Objective To study the clinical effects of oral administration of tranilast to suppress burn scar hyperplasy when the burn wounds began repairing or were completely healed.Methods Sixty burn patients from July 2011 to December 2013 were randomly divided into groups A and B, 30 patients in each group.Thirty patients were treated with orally-administered tranilast at the beginning of wound repair, while the other patients were treated with orally administered tranilast when the burn wounds were completely healed.The therapeutic effect of these two groups was compared.Results Six months after burn wound healing, Vancouver scar scale was applied to evaluate the ther-apeutic effect.No significant differences were found between these two groups ( p>0.05) , and no adverse reactions were observed.Conclusion No significant differences in clinical effects of oral tranilast administered at the begin-ning of burn wound repair and at the time point of complete healing.

AIM To provide toxicokinetics data for toxicity studies of repeated doses of sodium 9-[2-(phosphonomethoxy) ethyl] adenine (PMEA-Na). METHODS The concentrations of PMEA-Na in plasma and urine were determined by HPLC/MS/MS method after single and multiple iv administrations in dogs. Data were executed by the statistical moment method to acquire the toxicokinetics parameters. Serum biochemical tests and histopathological examination were performed. RESULTS The system exposure of PMEA-Na in dogs was dose-dependent over the dose range of 1.0-6.0 mg·kg-1. The areas under the plasma concentration-time curve of PMEA-Na after single and multiple iv administrations at 1.0, 3.0 and 6.0 mg·kg-1 dosage were (2.3±0.5), (8.4±1.6), (17.5±3.7) and (5.0±0.4), (15.9±3.2), (30.3±4.7)mg·L-1·h, respectively. The urinary excretion of PMEA-Na in 72 h after iv administration was (87.0±4.8)% at the dose of 3.0 mg·kg-1. In 6.0 mg·kg-1 dose group, liver enzyme activity of glutamic-pyruvic transaminase and serum levels of total bilirubin, blood urea nitrogen, creatinine and triglycerides were all significantly elevated; glucose level significantly decreased comparing with the control group. Histopathological observation showed distinct pathological changes in liver and kidney tissues of 6.0 mg·kg-1 dose group. CONCLUSION There was evidence of toxicity after repeated-dose (14 d) of PMEA-Na in dogs and the major toxicity target organs were the kidney and liver.

Objective To investigate the role of autophagy in radiation-induced death response of human nasopharyngeal carcinoma cells.Methods MTT method was used to detect cell viability of CNE-2 cells in different time after irradiation.Clonogenic survival assay was used to evaluate the effect of autophagy inhibitor (chloroquine phosphate) and autophagy inductor (rapamycin) on radiosensitivity of nasopharyngeal carcinoma cells.Cell apoptosis was assessed by flow cytometry.The expressions of LC3 and P62 were measured with Western blot.Cell ultrastructural analysis was performed under an electron microscope.Results Irradiation with 10 Gy induced a massive accumulation of autophagosomes accompanied with up-regulation of LC3-Ⅱ expression in CNE-2 cells.Compared with radiation alone,chloroquine phosphate (CDP) enhanced radiosensitivity significantly by decreasing cell viability (F =25.88,P ＜ 0.05),autophagic ratio (F =105.15,P ＜ 0.05),and LC3-Ⅱ protein level(F =231.68,P ＜0.05),while up-regulating the expression of P62 (F =117.52,P ＜ 0.05).Inhibition of autophagy increased radiation-induced apoptosis (F =143.72,P ＜ 0.05).Rapamycin (RAPA) also significantly decreased cell viability,but increased autophagic ratio and LC3-Ⅱ protein level while down-regulated the expression of P62.Induction of autophagy increased radiation-induced apoptosis(F =167.32,P ＜ 0.05).Conclusions Blockage of autophagy with CDP could enhance radiosensitivity in human nasopharyngeal carcinoma cells,suggesting that inhibition of autophagy could be used as an adjuvant treatment to nasopharyngeal carcinoma.

Objective To observe the expression of Rock Ⅰand its functional activation in renal tissue from a rat UUO model, and to investigate its role in the progression of renal interstitial fibrosis(RIF). Methods Expression of RockI mRNA and protein were examined by RT PCR and Western blotting, respectively.The phosphorylation of MBS(binding subunit of myosin phosphatase)—a substrate of Rock Ⅰwas detected by Western blotting and defined,as the mark of functional activation of the kinase. Results (1)The expression of Rock ⅠmRNA was increased before the onset of RIF(the 3rd day after the experiment) (F=15 18,P

Objective To analyze the influences of catheter related bloodstream infection(CRBSI) for ICU patients with PICC. Methods Information and documents of 164 PICC patients were collected from October 2014 to December 2016, general information, intravenous drugs and skin conditions were analyzed if they have any impacts on CRBSI. Results Sixteeen patients with CRBSI and 148 patients with non-CRBSI.The acute physiology and chronic health evaluation(APACHEⅡ) score,hospitalization time,PICC catheterization time was(22.25 ± 4.95)points,(99.44 ± 57.34)d, (67.44 ± 48.30)d in CRBSI patients, and (14.64 ± 6.86) points, 21.00(22.00) d, 12.00 (14.00) d in non-CRBSI patients. There were significant differences (U=439.00, 299.00, 383.00, all P<0.01). The incidence of injection of vasoactive drugs and skin edema were accounted for 8/16,10/16 in CRBSI patients,and 25.00%(37/148),31.08%(46/148) in non-CRBSI patients, the difference was statistically significant (χ2=4.53, 6.34, P<0.05). The APACHE II score was an independent risk factor for PICC catheter-related infections(OR=1.21,P<0.01). Conclusions The environment in ICU is quite complicated and patients often have the characteristic of instability, which drives us to evaluate the influence factors of CRBSI and offer guidance for PICC maintenance.These can help reduce the incidence of CRBSI in ICU and improve the quality of patients.

Malnutrition is a common complication in patients with malignant tumors, which affects the clinical outcome of cancer patients. Accurate identification of malnutrition is the premise of nutritional intervention and treatment, but uniform diagnostic criteria for malnutrition are currently lacking. With the official release of the Global Leadership Initiative on Malnutrition (GLIM) initiated by global nutrition experts in 2018, a large cohort of studies have been carried out. In this article, the specific content and controversies of the GLIM criteria, its accuracy validation and clinical predictive value in patients with malignant tumors were mainly reviewed, aiming to provide reference for subsequent research and clinical application of malignant tumor-related malnutrition.

Objective:To investigate sedation level for postoperative patients with mechanical ventilation in ICU, and to explore the related factors and patient outcomes with different sedation level.Methods:Totally 163 postoperative ICU patients from 11th June to 30th October 2018 were prospectively analyzed. Medical information and all the RASS (Richmond Agitation Sedation Scale) scores was recorded by nurses.Results:The 163 enrolled patients received 11 261.62 hours mechanical ventilation therapy, and 2 815 RASS scores were assessed and recorded by nurses. Among these scores, 80.3% (2 261/2 815) were at light sedation level, while 17.4% (490/2 815) and 2.3% (64/2 815) were at excessive or insufficient sedation level, respectively. All patients were divided into satisfactory sedation group and unsatisfactory sedation group according to the recommendations of guidelines, and used both univariate analysis and multivariate analysis. Compared to males, female patients tend to be in a satisfactory sedation level ( OR value was 0.39, P<0.05); use of midazolam may increase the risk of unsatisfactory sedation level ( OR value was 5.60, P<0.05); the longer sedation assessment interval ( OR value was 1.70, P<0.05), the more likely the patient′s sedation level is unsatisfactory ( OR value was 1.70, P<0.05) . Patients in sedation unsatisfactory group have higher rate of tracheostomy ( χ 2 value was 9.70, P<0.01), longer ICU stay ( U value was -2.33, P<0.05) and more medical expense ( t value was -4.26, P<0.01). Conclusion:The current sedation management in our ICU is satisfactory, but there is still a small part of patients in a state of insufficient sedation or excessive sedation. Sedation level is closely related to sedatives, RASS assessments interval performed by the nurses. This study provides a reference and basis for clinical sedation management and the sedation assessment strategies in the ICU.

Objective: To investigate the impact of bladder filling status on the movement of uterine and on the volume of organs at risk(OAR), so as to provide theoretical basis for individualized internal target volume (ITV) and planning target volume (PTV). Methods: Simulation CT images for a total of 27 patients with locally advanced cervical cancer were acquired with empty bladder, 1.0 h after bladder filling, 1.5 h after bladder filling, respectively. The volumes of uterine corpus, cervix, OARs, CTV and PTV 1.0 h after bladder filling were delineated. The impact of bladder filling status on the displacements of cervix and corpus, volumetric changes of rectum, small intestine, and the volumes of small intestine, bladder and rectum within PTV were analyzed. The correlation between bladder filling status and uterine displacement and volume of OAR was also investigated, as well as the volume of cervix and corpus in the PTV with empty bladder and 1.5 h after bladder filling. Results: Bladder filling status is different for individual cases. The maximum movement range of cervix and uterine body with bladder filling state was 0-3.04 cm and 0-4.31 cm respectively. The anterior displacements of corpus (F=7.818, P<0.05), the volumetric changes of blander, as well the volume of bladder and small intestine in the PTV (F=46.197, 44.609, 29.546, P<0.05) were significantly different between different bladder filling status. The bladder filling status was correlated with the displacements of the anterior of corpus, volumetric changes of small intestine, and the volumes of bladder and small intestine within the PTV (r=-0.232, -0.298, 0.915, -0.336, P<0.05). The volumes of cervix and corpus out of the PTV were significantly different between the empty bladder and 1.5 h after bladder filling (t=-1.326, -1.559, P<0.05). Conclusions Bladder filling status was different for individual patients. The displacements of the anterior of the corpus were significantly affected by the bladder filling status. Increasing the anterior margin of PTV was recommended. The consistency of bladder filling status was critical for the precise cervical cancer IMRT.

Objective: To understand the correlation between myopia related health belief and screen time of primary and secondary school students in Jing-an District of Shanghai, and to provide suggestions for reducing screen time and preventing myopia. Methods: Using the method of cluster sampling,1 585 students from grade one to grade eight of a primary school and a junior high school in Jing-an District were selected for a questionnaire survey regarding myopia related health belief, screen time and the correlation between them. Results: About 18.8%-44.4% of the students perceived themselves as myopia susceptible,which increased with grade (χ 2=33.25,P<0.01), 51.5%-78.0% of the students were aware of the adverse health impart of myopia, 39.3%-55.6% of the students were aware of unhealthy behaviors associated with myopia and 48.7%-77.5% of the students. More than 47.6% of the students daily screen time was more than 2 h/day, and daily screen time increased with grade (χ 2=12.18, P<0.01). Perceived susceptibility for myopia, awareness on adverse health impact of myopia and unhealthy behaviors associated with myopia, as well as self-efficacy associated with myopia prevention were associated with screen time of students. Conclusion The primary and middle school students in Jing an District show low lever of knowledge on myopia susceptibility and threat, but higher lever of knowledge on myopia severity and self-efficacy of preventing myopia. nearly half of the students use electronic screens too long or too close to their eyes. Awareness on myopia susceptibility, myopia-related behaviors and health impacts of myopia and self-efficacy, combined with screen time reduction might help myopia prevention.

Objective To gain insights into the supportive care needs of liver transplant recipients,in order to provide references for the formulation of effective and targeted intervention strategies.Methods Phenomenological research method was employed to conduct semi-structural in-depth interviews with 16 liver transplant recipients in the liver transplant center of a tertiary hospital in Shanghai from November 2021 to April 2022.Colaizzi 7-step analysis method and Nvivo software were used to analyze and extract the themes.Results 5 themes were extracted,including symptom management needs,longing for the perception and avoidance of recurrence risk,disease information management needs,emotional and psychological support and the return to social roles.Conclusion The physical distress and burden of liver transplantation recipients coexist.Although the initiative to seek medical treatment is high,the perception level of disease recurrence risk is not high.In order to meet the needs of liver transplant recipients and improve their quality of life,it is necessary to strengthen the health education of disease symptom management and related risk factors,pay attention to psychological counseling and strengthen social support,and provide targeted treatment care.