OBJECTIVE:To study the antitumor activity of Anthopleura xanthogrammica crude extract on human lung cancer SPC-A1 cells in vitro. METHODS:A. xanthogrammica crude extract obtained by the methods of repeated freezing and thawing,ac-etone precipitation. After treated with crude extract 0(blank control),0.625,1.25 and 2.5 mg/ml for 24,48 and 72 h,the activity of SPC-A1 cells were measured by MTT assay. The growth inhibition rate and IC50 were also calculated. 24 h later,the morphologi-cal changes of SPC-A1 cells were observed by HE staining and AO/EB fluorescence staining. RESULTS:MTT assay showed that A. xanthogrammica crude extract has significant inhibitory effect on the proliferation of human lung cancer SPC-A1 cells;with the increasing of the concentration and the extension of the time,the inhibitory rate was increased. Its 24 h,48 h ,72 h IC50 were 1.81,1.32 and 1.18 mg/ml. HE staining and AO/EB staining appeared obvious morphological changes of apoptosis that cell mor-phology narrowed,vacuoles arose in the cytoplasm,karyopyknosis and part of nuclear disappearance occurred. CONCLUSIONS:A. xanthogrammica crude extract has an inhibitory effect on the proliferation of human lung cancer SPC-A1 cells.

Objective:To construct a core competence evaluation index system for Anesthesia Intensive Care Unit (AICU) nurses, and to provide reference for the career orientation, training and management of AICU nurses.Methods:The first draft of the core competence evaluation index system of AICU nurses was developed by literature evaluation, semi-structured interview and group discussion. Using the purposive sampling method, 26 experts were selected for 2 rounds of expert consultation from August to September 2021 to determine the evaluation index system of core competence of AICU nurses, and the weights of indicators at all levels were determined by analytic hierarchy process.Results:The effective recovery rates of the 2 rounds of expert letter consultation questionnaire were respectively 92.31% (24/26) and 91.67% (22/24) , the expert authority coefficients were respectively 0.93 and 0.93, and the Kendall's harmony coefficients were respectively 0.28 and 0.19 (all P<0.01) . The final evaluation index system of AICU nurses' core competence included 4 first-level indicators (theoretical knowledge, nursing practice, comprehensive ability, personal characteristics) , 14 second-level indicators and 52 third-level indicators. Conclusions:The constructed evaluation index system of core competence of AICU nurses is scientific and reliable, which can provide a reference for the career orientation, training and management of AICU nurses.

Objective:To assess the efficacy and safety of cinepazide maleate injection in the treatment of patients with acute ischemic stroke.Methods:A multicenter, randomized, double-blind, placebo-controlled phase Ⅳ clinical trial, led by Peking Union Medical College Hospital, was conducted in 65 Hospitals in China. The efficacy of cinepazide maleate injection in patients with acute anterior circulation cerebral infarction with onset time of ≤48 hours, 7≤National Institute of Health stroke scale (NIHSS) score ≤25 was assessed from August 2016 to February 2019, using the proportion of modified Rankin scale (mRS) score≤1 and Barthel index (BI) score≤95 on day 14 as efficacy endpoint. The patients were divided into treatment group who were treated with cinepazide maleate injection and control group who were treated with placebo.Results:A total 937 patients were involved in the final efficacy analysis (466 in treatment group and 471 in control group). The proportion of subjects with mRS score≤1 on day 14 after treatment were higher in the treatment group than that in the control group (102/466(21.89%) vs76/471(16.14%)). Logistic regression analysis showed that patients treated with cinepazide maleate were significantly more likely to have a favorable outcome (mRS score≤1) than patients treated with placebo on day 14 ( OR=0.677, 95% CI 0.484-0.948 , P=0.023), and patients treated with cinepazide maleate were more likely to reach independence in activities of daily living (Barthel Index ≥95) than those treated with placebo on day 14 (125/466(26.82%) vs 91/471(19.32%); OR=0.632, 95% CI0.459-0.869, P=0.005). The rate of adverse events was similar between the treatment and control groups. Conclusion:The 14-day treatment with cinepazide maleate injection could reduce the degree of disability whereas did not increase the risk of adverse events.

Objective:To confirm the efficacy and safety of cinepazide maleate injection in acute ischemic stroke patients with obvious motor function deficit.Methods:This study is a subgroup analysis of multi-center, randomized, double-blind, placebo-controlled phase Ⅳ clinical trial. A total 812 patients of acute ischemic stroke with obvious limb motor deficit [motor function of limbs score in National Institutes of Health Stroke Scale (NIHSS) ≥4] were enrolled in this subgroup analysis. Patients received either cinepazide maleate injection or placebo. The treatment period was 14 days and follow-up was 90 days. The efficacy endpoints included the proportions of patients with a modified Rankin Scale (mRS) score ≤2, mRS score ≤1 and Barthel Index <95 on day 90. Safety was evaluated by recording all adverse events, monitoring vital signs, laboratory parameters and electrocardiogram.Results:A total of 732 patients were involved in the final efficacy analysis (361 in cinepazide maleate group and 371 in control group). The baseline limb motor function score of NIHSS was 5.23±1.43 in the cinepazide maleate group whereas 5.20±1.36 in the control group. Logistic regression analysis showed that following treatment for 90 days, the proportion of patients with a mRS score ≤2 was significantly higher in the cinepazide maleate group than in the control group [56.0% (202/361) vs 44.2% (164/371), OR=0.60, 95% CI 0.44-0.82, P=0.002]. The proportion of patients with a mRS score ≤1 was higher in the cinepazide maleate group than in the control group [43.3% (139/361) vs 35.2% (118/371), OR=0.69, 95% CI 0.50-0.97, P=0.031]. The proportion of patients with a Barthel Index <95 on day 90 was significantly lower in the cinepazide maleate group than in the control group [45.2% (145/361) vs 55.2% (185/371), OR=0.64, 95% CI 0.46-0.88, P=0.007]. During the treatment and follow-up period, the incidence of the most common adverse events in the cinepazide maleate group was 50.4% (199/395). Constipation and abnormal liver function were more common, but there were no statistically significant differences between the two groups. Conclusion:Cinepazide maleate injection is superior to placebo in improving neurological function and activities of daily living, reducing disability, and promoting functional recovery and safe in patients with acute ischemic stroke with obvious limb motor deficit.

Objective:To investigate the blood pressure change in patients with acute ischemic stroke (AIS) and hypertension treated with cinepazide maleate injection.Methods:This was a subgroup analysis of post-marketing clinical confirmation study of cinepazide maleate injection for acute ischemic stroke: a randomized, double-blinded, multicenter, placebo-parallel controlled trial, which conducted in China from August 2016 to February 2019. Eligible patients fulfilled the inclusive criteria of acute anterior circulation ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores of 7-25. The primary endpoints were mean blood pressure of AIS patients treated with cinepazide maleate or control, which were assessed during the treatment period (14 days), and the proportion of the patients with normal blood pressure was analyzed after the treatment period. Furthermore, a subgroup analysis was performed to investigate a possible effect of the history of hypertension on outcomes.Results:This analysis included 809 patients with hypertension. There was no significant difference in patients blood pressure and the proportion of patients with normal blood pressure (60.5% vs. 59.0%, P>0.05) between cinepazide maleate group and control group. Conclusion:Administration of cinepazide maleate injection does not affect the management of clinical blood pressure in patients with AIS.