To investigate the expression change of BDNF in lamina II of spinal cord from partial deafferented cats, L6 segmentsof spinal cord from 20 adult male cats (5 normal cats, 15 unilateral L6 spared roots cats allowed to survive 3 d, 6 d and 12 d re-spectively) were stained with immunohistochemical technique. The results showed: BDNF positive products were mainly dis-tributed in nerve terminals, varicosities and few neurons of spinal cord lamina II in normal cat. After operation, the density ofpositive nerve terminals and varicosities began to decrease on the third day, reached the lowest level on the 6th day and recoveredto normal level on the 12th day on operated side. But the number of BDNF neurons showed no obvious change. The authors sug-gest that the decreased density of BDNF positive products in lamina II on the 3rd and 6th day was related with the degenerationof the nerve fibers and varicosities after section of the adjacent dorsal roots. On the 12th day, the remaining L6 dorsal roots un-derwent collateral sprouting compensatoryly and reestablished functional connection with target neurons. Therefore, BDNF maybe involved in the normal physiological function and the plasticity of spinal cord after damage.

Objective: To evaluate the potential dosimetric beneifts and optimal indications of intensity modulated radiation therapy (IMRT) and hybrid intensity modulated radiation therapy (Hybrid IMRT) for the left side breast cancer patients after breast-conservation therapy.
Methods: Eight patients with left breast carcinoma who received breast-conservation surgery were selected for this study. Two plans were designed in 3-dimensional treatment planning system. The dose distributions of target volume and normal tissues, conformal index (CI) and heterogeneous index (HI) were analyzed by dose-volume histogram (DVH).
Results: The PTV coverage was the same in the two radiotherapy plans. A better dose uniformity throughout the whole breast in Hybrid IMRT plan was achieved. The CI, the percentage of PTV receiving more than 105% prescribed dose (V105%), the percentage of PTV receiving more than 110% prescribed dose (V110%), and the Dmax, Dmin and Dmean of PTV were similar in the two plans. We compared the Hybrid IMRT with IMRT: V13of the ipsilateral lung decreased from 27.66% to 20.7%, V5 of the contralateral lung decreased from 8.01% to 2.25%, V10 and V20 of the heart decreased from 35.23% and 16.77% to 19.22% and 10.6% respectively, V5 and V10 of the contralateral breast decreased from 35% and 10.39% to 20.38% and 5.7% respectively, all with significant difference. V30 and V40 of the ipsilateral lung and V40 of the heart increased by 1.28%, 1.48%, and 2.48%, with signiifcant difference.
Conclusion: Hybrid IMRT is a better choice for patients whose treatment position is inaccurate or cannot be repeated well.

OBJECTIVE: To investigate the inhibitive effect of E1A gene carried by PEI-Fe(3)O(4) nanometer particle (NP) on the cell growth of human cervical carcinoma cell in vitro and its mechanism, and to provide the experimental evidence for the feasibility of gene therapy for human cervical carcinoma. METHODS: E1A gene conjugated to PEI-Fe3O4 NP was transfected into human cervical carcinoma cell line Hela. The cell growth curve of Hela was drawn, the doubling time and the number of colony formations on the soft agar were calculated based on the cell count. RT-PCR and Western blot were used to detect the expression of the E1A and HER-2/neu in Hela cells. RESULTS: The cell doubling time of Hela cells transfected with E1A gene (Hela-E1A) was 1.53 times and 1.58 times longer than that of the Hela transfected with blank vector (Hela-vector) and blank Hela control (Hela), respectively. The E1A transfected Hela cells grew slower than those of the control group. The cell colony formation efficiency in the Hela-E1A (6.62%) group was significantly lower than that of Hela (30.48%) and Hela-vector (28.3%) groups (P<0.05). As compared to Hela and Hela-vector, the inhibition rate of Hela-E1A was 78.28% and 76.62% respectively. RT-PCR and Western blot demonstrated that the overexpression of E1A through gene transfection significantly inhibited mRNA and protein expression of HER-2/neu in Hela cells. CONCLUSION E1A gene can suppress the cell growth of human cervical carcinoma cell Hela in vitro. Down-regulated expression of HER-2/neu gene by E1A overexpression in Hela might contribute to the Hela growth inhibitive effect of E1A.
Adenovirus E1A Proteins ; genetics ; Cell Proliferation ; Female ; Gene Expression Regulation, Neoplastic ; Genetic Therapy ; methods ; HeLa Cells ; Humans ; Transfection ; Uterine Cervical Neoplasms ; genetics ; therapy

OBJECTIVE: To explore the reversal effect and mechanism of lobeline on the multidrug-resistance (MDR) of human breast cancer cells MCF-7/ADM. METHODS: In human breast cancer cell line MCF-7/ADM, MTT assay was used to determine the cell growth inhibiting ratio of MCF-7/ADM by ADM and Fu. Fluorospectorphotometer was employed to investigate the intracellular concentration of rhodamine123 to reflect the effect of lobeline on the activity of MDR-related protein P-glycoprotein (P-gp). Taking untreated MCF-7/ADM cells as controls, flow cytometry was applied to detect the intracellular concentration of rhodamine123 in MCF-7/ADM cell intervened with lobeline of 20 micromol/L. RESULTS: The sensitivity of MCF-7/ADM to ADM and Fu was significantly increased by lobeline in a dose-dependent manner. The inhibitive concentration 50 (IC(50)) of ADM declined from (44.81+/-0.43) mg/L to (16.72+/-0.75) mg/L with a reversion index of 2.68. The IC(50) of Fu declined from (53.12+/-1.60) mg/L to (38.90+/-1.43) mg/L with a reversion index of 1.37. The fluorescence intensity of lobeline-treated cells was significantly higher than that of the controls, when the concentration of lobeline was more than 10 micromol/L. With fewer side effects, the reversal efficacy of 20 micromol/L lobeline was 71.6% of the classical MDR reversal agent of verapamil at the same concentration. CONCLUSION Lobeline can reverse the MDR of MCF-7/ADM cells by inhibiting the activity of P-glycoprotein.
Breast Neoplasms ; pathology ; Cell Line, Tumor ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Female ; Glycoproteins ; antagonists & inhibitors ; Humans ; Lobeline ; pharmacology

Objective:To explore the influence of a midwife-led group health care model on primiparas′ self-efficacy and quality of life.Methods:The study included 200 primiparas who registered with the obstetrics department of our hospital between January and December 2019. The puerperas were divided into two groups with 100 cases each according to the random number table method. The control group received routine health care during pregnancy. The T-test and χ 2 test were used, while the observation group received midwifery-led group health care during pregnancy. The scores of maternal role adaptability, self-efficacy, weight control, delivery mode, breastfeeding, mental state, and quality of life was compared between the two groups. Results:After nursing, the mother′s role adaptability (63.14±9.38) and self-efficacy (34.16±2.89) scores in the observation group were higher than those in the control group (52.89±8.41 and 31.28±2.43, respectively) ( t=8.136, 7.627, P<0.05). The weight gain of the observation group in the third trimester [(3.68±1.22) kg] was less than that of the control group [(5.49±1.76) kg] ( t=8.452, P<0.05). The vaginal natural delivery rate of the observation group was 91% higher than the 71% of the control group (χ2=12.966, P<0.05), the cesarean section rate of the observation group was 9% lower than the 29% of the control group (χ2=12.966, P<0.05), and the exclusive breastfeeding rate in the observation group was higher than that in the control group ( χ2 =6.258, P<0.05). After nursing, the SAS (40.74±4.93) and SDS scores (42.16±5.07) of the observation group were lower than those of the control group (47.10±5.27 and 48.59±5.42, respectively) ( t=8.813, 8.664, P<0.05), and the four-dimension quality of life scores of the observation group were higher than those of the control group ( t=7.293, 7.406, 7.357, 8.767, P<0.05). Conclusion:A midwife-led group pregnancy care model can effectively enhance the self-efficacy of primiparas and improve their quality of life.

Background:Gross target volume of primary tumor (GTV?P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma (NPC), but it is unknown whether the same is true for locally advanced NPC patients treated with intensity?modulated radiotherapy (IMRT). This study aimed to clarify the prognostic value of tumor volume for patient with locally advanced NPC receiving IMRT and to ifnd a suitable cut?off value of GTV?P for prognosis prediction. Methods:Clinical data of 358 patients with locally advanced NPC who received IMRT were reviewed. Receiver oper?ating characteristic (ROC) curves were used to identify the cut?off values of GTV?P for the prediction of different end?points [overall survival (OS), local relapse?free survival (LRFS), distant metastasis?free survival (DMFS), and disease?free survival (DFS)] and to test the prognostic value of GTV?P when compared with that of the American Joint Committee on Cancer T staging system. Results:The 358 patients with locally advanced NPC were divided into two groups by the cut?off value of GTV?P as determined using ROC curves: 219 (61.2%) patients with GTV?P≤46.4mL and 139 (38.8%) with GTV?P>46.4mL. The 3?year OS, LRFS, DMFS, and DFS rates were all higher in patients with GTV?P≤46.4mL than in those with GTV?P>46.4mL (allP<0.05). Multivariate analysis indicated that GTV?P>46.4mL was an independent unfavorable prognostic factor for patient survival. The ROC curve veriifed that the predictive ability of GTV?P was superior to that of T category (P<0.001). The cut?off values of GTV?P for the prediction of OS, LRFS, DMFS, and DFS were 46.4, 57.9, 75.4 and 46.4mL, respectively. Conclusion:In patients with locally advanced NPC, GTV?P>46.4mL is an independent unfavorable prognostic indi?cator for survival after IMRT, with a prognostic value superior to that of T category.

A patient with osteomyelitis who developed a rash after previous treatment with vancomycin was admitted to the hospital due to a recurrence of osteomyelitis.After admission,the orthopedic doctor intended to perform a"calcium sulfate vancomycin implantation surgery"on him.Clinical pharmacist identified the patient's previous rash reaction as red man syndrome(RMS)rather than genuine drug allergy.At the same time,in response to the clinical doubt of whether patients with previous RMS can undergo"calcium sulfate vancomycin implantation surgery",clinical pharmacists reviewed and analyzed the literature,and suggested that the surgery can continue under close monitoring.The patient did not experience RMS or allergic reactions after surgery,and the condition improved.In this paper,the clinical pharmacists started with the identification of RMS and rapid allergic reactions,reviewed the literature on the local use of vancomycin and the risk of RMS,and provide suggestions for subsequent treatment,and also provide references for clinical safe drug use and treatment of similar diseases.

Objective:To explore the effect of solution focused approach (SFA) on breastfeeding rate and postpartum subjective well-being of primiparas with vaginal delivery.Methods:From May to December 2021, the convenient sampling was used to select 180 primiparas who underwent vaginal delivery in Department of Obstetrics in Hangzhou First People's Hospital as the research objects. Using the random block design method, they were divided into the control group and the observation group, with 90 cases in each group. The primiparas in the control group were given routine nursing care, while primiparas in the observation group were given SFA on the basis of the control group. The duration of exclusive breast feeding and the rate of breast feeding at 3 months after delivery were counted. Memorial University of Newfoundland Scale of Happiness (MUNSH) was used to evaluate the subjective well-being of patients in the two groups before and after nursing intervention, and the nursing satisfaction of the two groups was counted.Results:The breastfeeding rate of the observation group at 3 months after delivery was higher than that of the control group and the exclusive breastfeeding time was longer than that of the control group, and the differences were statistically significant ( P<0.05) . After nursing intervention, the scores of positive emotion and positive experience dimension and total score of MUNSH in the observation group were higher than those in the control group, and the scores of negative emotion and negative experience dimension were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The nursing satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:SFA can effectively improve the breastfeeding rate of primiparas undergoing vaginal delivery and improve postpartum subjective well-being and nursing satisfaction of primiparas, which is worthy of clinical application.

Objective To evaluate the effect of surgery-radiotherapy interval (SRI) on clinical prognosis of locally advanced stage c Ⅱ-Ⅲ breast cancer patients treated with neoadjuvant chemtherapy and modified radical mastectomy.Methods Clinical data of 1 087 breast cancer patients treated with neoadjuvant chemotherapy and modified radical mastectomy from 11 hospitals in China were retrospectively analyzed.The optimal threshold value of SRI upon clinical prognosis was determined by maxstat method.The effect of SRI on clinical prognosis was evaluated by using multivariate Cox regression analysis and propensity score matching (PSM).Results The median follow-up time was 72.9 months.The 5-year disease-free survival (DFS) and overall survival (OS) rates were 68.1％ and 81.8％.All patients were divided into SRI ≤18 weeks (n=917) and SRI＞ 18 weeks groups (n=170).Multivariate Cox regression analysis demonstrated that hormone receptor status (P＜0.001),pathological T stage (P＜0.001),pathological N stage (P＜0.001) and SRI (P=0.023) were independent influencing factors of DFS.Hormone receptor status (P=0.013),pathological T stage (P=0.006),pathological N stage (P＜0.001),endocrine therapy (P=0.013) and SRI (P=0.001) were significantly associated with OS.After balancing the clinical and pathological factors with PSM,patients with SRI＜ 18 weeks had superior DFS and OS to those with SRI＞ 18 weeks.Conclusions SRI affects the clinical prognosis of locally advanced breast cancer patients treated with neoadjuvant chemotherapy and modified radical mastectomy.Radiotherapy should be performed within 18 weeks after mastectomy.

OBJECTIVE To discuss the application effect of health care failure mode and effect analysis(HFMEA) and root cause analysis(RCA) in the intelligent management of narcotic use in the hospital. METHODS Set up an analysis team to use HFMEA to list potential failure modes in the flow chart of intelligent management of narcotic use in the hospital, and analyze and evaluate the key failure modes in combination with RCA, determine the root cause, and then formulate improvement measures and evaluate the effects after implementation. RESULTS After the implementation of the improvement measures, the risk priority number of the eight potential failure modes decreased significantly(P<0.05). The satisfaction of pharmacists, doctors and nurses with the intelligent management process of narcotic use in the hospital increased from (88.39±2.21)% to (98.04±0.51)%, from (87.79±1.36)% to (97.55±1.24)%, and from (90.79±1.39)% to (95.68±1.30)%, respectively. CONCLUSION HFMEA combined with RCA can reduce the risk of narcotic drug abuse, ensure drug quality and safety, reduce the occurrence of dispensing errors, and ensure the rational clinical use of narcotic drugs.