Objective In order to grasp the status quo of the internship nursing students' evidence awareness in our province, to improve the teaching measures, and to promote nursing safety. Methods We delivered questionnaires to 480 nursing students who were exercising practice in some major hospitals in our province about their contemporary consciousness of evidence, the results underwent analysis. Results The results showed that the awareness of nursing evidence was very poor in the new period. Conclusions It's imperative to enhance the normative education about evidence awareness among the nursing students.

Objective To explore and clarify the clinical features and management of patients with Castleman disease.Methods The clinicopathological features and therapeutic method of 65 patients with Castleman disease admitted to our hospital continuously from 2005 to 2012 were analyzed retrospectively.The mean follow-up time for the entire series was 40 (15-71) months.Results In contrast to Localized Castleman disease(LCD),Multicentric Castleman disease (MCD) patients were relatively older and exhibit various symptoms and abnormal laboratory tests.We found 44 tumor in LCD group.LCD ones,most of which were hyaline vascular (33/42,78.6％),were more likely originated in retroperitoneum,enterocoelia(10/44,22.7％) or mediastinum(10/44,22.7％).The initial treatment for LCD patients was complete surgical resection and all patients are current alive with no evidence of recurrence.MCD ones always accompanied by fever(9/23,39.1％),anemia(9/23,39.1％)and splenomegaly,and most of MCD patients were plasmacytic variants(14/23,60.9％) or mixed cellular variants (5/23,21.7％).We found 66 tumor in MCD group and they were more likely originated in neck (16/66,24.2％) and groin area (12/66,18.2％).Surgery combined with CHOP-like chemotherapy or CHOP-like chemotherapy alone was the mainstream treatment for MCD ones.21 patients achieved complete remission or partial remission,and only 2 patients died of lung infection.Whether patients could tolerate long-term chemotherapy or not was an important prognostic factor.Conclusions LCD patients had no typical clinical symptoms and could be cured by surgery.Most of MCD patients always had a good prognosis after receiving CHOP-like chemotherapy.

Objective: To observe the effect of herba artemisiae capillaris extracts (HACE) on the expression profile of microRNA (miRNAs) in the kidney tissue of the diabetic rats, and to explore the protective effect of HACE on the kidney tissue of diabetic rats from the miRNA angle. Methods: A total of 60 male Wistar rats were divided into control group (n=12), model group (n=24) and HACE group (n=24). The urinary albumin excretion rate and urinary protein excretion rate of the rats in various groups were detected. HE staining was used to detect the morphology of the kidney tissue of the rats in various groups after treated for 8 and 16 weeks; miRNAs chips were used to screen the expressions of miRNAs in the kidney tissue of the rats. The positive miRNAs were screened out from those with differentially expression amounts higher than 1. 74 times as well as high abundance, and RT-qPCR was used to verify the relative expression amounts of miRNAs. Results: Compared with model group, the glomeruli matrix accumulation of the rats in HACE group (after treated for 8 and 16 weeks) was significantly improved and the urinary albumin excretion rates were decreased (P<0. 05). The miRNAs chips results showed that there were 35 differentially expressed miRNAs in control and model groups and there were 17 differentially expressed miRNAs in model and HACE groups. The RT-qPCR results showed that after treated for 8 weeks, compared with control group, the relative expression amounts of miR-1306-3p (P<0. 05), miR-672-5p (P<0. 05) and miR-3550 (P<0. 01) in the kidney tissue of the rats in model group were decreased; compared with model group, the relative expression amount of miR-672-5p in the kidney tissue of the rats in HACE group was increased (P<0. 05). After treated for 16 weeks, compared with control group, the relative expression amount of miR-21-5p in the kidney tissue of the rats in model group was increased (P

Objective:To investigate the effect of the extract of Schisandra chinensis on the matrix metalloproteinases(MMPs) system in kidney tissue of the diabetic rats,and to explore its protective effect on the kidney tissue from the matrix degradation perspective.Methods:STZ was used to establish rat models of diabetes mellitus.A total of 45 diabetic rats were randomly divided into model group,extract of Schisandra chinensis group and Benazepril group,and there were 15 rats in each group.Another 15 rats were selected and used as normal control group.12 weeks after administration,the routine blood and urine biochemical indexes,the histological changes,blood glucose (BG),blood urea nitrogen(BUN),serum creatinine(Scr),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterin(LDL-C),total cholesterol(T-CHO),and triglyceride(TG) levels,excretion rates of albuminuria and proteinuria of the rats in various groups were detected;the expression amounts of fibronectin (FN),type Ⅳ collagen (Col Ⅳ),and matrix metalloproteinase inhibitor metalloproteinase-2 (TIMP-2) in kidney tissue of the rats were detected by immunohistochemical method;the activity of matrix metalloproteinase-2 (MMP-2) was detected by zymography.Results:Compared with model group,the glomeruli matrix accumulation of the rats in extract of Schisandra chinensis group was significantly improved,the excretion rate of albuminuria,LDL-C level and serum MDA level were decreased(P<0.05),the activities of CAT(P<0.01)and SOD(P<0.05)in kidney tissue were increased,and the level of MDA in kidney tissue was decreased(P<0.05).The immunohistochemistry results showed that compared with model group,the expression amounts of FN,Col Ⅳ,and TIMP-2 in kidney tissue of the rats in extract of Schisandra chinensis group were significantly decreased.The zymography results showed that compared with model group,the activity of MMP-2 in kidney tissue of the rats in extract of Schisandra chinensis group was significantly increased(P<0.05).Conclusion:Extract of Schisandra chinensis has protective effect on the kidney tissue of the diabetic rats induced by STZ,and the mechanism may be related to the inhibition of oxidative stress and the improvement of MMP-2 activity as well as the inhibition of TIMP-2 expression which could improve the matrix degradation.

Objective:To compare structure and function of mite Der f 3,Der p 3 and Eur m 3.Methods: Obtained mite allergens amino acid sequences from the International Union of Immunological Societies nomenclature database .Then physiochemical characterization,sequence alignment,secondary structure,three dimensional (3D) structure and epitopes of three proteins were analyzed by bioinformatics methods.Results:According to results of alignment ,Der f 3,Der p 3 and Eur m 3 displayed 88.51%sequence iden-tity.Der f 3,Der p 3 and Eur m 3 all contained three active sites and two trypsin functional domains ,which showed high identity of amino acid residues.Active sites of three proteins ,which closing to each other in three dimensional (3D) structure,constituting the active center of the enzyme.Secondary and 3D structure of three proteins all contains α-helices,β-sheets and random coils.Epitopes analysis revealed that Der f 3,Der p 3 and Eur m 3 all have 5 main potential epitopes located in random coils.Epitope sequences of Der f 3,Der p 3 and Eur m 3 overlapping in three domains (peptides of 79-81aa,129-135aa and 172-174aa),but the residues in these three domains were not identical.Conclusion:These studies lay the foundation for biochemical and genetic analysis of these 3 allergens,and may contribute to vaccine development for allergen-specific immunotherapy.

ObjectiveComparingfourgroupsofimmunosuppressivemousemodelsestablishedby cyclophosphamide administration in different doses and periods , we used partial least squares ( PLS) analysis to evaluate the immunosuppressive mouse models comprehensively and select the appropriate way to establish this model .Methods In this experimental study, 58 male KM mice were randomly divided into five groups: normal group (10 mice) were given normal saline daily by i.p.injection, model group 1 (12 mice) was given 40 mg/kg CTX daily by i.p.injection for 10 days, model group 2 (12 mice) was given 80 mg/kg CTX daily by i.p.injection for 3 days, model group 3 (12 mice) was given 40 mg/kg CTX daily by i.p.injection twice for a week, model group 4 (12 mice) was given 50 mg/kg CTX daily by i.p.injection for 7 days.After the injection of cyclophosphamide , the daily metabolic activities were detected everyday such as body weight , water intake , and food intake , organ index and immunological indexes such as blood RT of the model mice were measured as well .Using partial least squares ( PLS) analysis to the models and analyzing the final weight , final anal temperature , organ index , and blood routine examination in order to evaluate the immunosuppressive mouse models comprehensively .Results Compared with the normal group , different dosages of CTX reduced the weight and anal temperature of model mice (P<0.05), the food intake and water intake (P<0.01), and the spleen index and thymus index ( P<0.01 ) .Besides , the amount and percentage of basophilic granulocytes decreased ( P <0.05 ) , and the percentage of MCHC , macrophage went up , as well as the absolute value of WBC and lymphocytes were decreased in the model groups 1, 2, and 4 (P<0.05).According to the PLS analysis, there were significant differences among models 1, 2, and 4 when compared with the normal group , especially the most different in the model group 1.Conclusions After the PLS analysis of different indexes , the optimal way to establish immunosuppressive mouse models is the procedure with 40 mg/kg CTX daily injected i .p.for ten days .Our findings provide experimental evidence for the establishment of immunosuppressive mouse models .

Objective:This study was performed using preclinical transplanted animal experiments to analyce the effects and mechanisms of third-generation EGFR-TKIs combined with anti-angiogenic therapy, thereby providing theoretical basis for further clinical trials. Methods:Researchers constructed the transplant BALB/C nude mice models with H1975 lung adenocarcinoma cell line (EGFR T790M) and divided the mice into four groups and treated them with osimertinib (2.5 or 5 mg/kg/day, gavage) alone or plus bevacizumab (5 mg/kg/twice weekly, i.p.) when the tumors reached approximately 0.4-0.6 cm3 in volume. The tumor growth curve of tumor volume was drawn according to the time in every group. After 2 weeks of treatment, the mice were killed and the tumors were processed for immunohistochemical staining and Western blot analysis. Immunostaining was performed to detect:HIF-1α, VEGF, and microvessel density (MVD) by using SP method on paraffin sections. Western blot analysis was used to analyze the protein expression levels of EGFR, AKT, and ERK signal transduction pathways. Results:After 2 weeks of treatment in high-and low-dose osimertinib alone, tumor volume in the high-dose group was significantly less than in low-dose osimertinib-alone group (P<0.05). VEGF, HIF-1αexpression, and MVD were significantly low in the high-dose osimertinib-alone group (P<0.05). Increasing doses of osimertinib induced dose-dependent weakening of the p-EGFR, p-AKT, and p-ERK expression levels (P<0.05). In the low-dose osimertinib-plus-bevacizumab group and low-dose osimertinib-alone group, no significant difference in tumor volume and the above factors was observed. In the low-dose osimertinib-plus-bevacizumab group and high-dose osimertinib-alone group, tumor volumes did not exhibit significant difference (P=0.178). Moreover, VEGF, HIF-1αexpression, and MVD exhibited no significant difference. No significant difference in the p-EGFR, p-AKT, and p-ERK expression levels was found between high-dose osimertinib-alone group and low-dose osimertinib-plus-bevacizumab group (P>0.05). In the high-dose osimertinib-plus-bevacizumab group, tumor growth was not significantly greater than that in the high-dose osimertinib-alone group (P=0.642). No significant difference was observed in the above factors.In the high-and low-dose osimertinib-plus-bevacizumab groups, tumor volume and the above factors did not exhibit significant differences (P>0.05). Conclusion:Osimertinib has obvious antitumor effects in EGFR-mutant lung adenocarcinoma with T790M mutation cell xenografts. Bevacizumab has a synergetic inhibitory effect with osimertinib against EGFR-mutant lung adenocarcinoma with T790M mutation cell xenografts. Bevacizumab enhanced the antitumor effects of osimertinib by reducing VEGF expression and the microvascular density of the tumor, thereby improving the tumor microenvironment. Bevacizumab can enhance the effect of osimertinib by suppressing EGFR, ERK, and AKT phosphorylation, thereby synergistically inhibiting EGFR activation and downstream signaling.

Objective The aim of this study was to retrospectively review the efficacy and safety of treatment for unresectable locally advanced non-small cell lung cancer (LA-NSCLC).Methods A total of 98 patients treated in our hospital between January 2010 and December 2015 were enrolled in this study.Patients were divided into three groups:the thoracic radiotherapy (TRT) alone,concurrent chemoradiotherapy,and sequential chemoradiotherapy groups.The progression-free survival (PFS) and overall survival (OS) were analyzed via the Kaplan-Meier method,and compared with the log-rank/Breslow test.The prognostic factors were analyzed using the Kaplan-Meier and Cox multivariate proportional hazards models.Results The median PFS in the concurrent therapy group was longer than that in the TRT alone group (P ＜ 0.05).The median OS was improved in patients treated with concurrent or sequential therapy than in the TRT alone group (P ＜ 0.05).N stage,chemotherapy regimens,and radiotherapy modalities were independent prognostic factors of PFS in all patients (P ＜0.05).Similarly,N stage was an independent prognostic factor of OS in all patients (P ＜ 0.05).Overall,the treatment was deemed safe.The occurrence of hematotoxicity related to Karnofsky performance score (KPS) and chemotherapy regimens (P ＜ 0.05).Conclusion Patients with a lower N stage who received cisplatin-based double chemoradiotherapy demonstrated improved survival rates.Survival was significantly improved in LA-NSCLC patients treated with concurrent or sequential therapies compared with TRT alone.Overall,the treatment is safe.KPS and chemotherapy combination regimens may increase the occurrence of hematotoxicity.

The mental health status of 237 patients with coronary heart disease who participated in cardiac rehabilitation (CR) after coronary artery bypass grafting and 148 non-participating patients(control group) in three hospitals was evaluated,and the related factors for mental health of patients with CR were analyzed.The results showed that the anxiety,depression,and quality of life scores of patients after 2 months of participation in CR were significantly lower than those before CR (P＜0.05),and the incidence of anxiety and depressive symptoms was significantly lower than that in control group (18.5％ vs.31.1％ and 14.8 vs.25.0％,respectively,P＜0.05).The risk of anxiety and depressive symptoms was higher in CR participants with lower monthly income [OR=0.335(0.150-0.751),P=0.008],unemployment [OR=0.427(0.244-0.749),P=0.003] and knowing their own disease [OR=3.243(1.427-7.371),P=0.005].This study shows that CR can effectively improve the state of depression and anxiety and improve the quality of life.The implementation of CR shoμld fully consider a variety of influencing factors and develop a targeted rehabilitation program.

Objective To identify the expression of CD68-tumor-associated macrophages (TAMs) and proliferative marker Ki-67 in retroperitoneal malignant fibrous histiocytoma (MFH) and their clinical significance. Methods Clinical data about 35 patients with retroperitoneal MFH managed with surgery from February 2002 to December 2015 were retrospectively analyzed and all patients were followed up. There were 24 male and 11 female patients, and they were 18-71 years old, with mean age (53.0 ± 10.8) years old. Patients were divided into CD68 positive group (21 patients) and CD68 negative group (14 patients), while they were also divided into Ki-67 low expression (< 20%) group and Ki-67 high expression ( ≥ 20%) group, according to the immunohistochemical staining results. The overall survival time and all clinical data between two groups were compared. Kaplan-Meier estimations, Cox regression analysis, Fisher exact probabilities and Spearman correlations were performed. Results Of the 35 patients, 18 patients received radical resection, and 17 patients received palliative operation. The overall 1-, 3-, 5-year survival rates were 65.7%, 22.9%and 8.6%and the median survival was 17 (1-86) months. Factors associated with postoperative survival were FNCLCC grade (x2=7.002, P=0.008), modusoperandi of the tumor resection(x2=7.134, P=0.008), and CD68(x2=4.634, P=0.031) and Ki-67 overexpression (≥20%) (x2=8.898, P=0.003 ) . The difference between gender, age, tumor size, blood loss, removal of the joint organs and adjuvant therapy got no statistical significances (P > 0.05). Multivariate analysis showed that survival was associated with modusoperandi of the tumor resection and Ki-67 overexpression (P=0.003, 0.002, respectively). Conclusions Retroperitoneal malignant fibrous histiocytoma is a rare malignancy that display poor prognosis and high mortality. Complete resection remains the mainstream for retroperitoneal malignant fibrous histiocytoma. The patients' life span in CD68 positive or Ki-67 high expression is shorter. CD68 and Ki-67 plays a critical role in retroperitoneal malignant fibrous histiocytoma carcinogenesis and their high expression may be used as a potential survival predictor in patients with retroperitoneal MFH.