With the extended survival period of breast cancer patients and the increasing health demands, the concomitant diseases of breast cancer have gradually attracted the attention of both doctors and patients, and it is imperative to conduct comprehensive management of these diseases, in which the general practitioners, as the more comprehensive and complex medical talents, have not yet played their due roles. In this article, we report two cases of comprehensive management of concomitant diseases of breast cancer through collaboration of general practitioners and specialists (integrated general and specialist care). The role and function of general practitioners in this process were deeply analyzed, and the establishment of a consultation-liaison general practice model to further promote the role of integrated general and specialist care in integrated oncology care was advocated.

With the improvement of diagnosis and treatment level, most breast cancer patients survive in a chronic state for a long time, and the issue of concomitant diseases of breast cancer (CDBC) has become increasingly prominent. All-round and full-cycle management of these comorbidities can help improve patients’ quality of life and prognosis. General practice, with its long-term, comprehensive and responsible health care that is person-centered, family-based, community-wide and oriented to the maintenance and promotion of overall health, presents new opportunities for the health management of CDBC. This article will explore the application of consultation-liaison general practice through the integrated general and specialist care in the comprehensive management of CDBC, aiming to raise people’s awareness of it and promote the development of consultation-liaison general practice and the management model of the "Internet plus general practitioner team" , which will surely contribute to the all-round management of concomitant diseases in breast cancer patients.

With the extended survival period of breast cancer patients and the increasing health demands, the concomitant diseases of breast cancer have gradually attracted the attention of both doctors and patients, and it is imperative to conduct comprehensive management of these diseases, in which the general practitioners, as the more comprehensive and complex medical talents, have not yet played their due roles. In this article, we report two cases of comprehensive management of concomitant diseases of breast cancer through collaboration of general practitioners and specialists (integrated general and specialist care). The role and function of general practitioners in this process were deeply analyzed, and the establishment of a consultation-liaison general practice model to further promote the role of integrated general and specialist care in integrated oncology care was advocated.

With the improvement of diagnosis and treatment level, most breast cancer patients survive in a chronic state for a long time, and the issue of concomitant diseases of breast cancer (CDBC) has become increasingly prominent. All-round and full-cycle management of these comorbidities can help improve patients’ quality of life and prognosis. General practice, with its long-term, comprehensive and responsible health care that is person-centered, family-based, community-wide and oriented to the maintenance and promotion of overall health, presents new opportunities for the health management of CDBC. This article will explore the application of consultation-liaison general practice through the integrated general and specialist care in the comprehensive management of CDBC, aiming to raise people’s awareness of it and promote the development of consultation-liaison general practice and the management model of the "Internet plus general practitioner team" , which will surely contribute to the all-round management of concomitant diseases in breast cancer patients.

Objective To compare the predictive value of Fried frailty phenotype (FP) and Tilburg frailty Index (TFI) to the quality of life in community elderly people so as to provide a reference for the grass-roots general practitioners to choose the appropriate quality of life screening tool in the community elderly people.Methods Using the convenient sampling method,638 elderly people in the community were selected as the research subjects.FP and TFI were used to assess frailty,and the quality of life was evaluated by the brief health questionnaire (SF-12).The Kappa value was used to evaluate the consistency of the two scales. The Pearson correlation was used to detect the correlation between the two scales and SF-12 respectively,and the Bayes discriminant analysis was used to evaluate and analyze the predictive ability of the two scales on the quality of life.Results Among the 638 community elderly people,the screened incidence rate of frailty was 15.4％ by FP and 28.2％ by TFI,the Kappa value of FP and TFI consistence test was 0.569 (P<0.001). The results of correlation analysis showed that FP and TFI were negatively correlated with the total physical health score (PCS) and total mental health score (MCS) of SF-12 (FP with PCS and MCS,r=-0.772,-0.349,P<0.01;TFI with PCS and MCS,r=-0.738,-0.491,P<0.01).Taking the quality of life as the criterion,the cross-validation accuracy rates of FP and TFI for predicting the PCS decline were 76.65％ and 71.63％ respectively,which for MCS decline was 72.10％ and 75.55％ respectively.Conclusion Both FP and TFI all have the predictive value on the decline of quality of life of the community elderly people,but TFI has the characteristics of multi-dimensions and easy application,so it is more effective and practical for evaluating the quality of life in the community elderly people.

Objective To explore the viscoelasticity of relaxed myocardium in vivo through indentation method with an intervention ultrasound indentation system (IUIS). Methods Old myocardial infarction (OMI) models of canine were established by ligating left anterior descending branch of coronary artery for 3 months. The indentation creep tests were used respectively in OMI group and shame group (n=8, each) by IUIS in middle and advanced diastole stage in vivo. Test data were processed with three-parameter solid viscoelasticity model, and the viscoelastic parameters, such as instantaneous elastic modulus (E1), relaxation modulus (E∞), creep elastic modulus (E2) and viscous damping coefficient (η) in normal and infarcted myocardium were obtained and compared. Results All the parameters of E1, E∞, E2 and η increased obviously in OMI group than in sham group shown as follows: 27.81±6.74kPa vs. 6.78±2.43kPa; 17.87±3.59kPa vs. 4.52±1.56kPa; 49.54±14.35kPa vs. 16.82±12.37kPa and 1.97±0.78Pa.s vs. 0.66±0.40Pa.s. The differences were statistically significant (P<0.05). Conclusions IUIS is a feasible method to assess the viscoelasticity of relaxed myocardium in vivo. Three-parameter viscoelasticity model can be used to describe creep properties of relaxed myocardium. Both elastic modulus and viscosity resistance have increased in infarcted myocardium.

Objective To observe the preventive effect of the new nursing mode on the formation of deep venous thrombosis(DVT)in pregnant women with high risk factors.Methods 186 pregnant women who had high risk factors were selected,by using digital table method they were randomly divided into control group(93 cases)and observation group(93 cases).The control group was treated with routine nursing,the observation group was given the new nursing mode on the basis of routine nursing.The postpartum 2 weeks of lower limb swelling,pain,lower extremity deep vein thrombosis formation of incidence,and the nursing satisfaction were compared between the two groups. Results 2 weeks postpartum,the incidence rates of lower limb pain occurrence,lower extremity deep vein thrombosis in the observation group were 8.6%,2.1%,which in the control group were 20.4%,9.7%,there were statistically significant differences between the two groups(χ2 =4.56,4.82,all P <0.05).The satisfaction of the observation group was 95.6%,which of the control group was 81.7%,the difference between the two groups was statistically sig-nificant(χ2 =5.27,P <0.01).Conclusion The new nursing model used in pregnant women with high risk factors can effectively prevent the occurrence of DVT,reduce the incidence of DVT,improve the satisfaction of nursing.

ObjectiveTo investigate the learning curve of total thoracoscopicy cardiac surgery.MethodsClinical data of a succession of 125 patients undering total thoracoscopicy ASD and VSD repair between October 2004 to January 2010 were collected and reviewed.The procedure was perfomed by the same surgeon.The patients were divided equally into 5 groups (groupA,B,C,D and E,n =25 in each group ) according to the sequence of the operation.The operative time,extracorporeal circulation time,aortic cross-clamped time,the rate of conversion rate to thoracotomy and postoperative complications were compared between the 5 groups.ResultsThere were no statistically significant differences between the 5 groups with respect to age,gender,weight,dieases and surgical approach(P ＞ 0.05).The operative time,extracorporeal circulation time and aortic clump time in group A and group B significant longer then that in group C,group D and group E(P ＜0.05).Group A and group B was no statistically significant difference each other( P ＞ 0.05 ).Group C,D and E have no statistically significant differences between(P ＞0.05 ).The rate of conversion rate to thoracotomy and postoperative complications in 5 groups have no statistically significant differences comparative( P ＞ 0.05 ).ConclusionThe learning curve of total thoracoscopicy surgery is approximalely 50 cases.