OBJECTIVE:To prepare redox-responsive pluronic F127 micelles with high drug-loading efficiency. METHODS:The thiol derivative F127-SH with strong hydrophobicity was synthesized by introducing tert-butyl methacrylate and cysteamine to the hydrophobic segments of F127. Paclitaxel (PTX)-loaded redox-responsive pluronic F127 micelles with high drug-loading effi-ciency(F127-SS/PTX)were prepared by film-hydration method as well as oxidation reaction of thiol groups. The diameter,encap-sulation efficiency and drug-loading amount were detected,and the change of diameter and drug release behavior of micelles were investaged under reducing environment or non-reducing environment. RESULTS:Mean diameter of F127-SS/PTX micelles was about(77.87±1.79)nm,and encapsulation efficiency and drug-loading amount were(92.73±2.35)% and(16.25±0.99)%,re-spectively. The diameter of the micelles increased rapidly and drug release rate of PTX increased significantly in the presence of 10 mmol/L dithiothreitol. CONCLUSIONS:The redox-responsive pluronic F127 micelles with high drug-loading efficiency are pre-pared successfully.

Group cooperative learning is a modem education model.In order to prompt the exploration of the education model in the practice lesson of epidemiology,group cooperative learning method was adopted.There are five key steps for the conduction of group cooperative learning,including task assignment(learning points,research topics,and infomation retrieval) 3-5 days before the task is done,reviewing the key theoretical contents,requiring students to refer to inf'ormation; organizing students to review the theoretical knowledge; students' discussion and making PPT in small groups,team report by representatives,and summing up by teachers at last.Teachers should pay attention to the rationality of interior structure and group members' work.Choosing a proper research subject is very important for arousing the students' interest of study.Based on the active classroom atmosphere and students' feedback,group cooperative learning method plays an important role in promoting the teaching efficiency of practice lesson.However,there are still insufficiencies to be improved.

OBJECTIVE:To evaluate the association between UGT1A1 gene polymorphism and irinotecan-induced 3-4 degree neutropenia,and to provide evidenced-based reference for clinical treatment. METHODS:Retrieved from CJFD,Wanfang data-base,VIP,PubMed,EMBase,Science direct and Cochrane library,related studies about UGT1A1*28 and UGT1A1*6 gene polymorphism and irinotecan-induced 3-4 degree neutropenia were collected. After data extraction and quality evaluation of included studies,Meta-analysis was conducted by using Review Man 5.3 software. RESULTS:A total of 29 studies were included,involv-ing 2408 patients. UGT1A1*28 includ wild genotype TA 6/6(UGT1A1*1/*1)and mutations genotype TA 6/7(UGT1A1*1/*28)、TA 7/7(UGT1A1*28/*28),UGT1A1*6 includ wild genotype GG and mutations genotype GA、AA. Results of Meta-analysis showed:the incidence of 3-4 degree neutropenia in UGT1A1*28 and UGT1A1*6 mutations genotype were significantly higher than wild genotype,with statistical significance [UGT1A1*28:OR=1.92,95%CI(1.52,2.44),P<0.001;UGT1A1*6:OR=2.49, 95%CI(1.46,4.26),P<0.001]. Using medium-dose and high-dose of irinotecan,the incidence of 3-4 degree neutropenia in UGT1A1*28 and UGT1A1*6 mutations genotype were significantly higher than wild genotype,with statistical significance [UGT1A1*28:OR=2.06,95%CI(1.57,2.70),P<0.001);UGT1A1*6:OR=1.92,95%CI(1.35,2.74),P<0.001]. Using low-dose of irinotecan,there was no statistical significance in the incidence of 3-4 degree neutropenia between UGT1A1*28,UGT1A1*6 mutations genotype and wild genotype [UGT1A1*28:OR=1.20,95%CI(0.70,2.08),P=0.51;UGT1A1*6:OR=3.19,95%CI (0.85,11.89),P=0.08]. CONCLUSIONS:Using medium-dose and high-dose of irinotecan,UGT1A1*28 and UGT1A1*6 muta-tions will increase the risk of severe neutropenia in cancer patients. Using low-dose of irinotecan,there is no clear correlation be-tween gene polymorphism and the neutropenia.

Epidemiological,experimental and clinical studies had demonstrated the affinity between the development of tumor and prostaglandin E2 (PGE2).The level of PGE2 was elevated in tumor tissues and the relation was detected between PGE2 and the tumor size,tumor stage,metastasis,prognosis as well as reoccurrence.Thus,using inhibitors and detecting level of PGE2 play a vital role in the prevention and clinical treatment of tumors.

Objective To analyze the epidemic characteristics of brucellosis in Nangang District of Harbin City,and to provide a scientific basis for making strategies in prevention and control of the disease.Methods Descriptive epidemiological methods were used,epidemic characteristics (time distribution,regional distribution and population distribution) of the disease in Nangang District of Harbin City in 2006-2015 were studied,and brucellosis cases were reported online through the national epidemic network.Results A total of 105 cases of brucellosis were reported,the average annual incidence rate was 7.84/100 thousand and no death case.The number of cases was the highest in 2014,it was 21 cases,the incidence rate was 1.57/100 thousand;the number of cases was the least in 2010,it was 3 cases,the incidence rate was 0.22/100 thousand;in 2006,the number of cases was 9,the incidence rate was 0.67/100 thousand;in 2015,the number of cases was 17,the incidence rate was 1.27/100 thousand.The incidence of the disease was mainly concentrated in summer and autumn,accounting for 65.71％ (69/105),the number of summer onset was 38,accounting for 36.19％ (38/105);the incidence of the autumn was 31,accounting for 29.52％ (31/105).In 2006-2012,the incidence of the disease was mainly concentrated in Wanggang and Hongqi townships,accounting for 60.00％ (30/50);after 2013,the cases in urban areas were on the rise,Wanggang and Hongqi townships accounted for 34.55％ (19/55).Incidence of male youth was the highest,male and female incidence ratio was 2.18:1.00 (72:33);incidence peak was 30-60 years old,accounting for 60.95％ (64/105);after analyzing the incidence of occupational groups,farmer was the highest,accounting for 43.81％ (46/105).Transmission route was contact with cattle and sheep and lived in the environment cattle and sheep were breed,the number of cases was 34.Conclusions The incidence of brucellosis in Nangang District of Harbin City is rising after 2013.Disease season focus in summer and autumn,occupation focus in farmers,and the scope of the outbreak has been expanded.We should further strengthen publicity and education in disease focus season,improve the awareness of protection,in order to effectively control the epidemic of brucellosis.

Objective To study the effect of blood glucose fluctuations on the prognosis of thrombolytic therapy in patients with acute cerebral infarction. Methods A total of 83 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,General Hospital of Beijing Military Command ( the Affiliated 81st Brain Hospital ) from January to November 2013 were enrolled retrospectively. They were divided into cerebral infarction with type 2 diabetes mellitus group (DMCI group,n=47) and cerebral infarction without type 2 diabetes mellitus group (NDMCI group,n=36) according to whether they had diabetes mellitus or not and the results of oral glucose tolerance test at day 7 after admission. Continuous glucose monitoring system ( CGMS) was used to monitor glucose for 72 hours at day 7 after admission. The mean blood glucose, standard deviation of blood glucose level, mean blood glucose fluctuation,and hemorrhagic transformation during the follow-up period,as well as vascular recanalization were observed and compared. At day 90,the modified Rankin scale (mRS) score was used to evaluate the prognosis of the patients. Results ( 1 ) Comparing the dynamic glucose parameters of the patients with acute cerebral infarction in both groups,the mean blood glucose,standard deviation of blood glucose level,mean blood glucose fluctuations at 24 hours in patients of the DMCI group were higher than those of the NDMCI group ( 8 . 3 ± 2 . 6 mmol/L vs. 5 . 8 ± 1 . 3 mmol/L,2. 1 ± 0. 4 mmol/L vs. 1. 6 ± 0. 6 mmol/L,4. 3 ± 0. 8 mmol/L vs. 3. 6 ± 0. 5 mmol/L). There were significant differences (t=31. 419, 15.537,and 15. 372,respectively;all P<0. 01). (2) Four patients (8.5%) in the DMCI group had hemorrhagic transformation during the follow-up period,17 cases (36. 2%) had good recanalization,and 15 cases (31.9%) had good prognosis (the mRS score < 2 at day 90);1 patient (2.8%) in the NDMCI group had hemorrhagic transformation,21 patients (58. 3%) had good recanalization,and 21 cases (58. 3%) had good prognosis. There was significant difference between the recanalization after thrombolysis and the prognosis in patients of both groups (P<0. 05). Conclusion The great fluctuations of blood glucose in acute cerebral infarction patients with type 2 diabetes mellitus may be an important factor of affecting its prognosis of thrombolytic therapy.

Objective:To investigate the training status of robotic-assisted surgery nurses in hospitals with robotic-assisted surgery system in China, and to provide reference for the training and management of robotic-assisted surgery nurses.Methods:From August to December in 2021, hospitals with robotic-assisted surgery system in China were surveyed by a self-designed questionnaire distributed online.Results:The participants in the survey of 111 hospitals in 30 provinces, cities, autonomous regions and municipalities directly under the central government, nurses cooperated with robotic-assisted surgery exist the phenomenon of their own training was up to 96.40% (107/111) of hospital, 47.75% (53/111) of the hospital said the current training content also need to add other aspects of the course. Training duration of theoretical courses was 0-13 (2.86 ± 3.03) periods arranged by hospitals, and the training duration of practical courses was 1-60 (8.38 ± 9.91) d. 35.14% (39/111) of hospitals set up regular assessment after training, and the assessment cycle of them was 1-12 (4.08 ± 3.31) months. Many hospitals put forward suggestions on strengthening English training and attaching importance to team cooperation and so on.Conclusions:In our country, Robotic-assisted surgery nurses′ training has turned to that training themselves in operating rooms, the training time, form, content and other aspects have no uniform standard, strict admittance, standardization of specialist training , these are questions need to solve.

Objective To study the analysis of folic acid combined with vitamin for level two ischemic stroke prevention effect. Methods From April 2013 to January 2014 in our hospital , selected the patients with stroke in 100 cases as the research object. In digital method were randomly divided into observation group (50 cases) and control group (50 cases). The patients in the observation group was taken folic acid combined with vitamin , the control group only was given vitamins, in all patients on admission and at discharge on the plasma levels of Hcy, D-two dimer, fibrinogen, three glycerol, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol level, the effect of folic acid combined with the vitamin was observed. Results No significant differences between the two groups before treatment, plasma Hcy levels (P>0.05) in different ways, the observation group after treatment, the plasma Hcy levels were significantly lower than the control group , with significant difference ( P<0 . 05 ) . Two groups by different ways of treatment, the observation group was best accounted for 70% (35/50), the excellent and good rate was as high as 98% (49/50), significantly higher than the control group 44% (22/50) and 74% (37/50), with significant difference (P<0.05). On two groups of different ways of treatment of cerebral was stroke recurrence and score in patients with SIAS were compared, the recurrence rate of the observation group was lower than the control group, with significant difference (P<0.05), the SIAS score was significantly higher than that of the control group, with significant difference (P<0.05). Conclusion For the patients with stroke, should the use of folic acid combine with vitamin two level of prevention. The combine uses of folic acid and vitamin , can effectively reduce the incidence of stroke and recurrence rate.

Objective The objective of this study was to investigate and understand the life quality and its influencing factors in breast cancer patients with chemotherapy. Methods Based on the European Research and Treatment Association,the EORTC-BR53 scale consisting of QLQ-C30 and QLQ-BR23 was used as the main basis to design a questionnaire to investigate the life quality of breast cancer patients with chemotherapy. The rank sum test was used to evaluate the survival of breast cancer patients with chemotherapy. The grade logistics univariate and multivariate analyses were used to analyze the factors of prognosis and life quality of breast cancer patients. Results The median fun scores of QLQ-BR23 scale in the groups of <35 months,36~59 months and more than 60 months were 0,0,and 66. 67,respectively( P<0. 05). The median scores of annoy caused by alopecia were 33. 33,33. 33, and 10. 33 in three groups mentioned above,respectively(P<0. 05). The median scores of physical function of QLQ-C30 scale for modified radical mastectomy,segment plus sentinel and breast-conserving patients were 66. 67,66. 67,and 73. 33,respectively(P<0. 05). The median scores of nausea and vomiting in the modified radical mastectomy was 16. 67,and others were 0;the median scores of shape physique of QLQ-BR23 in three groups were 91. 67,100 and 100,respectively( P<0. 05);the median scores of sexual function were 0,16. 67 and 50,respectively(P<0. 05),and the median scores of sexual fun were 0,33. 33 and 66. 67,respectively(P<0. 05). To analyze the total symptoms of life quality,causing borrow money and pathological classification were the factors affecting the total life quality of breast cancer patients with chemotherapy(P<0. 05). The total symptoms of life quality were analyzed. Univari-ate analysis showed that borrows money due to illness and ductal carcinoma in pathological classification had significant. Conclusion The life quality of breast cancer patients with chemotherapy is mainly related to the pathological stage of patients and whether they have economic pressure.

Objective The objective of this study was to investigate the relationship between the methylation of phosphodies-terase 4C(PDE4C)gene in peripheral blood leukocytes,and its interaction with environmental factors and the pathogenesis of breast cancer. Methods A case-control study was conducted to select 402 cases of breast cancer and 470 cancer-free controls from Octo-ber 2010 to December 2014. The specific DNA methylation-modified quantitative PCR method was used to detect the methylation of PDE4C gene. The use of crossover analysis and multivariate logistic regression was used to analyze the relationship between the level of gene methylation and its interaction with environmental factors and the pathogenesis of breast cancer. Results PDE4C methylation was not found to be significantly associated with the onset of breast cancer. High-frequency/high-intake of whole grains,vegetables, onion-based plants,poultry,milk,and regular exercise could reduce the risk of breast cancer;high-frequency/high-intake of pork, irregular menstrual cycle,and a high psychological stress index could increase the risk of breast cancer. PDE4C hypermethylation had a significant combining effect with edible onion-producing plants greater than 3 times/week,with an OR of 0. 373(95% CI:0. 208~0. 668,P=0. 001). Conclusion Hypermethylation of PDE4C is not an independent risk factor for breast cancer,and its combination with environmental factors affects the risk of breast cancer.