Objective:To explore the current situation of demoralization syndrome among young and middle-aged female breast cancer patients with radiochemotherapy after radical resection and to analyze its influencing factors.Methods:From January 2019 to September 2019, this study selected 204 young and middle-aged female breast cancer patients of Breast Surgery at a ClassⅢ Grade A hospital in Jilin Province as subjects by convenience sampling. All patients were investigated with the General Information Scale, Demoralization Scale-Mandarin Version (DS-MV) , Medical Coping Modes Questionnaire (MCMQ) and the Social Support Rate Scale (SSRS) . A total of 204 questionnaires were sent out and 192 valid questionnaires were collected.Results:Among 192 young and middle-aged female breast cancer patients, the score of DS-MV was (33.72±14.23) ; the total score of MCMQ was (42.49±8.83) , scores of confronce, avoidance and resignation dimension were (19.12±4.10) , (14.28±3.26) and (9.39±3.48) respectively; the total score of SSRS was (35.39±6.23) . Multiple linear regression analysis showed that the influencing factors of demoralization of breast cancer patients included the age, education level, time after surgery, confronce coping, resignation coping and social support.Conclusions:Demoralization of young and middle-aged female breast cancer patients with radiochemotherapy after radical resection has a high level. Medical staff should provide targeted intervention for patients with young age, low level of education, short time after surgery, facing disease with the resignation coping style and low level of social support so as to improve their physical and mental health.

Objective To assess the efficacy and safety of ultrasound-guided percutaneous puncturing gastric wall implantation of 125 I seeds in advanced pancreatic carcinoma . Methods Sixty-five cases ( 65 tumors ) of advanced pancreatic carcinoma implanted 125 I seeds by ultrasound-guided percutaneous puncturing gastric wall were retrospectively analyzed . The change of length diameter of tumor and pain relief were evaluated . Results The total 65 cases were performed successfully according to the preoperative plans . In the following 3 months after the operation ,the results showed that complete remission (CR) was achieved in 19 cases ,partial remission( PR) was 33 ,stable disease( SD) was 10 and the progressive disease ( PD) was 3 . The overall response rate was 80％ . About the relief of pain ,complete relief patients were 36 , partial response patients were 11 and the invalid patients were 5 . The pain relief rate was 90 .38％ . There were no bleeding ,pancreatic fistula ,biliary fistula ,gastric perforation which need to do the surgery therapy . Two cases of pancreatic pseudocyst occurred when reviewed in the third month after the operation . Conclusions It is effective and safe to adopt ultrasound-guided percutaneous puncturing gastric wall implantation of 125 I seeds in advanced pancreatic carcinoma .

OBJECTIVE:To analyze the differences of inorganic elements in different parts of Saururus chinensis.METHODS:The samples were treated with microwave digestion.The contents of 25 inorganic elements were determined by inductively coupled plasma mass spectrometry (ICP-MS) method:RF power of 1 200 W,cooling gas flow of 14 L/min,auxiliary gas flow of 1.0 L/ min,atomizing air flow of 0.9 L/min,He as collision gas with flow rate of 4.8 mL/min,sampling cone aperture of 1.1 mm,skimmer cone aperture of 0.9 mm,super skimmer cone aperture of 1.0 mm,integral time of 1 s,delay time of 40 s,single hop as scanning mode,repeated for 3 times.The data of principal component analysis and partial least squares discriminant analysis were analyzed with the SIMCA-P 13.0 statistical software.RESULTS:The linear ranges of lithium (Li),beryllium (Be),boron (B),magnesium (Mg),aluminum (Al),titanium (Ti),vanadium (V),chromium (Cr),manganese (Mn),iron (Fe),cobalt (Co),nickel (Ni),copper (Cu),zinc (Zn),gallium (Ga),arsenic (As),cobalt (Sr),cadmium (Cd),tin (Sn),antimony (Sb),barium (Ba),mercury (Hg),thallium (Ti),lead (Pb) and bismuth (Bi) were 0.05-5.0 μg/L(r=0.999 9),0.05-5.0 μg/L(r=0.999 8),0.1-10.0 μg/L(r=0.999 5),1.0-100.0 μg/L(r=0.999 5),1.00-100.0 μg/L(r=0.999 3),0.10-10.0 μg/L(r=0.999 9),0.05-5.0 μg/L (r=0.999 7),0.05-5.0 μg/L(r=0.999 5),0.10-10.0 μg/L(r=0.999 8),1.00-100.0 μg/L(r=0.999 4),0.05-5.0 μg/L(r=0.999 9),0.05-5.0 μg/L(r=0.999 7),0.05-5.0 μg/L(r=0.999 5),0.05-5.0 μg/L(r=0.999 8),0.05-5.0 μg/L(r=0.999 6),0.05-5.0 μg/L(r=0.999 8),0.05-5.0 μg/L(r=0.999 9),0.05-5.0 μg/L(r=0.999 3),0.05-5.0 μg/L(r=0.999 4),0.05-5.0 μg/L(r=0.999 8),0.1-10.0 μg/L(r=0.999 6),0.05-5.0 μg/L(r=0.999 6),0.05-5.0 μg/L(r=0.999 6),0.05-5.0 μg/L(r=0.999 7),0.05-5.0 μg/L(r=0.999 4),respectively.The detection limits were no higher than 13.2 ng/L.RSDs of precision,stability and reproducibility tests were all lower than 5.12％.The recoveries ranged 90.18％-123.01％ (RSD were 2.05％-5.79％,n=6).The contents of Sb,Sn,Mn,Cd,Ti,Ba,Co,As,Be,Ga,Ni were higher in aerial part than in rhizome part,while the content of Cr was higher in rhizome part than in aerial part.CONCLUSIONS:Mg,Fe and A1 are abundant in aerial part and rhizome part of S.chinensis.The contents of inorganic elements are significantly different in different parts of S.chinensis.

Objective:To comprehensively and systematically retrieve domestic and international research on nurse-initiated protocolized weaning in adult mechanically ventilated patients, clarify its outcome indicators and effectiveness in clinical practice, and identify influencing factors in its implementation.Methods:Employing the scoping review methodology of Arksey and O'Malley, databases in both English and Chinese were systematically searched. Literature was selected based on inclusion and exclusion criteria, with two researchers independently screening, organizing, and analyzing the articles.Results:Eighteen publications were included: seven interventional studies, four qualitative studies, two cross-sectional studies, two on instrument development, and three reviews. Nurse-initiated protocolized weaning was found to be safe and effective, with common clinical outcome indicators including mechanical ventilation duration, weaning time, and ICU length of stay. Significant barriers included the professional knowledge level of nurses, team cooperation, nurses' personal characteristics, and the healthcare providers' underestimation of patients' clinical symptoms. Continuous care, patient involvement, a supportive nursing culture, and recognition of the nurse's role were facilitators of this treatment.Conclusions:Future research efforts should standardize and refine the intervention measures of nurse-initiated protocolized weaning and conduct large-sample, high-quality studies to provide references for the implementation of nurse-initiated protocolized weaning in China.

Objective:To analyze the medication rules in the ancient book Pu Ji Fang for the external treatment of acne based on data mining method. Methods:By screening out the methods of treating acne externally in Pu Ji Fang and establishing a standardized medical record database, this paper adopted the web version of Ancient and Modern Medical Record Cloud Platform to calculate the frequency, properties, flavors, and meridians of those medicines, and conduct cluster analysis by using IBM SPSS Modeler 18.0 software to analyze the association rules. Results:A total of 87 prescriptions were selected, including 164 kinds of Chinese materia medica, among which. Radix Angelicae, Ligusticum Wallichii, Rhizoma Typhoni and lead powder are frequently appeared. The properties of those medicines are mainly warm, cold and mild; the flavors of those medicines are mainly spicy, acrid, sweet and bitter, and the meridians mainly belongs to lung, spleen, stomach and liver meridians. The medical pair and group with the strongest associationion are Ligusticum Wallichii- Radix Angelicae and Rhizoma Typhonii- Radix Angelicae- Ligusticum Wallichii. Those freuently appeared medicines could be grouped into three categories. The paste dosage that was frequently appeared has strong correlation with tallow, mercury and lead powder, while the powder dosage that was frequenctly appeared has strong correlation with Angelica Dahurica, Radix Saponicae, Gleditsia sinensis, Radices Ligustici Sinensis and Ligusticum Wallichii. Conclusions:The application of data mining method could preliminarily reveal the medication rules of Pu Ji Fang for the external treatment of acne. The main treatment method is XinSanFaYue. The three categories of Chinese materia medica are used to treat the syndrome of asthenic habitus attacked by exogenous pathogenic factors, exterior attacked by wind heat and hot blood stasis respectively, showing the rules of treating acne externally before Ming Dynasty and providing references for the clinical treatment of acne.

Objective To explore chromobox protein homolog 2 (CBX2) expressions in relation to clinical features of patients and elucidate its role in the progression of hepatocellular carcinoma.Methods Using the Cancer Genome Atlas (TCGA) database,R language was used to analyze the distribution of differentially expressed mRNA in hepatocellular carcinoma.The different expression of CBX2 in HCC and adjacent tissues and its relationship with survival and clinical characteristics of patients were further analyzed.The expression of CBX2 in liver tissues,liver cancer tissue,and L02,HepG2 and SMMC-7721 cell lines was detected by real time-PCR and western blot.The expression of CBX2 was interfered by siRNA in hepatoma cell line.MTT,colony formation,transwell assays,and flow cytometry were used to identify the proliferation,apoptosis,invasion and clone-formation ability of HepG2 and SMMC-7721 cells after CBX2 down-regulation.According to the different data,t-test,ANOVA,chi-square test,and COX regression model were used for statistical analysis.Survival curve was plotted through Kaplan-Meier method.Results TCGA public database analysis showed that the expression of CBX2 mRNA in hepatocellular carcinoma tissues (7.296 ± 1.6115) was significantly higher than normal liver tissues (4.706 ± 0.940) (P =0.000).In addition,the overall survival time of patients with low CBX2 mRNA expression was significantly longer than that of patients with high CBX2 mRNA expression [(5.971 ± 0.411) years vs.(4.650 ± 0.503) years,P =0.001].The expression level of CBX2 mRNA was correlated with the pathological TNM stage (P =0.025) and differentiation degree (P ＜ 0.001) of liver cancer.COX regression analysis showed that CBX2 mRNA expression was an independent predictor of patient survival (P =0.013).siRNA was transfected and compared with the blank control group.The transgenic ability of HepG2 and SMMC-77221 cells decreased significantly at 72h (P ＜ 0.05) and 96h (P ＜ 0.05),and the apoptosis rate (11.430％ ± 0.215％) was higher than blank control group (6.6 00％ ± 0.170％) (P =0.003).The number of invasive cells ((both P ＜ 0.05) and relative colony forming cells ((both P ＜ 0.001) were significantly decreased.In 20 cases of tissue samples,the expression of CBX2 protein (relative expression level 3.020 ±0.269) in liver cancer was higher than that in adjacent tissues (relative expression level 0.886±0.065) (P ＜ 0.001).The overall survival time of patients with low CBX2 expression in liver cancer was longer than that of patients with high expression [(3.670 + 0.576) years vs.(0.834 + 0.153) years,P =0.004].Conclusion An evident high expression of CBX2 is an independent poor prognostic factor in hepatoma.Down-regulation of CBX2 expression can inhibit the progression of liver cancer.Therefore,CBX2 may be a prognostic biomarker and a new target for HCC treatment.

Objective:To explore the clinical effects of traditional Chinese medicine (TCM) dialectical feeding in patients with oral lichen planus of spleen and stomach damp-heat type.Methods:From January 2017 to December 2018, we selected 98 patients with oral lichen planus of spleen and stomach damp-heat type who visited the Oral Mucosal Diagnosis and Treatment Center of Integrated Traditional Chinese and Western Medicine in Qingdao Stomatological Hospital, the Affiliated Hospital of Qingdao University. Patients were divided into experimental group and control group by random number table method, each with 49 cases. Two groups adopted the same treatment methods of Chinese and Western medicine, and control group carried out conventional nursing, and experimental group conducted TCM dialectical feeding based on conventional nursing. Both groups had continuous intervention for 8 weeks. The physical sign scores, Visual Analogue Scale (VAS) scores, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores of patients of the two groups were compared before and after treatment.Results:The physical sign scores of the two groups at the fourth and eighth week of intervention were lower than those at the initial diagnosis, and the difference was statistically significant ( P<0.05) . After 8 weeks of intervention, the physical sign score of experimental group was lower than that of control group, and the difference was statistically significant ( P<0.05) . The VAS scores of the two groups at the the fourth and eighth week of intervention were lower than those at the initial diagnosis with a statistical difference ( P<0.05) . After 4 and 8 weeks of intervention, the VAS scores of experimental group were lower than those of control group, and the difference was statistically significant ( P<0.05) . After intervention, the SAS and SDS scores of the two groups were reduced, and that of experimental group was lower than that of control group also with a statistical difference ( P<0.05) . Conclusions:The use of TCM dialectical feeding nursing guidance for patients with spleen and stomach damp-heat type oral lichen planus can improve the patient's disease condition and pain symptoms, and relieve the patient's negative emotion.

Objective:To establish a scientific and comprehensive evaluation index system for teaching ability of dental specialist nurses, providing a basis for the selection and assessment of dental nursing instructors.Methods:Based on literature analysis, semi-structured interviews, and group discussions, preliminary evaluation indicators were formulated. From February to April 2023, the Delphi method was used to conduct two rounds of consultation with 27 experts from six provinces and municipalities in China to determine the evaluation index system for the teaching ability of dental specialist nurses. The analytic hierarchy process (AHP) was used to determine the weights of each indicator and its combined weight.Results:The authority coefficient of 27 experts was 0.895. In the two rounds of expert consultation, the effective response rates of the questionnaire were all 100% (27/27), and the Kendall harmony coefficients of various indicators were 0.179 to 0.240 and 0.200 to 0.261 respectively ( P<0.01). The final evaluation index system for teaching ability of dental specialist nurses was formed, including six primary indicators, 15 secondary indicators, and 71 tertiary indicators. Conclusions:The evaluation index system for teaching ability of dental specialist nurses has a reasonable structure, a scientific and rigorous construction process, and can provide a theoretical basis for the allocation of dental specialist human resources and nursing training assessment.

Objective:To compare the efficacy of acetabular magic hook plates versus quadrilateral area combined plates in treating complicated acetabular fractures.Methods:A retrospective analysis was conducted on 44 cases of complicated acetabular fractures treated at the Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from June 2017 to August 2022. Among these cases, 21 were treated with magic hook plate internal fixation (hook plate group) and 23 with quadrilateral area combined plate internal fixation (combined plate group). In the hook plate group, there were 15 males and 6 females, with an average age of 43.1±11.8 years. According to the Letournel-Judet classification, there were 13 double-column fractures, 5 anterior column with posterior semi-transverse fractures, and 3 T-type fractures. Additionally, 8 cases were classified as B2.2 type, 5 as C1 type, 4 as C2 type, and 4 as C3 type; 15 cases were APQ1 type and 6 were APQ2 type. In the combined plate group, there were 16 males and 7 females, with an average age of 41.7±12.8 years. This group included 15 double-column fractures, 6 anterior column with posterior semi-transverse fractures, and 2 T-type fractures. Additionally, there were 8 cases of B2.2 type, 6 cases of C1 type, 4 cases of C2 type, and 5 cases of C3 type; 15 cases were APQ1 type and 8 were APQ2 type. Comparative analyses included operative time, intraoperative blood loss, fracture healing time, Matta standard assessment, modified Merle d'Aubign-Postel scores, and postoperative complications.Results:All 44 patients were followed up for 10 to 24 months, with an average follow-up of 14 months. The acetabular fractures healed in all cases. The healing time was 3.6±0.9 months for the hook plate group and 3.7±0.9 months for the combined plate group, with no significant difference between the groups ( t=0.549, P=0.586). The hook plate group had an operative time of 138.3±30.7 minutes and intraoperative blood loss of 735.7±159.8 ml, compared to 163.9±48.7 minutes and 843.5±181.1 ml, respectively, in the combined plate group, both of which were statistically significant ( P<0.05). The reduction quality was excellent in 13 cases, good in 5 cases, and poor in 3 cases in the hook plate group, with an excellent and good rate of 86% (18/21). In the combined plate group, the reduction quality was excellent in 13 cases, good in 6 cases, and poor in 4 cases, with an excellent and good rate of 83% (19/23), showing no significant difference between the groups (χ 2=0.143, P=0.931). The modified Merle d'Aubign Postel scores of the hook plate group were 13.8±2.2 points, 15.3±2.5 points and 16.7±1.8 points at 3 months, 6 months and the last follow-up, respectively, and the combined plate group were 13.1±1.9 points, 14.6±2.1 points and 16.4±2.0 points, respectively ( P>0.05). However, both groups showed statistically significant improvements in hip function over time ( F=9.658, P<0.001; F=16.195, P<0.001). Wound fat liquefaction and lateral femoral cutaneous nerve injury occurred in one case each in both groups. In the combined plate group, there were 3 cases of incision fat liquefaction, 2 cases of lateral femoral cutaneous nerve injury, and 1 case of traumatic hip arthritis. No other complications such as incision infection, iliac vascular injury, or loss of internal fixation were observed in either group. Conclusion:Both magic hook plate fixation and quadrilateral area combined plate fixation are safe and effective for treating complex acetabular fractures. However, magic hook plate fixation offers advantages in reducing operative time and intraoperative blood loss, thereby simplifying and enhancing the safety of the procedure.

With the rapid development of organ transplantation in China,the donation after cardiac death (DCD) donor organs are widely used.However,the quality of these organs is relatively poor,so the way to preserve and maintain organ still remains a severe problem.Among them,ischemic reperfusion injury (IRI) impairs the organs severely.Acetaldehyde dehydrogenase 2 (ALDH2) protects organs from stress conditions,including ischemia-reperfusion injury,and the activation and autophagy inhibition also protects the organs from stress conditions as well.Recent studies showed that ALDH2 can regulate autophagy to inhibit the organ injury during ischemia-reperfusion.Our study aims to discuss the new findings in this mechanism.