Objective To explore the effect of gene mutations of epidermal growth factor receptor ( EGFR) on targeting therapy of advanced non-small cell lung cancer (NSCLC). Methods The 139 hospitalized patients who had been treated at least once with platinum-based chemotherapy and had tumor progression or recurrence after the last chemotherapy between December 2005 and December 2009, underwent EGFR gene test extracted from the pathological tissues. Based on the results of the test, the patients were divided into three groups: EGFR mutation per os (p.o.)Gefitinib (MPG) group, wild-type EGFR per os (p. o. ) Gefitinib (WpG) group and wild-type EGFR post-docetaxel chemotherapy (WpD) group. Clinical characteristics, pathology, treatment efficacy,survival time, performance status (PS) score, adverse reaction and quality of life of patients in the three groups were assessed. Results The EGFR mutation rate were higher in female, patients with adenocarcinoma and non-smokers than in male, smokers and those without adenocarcinoma. There were significant differences in median progression-free survival and median survival time among the three groups, which were 2.8 and 8. 9 months in MpG group, 2.0 and 7.1 months in WpG group,2.5 and 7. 8 months in WpD group(H=11. 198, 16. 991 ,all P＜0.01). The changes of PS score were significantly different between MpG group and WpG group (96. 8% vs. 62. 0%, x2 = 12. 583 ,P＜0. 01 ). However, there was no difference in changes of PS score between WpG group and WpD group (62. 0% vs. 66. 0%, x2 =0. 878,P＞0. 05). Conclusions The gene mutation of epidermal growth factor receptor may be served as an important indicator of advanced non-small cell cancer therapy.

Objective To estimate the degree of oxidative stress and atherosclerosis praecox in patients with systemic lupus erythematosus (SLE), and emphasize on exploring AOPPs' clinical significance in premature atherosclerosis in SLE. Methods The levels of AOPPs, Hey, MDA, SOD, baPMV and CIMT were detected by ELISA and spectropholometry in 44 non-menopausal female SLE patients and 31 healthy middle-aged women respectively, and baPWV. The results were compared with AOPPs of the two groups. Then each group was stratified based on disease duration (≥5 years or <5 years) and the disease activity(active and inactive) in SLE patients. The patients' TC, TG, LDL were analyzed. T test, t' test and Pearson correla-tion were selected. Results The levels of AOPPs, Hcy, MDA in SLE patients were significantly higher than those of the healthy controls (P<0.05). The activities of SOD were lower than controls (P<0.05). The levels of AOPPs, Hcy, MDA, SOD had statistical significance between SLE patients disease duration ≥5 years or <5 years, active or inactive groups. There were two cases with CAP in patients with SLE (more than 5 years disease duration),while there wasnone in healthy controls. The levels of baPWV and CIMT in patients with SLE were higher than healthy controls (P<0.05), and had statistical significance in SLE patients disease duration more than or less than 5 years (P<0.05). The oxidative stress targets (AOPPs, Hey, MDA, SOD) had significant correlation with the level of baPWV and CIMT (P<0.01). The level of serum AOPPs had significant positive correlation with the levels of Hcy, TC, TG and LDL (P<0.01～0.05). Conclusion SLE patients have increased oxidative stress , and significantly higher prevalence of atherosclerosis than healthy controls. The disease duration and oxidative stress play important roles in the duration of atherosclerosis. AOPPs probably involves in the accelerated atherosclerosis of SLE patients. It may be a predictor for SLE complicated with atherosclerosis praecox.

Objective To observe the effect of spinal cord stimulation on expression of spinal GLT-1 and GLAST in rats with diabetic neuropatbic pain.Methods Forty-eight healthy male SD rats,only 2 months old,weighting 250-300 g,using the random number table method,were divided into four groups (n=12):the control group (group C),diabetes neuralgia group (group D),false stimulation group (group N)and spinal cord stimulation group (group S).The model of diabetes was induced by the pedtoneal injec-tion of streptozocin (STZ),electrodes were placed into the epidural space 1 9 days after injection of STZ in groups N and S,in addition,group S was performed 26-28 days after injection of STZ.Mechanical contrac-tion leg threshold (MWT)were determined one day before STZ injection,2 d,7 d,14 d and 28 d after STZ injection.The rats were sacrificed,the lumbar spinal cord tissue were obtained for determination of GLT-1 and GLAST expression in spinal cord tissues on 28 d after measurement of MWT.Results Compared with group C,MWT was decreased 14 d and 28 d after STZ injection,and expression levels of GLT-1 and GLAST mRNA were increased on 14 d and 28 d (P<0.05);Compared with before STZ injection,MWT of group D,group N and group S was decreased on 14 d and 28 d (P<0.05);Compared with group D, MWT was increased,and expression levels of GLT-1 and GLAST mRNA were increased in group S on 28 d after STZ injection (P<0.05 ).Conclusion The mechanism of spinal cord stimulation reducing rats diabetes neuralgia may be related to elevating the expression of GLT-1 and GLAST.

Objective To evaluate the efficacy of dexmedetomidine in preventing postoperative de-lirium in the patients with schizophrenia. Methods Ninety patients with schizophrenia of both sexes, with American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 20-60 yr, weighing 45-90 kg, with a history of long-term use of antipsychotics, scheduled for elective emergency operation under general anes-thesia, were divided into 3 groups ( n=30 each) using a random number table method: high-dose dexme-detomidine group ( group HD ) , low-dose dexmedetomidine group ( group LD ) and control group ( group C) . In HD and LD groups, dexmedetomidine was intravenously injected in doses of 1. 0 and 0. 5 μg∕kg, respectively, over 10 min prior to induction of anesthesia, followed by continuous infusion at 0. 4 and 0. 2μg · kg-1 · h-1 , respectively, until the end of operation. Anesthesia was maintained with propofol, remifentanil and sevoflurane, and bispectral index value was maintained at 40-55. Patient-controlled intra-venous analgesia was performed within 48 h after operation, and visual analogue scale score was main-tained≤3. The end-tidal concentration of sevoflurane ( ETsev) was recorded at 30 min after endotracheal intubation. The sleep quality was evaluated and scored at 6 h and 1, 2 and 3 days after operation. The oc-currence of delirium during emergency from anesthesia and within 3 days after operation was recorded. The occurrence of postoperative adverse reactions such as bradycardia, hypotension and hypoxemia was also re-corded. Results Compared with group C, the ETsev, sleep quality scores at each time point after opera-tion and incidence of delirium during emergency from anesthesia and within 3 days after operation ( 3％) were significantly decreased in group HD, and the ETsev, sleep quality scores at 6 h after operation and in-cidence of delirium during emergency from anesthesia were significantly decreased ( P<0. 05) , and no sig-nificant change was found in the incidence of delirium within 3 days after operation in group LD ( P>0. 05) . The ETsev and incidence of delirium within 3 days after operation were significantly lower in group HD than in group LD ( P<0. 05) . There was no significant difference in the incidence of bradycardia, hypotension or hyoxemia among C, HD and LD groups (P>0. 05). Conclusion Dexmedetomidine given as a loading dose of 1. 0μg∕kg followed by a maintenance dose of 0. 4μg·kg-1 ·h-1 can prevent postoperative delirium effectively in the patients with schizophrenia.

Objective To evaluate the effect of spinal cord stimulation on the expression of neuronal nitric oxide synthase (nNOS) in the rats with diabetic neuropathic pain.Methods Forty-eight pathogen-free healthy male Sprague-Dawley rats,aged 2 nonths,weighing 250-300 g,were divided into 4 groups (n =12 each) using a random number table:control group (group C),diabetes mellitus group (group DM),sham operation group (group S) and spinal cord stimulation group (group SCS).Diabetic neuropathic pain was produced by intraperitoneal injection of 1％ streptozocin 75 mg/kg and confirmed by blood glucose level＞16.7 mmol/L on day 2 after streptozocin injection.Electrodes were implanted into the epidural space at 19 days after successful establishment of the model in S and SCS groups,and in addition spinal cord stimulation (frequency 50 Hz,pulse width 0.2 ms,intensity=2/3 of the lowest intensity) was performed for 30 min once a day at 26-28 days after successful establishment of the model in group SCS.The mechanical paw withdrawal threshold (MWT) was measured at 1 day before establishment of the model (T1) and 2,7,14 and 28 days after successful establishment of the model (T2-5).The rats were sacrificed after the last measurenent of MWT at T5,and the lumbar segment of the spinal cord was removed for determination of nitric oxide (NO) content and nNOS expression in spinal cord tissues.Results Compared with group C,the MWT was significantly decreased at T4.5,and the NO content and nNOS expression in the spinal cord were increased in DM,S and SCS groups (P＜0.05).Compared with group DM,the MWT was significantly increased at Ts,and the NO content and nNOS expression in the spinal cord were decreased in group SCS (P＜0.05).Conclusion The mechanism by which spinal cord stimulation allenuales diabetie neuropalhic pain is related to inhibiting nNOS expression and reducing NO production in rals.

Objective:To construct a Nurses′ Growth Mindset Assessment Scale, and to test the reliability and validity of the scale, so as to provide an assessment tool for accurately assessing nurses′growth mindset ability.Methods:From June to October 2021, taking the growth mindset theory as the research framework, at the same time, the related researches on the growth mindset were reviewed and analyzed, the item pool of the scale was comprehensively constructed, and the formal version of the scale was formed through factor analysis, Delphi method and other research methods. A total of 578 nurses from Qilu Hospital of Shandong University and Shandong Provincial Hospital were investigated to test the reliability and validity of the scale by simple sampling method.Results:The constructed formal scale consisted of 31 items and 3 dimensions. The 3 dimensions were self-awareness, attitude towards challenges and resilience to setbacks. The cumulative variance contribution rate was 65.954%. The Cronbach′s alpha coefficient was 0.926, and the Spearman-Brown split-half reliability coefficient was 0.750.Conclusions:Nurses′ Growth Mindset Assessment Scale has good reliability and validity, and can be used to evaluate the nurses′ growth mindset ability.

Descriptive epidemiological methods were adopted to analyze the epidemiological characteristics of scarlet fever in Hubei Province from 2009 to 2018. During this study, the epidemiological data was obtained from the Chinese Center for Disease Control and Prevention Information System. The results showed that there were 7 329 cases of scarlet fever reported in Hubei Province from 2009 to 2018 and the annual average incidence was 1.25 per 10 000. The number of cases was increased by years, and in 2018 it was the highest peak during these ten years and up to 1 758 which was account for 24% in these ten years, and the incidence was 2.98 per 10 000. The number of reported cases of male and female was 4 473 and 2 856, respectively, and both of the incidence rates were on the rise. The reported cases were distributed in 0-60 year-old group, mainly in the <15-year-old group (98.4%, 7 214/7 329). The season with the highest incidence rates were summer and winter. There were cases in all cities and prefectures, and the number of cases were the highest in Wuhan ( n=2 105), Yichang ( n=1 390), Jingzhou ( n=954) and Enshi ( n=1 090). Hence, it was very necessary to be on guard for the outbreak of scarlet fever and strengthen the surveillance in summer and winter for the people who were younger than 15 years old, especially in Wuhan, Yichang, Jingzhou and Enshi.

Descriptive epidemiological methods were adopted to analyze the epidemiological characteristics of scarlet fever in Hubei Province from 2009 to 2018. During this study, the epidemiological data was obtained from the Chinese Center for Disease Control and Prevention Information System. The results showed that there were 7 329 cases of scarlet fever reported in Hubei Province from 2009 to 2018 and the annual average incidence was 1.25 per 10 000. The number of cases was increased by years, and in 2018 it was the highest peak during these ten years and up to 1 758 which was account for 24% in these ten years, and the incidence was 2.98 per 10 000. The number of reported cases of male and female was 4 473 and 2 856, respectively, and both of the incidence rates were on the rise. The reported cases were distributed in 0-60 year-old group, mainly in the <15-year-old group (98.4%, 7 214/7 329). The season with the highest incidence rates were summer and winter. There were cases in all cities and prefectures, and the number of cases were the highest in Wuhan ( n=2 105), Yichang ( n=1 390), Jingzhou ( n=954) and Enshi ( n=1 090). Hence, it was very necessary to be on guard for the outbreak of scarlet fever and strengthen the surveillance in summer and winter for the people who were younger than 15 years old, especially in Wuhan, Yichang, Jingzhou and Enshi.

Objective This study aims to analyze the application value of the Kirkpatrick Evaluation Model in the evalu-ation of hospital service training.Methods A total of 100 hospital front desk service personnel participating in service training from July 2021 to July 2023 at Qingyuan People's Hospital were selected as the research subjects.They were randomly divided into a study group and a control group,with 50 participants in each group.The study group implemented training based on the Kirkpatrick Evaluation Model,while the control group received conventional training.The learning level,behavior level,reaction level,and result level(including service satisfaction,complaint rate,and occurrence of service incidents)of the two groups were compared,as well as the evaluation effects.Results The study group showed significantly higher scores in theoretical knowl-edge,skill operations,thinking patterns,and humanistic care compared to the control group.The training satisfaction was signifi-cantly higher in the study group.The scores for interpersonal communication,question answering,and front desk material man-agement were significantly higher in the study group.The service satisfaction and training effectiveness were significantly higher,while the complaint rate and occurrence of service incidents were significantly lower in the study group compared to the control group(P<0.05).Conclusion Implementing training for hospital front desk service personnel based on the Kirkpatrick Evalua-tion Model can improve their theoretical knowledge and service level,enhance patient satisfaction,and reduce the complaint rate and occurrence of service incidents.

The thermal environment increases the risk of thermal injury for persons under high temperature environment. A full understanding of the effects and hazards of the thermal environment on the human body is of great significance to improve the awareness of persons under high temperature environment and reduce occupational heat damage during work. The authors mainly review the thermal environment from aspects of the definition, mechanism of its influence on main functional systems of the human body, influencing factors of heat stress and progress of protection, so as to provide references for the identification and protection of heat-induced diseases for workers under high temperature environment.