Purpose To investigate the clinicopathological features,diagnosis,differential diagnosis and molecular charac-teristics desmoid fibromatosis the breast(DFB).Methods The clinicopathological data and prognostic information of 26 pa-tients with desmoid fibromatosis of the breast were collected.Their clinical characteristics,histological morphologies,immu-nophenotypes and molecular characteristics were analyzed.Re-sults All the 26 patients were female,with a median age of 34.5 years and an average age of 36.8 years(range from 13 to 69 years).There were 10 cases in left breast,14 cases in right breast and 2 cases in bilateral breast.Isolated and painless breast masses were found in all patients,and 3 cases were ac-companied by nipple depression.Grossly,most of them showed a poorly circumscribed tan-white to gray mass with a trabeculated appearance.Microscopically,all the tumors were composed of mild spindle cells with varying intervals of collagen fiber bun-dles.The boundary between the tumor and the surrounding breast tissue was not clear,and the tumor cells infiltrated adja-cent tissues,such as breast ducts,lobules,adipose tissue,and skeletal muscle.Uniform spindle or oval cells formed in fascicles and interwoven,without atypical or polymorphism;the nuclear chromatin was sparse or vacuolar,with small nucleoli,but mito-ses were rare or absent.Nuclear accumulation of β-catenin was present in 20 of 26 tumors,SMA was variously positive in 20 of 26,desmin was focally positive in 6 of 26;CKpan,CK5/6,p63,CD34,CD10 and S-100 were all negative.The Ki67 index was 5％-10％.The gene mutations of CTNNB1 exon 3 were found in 18 of 26 by Sanger sequencing,including T41A(83.3％),S45P(11.1％)and S45F(5.6％).Two patients also had familial adenomatous polyposis.Local resection was performed in 23 cases,mastectomy was performed in 2 cases,and one case did not require any additional treatment after core needle biopsy.20 cases were followed up for 1-108 months,and no recurrence occurred.Conclusion Desmoid fibromatosis of the breast is rare,and can mimic breast cancer clinically,ra-diologically and histologically.It should be always considered in differential diagnosis for the spindle cell proliferations of the breast.A diagnosis of DFB can be achieved basing on the typi-cal histopathology,immunohistochemistry,history and gene se-quencing.

Objective: Functional near infrared spectroscopy (fNIRS) was used to assess brain oxygenated hemoglobin (Oxy Hb) activation in college students with different sleep quality under the verbal fluency task (VFT), so as to better provide a theoretical basis for the neural mechanism for sleep quality improvement of college students. Methods: A simple random sampling method was used to investigate 96 college students from one university during 2020 and 2021. According to the results of the Pittsburgh Sleep Quality Index(PSQI), participants were divided into 3 groups: good sleep quality group( n =45), moderate group( n =33), and poor group( n =18). The 53 channel near infrared spectroscopy to collect cerebral blood oxygen signals under the VFT task. Association between oxygenated hemoglobin with sleep quality was analyzed. Results: About 18.75% of college students reported sleep quality problems, including long sleep latency (0.97±0.97) and poor subjective sleep quality (0.96±0.72). There was a significant negative correlation between PSQI score and average oxygenated hemoglobin (Avg HbO) index of dorsolateral prefrontal lobe ( r =-0.23, P =0.03). The Avg HbO index differed significantly between good and poor sleep quality groups on dorsolateral prefrontal lobe( P =0.05). Conclusion This study verified that there is a positive correlation between sleep quality and cognitive ability among college students. The fNIRS technique could accurately collect blood oxygen signals from dorsolateral prefrontal lobe during cognitive tasks, which proves to be an effective tool for identifying sleep quality of college students.

Objective:To explore the changing characteristics of self-efficacy, social support, psychological stress in patients with osteoporotic vertebral compression fractures (OVCFs) receiving conservative treatment at different treatment stages and their correlations with the recovery of lower back function.Methods:A total of 116 patients with acute OVCFs who were admitted to the Affiliated Hospital of Medical School, Ningbo University were selected from January 2017 to May 2019. Oswestry Disability Index (ODI) Questionnaire, General Self Efficacy Scale (GSES) , Perceived Social Support Scale (PSSS) and Perceived Stress Scale (PSS) were used to assess the lower back function, self-efficacy, social support and psychological stress of OVCFs patients. Questionnaires were filled out during outpatient reexamination or in-home follow-up, and the evaluation time was at the time of treatment and 1, 3, 6, and 12 months after conservative treatment. Analysis of variance and SNK- q test were used to explore the characteristics of each score over time, and linear regression analysis was used to explore the effects of GSES, PSSS, and PSS on ODI. Results:With the prolongation of treatment time, ODI, GSES, PSSS and PSS scores of OVCFS patients under conservative treatment showed a downward trend, and the scores at 3, 6 and 12 months after treatment were lower than those at 1 month after conservative treatment ( P<0.05) . The scores at 6 and 12 months after conservative treatment were lower than those at 3 months after conservative treatment ( P<0.05) . The scores at 12 months after conservative treatment were lower than that those at 6 months after conservative treatment ( P<0.05) . GSES, PSSS (total score, in-family support, out-of-family support) and PSS were independent influencing factors of ODI at one month after treatment ( P<0.05) . GSES, PSSS (total score, in-family support) and PSS were the influencing factors of ODI at 3 months after treatment ( P<0.05) . Conclusions:The self-efficacy and social support of conservatively treated patients with OVCFs are positively correlated with their lower back function, while psychological stress will reduce lower back function of such patients. It is suggested to add these non-physical factors to the rehabilitation nursing model and take appropriate intervention measures.

Objective To investigate the effects of companion support on oral medication compliance and anxiety in tumor patients.Methods A total of 78 cases of tumor patients with pain were randomly divided into intervention group (n=39) and control group (n=39) and investigated using randomized controlled study. Patients in control group received routine analgesic care, while patients in intervention group received additional 3-month companion support intervention. Treatment compliance and anxiety of patients were compared between two groups.Results After the intervention, patients′ treatment and medication compliance including number of oral medication, medication time, dosage, adherence to continuous medication in intervention group were better than patients in control group. The differences were statistically significant (t=6.366, 2.646, 3.552, 2.588, 3.551;P<0.05). The scores of anxiety of the patients in intervention group were significantly lower than that in control group (t=-2.542,P<0.05).Conclusions Companion support intervention can increase oral medication compliance and improve the anxiety of tumor patients.

Objective To compare the effects of fluid therapy by "measurement" water dispenser and routine fluid therapy on standard fluid therapy among patients with percutaneous coronary intervention (PCI) in coronary care unit (CCU). Methods A total of 204 patients with PCI were divided into observation group (n=102) and control group (n=102) by random number table. Patients in the observation group received drinking water plan according to regulatory requirements using the self-designed "measurement" water dispenser. Patients in the control group accepted nursing plan of routine drinking fluid therapy. This study compared the qualified rate of standardized drinking water, patient satisfaction, renal function and the incidence of contrast-induced nephropathy (CIN) three days after intervention between two groups. Results There were 102 (100.00%) qualified patients drinking water according to stipulations in the observation group, while there were 68 (66.67%) in the control group. The qualified rate of drinking water in the observation group was higher than that in the control group with a significant difference (χ2=38.4, P<0.01). There were two patients with contrast induced nephropathy in the observation group, and eight patients with contrast induced nephropathy in the control group (χ2=4.2,P=0.04). Conclusions The effect of fluid therapy by "measurement" water dispenser supplemented with diversified education is satisfactory among patients with PCI in CCU.

Objective To understand the situation of psychological distress, self-disclosure and intimate relationship in spouses of patients with breast cancer and analysis their interrelationship. Methods Totally 240 spouses of breast cancer patients from 3 class Ⅲ grade A hospitals in Jiangsu Province were investigated with distress thermometer (DT), distress disclosure index(DDI), short marital adjustment and prediction test as well as general information questionnaire from July 2015 to July 2016. Single factor analysis was performed using rank test, and correlations analysis was performed by Spearman analysis. Results The average score of psychological distress was(5.2±4.7) points, self-disclosure (36.5±32.7) points, intimate relationship (118.2±36.5) points and marital disorder detection rate was 25.9%. The prevalence of psychological distress was 67.4% and there was a significant difference in DT score among the spouses of patients with different education level (Z= 7.519,P<0.05). Spouse psychological distress was negatively correlated with self-disclosure degree and the degree of intimacy(r=-0.673,-0.721;P<0.01). Intimate relationship took a partial effects as mediator between the psychological distress and the degree of self-disclosure. Conclusions The incidence of psychological distress is high in spouses of patients with breast cancer, and the severity is influenced by self-disclosure and intimate relationship. Intimacy takes a partial effects as mediator between the psychological distress and the degree of self-disclosure.

Objective To explore the application effect of concept map teaching of group-discussing mode in standardized nursing training. Methods A total of 80 standardized training nurses in Wuxi No.2 People's Hospital from January 2016 to December 2016 were selected by purposive sampling and randomly divided into the intervention group and the control group, with 40 students in each. The control group was taught according to the conventional teaching method, and the intervention group was taught with the concept map teaching of group-discussing mode. The scores of the independent learning ability assessment scale and the scores of theoretical examination were compared before and after the intervention. The scores of the feedback evaluation scale of concept map teaching of group-discussing mode in the intervention group were observed. Results The score of each dimension and the total score of the independent learning ability assessment scale of the intervention group after intervention were higher than those in the control group, and the difference was statistically significant (P<0.05). The score of theoretical examination in the intervention group was higher than that in the control group with statistical difference (P<0.001). The nurses in the intervention group had a better feedback on the concept map teaching of group-discussing mode. Conclusions The concept map teaching of group-discussing mode obtains good application results in clinical nursing teaching and training, and it can improve the nurses' independent learning ability.

Objective To analyze the effects of Orem support-education system on negative emotions and self-management capabilities of lung cancer patients with chemotherapy.Methods A total of 85 cases of lung cancer patients treated with chemotherapy were selected and divided into,according to random number table method,observation group with 44 cases intervened by Orem support-education system,and control group with 41 cases treated by conventional health education.Changes of anxiety,depression and self-management capabilities before and after the intervention in the two groups were compared.Results After the intervention, anxiety and depression scores in the observation group were (41 .55 ±4.81 )points and (43.36 ±5.58)points, significantly lower than (46.73 ±3.91 )points and (48.22 ±6.1 0)points in the control group;capabilities of stress reduction,positive attitude,decision-making and self-management in the observation group were all higher than that in the control group (P <0.05).Conclusions Orem support-education system is significant for lung cancer patients with chemotherapy in alleviating their emotions of anxiety and depression,and enhancing their self-management capabilities.

Objective To investigate the optimal measures and clinical effect of perioperative nursing care for patients with cephalocervical cancer treated with CT-guided radioactive 125I seed implantation. Methods Preoperative, intraoperative and postoperative continuous and comprehensive nursing was strictly carried out in 93 patients with cephalocervical cancer who underwent CT-guided radioactive 125I seed implantation treatment. The clinical results were analyzed and evaluated. Results The 125I seed implantation procedure was successfully accomplished in all 93 patients; the success rate was 100%. Shedding of 6 particles was observed in one patient, and shedding of 5 particles was observed in another patient; grade Ⅳskin injury was seen in 3 cases, which were improved after symptomatic treatment. All patients were uneventful at the time of discharge from hospital. Conclusion To ensure a successful CT-guided radioactive 125I seed implantation for the treatment of cephalocervical cancer, professional, meticulous and standardized nursing is the important guarantee.

Objective To investigate antimicrobial resistance among Streptococcus pneumoniae clinically isolated from 14 teaching hospitals located at different areas in China in 2005-2008 and to give logical guidance for clinical empirical therapy.Methods A total of 1 317 non-repetitive S.pneumoniae isolates in 14 teaching hospitals from 2005-2008 were collected and sent to the central lab for reidentification and susceptibility testing, including 271 isolates collected in 2005, 391 isolates collected in 2006, 363 isolates collected in 2007 and 292 isolates collected in 2008. Most of the isolates were from community-acquired respiratory tract infections, which were isolated from outpatient or emergency department patients with respiratory tract infections or those patients with respiratory tract infections within ≤48 hours hospitalization.The districts where the organisms were isolated include North China, Northeast China, South China, Central and Northwest China and East China.The patients included adults, teenagers and children.The minimum inhibitory concentrations (MICs) or inhibitory zone diameter of 17 antimicrobial agents were determined by Etest method, agar dilution method or disk diffusion method.WHONET5.5 software was used to analyze susceptibility rate, intermediate rate, resistance rate, MIC50 and MIC90.Results Linezolid (100%) and fluoroquinolones (95.2%-99.7%) showed excellent activities against S.pneumoniae.Among β-lactams, amoxicillin-clavulanic acid remained high activities (73.8%-92.1%),followed by penicillin, ceftriaxone and cefepime with year-over-year decrease in activities.The activities of three second-generation cephalosporins were low (36.3%-38.4% in 2008).The activities of erythromycin, azithromycin, clindamycin, trimethoprim/sulfamethoxazole and tetracycline against S.pneumoniae were poor and decreased year over year.The incidence of penicillin non-susceptible S.pneumoniae (PNSP) was increasing especially for PISP (from 4.4% in 2005 to 20.2% in 2008).The incidence of PNSP in North China was low (6.0%), while this value were high in central China and East China (30.1% and 38.7%, separately).The incidence of PNSP in adults (15.7%) was obviously lower than that in children(≤5 years:33.0%) and teenagers (6-17 years:38.2%).Conclusions linezolid and fluoroquinolones showed excellent in vitro activity against S.pneumoniae, followed by penicillin and cephalosporins with year-over-year decrease of activity. Clinicians should pay more attention when using those antimicrobial agents with poor activity against S.pneumoniae, which include macrolides, clindamycin, trimethoprim/sulfamethoxazole and tetracycline.