Objective To explore the application of transitional care based on the Omaha system in postoperative rehabilitation of patients with breast cancer.Methods Seventy-two patients after radical mastectomy were assigned into two groups according to admission time,patients from June to December 2011 were set as the control group,patients from February to December 2012 were assigned to the intervention group,each group contained 36 patients.The patients in the control group received routine nursing,while patients in the intervention group were implemented transitional care program with Omaha system as framework from before discharge to 6-week follow-up after discharge from hospital.Nursing effect was compared between two groups from three aspects such as cognition,behavior and status.Results Twenty-three problems were found in the 6-week follow-up for the intervention group,including environmental domain,psychosocial domain,physiological domain and health-related behavior domain.Knowledge,behavior and status scores of the intervention group 6 weeks after discharge were significantly higher than those of the control group [(3.92 ± 0.48) scores vs.(2.41 ± 0.17) scores,(4.11 ± 0.49) scores vs.(2.83 ± 0.25) scores,(3.09 ±0.52) scores vs.(2.32 ±0.39) scores,t=14.81,15.36,9.42,P＜0.01 or 0.05].Conclusions Transitional care based on the Omaha system shows common problems in rehabilitation of patients with breast cancer after operation,and provides standardized program for rehabilitation nursing.It can achieve better nursing effect.

ObjectiveTo explore the role of autofluorescence bronchoscopy in lung cancer operation and the meaning of choice lung cancer operation mode.MethodsTo retrospectively analyze 32 non-small cell lung cancer patients.Before lung cancer operation,white light bronchoscopy (WLB) and autofluorescence bronchoscopy (AFB) had been done routinely.Compared the different invasive tumor conditions by WLB and AFB,operation modes were decided by the edge of the tumor which were proved by biopsy pathology.ResultsIn 32 cases,19 cases underwent pulmonary lobectomy.One case underwent carinal resection and reconstruction.8 cases underwent sleeve lobectomy.4 cases underwent other therapy because of tumor airway metastasis.In 8 cases which underwent sleeve lobectomy,3 ca ses were found by WLB and AFB together,5 cases were found only by AFB.In 4 cases who had no operation chance,2 cases were found by WLB and AFB together,2 cases were only by AFB.The sensitivity for the detection of bronchial premalignant lesions was extremelyhigher withthe addition of AFB than WLBalone ( P ＜ 0.05 ).ConclusionAutofluorescence bronchoscopy is a safe and efficient technique which could improve the sensitivity of diagnosis in lung cancer than WLB.It is important to select operation mode.

Objective To study the relationships between hepatocellular carcinoma (HCC) and the polymorphisms,promoter methylation,and expression of glutathione S-transferases P1 gene (GST) P1 gene.Methods Using methylation-special PCR (MSP),the methylated status of CpG islands of GSTP1 gene in tumor tissues of 53 HCC and its adjacent nontumor tissues were studied.The enzyme activities of GSTP1 were evaluated by ultraviolet colormetry.And using PCR-RFLP,the genetic polymorphisms of the GSTP1 genes of 74 healthy controls and 53 HCC patients were studied.Results The diffe-rences of the frequency of GSTP1 Ile/Ile,Ile/Val and Val/Val genotypes between HCC patients and the normal controls did not reach statistical significance (X~2=0.84,v=2,P=0.656).The frequency of methyla- tion of CpG islands of GSTP1 gene was significantly higher among the HCC tumor tissues when com- pared to the corresponding nontumor tissues (X~2=19.08,P＜0.001),and significantly higher in stageⅢ-Ⅳcases when compared to the stageⅠ-Ⅱcases (X~2=4.84,P=0.028).GSTP1 enzyme activities of cytoplasm in tumor cells were lower significantly than that in the adjacent nontumor tissues (t=2.49, P=0.014),and significantly higher in stageⅠ-Ⅱcases when compared to the stageⅢ-Ⅳcases (t= 2.31,P=0.025).On the other hand,the GSTP1 enzyme activities of cytoplasm in tumor cells with methylated status of GSTP1 gene were significantly lower than that in tumor cells with unmethylation (t=3.50,P=0.001).Conclusion GSTP1 inactivation via CpG island hypermethylation may contrib- ute to the pathogenesis of HCC.

Biomedical Research ; trends ; Humans ; Medicine, Chinese Traditional

Objective To investigate the association between the functional polymorphisms of Foxp3 gene and unexplained recurrent spontaneous abortion (URSA).Methods PCR-restriction fragment length polymorphism (rs3761548,rs2294021 ) and PCR with sequence-specific primers (rs2232365,rs5902434) were used to detect four polymorphisms of Foxp3 in 146 URSA cases and 112 normal controls.Results ( 1 ) The frequencies of rs3761548A/C were 10.3％,22.3％ in genotype C/C,38.4％,40.2％ in genotype A/C and 51.4％,37.5％ in genotype A/A between URSA patients and normal controls; the frequencies of rs2232365A/G were 5.5％,15.2％ in genotype A/A,47.9％,50.0％ in genotype A/G,46.6％,34.8％ in genotype G/G between URSA patients and normal controls; they all reached statistical difference ( P＜0.05 ).The carriers of rs3761548A allele and rs2232365G allele increased the risk of URSA (OR=1.73,1.61 ; all P ＜ 0.05 ).(2) There was no difference in the genotypic distribution of rs5902434del/ArTTpolymorphism between cases and controls ( P =0.10),but the frequency of del allele in URSA was statistically increased than that of controls (71.2％,62.5％ ; OR =1.49,P =0.04 ).(3) There was no different distribution in 3 genotypes (C/C,T/C,T/T) and 2 alleles (T and C) of rs2294021T/C between URSA patients and normal controls (P =0.18 and 0.08 ).(4) Estimated haplotype frequency distribution of rs5902434del/ATT,rs3761548A/C and rs22323565A/G showed haplotype del-A-G conferring the susceptibility to URSA ( OR =2.51,P ＜ 0.01 ) but haplotype del-C-G and ATT-A-A could provide protection on URSA ( OR =0.18,0.22 ; all P ＜ 0.01 ).Conclusion Functional polymorphisms of Foxp3 gene could probably confer the susceptibility to URSA,by altering Foxp3 function and (or) its expression.

Objective To evaluate the association between interleukin-I(IL-1)loci polymorphisms and increased risk of gastric carcinoma in samples from northern Chinese population.Methods Blood sam- ples from 126 patients with gastric cancer and 125 controls with chronic gastritis were collected.Genomic DNA was extracted and polymorphisms at -31(C to T),-511(C to T)and at intron 2(86-bp VNTR)of IL-I RN were genotyped by PCR-CTPP,PCR-RFLP and PCR.For detection of Hp infection fast urenase test,~(14)C breath test and serum anti-Hp IgG antibody assay were used.Results Five kinds of polymorphism of IL-IRN were found as 1/1,1/3,1/4,1/2 and 2/2,and the frequencies in patients were 76.19%、4.76%、6.35%、11.90% and 0.79%,respectively.However,the frequencies in controls were 76.00%、4.00%、4.80%、13.60% and 1.60%.No significant differences were observed between cases and controls in each genotype.The polymorphism of IL-IB-31 allele was C/C,C/T and T/T.The frequencies in patients were 12.70% ,47.62% and 39.68%,and in controls 28.00%,48.80% and 23.20% respectively.IL-1B- 31 T/T carriers were at an increase risk of gastric cancer with an odds ratio of 3.772(95% CI,1.786- 7.966).IL-IB-511 alleles were C/C,C/T and T/T.The frequencies in patients were 19.20%,56.80% and 24.00% and in controls,23.38%,49.19% and 27.42% respectively.No significant differences were observed between cases and controls in each genotype.Conclusion In Chinese population,the polymor- phism of IL-1B-31 alleles may be associated with the susceptibility of gastric cancer.However,no evidence was found to support that the polymorphisms of IL-1RN and IL-I B-511 alleles had relationship with gastric cancer.

OBJECTIVETo study the clinical effect of the Gartland III humerus supracondylar fractures in children by manipulative reduction and Kirschner wire percataneous internal fixation.

METHODSFrom July 2010 and July 2013, 60 patients with Gartland III humerus supracondylar fracture were selected and divided into treatment group and control group. In the treatment group 32 patients were treated with traditional bone setting tetradeca-manipulative reduction and percataneous Kirschner wire internal fixation,included 18 males and 14 females with an average age of (7.8 +/- 2.7) years old ranging from 5 to 11; in the control group 28 patients were treated with open reduction and Kirschner wire internal fixation,included 16 males and 12 females with an average age of (7.2 +/- 3.0) years old ranging from 4 to 12. The motion range of the elbow joint,the time of fracture clinical healing, and the effect after 6 months of Flynm clinical functional assessment standards were observed and compared.

RESULTSThe average fracture healing time of the control group (5.01 +/- 0.43) weeks was longer than that of the treatment group (4.29 +/- 0.29) weeks (t = 7.49, P = 0.00). At 6 months after treatment,the elbow motion range of the treatment group (146.02 +/- 2.28) was more than that of the control group (140.76 +/- 4.42) (t = -5.67, P = 0.00). At 6 months after treatment, according to Flynn evaluation, in the control group,there were 7 cases as excellent, 16 as good, 4 fair, 1 poor; in the treatment group, excellent in 21, good in 9, fair in 2 (U = 3.09, P = 0.002).

CONCLUSIONManipulative reduction and Kirschner wire percataneous internal fixation for treatment of children's Gartland III humerus condyle fractures can shorten fracture clinical healing time and the clinical curative effect is better.

Bone Wires ; Case-Control Studies ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Humeral Fractures ; physiopathology ; therapy ; Male ; Manipulation, Orthopedic ; methods

OBJECTIVETo investigate the way of diagnosis and therapy of parosteal osteosarcoma.

METHODSA retrospective review was conducted of 48 patients treated at our department between June 1964 and December 2001. The average age of patients in this study was 29.2 years (13 - 47 years). Thirty-two of the patients were female; sixteen were male. The single most common site is the posterior aspect of the distal femur (in 36 patients), followed by the femur shaft (in 6 patients), the proximal tibia (in 2 patients), etc. Nine patients had been operated on before referral to our department.

RESULTSThe average follow-up period from the first operation was 5.2 (0.25 - 24) years. In 36 of the 39 patients in whom a limb-salvage procedure was performed, a segment of the tumor-bearing bone was excised along with the tumor, whereas in 3 patients only the subadjacent cortex was excised with the tumor. In the limb-sparing group, the reconstruction was achieved by means of attenuated tumor bone or allograft in 23 cases, by endoprosthetic replacement in 9 cases, and by allograft replacement in 4 cases. The local resections were wide in 35 cases, and marginal in 13 cases. After marginal surgery, local recurrence occurred in 5/13 patients, whereas it occurred in 3/35 patients treated with wide resection. Pulmonary metastases developed in 6 patients, four patients died, and 2 patients are alive with disease. There were 4 cases of fractures of bone grafts. Four patients developed an infection. Long-term survival rate is 85.8%. For tumors that invaded the medullary canal there was no statistical association with local recurrence or metastasis. There is statistical significance between surgical margin and local recurrence.

CONCLUSIONSWide surgical excision alone is adequate treatment for patients with conventional parosteal osteosarcoma. A tumor-free margin remains the critical factor determining overall prognosis. When a marginal excision was knowingly done to preserve a major neurovascular bundle, the risk of recurrence was less than when it was done to shell-out a presumptively benign lesion. Repeated recurrence probably increases the risk of dedifferentiation and thereby worsens the prognosis. Recurrent lesions with multiple soft-tissue satellite nodules or involvement of the neurovascular structures may however require amputation to provide sufficient local control when a wide margin cannot be achieved. An individualized resection will be performed in the future probably under the help of the advanced technique of image to distinguish the reactive zone from the normal tissue precisely.

Adolescent ; Adult ; Bone Neoplasms ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Osteosarcoma, Juxtacortical ; diagnostic imaging ; surgery ; Prognosis ; Radiography

Metabolic engineering provide powerful tools for the systematic manipulation of cellular metabolic activities. The ptsG gene for glucose-specific transporter Enzyme II CBGlc of the phosphotransferase system was knock-out so as to reduce the accumulation of acetic acid in the high cell-density culture of Escherichia coli on excess glucose. The chloramphenicol-resistant cassette with short shared sequences on both ends generated by PCR was electroporated into Escherichia coli DH5alpha and JM109. Recombination between linear DNA cassettes and Escherichia coli chromosomes took place by Red recombinase functions. Therefore, the ptsG gene was disrupted to construct the mutants called DH5alphaP and JM109P. There was no difference between the mutants and parent strains in LB media.However, in LB media supplemented with glucose, the mutants of Escherichia coli deficient in ptsG showed greater biomass, together with exploiting more glucose. The maximal cell density obtained with DH5alphaP was approximately 3 times more than that of DH5alpha, then the result of JM109P increased fourfold. The products of recombinant protein TNF respectively accounted for 24.3% of total cellular protein in DH5alphaP with A600 8.28 and 20.8% of total cellular protein in JM109P with A600 7.62. The specific volume expression amount of TNF was greater in the ptsG mutant than in its parent strain. These results demonstrate that the ptsG-mutant strains will be available for high cell-density culture.
Culture Media ; Escherichia coli ; genetics ; growth & development ; Fermentation ; Mutation ; Phosphoenolpyruvate Sugar Phosphotransferase System ; genetics ; Polymerase Chain Reaction ; Recombinant Proteins ; biosynthesis ; Tumor Necrosis Factor-alpha ; biosynthesis

Objective：To explore the effect of group psychological service on mental health of the children left behind in rural areas.Methods：Totally 222 children left behind in rural areas were selected randomly and divided into intervention group and control group.The intervention group accepted 8 times of group psychological service.The Eysenck Personality Questionnaire(EPQ),Center for Epidemiological Studies of Depression scale for Children(CES-DC),Rutter Children's Behavior questionnaire for completion by teacher,Piers-Harris Children `s Self-concept Scale(PHCSS)were used in both groups to evaluate the effect at baseline,the end of the 7th intervention,and 6 months after the end of the intervention.Results：After intervention,the intervention group got lower scores than control group in EPQ-N [(8.2±5.8)vs.(10.2±6.1),P<0.05]in the first retest,and in CES-DC [(15.9±7.3)vs.(18.8±7.7),P<0.05]in the second retest.The group gained higher scores in anxietyand happy and satisfaction factors of PHCSS [(6.6±3.4)vs.(5.6±2.7),(6.5±1.9)vs.(5.7±1.8);Ps<0.05]. Conclusion：Group psychological service are effective to children left behind in rural areas with depression emotion and had a role in children's personality remodeling.