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

Objective To observe the clinical effect of Sangpa Zhike decoction in the treatment of acute exacerbations of chronic bronchitis. Methods 180 patients with acute exacerbation of chronic bronchitis admitted to Autonomous Prefecture Hospital of traditional Chinese medicine(TCM)in Changji,Xinjiang,from August 2012 to August 2013 were enrolled. They were divided into Sangpa Zhike decoction treatment group and western medicine treatment control group by random number table,90 cases in each group. General treatments were given to the two groups. In the Sangpa Zhike decoction treatment group,additionally only oral Sangpa Zhike decoction was given(composition:Morus alba 10 g,loquat leaf 10 g,Houttuynia 10 g,honey aster 15 g,honey coltsfoot flower 6 g,Zhejiang Fritillaria 12 g,perilla 10 g,white mustard seed 6 g,Platycodon grandiflorum 10 g,Rhizoma Cynanchi Stauntonii 12 g,tangerine peel 6 g,Stemona 6 g). The ingredients were mixed in water and boiled to form a decoction,one dose daily,divided into two parts to be taken twice a day. In the western medicine treatment group,the infection was controlled by western medicine and the drugs to eliminate cough and phlegm,etc were used. The therapeutic course in both groups was 7 days. The therapeutic effect for treatment of TCM syndromes and the cough quantized integration score in the two groups were observed after treatment. Results The cure rate of Sangpa Zhike decoction treatment group was significantly higher than that of western medicine treatment control group〔70.00%(63/90)vs. 33.33%(30/90),P<0.01〕. Before treatment,the cough symptom quantization integral scores in the two groups had no statistically significance, but after treatment,the scores in the two groups were significantly lower than those before treatment. And the score in Sangpa Zhike decoction treatment group was decreased more significantly (1.66±1.12 vs. 4.36±2.32, P<0.01). Conclusion Sangpa Zhike Decoction has obvious curative effect in the treatment of acute attack of chronic bronchitis.

Objective To investigate the diagnostic value of transbronchial needle aspiration (TBNA) and transbronchial biopsy(TBB) in central lung cancer.Methods Retrospectively analyzed the diagnostic data of 150 patients with central lung cancer who underwent TBNA followed by TBB in our hospital from January 2011 to October 2012.Results Among 150 patients with central lung cancer,33 cases had intracavity mass.Thirtythree cases (100％) were confirmed by TBB and 32 cases (97.0％) confirmed by TBNA.There was no statistically significant difference between the diagnosis of TBB and TBNA(P =0.90).There were 26 cases with simple stenosis,among which 1 case(3.9％) confirmed by TBB and 26 cases(100％) confirmed by TBNA.And there was statistically significant difference was observed between the diagnosis by TBB and TBNA (P =0.01) Sixteen cases belonged to the lumen external pressure type with 2 cases(12.5％) were confirmed by TBB and 16 cases(100％) confirmed by TBNA.And there was statistically significant difference was observed between the diagnosis by TBB and TBNA (P =0.02).Forty-seven cases had luminal stenosis combined with mucosal diffuse lesions with 25 cases(53.2％) confirmed by TBB and 40 cases(85.1％) confirmed by TBNA.And there was statistical difference was observed between the diagnosis of TBB and TBNA(P =0.04).Twenty-eight cases had mixed type central lung cancer with 27 cases(96.4％) confirmed by TBB and 28 cases(100％) confirmed by TBNA.No statistically significant difference was observed between the diagnosis of TBB and TBNA (P =0.87).Conclusion According to endoscopic performance of central lung cancer,accurate and reasonable choice of biopsy method can minimize inspection costs on the basis of maintaining positive rate of diagnosis in order to achieve optimal titer.

Objective To describe the MRI features and pathologic findings of biliary cystadenocarcinoma(BCAC)and to assess the diagnostic value of MRI in those tumors.Methods Five cases of BCAC were collected.All cases were proved by pathology.Non-enhanced and multiphase-enhanced MRI were performed in all cases.MRCP were performed in two cases.The MRI features of the five cases were reviewed retrospectively and correlated with pathologic findings.Results Histological evidence demonstrated five cases of BCAC.Four cases were solitary,whereas the other case was multifocal.All cases were solid and cystic lesions.Two cases were unilocular,whereas the other three cases were multilocular. Multiple mural nodules and irregular thickening cystic walls were presented in all cases.The cystic parts of the lesions were homogeneous in signal intensity and showed no enhancement after contrast administration in the five BCAC.Septa were present in three BCAC with multilocular cyst.On MRCP the bile duct dilatation was found in two BCAC.Conclusion MRI can reveal the characteristic findings of BCAC and accurate preoperative diagnosis can be made.