Nutrition studies of saturation/excursion dives were made in a hyper-baric chamber. Seven divers were investigated during a period of 26-day N2-O2 saturation dive to 36.5m with excursion to 60-75m using only air. Daily intake of food was surveyed by regular weighing method. The caloric and nutrient intakes were calculated from Chinese food composition tables. Urine samples were collected for estimation of vitamin B1, B2, 4-pyridoxic acid, ascorbic acid and also nitrogen. During the dive they lost the appe- tite for meat and oil, instead they preferred vegetables, fruits and beverages. Thus energy, protein and lipid decreased and a weight loss was observed. The urinary excretion of certain vitamins was reduced, especially marked with thiamine. Accordingly a suggestion on the allowance of certain nutrients was proposed.

Objective To improve the quality,efficacy,and efficiency of health checkup by establishing and implementing total quality management system.Methods Routine physical examination data of 5955 individuals (from January 2007 to May 2007,when total quality management system was not implemented) were analyzed and compared with 7520 individuals (from January 2008 to May 2008.when the system was implemented).Results The report quality of routine physical examination was significantly improved,and the qualification rate was increased from 82.6% to 98.2%.The healthcare service procedure was optimized.The examination time for the essential items was shoaened from 51 to 35 minutes.The result report time was reduced from 5 to only 1 day.The customer satisfaction rate Was increased from 86.3% to 98.1%; however,the suing rate Was decreased from 0.05% to 0.01%.The examination efficiency was significantly improved.The growth rate of checkup recipients was increased from 7.22% to 26.38%.There Was statistical significance before and after the implementation of the total quality management system (P

Nutrition studies were made on four divers performing a helium-oxygen saturation dive to a simulated depth of 200m in a hyperbaric chamber for about seven days. Daily intake of food was surveyed by regular weighing method and its calories and nutrients were calculated from Chinese food composition table. Fasting blood and 24h urine samples were collected on several occasions before, during and after the dive for estimation of free amino acid, nitrogen and minerals. Vitamin load test was conducted for evaluation of vitamin status. The results showed that during the dive intakes of cereal, meat and oil of divers were decreased, but vegetable, fruit and beverage intakes increased. An average body weight loss of 1.75 kg was found after a 7-day period, but little changes in the body fat. Free amino acid levels of serum and urinary output were reduced, especially the essential amino acids. The urinary excretion of minerals was in an acceptable range, but thiamin decreased markedly and not returned to an acceptable range until 10 days after leaving the hyperbaric chamber.

Objective To explore the value of PET-CT and CT in the assessment after radiofrequency ablation (RFA) in lung cancer.Methods Eighteen patients were randomly divided into short-term group ( 8 cases) and long-term group ( 10 cases).Patients in short-term group received PET-CT and CT examination within 10 days after RFA therapy,whereas those in long-term group got PET-CT and CT examination within 2 months after RFA therapy.The value of PET-CT and CT after RFA therapy through the result of the image was compared between two groups.Results All patients were classified as stable disease in CT,while in PET-CT assessment,33.33％ (6/18) of the patients presented complete remission and 66.67％ (12/18)presented partial remission.37.50％ (3/8) of short-term group presented complete remission,62.50％ (5/8) of short-term group presented partial remission.30.00％ (3/10) of long-term group presented complete remission,70.00％(7/l0) of long-term group presented partial remission.Conclusion PET-CT is superior to CT in the assessment of the effectiveness of RFA therapy,and there is no difference between short-term and long-term PET-CT examination,therefore early PET-CT is more with clinical significance.

OBJECTIVE:To observe the occurrence of paclitaxel(PTX)-induced muscle soreness and therapeutic efficacy and safety of diclofenac sodium. METHODS:Among 84 patients with malignant tumor receiving PTX chemotherapy,56 patients suf-fered from PTX-induced muscle soreness,among which 22 female patients suffered from medium and severe muscle soreness and then were randomly divided into group A and B,with 11 cases in each group. Group A was given Diclofenac sodium sustained-re-lease tablet 75 mg orally,once a day;group B was given Paracetamol and tramadol hydrochloride tablets one tablet orally,once a day,and then given Promethazine hydrochloride injection 100 mg subcutaneously,2-3 times a day when muscle soreness could not be born. Treatment course of both groups lasted for 5 d. The distribution of muscle soreness were observed. The onset time and dura-tion of muscle soreness were also observed as well as pain relief and the occurrence of ADR in group A and B. RESULTS:Among 84 cases,the incidence of muscle soreness was 66.67%,among which mild pain accounted for 23.81%,moderate pain accounted for 13.10%,and severe pain accounted for 29.76%. Among 56 patients with muscle soreness,earliest muscle soreness occurred on the day of medication,and most of muscle soreness occurred on 1-3 days after medication,mainly manifesting as sore,activity limitation when severe,associated with fatigue. The pain relief rate of group A and B were 100%,but the incidence of adverse re-actions in group A was significantly lower than group B,with statistical significances(P<0.05).CONCLUSIONS:Diclofenac sodi-um is similar to paracetamol and tramadol hydrochloride in the treatment of PTX-induced muscle soreness,but it is better than paracetamol and tramadol hydrochloride in safety.

Objective:To explore the effect of prospective nursing oriented to hypothermia prevention on the recovery of consciousness and stress response of general anesthesia patients in the Operating Room.Methods:The convenience sampling was used to select 120 surgical patients undergoing general anesthesia in Shanxi Provincial People's Hospital from June 2019 to December 2020. According to the operation time, the patients were divided into the control group and the observation group, each with 60 cases. The control group conducted conventional heat-preservation nursing, and the observation group carried out prospective nursing oriented to hypothermia prevention. The differences in perioperative stress indicators, recovery quality, and adverse reactions of anesthesia were compared between the two groups.Results:There was no significant difference in serum cortisol (COR) and norepinephrine (NE) before anesthesia and 12 hours after operation between the two groups ( P>0.05) . Serum COR and NE in the observation group were lower than those in the control group 30 minutes after the operation and 10 minutes after extubation, and the differences were statistically significant ( P<0.05) . The observation group's spontaneous breathing, recovery of consciousness, catheter removal, and Post-Anesthesia Care Unit (PACU) retention time were shorter than those of the control group, and the differences were statistically significant ( P<0.05) . The total incidence of adverse reactions of anesthesia in the observation group was lower than that in the control group also with a statistical difference ( P<0.05) . Conclusions:Prospective nursing oriented to hypothermia prevention can reduce the perioperative stress response of general anesthesia patients in the Operating Room, improve the quality of consciousness recovery, and reduce the adverse reactions of anesthesia.

OBJECTIVEThe aim of this study was to establish a standard protocol for detection of EGFR mutations in cytologic specimens.

METHODS287 cytologic samples were collected from the patients who were suspected of having lung cancer at six hospitals in Beijing. A detection protocol for EGFR mutations was designed. Two comparative experiments were carried out for the coincidence in EGFR mutation rates between direct sequencing (Seq) and amplification refractory mutation system (ARMS) methods, and between 40 matched cytologic samples with formaldehyde-fixed paraffin embedded (FFPE) cytologic blocks and cytospin slides.

RESULTSTumor cells were found in 236 out of 287 cases (82.2%, 236/287) . Among them, there were 31 cases (13.1%, 31/236) of low tumor cell content samples and 205 cases (86.9%, 205/236) of high tumor cell content samples. 180 cases in the high tumor cell content samples (87.8%, 180/205) were diagnosed to be consistent with NSCLC. 25 out of 194 cases were ruled out or indefinite to be diagnosed as NSCLC by immunohistochemistry. By direct sequencing, the mutation rate of EGFR was 27.8% (50/180) in NSCLC samples and 28.2% (50/177) in adenocarcinoma samples (high tumor content samples) . By ARMS, the mutation rate of EGFR was 45.6% (82/180) in NSCLC samples and 46.3% (82/177) in adenocarcinoma samples (high tumor content samples). The EGFR mutation rate in low tumor content samples was 38.7% (12/31) , there was no significant difference in EGFR mutation rates between the groups of low tumor cell content samples and high tumor cell content samples (P = 0.12). The concordance rate of EGFR mutation rates was 100% between scraping tumor cells from slides samples and from FFEP blocks in the 40 matched samples. Forty-eight out of 180 definitive NSCLC patients received Gefitinib therapy. The FPS was 12 months in the gefitinib-treated ARMS⁺ group and 2 months in the ARMS⁻ group (P < 0.001), and the OS was 19 months in the gefitinib-treated ARMS⁺ group and 7 months in the ARMS⁻ group (P = 0.003), but no significant differences were found in the efficacy (PFS and OS) of Gefitinib between Seq⁺ and Seq⁻ groups (P = 0.227, P = 0.510, respectively), and Seq⁺/ARMS⁺ and Seq⁻/ARMS⁺ groups (P = 0.354, P = 0.334, respectively).

CONCLUSIONSThe detection protocol for EGFR mutations in cytological specimens introduced in this study is tested to be reliable and feasible. Pathological evaluation and immunohistochemistry are important in the detection procedure of EGFR mutations in cytologic specimens. High sensitivity methods should be selected for detection of EGFR mutations in cytologic samples.

Adenocarcinoma ; metabolism ; Carcinoma, Non-Small-Cell Lung ; metabolism ; Humans ; Lung Neoplasms ; diagnosis ; epidemiology ; metabolism ; Mutation ; Mutation Rate ; Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor ; genetics ; metabolism

Objective:To understand the infectious status of Lyme disease among patients with arthritis symptoms in Hainan Province, and to provide a theoretical basis for prevention and control of Lyme disease.Methods:From 2013 to 2018, sampling surveys had been conducted in medical institutions in 8 cities in Hainan Province(Haikou, Sanya, Danzhou, Dongfang, Wenchang, Qionghai, Qiongzhong, Wuzhishan), 2 311 patients serum samples were collected with arthritis symptoms, and descriptive research were conducted base on the collected clinical data. The Indirect Fluorescent-Antibody Test (IFA) method was used for preliminary screening of Lyme disease antibody, the Western Blot (WB) method was used for IFA positive samples confirmation. Statistical analysis using χ2 test. Results:2 311 serum samples were tested by IFA, and 166 were positive with the positive rate of 7.18%. Further confirmed by WB method, 62 samples were positive, the positive rate of Lyme disease antibody was 2.68%(62/2 311). The positive rate of Lyme disease antibody among patients with arthritis in different regions of Hainan was statistically significant ( χ2 =40.636, P<0.001), and the positive rate in Qiongzhong city was the highest (8.81%, 14/159). Danzhou′s positive rate was the second highest, 5.62%(5/89). Dongfang city had the lowest positive rate (0.51%, 2/394). The positive rates of Lyme disease serum antibody in men and women were 2.79% (33/1 182) and 2.57% (29/1 129), respectively; the positive rates of antibodies between each age groups were in the range of 1.74% to 3.64%. The antibody positive rate of Lyme disease showed no significant difference between gender and age ( χ2 =0.110, P=0.740 ; χ2 =1.938, P=0.747). Conclusion:Patients with arthritis symptoms caused by Borrelia burgdorferi infection were found in 8 cities in Hainan province, but the Lyme disease antibody positive rate was different among cities, with Qiongzhong County being the highest.

Objective The aim of this study was to establish a standardized protocol for detection of ALK protein expression and gene fusion in cytologic specimens. Methods Lung adenocarcinoma cytologic specimens were collected from seven hospitals in Beijing city. A detection protocol for ALK protein expression and gene fusion was designed according to the results of comparative experiment. Ventana immunohistochemical ( IHC) ALK( D5F3) detecting ALK protein expression was performed in 203 prepared
formalin?fixed paraffin?embedded ( FFPE) cell blocks. ALK gene fusion in 98 EGFR gene wild type cytologic specimens and in 4 bronchoalveolar lavage fluid ( BL ) samples was detected by quantitative reverse transcription polymerase chain reaction (qRT?PCR). ALK gene fusion in the Ventana IHC ALK (D5F3) positive samples was further tested by fluorescence in situ hybridization ( FISH) . Six patients with ALK IHC?positive result were followed up to analyze the responses of crizotinib therapy. Comparative experiments:( 1) Comparison of the results of 4% neutral buffered formalin fixed for different time ( 24 h, 48 h, 72 h) on the Ventana IHC ALK (D5F3) staining was conducted in two cases of IHC ALK positive FFPE cell blocks;(2) Comparing qRT?PCR results for ALK fusion in samples from FFPE cell blocks and cytospin prepared slides in 10 cases of lung adenocarcinoma cytologic specimens. Results Among the specimens examined using the standardized protocol recommended by this study, 229 cases of cytologic specimens met the diagnostic criteria of lung adenocarcinoma. Among them, 207 cases obtained ALK gene test results ( by at least one method), with an ALK test ratio of 90.4% (207/229).FFPE cell blocks were successfully prepared in 203 cases, Ventana IHC ALK ( D5F3) were successfully performed in all the 203 FFPE cell blocks ( 100%) , and the ALK protein positive detection rate was 10.3% (21/203). ALK fusion was tested in 98 FFPE cytologic samples of EGFR wild types by qRT?PCR, and 96 out of 98 ( 97. 96%) cytologic samples were successfully performed.18 out of 19 IHC ALK?positive cases were verified to be of ALK fusion status by qRT?PCR. The concordance rate was 94.7% ( Kappa=0.967, P<0.001) between Ventana IHC ALK( D5F3) and qRT?PCR, and the sensitivity of the Ventana IHC ALK ( D5F3) assay compared with qRT?PCR was 100%and the specificity was 98. 7%. FISH assay was used to verify the positive cases detected by Ventana IHC ALK(D5F3) staining. Two cases of low tumor cell content FFPE samples obtained indefinite results by FISH test. The six patients with positive ALK protein expression received crizotinib therapy, and 5 paitents got treated effectively. For two ALK IHC positive cases, which were 4% neutral buffered formalin fixed for 72 h, the result of Ventana IHC ALK(D5F3) staining became weakened obviously and uneven. In 10 cases of samples, total RNA was extracted from FFPE cytologic sections and cytospin prepared slides, and the results of qRT?PCR test and ALK gene fusion showed good concordance. Conclusions The standardized protocol recommended in this study expands the detection types and quantity of cytologic specimens for ALK protein expression and gene fusion and increased the detection rate. Ventana IHC ALK( D5F3) is a reliable method for detecting ALK protein expression in FFPE cell blocks. The pathologic quality control procedure prior to Ventana IHC ALK( D5F3) is crucial for the accuracy of testing the ALK gene status. When FFPE cell blocks could not be prepared or prepared unsuccessfully from the cytologic specimens, qRT?PCR may be an alternative option for the detection of ALK gene fusion.

Objective:To construct an anticipatory grief intervention scheme for family caregivers of advanced cancer patients based on narrative theory, and to provide reference for anticipatory grief nursing intervention.Methods:From October 2022 to May 2023, through literature research, semi-structured interview and brainstorming method, the first draft of nursing intervention plan was constructed, the Delphi method was used to conduct 2 rounds of correspondence consultation with 15 experts, and the indicators at all levels were modified according to the opinions of experts, and the final draft of intervention plan was formed.Results:The experts were all female, aged (49.67 ± 5.83) years old. The authority coefficient of the two rounds of experts was 0.87. The Kendall coordination coefficients of the first, second, and third level indicators after the first round of expert inquiry were 0.195, 0.113, and 0.093, respectively. The Kendall coordination coefficients of the first, second, and third level indicators after the second round of expert inquiry were 0.200, 0.119, and 0.101, respectively. The differences were statistically significant ( χ2 values were 8.76-107.21, all P<0.05).Finally, a nursing intervention plan based on narrative theory was formed, which included 4 primary indicators, 19 secondary indicators and 72 tertiary indicators. Conclusions:The anticipatory grief intervention scheme for family caregivers of advanced cancer patients is scientific, practical and feasible, and can be used for psychological nursing of family caregivers.