Objective To investigate the effect of informational support on disease uncertainty in liver cancer patients undergoing interventional therapy. Methods Sixty patients of liver cancer patients undergoing interventional therapy were randomly divided into the intervention group and the control group with 30 in each.The control group was treated with general treatment and care. The patients in the intervention group were given general treatment and care with a series of informational support interventions. Patients in the two groups were measured by uncertainty in illness scale (MUIS) at the day of admission,before operations and discharged from hospital. The measurement results were statistically analyzed. Results There was significant decrease about disease uncertainty scores both on the day before operation and the day before discharge in the intervention group compared to the day of admission. The decreasing score of uncertainty in illness in the intervention group was significantly greater than the control group on the day before operation and the day before discharge. Conclusions A series of informational support interventions could significantly reduce the diseases uncertainty in liver cancer patients undergoing interventional therapy.

Objective To summarize the geographical distribution,phenotype and genotype data of 206 thalassemia families underwent prenatal diagnosis to provide information for clinical genetic counseling and avoid the birth of severe thalassemia children.MethodsTotally,206 thalassemia families were collected from Southern Medical University Nanfang Hospital from January 2008 to December 2009.Genomic DNA was extracted from peripheral blood,villus,amniotic fluid or cord blood from the couples or the fetuses.Gap-polymerase chain reaction (gap-PCR) and reverse dot blot (RDB) technology were used to detect the common α and β-thalassemia mutations.DNA sequencing was used to detect the rare mutations.Follow-up visit were done half a year after the fetuses were born. Results The 206 thalassemia families came from 12 provinces and areas across China,including Heilongjiang province.Mutations detected in α-thalassemia families included --SEA/,-α3.7/,-α4.2/,αCS α/ and αQS α/,which were all included in the testing kit. While there were 4 kinds of β-thalassemia mutations,Gγ+ (A γδβ)0,-28(A→C),CD54-58(-TATGGGCAACCCT) and CD37(G→A),could not be identified with routine testing kit. The 57 α-thalassemia families consisted of 11(19.3％) severe thalassemia,induding 8 Bart's hydrops syndrome and 3 Hb H disease,26(45.6％) heterozygote and 20(35.1％) normal infants,and the 149 β-thalassemia majors families consisted of 28 (18.8％) severe thalassemia,82(55.0％) heterozygote and 39 (26.2％) normal infants.Among the β-thalassemia heterozygotes,there was one 13-trisomy.Follow-up visit found that babies with Bart ' s hydrops syndrome (n =8),Hb H disease (n =3),β-thalassemia majors (n =28) and β thalassemia heterozygote combined with 13-trisomy(n=1) were aborted.Conclusions Thalassemia was found in some north area other than south of China,which should be paid more attention by clinicians.Gap-PCR and PCR-RDB technology are effective measures for thalassemia prenatal diagnosis in identifying major thalassemia fetuses before their birth,thus reduce the birth rate of thalassemia baby.But missed diagnosis might exist during the screening,so it is necessary to perform DNA sequencing on those patients with positive symptoms and negative common genetic diagnostic results.At the same time,prenatal diagnosis of chromosomal disorders should not be neglected for high-risk families.

OBJECTIVETo investigate the role of the PI3K/Akt signaling pathway in hydrogen sulfide-induced alterations in expression of collagen I and collagen III in hepatic stellate cells.

METHODSIn vitro cultured rat hepatic stellate cells (HSC-T6) were treated with hydrogen sulfide, or left untreated for use as controls, and divided into groups for treatment with different inhibitors for the various factors involved in the PI3K/Akt signaling pathway. Reverse transcription-PCR was used to measure Collagen I and collagen III mRNA expression. Western blotting was used to detect the protein expression of PI3K and p-Akt, which are upstream proteins of the PI3K/Akt pathway.

RESULTSCompared with the untreated control cells, the hydrogen sulfide treated cells showed elevated expression of collagen I mRNA (F =14.635, P less than 0.05), collagen III mRNA (F =14.620, P less than 0.05), PI3K protein (F =26.672, P less than 0.05), and p-Akt (F =23.522, P less than 0.05). Compared to the cells treated with hydrogen sulfide alone, the cells treated with the various inhibitors showed lower expression of collagen I mRNA (F =14.635, P less than 0.05), collagen III mRNA (F=14.620, P less than 0.05), PI3K protein (F =26.672, P less than 0.05), and p-Akt protein (F =23.522, P less than 0.05).

CONCLUSIONHydrogen sulfide can activate the PI3K/Akt pathway and elevate the expression of collagen I and collagen III in rat hepatic stellate cells.

Animals ; Cells, Cultured ; Collagen Type I ; metabolism ; Collagen Type III ; metabolism ; Hepatic Stellate Cells ; drug effects ; metabolism ; Hydrogen Sulfide ; pharmacology ; Phosphatidylinositol 3-Kinases ; metabolism ; Proto-Oncogene Proteins c-akt ; metabolism ; RNA, Messenger ; genetics ; Rats ; Signal Transduction

Objective To investigate pregnancy outcomes and neurodevelopment in fetuses with ventriculomegaly. Methods This was a cohort study of 173 gravidas with singleton pregnancy who were diagnosed with fetal ventriculomegaly by ultrasound in Prenatal Diagnostic Center of Nanfang Hospital Affiliated to Southern Medical University from March 2010 to July 2016. Thirty normal gravidas who received antenatal care in the same hospital and at the same period were selected as control. Clinical data were collected. Gravidas who had chosen to continue their pregnancy were followed up to monitor the variations of fetal ventricular. Fetal mild and moderate ventriculomegaly were respectively defined as a ventricular atrial width of 10-12 mm and >12 mm but <15 mm. Isolated ventriculomegaly (IVM) indicated those without any other ultrasound abnormalities, otherwise the case would be defined as non-isolated ventriculomegaly (NIVM). Among the 173 gravidas, 54 cases were mild IVM, 53 mild NIVM, 26 moderate IVM and 40 moderate NIVM. Fetuses with chromosome abnormalities were excluded from the study. Neonatal behavioral neurological assessment (NBNA) was used to analyze the neonatal neurodevelopment at the age of 7 days, and Bayley scales of infant development was used to evaluate the development of nervous system at the age of 6 months through analyzing their mental development index (MDI) and psychomotor development index (PDI). Statistical methods included t test, χ2 test (or Fisher's exact test), nonparametric test, Mann-Whitney test and multiple Kruskal-Wallis H test. Results (1) Among the 107 fetuses with mild ventriculomegaly, 72.9％ (78), 23.4％ (25) and 3.7％ (4) of them regressed, stabilized and progressed,respectively; however, among the 66 moderate cases, the figures were 45.4％ (30), 37.9％ (25) and 16.7％ (11) respectively (χ2=15.769, P<0.001). For those in the IVM and NIVM subgroups within the moderate ventriculomegaly group, significant difference was shown [17(65.4％), 8(30.8％) and 1(3.8％) vs 13(32.5％), 17(42.5％) and 10(25.0％), χ2=8.552, P=0.014], but not within the mild groups (χ2=2.412, P=0.299). (2) There were 164 gravidas who continued their pregnancy and delivered. Significant differences in NBNA score were observed between the ventriculomegaly group and the control (37.70±1.80 vs 38.53±1.38, t= - 2.424, P<0.05). Numbers of neonates with NBNA score < 36 and ≥ 36 points were 5(4.7％) and 101(95.3％) in the mild group, and 8(13.8％) and 50(86.2％) in the moderate group (χ2=4.231, P=0.004). There was significant difference in NBNA score between the IVM and NIVM subgroup within neither mild nor moderate group (χ2 were 0.210 and 0.201, P were 1.000 and 0.720). (3) Totally, 137 cases completed the assessment of nervous system development at the age of 6 months. There was significant difference in PDI score between the ventriculomegaly group and the control (90.50±10.85 vs 95.80±9.65, t= - 2.471, P=0.014), but not in MDI score (95.42+11.20 vs 99.50+12.00, t= - 1.786, P=0.076). (4) The comparison of the proportion of excellent, average and poor PDI scores: Significant differences were found between the IVM and NIVM subgroup within the moderate ventriculamegaly group and in the different intrauterine outcome groups [IVM vs NIVM groups: 3(15.0％), 16(80.0％) and 1(5.0％) vs 1(3.1％), 24(75.0％) and 7(21.9％),Z= - 2.097, P=0.036;intrauterine regression, stable and progress group: 9(10.6％), 75(88.2％) and 1(1.2％);3(6.5％), 37(80.4％) and 6(13.1％) vs 0, 2(2/6) and 4(4/6), χ2=19.808, P<0.001], but not between the mild and moderate vetriculamegaly group, or between the subgroups within the mild ones (Z were - 1.869 and - 1.946, P were 0.062 and 0.052). (5) The comparison of the proportion of excellent, average and poor scores of MDI: Significant difference was only found among the different intrauterine outcome groups[13(15.3％), 71(83.5％), 1(1.2％); 2(4.4％), 41(89.1％), 3(6.5％) vs 0, 5(5/6), 1(1/6); χ2=7.980, P=0.018], but not in any other comparisons (all P>0.05). Conclusions Prognosis of fetal ventriculomegaly is affected by co-existed abnormalities and intrauterine progression. Fetus with mild ventriculomegaly can also have risk of abnormal neural development, suggesting that we should pay much attention to such cases and a regular follow-up is required.

Objective:To explore the mediating effect of nurses′ self-efficacy in palliative care between the past behavioral experience of end-of-life care and core competence, and provide theoretical reference for improving the core competence of clinical nurses in palliative care.Methods:579 clinical nurses from 2 tertiary general hospitals in Shandong Province were investigated by convenience sampling method using general information questionnaire, nurses′ self-efficacy questionnaire for palliative care and palliative care nurses′ core competency questionnaire. The data were analyzed by SPSS 25.0.Results:The total score of core competence of hospice care of 579 nurses was (71.41 ± 22.74), nurses′ self-efficacy of palliative care was positively correlated with their core competence ( r = 0.648, P<0.01), past behavior experience was positively correlated with self-efficacy ( r = 0.479, P<0.01), positively correlated with core competence ( r = 0.427, P<0.01). Nurses′ self-efficacy of palliative care played a partial mediating role between the pastbehavioral experience and core competence, which accounted for 64.67% of the total effect. Conclusions:The past behavioral experience of end-stage nursing can directly or indirectly affect the core competence of nurses in palliative care through self-efficacy. It can improve the core competence of palliative care by taking active measures to enrich the past behavioral experience of end-of-life care and improve self-efficacy.

Objective: To study the toxicological effects of Nao-de-kang on rats. Methods: According to the digital table, SD rats were randomly divided into blank group and Nao-de-kang small dose group(3.85g/kg), high dose group(7.71g/kg) and maximum tolerated dose group(77.14g/kg), 20 rats in each group, half male and half female.All groups were treated for 12 weeks, and the maximum tolerated dose group was treated for 1 week.The animal activity during treatment, the blood routine indicators, blood biochemical index and the organs for pathological examination were recorded and compared. Results: There was no mortality in the dose group of rats in the experimental period.The weights of 4 groups had no statistically significant differences during treatment(F=0.688, 0.540, 0.121, 0.065, 0.128, 0.239, 0.199, 0.378, 0.127, 0.446, 0.906 and 0.665, P=0.562, 0.585, 0.886, 0.937, 0.880, 0.788, 0.820, 0.687, 0.881, 0.642, 0.410 and 0.518), male and femal′s red blood cell(RBC)(♀: F=0.178, P=0.910, ♂: F=0.119, P=0.948), hemoglobin(HGB)(♀: F=0.046, P=0.987, ♂: F=0.072, P=0.975), hematokrit(HCT)(♀: F=0.126, P=0.944, ♂: F=0.054, P=0.983), platelet(PLT)(♀: F=0.515, P=0.675, ♂: F=0.500, P=0.685), white blood cell(WBC)(♀: F=0.078, P=0.972, ♂: F=0.057, P=0.982), eosnophils(Eos)(♀: F=0.078, P=0.972, ♂: F=0.057, P=0.982), lymphocyte(Lym)(♀: F=0.078, P=0.972, ♂: F=0.057, P=0.982), neutrophilic granulocyte(Neu)(♀: F=0.134, P=0.939, ♂: F=0.090, P=0.999), alanine aminotransfease (ALT)(♀: F=0.572, P=0.637, ♂: F=0.200, P=0.896), aspartate aminotransferase(AST)(♀: F=0.572, P=0.637, ♂: F=0.200, P=0.896), total protein(TP)(♀: F=0.665, P=0.579, ♂: F=0.343, P=0.795), albumin(ALB)(♀: F=0.533, P=0.663, ♂: F=0.668, P=0.577), triglyceride(TG)(♀: F=0.843, P=0.480, ♂: F=0.561, P=0.644), cholesterol(CHOL)(♀: F=0.245, P=0.864, ♂: F=0.046, P=0.987), glucose(GLU)(♀: F=0.216, P=0.884, ♂: F=0.095, P=0.963), urea nitrogen(BUN)(♀: F=0.172, P=0.914, ♂: F=0.203, P=0.894)and creatinine(Cr)(♀: F=0.172, P=0.914, ♂: F=0.203, P=0.894) had no statistically significant differences. Conclusion Nao-de-kang has no obvious side effect.