Objective:To explore the effect of music relaxation training combined with Huangqi Jianzhong Decoction oral administration and foot bath on fatigue status and quality of life in patients with cancer related fatigue.Methods:A total of 90 patients with cancer related fatigue in our hospital from January 2019 to October 2020 were selected. The patients were divided into 2 groups by random number table method, with 45 in each group. Both groups were given health and diet education. The control group was given music relaxation training, and the observation group took Huangqi Jianzhong Decoction oral administration and foot bathing on the basis of the control group. Both groups have a course of treatment of 4 weeks, a total of 3 courses. The TCM syndrome scores were observed before and after treatment, and the Piper Fatigue Score (PFS) was used to evaluate fatigue status, and the Karnofsky functional state score was used to evaluate the quality of life of patients, evaluation of clinical efficacy.Results:After treatment, 43 patients in the observation group and 42 patients in the control group were analyzed. The total effective rate of the observation group was 83.72% (36/43), which was significantly higher than 64.29% (27/42) of the control group ( χ2=4.18, P=0.041). After treatment, the TCM syndrome scores in the observation group was significantly lower than that of the control group ( t=2.48, P=0.015). After treatment, the Karnofsky functional state score in the observation group was significantly higher than that of the control group ( t=2.83, P=0.006). After treatment, the emotion score (4.35±1.02 vs. 5.03±1.01, t=3.09), feeling score (4.31±1.06 vs. 5.00±1.02, t=3.06) and total score (4.23±1.07 vs. 4.87±1.10, t=2.72) in the observation group were significantly lower than those in the control group ( P<0.01). Conclusion:Music relaxation training combined with Huangqi Jianzhong Decoction oral administration and foot bathing can alleviate the fatigue state of CRF patients and improve the quality of life.

Objective:To explore the mediating effect of chronic disease self-efficacy between fatigue and social support in breast cancer patients undergoing chemotherapy.Methods:This study was a cross-sectional study. From July 2020 to April 2021, convenience sampling was used to select 376 patients with breast cancer undergoing chemotherapy in the Shandong Provincial Hospital Affiliated to Shandong First Medical University as the research object. The General Information Questionnaire, Fatigue Scale-14, Chronic Disease Self-Efficacy Scale and Social Support Rating Scale were used to investigate the patients. Structural equation modeling was used to test the mediating effect among variables. A total of 376 questionnaires were distributed, and 372 valid questionnaires were recovered, with a valid recovery rate of 98.94%.Results:Among 372 breast cancer patients undergoing chemotherapy, the total scores of the Fatigue Scale-14, Chronic Disease Self-Efficacy Scale and Social Support Rating Scale were (10.61±1.81) , (5.00±2.53) and (43.42±12.59) , respectively. Chronic disease self-efficacy was positively correlated with social support in breast cancer patients undergoing chemotherapy ( r=0.493-0.648, P<0.01) , and social support was negatively correlated with fatigue ( r=-0.703--0.234, P<0.01) , and self-efficacy was negatively correlated with fatigue ( r=-0.729--0.220, P<0.01) . Chronic disease self-efficacy played a partial mediating role between fatigue and social support in breast cancer patients undergoing chemotherapy (β=-0.335, P<0.01) , and the mediating effect accounted for 47.59% of the total effect. Conclusions:Social support can indirectly affect fatigue through chronic disease self-efficacy in breast cancer patients undergoing chemotherapy. Nurses should focus on improving the chronic disease self-efficacy and social support of breast cancer patients undergoing chemotherapy.

Objective:To explore the characteristics of multimodal ultrasound before neoadjuvant chemotherapy (NAC) and the degree of postoperative pathological remission and B-cell lymphoma-2 (BCL-2) .Methods:From Jan. 2018 to Dec. 2020, female breast cancer patients who underwent breast-conserving or total mastectomy surgery at Shaanxi Hospital of traditional Chinese Medicine were selected as the research objects. Routine ultrasound, automatic breast full-volume imaging, and contrast-enhanced ultrasound were performed before chemotherapy. The postoperative pathological remission was evaluated according to Miller and Payne’s modified pathological response grading standard. The expression of BCL-2 in breast cancer tissue was detected by immunohistochemistry. Univariate analysis was performed on the characteristics of MHR, NMHR and bcl-2 with different expression status. Then, binary Logistic regression was used to analyze the significant variables in univariate analysis.Results:Among 186 patients, 84 patients (45.2%) were in MHR group and 102 patients (54.8%) in NMHR group after NAC surgery. The maximum diameter of mass in NMRH group was > 4 cm. The proportion of CM, irregular shape of mass, microcalcification, high enhancement of CEUS and perfusion defect (62.7%, 62.7%, 70.6%, 62.7%, 66.7%) was significantly higher than that of MRH group (38.1%, 40.5%, 39.3%, 41.7%, 31.0%, P<0.05) . The proportion of irregular shape, microcalcification, Alder blood flow grade 2-3, hyperenhancement and peripheral radiation enhancement in low bcl-2 expression patients (65.1%, 69.8%, 65.1%, 71.7%, 72.6%, respectively) was significantly higher than that in high Bcl-2 expression patients (36.2%, 38.7%, 27.5%, 28.7%, 38.8% respectively) (all P<0.05) . Multivariate Logistic analysis showed that irregular masses, with microcalcifications, and high CEUS performance were independent risk factors for NMHR (all P<0.05) ; irregular masses, with microcalcifications, and CEUS manifestations of peripheral radial enhancement were independent risk factors for low expression of BCL-2 (all P<0.05) . Conclusion:Multimodal ultrasound features can be used to predict the degree of pathological remission and the expression of BCL-2 in breast cancer patients with NAC, which helps to select treatment options and predict the prognosis of patients.

Objective:To construct a plan for relieving fatigue in breast cancer patients undergoing chemotherapy.Methods:We combined literature and clinical experience to construct a fatigue relief plan for breast cancer chemotherapy patients from August to October 2020. A total of 21 domestic two-glandular surgeons, nursing experts, and surgical nursing teachers were invited to conduct 2 rounds of Delphi expert letter inquiries, and analyzed the positive coefficient of experts and the degree of expert authority to evaluate the reliability of experts, and evaluated the coordination degree of expert opinions through the coefficient of variation and Kendall's harmony coefficient.Results:The effective response rate of the two rounds of questionnaires was 100%, the enthusiasm coefficient of experts was very high. The authority coefficients of the 2 rounds of consulting experts were 0.89 and 0.90 respectively (all>0.7), expert authority coefficient was very high. The Kendall harmony coefficients of the first-level and second-level indicators in the first round were 0.160 and 0.086, statistically significant (all P<0.05). In the second round, the Kendall′s harmony coefficients of dimension, first-level and second-level indicators were 0.190, 0.211, 0.378, statistically significant (all P<0.05). The coefficient of variation of each item in the second round was 0.04-0.12, and the full score rate was 28.57%-95.24%. All met the index screening standards established by the scheme. Finally, 3 dimensions, 3 first-level indicators and 16 third-level indicators were determined. Conclusions:The fatigue relief plan for breast cancer chemotherapy patients has necessity, practicality and scientificity.It has guiding significance for standardizing the fatigue relief of patients undergoing chemotherapy after radical mastectomy.

Objective: To investigate the clinical outcomes of selective major aortopulmonary collaterals(MAPCAs) unifocalization and report histopathological findings in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals(PA/VSD/ MAPCAs). Methods: The study enrolled 6 MAPCAs/VSD/PA patients with age ranged from 6 to 96 months and body weight ranged from 5.0 to 23.0 kg. These patients underwent selective MAPCAs unifocalization and primary repairs. Preoperative cardiac catheter, selective arteriography, cardiac CTA and intraoperative pathology were performed to identify different function, anatomic distribution and histopathology of MAPCAs. Results: 6 MAPCAs/VSD/PA patients underwent selective MAPCAs unifocalization and primary repair. No death occurred after operation and at follow-up which lasted for 1 to 20 months. Preoperative cardiac catheter, selective arteriography and intraoperative histopathology demonstrated distribution of functional MAPCAs similar to native pulmonary artery arborization and participating in arterial gas exchange. Functional MAPCAs were classified into elastic arteries according to histopathology. Conclusion There are two histological type of MAPCAs which play different roles. Selective unifocalization to functional MAPCAs which are classified into elastic arteries like native pulmonary artery is a safe and effective treatment approach for PA/VSD/MAPCAs.

Objective To investigate the impacts of the left ventricular size for infants with total anomalous pulmonary venous connection(TAPVC) on the early results of anatomical correction.Methods From Jan 2010 to Jun 2013,103 cases of TAPVC children under 1 year of age received biventricular correction in our hospital,including 65 males and 38 females with the mean body weight of(5.3 ± 1.3) kg.Taking left ventricular end-diastolic volume index(LVEDVI) of 20 ml/m2 as a boundary,all the children were divided into two groups:Small LV group and the Near normal LVgroup.Various factors including age,body weight,pathological type,pulmonary venous obstruction and restricted atrial septal defect were compared between the two groups.The Z value were introduced to demonstrate the small extent of the left atrium and left ventricle of TAPVC patients in comparison with the normal children.TAPVC correction surgery were performed with conventional median sternotomy,moderate hypothermic cardiopulmonary bypass and combined malformations were treated simultaneously.Results 45 patients were classified to Small LV group and 58 patients were classified toNear normal LV group.71.1％ of all Small LV patients was diagnosed as the obstruction type of TAPVC,the ratio was significantly higher than that of theNear normal LV group.The Z value of left ventricular end-diastolic diameter in theSmall LV group was significantly lower than that of the Near normal LV group.The mean CPB and aortic clamping time of all patients were (96.6 ± 34.4) min and (58.0 ±21.1) min respectively.There were 4 early postoperative death and the overall mortality was 3.9％.No patient was dead of low cardiac output.The duration of postoperative mechanical ventilation,ICU stay and vasoactive drugs application in Small LV group was significantly longer than that of Near normal LV group.Conclusion TheSmall LV,which should be viewed as relative dysplasia of left ventricle ,is more common in obstructive type of TAPVC.As long as the sizes of mitral valve and aortic valve were not significantly reduced,anatomic correction can be implemented and need not to concern the reducing degree of left ventricle.Nevertheless,the prevention and treatment of low cardiac output in the operation and early postoperative period were still key points for small LV patients to achieve good surgical results.

Objective To explore the relationship between single nucleotide polymorphisms (rs12953-717) of SMAD7 and susceptibility of non-small cell lung cancer (NSCLC) in Chinese Han population.Methods A single nucleotide polymorphisms (rs12953717) from SMAD7 was detected via Sequenom system in 528 NSCLC cases and 762 healthy controls.Data was statistically analyzed by unconditional Logistic regression method.Results rs12953717 had significant differences between non-small cell lung cancer patients and the controls.Compared with CC/TT (CC combined with TT) genotype,the adjusted odds ratio for the CT genotype was 4.107 (95％ CI:3.206 ～ 5.260,P =0.000 1).Smokers had a 2.004 odds ratio (95 ％ CI =1.583 ～ 2.537,P =0.000 1) of NSCLC compared with the controls.There was a 10.074-fold increased risk of NSCLC among the subjects with CT genotype and smokers.Conclusion The polymorphism of rs12953717 may have relation with risk of NSCLC.Heterozygote (CT) is a susceptibility genotype of NSCLC.Smoking is one of the risk factors of NSCLC.Smoking and CT genotype have synergistic effects on NSCLC susceptibility.

Objective To study the clinical characteristics of epidemic Japanese encephalitis in 4 adult patients and to improve the level of diagnosis.Methods The clinical characteristics, laboratory results and MRI features of 4 adult patients with epidemic Japanese encephalitis hospitalized in our hospital between 2007 and 2008 was retrospectively reviewed and analyzed.Results All patients were sporadic.Two were female and others were male with the age from 34 to 68 years old and onset in summer and autumn.One patient had diarrhea at onset while others had fever and headache at onset.All patients had high fever and psychiatric symptoms.Two patients had respiratory failure.Obvious elevation of white cells in cerebrospinal fluid was seen in all patients and Japanese viral antibody of IgM was all positive whereas the image of MRI was abnormal only in one patient.Two patients had neurological sequelae.Conclusions The clinical manifestations of epidemic Japanese encephalitis in adults are severe and untypical and the respiratory failure is likely to occur.

Objective To study the relationship between quality of life and social support and ex-plore effective ways to improve quality of life in patients with cardiomyopathy. Methods In-hospital pa- tients (50 cases) with eardiomyopathy were randomly selected and inquired by applying general quality life inventory(GQOLI-74) and social support rating seale(SSRS),compared with 45 normal people as the con- trol group. Results Compared with the control group, quality of llfe (P < 0.05) and social support (P <0.01 ) in patients with eardiomyopathy decreased significantly.Social support was positively related with quality of life (r =0.614, P < 0.01 ). Conclusions Quality of life is closly related with social support in patients with cardiomyopathy. Improving quality of life by social support in patients with cardiomyopathy should be emphasized and make effective use of in the courses of nursing.

Objective To evaluate the role of serum CA125 level in diagnosing the epithelial ovarian tumor.Methods Serum CA125 level of seventy-two patients who were operated for epithelial ovarian tumor between Apr 2005 and Jun 2007 in PUMC hospital were recruited and analyzed retrospectively.Using microparticle enzyme immunoassay(MEIA) to determine the serum CA125 level,and evaluate the serum CA125 level in diagnosing epithelial ovarian cancer.Results The CA125 was higher than 35?/ml in 35/39 ovarian serous cystadenocarcinoma cases with 89.7% positive rate,CA125 was higher than 35?/ml in 9/12 ovarian borderline serous cystadenoma with 75% positive rate,and CA125 was higher than 35?/ml in 4/21 ovarian serous cystadenoma with 19% positive rate.Conclusion The serum CA125 level before operation can predict benign epithelial tumor or epithelial ovarian cancer.