This study was aimed to establish rat bladder tumor animal models to investigate the in viva antitumor effect of polyanhydride-pirarubicin (PAD-THP), a long-lasting anti-cancer implant, in the bladder tumor of animal models. The model of bladder cancer was set up with N-butly-N-(4 hydroxybutyl) nitrosamine (BBN) feeding into rats. The PAD-THP long-acting anti-cancer implants containing the drugs and the same dose of the THP naked drug were placed under the bladder mucosa of bladder tumor model in vivo. The pirarubicin plasma concentration was measured with high performance liquid chromatography (HPLC) detection in vivo. The effective drug concentration and lasting period were observed and compared in the animal bodies. The tumor sizes were measured before and after the treatment. The in viva antitumor effects were analyzed and compared. The results showed that more significant antitumor effect of PAD-THP implants on the local drug release characteristics were presented compared with that of the same dose of THP bare drug group and there were significant differences (P<0. 05) between the two methods. All the results indicated that the PAD-THP anti-cancer implants in the postoperative local treatment of bladder tumors would show prosperous in the future for clinical application.
Animals ; Antineoplastic Agents ; administration & dosage ; Butylhydroxybutylnitrosamine ; Delayed-Action Preparations ; administration & dosage ; Disease Models, Animal ; Doxorubicin ; administration & dosage ; analogs & derivatives ; Female ; Implants, Experimental ; Polyanhydrides ; administration & dosage ; Rats ; Rats, Sprague-Dawley ; Urinary Bladder Neoplasms ; chemically induced ; drug therapy ; pathology

Objective To explore the effect of scanning time on CT perfusion (CTP) imaging quality and the accuracy of parameters in acute stroke patients.Methods CTP data of 30 patients with unilateral acute cerebral infarction were investigated retrospectively.CTP data with scanning times of 56 s,52 s,48 s,44 s,40 s and 36 s were analyzed for image postprocessing,the time density curves (TDCs) of the superior sagittal sinus (SSS),perfusion maps and the parameter values of ROI were obtained,and the first passage time of SSS was recorded.Results Compared with 56 s group,there was no significant difference of the image quality in the scanning time of 52 s group and 48 s group (both P＞0.05).The image quality was significantly negatively correlated with the first passage time of SSS in 52 s group,48 s group,44 s group,40 s group and 36 s group.Compared with 56 s group,there were significant differences in partial parameters of ROI when the scanning time was 44 s (all P＜0.05).Conclusion Decreasing whole-brain CTP scanning time reasonably can ensure the image quality and the accuracy of parameters and reduce the radiation dose.The whole-brain CTP with delay of 8 s,and scanning time of 48 s are recommended.

Objective To explore the association of CT perfusion parameters to plasma levels of vascular endothelial growth factor (VEGF) and CD105 in patients with lung cancer to provide a reference for the treatment of patients with vascular targeting anti-selection.Methods Forty eight consecutive patients with diagnosed solitary pulmonary nodules underwent perfusion by 64-slice spiral CT.Among them,31 patients were diagnosed as lung cancers and 17 diagnosed as benign lesions.Statistical methods were used to analyze the differences of CT perfusion parameters [blood flow (BF),blood volume (BV),permeability surface (PS),and mean transit time (MTT)] between benign and malignant lesions,and to observe the correlation between cancer perfusion parameters and VEGF,and CD105.Results Compared to the group of benign lesions,the perfusion parameters BF,BV,and PS in the group of lung cancers were significandy higher than the group of benign lesions (P ＜ 0.05).MTT was not different between two groups (P ＞ 0.05).There were positive correlations between the expressions of VEGF or CD105 and perfusion parameters (BF,BV,and PS) of lung cancers.There were no correlation between perfusion parameter MTT and VEGF or CD105 (P ＞ 0.05).Conclusions CT perfusion parameters BF,BV,and PS can help in differentiating malignant from begin lesions.There is positive correlation between the perfusion parameters (BF,BV,and PS) and VEGF,and CD105 of lung cancers.It indicates that CT perfusion imaging is closely related to tumor angiogenesis,which may provide a non-invasive method to evaluate the blood supply.

Objective:To analyze the differences in neuronal activation during fear memory extinction in various sub-regions of the hippocampus in post-traumatic stress disorder(PTSD)mice.Methods:Two immediate early gene-pro-tein labeling strategies were employed to label neurons associated with fear extinction in PTSD mice.In the first group,Arc protein in hippocampal neurons was labeled and observed through immunofluorescence staining in wild-type mice.In the second group,Fos-CreERT2;Ai9 transgenic mice were injected with tamoxifen 23 hours prior to inducing fear memory extinction,and the relevant neurons were labeled with fluorescent proteins for observation.The number of labeled hippocampal neurons and the dendritic branch structure were analyzed to compare the activation levels of hipp-ocampal neurons and the plasticity of neuronal dendrites.Results:The two groups of Arc and Fos positive neurons were mainly distributed in the dorsal hippocampus,in which Arc protein chromogenic was enriched in CA3 and DG subre-gions,while CA1 and CA2 subregions were scattered,while Fos-positive neurons were enriched in the DG subregion of hippocampus and scattered in CA1,CA2 and CA3 subregions.Compared to the control group,there was no significant difference in the number of neurons expressing Arc protein in each subregion of the hippocampus in the PTSD group.The number of Fos-positive neurons in CA1,CA3 and DG subregions in the hippocampus of the PTSD group was signifi-cantly increased(P＜0.01).The dendritic branches of neurons in the hippocampal region were observed and analyzed in Fos-CreERT2;Ai9 mice from both groups,but no significant changes were found.Conclusion:Abnormal activation of neurons occurs in different subregions of the hippocampus during fear extinction in PTSD mice,although there are no significant plasticity changes in the dendritic branches of the activated neurons.

Objective: To evaluate the clinical effect of pereutaneous vertbroplasty (PVP) combined with implantation of iodine-125 (125 I)radioactive particle in the treatment of vertebral metastasis,and to provide basis for the treatment of vertebral metastasis.Methods:A total of 69 patients with vertebral metastasis were divided into test group (n=32)and control group (n=37);the patients in test group were treated with PVP comined with implantation 125 I radioactive particle and the patients in control group were treated with PVP only.The heights of anterior and posterior vertebral bodies of the patients before and after treatment were detected by X-ray.The numerical rating scale (NRS)scores,pain relief rate and the incidence of surgical complications of the patients were recorded before operation and 1 d,1 week,1 month,3 months,and 6 months after operation.Results:The operation was successfully performed in all the patients without local bleeding;there were no movement dysfunction and nerve compression phenomenon.There was no leakage of bone cement.All the 125 I radioactive particles located well and there was no particle obscission.The heights of vertebral bodies of the patients in two groups after operation were increased compared with before operation (P <0.05).The NRS scores of the patients in two groups s at 1 d,1 week,1 month,3 months,6 months after operation were significantly decreased compared with before operation (P <0.05);compared with control group,the NRS scores of the patients in test group at 1 d,1 week, 1 month,3 months,6 months after operation were decreased (P <0.05).The incidence of pulmonary embolism or radiation myelitis complications was about 4.3% in 69 patients.Compared with control group,the difference in the incidence of complications of the patients in test group was not significant (P < 0.05 ).Conclusion:PVP combined with 125 I radioactive particle implantation is a safe and effective method in the treatment of vertebral metastasis,which can relieve the pain of the patients obviously compared with PVP.

Objective:To construct a psychological support training program for palliative care specialist nurses based on positive psychology theory and make a preliminary application.Methods:From August to September, 2020, 142 palliative nursing specialist nurses in Hunan Provincial Palliative Nursing Specialist Training Base were selected as the research objects. Based on positive psychology therapy, using literature review and analysis, semi-structured interviews, expert group meetings and other methods to construct the program, and the work stress, psychological resilience and subjective well-being scores of nurses before and after 8 weeks of psychological support training were compared.Results:The program included three dimensions: cognition, emotion and behavior. After the psychological support training for 8 weeks, the nursing staff′s work stress score 80.76 ± 20.43 was lower than that before the psychological support training 84.70 ± 19.88, the difference was statistically significant( t=6.59, P<0.05), and the psychological resilience score 64.40 ±14.26 was higher than that before the psychological support training 60.19 ±15.85, the difference was statistically significant ( t=-7.39, P<0.05), and the subjective well-being score 75.70 ± 7.70 was higher than that before the psychological support training 74.13 ± 5.98, the difference was statistically significant ( t=-3.52, P<0.05). Conclusions:The psychological support training program based on positive psychology theory can reduce the the work stress, improve psychological resilience and increase subjective well-being of palliative care specialist nurses.

Objective:To analyze and summarize the efficacy and safety of thalidomide in the treatment of refractory systemic juvenile idiopathic arthritis（sJIA）.Methods:The clinical data of ten patients with refractory sJIA admitted to Department of Nephrology and Immunology in Children's Hospital of Hebei Province from January 2015 to March 2022 were collected，and the clinical manifestations，efficacy and safety of thalidomide in the treatment of refractory sJIA were analyzed retrospectively. Systemic juvenile arthritis disease activity score（sJADAS）was used to evaluate the efficacy of the treatment. Statistical analysis was performed by repeated measurements using general linear models.Results:Among the 10 children（4 males and 6 females）with refractory sJIA，the average age of onset was（7.5±3.3）years. Seven patients were complicated with macrophage activation syndrome at an early stage of disease.The average course of disease was（4.4±1.7）years，and the longest course of disease was 8.3 years. Before the application of thalidomide，all the 10 children experienced relapses（ranging from 2 to 10 times）. The indices of 10 children treated with thalidomide at 6 months and 12 months were compared with those before treatment. Peripheral blood leukocytes［（10.19±3.67）×10 9/L，（8.53±2.83）×10 9/L vs.（16.11±7.81）×10 9/L， F=7.918，11.084， P=0.020，0.009］，C-reactive protein［19.13（0.38，35.21）mg/L，8.05（0.10，18.00）mg/L vs. 59.34（24.20，131.90）mg/L， F=7.030，12.731， P=0.026，0.006］，sJADAS scores［6.00（1.50，12.50）scores，3.00（0，12.50）scores vs. 20.00（11.50，28.00）scores， F=14.710，17.870， P=0.004，0.002］were decreased significantly. The doses of prednisone［0.13（0，0.45）mg/（kg·d），0.02（0，0.06）mg/（kg·d）vs. 0.42（0.16，1.47）mg/（kg·d）， F=5.890，7.623， P=0.041，0.022］were significantly decreased.All the differences were statistically significant. Prednisone was successfully discontinued in 7 cases. Tocilizumab was gradually withdrawn in 3 cases，and tocilizumab administration interval was prolonged in 1 case. None of the 10 children had serious adverse reactions. Conclusion:Thalidomide is clinically effective in the treatment of sJIA，and can reduce the required dose of prednisone and prolong the tocilizumab free remission.

Objective:To compare the similarities and differences of macrophage activation syndrome（MAS）combined with systemic juvenile idiopathic arthritis（sJIA）versus with juvenile onset systemic lupus erythematosus（JSLE）.Methods:The clinical data of 48 children with MAS admitted to the Department of Nephrology and Immunology in Children's Hospital of Hebei Province from May 2015 to January 2023 were retrospectively analyzed. The patients were divided into sJIA-MAS and JSLE-MAS group，and the clinical manifestations，laboratory indicators and treatment of the two groups were compared.Results:Among the 48 children（14 males and 34 females）with MAS，the average age of onset was 9.5（3.0，11.8）years. There were 28 cases（11males and 17 females）of sJIA-MAS and 20 cases（3 males and 17 females）of JSLE- MAS. All the 48 children with MAS had fever and hyperferinemia，and the fever with sJIA-MAS was mostly continued fever or remittent fever. Respiratory tract infection was the most common trigger in sJIA-MAS［15 cases（53.6%）］，and disease activity was the most common trigger in JSLE-MAS［13 cases（65.0%）］.Additionally，viral infections（EB virus and cytomegalovirus）were also one of the triggers in MAS［sJIA：7 cases（25%），JSLE：4 cases（20%）］.Compared with JSLE-MAS，the number of days with fever［15.0（12.0，21.0）days vs. 6.0（4.0，9.5）days， Z=-3.812， P=0.001］and the length of hospital stay［29.0（26.3，39.8）days vs.26.0（19.3，30.8）days， Z=-1.958， P=0.049］were longer in sJIA. Compared with JSLE-MAS，ALT［（685.32±561.67）U/L vs.（139.61±124.44）U/L， t=4.973， P=0.001］，AST［784.00（235.25，1 251.25）U/L vs.189.50（53.25，374.08）U/L， Z=-3.283， P=0.001］，CRP［11.48（3.56，28.89）mg/L vs.1.91（0.53，8.98）mg/L， Z=-3.200， P=0.001］，ferritin［32 167.0（12 384.8，65 963.8）μg/L vs.2 003.5（922.5，11 430.0）μg/L， Z=-4.130， P=0.001］，ferritin max/ESR min［1 353.35（355.75，4 342.53）vs.91.92（34.94，291.53）， Z=-4.120， P=0.001］were higher in sJIA.The decrease of CRP was greater in sJIA［80.04（45.64，143.71）mg/L vs.10.20（6.27，25.64）mg/L， Z=-4.433， P=0.001］.Compared with sJIA-MAS，peripheral white blood cell counting［4.05（2.90，7.73）×10 9/L vs.1.56（1.15，3.47）×10 9/L， Z=-3.577， P=0.001］and platelet counting［（162.68±92.19）×10 9/L vs.（110.10±72.99）×10 9/L， t=2.118， P=0.040］were lower in JSLE-MAS. Kidney involvement was more common in JSLE-MAS［10 cases（50%）vs.0 cases（0%）， χ 2=17.684， P=0.001］.There was no significant difference in the incidence of sJIA-MAS and JSLE-MAS meeting the criteria of hemophagocytic lymphohistiocytosis［6 cases（21.4%）vs.5 cases（25.0%）， χ 2=0.084， P=0.772］. Conclusion:Compared with JSLE-MAS，sJIA-MAS is more dangerous and difficult to control，while JSLE-MAS involves more organs，among which the blood system and kidney are more common.

Objective:To understand the cognition of the family caregivers of terminal cancer patients on digital health intervention, to clarify their actual needs, and to analyze the obstacles to their acceptance of digital health intervention, so as to develop a digital health intervention plan for the family caregivers of terminal cancer patients.Methods:From February 2024 to March 2024, the family caregivers of 16 patients with terminal cancer in Hunan Cancer Hospital Pain Hospice Ward were selected by objective sampling, who met the inclusion and exclusion criteria were interviewed in a semi-structured manner about the cognition and needs of digital health intervention, and the interview contents were sorted and analyzed using the Colaizzi7 step method.Results:A total of 16 family caregivers of terminal cancer patients, 4 males and 12 females, aged 26-55 years, were interviewed. Four themes were distilled from the interview results: family caregivers of terminally cancer patients agree on the importance of digital health interventions; lack of awareness of digital health interventions; expectations of digital health interventions; and possible confounders affecting digital health interventions.Conclusions:The family caregivers of terminal cancer patients had insufficient awareness of digital health intervention, but all showed affirmation of the development of digital health intervention services. It is recommended to actively improve the basic conditions of digital health services, strengthen publicity, raise the level of awareness of the family caregivers, and positively overcome the relevant interfering factors, so as to gradually promote the development of digital health services.

Objective This paper aims to investigate and analyze the baseline conformity rate of bacterial culture exami-nation records in a tertiary specialized hospital.By doing this,this paper seeks to understand the current situation of medical re-cord writing of bacterial culture examination and explore the improvement path and relevant measures for enhancing the conformity rate of bacterial culture examination records.Methods According to the requirements of"Quality Control Index of Medical Re-cord Management(2021 Edition)",a retrospective analysis was conducted on 6 317 medical records that underwent bacterial culture examination in 2022.Results The execution rate of medical orders was 100.00％,the completeness rate of the report sheet was 100.00％,the record rate of medical records was 81.05％,the analysis rate of results was 33.07％,and the conformi-ty rate of bacterial culture examination records was 33.07％.Conclusion It is imperative to enhance the conformity rate of bac-terial culture examination records and improve the quality of medical records in terms of content.