AIM To study the cancer promoting effects of N nitrosodiethylamine (DEN) and 2 Acetylaminofluorene (2 AAF). METHODS Medium Term Rat Liver Bioassay (MTRLB). Male SD rats were initially given a single dose (200 mg?kg -1 ) of DEN ip and starting 2 weeks later, were treated with 10, 33 and 100 ppm DEN in drinking water, or with 2 2, 6 6 and 22 mg?kg -1 2 AAF by gavage for 6 weeks. All rats were subjected to two thirds partial hepatectomy at week 3 and killed at the end of week 8. Carcinogenic potential was scored by comparing the numbers and areas in induced glutathione S transferase placental form (GST P) positive foci in the liver with those of corresponding control group given DEN alone. RESULTS Both DEN and 2 AAF caused the increases of the numbers and areas of GST P positive foci in the liver, and showed dose response relationship. CONCLUSION Both DEN and 2 AAF shows cancer promoting effects, and MTRLB was a convenient, economical and effective tool to study the cancer promoting effects of test chemicals.

Objective To study the effect of postoperative rehabilitation of meditation training on repeat cesarean section patients. Methods A total of 86 cases of repeat cesarean section from October 1st, 2014 to October 1st, 2016 were collected. The patients were divided into the observation group (43 cases) and the control group (43 cases) by random digits table method. The observationgroup received meditation therapy by a well-trained nurse based on the routine treatment. The control group was treated with routine treatment. The two groups were compared by postoperative pain score, anxiety and depression scores, the first breastfeeding time, the first urination time and satisfaction. Results After intervention, the postoperative pain visual scores of the observation group and the control group were 3.21 ± 1.51 and 5.41±1.45 respectively, the difference was statistically significant (t=3.817, P<0.01). After intervention, the scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) of the observation group were 10.86±1.95,9.22±2.76, and 16.88±2.09,14.02±3.79 in the control group, the differences were statistically significant (t=11.518, 6.317, P<0.01). The first out-of-bed time of the observation group were as follows:<4 h:9.30%(4/43), 4-6 h:88.37%(38/43),>6 h/failure:2.32%(1/43). While the data of the control group were <4h: 18.60%(8/43), 4-6 h: 67.44%(29/43), >6 h/failure: 13.95%(6/43), the differences were statistically significant (t=6.114, P<0.05). The satisfaction of the observation group and the control group were 98.47% (42/43) and 91.69% (39/43) respectively, the difference was statistically significant. (χ2=7.679, P<0.01). ConclusionsMeditation can effectively reduce the postoperative pain, reduce the incidence of anxiety, shorten the first time of breastfeeding and urination, and improve patients′satisfaction.

Objective To investigate the efficacy of sophocarpine in rats with alcoholic liver disease and its effects on the expression of tumor necrosis factor (TNF)-α,interleukin (IL)-6 and transforming growth factor (TGF)-β1.Methods A total of 48 male Sprague-Dawley adult rats were evenly divided into healthy control group,model group,prevention group and treatment group.The rats in the healthy control group were gavaged with 0.9％NaCl every day for 12 weeks.The rats in the model group,prevention group and treatment group were gavaged with alcohol for 12 weeks to establish the model.The prevention group was injected with 20 mg · kg1 · d1 sophocarpine for 12 weeks.Since the fifth week,the treatment group was continuously injected with 20 mg · kg1 · d-1 sophocarpine for eight weeks.The histological changes were evaluated.The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase ( AST ), alkaline phosphatase (AKP),triglyceride (TG) and total cholesterol (TC) were examined.And the expression of TNF-α,IL-6 and TGF-β1 in liver tissue at mRNA and protein level were detected with immunohistochemistry and real-time polymerase chain reaction (PCR) assay.Comparison among groups was perform with single factor analysis of variance,pairwise comparisons with least significant difference method (LSD method),ranked data with Kruskal-Wallis H-test and multiple pairwise comparison with Nemenyi test.Results Compared with model group,hepatic steatosis and inflammatory cell infiltration were significantly improved in the treatment group and prevention group.The levels of ALT (41.40 U/L± 10.53 U/L and 40.75 U/L±6.94 U/L vs 58.37 U/I±5.35 U/L),AST(121.60 U/L±16.24 U/L and 109.50 U/L±9.23 U/L vs 156.63 U/L±32.47 U/L),AKP(114.88 U/L±40.37 U/L and 112.60 U/L±44.34 U/L vs 161.75 U/L±28.95 U/L),TG (4.19 mmol/L±0.99 mmol/L and 2.69 mmol/L± 1.35 mmol/L vs 4.50 mmol/L±0.99 mmol/L) and TC (1.48 mmol/L±0.28 mmol/L and 1.43 mmol/L±0.19 mmol/L vs 1.67 mmol/L±0.20 mmol/L) significantly decreased and the difference was statistically significant ( all P＜0.05).The expression of TNF-α,IL-6 and TGF-β1 at mRNA and protein level in liver tissue of model group were significantly higher than those of healthy control group,prevention group and treatment group.After treated with sophocarpine,the expression of TNF-α(mRNA:1.36 ± 0.08,1.16 ± 0.05 ; protein:3.38 ％ ± 0.82 ％,1.74 ％ ± 0.65 ％ ),IL-6 (mRNA:1.51 ± 0.05,1.39 ± 0.02; protein:5.89％ ± 0.96％,4.26％ ± 0.53％) and TGF-β1 (mRNA:1.39±0.04,1.37±0.02; protein:4.27％ ±0.97％,2.11％ ±0.83％) of treatment group and prevention group at mRNA and protein level significantly lower than those of model group (mRNA:1.81±0.16,1.95 ±0.13,1.84±0.22; protein:5.82％ ± 1.21％,7.63％ ±1.03％,5.33％± 1.12％) and the difference was statistically significant (all P＜0.01).Conclusion Sophocarpine significantly alleviates alcohol induced liver injury in rats,improves liver steatosis and inflammatory reaction degree,which may be related with the downregulation of TNF-α,TGF-β1 and IL-6 expression in liver tissue of ALD rats.

BACKGROUND: As a result of immature brain of children and their imperfect blood brain barrier, improper clinical treatment would affect growth and development of children. It is fully important to perform further investigation on immature brain injury induced neurodegeneration.OBJECTIVE: To observe the ultramicrostructure of neurons in homolateral parietal cortex and hippocampus in newborn 7-day SD rat with contusion of parietal cortex.DESIGN: Completely randomized controlled trial.SETTING: Laboratories of Nerve Morphology and Cytobiology, Medical College of Shanghai Jiaotong University; Electron Microscope Room of Institute for Physiology, Chinese Academy of Science.MATERIALS: The experiment was performed in Teaching and Research Section of Anatomy, Laboratories of Nerve Morphology and Cytobiology ofShanghai Second Medical University (Medical College of Shanghai Jiaotong University; Electron Microscope Room of Institute for Physiology of Chinese Academy of Science from October 2002 to June 2003. A total of 19newborn 7-day SD rats were randomly divided into experimental group, operation control group and normal control group with 15, 2 and 2 in each group respectively.METHODS: In experimental group, free-fall device for brain injury was used for establishing model of contusion of parietal cortex in newborn 7-day SD rat. Anesthesia and scalp incision were conducted, without using free-fall device in operation control group. But above procedures were not carried out in normal control group. The changes of ultramicrostructure were observed under transmission electron microscope after routine treatment of electron microscopic samples.MAIN OUTCOME MEASURES: Ultramicrostructure of neurons in homolateral parietal cortex and hippocampus.RESULTS: All the 19 rats entered results analysis. ① There were two sorts of morphological changes in neurons in experimental group. One was evident swelling of dendrites and bodies of neurons, accompanied with the changes of organelles. In the early stage, expansion of endoplasmic reticulum cisterna could be observed and mitochondria became compact and concentrated. Then, vacuolization of endoplasmic reticulum, progressive swelling and vacuolization of mitochondria, dissociation of polysomes from rough endoplasmic reticulum and scattering of them in cytoplasm could be seen. Changes of nucleolus presented after significant changes of cytoplasm. Nuclear chromatin clustered together under karyotheca and arranged as clockface, which were some masses with irregular contours gathering to the center. Axons were almost normal. The other was concentration of cytoplasm and nucleolus with vacuolizations of unequal size in cytoplasm. ②There was no abnormal change in neurons in homolateral parietal cortex and hippocampus both in operation control group and normal control group.CONCLUSION: Swelling of brain cell and concentration of cytoplasm and nucleolus after brain injury play important roles in brain injury-induced neurodegeneration of immature rats.

Objective To summarize the clinical features of graft failure (GF)after non-T-cell depleted haploidentical hematopoietic stem cell transplantation (Haplo-HCT), and to investigate the causes and treatment. Methods A retrospective analysis was carried out on 174 patientswho accepted the non-T-cell depleted Haplo-HCT from Jan 2012 to Dec 2013. The patients′ donor specific anti human leukocyte antigen antibodies (DSA) from the peripheral blood serum were detected and those DSA positive patients were treated by immunoglobulin or plasma exchange before transplatation. Results A total of three patients with acute myeloid leukemia got GF, the incidence rate was 1.72%. The patient with primary GF was given a secondHaplo-HCT, but did not get implanted with leukemia remission and three lineages persistently low , he was died of pulmonary infection eight monthes after the second transplant. One of the secondary GF patients was given peripheral blood mononuclear cells(PBMNCs) mobilized by granulocyte colony stimulating factor (G-CSF) from the donor, and got full donor chimerism on day 16 after infusion. The disease-free survival has been for 18 months. The other case was found that DSA was positive, the mean fluorescence intensity (MFI) value was 15000, then Rituximab and PBMNCs mobilized by G-CSF were administrated successively. On day 14 after infusion the partient got full donor chimerism , and MFI turned negative. The patient has been disease-free survival for 41 months. Conclusion Graft failure is a rare but fatal complication after non-T-cell depletedHaplo-HCT, Rituximab followed by PBMNCs are effective measures for DSA related GF, as were worthy of further study.

Objective:To discuss the effect of experiential diet education on the compliance of low-protein diet in patients with chronic kidney disease(CKD), provide basis for improving the compliance of low protein diet in patients with CKD.Methods:A total of 119 patients with CKD stage 3 who were hospitalized from March 2018 to September 2019 in the Division of Nephrology of Beijing Anzhen Hospital, Capital Medical University were selected. They were divided into the following two groups according to the admission time: the control group (58 cases) from March to December 2018 received traditional education, and the observation group(61 cases) from January to September 2019 received systematic experiential diet education on the basis of the control group. At the time of discharge, the eating experience of the observation group was investigated. Three months after discharge, the LPD compliance of the patients in the two groups were investigated by questionnaire, and statistical analyses were performed. And the reason why the observation group could not continue to use CKD nutrition package was analyzed.Results:The score of compliance was (49.44±6.38) points in the observation group and (45.50±6.45) points in the control group, the difference was statistically significant ( t value was 2.68, P<0.05). At the time of discharge, the satisfaction of the observation group was more than 70%, but only 6 patients (9.8%,6/61) adhered to the nutritional package after 3 months. The main reasons why 55 patients could not insist were expensive cost and inconvenient production. Conclusions:Experiential diet education for patients with CKD is a brand-new education model combining routine education and diet experience practice. It can effectively improve the compliance of patients with LPD, which is worth being popularized.

Objective:To explore the clinical efficacy of consolidation chemotherapy combined with microtransplantation in the treatment of elderly patients with acute myeloid leukemia (AML).Methods:The clinical data of 45 elderly patients with AML in Suzhou Yongding Hospital from January 2016 to December 2018 were retrospectively analyzed. After 1 or 2 courses of induced chemotherapy, the patients achieved complete response (CR). Among them, 20 patients were given consolidation chemotherapy (single group), and 25 patients were given consolidation chemotherapy combined with microtransplantation (combined group). After 3 courses of treatment, the minimal residual disease (MRD), quantitative expression of WT1 gene and adverse reactions were compared between 2 groups; the quality of life before treatment and after treatment was evaluated by quality of life-BREF (QOL-BREF). The patients were followed up to November 1, 2020, and the median follow-up was 30 months. The overall survival and progress-free survival (PFS) were recorded.Results:The MRD negative rate and WT1 gene negative rate after treatment in combined group were significantly higher than those in single group: 60.00% (15/25) vs. 25.00% (5/20) and 52.00% (13/25) vs. 20.00% (4/20), and there were statistical differences ( P<0.05). The recovery times of neutrophils and platelets in combined group were significantly shorter than those in single group: 10 (8, 12) d vs. 16 (13, 20) d and 14 (11, 17) d vs. 24 (19, 30) d, and there were statistical differences ( Z = 3.152 and 4.285, P<0.05). No adverse reactions such as liver and kidney abnormalities or gastrointestinal reactions occurred in 2 groups; and no specific graft versus host disease (GVHD) occurred in the combined group. The each item scores of QOL-BREF after treatment in combined group were significantly higher than those in single group, and there were statistical differences ( P<0.01). The 2-year overall survival rate and PFS rate in combined group were significantly higher than those in single group: 60.00% (15/25) vs. 35.00% (7/20) and 52.00% (13/25) vs. 25.00% (5/20), and there were statistical differences ( χ2 = 4.235 and 4.742, P = 0.040 and 0.029). Conclusions:Consolidation chemotherapy combined with microtransplantation is effective and safe in the treatment of elderly patients with AML. It can significantly improve the quality of life, and improve the overall survival rate and PFS rate.

Objective? To investigate the health belief of colorectal cancer and its screening in relatives of patients with hereditary colorectal cancer,and to analyze its influencing factors. Methods? Totally 148 blood relatives of patients with hereditary colorectal cancer hospitalized in the Department of Colorectum of a Class ⅢGrade A hospital in Guangzhou from December 2016 to May 2018 were selected using convenient sampling, and investigated with the self-made general information questionnaire and Chinese Colorectal Cancer Health Belief Scale (CCCHBS). SPSS 20.0 was used for statistical analysis. Results? The colorectal cancer health belief of blood relatives of patients with hereditary colorectal cancer totaled (3.37±0.35) in which the perception and acceptance levels of screening benefits, health motives and self-efficacy of colorectal cancer were higher, while the perception levels of severity of colorectal cancer, barriers against colorectal screening and susceptibility were lower. Multivariate linear regression analysis revealed that household income per capita, educational background, with commercial medical insurance or not and the number of blood relatives with cancer were the influencing factors for health belief levels, which accounted for 41.9% of the total variance. Conclusions? The health belief in blood relatives of patients with hereditary colorectal cancer remain at a medium level. Medical and nursing workers should pay attention to the blood relatives of patients with hereditary colorectal cancer with lower educational background, lower household income and less blood relatives with cancer, take measures to improve their health belief levels, and facilitate colorectal cancer screening behaviors so as to prevent and control colorectal cancer in a better manner.

Depressive disorder is a common mental disorder.At present, the diagnosis of depressive disorder mainly relies on patients' self-reported symptoms and clinical interviews which are relatively subjective.As one of the new technologies assisting diagnosis and therapeutic effect evaluation of depressive disorder, near-infrared spectroscopy (NIRS) has received a lot of attention in recent years.This article reviewed studies of using NIRS in the diagnosis and therapeutic effect evaluation of depressive disorder in the past five years.The review showed that NIRS could reflect abnormal hemodynamic activities of the prefrontal cortex and temporal cortex of patients with depressive disorder, especially the dorsolateral prefrontal cortex and inferior frontal gyrus.Changes of concentration of oxygenated hemoglobin in these areas showed higher accuracy in assisting the diagnosis of depression disorder.Until now, only a few longitudinal studies utilized NIRS to compare changes of cerebral hemodynamic activities at different time points of treatment which preliminarily confirmed the potential of NIRS in the evaluation of therapeutic effects of depressive disorder.In future, more large-scale studies will be needed to further determine the specific application standards for NIRS in the diagnosis and therapeutic effect evaluation of depressive disorder.

Objective: To analyze the causes of preoperative miscarriage of pancreatic serous cystadenoma (SCN) and find the ways to improve it. Methods: Clinical data of 425 pancreatic cystic neoplasm patients who underwent surgical resection from January 2006 to December 2016 in Department of Pancreatic Surgery in Huashan Hospital were retrospectively analyzed.Excel database was created which covered 128 fields of 7 fields: general information of patients, preoperative blood biochemical indexes, tumor markers, surgical related data, postoperative complications, imaging findings and pathology.One hundred and sixty-one cases of SCN were analyzed in depth, mainly in three aspects: surgical benefit, preoperative imaging diagnostic value and interference factors in preoperative judgement.The classification data were analyzed by χ² test and the quantitative data were analyzed by t test.The Logistic regression model was used for multiple factor analysis. Results: Of the 425 PCN cases surgically removed, 161 cases (37.9%) were SCN, the incidence of operative complications was 40.4%(65/161), the hospitalization days was (20.7±12.1)days and the medical cost was (75 267±37 866) yuan.Only 3 of 161 cases of SCN were accurately diagnosed by preoperative imaging methods, 61 cases were diagnosed as "cystic lesions of pancreas" (37.9%) and 52 cases were diagnosed as "pancreatic cystadenoma" (32.3%). SCN was misdiagnosed as MCN(32.3%) and IPMN(28%) before operation.25.5% of them were diagnosed as SCN before operation, but still underwent radical operation.The rate of preoperative imaging diagnosis for identifying SCN was 62.8%.The lack of preoperative endoscopy and the lack of understanding of the image characteristics and biological behavior of SCN were the most important factors affecting the accuracy of preoperative judgment.Statistics found that gender, age, CA125 and tumor location can be used as independent factors contribute to the clinical identification(χ²=8.995, P=0.003; χ²=10.019, P=0.007; t=3.157, P=0.002; χ²=6.790, P=0.009). Logistic analysis showed that women, older than 60 years old, the tumors located in the pancreatic body and tail were the independent factors of SCN classification and diagnosis (OR=0.481, 0.376, 0.577, 0.666, 95% CI: 0.305-0.759, 0.199-0.710, 0.361-0.924, 0.433-1.024, P=0.002, 0.003, 0.022, 0.064). Conclusions SCN has more benign biological behavior.Although surgical excision is acceptable for clinical safety, the corresponding benefit is very limited.It is possible to improve the rationality of SCN clinical operation decisions to some extent by performing endoscopic examination, imaging doctors to improve the SCN feature recognition and surgeons to enhance the awareness of SCN.