Objective:To systematic review the efficacy and safety of external application of traditional Chinese medicine on treatment of breast cancer related lymphedema.Methods:CNKI, Wanfang Data, VIP, Sino-Med, The Cochrane Library, PubMed, Web of Science were searched for related randomized controlled trials, the retrieval time was from inception to May 25, 2020. Two researchers independently screened and evaluated the included studies. Meta-analysis was performed by RevMan 5.4 software.Results:A total of 16 studies involving 1 315 patients with breast cancer related lymphedema were included, and the methodological quality of the included studies was not high. Compared with conventional treatment, external application of traditional Chinese medicine combined with conventional treatment had advantages in improving the total efficiency( P<0.01) and quality of life( P<0.01), reducing pain( P<0.01) and improving upper limb function( P<0.01), without obvious adverse reactions( P>0.05), but there was no improvement in depression( P>0.05). Compared with conventional treatment, external application of traditional Chinese medicine could improve the total efficiency( P<0.01). Compared with placebo sticker combined with conventional treatment, external application of traditional Chinese medicine combined with conventional treatment can reduce circumference( P<0.05) and reduce pain( P<0.01), without obvious adverse reactions( P>0.05). Conclusions:Available evidence suggests that external application of traditional Chinese medicine may be a potential treatment method for breast cancer related lymphedema. Due to the poor methodological quality of the included studies, high-quality randomized controlled trials are still needed.

Objective:To explore the development status and research hotspots of international mobile medical application, so as to provide references for domestic research on mobile medical applications.Methods:We systematically searched English documents included in the Web of Science core database from 2009 to 2019, and the document type was the article. CiteSpace (V.5.6.R2 version) software was used to visually analyze research institutions, source journals, cited documents and keywords of international mobile medical applications.Results:A total of 4 705 documents were included. Research on international mobile medical applications continued to increase. The institution and journal with the most publications were the University of Washington and JMIR Mhealth and Uhealth respectively. Through the keyword co-occurrence clustering of related literature, four research hotspots were obtained: the feasibility study of mobile medical applications, the intervention research of mobile medical applications, disease management and self-care, and the evaluation of mobile medical applications. Conclusions:In order to promote the development of mobile medical application in China, it is recommended that future researchers should pay attention to the research result of international authoritative institutions and journals in a timely manner, learn from the knowledge base of international mobile medical application research, and explore the road of application development in line with my country's national conditions.At the same time, it is necessary to standardize the design of research programs, carry out high-quality intervention research, and build my country's mobile medical application evaluation system as soon as possible.

This paper reviews the literature about the common complications, evaluation tools and intervention measures of free flap repair for tongue cancer patients at home and abroad, summarizes the current research status, and points out that the nursing plan of free flap repair for tongue cancer patients needs to be further standardized, and needs to carry out evidence-based clinical research.

Recently, probiotics are more and more used in low birth weight infants, we reviewed the safety and effectiveness of probiotics in low-birth-weight infants from the aspects of intestinal flora characteristics, promoting growth and development, prevention and treatment of related diseases, economic safety, and nursing countermeasures.

Objective:To systematically evaluate effects of auricular acupoint pressing on improving perimenopausal insomnia.Methods:The randomized controlled trials of auricular plaster therapy to improve perimenopausal insomnia was searched by computer in domestic and foreign databases, and the search time was from the establishment of each database to October 25, 2018. Two researchers independently screened the literature, extracted data and evaluated the risk of bias in the included literature and RevMan 5.3 analysis software was used for data analysis.Results:A total of 6 Chinese literatures were included. Meta-analysis results showed that there was no statistically significant difference in Pittsburgh Sleep Quality Index (PSQI) score reduction by auricular acupoint pressing compared with estazolam ( WMD=-0.06, 95% CI: -0.96-0.84, P=0.90) .Auricular acupoint pressing was better than Anshen Buxin capsule in reducing PSQI score ( WMD=-5.16, 95% CI: -7.37--2.95, P<0.000 01) . Auricular acupoint pressing could effectively improve perimenopausal insomnia, and the difference was statistically significant ( RR=1.19, 95% CI: 1.08-1.31, P=0.000 4) . Auricular acupoint pressing with beans combined with oral modified Huanglian Ejiao Decoction was better than oral modified Huanglian Ejiao Decoction alone in reducing Athens Insomnia Scale (AIS) scores ( WMD=-2.60, 95% CI: -4.42--0.78, P=0.005) . Compared with modified Chaihu Guizhi Longgu Muli Decoction treatment, auricular acupoint pressing combined with modified Chaihu Guizhi Longgu Muli Decoction could effectively reduce the modified Kupperman score ( WMD=-4.07, 95% CI: -6.36--1.78, P=0.000 5) . In terms of reducing the scores of the social support scale, there was no statistically significant difference between the auricular acupoint pressing with beans and estazolam ( WMD=-0.16, 95% CI: -1.26-0.94, P=0.78) . Conclusions:Auricular acupoint pressing has advantages in improving the total effective rate, reducing PSQI score and AIS score and improving Kupperman score. Limited by the quantity and quality of the included literatures, more large-sample high-quality studies with long-term follow-ups are needed for verification.

Objective To compare Montreal cognitive assessment-basic ( MoCA-B ) and mini-mental state examination (MMSE) in screening cognitive dysfunction of acute stroke patients. Methods The cognitive function of patients (n=83) with acute stroke onset within 10 days (including new cerebral infarction and cerebral hemorrhage) were assessed using MMSE and MoCA-B. The classification of patients with cognitive impairment was compared between the two scales. The consistency of cognitive impairment and affected domains assessed by MMSE or MoCA with experts were evaluated. Results ①There were 32 cases (38.6%) with abnormal MMSE score and 40 cases (51.8%) with abnormal MoCA-B score. ②The the diagnostic consistency of MoCA-B with experts was 89.16%. The false positive of MMSE was 2.41%and the false negative (rate of missed diagnosis) was 16.87%.False positives of MoCA-B were 4.82%and false negatives (rate of missed diagnosis) were 6.02%.③Among the 51 patients with normal MMSE, 15 had abnormal MoCA-B (29.4%). There were significant differences between these two score system in executive function, verbal fluency, directivity, abstraction, delayed recall, visual perception, naming and other cognitive domains (P＜0.05). Conclusion MoCA-B scale may be more sensitive and better than MMSE scale in screening for cognitive impairment in patients with acute stroke.

Objective To explore the association of MTHFR C677T polymorphism and birth body mass with the vulnerability of autism in Chinese Han population. Methods Totally 1 505 children with au-tism have been recruited,using the diagnosis and statistical manual,4th revised version ( DSM-IV-R) diag-nostic criteria for autism. And 1 308 healthy control subjects sex matched with the children with autism were enrolled for the study. All the participants were identified the birth body mass ( kg) according to the birth medical recording. All the subjects were examined the MTHFR C677T genotypes,using the polymerase chain reaction- restrict fragment length polymorphism (PCR-RFLP) methods. The frequencies of genotypes,alleles and birth body mass were compared between autism and healthy control groups using the chi-square and other tests. Results The MTHFR C677T (P=0. 004,OR=1. 18,95% CI=1. 02-1. 29),low birth body mass (<2. 5 kg) (P=0. 001,OR=1. 04,95%CI=1. 02-1. 06),and their interactive effects ( P=0. 0001,OR=2. 18,95%CI=1. 44-3. 32) were associated with the vulnerability of autism. Conclusions The MTHFR C677T polymorphism,low birth body mass and their interactive effects might be associated with susceptibility of autism in Chinese Han population.

Objective? To understand the research status of experiential teaching applied in nursing course teaching at home and abroad, and to explore the existing problems so as to provide information and direction for further researches and development. Methods? Literatures were retrieved in China national knowledge infrastructure (CNKI), WanFang database, VIP, SinoMed and PubMed from building database to June 2018. We extracted related literatures and analyzed them by bibliometric analysis. Results? A total of 228 literatures were included with 207 Chinese and 21 English papers. The number of papers published after 2010 was upward trend. The number of core journals (29) and SCIs (6) was less. Research methods focused on empirical research with 126 papers accounting for 55.26%. A total of 31 kinds of course applied this teaching method. The teaching effects were mainly evaluated with the questionnaire. Conclusions? The application of experiential teaching in nursing courses was paid more attention to. The teaching was applied in diverse courses, but the quality of literatures needed to be improved. In the future,researchers should lay emphasis on scientific rigorous design and diverse evaluation methods so as to improve the objectivity and reliability of teaching effects.

Objective To investigate the effect of L-asparaginase on the coagulation function of patients with acute lymphoblastic leukemia. Methods The general information of 100 patients with acute lymphoblastic leukemia from January 2013 to January 2017 admitted in the Department of Hematolog was retrospectively analyzed. All patients received no anticoagulation before chemotherapy. All patients were treated with routine treatment after admission, namely with vincristine + daunorubicin + prednisone induction therapy and then with VDLP regimen chemotherapy, combined with intravenous injection of L-asparaginase 8000 U/m2, once every other day. After 3 months of treatment, its clinical efficacy was evaluated, and adverse reactions during treatment were observed. The changes of coagulation indexes were compared before treatment and at 1 day and 7 days after treatment. Results Of the 100 patients, there were 22 cases of complete remission, 40 cases of partial remission, 26 cases of stable condition and 12 cases of progression, with total efficiency of 62％(62/100). During the treatment of 100 patients, 10 cases had allergy, 9 had a drop in white blood cell count, and 8 had gastrointestinal reactions including nausea and vomiting. On the first day after treatment, the levels of PT, APTT and TT in 100 patients were significantly higher than those before treatment, with significant difference (P＜ 0. 05 or P＜0. 01). However, the FIB level in patients was significantly lower than that before treatment, with significant difference (P＜0. 05). There were no significant differences between the levels of PT, APTT and TT in all patients at one week after treatment and those before treatment (P＞0. 05). Although FIB level in all patients at one week after treatment increased compared with that at one day after treatment, the difference had no significant difference. While the level of FIB was significantly lower than that before treatment, and the difference was significant (P＜0. 05). Conclusion L-asparaginase is effective and safe in the treatment of acute lymphoblastic leukemia, but it is easy to produce adverse reactions such as abnormal coagulation function. Therefore, the clinical application of L-asparaginase in the treatment of acute lymphoblastic leukemia should be dynamically monitored in patients in order to actively correct coagulation disorders, and the drug should be discontinued when necessary.

Objective To study the effect of Shengmai injection on the platelet parameters and CD4+CD25+cells in peripheral blood of patients with chronic lymphocytic leukemia,and to explore the optimal regimen for patients with chronic lymphocytic leukemia.Methods One hundred and twenty patients with chronic lymphocytic leukemia were enrolled in this study from January 2012 to December 2014.(D1),vincristine 4mg(d1),prednisone 60 mg/d(d1-5)were given to the CHOP regimen in the control group: cyclophosphamide 600 mg/m2(d1),doxorubicin 25 mg/m2(d12)28d a course of treatment,a total of 4 courses,the observation group of patients in the control group of patients treated on the basis of Shengmai injection,compared the two groups of patients with chemotherapy,platelet parameters and serum CD4+CD25+T cells and Th17 cells.Results After treatment,the PLT,MPV and PDW of the observation group were(215.4± 31.7),(9.5±2.5)and(16.9±2.4),respectively,which were significantly higher than those of the control group.The CD4+CD25+T cells in the observation group were(1.5±0.8)The total effective rate of the control group was 35.0％,the total effective rate was 35.0％,and the total effective rate of the control group was 35.0％.There were significant difference between the control group and the control group(P<0.05),The difference was statistically significant.Conclusion Shengmai injection combined with CHOP regimen in chronic lymphocytic leukemia patients can improve immune function,promote platelet growth,improve platelet clinical parameters,and help improve the efficiency of chemotherapy,compared with CHOP alone Program treatment is better,worthy of clinical application.