Objective To investigate the effects of health education model on the efficacy and toxicity of chemotherapy in patients with gastrointestinal cancer. Methods Random digit table was used to divide 108 patients with gastrointestinal cancer divided into control group and observation group , 54 cases in each group: the former was treated with routine nursing care and the latter with education model based on health awareness theory. The two groups compared in terms of efficacy and toxicity of chemotherapy. Results The effective rate in the observation group was significantly higher than that of the control group (P<0.05). The hematologic toxicity, gastrointestinal toxicity, skin toxicity, heart, lung and kidney toxicity in the observation group during chemotherapy were significantly lower than those of the control group (P<0.05). Conclusion The health education model on the efficacy and toxicity of chemotherapy in patients with gastrointestinal cancer can improve the effect and reduce the occurrence.

Betel quid dependence(BQD)is a chronic recurrent brain disease characterized by loss of self-control and compulsive repeated use of drugs, which conforms to the characterics of addictive behavior classified by the World Health Organization.Long term chewing Betel nut can increase the risk of a variety of cancers such as oral cancer.The BQD research lacks the ideal animal model whereas the mechanism of BQD is still not clear, and there is no effective treatment and prevention. Notably, neuroimaging technology has provided a non-invasive, quantitative assessment method for the neural mechanism of BQD. The author summarized the neural mechanism and imaging studies progress of BQD, and these findings provided preliminary objective evidence for the brain changes of BQD, which was helpful for the deep understanding of the neuropathic mechanism of BQD, and provided theoretical basis for the early intervention and treatment.

Objective: To investigate the effect of Yupingfeng on hyaluronic acid (HA) and Foxp3⁺ Treg in patients with nasopharyngeal carcinoma. Methods: A total of 58 cases of nasopharyngeal carcinoma were divided into two groups, 30 cases in the treatment group, 28 cases in the control group. Patients in two groups were treated with synchronous radiotherapy and chemotherapy treatment, the treatment group was treated with the Yupingfeng granules through oral administration, 10 g/time, tid for 2 courses. The serum Foxp3⁺ Treg markers of each group were detected by flow cytometry assay before treatment and after treatment, and the level of HA in serum was detected by radio immunoassay. Results: After radiotherapy and chemotherapy, the contents of Foxp3⁺ Treg and HA were significantly decreased in two groups (P < 0.05), and the decrease of treatment group was more significantly (P < 0.01). Correlation analysis showed positive correlation between Foxp3⁺ Treg and HA (P < 0.05). After treatment, the incidence of side effects in two groups was significantly decreased. And there was significant difference between two groups (P < 0.05). Conclusions: Combined chemotherapy and radiotherapy with Yupingfeng treatment can decrease the levels of Foxp3⁺ Treg and HA in nasopharyngeal carcinoma patients. Yupingfeng can also effectively reduce the side effect due to radiation and chemotherapy.

Objective: To investigate the effect of blocking the B7/CD28 pathway on rheumatoid arthritis mice and its possible mechanism. Methods: 40 DBA/1 mice were randomly divided into normal control group, model group, CTLA4-Ig low-dose group and cytotoxic T lymphocyte antigen-4 immunolobulin(CTLA4-Ig) high-dose group. Except for the normal control group, the other three groups were prepared for rheumatoid arthritis models. At 0, 5 and 10 days after the second immunization, the CTLA4-Ig low-dose group and CTLA4-Ig high-dose group were intraperitoneally injected with 50 mg/kg and 100 mg/kg CTLA4-Ig, respectively, the normal control group and the model group were injected with the same amount of saline. Vernier calipers were used to measure the thickness of the ipsilateral hindfoot of the mouse for arthritis score; the serum levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6(IL-6) and interleukin-17(IL-17) were detected by ELISA, images were acquired and bone tissue morphometric parameters were measured through Micro-CT scanning, HE staining observed the pathological changes of the knee joint, TRAP staining detected osteoclasts in knee joint tissues, real-time fluorescent quantitative PCR and Western blot detected osteoprotegerin(OPG), receptor activator of NF-κB(RANK), receptor activator of NF-κB ligand(RANKL) mRNA and protein expression, immunohistochemical staining detected nuclear factor κB(NF-κB) expression. Western blot was used to detect the expression of related proteins in the NF-κB signaling pathway. Results: Compared with the model group, after high-dose CTLA4-Ig treatment, RA mouse foot swelling and arthritis scores were reduced, the levels of TNF-α, IL-1β, IL-6 and IL-17 in serum were reduced, the knee joint damage was significantly reduced, bone mineral density(BMD), trabecular thickness(Tb.Th), bonevolume(BV) and bone volume fraction(BV/TV) increased, the number of TRAP positive cells decreased, the relative expression of OPG mRNA and protein in the tissue was up-regulated, while the relative expression of RANK, RANKL mRNA and protein were down-regulated. At the same time, the relative expression of p-p65 and p-IκBα protein decreased, the positive expression area of NF-κB decreased, and the difference were statistically significant(P<0.01); After CTLA4-Ig low-dose treatment, the serum levels of TNF-α, IL-1β, IL-6 and IL-17 in RA mice were significantly lower than those in the model group, and the area of NF-κB positive expression in the tissue was reduced, the difference were statistically significant(P<0.01). Conclusion CTLA4-Ig to block the B7/CD28 pathway has a significant therapeutic effect on mouse rheumatoid arthritis, which can inhibit the inflammatory response, reduce bone destruction and prevent the activation of the NF-κB signaling pathway.

Objective To explore the clinical features of critical cases of coronavirus disease 2019 (COVID-19). Methods The clinical data of nine patients who were diagnosed with critical COVID-19 in Hainan General Hospital from January 21, 2020 to February 6, 2020 were retrospectively analyzed. RT-PCR testing for 2019 novel coronavirus (2019-nCoV) was performed with multi-sites synchronize specimens including pharyngeal swab, blood, excrement, and urine. The serum levels of leucocyte, C-reactive protein, procalcitonin and lactic acid between the improved group (five cases) and the deteriorated group (four cases) were compared. The t test was used for comparison of normally distributed continuous data between groups. Results There were eight males (88.9%) and 1 female enrolled. The patients aged 28-77 years old, with an age of (52.9±18.0) years. By March 4, 2020, all five cases in improved group were cured and discharged, three cases in deteriorated group died and 1case remained in critical condition. All multi-sites specimens of patients in improved group turned negative in 2-4 weeks of illness onset, while those of cases in deteriorated group showed sustained viral nucleic acid positive (up to 48th day of illness onset). The white blood cell counts ((13.52±8.24)×10 9 /L vs (10.49±4.46) ×10 9 /L), C-reactive protein ((139.71±87.46) mg/L vs (78.60±55.40) mg/L) and procalcitonin ((2.32±4.03) ng/mL vs (0.28±0.58) ng/mL) , lactic acid ((3.70±4.14) mmol/L vs (2.33±0.53) mmol/L) in deteriorated group were all significantly higher than those in improved group ( t =2.908, 5.009, 4.391 and 2.942, respectively, all P <0.01). A rapid rise of serum IL-6 level up to 8 500 pg/mL was observed in one patient three days prior to death. Conclusion Among the patients with critical COVID-19, serum levels of inflammatory cytokines of the death cases are higher than those of improved and discharged cases.

BACKGROUNDPost-traumatic stress disorder (PTSD) is a mental disorder with delayed or chronic onset caused by unusual, threatening, or disastrous psychological trauma, and it is an important manifestation of post-disaster mental and behavioral disorders. Studies have shown that IL-6 is a cytokine associated with PTSD occurrence. This study aimed to explore the role of cytokine and ethnicity in the pathogenesis of PTSD by examining levels of serum cytokines IL-2, IL-6, IL-8, TNF-α, and cortisol in PTSD patients of Li and Han ethnic groups.

METHODSLevels of serum cytokines IL-2, IL-6, IL-8, TNF-α, and cortisol were examined by enzyme-linked immunoabsorbent assay (ELISA) method and assessed by PCL-C scale among 30 PTSD patients of Han ethnicity and 30 of Li ethnicity, and compared with 30 normal controls of Han and Li ethnicity, respectively.

RESULTSPTSD patients of Li ethnicity scored higher than PTSD patients of Han ethnicity, and normal controls of Li and Han ethnic groups in each of the re-experiencing, avoidance/numbing, and hyperarousal symptoms. The differences reached statistical significance (P < 0.05). In PTSD patients of Li ethnicity compared to patients of Han ethnicity and normal controls of either Li or Han ethnicity, the levels of IL-2, IL-6, IL-8, and TNF-α were higher, and the level of cortisol was lower.

CONCLUSIONSThere are ethnic differences in re-experiencing, avoidance/numbing, and hyperarousal symptoms among PTSD patients. The levels of serum cortisol and cytokines are strongly associated with the race.

Adult ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Hydrocortisone ; blood ; Interleukin-2 ; blood ; Interleukin-8 ; blood ; Male ; Stress Disorders, Post-Traumatic ; blood ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVE: To investigate the irregular antibody positive rate and antibody specificity in children with thalassemia received long-term blood transfusion in Hainan area and analyze the causes of antibody screening positive. METHODS: Micro-column gel method was used to screen the irregular antibody in 49 children who received transfusion treatment in our hospital, and the antibody specificity of the positive samples was evaluated. RESULTS: Fourteen of 49 cases showed positive for screening. Among them, 11 cases showed Rh blood group antibody after detecting antibody specificity, 1 case showed the coexistence of irregular antibody and autoantibody. One case for anti-JK CONCLUSION Most of the antibodies produced after long-term blood transfusion in the children with thalassemia belong to Rh blood group antibodies; the children with mixed thalassemia are more likely to produce antibodies; the antibody screening positive rate of Li nationality is higher than that of Han nationality, which may be caused by the genetic difference of blood type between Li nationality and Han nationality.
ABO Blood-Group System ; Blood Grouping and Crossmatching ; Blood Transfusion ; Child ; Female ; Humans ; Infant ; Male ; Rh-Hr Blood-Group System ; beta-Thalassemia

Objective:To evaluate the clinical effect and safety of piezoelectric osteotomy in lateral sinus floor augmentation.Meth-ods:53 implants were placed in 30 sites after lateral sinus floor augmentation(LSFA)in 29 patients by piezoelectric osteotomy.47 implants were placed simultaneously with LSFA,6 were delayed.6-8 months after implantation,the final fixed prostheses were per-formed.The patients were followed-up at 3,6,and 12th months after restoration.Results:The mean residual bone height(RBH) was 4.46 mm before operation.The mean height of sinus elevation was 7.34 mm after operation.No membrane perforation occurred. Peri-implantitis,peri-implant mucositis and implant mobility were not found during follow-up.X-ray examination showed good os-seointegration in the interface between the implants and bones.The implant survival rate and the operation success rate were 100%. Conclusion:The application of piezosurgery is safe and reliable in lateral sinus floor augmentation.

Objective: To observe the influence of preemptive analgesia by nalbuphine combined with flurbiprofen in the platelet activity indexes of the patients with decompensated cirrhosis, and to explore its quality of analgesia in the patients with decompensated cirrhosis. Methods: A total of 120 patients with decompensated cirrhosis were randomly divided into combination group (40 cases, given nalbuphine combined with flurbiprofen before anesthesia), nalbuphine group (40 cases, given nalbuphine before anesthesia) and flurbiprofen group (40 cases, given flurbiprofen before anesthesia). The postoperative patient-controlled intravenous analgesia (PCIA) was carried out with sufentanil in all the patients. The indexes of visual analog score (VAS), PCIA compression number, sufentanil consumption, Ramsay score, thrombelastogram (TEG) indexes (R value, K value, a angle, MA value and CI value) and the maximum aggregation rate by arachidonic acid (MARAA) and β-endorphin (β-EP) level, recovery time, and agitation occurrence rate of the patients in various groups were recorded 12 h and 24 h after operation. Results: The indexes of VAS, PCIA compression number, sufentanil consumption and 3-EP level of the patients in combination group were lower than those in the other groups 12 and 24 h after operation (P< 0. 05), but the differences of the above indexes of the patients in nalbuphine group and flurbiprofen group were not significant (P>0. 05). The Ramsay scores of the patients in three groups had no differences at 12 and 24 h after operation (P>0. 05). Compared with nalbuphine group, the R values and K values of the patients in combination group and flurbiprofen group at 12 and 24 h after operation were increased (P<0. 05), and the a angle, MA values, CI values and MARAA of the patients in combination group and flurbiprofen group were decreased (P<0. 05), but the above indexes of the patients in combination group and flurbiprofen group had no significant differences (P> 0. 05). The recovery time of the patients among three groups had no significant difference (F=2. 054, P=0. 102). The agitation occurrence rate during recovery period of the patients in case group was the highest (F=5. 624, P= 0. 001), and there was no significant difference in the agitation occurrence rate during recovery period of the patiens between nalbuphine group and flurbiprofen group (χ2 =3. 020, P=0. 091). Conclusion: Combination of nalbuphine and flurbiprofen in the patients with decompensated cirrhosis before analgesia can improve the quality of postoperative analgesia and can' t inhibit the activity of platelet obviously.

Objective: To investigate the effects of pectic polysaccharides extracted from Rauwolfia verticillata (Lour.) Baill.var.hainanensis Tsiang on an experimental murine colitis model. Methods: Experimental colitis was induced by dextran sulfate sodium (DSS), and mice were divided into 4 groups: control, DSS alone, DSS plus SASP, DSS plus pectic polysaccharides. The disease activity index (DAI) and histological score were observed. The tumor necrosis factor (TNF)- α and interleukin (IL)-17 levels were measured by enzyme-linked immunosorbent assay. I κ B and NF- κ B p65 expression were assessed by western blot analysis. Myeloperoxidase (MPO) activity was determined by using MPO assay kit. Results: Administration of pectic polysaccharides significantly reduced the severity of DSS-induced colitis as assessed by DAI and histological score, and resulted in down regulation of MPO activity and NF- κ B p65 expression and subsequent degradation of I κ B protein, strikingly reduced the production of TNF- a and IL-17. Conclusions: Pectic polysaccharides extracted from Rauvolfia verticillata (Lour.)Baill.var. hainanensis Tsiang exerts beneficial effects in experimental colitis and may therefore provide a useful therapeutic approach for the treatment of UC.