Objective To establish a cell level-based negative enrichmen technique to detect circulating tumor cells (CTCs) in the peripheral blood of patients with epithelial ovarian cancer.Methods The colon cancer SKOV-3 cells were mixed with 2 ml whole blood from healthy donors at different ratio.Quantification of CTCs was performed using immunomagnetic bead based negative enrichment combined with immunofluorescence antibody method.The method was evaluated the recovery rate of target cells,Samples of 32 patients with ovarian cancer and 10 controls were assayed for CTCs detection by above method.Results ①The recovery rate was ranging from 64％ ～80％ by spiking varying numbers of SKOV-3 into 2 ml blood samples of healthy volunteers.Regression analysis of number of recovered SKOV-3 cells yielded a regression equation of Y=0.782X-1.408 and a coefficient of determination of R2 =0.998.②Did not detect CK8/18-+ circulating tumor cells in 10 controls,and CK8/18+ circulating tumor cells in 18 cases of 32 Patients with ovarian cancer.The positive rate of CK 8/18 + circulating tumor cells was significantly differences between the two groups (x2 =7.681,P＜0.01).③The presence ofCTCs was significantly correlated with distant metastasis (x2 =5.776,P＜0.05).Conclusion The method of immunomagnetic bead based negative enrichment combined with immunofluorescence antibody technique for CTCs detection in peripheral blood of patients with ovarian cancer has a clinical value of application and extension.

Objective To investigate the effect of 6 sigma nursing quality management model in rescue of patients with severe trauma.Methods According to the admission sequence,268 patients with severe trauma were selected as control group and treated with traditional first aid pattern; another 292 with severe trauma were chosen as the observation group and treated with 6 sigma nursing management mode(definition,measure,analysis,improvement and control).The two groups were compared in terms of rescue success rate and effective rescue time.Result The rescue success rate in the observation group was significantly higher than that in the control group and the effective rescue time in the observation group was significantly shorter than that in control group(P<0.05). Conclusion The application of 6 sigma nursing management mode in rescue of patients with severe trauma can improve the success rate,shorten the effective rescue time,so it enhances the nursing quality of severe trauma.

Objective To explore the influence of the medication adherence and family function on mental disability status of the schizophrenia patients.Methods Morisky Medication Adherence Questionnaire(MAQ),Assessment Schedule Ⅱ (WHO-DAS Ⅱ),Family APGAR Index(APGAR) were used to analyze the influence of the medication adherence and family function on the schizophrenia mental disability patients.120 convalescence mental disability patients were included in Inner Mongolia Anding hospital.Results The mean score of medication adherence and family function of the schizophrenia mental disability patients was (2.40±1.10) points and (4.87±2.42) points,they both played a significant role on the effect of mental disability.The main effect of medication adherence and family function were significantly different.Through the simple effect analysis,the mental disability score was different in the various medication adherence level under the various family function situation,and the mental disability score was also different in the various family function situation under the medication adherence level.Conclusions Both medication adherence and family function have effect on mental disability status of the schizophrenia patients.The medical staff should take targeted measures to delay or improve patients' mental disability status.

Objective In view of the schizophrenia risk factors during the recovery,to explore a supportive intervention program suitable for the rehabilitative schizophrenic patients.Methods Totally 64 rehabilitative schizophrenic patients were divided into the experimental group and the control group with 32 cases in each group.All the patients received the same treatment with antipsychotic drugs.The patients in the control group received the routine health education.In addition,the patients in the experimental group received supportive intervention for 4 months.The patients were assessed by IBS,APGAR,GSES and SDSS before and after intervention.Results Main effect of group factor and time factor of GSES,SDSS,APGAR and IBS had statistical significances.There were significant interaction in the scores of SDSS,APGAR and IBS.Simple effect analysis demonstrated the scores of GSES,SDSS,APGAR and IBS in the experimental group were higher than those of the control group after the intervention.Except the score of GSES,there was no differences in other scales before and after the intervention of the control group.Conclusions Supportive intervention program for the rehabilitative schizophrenic patients have good practice guidance.It can improve the patients' self-efficacy,family function and social function,also can correct irrational beliefs and to help patients better adapt to society.

ObjectiveTo observe the effect of acupuncture on rat model with damp-heat syndrome.MethodsThe combined use of high fat diet,damp-heat environment and infection of bacillus coli was adopted to establish rat models with damp-heat syndrome.A 10-day acupuncture treatment was given to the models.Results Changes can be found in both symptoms and signs of the model rat,which were held to meet the features of damp-heat syndrome.Moreover,abnormity can be found in the expression of the whole blood viscosity [(2.95 ±0.18)、(3.31±0.20)、(9.52±0.53)]mPa ? s,the expression of SOD and MDA of the blood serum and the skin [(4.21 ± 0.3)、(8.51 ± 0.42)]mPa ? s and [( 1.35 ± 0.16)、(1.26 ± 0.20)]mPa ? s.under high,medium and low shear rate.And improvements can be found in the expression of the whole blood viscosity [(2.70± 0.15)、(2.98 ±0.27)、(8.93 ± 0.80)]mPa ? s,the expression of SOD and MDA of the blood serum and the skin [(4.52 ± 0.26)、(7.00 - 0.62)]mPa ? s,[( 1.49 ± 0.12)、( 1.05 ± 0.24)]mPa ? s under high,medium and low shear rate.Conclusion Acupuncture at Yinlingquan (SP9) and Neiting (ST44) can improve the high blood viscosity situation of rat model with damp-heat syndrome,and enhance the ability of the body to eliminate hyperoxide as well.

Objective To estimate the diagnostic vaule of circulating tumor cells (CTCs) detection for epithelial ovarian cancer,and investigate the relationship between the presence of CTCs and the clinic pathologic characteristics of epithelial ovarian cancer patients.Methods Quantification of CTCs were performed using immunomagnetic bead based negative enrichment combined with flow cytometry in 65 patients with epithelial ovarian cancer,21 patients with benign ovarian diseases,and 10 healthy subjects.The differences among groups were analyzed by the Kruskal-Wallis H test (multi group comparison) and the Mann-Whitney U test (two group comparison),and the chi-square test was used in the positive rate comparison,the receiver operating characteristic (ROC) curve was established.The relationship between CTCs and clinic pathologic characteristics of epithelial ovarian cancer patients were analyzed.Results The receiver operating characteristic analysis showed the cut off value was 4.5 (＞ 4),the AUC was 0.806,and sensitivity,specificity and positive value (PPV) were 55.4 ％,96.8 ％ and 97.3 ％ respectively,in detecting patients with ovarian carcinoma malignancy.Quantification of CTCs in epithelial ovarian cancer was correlated with FIGO stages or distance metastasis (all P＜0.05),but not with patient age,histological types,pathologic differentiation,amount of ascites,tumor size and lymph node metastasis (all P＞0.05).Conclusion The detection of peripheral CTCs has a certain diagnosis value in epithelial ovarian cancer,especially with related to FIGO stages and distant metastasis.

Objective To explore whether CD44 +/CD24 + expressing cervical cancer cells are resistant to X-ray irradiation and investigate the underlying mechanism.Methods Cervical cancer cell line (Siha) was cultured in vitro and the CD44 +/CD24 + expressing cells were sorted with a flow cytometer.The cells were irradiated with 8,16 and 30 Gy of 6 MV X-rays.Colony formation test was used to evaluate the radiosensitivity of CD44 +/CD24 + expressing cervical cancer cells.Cell morphology was observed by electronmicroscopy,cell apoptosis was analyzed with a flow cytometer and also verified with a DNA ladder assay.Gene expression was determined by RT-PCR.Results After radiation,the ratio of CD44 +/CD24 + cells significantly increased.Compared to Siha cells,the radiosensitivity of CD44 +/ CD24 + cells decreased (t =93.99-400.45,P ＜0.05),and the expressions of bcl-2,survivin and Oct4 mRNA increased in CD44 +/CD24 + cells (t =221.35,941.65,82.27,P ＜0.01).Both apoptotic body and specific DNA ladder pattern were observed in cells but not in the CD44 +/CD24 + Sihacells which had no obvious morphological changes of apoptosis.Conclusions The CD44 +/CD24 + expressing cervical cancer cells are resistant to X-rays due to expression of anti-apoptosis factors.

Background and purpose:One of the reasons why cancer cells are resistant to chemotherapy is the existence of cancer stem cells. The purpose of this study was to investigate the chemoresistance of CD44+/CD24+ Siha cells to cisplatin and its mechanisms.Methods:Siha cells were cultivatedin vitro. The CD44+/CD24+ Siha cells were sorted out by fluorescence activated cell sorter (FACS) andin vitro proliferation was detected by MTT assay after treatment with the different concentrations of cisplatin. The cell apoptosis rate was detected by flow cytometry after 10 μg/mL cisplatin acted on CD44+/CD24+ Siha cells for 24, 48 and 72 h. The relative mRNA and protein expressions of Bcl-2, Oct-4 and ABCG2 were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot, respectively. Results:The survival rates of CD44+/CD24+ Siha cells treated with different concentrations of cisplatin (0.1, 1, 5, 10, 15 and 20 μg/mL) were higher than those of their parental Siha cells [(88.42±1.51)%vs (92.87±1.5)%, (79.94±1.05)%vs (84.72±1.09)%, (69.78±0.81)%vs (75.13±2.86)%, (58.97±0.70)%vs (65.79±2.71)%, (49.60±0.88)%vs (52.10±0.52)%, (45.13±0.69)%vs (48.84±1.02)%,P<0.05]. Compared with their parental Siha cells, the apoptosis rates of CD44+/CD24+ Siha cells were lower after 10 μg/mL of cisplatin acting on them for 24, 48 and 72 h, respectively [(3.05±0.16)%vs (5.17±0.27)%, (17.94±2.02)%vs (32.60±4.28)% and (40.14±3.01)%vs (56.62±5.32)%,P<0.05]. The results from both qRT-PCR and Western blot indicated that Oct-4, ABCG2 and Bcl-2 were highly expressed on CD44+/CD24+ Siha cells. A significant difference was found in Oct-4, ABCG2 and Bcl-2 expression between CD44+/CD24+Siha cells and their parental cells (P=0.015<0.05).Conclusion:CD44+/CD24+ Siha cells could be resistant to apoptosis induced by cisplatin and expressed high levels of cancer stem cell markers such as Oct-4 and ABCG2. This study lays the basis for useful isolation and further targeted therapy of cervical cancer stem cells.

Objective To analyze the result and adverse reactions of radiation therapy in patients with pelvic recurrence following cervical cancer postoperative.Methods A retrospective analysis of 147 patients with pelvic recurrence after surgical treatment of cervical cancer in the Fourth Hospital of Hebei Medical University from August 2004 to December 2016 was performed.All patients received radiotherapy with or without chemotherapy.According to different clinical factors and pathological factors,Logistic regression analysis was used to analyze the factors influencing radiotherapy outcomes in patients with pelvic recurrence after cervical cancer surgery.The Kaplan-Meier method was used to analyze the survival rate,and the corresponding survival curve was drawn.The survival rate and prognosis related factors were compared by using the log-rank test.The COX proportional hazards regression model was used for multivariate analysis of statistically relevant factors in univariate analysis.After treatment,toxicities were analyzed using chi-square test.Results The median follow-up time was 33.2 months.95％ of the patients completed radiation therapy with a dose of ≥ 67 Gy (median radiotherapy dose),and 91 patients (61.9％) had complete remission (CR).The 5-year local control (LC),progression-free survival (PFS),distant metastasis-free survival (DMFS),and overall survival (OS) were 63.6％,56.0％,73.9％,and 55.0％,respectively.Univariate logistic regression analysis showed that FIGO staging (stage 0-ⅠB and ⅡA-ⅡB),pelvic sidewall involvement,and recurrent tumor volume were associated with complete remission (P＜0.05).Multivariate statistical analysis found that FIGO staging and pelvic sidewall invasion were independent factors influencing the efficacy and survival of patients with pelvic recurrence after cervical cancer surgery (P＜0.05).Patients with pelvic wall invasion after cervical cancer surgery had a higher incidence of ≥ grade 2 proctitis than those without pelvic walls involved,which were 26.9％ and 16.7％,respectively.Conclusions This study shows that after the surgical treatment of cervical cancer patients with pelvic recurrence can be tolerated by toxicities after radiation therapy.In addition,the incidence of toxicities in patients with pelvic wall invasion was significantly higher than those without pelvic wall invasion.Preoperative staging and the pelvic wall involvement are independent influencing factors influencing the effect of radiotherapy and long-term prognosis in patients with pelvic recurrence after cervical cancer surgery.

OBJECTIVETo identify risk factors of hepatocellular carcinoma (HCC) in cirrhotic patients with chronic hepatitis B (CHB).

METHODSA total of 715 cirrhotic patients with CHB were recruited from the Zhongshan Hospital Affiliated to Fudan University and enrolled in this case-control study between January 2009 and September 2014. All participants were Chinese Han residing in Shanghai and the surrounding areas. The patients were divided into a cirrhosis group (n =281) and a HCC group (n=434). History of hepatitis B infection and HCC, as well as clinical data from serological, imaging and pathological examinations were collected for analysis.SPSS software, version 19.0, was used for all statistical comparisons.

RESULTSSingle factor analysis indicated that development of HCC in cirrhotic patients with CHB was significantly associated with male sex, age of 50 years or more, family history of HCC, alcohol consumption,fatty liver, detectable levels of hepatitis B virus (HBV) DNA, and history of HBV infection without effective antiviral treatment. Multivariate logistic regression analysis indicated that age of 50 years or more (P =0.005, odds ratio [OR] =1.766), history of alcohol consumption (P =0.002, Or = 2.570), family history of HCC (P =0.014, Or = 2.268), fatty liver (P =0.023, Or = 3.390), and history of HBV infection without effective antiviral treatment (P < 0.001,Or = 5.389) were risk factors of HCC.The risk factors for development of HCC in cirrhotic patients with hepatitis B after achieving sustained virologic suppression (SVS) were family history of HBV infection (P =0.014, Or = 2.537), family history of HCC (P =0.037,Or = 3.339) and fatty liver (P =0.018, Or = 11.646).

CONCLUSIONRisk factors of HCC in cirrhotic patients with CHB include age,drinking history,family history of HCC, fatty liver, and ineffective antiviral treatment of CHB.Family history of HBV infection or HCC, and fatty liver disease, were significantly associated with HCC development after SVS in patients with hepatitis B-related cirrhosis.

Alcohol Drinking ; Antiviral Agents ; Carcinoma, Hepatocellular ; Case-Control Studies ; China ; Fatty Liver ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis ; Liver Neoplasms ; Male ; Odds Ratio ; Risk Factors