Clinical value of lymph node dissection for intrahepatic cholangiocarcinoma / 中华肝胆外科杂志

Objective:To evaluate the clinical value of lymph node dissection (LND) for intrahepatic cholangiocarcinoma (ICC) after surgical resection.Methods:A retrospective study was conducted on the clinical data of 156 patients who underwent surgery for ICC in Eastern Hepatobiliary Surgery Hospital of Naval Military Medical University from November 2010 to December 2017, including 94 males and 62 females, aged (60.0±9.5) years. Curative surgery was performed in 114 cases. Of 64 cases were in stage Ⅰ according to American Joint Committee on Cancer (AJCC), including 38 cases of non-lymph node dissection (NLND) and 26 cases of LND; 21 cases were in AJCC stage Ⅱ, including 11 cases of NLND and 10 cases of LND; 22 cases were in AJCC stage Ⅲb, including 14 cases of LND and 8 cases of lymph node resection (LNR); 5 cases were in AJCC stage Ⅲa, 2 cases were in AJCC stage Ⅳ. Univariate and multivariate Cox regression analysis were used for the risk factors of ICC prognosis. The log-rank test compared the survival rates of the two groups.Results:Cox multivariate analysis indicated that lymph node metastasis was independent risk factors for prognosis in patients with ICC ( HR=1.96, 95% CI: 1.09-3.55, P=0.026). A total of 114 patients were included in the curative surgery group. The 1-, 3-, and 5-year overall survival (OS) rates of the negative lymph node group ( n=91) were 65.9%, 47.3% and 35.6%, respectively, which were significantly better than those of the positive lymph node group ( n=23) who had 1-, 3-, 5-year OS rates of 56.5%, 17.7% and 0, respectively (χ 2=8.11, P=0.004 ). In stage Ⅰ and Ⅱ patients, there were no significant differences in 1-, 3-, 5-year OS rates between the NLND group and the LND group (both P>0.05 ). In stage Ⅲb patients, the LND group had 1-, 3-, 5-year OS rates of 71.4%, 29.8% and 0, respectively, significantly better than those of the LNR group who had 1-, 3-, 5-year OS rates of 37.5%, 0 and 0, respectively (χ 2=6.45, P=0.011). Conclusions:Lymph node metastasis is an independent risk factor affecting the prognosis of ICC. Lymph node dissection should be performed cautiously in ICC with AJCC stage Ⅰ and Ⅱ, while routine lymph node dissection is recommended in ICC with AJCC stage Ⅲb.

Determination of eight active components of Bufei Huoxue Capsules in rat plasma and their pharmacokinetics by UHPLC-MS/MS / 中国中药杂志

An ultra-high performance liquid chromatography-tandem mass spectrometry(UHPLC-MS/MS) method was established to investigate the pharmacokinetic behaviors of psoralenoside, isopsoralenoside, calycosin-7-glucoside, ononin, psoralen, isopsoralen, methylnissolin, and neobavaisoflavone in rat plasma after oral administration of Bufei Huoxue Capsules. After SD rats were administered with Bufei Huoxue Capsules suspension by gavage, blood samples were collected from the inner canthus at different time points. After protein precipitation, plasma samples were separated on ACQUITY UPLC BEH C_(18) column(2.1 mm×100 mm, 1.7 μm). The mobile phase consisted of acetonitrile(A) and water(B) containing 0.1% formic acid in gradient elution. The positive and negative ions were measured simultaneously in the multi-reaction monitoring(MRM) mode. The pharmacokinetic parameters were calculated and fitted by DAS 3.2.8. Psoralenoside, isopsoralenoside, calycosin-7-glucoside, ononin, psoralen, isopsoralen, methylnissolin, and neobavaisoflavone were detected in the rat plasma after drug administration, with AUC_(0-t) of(3 357±1 348),(3 555±1 696),(3.03±0.88),(2.21±0.33),(1 787±522),(2 295±539),(5.69±1.41) and(3.40±0.75) μg·L~(-1)·h, and T_(max) of(1.56±0.62),(1.40±0.70),(0.21±0.05),(0.25±0.12),(0.26±0.11),(0.34±0.29),(0.74±0.59), and 0.25 h. The method is proved specific and repeatable and is suitable for the determination of psoralenoside, isopsoralenoside, calycosin-7-glucoside, ononin, pso-ralen, isopsoralen, methylnissolin, and neobavaisoflavone in the rat plasma, which can be applied to pharmacokinetic study.

Application of medical science popularization competition in nursing interns from the perspective of healthy China / 中国实用护理杂志

Objective:To explore the application effect of medical science competition in nursing interns whocontribute to "healthy China" , and to improve their health education awareness, ability, method and self-confidence.Methods:A total of 205 nursing interns who worked in Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from 2019 to 2020 were selected as the research objects. They were divided into the control group (105 cases) and the experimental group (100 cases) according to whether they participated in the medical science competition. The control group learned the form and method of health education in clinical rotation according to the traditional practice teaching plan. The experimental group volunteered to participate in the medical science competition, which required the dissemination of health knowledge through various forms. Before and after the competition, the health education ability assessment scale was used for comparison.Results:Before the medical science competition, there was no significant difference in the total score of assessment, planning, implementation, evaluation and health education between the control group and the experimental group ( t values were 0.765 - 1.749, all P>0.05). After the medical science competition, the total scores of assessment, planning, implementation, evaluation and health education ability of nursing interns in the experimental group were (24.38 ± 4.72), (17.98 ± 3.98), (25.16 ± 5.36), (12.57 ± 2.96) and (80.09 ± 15.65) respectively, while those in the control group were (22.45 ± 6.29), (16.61 ± 4.77), (23.04 ± 6.55), (11.31 ± 3.46) and (73.41 ± 19.69).The differences between the two groups were statistically significant ( t values were 2.226 - 2.795, all P<0.05). Conclusions:The medical science competition can improve the health education ability of assessment, planning, implementation, evaluation of nursing interns and contribute to "healthy China" .

Applying structural equation model to construct the index of influencing factors of clinical nursing teaching quality / 中国实用护理杂志

Objective:to construct and test the structural equation model of influencing factors of clinical nursing teaching quality, and analyze the influencing factors and strength of clinical nursing teaching quality.Methods:Based on the literature, 20 indexes influencing the quality of clinical nursing teaching were selected. In July 2019, clinical nursing teachers of a third class a medical institution were selected for convenient sampling survey. Through factor analysis, 20 indexes were classified into 6 dimensions, namely, teaching environment, teaching attitude, teacher quality, teacher behavior, teaching management and teaching quality.Results:The structural equation model of influencing factors of clinical nursing teaching quality was constructed. The fitting index of the model reached the standard value, and the model had a good fit.Conclusion:With the help of this model, the nursing administrators can find out the factors and intensity that affect the quality of clinical nursing teaching, which is helpful to put forward the improvement strategies of improving the quality of clinical nursing teaching, to improve the effect of clinical nursing teaching, to improve the quality of clinical nursing teaching, and to provide reference for the research of similar clinical nursing teaching quality.

Research Progress of NGAL in Inflammatory Bowel Disease / 胃肠病学

Inflammatory bowel disease (IBD) is a chronic and recurrent inflammatory disease of gastrointestinal tract, including Crohn's disease and ulcerative colitis. The exact etiology and pathogenesis of IBD are still not clear. Neutrophil gelatinase-associated lipocalin (NGAL) plays an important role in regulating intestinal immunity, maintaining intestinal epithelial cell barrier, and coordinating the composition of intestinal flora. In addition, NGAL is useful for helping the clinical testing of IBD. This article reviewed the research progress of NGAL in IBD.

Effect of electrode temperature on measurements of transcutaneous carbon dioxide partial pressure and oxygen partial pressure in very low birth weight infants / 中国当代儿科杂志

OBJECTIVES@#To evaluate the accuracy and safety of measurements of transcutaneous carbon dioxide partial pressure (TcPCO@*METHODS@#A total of 45 very low birth weight infants were enrolled. TcPCO@*RESULTS@#There was no significant difference in TcPCO@*CONCLUSIONS@#Lower electrode temperatures (38-41℃) can accurately measure blood carbon dioxide partial pressure in very low birth weight infants, and thus can be used to replace the electrode temperature of 42°C. Transcutaneous measurements at the lower electrode temperatures may be helpful for understanding the changing trend of blood oxygen partial pressure.

Analysis on active surveillance results of occupational pneumoconiosis in Beijing in 2019 / 中国职业医学

OBJECTIVE: To analyze the active surveillance results of occupational pneumoconiosis(hereinafter referred to as “pneumoconiosis”) in Beijing in 2019. METHODS: A total of 2 634 dust exposed workers were recruited as the active surveillance subjects by judgment sampling method. The abnormalities and influencing factors of High kV or digital photography of posterior-anterior chest radiography(hereinafter referred to as “chest radiography”) and lung function were analyzed. RESULTS: The detection rate of abnormal chest radiograph and pulmonary dysfunction were 14.0%(368/2 634) and 6.6%(175/2 634), respectively. The multivariate logistic regression analysis showed that the risk of abnormal chest radiograph in dust-exposed workers increased with age(P<0.01). Mining and construction workers had higher risk of abnormal chest radiograph than manufacturers(all P<0.05). The risk of abnormal chest radiograph of dusk-exposed workers in state-owned and foreign enterprises was higher than that of workers in private enterprises(P<0.05). The risk of pulmonary dysfunction was increased with age and length of dust exposure(all P<0.05). Workers exposed to silica dust and aluminum dust had higher risks than those exposed to welding dust(all P<0.01). The risk of pulmonary dysfunction of workers in small and micro enterprises was higher than that of workers in large enterprises(all P<0.01). Mining workers had higher risks of pulmonary dysfunction than manufacturing workers(P<0.05). CONCLUSION: Age, length of dust exposure, dust type, industry type, enterprise scale and economic type were the influencing factors of lung injury of dust exposed workers. Therefore, the supervision of key population and industries should be strengthened to reduce the occurrence of pneumoconiosis.

On the management of teachers by applying "teaching club" / 中华医学教育探索杂志

In order to improve teachers' teaching ability and manage teachers effectively, we try to organize teachers to carry out a series of activities in the form of "teaching club". We set up six teaching clubs according to the key points of teaching work and teaching hot spots. We explore the formation of "teaching club" as a means of modern teacher management model, through the implementation of the teacher-centered concept, establish an efficient and flexible management system, and establish and improve the active development of behavior and other strategies. Through a period of practice and exploration, we have gained benefits and even made breakthroughs in many aspects, such as the construction of teaching team, curriculum construction and teaching competition. The management strategies mentioned above provide new ideas for the development of teacher management.

Mucormycosis in patients with hematological diseases: seven cases reports and literature review / 中华血液学杂志

Objective: To explore the clinical characteristics, diagnosis, treatment and prognosis of patients with hematological diseases that complicated by mucormycosis, and to improve the understanding and clinical diagnosis and treatment of the disease. Methods: The clinical data of 7 patients suffering from mucormycosis during September 2012 and September 2018 were retrospectively analyzed, and their clinical characteristics, treatment process and prognosis were analyzed. Results: Of 7 patients, there were 4 males and 3 females, with a median age of 36 (19-79) years old. Two patients were diagnosed as acute myeloid leukemia as the underlying disease, the other 5 patients suffered from acute B lymphoblastic leukemia, peripheral T cell lymphoma, chronic myelocytic leukemia in blastic phase, myeloproliferative neoplasm and severe aplastic anemia after transplantation, respectively. Among them, disease types of mucormycosis were pulmonary in 4 patients, rhino-orbital-cerebral in 1 patient, cutaneous in 1 patient and disseminated in 1 patient. All the cases were confirmed by biopsy histopathology. The treatment drugs were amphotericin B or liposomal amphotericin B, and posaconazole. Surgical treatment was performed in 4 patients, 3 out of 4 achieved radical debridement, and the other one had local debridement. Two patients were cured, 1 patient was improved and 4 patients died. Conclusions: The clinical manifestation and image feature of mucormycosis in patients with hematological diseases were diverse, and the mortality rate is high, diagnosis mainly depends on histopathology. Early diagnosis, control of underlying disease, improvement of immunosuppressive status, timely effective antifungal therapy and radical surgical debridement are the key points for improving the survival rate of patients with hematological diseases complicated by mucormycosis.

The effect of injecting mouse nerve growth factor on the recovery of hand function in patients with cubital tunnel syndrome / 中华物理医学与康复杂志

Objective To observe the effectiveness of injecting mouse nerve growth factor ( mNGF) on the recovery of hand motor function among patients with cubital tunnel syndrome. Methods A total of 138 patients with moderate to severe cubital tunnel syndrome were randomly divided into groups designated as A, B and C, each of 46. Twenty micrograms of mNGF was injected daily 1 mm from the ulnar nerve at the cubital tunnel for the patients of group A and the injection site was moved 1 mm distally everyday along the nerve , but injected intramuscularly for those in group B. Those in group C received 500 μg of mecobalamin injected intramuscularly 3 times a week. The whole intervention consisted of two 4-week phases, with an interval of 2 months. Before and after the intervention, the function of internal hand muscles, hand function recovery rates and any electrophysiological changes in the ulnar nerve were measured and compared between the two groups. Results All of the patients showed significant improve-ment in hand muscle function and neuroelectrophysiology. The incidence of had muscle atrophy, Tinel′s sign, posi-tiveness in the paper clamping test and claw hand all significantly improved compared with before the treatment in all three groups. The average Disability of Arm Shoulder and Hand score in group A after the treatment was significantly higher than the group B and group C averages. The average ulnar nerve conduction velocity, incubation period and amplitude of group A after the treatment were all significantly better than before the treatment and better than the other groups′averages. After the treatment, the average hand function recovery in group A reached 91％, significantly high-er than in groups B ( 76％) and C ( 59％) . Conclusion Injecting mNGF next to the ulnar nerve is superior to in-jecting it intramuscularly in promoting the recovery of the ulnar nerve and hand function for patients with moderate to severe cubital tunnel syndrome.

Expressions and Significance of MMP-7 and SDC-1 in Inflammatory Bowel Disease / 胃肠病学

Background: Matrix metalloproteinase-7 (MMP-7), a member of the MMPs family, is expressed in injured mucosal epithelial cells of many organs. Syndecan-1 (SDC-1), a substrate of MMP-7, plays an important role in tissue repair and maintaining intestinal barrier function. Aims: To investigate the expressions and significance of MMP-7 and SDC-1 in inflammatory bowel disease (IBD). Methods: Forty-five intestinal mucosa samples and fifty peripheral blood samples from inpatients with active IBD were collected during Jan. 2017 to Jan.2018 at the Second Affiliated Hospital of Zhengzhou University. Thirty intestinal mucosa samples and thirty-five peripheral blood samples from non-IBD subjects were served as controls. Expressions of MMP-7 and SDC-1 in intestinal mucosal tissue were detected by immunohistochemistry, and serum SDC-1 level was determined by ELISA. Results: MMP-7 was highly expressed in intestinal mucosal tissue of IBD patients, especially in mucosal epithelium bordering the ulcer area. Compared with control group, the expression of MMP-7 was significantly increased and that of SDC-1 was significantly reduced in intestinal mucosal tissue of IBD patients (P<0.05). In contrast, the serum level of SDC-1 was significantly increased in IBD patients (P<0.05). Spearman correlation coefficient analysis revealed a positive correlation between MMP-7 expression and the disease activity of IBD (rs=0.519, P<0.05 for ulcerative colitis; rs =0.583, P<0.05 for Crohn's disease), and a negative correlation between MMP-7 and SDC-1 in inflamed mucosa (rs=-0.646, P<0.05). Conclusions: Increased MMP-7 expression in intestinal mucosal tissue may contribute to the initiation and development of IBD via cleaving SDC-1 and impairing mucosal healing.

Mucormycosis in patients with hematological diseases: seven cases reports and literature review / 中华血液学杂志

Objective@#To explore the clinical characteristics, diagnosis, treatment and prognosis of patients with hematological diseases that complicated by mucormycosis, and to improve the understanding and clinical diagnosis and treatment of the disease.@*Methods@#The clinical data of 7 patients suffering from mucormycosis during September 2012 and September 2018 were retrospectively analyzed, and their clinical characteristics, treatment process and prognosis were analyzed.@*Results@#Of 7 patients, there were 4 males and 3 females, with a median age of 36 (19-79) years old. Two patients were diagnosed as acute myeloid leukemia as the underlying disease, the other 5 patients suffered from acute B lymphoblastic leukemia, peripheral T cell lymphoma, chronic myelocytic leukemia in blastic phase, myeloproliferative neoplasm and severe aplastic anemia after transplantation, respectively. Among them, disease types of mucormycosis were pulmonary in 4 patients, rhino-orbital-cerebral in 1 patient, cutaneous in 1 patient and disseminated in 1 patient. All the cases were confirmed by biopsy histopathology. The treatment drugs were amphotericin B or liposomal amphotericin B, and posaconazole. Surgical treatment was performed in 4 patients, 3 out of 4 achieved radical debridement, and the other one had local debridement. Two patients were cured, 1 patient was improved and 4 patients died.@*Conclusions@#The clinical manifestation and image feature of mucormycosis in patients with hematological diseases were diverse, and the mortality rate is high, diagnosis mainly depends on histopathology. Early diagnosis, control of underlying disease, improvement of immunosuppressive status, timely effective antifungal therapy and radical surgical debridement are the key points for improving the survival rate of patients with hematological diseases complicated by mucormycosis.

Influence of different levels of skin pricking test on the short-term efficacy of subcutaneous immunotherapy in allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

To explore the effect of different levels of skin pricking test on short-term efficacy of subcutaneous immunotherapy with allergic rhinitis.Thirty-one AR patients were included in our study.All the patients had received subcutaneous immunotherapy for 1 year.According to the levels of SPT the patients were divided into 3 groups(grade 2,10 persons;grade 3,10 persons and grade 4,11 persons).Of all the patients,the nasal symptoms visual analogue scale(VAS)score,medication score and rhinoconjunctivitis quality of life questionnaire(RQLQ)were investigated both before and after receiving 1 year subcutaneous immunotherapy.The total effective rate of VAS score,RQLQ score and medication score was 61.30%,58.06% and 64.52% respectively,but there was no statistical difference among the 3 groups after 1 year subcutaneous immunotherapy(P=0.573,0.136,0.699,>0.05).This study confirms the short efficacy of subcutaneous immunotherapy in AR patients with different levels of SPT.But the level of SPT was not an objective index for shortterm efficacy of subcutaneous immunotherapy of AR.

Advances in Study on Relationship Between Epithelial Sodium Channel and Inflammatory Bowel Disease / 胃肠病学

Inflammatory bowel disease (IBD)is an autoimmune disease leading to diarrhea,abdominal pain,and weight loss. The pathogenesis of diarrhea remains unclear,however,increasing evidence has shown that the epithelial sodium channel (ENaC)is associated with diarrhea. ENaC is crucial in the control of sodium homeostasis,extracellular fluid volume,blood pressure. This article reviewed advances in study on relationship between ENaC and IBD.

Relationship between High-risk HPV Infection and Cervical Lsesions in Cervical Cancer Opportunistic Screening / 实用妇产科杂志

Objective:To analyze the infection rate of high-risk HPV(hr-HPV) and its relationship with cervical intraepithelial neoplasms in cervical cancer screening population.Methods:The positive rate of HPV 16,18 and other 12 kinds of HPV subtypes from 2015.Jun to 2016 Nov was calculated and the infection rate in CIN Ⅱ+ population were analysed.Results:In the cervical cancer screening population,the total HPV positive rate was 19.0％,the positive rate of HPV 16,HPV 18 and other 12 kinds of HPV were 5.0％,1.6％ and 15.2％ respectively The risk to develop CIN Ⅱ + in HPV 16,HPV 18 and 12 other hr-HPV positive TCT ASCUS/LSlL population was 55.2％,35.5％ and 38.9％ respectively The risk to develop CIN Ⅲ+ was 25.3％,7.7％ and 6.9％ in HPV 16,HPV 18 and other 12 kinds of hr-HPV positive TCT ASCUS/LSIL population respectively In the CIN Ⅱ + population,45.0％ cases were 12 other hr-HPV positive while 46.3％ were HPV 16 positive and the positive rate of HPV 18 was 8.7％.Conclusions:In the cervical cancer screening population,the rate of HPV 18 positive was low,the rate of other 12 kinds of HPV positive was high.It's necessary to establish exact classification for the positive rate of each subtype.hr-HPV genotyping plays an important role in cervical cancer screening.In the referral to colposcope population,the rate of HPV 18 positive was low,the TCT results showed ASCUS/LSIL risk of HPV 18 positive and other 12 kinds of HPV positive was low.Consider using shunt detection to improve screening specificity.

The relationship between genital tract microecology and cervical lesions should be emphasized / 中华检验医学杂志

The cervical epithelium can be affected by vaginal microecosystem inevitably, for the specificity of the cervical anatomy.HPV infection and cervical cancer,as well as vaginitis are associated with the imbalance of vaginal microecosystem.High-risk HPV infection is closely related to cervical cancer and precancerous lesions,with HPV16 and HPV18 causing 70%cervical cancer worldwide.Therefore,HPV test is significant in cervical cancer screening and follow-up.However, HPV test is used for cervical cancer or precancerous lesions detection clinically.In consequence, a threshold of HPV test for CIN2 +lesions evaluation should be set.In conclusion, it is important to understand the relationship among vaginal microecosystem,HPV infection and cervical cancer and precancerous lesions.Clinicians should know the purpose of HPV detection, which will contribute to clinical diagnosis and treatment of cervical cancer and precancerous lesions.(Chin J Lab Med,2018,41:267-269)

Two- to four-year follow-up analysis of three different pulpally involved high degree of difficulty cases managed with endodontic treatments using Mineral Trioxide Aggregate / Шинэ санаа Шинэ нээлт

@#Mineral Trioxide Aggregate (MTA) is a biocompatible, antibacterial, radiopaque, and dimensionally stable material after setting. Furthermore, it can set in the presence of moisture, and has a high sealing ability. The objectives of this study were to describe managements of three different exceptionally complicated endodontics cases using MTA, and to evaluate its outcomes of using MTA in long-term follow-up based on modern concept of endodontics. Case #1: A 23-year-old patient diagnosed with combined endodontic-periodontal lesion with palatogingival groove of maxillary right lateral incisor was referred to our department. A treatment of interdisciplinary approach involving root canal treatment, periodontal initial therapy, root resection, guided tissue regeneration and bone grafting was performed. The case showed complete clinical normalcy and radiographic healing on periapical radiograph after 3-year follow-up, and outcome was defined as healed. Case #2: A 33-year-old patient had a perforated resorptive lesion to mesial external root surface of tooth 21. The diagnosis was perforating internal root resorption with pulp necrosis and asymptomatic apical periodontitis. A treatment plan of revascularization with MTA coronal plug was made. The case #2 showed clinical normalcy, complete healing of alveolar bone and incomplete healing of resorptive area radiolucency on CBCT after 4-year follow-up, and outcomes were defined as healing. Case #3: An 18-year-old patient with pulp necrosis and chronic apical abscess at immature left maxillary lateral incisor with open apex received treatment of apexification with MTA and followed-up regularly. The case showed complete clinical normalcy and radiographic healing on periapical radiograph, but incomplete healing of the periapical lesion was observed on CBCT after 4-year follow-up. This outcome was defined as healing. 1. MTA may be a suitable material for use as a plug material that prevents infection and blood flow to the main root canal during periodontal surgery, perforation repair and internal root resorption filling and root canal obturation of apexification treatment. 2. Extruded MTA through the apical foramen may not have an adverse effect to periapical tissues, also could be result in osseous healing. Moreover, extruded MTA might have a property to resorb. 3. Tooth discoloration could be a potential drawback of white MTA when it is used as endodontic repair material and the discoloration tends to continuously develop for a while.

Historical story on natural medicinal chemistry: Determination of absolute configuration of natural products by Mosher's method / 中草药

Determination of the absolute configuration is considered one of the most complicated works in the natural products study. Mosher's method provides a practical solution for the stereochemistry determination of natural products by means of NMR spectroscopy. This article, which reviews the classic application of Mosher's method, is one of the series of historical stories on natural product chemistry published in this journal.

Effect of collaboration care model on diseases attitude and self-efficacy of patients with chronic hepatitis B / 中国实用护理杂志

Objective To investigate the effect of collaborative care model on diseases attitude and self-efficacy of patients with chronic hepatitis B. Methods Ninety-six cases of patients with chronic hepatitis B were selected. Forty-seven cases who were hospitalized from June 2015 to December 2015 were seemed as the control group, while 49 cases who were hospitalized from January 2016 to June 2016 were seemed as the collaboration group. Patients in control group were accepted routine care measures for chronic hepatitis B. Patients in collaboration group were accepted collaboration care measure on the basis of routine care, including patient assessment and collaboration care program development, health knowledge for patients and their families guiding and basic skills training, and psychological guidance intervention. Respectively, at admitting to hospital and after intervention 4 weeks, the diseases attitude of patients with chronic hepatitis B diseases, self-care ability and self-efficacy were assessed. Results There were no significant differences in attitude score, self-care ability score, self-efficacy score before intervention between two groups (P>0.05). They were improved after intervention compared with before intervention, the difference was statistically significant (t=3.197-25.376, P<0.01 or 0.05). The attitude in the face, avoid and give up score respectively in collaborative nursing group after intervention were (28.2±5.3), (9.8±4.2), (5.1±1.7) points, and (23.4±4.1), (14.1±3.8), (8.2±1.9) points in control group, the difference was statistically significant (t = 4.393, 4.220, 9.285, P < 0.01). The health knowledge of self-care ability, self-care skill, since the sense of responsibility, self-concept scale in collaborative nursing group after intervention were (48.2±3.4), (39.5±4.0), (33.1±5.5), (29.1±3.7) points, and (39.4±4.2), (30.2± 3.5), (24.7±4.8), (25.2±3.5) points in control group, the difference was statistically significant (t=5.137-11.286, P<0.01). The self-efficacy in each entry score and total score in collaborative nursing group were (3.4 ± 0.7), (31.5 ± 4.6) points and (2.8 ± 0.4), (20.7 ± 5.1) points in control group, the difference were statistically significant (t=5.288, 14.579, P<0.01). Conclusions Collaborative care model could help chronic hepatitis B patients to establish correct disease attitude, improve self-care ability and enhance self-efficacy.

The factors analysis on pregnant outcomes between well-differentiated endometrial cancer and atypical endometrial hyperplasia after conservative treat ment / 实用肿瘤学杂志

Objective To identify factors that might affect establishing pregnancy following conservative treatment by medroxyprogesterone acetate ( MPA)for well -differentiated endometrioid adenocarcinoma ( EC) or a-typical endometrial hyperplasia(AEH).Methods A retrospective study of 65 patients with EC/AEH were divid-ed into a pregnancy group ( n=34 ) and a non -pregnancy group ( n=31 ) .The influent factors on establishing pregnancy were detected by statistical analysis .Results There was no significant difference in clinical character-istics between pregnancy group and non -pregnancy group .There were significantly different between pregnancy group and non-pregnancy in the duration of MPA administration ,the time to disappearance of lesions ,the age of pregnancy permission ,the number of D&C procedures performed ,and endometrial thickness during ovulation ( P<0.05).The multivariate logistic regression analysis identified that the recurrence (OR=2.323,P=0.015),endo-metrial thickness during ovulation (OR=0.283,P <0.001),and age of pregnancy permission (OR=2.524,P=0.039) were significant factors affecting pregnancy outcomes .Conclusion Recurrence, endometrial thickness during ovulation ,and the age of the pregnancy permission were considered to affect pregnant establishment follow -ing conservative treatment with MPA .Assisted reproductive technology immediately after achieving tumor disap-pearance by MPA would therefore be beneficial for patients with disease recurrence ,thin endometrium ,or a higher age of pregnancy permission .