combined application of ultra-sonic TI-RADS and SWE.
Carcinoma ; complications ; Elasticity Imaging Techniques ; Humans ; Predictive Value of Tests ; Sensitivity and Specificity ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; diagnosis

Objective To study the inhibitory effect of fluorouracil combined with DDP on the growth of human osteosarcoma cell line MG-63,and to explore its influence on the expressions of transient receptor potential vanilloid 5 (TRPV5 )and transient receptor potential vanilloid 6 (TRPV6 )proteins.Methods The MG-63 cells were cultured by the density of 5 × 104 mL-1 .Fluorouracil group,DDP group,fluorouracil+ DDP group and control group containing 10% FBS were set up.The inhibitory rates of growth of MG-63 cells at different time were detected by CCK-8 assay.The apoptosis of MG-63 cells after treated with different drugs was determined by Hoechst staining Kit.The immunocytochemical staining was used to treatent to detect the expressions of TRPV5 and TRPV6 before and after treatment.Results Fluorouracil and DDP both inhibited the growth of MG-63 cells in a time-and dose- dependent manner.There were a lot of black particles in the MG-63 cells and the cells were smaller,aging or death when they were exposed to fluorouracil or DDP.Compared with 24 h group,the inhibitory rates of proliferation of MG-63 cells after treated with the sigle drug of fluorouracil or DDP for 48 and 72 h were increased significantly (P <0.05).Compared with control group,the apoptotic rates of MG-63 cells in fluorouracil group and DDP group 24,48,and 72 h after treatment were increased (P < 0.01)in a time-dependent manner. The expression levels of TRPV5 and TRPV6 in MG-63 cells 72 h after treatment of fluorouracil and DDP were decreased significantly compared with before treatment (P < 0.05 ). Conclusion Fluorouracil, DDP and fluorouracil combined with DDP could significantly inhibit the proliferation of MG-63 cells,induce the apoptosis, and decrease the expression levels of TRPV5 and TRPV6.

Objective To investigate the relationship between early progression in elderly patients with minor stroke and abnormal circadian rhythm of blood pressure.Methods From June 2013 to December 2016,180 patients with mild stroke (age >65 years,the National Institutes of Health Stroke Scale Score ≤3) at the Department of Neurology,Beijing Zhongguancun Hospital were recruited retrospectively.They were divided into either a progress group (n=48;the National Institute of Health Stroke Scale score increased≥2) or a non-progress group (n=132) according to whether they developed an early neurological deterioration (within 5 days after onset).The baseline data,risk factors for cerebrovascular disease (hypertension,diabetes mellitus,stroke,chronic smoking,alcohol consumption,hyperlipidemia,and homocysteine) in patients of both groups were compared.The normal (dipper-type blood pressure)/abnormal circadian rhythm of blood pressure (non-dipper-type blood pressure,super dipper-type blood pressure,and inverse dipper-type blood pressure) were monitored by ambulatory blood pressure monitoring.The guilty arteries were divided into severe stenosis or occlusion,non-severe stenosis or without stenosis.Multivariate logistic regression analysis and multi-class dummy variable analysis were further performed.Results The proportions of past diabetes history,stroke history,abnormal circadian rhythm of blood pressure,severe stenosis and occlusion of guilty artery in the patients of the progress group were higher than those of the non-progress group (70.8% [n=34] vs.49.2% [n=65],64.6% [n=31] vs.47.7% [n=63],89.6% [n=43] vs.26.5% [n=35],and 77.1% [n=37] vs.39.4% [n=52] respectively).The differences were statistically significant (all P<0.05).The factors of having statistical differences were substituted into multivariate logistic regression analysis,which showed that abnormal circadian rhythm of blood pressure (OR,7.072,95%CI 3.004-16.431;P<0.01) and severe stenosis or occlusion of guilty arteries (OR,6.217,95%CI 2.034-14.212,P=0.003) were the independent risk factors for early progression of minor stroke in the elderly.The dummy variable analysis of abnormal circadian rhythm of blood pressure showed that the super dipper-type blood pressure (OR,13.429,95%CI 4.175-111.668;P<0.01) in abnormal circadian rhythm of blood pressure was an independent risk factor for early progression of minor stroke in the elderly.Conclusion The abnormal circadian rhythm of blood pressure,especially super dipper-type blood pressure,may be the independent risk factor for early progression of minor stroke in the elderly,which needs to pay close attention to early intervention.

Objective:To evaluate the mortality and risk factors for acute kidney injury (AKI) in hospitalized patients by the risk, injury, failure, loss, end stage kidney disease (RIFLE) and acute kidney injury network (AKIN).
Methods:We constructed a retrospective study of all AKI patients in the Second Xiangya Hospital of Central South University between February 2006 and January 2011. The diagnosis and classiifcation of AKI were reconifrmed and categorized by RIFLE and AKIN criteria. To compare the clinical characteristics, mortality and associated risk factors in AKI patients by the RIFLE and AKIN stage, univariate analysis and multivariate logistic regression analysis were performed. Results:The patients were diagnosed as AKI by AKIN (n=1027) or by RIFLE criteria (n=1020). There was no signiifcant difference in the hospital mortality, hospital length stay (days), or the proportion of complete recovery in each stage of AKI patients by RIFLE and AKIN (P>0.05). In the univariate analysis, age, pre-renal causes, proportion of hospital acquired AKI, mechanical ventilation, hypotension, the number of failed organs, acute tubular necrosis-index severity score (ATN-ISS), and the peak of serum potassium ion concentration were signiifcantly higher in the non-survivors than in the survivors (P<0.05). Logistic regression analysis revealed that age older than 65, hospital acquired AKI, hypotension, number of failed organs, ATN-ISS scores, and the peak of serum potassium ion concentration were independent risk factors for hospital mortality. Conclusion:Both RIFLE and AKIN criteria have similar scientiifc value in assessing hospital mortality. AKI stage is associated with the recent prognosis of AKI patients.