Objective:To evaluate the shoulder functions of four groups of patients who underwent different kinds of neck dissections.Methods:40 patients who underwent neck dissection were included,7 patients preserved both accessory nerve and the cervical branches,8 preserved accessory nerve,11 preserved cervical branches and 14 sacrificed both of them.All patients were assessed subjectively at 2 weeks and 6 months after operation,using a questionnaire and an electromyograghy method.Results:The patients whose accessory nerves were preserved had a significant functional rehabilitation of the shoulder,while those who preserved only the cervical branches had a better result than the RND 6 months postoperation.Conclusion: Preservation of the branches from C2-C4 to trapezius muscle during the modified neck dissection should be taken into consideration to improve shoulder functions.

Objective To explore the current situations in self-management of cancer patients over peripherally inserted central catheter (PICC) and the influencing factors. Method Self-designed general demographic data form, disease-related questionnaire and PICC self-management ability for cancer patients were used to investigate 98 tumor patients with PICC. Results The total score on self-management ability of the cancer patient with PICC was (150.85 ± 17.35). The influencing factors of their self-management of PICC included education level, economic condition, presence or absence of long-term caregivers and cognitive disorders, all contributive to the prediction of 28.60%total variance for the patients′self-management capability. Conclusions Cancer patients have a better ability in managing PICC, but a few patients failed to grasp self-management skills, which was resulted from many factors. Nurses should pay more attention to those with less education, under poorer economic conditions and without long-term caregivers, and provide them with more care and education so as to comprehensively improve their self-management skills.

Objective To explore the risk factors of surgical site infection(SSI)in patients undergoing selective brain tumor resection,and provide reference for clinical prevention and treatment.Methods Patients who under-went selective brain tumor resection in the neurosurgery department of a hospital during April-September 2013 and April-September 2014 were monitored prospectively,monitoring programme and individualized questionnaire were formulated,the basic data,operation condition,postoperative symptoms/signs,laboratory test results,infection-related factors,and antimicrobial use in patients were collected,risk factors for infection were analyzed.Results A total of 205 patients were investigated,23 (11 .22%)of whom had SSI;univariate analysis showed that body mass index (BMI),NNIS score,and cerebrospinal fluid leakage were related to the occurrence of SSI(all P<0.05);lo-gistic regression analysis showed that high NNIS score and cerebrospinal fluid leakage were independent risk factors for SSI in patients undergoing selective brain tumor resection(both P<0.05).Conclusion Incidence of SSI is high-er in patients with selective brain tumor resection,corresponding preventive measures should be taken according to different risk factors including cerebrospinal fluid leakage.

Objective: To observe the effect of supplementation with anthocyanins (ANTH)purified from outlayer of black rice (BRF) on atherosclerotic (AS) plaque formation and inflammatory signal-transduction. Methods: Forth five male ApoE-defieient mice of 4 w age, were randomly divided into 3 groups: positive control (Group A), BRF (Group B ), ANTH (Group C), 15 in each group. Another 15 male ApoE-deficient mice served as negative control (Group D ). Group A and D were fed AIN-93G purified diet, Group C and B fed the same diet with 5% BRF not containing ANTH and 0.39% ANTH (containing 42% total flavonoids) respectively. The animals were fed for 20w, then blood, hearts and aortas were examined to verify inflammatory signal transduction. Results: There were no visible AS plaques in group D but much more severe in group A and B than C respectively. Compared with group A, supplememation of ANTH of BRF significantly increased the activity of T-NOS and cNOS, decreased the activity of iNOS but not significantly. The level of protein expression of ICAM- 1, NF-?B gene and mRNA expression of COX-2 gene were significantly decreased in aorta. Conclusion: The action of anthocyanins of BRF could be attributed to its anti-inflammatory activity to reduce COX-2, INOS and ICAM-1 expression which might be modulated by NF-?B.

Objective To improve the recognition of aggressive natural killer-cell leukemia(ANKL)complicating muhiple organ failure(MOF).Methods A Fare case of ANKL was reported,and the related literatures were reviewed. Results One case of ANKL was diagnosed by bone marrow morphology and immunophenotypes of CD2,CD16,CD56,who developed multiple organ failure involving in liver,kidney,heart,lung,severe metabolic acidosis,tumour lysis syndrome and disseminated intravascular coagulation(DIC)in course of the disease and chemotherapy.VP regimen and symptomatic treatment were performed,and the disease could be stable shortly but died of the failure of lung and heart soon. Conclusion ANKL has a fulminant clinical course and diffuse infihration of tumor cells resulted in multiple organ failure with poor response to treatment and unfavorable prognosis.

Objective To investigate the diagnostic value of the real-time tissue elastography (RTE)and AST/PLT ratio in-dex (APRI)for the assessment of the early stage liver fibrosis in chronic liver disease patients.Methods Totally 90 patients with chronic liver disease were enrolled in the present study.The RTE score and the area percentage of the blue color (AREA,one of the elastic characteristics),the AST and PLT were recorded.Compared the results among different stages of liver fibrosis reported by biopsy considered as the gold standard for the assessment of liver fibrosis.The accuracy of the diagnosis of liver fibrosis by RTE scores,AREA and APRI were compared.Results RTE scores,AREA and APRI increased with the stage of liver fibrosis. Taking ≥S1 as the diagnosis standard of the early stage liver fibrosis,the area under the curve of ROC for RTE scores,AREA and APRI were 0.88,0.92,0.76 (P <0.05).Conclusion RTE is a new and promising sonography-based noninvasive method for the assessment of hepatic fibrosis in patients with chronic liver disease.Combined RTE with APRI have great clinical significance in di-agnosing the early stage liver fibrosis in chronic liver disease patients.

Objective To explore the effects of one time loading of different doses of simvastatin before percutaneous coronary intervention (PCI)on post-PCI inflammation,oxidation stress and the endothelium function in (ACS) patients. Methods Totally 124 cases with ACS were randomly divided into two groups:high dose simvastatin group(40 mg,62 cases),low dose simvastatin group (20 mg,62 cases). Each group was given the same basic treatment. Blood samples were obtained from all the patients before and 12 h after PCI,and endothelin-1 (ET-1),nitric oxide (NO),interleukin-10(IL-10),high sensitive - C reactive protein(hs-CRP),superoxide dismutase (SOD) and malondialdehyde(MDA) were detected. Results The baseline information,distribution of sex,age,and implanted frames had no significant differences between the two groups (P＞0.05).Before PCI,the levels of ET-1,NO,IL-10,hs-CRP,SOD and MDA had no significant differences (P＞0.05) between the two groups.After PCI,ET-1,IL-10 and hs-CRP levels in simvastatin 40 mg group were significant lower while NO level was higher than in simvastatin 20 mg group[(4.4 ± 1.1)ng/L vs.(4.8±1.2)ng/L,t=2.03,P=0.044; (15.0±6.3) ng/L vs.(18.7±9.0)ng/L,t=2.68,P=0.008;(26.9±10.0)ng/L vs.(31.5± 11.7)ng/L,t=2.52,P =0.022;(51.9± 10.9)μmol/L vs.(47.1±11.8)μmol/L,t=2.37,P=0.020].There were no significant differences in MDA and SOD levels between the two groups.For safety,all the patients had no abnormality in liver and kidney function after treatment. Conclusions Compared with 20 mg simvastatin loading before PCI,the 40mg simvastatin loading may decrease the inflammatory cytokines and improve the endothelium function more effectively.

Objective To evaluate the difference of the surrounding normal tissue and lesion apparent diffusion coefficient (appar-ent diffusion coefficient,ADC)value in identify malignant and benign breast lesions.Methods There were 65 suspicious malignant breast lesions received by DWI scan and dynamic contrast-enhanced MRI (DEC-MRI)in 64 patients.The ADC value of breast lesions and peripherial glands were respectively measured,and then the difference was calculated.Receiver operating characteristic curve (ROC)analysis was used to evaluate the difference’s performance in identification between benign and malignant breast lesions.Re-sults There were 35 malignant lesions and 30 benign lesions.For the malignant lesions,the optimal threshold values for ADC of breast lesions were 1.28×10-3 mm2/s.The area under the ROC was 92.2%,the sensitivity and specificity were 76.7% and 94.3%.While the optimal threshold values for ADC were 0.63×10 -3 mm2/s in the benign lesions.The area under the ROC was 94.9%,the sensitivity and specificity were 88.6% and 96.7%.Conclusion ADC difference can reduce the influences of individual physiological factors,different machine,scanning parameters,which play an important role in identification between benign and malignant breast lesions.

Objective Androgen receptor ( AR) is extensively expressed in breast cancer and influences the proliferation of the malignant cells.Our study aimed to investigate the effect of AR on estrogen receptor (ER)-positive breast cancer. Methods ER-positive MCF-7 breast cells were exposed to various concentrations of agonist dihydrotestosterone ( DHT) or antagonist bicalutamide or left untreated .Then the proliferation and apoptosis of the cells were determined by MTT assay , cell counting , and flow cytometry , and the expressions of the proteins related to cell cycle regulation were detected by Western blot . Results The relative gray value of AR was significantly increased in the DHT group (1.055 ±0.020) but decreased in the bicalutamide group (0.705 ±0.010) as com-pared with the blank control (0.795 ±0.020) (both P<0.05).Flow cytometry showed that the early apoptosis rate of the breast cancer cells was markedly higher in the DHT group ([51.20 ±0.312]%) but lower in the bicalutamide group ([2.410 ±0.367]%) than in the blank control ([3.540 ±0.375]%) (both P<0 .01). In comparison with the control group , the expressions of the p53, p73 and p21 proteins in the MCF-7 cells were remarkably up-regulated in the DHT group but down-regulated in the bicalutamide group ( both P<0.05). Conclusion AR inhibits the proliferation of ER-posi-tive breast cancer cells , which suggests that it may be a potential ther-apeutic target for ER-positive breast cancer .

AIM: To explore the effect of dietary black rice outlayer fraction (BRF) on inducible nitric oxide synthase (iNOS) expression, and elucidate the possible mechanism of BRF anti-atherogenesis in apoE-deficient mice. METHODS: After 16 weeks intervention by 5% BRF, aortic iNOS activity in different groups was determined by RIA. iNOS mRNA expression in aorta were analyzed by RT-PCR. RESULTS: Mice in BRF group showed weaker expression of iNOS mRNA and lower iNOS activity than those in positive and WRF group (P0.05). CONCLUSION: The supplementation of BRF has dramatically reduced aortic sinus atherosclerotic plaque areas compared to WRF in apoE-deficient mice and its action of anti-atherogenesis may be attributed to its inhibition of iNOS activity and iNOS mRNA expression.