Objective To study the function of hypoxia mimics of different exposure time of deferasirox in improving the growth of micrangium in a narrow pedicle flap.Methods Fourty male SD rats were divided into 2 groups:experimental group was fed with deferasirox 100 mg/kg per day from 1d,3d,5d and 7d,respectively,before the surgery of transferring the narrow pedicle flap,while control group just fed with saline.After 7 days,the immunohistochemistry,Western blot and quantitative reverse transcription-PCR (qPCR) were performed to examine the expression of CD34.qPCR was used to examine the expression of HIF-1α,VEGF in order to investigate the regulatory effect of deferasirox in improving the growth of micrangium and the distinction among the different exposed time of deferasirox in the narrow pedicle flap.Results The deferasirox group exhibited a marked improvement in flap healing time,and with the increasing administration time of deferasirox,the expression of MVD,HIF-1α and VEGF was improved in each treated group (P＜0.05).Conclusions Deferasirox can induce HIF-1α secretion and increase CD34 expression,and so deferasirox can protect endothelial cells from hypoxic and ischaemic injury.

Objective To investigate the effect of deferasirox on DLL4 expression and angiogenesis in a narrow pedicle and random flap in rats.Methods Twenty SD rats were randomly divided into the deferagirox group and control group.Rats were subjected to deferagirox of 100 mg · kg-1 · d-1 inthe experimental groups,respectively and the same dose saline in the control group for 1 week. In each group,flap were created in the bilateral back of each rats.Ratio of length to width of tissue in the pedicle portion and the flap portion was 1 cm × 1 cm and 3 cm × 3 cm,respectively.The tissue samples were taken from the pedicle and the middle portions of the flap.The DLL4 and CD105 expression was also detected with immunohistochemistry (SABC).Results Compared with control group,whatever in the pedicle portion or the middle portion,there was a significant increase of microvessels marked by CD105 and a significant decrease of flap microvessels stained by DLL4 in the deferagirox group.In both groups,compared with the pedicle portion,there was a significant increase of microvessels marked by CD105 and DLL4 in the the middle portion.Conclusions Deferasirox can in crease the CD105 expression and angiogenesis of the slender narrow pedicle random flap.This process might be related to the inhibition of DLL4 protein expression,which is significant in the notch signaling pathway.

Objective To perfect the purification method of recombinant fusion protein of Hespintor (rHespintor) for increasing the protein extraction efficiency,and to investigate its effects on the proliferation,migration and invasion of hepatoblastoma cell line HepG2.Methods In the recombinant protein extraction,the inclusion body washing process was added and the protein purification buffer system was changed.BAPNA was used as the substrate.The inhibitory effect tof purified rHespintor on trypsin hydrolysis was detected.The blank group served as the control group.The MTT test,cell scratch wound healing test and tumor cell invasion test were performed to detect the effect of rHespintor on growth of hepatoblastoma HepG2 cells and its effect.Results The urea gradient washing on the inclusion body protein could effectively remove the vast majority of impure proteins from the targeted protein.After one-step purification,the target protein rHespintor exhibited a high inhibition effect of trypsin hydrolysis,and the inhibitory effect was exhibited a dose-dependent manner.After acting on hepatoblastoma HepG2 cells with rHespintor,the cell proliferation ability was inhibited,the migration ability was reduced and the number of invaded cells were significantly decreased.Conclusion rHespintor can significantly inhibit the proliferation,migration and invasion of hepatoblastoma cell line HepG2 cells in vitro.

Objective To understand the present situation and requirements of health education in schistosomiasis control in Hubei Province,so as to improve the health education to the targeted people. Method Through the questionnaire survey and field investigation,the data of the present situation and requirements of health education in schistosomiasis control were collect-ed in 24 counties(cities)of Hubei Province,and these data included the related institution structure of health education,basic information of personnel,equipment,funds,and health education working form. All the data collected were analyzed and evalu-ated. Results Among the 24 counties,there were 12 independent departments of health education,accounting for 50%. In terms of the basic information of the health education staff,the youngest person was 34 years old and the eldest was 58 years old,and the mean age was 46.55± 6.9 years. For the formal school education of the staff,5 had senior high school or below edu-cation (20.8%),16 had college education (66.7%),3 had bachelor degree or above (12.5%). There were 10 counties (41.70%)with the special funds for health education work but there were 3 counties(12.50%)without the special funds. Con-clusion The effectiveness of health education work in schistosomiasis control is remarkable,but there are still deficiencies in professional staff and funds in Hubei Province.

Objective To investigate the changes of the gray matter in patients with rheumatoid arthritis (RA) based on the voxel based morphometry (VBM).Methods 35 patients with RA and 30 healthy volunteers with age,sex and education level matched performed a high-resolution 3D-T1-weighted whole brain structural scan by GE Signa HDxt 1.5T MRI scanner.The high resolution T1WI images were preprocessed by the VBM 12 implemented in the SPM 12 software to display the gray matter structures of the RA patients and the healthy volunteers.T test was used to compare the morphological changes of gray matter between the RA patients and the volunteers.Results The gray matter volume gray matter volume in the right lentiform nucleus,left frontal lobe and left cerebellum posterior lobe significantly decreased in RA patients,and their gray matter volume had no correlation with the clinical indications.The increase of gray matter volume was not found in the RA patients.Conclusion RA patients show decreased gray matter volume in several cerebral regions,which suggests that RA can lead to the brain structural abnormalities.VBM can provide an objective imaging evidence to evaluate the cerebral morphological abnormalities of RA.

Objective:To analyze the prognostic factors of robot-assisted radical cystectomy (RARC).Methods:The clinical data of 224 patients underwent RARC from December 2014 to December 2018 in Nanjing Drum Hospital were reviewed. There were 193 males and 31 females, aged 36-92 years, with mean of 68 years. There were 7 patients(3.1%)undergoing neoadjuvant chemotherapy, the ASA scores of 125 patients (55.8%) were more than 2, and the mean body mass index was 23.4(15.4-35.5)kg/m 2. All patients were treated with RARC, with 72(32.1%) patients undergoing intraoperative blood transfusion. Kaplan-Meier method was used to analyze recurrence-free survival rate (RFS), cancer-specific survival rate (CSS) and overall survival rate (OS). Cox multivariate risk ratio model was used to evaluate the correlation between survival outcome and perioperative and pathological factors in patients treated with RARC. Results:For pathological status, there were 82 of ≤T 1, 64 of T 2, 57 of T 3 and 21 of T 4. Of all the patients, 49(21.9%) had lymph node metastasis, 12(5.4%) had positive surgical margin, 82(36.6%) had lymphovascular invasion(LVI), and 41(18.3%) underwent adjuvant chemotherapy. Follow-up time was between 11-60 months, and the median follow-up time was 24 months. The 5-year cumulative OS, RFS and CSS were 57.15%, 48.84% and 59.60%, respectively. Univariate Cox regression analysis showed that T stage( HR=5.764, 95% CI 1.926-17.249, P=0.002; HR=4.086, 95% CI 1.611-10.364, P=0.003; HR=9.391, 95% CI 2.118-41.637, P=0.003), N stage( HR=6.446, 95% CI 3.438-12.087, P<0.001; HR=5.661, 95% CI 3.086-10.385, P<0.001; HR=5.980, 95% CI 2.982-11.992, P<0.001), LVI( HR=3.319, 95% CI 2.008-5.486, P<0.001; HR=2.894, 95% CI 1.782-4.701, P<0.001; HR=3.471, 95% CI 2.017-5.974, P<0.001), American Society of Anesthesia (ASA)score( HR=2.888, 95% CI 1.619-5.150, P<0.001; HR=1.765, 95% CI 1.060-2.940, P=0.029; HR=2.612, 95% CI 1.424-4.792, P=0.002), body mass index( HR=0.886, 95% CI 0.819-0.957, P=0.002; HR=0.885, 95% CI 0.819-0.955, P=0.002; HR=0.862, 95% CI 0.792-0.938, P=0.001), age( HR=1.580, 95% CI 1.250-1.997, P<0.001; HR=1.362, 95% CI 1.088-1.705, P=0.007; HR=1.530, 95% CI 1.190-1.968, P=0.001) and intraoperative blood transfusion( HR=1.899, 95% CI 1.160-3.108, P=0.011; HR=2.218, 95% CI 1.371-3.587, P=0.001; HR=2.227, 95% CI 1.312-3.782, P=0.003) were significantly related to survival outcome. Multivariate Cox regression analysis showed that T stage( HR=4.506, 95% CI 1.433-14.175, P=0.01; HR=3.159, 95% CI 1.180-8.454, P=0.022; HR=7.810, 95% CI 1.674-36.444, P=0.009), N stage( HR=6.096, 95% CI 2.981-12.467, P<0.001; HR=5.368, 95% CI 2.683-10.740, P<0.001; HR=5.539, 95% CI 2.497-12.288, P<0.001) and ASA score( HR=6.180, 95% CI 2.371-16.110, P<0.001; HR=2.702, 95% CI 1.175-6.215, P=0.019; HR=6.471, 95% CI 2.290-18.286, P<0.001) were independent predictors of RFS, CSS and OS, and adjuvant chemotherapy( R=0.434, 95% CI 0.202-0.930, P=0.032) could only predict OS. Conclusion:T stage, N stage and ASA were main independent predictors of postoperative survival outcomes, and adjuvant chemotherapy was independent predictor of OS.

Objective:To evaluate the effects of Xiongzhi Dilong decoction(XZDLD)and its wind medicine on calcitonin gene-related peptide(CGRP)-induced migraine and explore the mechanism through the CGRP/inducible nitric oxide synthase(iNOS)pathway.Methods:Rats were divided into control,model,XZDLD,XZDLD(external wind),XZDLD(internal wind),and olcegepant groups.CGRP was injected into the dura mater to induce a migraine.The frequency of head scratching,cage climbing,and facial grooming was observed.The pain threshold,the levels of CGRP,pituitary adenylate cyclase activating polypeptide(PACAP),substance P(SP),and the plasma protein extravasation(PPE)ratio were measured.The phosphorylation levels of p38,extracellular signal-regulated kinase 1/2(ERK1/2),and expression of iNOS were detected by western blot.Results:Compared with the model group,the three modified XZDLD groups showed reduced frequency of head scratching and cage climbing in the first 30 min(all P＜.05).Facial grooming frequency was reduced in XZDLD and XZDLD(external wind)groups(P=.0003 and P=.0131,respectively).External wind medicine played a more important role in increasing mechanical pain threshold than internal wind medicine.Moreover,compared with the model group,the three modified XZDLD groups demonstrated reduced plasma levels of CGRP and PACAP(all P＜.05).No difference in the SP level was observed among the six groups.XZDLD reduced PPE ratio.XZDLD and XZDLD(external wind)groups suppressed the CGRP/iNOS pathway by inhibiting the p-p38/p38 ratio and the expression of iNOS.No difference in pERK1/2/ERK1/2 ratio was detected among the six groups.Conclusion:XZDLD increases pain threshold,downregulates the expression of CGRP and PACAP,and reduces PPE ratio by inhibiting the CGRP/iNOS pathway.External wind medicine is more effective than internal one on improving facial grooming and head scratching,increasing the mechanical pain threshold,and inhibiting the expression of iNOS.

Objective:To systematically evaluate the effect of couple-centered psychological intervention on breast cancer patients.Methods:Randomized controlled trials published in PubMed, Embase, Web of Science, Scopus, CINAHL, Cochrane Library, JBI, CNKI, Wanfang, Vip and CBM database on the effect of psychological intervention on breast cancer patients with husband and wife as the center were searched by computer. The retrieval time was from the establishment of the database to September 2020. Two reviewer independently conducted literature screening, data extraction and literature quality evaluation according to the inclusion and exclusion criteria, and Meta analysis was carried out using RevMan 5.3 software.Results:A total of 879 patients were included in 11 articles. Meta analysis results showed that the couple-centered psychological intervention not only improved the quality of life, but also improved the anxiety of breast cancer patients ( SMD=1.54, 95% CI 0.22-2.86, P=0.02) and depression ( SMD=1.22, 95% CI 0.12-2.33, P=0.03). Conclusions:After psychological intervention, the anxiety and depression of breast cancer patients were improved and the quality of life was also improved. Due to the inconsistency in the mode, frequency and evaluation index of psychological intervention, more large samples and high-quality studies are needed to further verify the effect of couple-centered psychological intervention on breast cancer patients and spouses centered on husband and wife.

Objective To establish a training program for caregivers of people with dementia based on the Model of Caregiver Skill Building/Effectiveness and evaluate its practical effect.Methods The objective sampling method was used to select 72 caregivers from two nursing homes which were the specialised shelters for the dementia elderly in Xi'an.The subjects were randomly divided into a training group with 39 caregivers and a control group with 33 caregivers.The control group received training in routine care,while the training group was given training based on Farran's Model of Caregiver Skill Building/Effectiveness for 3 months.The training was composed of our modules:caring knowledge,skills,emotion management and resource utilisation,which included key training elements in knowledge of dementia and nursing,emotion management through yoga and mental training and improvement of nursing skills through instructions.The caregiver burden inventory(CBI)and self-rating depression(SDS)were used to evaluate the effect of caregivers training before and after the training.Result After the training,the scores CBI and SDS of the caregivers were significantly lower than those in the control group and lower than the scores before training(all P<0.05).Conclusion The training program based on the Model of Caregiver Skill Building/Effectiveness can effectively reduce the burden and depression of caregivers in dementia care.

Objective To summarize present randomized controlled trials ( RCTs) and assess the effect of physical training on vasovagal syncope using meta-analysis method. Methods According to inclusion and exclusion criteria of literature review, articles during 2012 to 2013 were selected from medical electronic databases searching, including Cochrane Library, PubMed, Medline, EMBASE, Elsevier, Ovid, CNKI, and Wanfang by computer. Results Six RCTs were selected finally. According to Meta-analysis of 6 RCTs, it represented that 6 RCTs included totally 250 patients in treatment group and 265 patients in control group, and indicated patients in treatment group ( 252 cases ) having lower rate of syncope recurrence as compared with control group (265 cases) (RR =0. 40, 95%CI; 0. 24 -0. 69,P =0. 000 5). Conclusions The currently published RCTs support that physical training can be effective treatment of vasovagal syncope and further large-scale multicentre and better designed study were still expected to give more convincing evidence.