Objective To explore the short term treatment effectiveness and the side-effect of radiotherapy combined with two kinds of chemotherapy scheme on nasopharyngeal carcinoma patients with stage Ⅲ and Ⅳa.Methods One hundred and fifty nasopharyngeal carcinoma cases with stage Ⅲ/Ⅳa were randomly divided into A and B group.Patients in A group (75 cases) were received radiotherapy combined with 2 courses ((21-28) d/course) paclitaxel (135 mg/m2) + cis-platinum complexes (DDP) 80 mg/m2 chemotherapy concurrently,while patients in B group (75 cases) were received radiotherapy combined with 6 courses DDP 30 mg/m2 per week chemotherapy concurently.The short term treatment effectiveness and the sideeffect of radiotherapy combined with two kinds of chemotherapy scheme were observed.Result After the treatment,the primary lesion complete remission(CR) rate in A group and B group were 68％ (51/75),52％ (39/75).The CR rate of lymph node of neck in A and B group was 64.0％ (48/75),48.0％ (36/75) and 45.3％ (34/75),20.0％ (15/75) of primary lesion and lymph node of neck.The differences were significant(x2=4.25,3.90,10.94 ;P ＜0.05).After 3 months of treatment,there was no significant difference between A and B group in terms of CR rate of the primary lesion,lymph node of neck and primary lesion and lymph node of neck (P ＞0.05).During the treatment,the rate of bone marrow depression at grade Ⅲ in A group and B group were 38.67％ (29/75) and 21.33％ (16/75),21.33％ (16/75) and 6.67％ (5/75) in terms of the rate of grade gastrointestinal reaction at stage Ⅲ,46.66％ (35/75) and 21.33％ (16/75) regarding of oral cavity mucomembranous injury at stage Ⅲ,21.33％ (16/75) and 9.34％ (7/75) in terms of the rate of radioactivity skin destruction at stage Ⅲ.All differences were significant (P ＜ 0.05).During the short-term follow up (1-3 years),both the rate of local recurrence and the rate of metastasis in A group was as same as that in B group(P ＞0.05).Conclusion During the treatment,the side-effect of approach of paclitaxel (135 mg/m2) + DDP 80 mg/m2 in stage Ⅲ/Ⅳa nasopharyngeal carcinoma patients is more severity than that of DDP 30 mg/m2 per week chemotherapy.However,there is no significant difference in terms of the short term treatment effectiveness.The prospective efficacy needs to be further investigation.

Objective To study the relationship between the level of serum thrombomodulin (TM ) ,radiation dose-volume factors with acute radiation pneumonitis (ARP) .Methods 54 patients with lung cancer were given the routine 3 -dimensional conformal radiation therapy(3DCRT) and chemotherpy ,20 cases received the concurrent radiochemotherapy and 34 cases were performed the the sequential chemotherapy .The serum TM level was measured with enzyme-linked immunosorbent assay(ELISA) before radio-therapy(B-RT) and at 30 Gy(M-RT) in radiotherapy .The ARP grade was evaluated according to the criteria of the Common Ter-minology Criteria for Adverse Events(CTCAE v3 .0) by the National Caner Institute(NCI) ,grade 2 or more was taken as ARP . The relationship between the serum TM level ,dose-volume factors with ARP was analyzed .Results 20 cases (37% ) had ARP .12 cases got grade 2 ARP and 8 cases had grade 3 .The occurrence rates of ARP in the minimal lethal dose (MLD) Gy <10 and >10 groups ,V5 < 50% and ≥ 50% groups ,V10 < 40% and ≥ 40% groups ,V20 < 25% and ≥ 25% groups ,V30 < 13% and ≥ 13%groups ,TM decrease group and TM increase group after 30 Gy radiation were 8% vs .62% ,7% vs .69% ,21% vs .75% ,28% vs . 56% ,15% vs .57% and 50% vs .13% respectively ,the differences had statistical significance (χ2 = 16 .83 ,22 .29 ,14 .05 ,3 .97 , 10 .08 ,6 .46 ,P<0 .05);in the ARP group and non-ARP group ,MLD ,V5 ,V10 ,V20 and V30 were (12 ± 2) vs .(9 ± 2) ,(58 ± 10) vs .(43 ± 10) ,(42 ± 8) vs .(30 ± 8) ,(23 ± 3) vs .(19 ± 6) ,(15 ± 4) vs .(11 ± 4) respectively ,the differences had statistical signifi-cance (t= -4 .96 ,-5 .27 ,-5 .70 ,-3 .37 ,-3 .61 ,P<0 .05) .Conclusion Multiple dose-volume parameters are associated with the occurrence rate of ARP .The patients with decreased serum TM level after radiotherapy are liable to develop ARP .

Objective To explore effect of family-centered discharge guidance on family care of premature infants in NICU.Methods A total of 174 premature infants with extremely low birth weight in NICU were studied and were randomly divided into study group and control group,with 87 cases per group.Control group received conventional discharge guidance while the study group received family-centered discharge planning.Height and weight changes of neonates at discharge,and at correct gestational age of 2,4,6 months were observed.Nursing knowledge and nursing skills,Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores of puerperae were observed in two groups on admission and at discharge.Breastfeeding rate,re-hospitalization rate,morbidity and mortality within 6 months were compared.Results The body weight,body length and head circumference were not statistically significant of two groups at birth and at corrected gestational age of 40 weeks (P ＞ 0.05),and they were heavier,and larger than those of the control group at corrected gestational age of 2,4 and 6 months (P ＜ 0.05).Breastfeeding rate in the study group was higher,morbidity rate and readmission rate were lower than that of the control group (P ＜ 0.05),but there was no significant difference in mortality of two groups (P ＞ 0.05).At discharge of NICU,mothers of premature infants had no statistically significant difference in nursing knowledge and skills (P ＞ 0.05),but they commanded more after 2 monthsof discharge (P ＜ 0.05),and study group improved more significantly (P ＜ 0.05).At discharge of NICU,SAS and SDS scores of infants'mothers were not statistically significant (P ＞ 0.0 5),but it was significantly decreased at 2 months of discharge (P ＜ 0.0 5),and study group decreased more (P ＜ 0.0 5).Conclusion Family-centered discharge guidance can increase the physical development of children,reduce the morbidity rate,and improve the family's bad mood,so it is worthy of clinical promotion.

Objective To explore effect of family-centered discharge guidance on family care of premature infants in NICU.Methods A total of 174 premature infants with extremely low birth weight in NICU were studied and were randomly divided into study group and control group,with 87 cases per group.Control group received conventional discharge guidance while the study group received family-centered discharge planning.Height and weight changes of neonates at discharge,and at correct gestational age of 2,4,6 months were observed.Nursing knowledge and nursing skills,Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores of puerperae were observed in two groups on admission and at discharge.Breastfeeding rate,re-hospitalization rate,morbidity and mortality within 6 months were compared.Results The body weight,body length and head circumference were not statistically significant of two groups at birth and at corrected gestational age of 40 weeks (P ＞ 0.05),and they were heavier,and larger than those of the control group at corrected gestational age of 2,4 and 6 months (P ＜ 0.05).Breastfeeding rate in the study group was higher,morbidity rate and readmission rate were lower than that of the control group (P ＜ 0.05),but there was no significant difference in mortality of two groups (P ＞ 0.05).At discharge of NICU,mothers of premature infants had no statistically significant difference in nursing knowledge and skills (P ＞ 0.05),but they commanded more after 2 monthsof discharge (P ＜ 0.05),and study group improved more significantly (P ＜ 0.05).At discharge of NICU,SAS and SDS scores of infants'mothers were not statistically significant (P ＞ 0.0 5),but it was significantly decreased at 2 months of discharge (P ＜ 0.0 5),and study group decreased more (P ＜ 0.0 5).Conclusion Family-centered discharge guidance can increase the physical development of children,reduce the morbidity rate,and improve the family's bad mood,so it is worthy of clinical promotion.

Objective:To deeply understand parents' cognition and psychological experience towards depressive disorder in adolescents with non-suicidal self-injury behavior.Methods:This study was a qualitative study. Using the purposive sampling method, semi-structured interviews were conducted with 12 parents of adolescents with depressive disorder and non-suicidal self-injury admitted to Huaian Mental Health Center from June to October 2022. Colaizzi 7-step analysis method was used to analyze the interview data.Results:Parents' cognition and psychological experience of adolescent depressive disorder with non-suicidal self-injury behavior was extracted into 3 themes, namely, insufficient cognition of the disease, experience of various negative emotions and desire for multiple support and help.Conclusions:Parents generally lack understanding and have cognitive misconceptions about the related knowledge of adolescent depressive disorder with non-suicidal self-injury behavior and have severe negative emotions. It is suggested that the medical staff should pay attention to the cognition and psychological experience of the parents, and construct and improve the management system of adolescents with depression disorder accompanied by non-suicidal self-injury behavior, so as to reduce the risk of self-injury and suicide of the children.

Objective:To explore the interaction needs between depressed adolescents with non-suicidal self-injury behavior and their parents.Methods:From June to November 2023, purposive sampling was used to select depression adolescents with non-suicidal self-injury behavior and their parents admitted to Huai'an Third People's Hospital as respondents. The semi-structured interview was used to collect data. The paired interview and Colaizzi 7-step analysis methods were used to analyze and summarize interview data.Results:Fifteen pairs of adolescents and their parents were interviewed. The needs of depressed adolescents with non-suicidal self-injury behavior for parental attention were summarized as controlling emotions, empathetic perception, reducing stress, mental dependence, autonomous decision-making, and mutual respect. The needs of parents for depressed adolescents with non-suicidal self-injury behavior were summarized as overcoming depression, restoring education, emotional response, actively seeking help, deep communication, and easing relationships.Conclusions:There are various interactive needs between depressed adolescents with non-suicidal self-injury behavior and their parents, which are closely related but contradictory in coping with the illness. It is recommended that medical and nursing staff conduct research on patients and their parents as a whole and provide personalized and targeted two-way guidance and emotional support through in-depth understanding and careful consideration of the multi-level interaction needs of both parties.

Objective To establish a UPLC-MS/MS method to measure the content of monoester-alkaloids(benzoylmesaconine,benzoylaconine,benzoylhypaconine)and diester-alkaloids(mesaconitine,hyp-aconitine,aconitine)in Fengshiantai tablets.To provide a basis for quality control by conducting chemometric analysis and risk assessment on the measurement results.Methods The components were separated on Waters BEH C18 column(2.1 mm×100 mm,1.7 μm)with methanol and 0.1%formicacid aqueous solution as the mobile phase by gradient elution at a flow rate of 0.3 mL·min-1.The column temperature was set at 35℃.The injection volume was 1 μL.The detection was carried out by electrospray ionization(ESI),and electron spray ionization source was adopted in positiveion detection with multiple reaction monitoring mode(MRM).Results Six components showed good linear relationships within their own ranges(r≥0.9990),whose average recovery rate of samples were 90.3%-107.6%with the RSD of 0.9%-1.8%.In 23 batches of tested samples,the diester-alkaloids contents ranged from 1.35 to 19.49 μg per tablet,which indicated low risk of drug safety;the monoester-alkaloids contents ranged from 20.17-99.55 μg per tablet.The results of chemometrics showed that 23 batches of samples were classify into four categories,and there were certain differences in sample quality among different production enterprises.Conclusion The established method is stable and reliable,and can be used for quality control of Fengshi Antai tablets.

Objective To analyze the residual status,transfer behavior,and risk of paclobutrazole in the national mar-ket of Shenmai granules.Methods GC-MS/MS determined the residual amount of paclobutrazol in Shenmai granules,and ANOVA analyzed the distribution characteristics of sample residuals.The transfer rule of paclobutrazol from Ophiopogonis Radix to Shenmai granules was investigated by simulating the production process,and chronic exposure assessment was performed using the point evaluation model.Results The established method can accurately determine the residual amount of paclobutrazol in Shenmai granules.The residual amount of paclobutrazol in 85 batches of Shenmai granules ranged from 0.001 3 to 0.015 8 mg·kg-1,and there was a statistical difference in the residual amount among different enterprise samples.The transfer rate of paclobutrazol from decoction pieces to preparations was 29.8%.The chronic risk quotient(HQc)of paclobutrazol residues in Shenmai granules was 0.000 7%,far lower than 1.Conclusion There is a general presence of paclobutrazol residues in Shenmai granules.The risk assessment results show that the normal dosage of Shenmai granules does not pose an unacceptable risk to the general population.The residual distribution characteristics and process transfer rules can provide a reference for safety risk control in production enterprises.