Objective:To explore the effect of humanistic care on the quality of life and the negative emotion of patients with liver cancer operation. Methods: A total of 577 patients with liver cancer surgery were selected to participate in this study from January 2014 to December 2015 . From January 2014 to December 2014 , 288 cases of liver cancer patients were given routine nursing care as the control group. From January 2015 to December 2015, 289 patients were given humanistic care nursing as experimental group. The emotion of depression and anxiety were evaluated using Self-rating Depression Scale and Self-rating Anxiety Scale, the quality of life was evaluated with the core scale of life quality measurement system for cancer patients, while sleep quality with the Pittsburgh Sleep Quality Index. Results:Both depression and anxiety score of the subjects in experimental group were lower than those in the control group(P<0. 05). Physical function, cognitive function, social function, emotional function, role function, and overall health status of the subjects in the experimental group were higher than those in the con-trol group (P<0. 05), while pain, tiredness, nausea, vomiting, shortness of breath, insomnia, diarrhea, loss of appetite, constipation, economic difficulties and other score were statistically lower than those in the control group (P<0. 05). The subjects′quality of life of in the experimental group was better than those in the control group(P<0 . 05 ) , but the sleep index score was lower in the experimental group ( P<0 . 05 ) . Conclusion: Humanistic care nursing can effectively reduce the negative emotions of patients with liver cancer surgery, and thus to improve the quality of life.

Objective To examine the antimicrobial susceptibility and prevalence of blaKPC gene in carbapenem-resistant Klebsiella pneumoniae (CRKP) strains isolated in Huashan Hospital,Fudan University.Methods The CRKP strains isolated in Huashan Hospital from January to December of 2014 were included in this study.The MICs of antibiotics were determined using CLSI broth dilution method.The blaKPC gene was amplified by polymerase chain reaction (PCR).Results A total of 205 CRKP strains were isolated,mainly from respiratory tract (76.1％,156/205) and urine specimens (18.5％,38/205).Antimicrobial susceptibility test indicated that CRKP isolates had higher resistance rates (85％-100％) to the antimicrobial agents except colistin (1.5％),tigecycline (0.5％),trimethoprim-sulfamethoxazole (51.0％) and amikacin (74.9％).Most (87.8％,180/205) of the CRKP strains were positive for blaKPC gene.Conclusions CRKP are mostly isolated from patients with lower respiratory tract infection and/or urinary tract infection in Huashan Hospital.The strains were highly resistant to the antibacterial agents tested except colistin and tigecycline.Production of KPC-type carbapenemase is the common mechanism of carbapenem resistance in these K.pneumoniae isolates.

Objective To construct wtp53/junB fusion gene and its eukaryotic expression vector in order to provide the basis for further application of polygene union therapy in hepatocellular carcinoma. Methods Polymerase chain reaction (PCR), reverse transcription-PCR (RT-PCR) and gene recombination techniques were used to construct the eukaryotic vector of pEGFP-C1-wtp53/junB fusion gene, which carries the enhanced green fluorescent protein (EGFP). The transfection of pEGFP-C1-wtp53/junB in hepatoma HepG2 cells was detected by the location of green fluorescence. Results The DNA sequence of wtp53/junB fusion gene was successfully cloned into the pEGFP-C1 plasmid and the sequence was the same as what we expected. Green fluorescence located on cell nucleus proved that pEGFP-C1-wtp53/junB was transfected into HepG2 cell line successfully. Conclusion We successfully constructed the eukaryotic vector of pEGFP-C1-wtp53/junB fusion gene, which carries the EGFP, and transfects it into human hepatoma cell nucleus. It may lay the basis for studying the synergetic effect of wtp53 and junB in hepatocellular carcinoma.

Objective To test the efficacy of low-frequency electrical acupoint stimulation plus rehabilitation training in improving swallowing function after stroke. MethodsEighty dysphagic stroke patients were randomly allocated into 2 groups of 40.Patients in the experimental group received low-frequency electrical acupoint stimulation plus 2 courses of rehabilitation training.Control group patients received the same protocol,but the electrical stimulation was not over acupoints.Their swallowing function was assessed using the Kubota water drinking test.ResultsAfter treatment,both groups showed significantly lower Kubota scores compared with pre-treatment.Prepost test difference was 1.25 ± 0.78 in the experimental group and 0.70 ± 0.72 in the control group,a significant difference.The total recovery rate in the experimental group was 87.5％.In the control group it was 55％.The improvement in swallowing function was significantly better in the experimental group.Conclusion Both groups showed a significant improvement in swallowing function,but low-frequency electrical acupoint stimulation increased the effectiveness of the rehabilitation training.

This study explored the double lethal effects of pEGFP-C1-wtp53/junB fusion gene on hepatocellular carcinoma (HCC) cells. wtp53/junB fusion gene was constructed and transformed into HepG2 cell line. Expression of KAI1 was detected by quantitative real-time PCR and Western blotting, cells apoptosis rate was detected by flow cytometry, proliferation of cells was detected byMTT chromometry, cell transmigration was detected by using transwell systems. The results showed that after transformation with pEGFP-C1-wtp53/JunB, the expression level of KAI1 protein was up-regulated, being 8.13 times the blank control group in HepG2 cells and significantly higher than 2.87 times which transformed with pEGFP-C1-JunB, 3.11 times which transformed with pEGFP-C1-wtp53 (P<0.001). Apoptosis rate of HepG2 cells transformed with pEGFP-C1-wtp53/JunB was significantly higher than that of other groups (P<0.001), and invasive ability of HepG2 cells transformed with pEGFP-C1-wtp53/JunB was significantly lower than other groups(P<0.001). It was concluded that the fusion gene of wtp53 and JunB could not only inhibit the growth of hepatoma cells and promote tumor cell apoptosis, but also suppress the invasive ability of tumor cells by up-regulating the expression of KAI1.

This study explored the double lethal effects of pEGFP-C1-wtp53/junB fusion gene on hepatocellular carcinoma (HCC) cells. wtp53/junB fusion gene was constructed and transformed into HepG2 cell line. Expression of KAI1 was detected by quantitative real-time PCR and Western blotting, cells apoptosis rate was detected by flow cytometry, proliferation of cells was detected byMTT chromometry, cell transmigration was detected by using transwell systems. The results showed that after transformation with pEGFP-C1-wtp53/JunB, the expression level of KAI1 protein was up-regulated, being 8.13 times the blank control group in HepG2 cells and significantly higher than 2.87 times which transformed with pEGFP-C1-JunB, 3.11 times which transformed with pEGFP-C1-wtp53 (P<0.001). Apoptosis rate of HepG2 cells transformed with pEGFP-C1-wtp53/JunB was significantly higher than that of other groups (P<0.001), and invasive ability of HepG2 cells transformed with pEGFP-C1-wtp53/JunB was significantly lower than other groups(P<0.001). It was concluded that the fusion gene of wtp53 and JunB could not only inhibit the growth of hepatoma cells and promote tumor cell apoptosis, but also suppress the invasive ability of tumor cells by up-regulating the expression of KAI1.
Carcinoma, Hepatocellular ; genetics ; metabolism ; pathology ; Cell Line, Tumor ; Hep G2 Cells ; Humans ; Liver Neoplasms ; genetics ; metabolism ; pathology ; Transcription Factors ; genetics ; metabolism ; Tumor Suppressor Protein p53 ; genetics ; metabolism

Objective To analyze the distribution characteristics and influencing factors of X-ray diagnostic imaging in Shandong province,and to estimate the application frequency of X-ray diagnostic imaging in the province,and provide data support for X-ray equipment.Methods A random sampliug method was used to extract 32 medical institutions as respondents from 10 prefecture-level cities in Shandong province.The basic information of medical institutions and the age,sex,examination and procedure of the subjects were analyzed.The distribution of the X-ray application was analyzed and estimated by using a multiple linear regression model.Results Totally 14 694 085 subjects were surveyed,and the proportion of male and female in the sample was not completely uniform.A total of 2 099 155 X-ray diagnostic information was collected in 2016,and the frequency of conventional radiography was the highest,accounting for 59.49％.The next was CT examination,accounting for 28.34％.The frequency of the two examinations showed an increasing trend with the age of subjects.For the total frequency of conventional diagnostic radiography and CT examination,the tertiary hospitals accounted for the highest proportion of the total,up to 52.13％,while the secondary hospitals accounted for the relatively low proportion of 30.09％,and the primary hospitals the lowest with 17.77％.The chest radiography had the highest proportion in conventional radiography accounting for 32.79％ of the total frequency of X-ray diagnostic imaging,and the head procedure had the highest proportion in CT examination,accounting for 10.07％ of the total frequency of X-ray diagnostic imaging.The fluoroscopy,mammography and dental radiography were mainly concentrated in the tertiary hospitals,and the primary hospitals had mainly radiography.Multiple linear regression models showed that the frequency of application of conventional X-ray diagnostic imaging (including radiography,fluoroscopy,dental radiography and mammography) was positively correlated with equipment quantity,number of outpatient and emergency patients,and tertiary hospitals (t=4.334,3.615,2.339,P＜ 0.05).CT examination was positively correlated with equipment quantity and the number of inpatient (t =2.167,2.595,P＜0.05).The frequency of conventional X-ray diagnostic imaging and CT examination in Shandong province were estimated about 491.17 examinations per 1 000 population and 258.17 examinations per 1 000 population respectively.Conclusions The frequency of X-ray exposure in Shandong province increased significantly compared with that during the " 9th Five-Year Plan" period.All relevant departments should take effective measures to strengthen medical radiation protection and reduce radiation risk.

Conversion therapy has become the core in the treatment of borderline resectable or unresectable liver cancer, which provides resectable opportunities for more advanced liver cancer patients. In accordance with the first-choice treatment regimen recommended by the guidelines, the authors reported a successful case of Atezolizumab and Bevacizumab (T+A regimen) conversion therapy. The patient with initially borderline resectable advanced liver cancer was performed liver segment resection sucessfully after conversion therapy, and non-tumor recurrence was observed at postoperative 9 months. Postoperative pathological examination showed combined hepatocellular-cholangiocarcinoma, which also indicated the important value of T+A regimen in the conversion therapy of combined hepatocellular-cholangiocarcinoma.

Objective: To investigate the effect of 1q21 amplification (1q) on the therapeutic response and prognosis of bortezomib(Btz) in the treatment of newly diagnosed multiple myeloma (MM) patients. Methods: A total of 180 newly diagnosed MM were included for analyses of clinical characteristics, cytogenetics, objective response rate (ORR), progression-free survival (PFS) and overall survival (OS), retrospectively. Gene expression profiling (GEP) was analyzed using publicly available R2 platform. Results: ① In 180 patients, 1q was found in 51.1% cases. Of them, 174 patients had complete follow-up data, including 88 cases with 1q and 86 without 1q (non-1q). ②Incidence of 1q was positively associated with percentage of IGH rearrangement (72.2%, P=0.017) and 1p deletion (1p) (27.8%, P=0.040). ③ The median PFS was 15.0 and 20.3 months for the 1q group and non-1q group, and the median OS was 29.4 and 44.0 months, respectively. Both PFS and OS of 1q group was significantly shorter than those of the non-1q group (P=0.029 and 0.038, respectively). Multivariate analysis further revealed that 1q was an independent prognostic factor for both PFS (HR=1.910, 95% CI 1.105-3.303, P=0.020) and OS (HR=2.353, 95% CI 1.090-5.078, P=0.029). ④ In 91 evaluable cases with 1q, very good partial remission (VGPR) rate was higher after treatment with Btz than those without Btz (62.1% vs 40.0%, P=0.032). Of note, the patients with 1q who received auto-HSCT after induction with Btz had significantly longer PFS than those without auto-HSCT (19 months vs 13 months, P=0.048). ⑤GEP analysis revealed that 1q21 amplification predominantly up-regulated expression of >50% genes within 1q21 region, and also altered expression of 28% genes in chromosome 1 and 10% genes in whole genome, particularly related to DNA repair and cell cycle. Conclusions 1q is an independent adverse prognostic factor in patients with newly diagnosed MM. It is often associated with 1p deletion and IGH rearrangement. Patients with 1q respond well to Btz-based regimen, but they fail to gain long-term benefit from this treatment itself. However, auto-HSCT following Btz induction might improve survival of patients with 1q, suggesting a potential strategy to treat this high-risk subset of MM. GEP analysis warrants further attention in understanding the mechanisms underlying the high-risk of 1q.

Objective:To study the clinical and genetic characteristics of familial paroxysmal exercise-induced dyskinesia with Parkinson-like manifestations in the elderly.Methods:Clinical data of 9 family members were analyzed, including 2 patients(both received treatment)consenting to appropriate therapy and prediction protocols.DNA was extracted from peripheral blood samples, and then second-generation sequencing mutation screening.Results:The tremor of two probands in the family was completely brought under control by oxcarbazepine treatment.In 5 family members, a heterozygous mutation of base G>C in exon 2 c. G366C: P.QCon122H at position 29824741 of the PRRT2 gene was found, resulting in the mutation of the amino acid at 122 from glutamine to histidine, which was predicted by SIFT and M-CAP to be harmful.Sanger sequencing of pedigree samples showed that the sisters, brothers and nephews of the proband were heterozygous and their nieces were of the wild type.Conclusions:Q122 of PRRT2 protein can cause the Parkinson-like limb tremor phenotype, and antiepileptic drugs are also effective for paroxysmal exercise-induced dyskinesia in the elderly.