Objective To provide the nurse care evidence of nutritional intervention in patients with lung cancer during radiotherapy and chemotherapy by analyzing the nutritional status of these patients.Methods 55 patients with lung cancer who received chemotherapy and radiotherapy were selected.The nutritional status of these patients were evaluated by laboratory examination data at the time of hospitalized,ongoing and the end of radiotherapy. Results The hemoglobin(Hb),albumin(ALB),body mass and body mass index(BMI)were (130.50 ±17.80)g/L, (41.02 ±5.68)g/L,(61.29 ±8.75)kg,(22.36 ±2.78)kg/m2 respectively at admission;(115.90 ±19.00)g/L, (37.94 ±5.55)g/L,(59.95 ±9.05 )kg,(21.86 ±2.86)kg/m2 respectively during the course of radiotherapy;(110.40 ±19.40)g/L,(36.91 ±5.30)g/L,(58.91 ±9.30)kg,(21.48 ±2.99)kg/m2 respectively at the end of radiotherapy.At different stages of radiotherapy,the nutritional index gradually decreased,the Hb was lower in the middle of the radiotherapy than on admission,the difference was significant(t =8.611,P <0.05).The Hb in the late stage of radiotherapy was lower than the middle,the difference was significant(t =2.492,P <0.05).Although the ALB in the latter stage of radiotherapy was lower than the middle,but the difference was not statistically significant (t =1.464,P >0.05),and the difference was significant compared with on admission(t =4.815,P <0.05).The weight of the patients in the middle period of radiotherapy was less than the time of admission,but the difference was not statistically significant(t =0.781,P >0.05).The weight of patients in the late stage of radiotherapy was lower than the medium term,but the difference was not statistically significant as well(t =0.601,P >0.05),and there was no significant difference compared with on admission(t =1.382,P >0.05).The BMI of the patients with radiotherapy was lower than that at the time of admission,the difference was not statistically significant(t =0.091,P >0.05).The BMI of patients with radiotherapy was lower than that in the medium term,whereas the difference was not statistically significant(t =0.690,P >0.05),and the difference was not statistically significant compared with on admission(t =1.599,P >0.05).The Hb (F =16.643,P =0.000)and ALB(F =7.736,P =0.001)decreased significantly in particular.Conclusion The risk of malnutrition in patients with lung cancer is exist during radiotherapy and chemo-therapy,and it is obvious in the middle -late stage,the changes of physical and biochemical indexes have been appeared,and among them,Hb and ALB are the most obvious,so should be monitored and managed cause these data varied significantly.

Objective:To analyze influencing factors for the clinical efficacy of Perampanel monotherapy in children with focal epilepsy and promote rational clinical use of Perampanel.Methods:Children who were diagnosed with focal epilepsy and treated with Perampanel monotherapy in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from June 2021 to August 2022 were included in this retrospective study.Efficacy at 3, 6 and 12 months after treatment was taken as the dependent variable.The gender, age at onset, age at initiation of Perampanel monotherapy, course of disease, weight, body mass index (BMI), seizure frequency, epilepsy syndrome, etiology, previous clinical history, developmental retardation, starting and maintenance doses, blood concentration, CYP3A4 and CYP3A5 gene mutations were taken as the independent variables.The effects of these factors on the efficacy of Perampanel monotherapy were analyzed using the Cox proportional hazards regression.The random forest and decision tree models were used to sequence the significance of the influencing factors and find the optimal cut-point for classification. Results:A total of 43 children (31 boys and 12 girls) were enrolled in this study.The average age at onset was (7.6±2.1) years, and the average age at initiation of Perampanel monotherapy was (7.8±2.7) years.The Cox proportional hazards regression analysis indicated that the greater the BMI, the worse the efficacy of Perampanel ( HR=0.74, 95% CI: 0.55-0.99, P=0.045). Through machine learning, the BMI was found to be a significant covariate affecting the efficacy, and when BMI≥21.8 kg/m 2, the negative effect was more significant. Conclusions:The clinical efficacy of Perampanel monotherapy in children with focal epilepsy is related to BMI.The dose of Perampanel for obese children with epilepsy may need to appropriately increase.

Objective To summarize and analyze the difficulties and key points in the measurement of gross α and gross β radioactivity in water based on the results of national measurement capability comparison assessment, and provide the basis and reference for the future work and the development of new local standards. Methods The research team participated in the comparison assessment for measurement of the gross radioactivity in water samples organized by National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention. According to the comparison assessment results and the content in the national standard GB/T 5750.13—2023 (published draft), the steps of spike recovery involved during the measurement were analyzed and discussed. Two different formulas used for spike recovery calculation were analyzed for their impact on the final measurement results. Results When the spike recovery F_(derived) derived from the formulas was used for result calculation, the spike recovery ranged as follows: gross α: 63.00%−84.60%, and gross β: 95.0%−99.1%; 3/6 of the comparison results were determined as excellent and 3/6 as pass as a whole (among them, 4 were excellent and 2 were pass for both single gross α assessment items and single gross β assessment items). When the spike recovery F from the GB/T 5750.13—2023 (published draft) was used for result calculation, the spike recovery ranged as follows: gross α: 39.69%−71.57%, and gross β: 90.25%−98.21%; 5/6 of the comparison results were determined as fail and 1/6 as pass (among them, 5 were fail and 1 was pass for single gross α assessment items; 5 were excellent and 1 was pass for single gross β assessment items). When two different formulas were used for spike recovery calculation, there was a significant difference in gross α radioactivity measurement (t = 4.27, P = 0.03 < 0.05), but there was no significant difference in gross β radioactivity measurement (t = 0.667, P = 0.524 > 0.05). Conclusion In the measurement of gross α and gross β radioactivity in water, appropriate reference to the spike recovery has a great influence on the measurement results. Therefore, quality control should be strengthened to further ensure the accuracy of measurement.

Perampanel, one of the third-generation antiseizure drugs, can non-competitively bind a-amino-3- hydroxyl-5-methyl-4-isoxazole-propionate receptor. It has been approved for both monotherapy and adjunctive treatment of patients≥4 years old with focal epilepsy (with or without secondary generalized seizures) in China. Researches on treatment of perampanel in special population such as children, the elderly and women have been constantly updated, but summaries on them are lacked recently. This review summarizes the latest clinical studies on the above-mentioned population, providing reasonable basis for clinicians.

Objective:To investigate the status of monotherapy for newly diagnosed tic disorders and its comorbidity in children, so as to provide a reference for clinical medication.Methods:A questionnaire survey was conducted to collect the application experience of monotherapy for newly diagnosed tic disorders and comorbidities in 110 pediatric neurologists and psychiatrists from Chinese Tic Disorders Study Consortium from February to August in 2019. Doctors were asked to rate treatment options based on a rank 5-point scale with "1" least appropriate and "5" most appropriate. The drug evaluation index was based on the comparison of the median score of a single drug with the overall scores of all drugs in this disease ( M( Q1, Q3)), single drug M≥ overall Q3 was recommended as preferred drugs; overall Q1≤ single drug M< overall Q3 was considered as secondary drugs; single drug M< overall Q1 was considered as unsuitable drugs. Results:Among 110 electronic questionnaires, 94 (86%) were availably responded, responding doctors included 37 (39%) males and 57 (61%) females, the age of responding doctors was (48±10) years, and their working year was (17±10) years. In the investigation of the first and second monotherapy for newly diagnosed tic disorders in children without comorbidities, there were no preferred drugs for mild transient tic disorders. The scores of clonidine, aripiprazole and tiapride were 4 (3, 4), 4 (3, 4), 4 (4, 5) scores respectively, and were greater than overall scores (3 (2, 4) scores), so they could be recommended as the preferred drugs for moderate chronic tic disorders, the recommendation for initial mild Tourette syndrome (TS) treatment was the same as preferred drugs for moderate chronic tic disorders. Similarly, clonidine, aripiprazole, tiapride and haloperidol could be recommended as the preferred drugs for other kinds of tic disorders. As for the second monotherapy, the preferred drugs for moderate transient tic disorders, mild chronic tic disorders and severe TS were all aripiprazole, tiapride, haloperidol, sulpiride, clonidine and topiramate. While clonidine, aripiprazole, tiapride could be considered as preferred drugs for severe transient tic disorders, moderate to severe chronic tic disorders and mild to moderate tic disorders. In the investigation of monotherapy for newly diagnosed tic disorders in children with comorbidities, for moderate chronic tic disorders and TS comorbid with obsessive-compulsive disorder, aripiprazole (4 (3, 5) scores) and sertraline (4 (3, 4) scores) were preferred drugs,the median scores of which were all greater than overall scores (3 (3, 4) scores), they were also the preferred treatment for severe transient tic disorders and mild chronic tic disorders. For mild and moderate transient tic disorders, severe chronic tic disorders and TS comorbid with obsessive-compulsive disorder, aripiprazole, fluvoxamine, fluoxetine, haloperidol and sertraline were preferred drugs. When comorbid with attention deficit hyperactivity disorder (ADHD), severe transient tic disorders, moderate chronic tic disorders and TS, tomoxetine and clonidine were recommended as preferred drugs (both 4 (4, 5) scores), and tomoxetine and clonidine were also the preferred treatment for severe TS. For severe chronic tic disorders comorbid with ADHD, clonidine (5(4, 5) scores) was preferred drug, greater than overall scores (4 (3, 5) scores), while for mild and moderate transient tic disorders clonidine, tomoxetine, guanidine and methylphenidate were recommended as preferred drugs. For mild chronic tic disorders and TS comorbid with ADHD tomoxetine was preferred drug. When comorbid with sleep disorders, there were no preferred drugs for mild transient tic disorders; estazolam (3 (2, 3) scores) was the preferred drug for mild chronic tic disorders and TS comorbid with sleep disorders. For othe kind of tic disorders comorbid with sleep disorders, estazolam, melatonin and clonazepam were preferred drugs. When comorbid with anxiety and depressive disorders, for all kinds of tic disorders sertraline was recommended as preferred drugs, the median scores of sertraline were all (4 (3, 5) scores) in severe transient tic disorders, moderate to severe chronic tic disorders and moderate TS, and greater than overall scores (3 (3, 4) scores). While severe chronic tic disorders comorbid with anxiety and depressive disorders, fluvoxamine could also be chosen as preferred drugs.Conclusions:Drug therapy is not recommended for mild transient tic disorders, while tiapride, aripiprazole, clonidine, and haloperidol are mainly preferred drugs for the other kinds of tic disorders. Corresponding drugs should be selected when tic disorders are combined with obsessive-compulsive disorder, ADHD, sleep disorders, anxiety, depression, etc.

Objective To explore the role of neogambogic acid in the characteristics of colorectal cancer stem cells (CRC-CSCs) through the Wnt/β-catenin signaling pathway. Methods The colorectal cells SW480 and HCT166 were divided into control group and neogambogic acid groups (1.5, 3, 6, and 12 μmol/L). The viability of CRC-CSCs was determined by MTT method, and spheroid and clone formation assays were used to assess the capacity of spheroid formation and self-renewal ability of the cells. The effects of neogambogic acid on the apoptosis and cell cycle of CRC-CSCs were evaluated by flow cytometry assays. Real-time quantitative PCR was used to detect the mRNA expression levels of relative markers (CD133, CD44, ALDH1, Oct4, and Nanog) of CRC-CSCs, and the protein expression levels of the self-renewal marker (PCNA), apoptosis markers (cleaved caspase-3 and cleaved caspase-9), and Wnt/β-catenin signaling pathway markers (p-GSK3β, GSK3β, β-catenin, and Wnt) were analyzed using Western blot. Results Compared with the control group, after neogambogic acid treatment, the viability of SW480 and HCT116 cells decreased (P<0.05), the spheroid forming ability and the clone numbers of CRC-CSCs decreased (P<0.001, P<0.01) but the cell apoptosis rate increased (P<0.01), and cell cycle was arrested in G₀/G₁ phase. Moreover, neogambogic acid downregulated the mRNA and protein expression of relative markers of CRC-CSCs (CD133, CD44, ALDH1, Oct4, and Nanog), PCNA, p-GSK3β, β-catenin, and Wnt (P<0.05) and upregulated the expression of cleaved caspase-3, cleaved caspase-9, and GSK3β (P<0.01). Conclusion Neogambogic can inhibit the stem cell properties of colorectal cells via inhibition of Wnt/β-catenin signaling pathway. As a result, neogambogic acid may be an attractive agent against colorectal cancer.

The endocrown, a modified overlay or crown, is considered to have the advantages of adhesive retention and mechanical retention. Marginal adaptation and mechanical strength are common criteria for evaluating endocrowns. This review studied these aspects of endocrowns to guide further clinical application. Results from previous academic studies indicate that endocrowns made of different materials, such as glass-based ceramics, zirconia-based ceramics and resin-based ceramics, exhibit clinically acceptable marginal adaptation. Zirconia is a common dental material, but when used in endocrowns, it tends to present a risk of irreparable tooth root fractures. Compared with products manufactured with zirconia, endocrowns manufactured with resin-based ceramics and glass-based ceramics, such as lithium disilicate ceramics, do not tend to cause irreparable results, such as tooth root fracture, but their mechanical strengths are not as good as those of zirconia. At the same time, the tooth prepration design such as the types of endocrowns, the pulp chamber extension depth and angles, the endocrown thickness can influence the mechanical strength of endocrowns as well. Compared with traditional zirconia, self-glazed zirconia, a new type of material used to restore defective teeth, has the similar elasticity modulus（210 GPa）and better aesthetic advantages, and is suitable for short crown patients with insufficient occlusal space. Further study is warranted to improve the performance of endocrowns made from ceramic materials to prevent root fracture.