The successful separation of breast cancer stem cells (BCSCs) is the foundation of BCSC research.At present,people could gather BCSCs to some extent in a number of ways.However,as more and more biomarkers are found in BCSCs separation,the heterogeneity becomes a hot spot.How to gather BCSCs as much as possible and how to explain the heterogeneity could provide new insights in the treatment of breast cancer.

Objective To investigate the effects of EMP exposure to male BABL/c mice on the reproduction and its sex ratio.Methods Thirty-three male BALB/c mice were randomly divided into sham-exposed group,10 000 pulses/d exposed group,and 100 000 pulses/d exposed group with 50 Hz static magnetic field of 35 kV/m for 2 weeks consecutively,then the male mice were mated with unexposed females (1 male vs.2 female).Mated males were sacrificed to examine the exposure effects on sperm number and testis index after 7 days of mating.The sex ratio of embryos collected from unexposed mated females was investigated by PCR.Results The sex ratio of offspring was 0.298 (14/47) in the 10 000 pulses/d exposed group,significantly lower than 0.871 (27/31) in the sham-exposed group.No statistical changes were observed in the sex ratio of offspring,sperm number,the weights of testis and testis index after 100 000 pulses/d exposure.Conclusions The exposure of male mice to 35 kV/m EMP at 10 000 pulses/d for 2 weeks consecutively may change the sex ratio of mice's offspring.

Objcetive To investigate the protective effects of the nitroxides R-1 on human liver cells exposed to ionizing radiation.Methods Human liver cells L-02 were cultured and irradiated with 60Co γ-rays at the doses of 0,1,2,4,and 8 Gy,in order to screen the proper irradiation dose.WR2721 at the terminal concentration of 4 mmol/L was used as positive control.L-02 cells irradiated with 4 Gy were added with R-1 at the terminal concentration of 0.25 μmol/L at 30 min before irradiation or immediately after irradiation.MIT method was used to screen the proper conditions for follow-up experiment 72 h later.L-02 cell culture fluid was added with R-1 at the concentrations of 0,0.125,0.25,0.5,and 1 μmol/L,respectively for 30 min before irradiation at the doses of 0,1,2,4,and 8 Gy to ealculate clone formation rate at 10 d post-irradiation.L-02 cells were cultured and divided into 4 groups:control group without any treatment.drug group pretreated by 0.25 μmol/L R-1 only,irradiation group,irradiated at 4 Gy only,and drug + irradiation group with combination of 0.25 μmol/L R-01 and 4 Gy irradiation.The inverted microscopy and Hoechst 33258 staining and flow eytometry were used to observe the apoptosis of the cells at 24,48,and 72 h later.Results Nitroxides R-1 did not inhibit the viability of L-02 cell when its concentration was less than 1 μmol/L and it inhibited the L-02 cell growth when the concentration wu higher than 2 μmoL/L.The A value and colony formation rate of different concentration of R-1 groups were all higher than those of the irradiation group,and the effect of the 0.25 μmol/L drug concentration group was the most significant.Consequently,the concentration 0.25 μmoL/L was selected for follow-up experiment.Compared with the irradiation group,the L-02 cells of the pretreatment group showed solid adherence, increased refraction,clear outline,less apoptotic and dead cells at 4 Gy post-irradiation.Conclusions Nitroxides R-1 can protect the human liver cells from 60Coγ-ray induced injury effectively.The mechanism of its protective effect may be the reduction of apoptosis.

Objective: To explore the status of lymph node metastasis of middle third thoracic esophageal squamous cell carcinoma and its influence on the prognosis and to seek the reasonable range of lymphade-nectomy. Methods: A total of 129 patients who underwent curative esophagectomy with modern two-field lymphadenectomy of middle third thoracic esophageal squamous cell carcinoma were reviewed. Results: The lymph node metastasis rate was 56.6% and the upper mediastinal lymph node metastasis rate was 43.4%. The lymph node metastasis ratio (positive nodes/total dissected nodes, LMR) was 11.3%. Paraesophageal lymph nodes, lymph nodes near the right recurrent nerve, the left gastric and infracadnal lymph nodes were most commonly involved when the tumor was located in the middle thoracic esophagus. Tumor differentiation, the depth of tumor invasion and the length of tumor were influencing factors for lymph node metastasis. The 5-year survival of N_0, N_1 (LMR≤20%) and N_1 (LMR>20%) patients were 50.4%, 31.0% and 6.8%, respective-ly, with a significant difference among the three groups (P=0.000). Conclusion: LMR was one of the key fac-tors affecting the prognosis, of esophageal cancer. Patients with middle third thoracic esophageal carcinoma should be treated with radical surgery with modern two-field lymphadenectomy.

Objective To explore the effects of application and management of the standardized training system for newly graduated registered nurses. Methods A total of 238 newly graduated nurses in Peking University First Hospital were selected by purposive sampling method. The 138 nurses who were enrolled in August 2015 were assigned into control group, adopting the traditional training program for new nurses. The 100 newly enrolled nurses in August 2016 were assigned into observation group, adopting the new standardized training program for new nurses. After training, the nurses of both groups were evaluated with the Transition Shock of Newly Graduated Nurses Scale (TSNGNS), the New Nurse Standardized Training Satisfaction Questionnaire, and the comprehensive examination paper. Results The total scores of TSNGNS, physical dimension, psychological dimension, social culture and development of nurses in the observation group were lower than those in the control group after training, and the differences were statistically significant (P＜0.01). After training, the total score and each dimension score of nurse satisfaction questionnaire in the observation group were higher than those in the control group, and the differences were statistically significant (P＜0.05). After the training, the comprehensive examination score of the nurses in the observation group was higher than that in the control group, and the difference was statistically significant (P＜ 0.01). Conclusions The implementation of the new training scheme can effectively relieve the new nurses' transition shock and improve their satisfaction and comprehensive evaluation score during training.

Aim To determine the effective compo-nents of Semen Ziziphi Spinosae for sedative-hypnotic and its mechanism. Methods The extraction of Se-men Ziziphi Spinosae and the rat brain homogenates were prepared. High concentrations of Diazepam com-petitively replaced the ligand compounds of Semen Ziz-iphi Spinosae combining BDZ receptor in brain tissue, and all the compounds with sedative and hypnotic effects were collected and identified by HPLC and LC-MS technique, as the compounds extracted from the brain tissue were administered with Semen Ziziphi Spi-nosae. The brain tissue was administered with Diaze-pam, and with Semen Ziziphi Spinosae and Diazepam. Results The HPLC chromatograms show that the peak time of BDZ receptor ligand compounds was 2. 71 min and 46. 87min, when compared with Diazepam. And the LC-MS chromatograms display the relative molecu-lar weight of the ligand compounds was 274. 28 m/z, 453. 34 m/z,496. 34 m/z and 608. 38 m/z respective-ly. According to the fingerprint of Semen Ziziphi Spi-nosae, these compounds may be fatty acid substances and lupine pill triterpene compounds. Conclusions On the basis of the principle of receptor ligand bind-ing, we established a way to quickly analyze and iden-tify the role of natural products in the same drug target compounds. The method not only can clearly define the effective components of natural products, but also clar-ify the mechanism of action of the compounds. The ac-tive ingredient of calm hypnosis in Semen Ziziphi Spi-nosae may be fatty acid substances Palmitic acid ( C16 H32 O2 ) and lupine pill triterpene compounds Alphitolic acid( C30 H48 O4 ) and Spinosin( C28 H32 O15 ) . They exert their sedative and hypnotic effects by combining with BDZ receptor, and the research has laid a theoretical foundation for the further study about mechanism of Se-men Ziziphi Spinosae.

Objective To compare the clinical efficacy of robotic low anterior resection (R-LAR) and laparoscopic low anterior resection(L-LAR) for rectal cancer.Methods The case-control studies for comparing the clinical efficacy of R-LAR and LLAR for rectal cancer were retrieved from databases,including PubMed,OVID,Springer,Wanfang and VIP,till June 2016.The studies were selected in accordance with inclusion and exclusion critera,and the data were extracted and evaluated by two researchers.The RevManS.3 software was used for Meta-analysis.Results A total of 7 studies including 1 126 patients with rectal cancer were included,592 cases in the R-LAR group and 534 cases in the L-LAR group.Compared with the L-LAR group,in the R-LAR group the operation time was longer (MD=33.84,95％ CI:4.25-63.43,P =0.03),the conversion rate was lower (OR =0.10,95％CI:0.03-0.36,P=0.000 5),and more lymph nodes were dissected (MD=1.24,95％CI:0.31-2.17,P=0.009).No statistically significant difference was found in length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage between the two groups (P ＞ 0.05).Conclusion Compared with L-LAR,RLAR is characterized by longer operation time,lower conversion rate and more thoroughly removing lymph nodes.And the length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage of R-LAR are similar to those of L-LAR.

Objective:To explore the effects of metformin on levels of peripheral blood regulatory T cells (Treg)/Th17 cells and related cytokines in patients with type 2 diabetes mellitus (T2DM) and influenza A.Methods:A total of 108 patients with T2DM and influenza A treated in Zhejiang Veteran Hospital were prospectively enrolled between April 2021 to April 2022. According to different medication methods, they were divided into observation group (54 cases, oseltamivir + metformin) and control group (54 cases, oseltamivir + gliclazide). The average usage time and dosage of oseltamivir, concentration of blood lactate and blood gas level, counts of Th17 and Treg cells, and levels of related cytokines in the two groups were compared before and after treatment.Results:The average usage time and dosage of oseltamivir, and concentration of blood lactate were higher in observation group than control group: (8.94 ± 0.88) d vs. (7.23 ± 0.79) d, (1.32 ± 0.15) g vs. (1.08 ± 0.11) g, (1.83 ± 0.43) mmol/L vs. (1.61 ± 0.32) mmol/L, P<0.05. The differences in pH, partial pressure of arterial oxygen (PaO 2) and partial pressure of arterial carbon dioxide (PaCO 2) between the two groups had no statistically significant before and after treatment ( P>0.05). After treatment, the differences in count of Treg cells, interleukin-10 (IL-10), interleukin-4 (IL-4), CD 3+, CD 4+ and CD 4+/CD 8+ between the observation group and the control group were statistically significant: (35.48 ± 5.64)% vs. (42.53 ± 6.17)%, (30.49 ± 4.72) ng/L vs. (35.64 ± 5.08) ng/L, (32.15 ± 3.06) ng/L vs. (35.33 ± 3.12) ng/L, (61.39 ± 3.28) % vs. (66.27 ± 3.05)%, (34.12 ± 1.93)% vs. (36.59 ± 2.61)%, 1.26 ± 0.34 vs. 1.52 ± 0.41, P<0.05. After treatment, the count of Th17 cells, Th17/Treg, interleukin-17 (IL-17) and γ-interferon (IFN-γ) in the observation group were higher than those in the control group:(8.69 ± 1.42)% vs. (7.94 ± 2.03)%, 0.24 ± 0.06 vs. 0.19 ± 0.05, (17.67 ± 3.11) ng/L vs. (12.18 ± 3.42) ng/L, (287.48 ± 45.12) ng/L vs. (254.27 ± 41.09) ng/L, P<0.05. During treatment, the difference in incidences of adverse reactions between the two groups had no statistically significant ( P>0.05). Conclusions:Oseltamivir combined with metformin can recover the balance of Th17/Treg cells in patients with T2DM and influenza A to a certain extent. Clinically, level of blood lactate should be monitored.

Objective:To explore new head nurses' demands of training and construct the theoretical framework of training demands of new head nurses. In order to provide reference for management department about making training plans and improving the competence of new head nurses.Methods:From November 2018 to March 2019, semi-structured in-depth interviews were conducted with 15 new head nurses in a ClassⅢ Grade A hospital in Beijing by using the objective sampling method. The data were sorted out and analyzed by the grounded theory, the themes were separated out and then the training model is built.Results:34 concepts, 13 categories and 4 main categories were extracted. The core categories including external-driven, self-development, training needs and key elements of training. Eventually, the theoretical framework of training demands in new head nurses was developed.Conclusions:Under the role of external drive and self-development, the new head nurse has a strong desire for training. The management department should formulate training strategies according to the specific needs of the new head nurse to meet their training intentions, help them adapt to the working environment as soon as possible and promote the development of their own education.

This article reviewed the intension and current status of knowledge translation in health care and analyzed the existing problems including a lack of nursing evidence summary, low quality of nursing evidence, nurses with low ability in evidence-based and insufficient evidence-based atmosphere. It is recommended that knowledge translation researchers of the institutions and clinical knowledge translation practitioners should work closely together to carry out integrated knowledge translation research, and should produce more best evidence summary and knowledge translation tools close to clinical needs, accelerate the cultivation of evidence-based nursing talents at all levels, and use a variety of incentives to support evidence-based practice,apply the concepts and methods of knowledge translation to improve the quality of nursing and promote the development of nursing science.