Objective To observe the major adverse reaction of irinotecan in combination with fluorouracil for advanced colorectal cancer,and sum up the nursing experience of acetylcholine syndrome and acute delayed diarrhea.Methods Pathologically confirmed 45 cases of patients with advanced colorectal cancer were treated with modified FOLFIRI regimen for total of 190 cycles.Results Acetylcholine syndrome rate was 28.9%,the incidence of acute delayed diarrhea was 40.0% ,more than 3 grade diarrhea was 6.7%.Conclusion The incidence of acute delayed diarrhea in Chinese patients is lower than in caucasians,and reasonable care measures can reduce the occurrence of adverse reactions,irinotecan in combination with fluorouracil is a safe and effective regimen for Chinese patients.

Plasma levels of artial natriuretic polypeptide (ANP), cyclic GMP (cGMP), renin activity (PRA), angiotensin II (AT II) and arginine vasopressin (AVP) were measured by radioimmunoassay in 30 patients with acute heart failure (AHF), 30 chronic heart failure (CHF), 30 chronic atrial fibrillation (CAF) and 27 paraxysmal atrial fibrillation and supraventricular tachycardia (SVT). The results showed that plasma ANP and cGMP levels in all these four groups were significantly higher than those in the normal group (P

Objective To explore the effects of nurse-physician collaboration model on anxiety, depression and quality of life (QOL)of patients undergoing concurrent chemo-radiotherapy.Methods A total of 1 80 eligible patients from December 201 3 to December 201 4 were randomly divided into study group (n =96) and control group (n =84).The patients of study group received nurse-physician collaboration nursing,while the patients of control group received routine nursing.The self-rating anxiety scale (SAS ),self-rating depression scale (SDS ) and European organization for research and treatment of cancer quality of life questionnaire-3.0 (EORTC QLQ-C30)were used to investigate the differences between groups before and after intervention.Results Anxiety and depression in study group were better than those in control group after treatment,and the difference was statistically significant (P <0.05).Overall health,emotional function,social function,cognitive function,role function,pain,insomnia and breathing difficulties were better in study group than those in control group after treatment (P <0.05).Conclusions Nurse-physician collaboration model can improve the anxiety,depression and QOL of patients receiving chemoradiotherapy.

Objective:To investigate the levels of serum high mobility group box (HMGB) 2 and HMGB3 and clinical significance in patients with non-small cell lung cancer (NSCLC) .Methods:A total of 137 NSCLC patients admitted to the First Affiliated Hospital of Xi'an Medical University from January 2020 to January 2022 were selected as the NSCLC group, and another 90 cases who underwent healthy medical checkups during the same period were selected as the healthy group. Serum HMGB2 and HMGB3 levels were compared between the two groups. The relationship between serum HMGB2 and HMGB3 levels and the clinical and pathological characteristics of NSCLC patients was analyzed. NSCLC patients were divided into a good prognosis group ( n=86) and a poor prognosis group ( n=51) according to the prognosis, and the clinical data of the two groups were compared. Multivariate logistic regression was used to analyze the influencing factors of the prognosis of NSCLC patients. Receiver operator characteristic (ROC) curve was used to analyze the predictive value of serum HMGB2 and HMGB3 on the prognosis of NSCLC patients. Results:Serum HMGB2 [ (6.35±1.66) ng/ml vs. (2.58±0.76) ng/ml, t=20.19, P<0.001] and HMGB3 [ (2.48±0.56) ng/ml vs. (1.09±0.13) ng/ml, t=23.13, P<0.001] levels in NSCLC group were higher than those in healthy group. Serum HMGB2 and HMGB3 levels of NSCLC patients with a history of smoking ( t=2.80, P=0.006; t=5.04, P<0.001), lymph node metastasis ( t=3.53, P=0.001; t=4.02, P<0.001), and TNM stage Ⅲ-Ⅳ ( t=2.58, P=0.011; t=3.82, P<0.001) were significantly higher than those of patients with no history of smoking, no lymph node metastasis, and TNM stage Ⅰ-Ⅱ. The serum levels of HMGB2 [ (7.80±1.83) ng/ml vs. (5.49±1.56) ng/ml, t=7.85, P<0.001] and HMGB3 [ (2.91±0.78) ng/ml vs. (2.23±0.43) ng/ml, t=6.58, P<0.001) ] in the poor prognosis group were higher than those in the good prognosis group, and the proportion of patients with lymph node metastasis ( χ2=4.81, P=0.028), history of smoking ( χ2=11.67, P=0.001), and TNM stage Ⅲ-Ⅳ ( χ2=6.18, P=0.013) was significantly higher than that in the good prognosis group. Multivariate logistic regression analysis showed that lymph node metastasis ( OR=1.96, 95% CI: 1.14-3.36, P=0.015), smoking history ( OR=2.02, 95% CI: 1.33-3.06, P=0.001), TNM stage ( OR=2.28, 95% CI: 1.35-3.86, P=0.002), HMGB2 ( OR=2.01, 95% CI: 1.40-2.91, P<0.001), and HMGB3 ( OR=1.99, 95% CI: 1.25-3.15, P=0.003) levels were independent influencing factors of prognosis of NSCLC patients. ROC curve analysis showed that the area under the curve (AUC) of serum HMGB2 and HMGB3 alone and in combination to predict the prognosis of NSCLC patients were 0.833, 0.862 and 0.922, respectively, and the AUC predicted by the combination was significantly higher than that predicted by serum HMGB2 ( Z=2.44, P=0.015) and HMGB3 ( Z=2.54, P=0.011) alone. Conclusion:Serum HMGB2 and HMGB3 levels are up-regulated in NSCLC patients and are closely associated with poor prognosis, and the combined detection of the two has certain predictive efficacy for prognosis of NSCLC patients.

Objective To explore influences of bedside sitting nursing on mechanical ventilation duration of patients with chronic obstructive pulmonary disease (COPD). Methods Ninety six patients with COPD admitted in the hospital from January 2013 to January 2014 were selected as research subjects, who were divided into control group and obser-vation group with 48 patients in each group according to different nursing modes. The patients in the control group were subjected to conventional treatment and nursing, while the patients in the observation group were subjected to bedside sitting nursing on the basis of that applied in the control group, mechanical ventilation duration, length of hospital stay, changes in blood and vigor indexes before and after nursing of two groups of patients were compared and analyzed. Re-sults The differences in comparisons of PaO2, PaCO2 and SpO2 levels of patients in two groups had no statistically signif-icant before nursing (P>0.05); and PaO2, PaCO2 and SpO2 levels of patients in the observation group after nursing were better than those indexes of patients in the control group (P<0.05). Mechanical ventilation duration and length of hospital stay of patients in the observation group were lower than those of patients in the control group, the successful removal of respirators used in the observation hit was 85.4%, was higher than 64.6% in the control group, the incidence of ven-tilator associated pneumonia was 4.2%, was lower than 22.9% in the control group, and the difference was significant (P<0.05). Conclusion The bedside sitting position can effectively improve the ventilation function of patients with COPD, reduce the duration of mechanical ventilation, decrease the occurrence of ventilator associated pneumonia, shorten hospitalization time, and improve the quality of survival, delivering high clinical application value.

Purpose: C5α receptor 1 (C5ΑR1) is associated with the development of various human cancers. However, whether it is involved in the development of hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC) is poorly understood. We explored the expression, biological role, and associated mechanisms of C5AR1 in HBV-related hepatoma cells. Materials and Methods: The expression of C5ΑR1 mediated by HBV and HBV core protein (HBc) was detected in hepatoma cells. The function of nuclear factor кB (NF-κB) pathway in HBc-induced C5AR1 expression was assessed. The roles of C5ΑR1 in the activation of intracellular signal pathways, the upregulation of inflammatory cytokines, and the growth and migration of hepatoma cells mediated by HBc, were investigated. The effect of C5α in the development of HCC mediated by C5AR1 was also measured. Results: C5ΑR1 expression was increased in HBV-positive hepatoma cells. Dependent on HBc, HBV enhanced the expression of C5ΑR1 at the mRNA and protein levels. Besides, HBc could promote C5ΑR1 expression via the NF-κB pathway. Based on the C5ΑR1, HBc facilitated the activation of JNK and ERK pathways and the expression and secretion of interleukin-6 in hepatoma cells. Furthermore, C5ΑR1 was responsible for enhancing the growth and migration of hepatoma cells mediated by HBc. Except these, C5α could promote the malignant development of HBc-positive HCC via C5AR1. Conclusion We provide new insight into the mechanisms of hepatocarcinogenesis mediated by HBc. C5ΑR1 has a significant role in the functional abnormality of hepatoma cells mediated by HBc, and might be utilized as a potential therapeutic target for HBV-related HCC.

Purpose: C5α receptor 1 (C5ΑR1) is associated with the development of various human cancers. However, whether it is involved in the development of hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC) is poorly understood. We explored the expression, biological role, and associated mechanisms of C5AR1 in HBV-related hepatoma cells. Materials and Methods: The expression of C5ΑR1 mediated by HBV and HBV core protein (HBc) was detected in hepatoma cells. The function of nuclear factor кB (NF-κB) pathway in HBc-induced C5AR1 expression was assessed. The roles of C5ΑR1 in the activation of intracellular signal pathways, the upregulation of inflammatory cytokines, and the growth and migration of hepatoma cells mediated by HBc, were investigated. The effect of C5α in the development of HCC mediated by C5AR1 was also measured. Results: C5ΑR1 expression was increased in HBV-positive hepatoma cells. Dependent on HBc, HBV enhanced the expression of C5ΑR1 at the mRNA and protein levels. Besides, HBc could promote C5ΑR1 expression via the NF-κB pathway. Based on the C5ΑR1, HBc facilitated the activation of JNK and ERK pathways and the expression and secretion of interleukin-6 in hepatoma cells. Furthermore, C5ΑR1 was responsible for enhancing the growth and migration of hepatoma cells mediated by HBc. Except these, C5α could promote the malignant development of HBc-positive HCC via C5AR1. Conclusion We provide new insight into the mechanisms of hepatocarcinogenesis mediated by HBc. C5ΑR1 has a significant role in the functional abnormality of hepatoma cells mediated by HBc, and might be utilized as a potential therapeutic target for HBV-related HCC.

Objective:To investigate the factors affecting the accuracy of electronic portal imaging device (EPID)-based in vivo dose verification in radiotherapy for patients with lung and esophageal cancers, and to recommend the workflow and specifications for the application of the in vivo dose verification. Methods:This study randomly selected 32 patients who received radiotherapy for esophageal and lung cancers at the Department of Radiation Oncology, Jinhua Municipal Central Hospital from May to August 2022, including 14 lung cancer cases and 18 esophageal cancer cases. Using a uRT-linac 506c linear accelerator, these patients were treated according to the dynamic intensity-modulated radiotherapy (dIMRT) and EPID-based In vivo dose verification ( In vivo EPID) plans developed with the uRT-TPOIS planning system. The In vivo dose verification performed during the treatment included 238 fractions of In vivo EPID and 80 fractions of image-guided radiotherapy (IGRT) for the lung cancer cases, as well as 414 fractions of In vivo EPID and 105 fractions of IGRT for the esophageal cancer cases. The 2D γ passing rate for each irradiation field was obtained according to the set threshold value. Furthermore, fractioned irradiation fields with γ-passing rates below the threshold value were analyzed, and primary factors decreasing the γ-passing rate were further analyzed by combining the online CT images and 3D reconstruction-derived dose. Results:For lung and esophageal cancers, the mean γ-passing rates were 95.1% ± 5.7% and 96.5% ± 4.5%, respectively at 3 mm/5%; 91.5% ± 8.4% and 92.2% ± 4.9%, respectively at 3 mm/3%, and 79.1% ± 14.7% and 83.7% ± 8.2%, respectively at 2 mm/2%, indicating no statistically significant differences between two cancers ( P > 0.05). The average γ passing rate for beam orientations near 0°/180° (Group A) was higher than those near 90°/270° (Group B) 3 mm/5%: Z = -25.4, P < 0.05; 3 mm/3%: Z = -26.8, P < 0.05). The IGRT correction of setup errors significantly improved the γ passing rates (96.3% ± 5.1% and 96.4% ± 4.9%, respectively at 3 mm/5%, Z = -5.50, P < 0.05; 92.3% ± 8.0% and 91.3% ± 7.7%, respectively at 3 mm/3%, Z = -9.54, P < 0.05). The results of In vivo dose verification were affected by changes in the volumes and motion of tumors and normal tissues, radiotherapy positioning, and adequacy of pre-treatment preparation. Conclusions:EPID-based In vivo dose verification during radiotherapy can avoid incorrect irradiation. However, it is necessary to standardize the workflow of the EPID-based In vivo dose verification to avoid the decrease in the γ passing rate caused by artificial factors.

Objective To evaluate the risk factors and sonographic findings of pregnancies complicated by placenta increta or placenta percreta. Methods Totally, 2219 cases were retrospectively analyzed from 20 tertiary hospitals in China from January 2011 to December 2015. The data were collected based on the original case records. All cases were divided into two groups, the placenta increta (PI) group (79.1％, 1755/2219) and the placenta percreta (PP) group (20.9％, 464/2219), according to the degree of placental implantation. The risk factors and sonographic findings of placenta increta or percreta were analyzed by uni-factor and logistic regression statistic methods. Results The risk factors associated with the degree of placental implantation were age, gravida, previous abortion or miscarriage, previous cesarean sections, and placenta previa (all P<0.05), especially, previous cesarean sections (χ2=157.961) and placenta previa (χ2=91.759). Sonographic findings could be used to predict the degree of placental invasion especially the boundaries between placenta and uterine serosa, the boundary between placenta and myometrium, the disruption of the placental-uterine wall interface and loss of the normal retroplacental hypoechoic zone(all P<0.01). Conclusions Previous cesarean sections and placenta previa are the main independent risk factors associated with the degree of placenta implantation. Ultrasound could be used to make a prenatal suggestive diagnosis of placenta accreta spectrum disorders.

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.