Objective:To investigate the views of doctors on the incidence and treatment tactics of mild progression after epithelial growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)treatment in lung adenocarcinoma and provide suggestions to optimize the counter-measure strategies.Methods:Convenience sampling was used to conduct an online questionnaire survey for doctors specializing in onco-logy and respiratory diseases.Results:584 valid questionnaires were collected,and all the doctors expressed concerns regarding mild tumor progression after EGFR-TKI treatment.The coping strategies included maintaining the original TKI treatment,adding other treatments to the original TKI,changing the regimen,and performing secondary tissue biopsy,among which,most doctors chose to add other treatments to the original TKI.Conclusions:Doctors have noticed the enlargement of target lesions in still stable disease(SD)and most frequently chose to add other treatments to the original TKI as a coping strategy.This finding can provide a reference for framing future guidelines for large sample prospective clinical studies that are needed to find the most effective synergistic treatment options.

Objective:To investigate the views of doctors on the incidence and treatment tactics of mild progression after epithelial growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)treatment in lung adenocarcinoma and provide suggestions to optimize the counter-measure strategies.Methods:Convenience sampling was used to conduct an online questionnaire survey for doctors specializing in onco-logy and respiratory diseases.Results:584 valid questionnaires were collected,and all the doctors expressed concerns regarding mild tumor progression after EGFR-TKI treatment.The coping strategies included maintaining the original TKI treatment,adding other treatments to the original TKI,changing the regimen,and performing secondary tissue biopsy,among which,most doctors chose to add other treatments to the original TKI.Conclusions:Doctors have noticed the enlargement of target lesions in still stable disease(SD)and most frequently chose to add other treatments to the original TKI as a coping strategy.This finding can provide a reference for framing future guidelines for large sample prospective clinical studies that are needed to find the most effective synergistic treatment options.

OBJECTIVES: The prevalence of human immunodeficiency virus (HIV) associated neurocognitive disorders (HAND) in people living with HIV/acquired immunodeficiency syndrome (PLWHA) worldwide is as high as 42.6%. This study aims to investigate the neurocognitive function status and its influencing factors in PLWHA, providing evidence for early identification and intervention of neurocognitive impairment in this population. METHODS: PLWHA aged 18 and above who received outpatient or inpatient care at the First Hospital of Changsha between June and August 2019 were included. Sociodemographic and HIV-related information were collected. Neurocognitive function was assessed using the Brief Neurocognitive Screen (BNCS), which includes the Digit Symbol Test (DST) and Trail Making Test A and B (TMT-A and TMT-B). Impaired neurocognitive function was defined as abnormal scores in at least one dimension (DST score <30, TMT-A time >60 seconds, TMT-B time >90 seconds). RESULTS: A total of 375 PLWHA were included, of whom 212 (56.5%) exhibited neurocognitive impairment. Higher impairment rates were observed among females, individuals aged ≥50 years, those with primary education or below, and those who were married/cohabiting (all P<0.05). Heterosexual transmission accounted for the majority of infections (233 cases, 62.1%), with a significantly higher rate of neurocognitive impairment (69.1%) compared to homosexual transmission and unknown routes (P<0.001). Higher WHO clinical stages were associated with increased impairment rates (P<0.001). PLWHA with a nadir CD4⁺ T cell count <200 cells/mm³ or an infection duration ≥5 years had significantly higher impairment rates than those with higher CD4⁺ T cell count or shorter infection durations (both P<0.05). Logistic regression analysis showed that patients with a nadir CD4⁺ T cell count <200 cells/mm³ had a significantly higher risk of neurocognitive impairment (OR=2.461, 95% CI 1.116 to 5.427). Compared to WHO stage I, the risk increased progressively in stage II (OR=6.005, 95% CI 2.906 to 12.407), stage III (OR=6.989, 95% CI 2.502 to 19.523), and stage IV (OR=22.059, 95% CI 7.289 to 66.760; all P<0.05). CONCLUSIONS Potential risk factors for neurocognitive impairment in PLWHA include low nadir CD4⁺ T cell counts and advanced WHO clinical stages. The lower the CD4⁺ T cell count and the higher the clinical stage, the greater the risk of neurocognitive dysfunction.
Humans ; Female ; Male ; Middle Aged ; HIV Infections/psychology* ; Adult ; Acquired Immunodeficiency Syndrome/psychology* ; Neuropsychological Tests ; Cognitive Dysfunction/epidemiology* ; Neurocognitive Disorders/epidemiology* ; CD4 Lymphocyte Count ; Risk Factors ; Aged

Objective:To investigate the incidence of venous thromboembolism (VTE) in patients with esophageal cancer (EC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 8 458 EC patients who were admitted to Sichuan Cancer Hospital from January 2017 to December 2021 were collected. There were 6 923 males and 1 535 females, aged (64±9)years. There were 3 187 patients undergoing surgical treatment, and 5 271 cases undergoing non-surgical treatment. Observation indicators: (1) incidence of VTE in EC patients; (2) treatment and outcomes of patients with VTE. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the nonparameter rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the nonparameter rank sum test. Results:(1) Incidence of VTE in EC patients. Of 8 458 EC patients, 175 cases developed VTE, with an incidence rate of 2.069%(175/8 458). Among 175 VTE patients, there were 164 cases of deep venous thrombosis (DVT), 4 cases of pulmonary embolism (PE), 7 cases of DVT and PE. There were 59 surgical patients and 116 non-surgical patients. There was no significant difference in thrombus type between surgical and non-surgical EC patients with VTE ( χ2=1.95, P>0.05). Of 3 187 surgical patients, the incidence of VTE was 1.851%(59/3 187), including an incidence of 0.157%(5/3 187) of PE. PE accounted for 8.475%(5/59) of surgical patients with VTE. Of 5 271 non-surgical patients, the incidence of VTE was 2.201%(116/5 271), including an incidence of 0.114%(6/5 271) of PE. PE accounted for 5.172%(6/116) of non-surgical patients with VTE. There was no significant difference in the incidence of VTE or PE between surgical patients and non-surgical patients ( χ2=1.20, 0.05, P>0.05). (2) Treatment and outcomes of patients with VTE. Among 175 EC patients with VTE, 163 cases underwent drug treatment, and 12 cases did not receive treatment. Among 163 cases with drug therapy, 158 cases underwent anticoagulant therapy, 5 cases were treated with thrombolysis. All the 163 patients were improved and discharged from hospital. Conclusions:The incidence of VTE in patients with EC is relatively low, as 2.069%. There is no significant difference in the incidence of VTE or thrombus type between surgical EC patients and non-surgical EC patients.

AIM: To investigate the possible use of anti-FGF-2 nanobody for the treatment of pathological neovascularization. METHODS: SD rats were divided into a sham operation group, a control group (3 mm diameter circular filter paper soaked with 1 mol/L NaOH solution was applied to the central part of the cornea of rats for 30 s to prepare the rat model of alkali-burn angiogenesis) and a treatment group (treated with a drop of 3 mg/mL anti-FGF-2 nanobody 7 days after the operation. Repeat application 3x/day for 14 days). Corneal angiogenesis was measured by stereoscopic microscopy and CD31 immunohistochemical staining. The mRNA and protein expression levels of VEGF and FGF-2 were detected by quantitative fluorescence PCR (qPCR), enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry.RESULTS: (1) Blood vessel: The area of the treatment group was significantly reduced compared with the model group, and the vascular lumen was narrower (P<0.05). The difference was the most significant after 14 days of drug intervention; (2) Expression level of FGF-2 mRNA and protein: the model group had similar results to the treatment group (P>0.05); (3) Expression levels of VEGF mRNA and protein: The treatment group was significantly higher than the model group (P<0.05). In addition, the expression of VEGF also increased significantly in the continuous administration of the sham operation group. CONCLUSION: Anti-FGF-2 nanobody can be used for the treatment of angiogenesis. However, the expressions of VEGF will compensatorily increase after blocking FGF-2 in normal or pathological rats.

Objective:To explore the current situation of work stress and job burnout of nursing staff in the Department of Infectious Diseases, and analyze its influencing factors.Methods:From January to June 2020, 63 nurses from the Department of Infectious Diseases of Zhejiang Hospital and the Affiliated Hospital of Chengde Medical University were selected as research subjects. Questionnaires were used to investigate general information, work stress, and job burnout.Results:63 questionnaires were issued and 60 were recovered. There was a statistically significant difference in work stress scores of nurses with different working hours, daily number of patients admitted, public recognition and respect, and training times ( P<0.05) . There were statistically significant differences in the scores of the personal accomplishment dimension of nurses with or without administrative positions and different professional titles, and in the scores of the depersonalization tendency dimension of nurses with different education levels, public recognition and respect, and training times, and in the scores of the emotional exhaustion dimension of nurses with different working hours, daily number of patients admitted, public recognition and respect, and training times ( P<0.05) . Conclusions:Nursing staff in the Department of Infectious Diseases are under high work stress, overall burnout is mild, and the personal sense of accomplishment of the nursing staff is low. The main reasons for this are closely related to the daily number of patients admitted, public recognition and respect, and the training times.

Objective To investigate whether advanced glycation end products (AGEs) can induce the expression of Ros,JC-1 and its apoptosis-related proteins in glomerular mesangial cells under high glucose environment,induce apoptosis and injury of glomerular mesangial cells.Methods Rat glomerular mesangial cell line HBZY-1 was cultured in vitro.The cells were cultured with different concentrations of AGEs for 0,12,24 and 48 hours respectively.MTT assay was used to observe the cell proliferation ability.After the optimal time and concentration of AGEs were selected,the caspase enzyme inhibitor Z-VAD-fmk and reactive oxygen species (ROS) scavenger N-acetyl-L-cysteine (NAC) were cultured and the apoptosis rate was detected by cell death detection apoptosis ELISA plus and Annexin V-FITC/PI kit.JC-1 staining was used to detect the changes of mitochondrial membrane potential (MMP).Cell ROX deep red flow cytometry was used to detect the total ROS level.The expression of anti-apoptotic protein Bcl-2,pro-apoptotic protein BAX,caspase-9,caspase-3 and poly ADP-ribose polymerase (PARP)-activated fragments was detected by Western blotting.Results AGEs could decrease the activity of glomerular mesangial cells in a time and concentration-dependent manner,and induce cell death.The percentage of apoptotic cells in glomerular mesangial cells was significantly increased after treatment with 250 mg/L AGEs for 24 h (P ＜ 0.01),and Z-VAD-fmk could significantly alleviate AGEs-induced glomerular mesangial cell apoptosis (P ＜ 0.01).Compared with the control group,AGEs increased the level of intracellular reactive oxygen species and decreased MMP in a time-dependent manner,and the two time points that AGEs significantly caused the change were 1 h and 2 h (all P ＜ 0.01).AGEs also reduced the expression of antiapoptotic protein Bcl-2 and increased the expression of pro-apoptotic protein Bax,cleaved caspase-9,cleaved caspase-3 and cleaved PARP (all P ＜ 0.01).Compared with AGEs group,NAC could significantly stabilize MMP (P ＜ 0.01),increase Bcl-2 expression (P ＜ 0.01),and decrease the expression of BAX,cleaved caspase-9,cleaved caspase-3 and cleaved PARP (all P ＜ 0.01).Conclusion AGEs induce mitochondrial pathway apoptosis in glomerular mesangial cells by increasing intracellular ROS level and destroying MMP.

Objective: To investigate the effects of abated microRNA-21 (miRNA-21) on phosphatase and tensin homologue on chromosome ten protein (PTEN) and PI3K/Akt/mTOR pathway, as well as their further influence on the autophagy in high glucose (HG, 25.0 mmol/L) induced rat glomerular mesangial cells. Methods: MiRNA-21 inhibitor and negative control were transfected by liposome 2000 into rat glomerular mesangial cells (HBZY-1). The cells were divided into normal glucose (5.5 mmol/L) group, normal glucose+negative control group, normal glucose+miRNA-21 inhibitor group, HG group, HG+negative control group and HG+miRNA-21 inhibitor group. Cell proliferation and hypertrophy were assayed by MTT and the ratio of total protein to cell number respectively. The miRNA-21 expression was detected using real time PCR. The expressions of PTEN/Akt/mTOR signaling signatures, autophagy-associated protein (p62 and LC3 Ⅱ) and collagen Ⅰ was detected by Western blotting and real time PCR. Autophagosomes were observed using electron microscopy. Results: Compared with those in normal glucose group, in HG group cells had hypertrophy and proliferation, up-regulated miRNA-21 expression, and down-regulated PTEN protein and mRNA expressions (all P<0.01). Also there were and up-regulated p-Akt, p-mTOR, p62 and collagen Ⅰ expression, and lower LC3 Ⅱ expression and autophagosomes (all P<0.01). Further, compared with those in HG group, cells hypertrophy and proliferation in HG+miRNA-21 inhibitor group were reduced, expressions of p-Akt, p-mTOR, p62 and collagen Ⅰ were down-regulated, while expressions of PTEN and LC3 Ⅱ and autophagosomes were up-regulated (all P<0.01). Conclusions MiRNA-21 inhibitor up-regulates PTEN expression, which inhibits the activation of Akt/mTOR signaling pathway, ameliorates cell hypertrophy, proliferation and enhances autophagy to reduce extracellular matrix accumulation.

Objective To understand psychiatry hospital nurse' s self-compassion situation, explore the influencing factors, for nursing managers to know about the clinical nurses psychological health and to provide a reference data of intervention to improve the level of self-compassion. Methods A total of 381 clinical nurses from the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) completed the survey using the questionnaire including the Self-Compassion Scale (SCS) and general information questionnaire. The influence factors were analyzed by chi-square test and Logistic regression analysis. Results The total score of SCS was (85.43 ± 10.23) points in 381 clinical nurses with the medium level, which was less than that of other nurse group (109.21±9.76) points, and there was significant difference(t=-45.388, P < 0.01).The Logistic regression analysis showed that female and working in the psychiatric ward were the risk factors of self compassion(OR=1.772, 1.995, P<0.05 or 0.01). While on the night shift was the protective factor(OR=0.536, P < 0.01). Conclusions Psychiatric hospital nurse' s self-compassion is at medium level. When the nurses cope with the negative events may lack adjustment method. Nursing managers should pay attention to train the ability of the nurse individual self-compassion, targeted to carry out active intervention measures.

Objective To investigate the expression of Notch signaling molecules, transforming growth factor-β (TGF-β) and fibronectin (FN) in mesangial cell induced by high glucose, and the underlying mechanism of cordyceps sinensis.Methods Rat glomerular mesangial cells were divided into following groups: normal control group (5.5 mmol/L glucose), hypertonic control group (5.5 mmol/L glucose+ 19.5 mmol/L mannitol), high glucose group (25.0 mmol/L glucose), DAPT inhibitor group (25.0 mmol/L glucose + 1 μmol/L DAPT), cordyceps sinensis intervention group (25.0 mmol/L glucose+10 mg/L cordyceps sinensis).Cell proliferation was detected by MTT.The protein and mRNA expression of Notch signaling molecules (Notch1, Jagged1 and Hes1), TGF-β and FN was detected by Western blotting and real time PCR.Results Compared with normal control group, high glucose induced mesangial cell proliferation, as well as the mRNA and protein expression of Notch1, Jagged1, Hes1, TGF-β1 and FN was up-regulated in high glucose group (all P ＜ 0.05).Compared with that in high-glucose group, DAPT and cordyceps sinensis inhibited high glucose-induced mesangial cell proliferation and down-regulated the mRNA and protein expression of Notch pathway, TGF-β1 and FN (all P ＜ 0.05).Conclusion By inhibiting the abnormal activation of Notch signaling pathway and TGF-β signaling pathway, cordyceps sinensis may alleviate high glucose-induced mesangial cell proliferation and reduce extracellular matrix accumulation, thus protecting kidney.