Objective To compare the influence of the continuous airway humidification with microp-ump and the discontinuous dripping technique on patients. Methods Randomized grouping method was adopted, 25 cases with tracheotomy in the observation group used continuous airway humidification with micro-pump, 24 cases in the control group used dripping technique via airway for airway humidification. The two groups were compared retrospectively. Results The oxygen saturation rate in the observation group increased compared with that of the control group, sputum callus formation, irritating cough, airway bleeding and pul-monary infection was significantly lower than those of the control group. Condusious The effect of continu-ous airway humidification with micro- pump is superior to the traditional method of inconsistent endotracheal dripping, the former can also decrease nursing workload of airway humidification.

Objective To investigate the influence of cognitive training on patients with Alzheimer's disease. Methods 30 patients received cognitive function training based upon drug treat-ment. Patients were assessed with mini- mental state examination (MMSE) and functional independence measure(FIM) before and after treatment, the results went through t test. Results After training, cog-nitive function and self- care ability after treatment greatly alleviated compared with those before train-ing. Conclusions Cognitive training can improve cognitive function and self- care ability of patients with Alzheimer's disease and facilitate their life quality.

ObjectiveTo explore the characteristics and risk factors of suicidal ideation among community subjects in Xiamen city and to provide appropriate suicide intervention strategies.MethodsUsing multi-stage stratified cluster sampling,12071 subjects aged 18 years and older were identified in Xiamen City.Their suicidal ideation was recorded with the investigation list made by Beijing Huilongguan Hospital Beijing Suicide Research and Prevention Center.Psychiatrists determined their diagnosis with Diagnostic and Statistical Manual of Mental Disorder 4th edition (DSM-Ⅳ).ResultsA total of 10757 subjects completed the survey,the completion was 89.1％.The life-time prevalence of suicidal ideation was 2.48％ (95％CI:2.19％ ～ 2.77％ ),the prevalence was higher in female(3.00％ ) than male( 1.88％ ) (RR =1.60,95％CI:1.24 ～2.06).Analysis of risk factors by single logistic regression showed that the suicidal ideation of persons were mostly in female,44 years and older group,in rural,not-being married,no medical insurance,poor mental or physical health in last month,being in hospital due to the mental problems,low quality of life,living alone,having blood relatives or acquaintance with suicidal behavior.While the risk factors by muhivariate logistic regression were ranked as follows:having acquaintance with suicidal behavior (OR =3.66,95％CI:2.44 ～5.50),being in hospital because of mental problems (OR =3.30,95％CI:1.08 ～10.09),poor mental health in last month(OR =3.17,95％CI:2.37 ～4.24),any blood relatives having suicidal behavior (OR =2.91,95％CI:1.61 ～ 5.25 ),low of quality of life (OR =2.21,95％CI:1.50 ～ 3.26 ),not-being married (OR =1.73,95％CI:1.28 ～ 2.32),living alone (OR =1.65,95％CI:1.18 ～ 2.32),being female (OR=1.57,95％CI:1.21 ～ 2.05).The prevalence of mental disorders in suicidal ideation was 46.4％.ConclusionThe prevalence of suicidal ideation is significantly higher in female residents than in male.Having acquaintance with suicidal behavior,being in hospital due to the mental problems as well as poor mental health in last month are the main risk factors of suicidal ideation.

This paper reported a pair of twin babies who were diagnosed as monochorionic (MC) twins (MC) in the first-trimester ultrasound scan after in vitro fertilization.Fluorescence in situ hybridization and chromosomal karyotype analysis of amniotic fluid that was randomly collected from one of the twins were performed in the second trimester,but no abnormality was detected.Chromosome karyotype analysis of peripheral blood of the twins at the age of two days and three years showed that both were chi 47,XY,+21/46,XX.And the single nucleotide polymorphism microarray analysis of oral mucosa cells of the twins at three years old showed that the boy was 47,XY,+21 and the girl was 46,XX.Therefore,we confirmed that they are MC dizygotic twins presenting with blood chimerism but no tissue chimerism.Simply the boy presented with facial features of Down syndrome.

Objective To review the newly developed solid self-microemulsifying drug delivery system (S-SMEDDS).Meth-ods Relevant literatures at home and abroad in recent years were consulted and summarized .Results Solid self-microemulsions car-rier, solidification technology and controlled release formulations were discussed , in order to provide relevant references for improving the bioavailability of water-insoluble drugs and the SMEDDS technology for drug release characteristics .Conclusion The utilization of the solid self-emulsifying drug delivery system could significantly enhance the oral bioavailability of water -insoluble drugs .As a new formulation, S-SMEDDS presented huge potential .

Cost data caliber governance is key to fine cost management. To tackle the troubles in cost data management at multiple campuses of one hospital, the authors built a multi-campus cost data caliber governance mode. By means of enhanced top-level design, the mode carried out data governance by such measures as the establishment of data dictionary mapping library, standardizing department names and caliber, classification of charging items of medical services, precisely matching between fixed assets and charging items, interconnecting the management system of charging library and the procurement library of consumables, as well as precisely matching surgical disease types and charging items. These measures accomplished the consistency and comparability of cost data across campuses, building an automated, streamlined, standardized and integrated data governance mode for reference of hospitals with multiple campuses in need of cost management.

Objective:To explore the prognostic factors predicting the recovery of elderly patients with hospital-acquired pneumonia(HAP).Methods:Data of HAP inpatients aged over 60 years in the First Affiliated Hospital of Nanjing Medical University between October 2015 and October 2020 were collected.Body mass index(BMI), neutrophil/lymphocyte rate(NLR), Charlson Comorbidity Index(CCI), Combined Comorbidity Score(CCS)and other data were retrospectively analyzed.The predictive value of the related factors was evaluated by using the Student's t test, the Logistic regression model and the receiver operating characteristic curve(ROC). Results:A total of 200 cases were enrolled in this study, and grouped into survival group(n=158)and death group(n=42). There were significant differences between the death group and the survival group in length of age, BMI hospital stay, state of consciousness, swallowing function, indwelling gastric tube, the use of proton pump inhibitors, leukocyte count, lymphocyte count, neutrophil count, hemoglobin, NLR, albumin, alanine aminotransferase, aspartate aminotransferase, D-dimer, C-reaction protein, procalcitonin(all P<0.05). Scores of CCI and CCS were higher in the death group than in the survival group[(6.79±2.86) vs.(3.42±1.98), (6.21±3.08) vs.(1.66±1.94), t=-7.193, -9.116, both P<0.001]. Multivariate Logistic analysis showed that age>86 years( OR=1.155, 95% CI: 1.014-1.316), BMI<21.77 kg/m 2( OR=0.651, 95% CI: 0.480-0.883), neutrophil count>10.10×10 9/L( OR=1.208, 95% CI: 1.025-1.422), C-reaction protein>59.32 mg/L( OR=1.055, 95% CI: 1.018-1.093), CCS>6.21 scores( OR=2.859, 95% CI: 1.559-5.244)were risk factors for death inpatients aged 60 years and older with HAP.Area under the ROC curve showed that CCS could better predict the mortality of elderly patients than CCI, and the areas under the ROC curve were 0.831(95% CI: 0.753-0.909)and 0.898(95% CI: 0.850-0.946)respectively(both P< 0.001). Conclusions:The elderly patients with HAP are inclined to multiplecomplications and high mortality rates.Combined application of multiple assessment systems and clinical indicators can improve the ability to predict the outcome of HAP.

Background: In China, secondary cytoreductive surgery (SCR) has been widely used in ovarian cancer (OC) over the past two decades. Although Gynecologic Oncology Group-0213 trial did not show its overall survival benefit in first relapsed patients, the questions on patient selection and effect of subsequent targeting therapy are still open. The preliminary data from our pre-SOC1 phase II study showed that selected patients with second relapse who never received SCR at recurrence may still benefit from surgery. Moreover, poly(ADP-ribose) polymerase inhibitors (PARPi) maintenance now has been a standard care for platinum sensitive relapsed OC. To our knowledge, no published or ongoing trial is trying to answer the question if patient can benefit from a potentially complete resection combined with PARPi maintenance in OC patients with secondary recurrence. Methods SOC-3 is a multi-center, open, randomized, controlled, phase II trial of SCR followed by chemotherapy and niraparib maintenance vs chemotherapy and niraparib maintenance in patients with platinum-sensitive second relapsed OC who never received SCR at recurrence. To guarantee surgical quality, if the sites had no experience of participating in any OC-related surgical trials, the number of recurrent lesions evaluated by central-reviewed positron emission tomography–computed tomography image shouldn't be more than 3. Eligible patients are randomly assigned in a 1:1 ratio to receive either SCR followed by 6 cyclesof platinum-based chemotherapy and niraparib maintenance or 6 cycles of platinum-based chemotherapy and niraparib maintenance alone. Patients who undergo at least 4 cycles of chemotherapy and must be, in the opinion of the investigator, without disease progression, will be assigned niraparib maintenance. Major inclusion criteria are secondary relapsed OC with a platinum-free interval of no less than 6 months and a possibly complete resection. Major exclusion criteria are borderline tumors and non-epithelial ovarian malignancies, received debulking surgery at recurrence and impossible to complete resection. The sample size is 96 patients. Primary endpoint is 12-month non-progression rate.

Background: Two randomized phase III trials (EORTC55971 and CHORUS) showed similar progression-free and overall survival in primary or interval debulking surgery in ovarian cancer, however both studies had limitations with lower rate of complete resection and lack of surgical qualifications for participating centers. There is no consensus on whether neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) could be a preferred approach in the management of advanced epithelial ovarian cancer (EOC) in the clinical practice. Methods The Asian SUNNY study is an open-label, multicenter, randomized controlled, phase III trial to compare the effect of primary debulking surgery (PDS) to NACT-IDS in stages IIIC and IV EOC, fallopian tube cancer (FTC) or primary peritoneal carcinoma (PPC).The hypothesis is that PDS enhances the survivorship when compared with NACT-IDS in advanced ovarian cancer. The primary objective is to clarify the role of PDS and NACT-IDS in the treatment of advanced ovarian cancer. Surgical quality assures include at least 50% of no gross residual (NGR) in PDS group in all centers and participating centers should be national cancer centers or designed ovarian cancer section or those with the experience participating surgical trials of ovarian cancer. Any participating center should be monitored evaluating the proportions of NGR by a training set. The aim of the surgery in both arms is maximal cytoreduction. Tumor burden of the disease is evaluated by diagnostic laparoscopy or positron emission tomography/computed tomography scan. Patients assigned to PDS group will undergo upfront maximal cytoreductive surgery within 3 weeks after biopsy, followed by 6 cycles of standard adjuvant chemotherapy. Patients assigned to NACT group will undergo 3 cycles of NACT-IDS, and subsequently 3 cycles of adjuvant chemotherapy. The maximal time interval between IDS and the initiation of adjuvant chemotherapy is 8 weeks. Major inclusion criteria are pathologic confirmed stage IIIC and IV EOC, FTC or PPC; ECOG performance status of 0 to 2; ASA score of 1 to 2. Major exclusion criteria are non-epithelial tumors as well as borderline tumors; low-grade carcinoma; mucinous ovarian cancer. The sample size is 456 subjects. Primary endpoint is overall survival.

Objective: To investigate whether cancer-associated- fibroblasts (CAF), the key component of tumor microenvironment, regulate the chemoresistant capacity of lung cancer cell line A549 through SDF-1 secretion. Methods: Primary cell isolation techniques was used to isolate cancer-associated-fibroblasts from lung cancer patients. MTT assay was applied to determine the proliferation and chemoresistance of A549 cells. Quantative PCR was used to detect the mRNA changes of Bcl-xL. Western blotting was used to detect the protein expression of Bcl-xL. ELISA was applied to detect the SDF-1 secretion from normal fibroblasts (NF) and CAF. Results: CAF promoted the proliferation of A549 cells, while NF had no significant effect on them. After 72 hrs incubation, the absorbance value of A549+ CAF medium group was 0.814±0.006, significantly different from the 0.753±0.006 of the A549+ NF medium group (P<0.05). The Q-PCR assay indicated that mRNA expressions of Bcl-xL in the A549 group, A549+ NF medium group and A549+ CAF medium group were 1.00±0.11, 1.10±0.09 and 3.50±0.30, respectively, showing a significant difference between the A549+ NF medium group and A549+ CAF medium group (P<0.05). The Western blot showed that protein expressions of Bcl-xL in the A549 group, A549+ NF medium group and A549+ CAF medium group were 1.00±0.08, 1.10±0.12 and 3.10±0.25, respectively, with a significant difference between the A549+ NF medium group and A549+ CAF medium group (P<0.05). The ELISA results showed that the SDF-1 concentrations in the A549+ NF medium group and A549+ CAF medium group were 3.23±0.02 and 9.53±0.10, respectively, significantly different from each other (P<0.05). The MTT assay indicated that the absorbance values of OD of A549 group, A549+ AMD3100 group, A549+ NF medium group, A549+ NF medium+ AMD3100 group, A549+ CAF medium and A549+ CA Fmedium+ AMD3100 group were 0.43±0.03, 0.25±0.02, 0.48±0.03, 0.31±0.03, 0.72±0.06 and 0.45±0.03, respectively. The data of A549+ NF medium group was significantly different from that of A549+ CAF medium group (P<0.05). Conclusions Cancer-associated-fibroblasts enhance the drug resistance of A549 cells through SDF-1 secretion, upregulating the expression level of Bcl-xL through interaction with CXCR4. Our study not only illustrates that tumor microenvironment is able to enhance drug resistance of tumor, but also provides experimental evidence for the cancer-associated-fibroblasts as a potential therapeutic target for the treatment of lung cancer.