Objective To investigate the correlation of position movement of primary tumor with interested organs and skin markers,and to investigate the correlation of volume variation of primary tumors and lungs during different respiration phases for patients with lung cancer at free breath condition scanned by four-dimensional CT (4DCT) simulation.Methods 16 patients with lung cancer were scanned at free breath condition by simulation 4DCT which connected to a respiration-monitoring system.A coordinate system was created based on image of T5 phase,gross tumor volume (GTV) and normal tissue structures of 10 phases were contoured.The three dimensional position variation of them were measured and their correlation were analyzed,and the same for the volume variation of GTV and lungs of 10 respiratory phases.Results Movement range of lung cancer in different lobe differed extinct:0.8 - 5.0 mm in upper lobe,5.7 -5.9 mm in middle lobe and 10.2 - 13.7 mm in lower lobe,respectively.Movement range of lung cancer in three dimensional direction was different:z-axis 4.3 mm ± 4.3 mm＞ y-axis 2.2 mm ± 1.0 mm ＞ x-axis 1.7 mm ± 1.5 mm ( x2 =16.22,P =0.000),respectively.There was no statistical significant correlation for movement vector of GTV and interested structures (r =-0.50 - -0.01,P =0.058 - -0.961 ),nor for volume variation of tumor and lung ( r =0.23,P =0.520 ).Conclusions Based on 4DCT,statistically significant differences of GTV centroid movement are observed at different pulmonary lobes and in three dimensional directions.So individual 4DCT measurement is necessary for definition of internal target volume margin for lung cancer.

AIM:To compare the cloning efficacy of full-length HBV genome amplified by single fragment PCR and two fragment PCR for choosing the suitable method for full-length HBV genome cloning.METHODS:To amplify the full-length HBV genome from 85 sera sample of HBV patients,single fragment PCR and two fragment PCR were conducted.The products were cloned into the vector and sequenced after identified with double enzyme digestion.At the same time,the titers of 85 samples were detected by real-time PCR.RESULTS:Compared with two fragment PCR,single fragment PCR requested higher level of sera HBV DNA for successful amplification of full-length HBV genome,and the efficacy of single fragment PCR was lower than that of two fragments PCR(P

Objective:To further explore the symptom experience and coping strategies of patients with multiple myeloma, so as to provide reference for the formulation of symptom management programs.Methods:Objective sampling method was used to conduct semi-structured in-depth interviews on 15 patients with multiple myeloma in Hematology Department of Nanjing Drum Tower Hospital from December 2021 to June 2022 and the model of symptom management theory was used as the framework to construct an interview outline. The Colaizzi 7-step analysis method was used to analyze data and extract themes.Results:Three main themes were summarized: symptom experience (obvious symptom perception, poor symptom assessment ability, negative symptom response); symptom management strategy (vague knowledge of symptom management, hope to get professional guidance, expect to get continuity of management); symptom management outcomes (recurrent anxiety, reordering, adaptive behavior).Conclusions:Patients with multiple myeloma have diverse and complex real symptom experience in different periods. Medical staff should pay attention to patients′ symptom response and coping needs and develop a systematic symptom management plan, so as to help them create better self-management and improve their quality of life.

Objective:To summarize the relevant evidence of exercise intervention for patients with multiple myeloma at home and abroad, and provide evidence-based basis for medical staff to formulate exercise intervention programs.Methods:Through the method of evidence-based nursing, the literatures related to exercise intervention for patients with multiple myeloma were systematically retrieved from relevant guideline websites, professional association websites and databases at home and abroad, including best practices, recommended practices, guidelines, expert consensus, evidence summary, systematic reviews and so on. The search time limit was established until April 16, 2024. Two researchers evaluated the quality of the literature and extracted the data. JBI pre-classification of evidence and level of Recommendation system (2014 version) was used to determine the level of evidence items and recommendation level.Results:A total of 15 articles were included, including 1 clinical decision, 4 guidelines, 8 systematic reviews, 1 expert consensus and 1 evidence summary. A total of 26 pieces of evidence were summarized, including 5 aspects, including applicable population, exercise evaluation, exercise plan, exercise precautions and exercise management.Conclusions:The best evidence summarized in this study provides a basis for the development and management of exercise intervention in patients with multiple myeloma. It is suggested that clinical staff should fully consider the clinical context when applying the evidence, and develop personalized exercise intervention programs based on the patient′s status and preferences.

OBJECTIVETo study the pattern of CGG repeat instability within germline cells derived from two male fetuses affected with Fragile X syndrome (FXS).

METHODSThe length and methylation status of CGG repeats within the testes of a fetus carrying a full FXS mutation and another fetus carrying mosaicism FXS mutation were analyzed with Southern blotting and AmplideX FMR1 PCR. Immunohistochemistry was also applied for the measurement of FMR1 protein (FMRP) expression within the testes.

RESULTSFor the fetus carrying the full mutation, Southern blotting analysis of the PCR product has detected an expected band representing the full mutation in its brain and a premutation band of > 160 CGG repeats in its testis. Whereas the pattern of premutation/full mutation in mosaic testis was similar to that in peripheral blood and no sign of contracted fragment was found other than a band of about 160 CGG repeats. Immunohistochemistry assay with a FMRP-specific antibody demonstrated a number of FMRP-positive germ cells, which suggested a contraction from full mutation to premutation alleles.

CONCLUSIONThis study has clarified the instability pattern of CGG repeat and expression of FMRP protein within the testes of fetuses affected with FXS, confirming that the CGG repeat can contract progressively within the germline. The FMRP expression in the testis is consistent with spermatogonium proliferation, and thus the contraction from full mutation to unmethylated premutations may occur for the requirement of FMRP expression during spermatogenesis. The better understanding of FMRP function during germ cell proliferation may elucidate the mechanism underlying the contraction of full FXS mutation in male germline.

Abortion, Eugenic ; Blotting, Southern ; Brain ; embryology ; metabolism ; DNA Methylation ; Fatal Outcome ; Fetus ; cytology ; metabolism ; Fragile X Mental Retardation Protein ; genetics ; metabolism ; Fragile X Syndrome ; diagnosis ; genetics ; Humans ; Immunohistochemistry ; Male ; Mosaicism ; Mutation ; Polymerase Chain Reaction ; Spermatozoa ; metabolism ; Testis ; cytology ; embryology ; metabolism ; Trinucleotide Repeat Expansion ; genetics

Objective:To evaluate the effect of adductor canal block(ACB)and local infiltration anesthesia(LIA)around the knee joint on inflammatory responses in the patients undergoing total knee arthroplasty(TKA).Methods:Sixty American Society of Anesthesiologists physical status Ⅱor Ⅲ patients of both sexes, aged 54-76 yr, scheduled for elective TKA, were divided into 2 groups ( n=30 each) using a random number table method: ACB group (group A) and ACB combined with LIA around knee joint group (group AL). ACB was performed with 0.5% ropivacaine 15 ml after endotracheal intubation in group A and group AL, and in addition LIA was performed around the knee joint after the osteotomy was completed during surgery in group AL.The patient-controlled ACB analgesia was applied at the end of surgery in both groups.The analgesic solution contained ropivacaine 400 ml (in 0.9% normal saline 200 ml), and the analgesic pump was set up to deliver a 5 ml bolus dose with a 30-min lockout interval and background infusion at 5 ml/h.When visual analog scale score>4, and pain was still not relived at 30 min after pressing by patients, pethidine hydrochloride 100 mg was intramuscularly injected as rescue analgesic.Peripheral venous blood samples were collected immediately before surgery (T 0) and at 24, 48 and 72 h after surgery (T 1-3) for determination of serum interleukin-6 (IL-6) and IL-10 concentrations by enzyme-linked immunosorbent assay.The muscle strength on the affected side was assessed at T 1-3.The patients′ satisfaction score, requirement for rescue analgesia, and adverse effects were recorded. Results:Compare with group A, the serum IL-6 concentrations were significantly decreased and serum IL-10 concentrations were increased at each time point after surgery, postoperative patients′ satisfaction scores were increased, the requirement for rescue analgesia was decreased ( P<0.05), and no significant change was found in the quadriceps strength of the affected limb and incidence of adverse reactions after surgery in group AL ( P>0.05). Conclusion:ACB and LIA around the knee joint can mitigate postoperative inflammatory responses in the patients undergoing TKA.

Objective:To improve the early graded rehabilitation nursing model suitable for postoperative children with congenital heart disease, providing reference for related research and clinical practice.Methods:Searched databases like JBI, PubMed, Medline, CINAHL, CNKI, Wanfang Data and related websites for information on postoperative rehabilitation of children with congenital heart disease. We improved the first draft model with qualitative interview results and used Delphi method to conduct two rounds of consultation for 16 experts from 6 provinces and cities to further test the scientific and feasibility of the model.Results:The early graded rehabilitation nursing model for postoperative children with congenital heart disease includes 4 first-level items, 15 second-level items and 48 third-level items. The 4 first-level items are the evaluation of the early graded rehabilitation nursing model, the grading standard of the early graded rehabilitation nursing model, the implementation of the early graded rehabilitation nursing model, the effect evaluation and health education. Experts′ response rates were 100% in the 2 rounds, experts′ authority coefficient were 0.82 and 0.84 respectively, and the Kendall′ s W rank-order correlation coefficients of all levels of indicators were 0.188-0.246, 0.223-0.287 (all P<0.01). Conclusions:The improved early graded rehabilitation nursing model for postoperative children with congenital heart disease is scientific, pertinence and safe, which can provide guidance for clinical rehabilitation nursing practice.

Objective To compare the CGG-repeat-length and its methylation status in fetal tissues and to explicate the heterogeneity of CGG repeats.Method Multiple tissues from a full mutation (August 2013) and a mosaic aborted fetus of 23-week gestation(May 2012) were collected and genomic DNA from these tissues was extracted.The CGG-repeat-length and methylation status in fetal tissues were determined by a combined strategy of Southern blotting and GC-Rich PCR.FMR1 expression was measured by real time PCR and Western blotting.Result CGG-repeat-length in different tissues of each fetus was similar.A major methylated band in the full mutation range (540 CGG repeats) was detected in the brain,skin,testis and kidney tissues of Case 1.An unmethylated premutation band with 160 CGG repeats,and another two bands with 470 and 1 100 CGG repeats in the full mutation range were shown in the brain,skin,testis,lung,stomach,gut,liver,kidney,heart and blood of Case 2.However,the methylation status of CGG repeats in the mosaic fetus was heterogeneous among different tissues.The lowest premutation ratio was in the brain of the mosaic fetus compared with other tissues,and correspondingly FMR1 expression in its brain was minimum.Conclusion This study clarify the tissue heterogeneity of CGG repeats and provides information for the genetic counseling and clinical diagnosis in fragile X syndrome.Based on the fact that the mosaic fetus' mother is a carrier of full mutation,it is speculated that the maternal CGG repeat has contracted before the differentiation of trilaminar germ disc.

Objective A HPLC-quantitative analysis of multi-components by single marker(QAMS)was established to determine 5 ingredients including uracil,uridine,hypoxanthine,inosine and guanosine in Periplaneta americana.Methods Separation took place on a Agilent ZORBAX SB-Aq column(250 mm×4.6 mm,5 μm)by gradient elution of methanol-0.01 mol·L-1 potassium dihydrogen phosphate at 20℃with a flow rate of 1.0 mL·min-1.The detection wavelength was 260 nm and the injection amount was 10 μL.The relative correction factors(fa/b)was calculated for the other four components with uridine as an internal standard.The content of 5 ingredients in 10 batches of Periplaneta americana was determined by QAMS.Results were compared with those of external standard method(ESM).Results Five nucleosides showed good linear relationships in their own ranges(r＞0.999 5),and the average recoveries ranged from 97.0%to 100.8%.The relative correction factors of uracil,hypoxanthine,inosine and guanosine were 0.908 0,1.005 3,1.969 5 and 1.303 4,respectively.Conclusion The established method is accurate and stable.It can provide theoretical reference for the quality control of Periplaneta americana.

OBJECTIVETo observe the effect difference between fire needle combined with chemotherapy and fire needle on quality of life in patients with chemotherapy of non-small cell lung cancer (NSCLC).

METHODSWith randomized controlled method, a total of 60 patients with chemotherapy of NSCLC were divided into an observation group (fire-needle plus chemotherapy group) and a control group (chemotherapy group), 30 cases in each one. The observation group was treated with fire needle atpoints which consisted of Geshu (BL 17) and Danshu (BL 19), combined with chemotherapy selected from TP (paclitaxel+cisplatin)/GP (gemcitabine+cisplatin)/DP (docetaxel+cisplatin)/NP (vinorelbine+cisplatin) by the oncologist according to patients' condition. The fire needle was given once a day for 7 days, and chemotherapy was given for 21 days. The control group was treated with chemotherapy alone for 21 days. Before and after treatment, response evaluation criteria in solid tumors (RECIST) was applied for evaluation, and Karnofsky performance status (KPS) and functional assessment of cancer therapy-lung (FACT-L) were applied for evaluation of quality of life in patients with chemotherapy of NSCLC.

RESULTSThe effective rate was 20.0% (6/30) and the stability rate was 73.3% (22/30) in the observation group, which were insignificantly higher than 16.7% (5/30) and 63.3% (19/30) in the control group, respectively (both>0.05). The KPS after treatment was lower than that before treatment in the control group (<0.05); the KPS after treatment was similar to that before treatment in the observation group (>0.05); the KPS in the observation group after treatment was higher than that in the control group (<0.05). The total score and each item score of FACT-L after treatment were higher than those before treatment in the observation group (all<0.05); the physical score and emotional score of FACT-L after treatment were higher than those before treatment in the control group (both<0.05); the total score, physical score, functional score and subscale score in the observation group were significantly higher than those in the control group after treatment (all<0.05), while the social/family score and emotional score in the observation group were insignificantly higher than those in the control group (both>0.05). The differences of KPS total score before and after treatment in the two groups had moderate positive correlation with differences of FACT-L total score (<0.01).

CONCLUSIONFire needle can improve quality of life in patients of NSCLC chemotherapy.