AIM: The gel vehicle was optimized by release and transdermal resorption of integerrimine in vitro in order to design its anti-cancer transdermal drug delivery system. METHODS: The releasing rate was detected by dissolution Vilia-Chien diffusion cells, nude mouse skin were used as permeation barrier, the concentration of integerrimine in samples was measured by RP-HPLC. RESULTS: Integerrimine releases of three different vehicles conformed to Higuchi equation, the releasing rate of CMC-Na gel is faster than that of HPMC gel, and that of Carbopol gel is the slowest in three, and corresponded with zero kinetic equation. CONCLUSION: HPMC is an drug vehicle of choice.

Objective To investigate the influence of pregnancy on the production of reactive oxygen species (ROS) from mouse peripheral blood neutrophils (PMN),the levels of NO and cytokines from serum,the activation of T lymphocytes,and initially find the immune regulation effects of pregnancy on the mouse peripheral blood lymphocytes.Methods Take the BALB/c mice which were at the mid trimester of pregnancy (day 14) as the object,full blood staining using ROS probe 2',7'-dichlorodihydrofluorescein diacetate (H2DCFDA) combing with flow cytometry was used to test the levels of ROS from PMN.The production of NO from peripheral blood serum were analyzed by Griess kit while the soluble cytokines interleukin (IL) 6,IL-10,monocyte chemotactic protein 1 (MCP-1),interferon γ (IFN-γ),tumor necrosis factor α (TNF-α) and IL-12 were detected by liquid protein quantitative technology cytometric bead array (CBA) using flow cytometry.The activation of peripheral blood lymphocytes at early,middle and later phases which marked with CD69,CD25 and CD71 respectively were tested by flow cytometry and two-color fluorescent staining.Results Comparing to the normal non-pregnant mouse,pregnancy obviously promoted the production of ROS from PMN (101.1 ± 2.2 versus 134.5 ± 10.3,P ＜ 0.05).Comparing to the normal non-pregnant mouse,pregnancy obviously promoted the secretion of NO [(22.7 ± 0.7) versus (36.3 ±1.2) μmol/L,P ＜0.01].In normal non-pregnant mouse,the serum levels of IL-6,IL-10,MCP-1,IFN-γ,TNF-αandlL-12were (9.3±0.5),(26.7±0.9),(21.2±1.6),(14.5 ±1.8),(22.6±1.6) and (8.4 ± 1.2) pg/ml,while in pregnancy group the levels were (26.5 ± 1.0),(40.4 ± 2.5),(25.1 ±0.7),(457.4 ± 17.9),(93.2 ± 4.3) and (7.5 ± 0.9) pg/ml correspondingly ; the levels of IL-6,IFN-γ,TNF-α from peripheral blood serum (P ＜ 0.01),while had no effects on the production of IL-10 and MCP-1 (P ＞ 0.05).About the CD3+ T lymphocytes activation,in normal non-pregnant mouse,the CD69,CD25 and CD71 expression rate were (0.43 ±0.15)％,(5.13 ±0.25)％ and (0.37 ±0.11)％,while in pregnancy group the CD69,CD25 and CD71 expression rate were (0.40 ±0.10)％,(6.17 ±0.40)％ and (6.10 ±0.31)％.The levels of middle and later phases markers as CD25 and CD71 were highly up-regulated (P ＜ 0.05),while the early phase action CD69 had no obvious variation (P ＞ 0.05).Conclusion The mid trimester of pregnancy promoted the production of ROS from PMN,the levels of NO,IL-6,IFN-γ,TNF-αfrom peripheral blood serum,and the middle-and later-phase activation of T lymphocytes.

Objective:To explore the feasibility of ultrasound screening and diagnosis of fetal cleft palate in early pregnancy, analyze and summarize the imaging technology and image characteristics of two-dimensional and three-dimensional ultrasound in normal fetus and cleft palate fetus.Methods:A total of 10 519 pregnant women participated in the early pregnancy were included from January 2016 to June 2020 in Shenzhen Hospital, University of Chinese Academy of Sciences. The palatal line on the standard section of fetal nuchal translucency (NT) measurement was used as a screening marker for routine observation. For fetuses with abnormal palatine line, posterior nasal triangle of coronal plane and axial plane of maxillary alveolar arch of two-dimensional ultrasound were added as the diagnostic sections, and three-dimensional volume data of fetal face were collected, and three dimensional multimodal imaging technology was used to analyze the volume data off-line to determine or exclude fetal severe cleft palate. All fetuses were followed up during the second trimester for deformity scanning and post natal (or induced labor) assessment.Results:Of the 10 519 fetuses, the standard NT plane was obtained and the palatal line was observed in 10 204 cases(97.01%), with normal palatal line in 10 169 cases.In 35 suspected cases, 13 cases were confirmed cleft lip and palate by two and three dimensions ultrasound, and were confirmed by induced labor. There were 7 cases in unilateral side, 3 cases in bilateral, 2 cases in median cleft lip and palate, 1 cases in irregular cleft lip and palate, and no false positive results were reported. Twenty-two suspicious cases were excluded by increasing the two-dimensional sectional and three-dimensional volumetric off-line analysis, and screening after the second trimester and after birth. There was 1 case of missed diagnosis of simple cleft palate.Conclusions:Palatal line is a good screening marker for fetal cleft palate in early pregnancy. For fetuses with abnormal palatine line, the adding of posterior nasal triangle and the axial plane of maxillary alveolar arch, and combining three-dimensional volume data for off-line analysis can determine or exclude severe cleft palate. This study is of great significance for early screening and diagnosis of severe fetal cleft palate, prenatal genetic counseling and prevention birth defect.

Objective To explore a simple and effective operative procedure for treatment of pa-tellar fractures.Methods The clinical data of 108 patients (including 76 males and 32 females) with patellar fractures were analyzed.The age of the patients ranged from 18 years to 82 years.There were 67 patellar fractures on the right extremities and 41 on the left.Fracture types included transfractures in 43 patients, comminuted fractures in 54, torn fractures in eight and longitudinal fractures in three.Period from injury to operation ranged from 3 hours to 10 days.During operation, the broken patella was exposed for reduction and temporary pliers fixation;then, a five-pointed star woven with two absorbable sutures was placed on the broken patella, two semi-circular sutures around the patellar edge were made with su-tures which were through five points of the five-pointed star.When two sutures were pulled and knotted,the five-pointed star was also stretched to fix the patellar fractures firmly.Models of transverse patellar fractures were made in 20 knee joints of catties, which were divided into two groups randomly.Patellar fractures in Group A were fixed with five-pointed star lattice sutures and those in Group B with AO inten-sion bands.Loading test was performed on quadriceps femoris with materials test system for measuring the width of each fractured patella after the test.Results All patients were followed up for 6-60 months (mean 20 months) , which showed that all patellar fractures were healed.According to Bostman scoring system, the efficacy was excellent in 76 patients and good in 32.The experiment showed no statistical difference in the fracture disjunction distance between two methods (P > 0.05).Conclusion For treatment of patellar fractures, five-pointed star lattice sutures have the advantages of simple operation,reliable fixation, early postoperative exercise, fast recovery, satisfactory outcome and free need of reoper-ation for removing internal fixation.

Objective: To investigate the effect of cognitive behavioural therapy (CBT), which is dominated by nurses, on depression in patients with acute leukemia. Methods: Patients with acute leukemia admitted to the Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were evaluated with a rapid depressive symptom (QIDS-SR16) self-rating scale. Patients with a score higher than 11 were psychiatrists from the Shanghai Mental Health Center. Interviews and Hamilton Depression Rating (HAMD-17) assessment and clinical stereotype examination (SCID-I) diagnostic screening were performed. Patients with significant depressive symptoms who met the inclusion criteria were included (without considering DSM-5 diagnosis for depressive disorder). The computer random number method was assigned to the control group (group C), the therapist-led group CBT group (group T), the group CBT group with the nurse as the main body and therapists as the supervisors (group N). The group C was given the conventional method and the group T and N was given the standardized group CBT once a week for 8 weeks. Interviews were performed at baseline (before intervention), 4 weeks, and 8 weekends to assess the HAMD scale score. Results: Finally, 90 patients were enrolled, 30 in each group. At the end of the 4th week, the HAMD scale score (22.60±2.71) in the group T was lower than that before the intervention (25.77±2.93), and lower than the group N (24.57±2.82) and the group C (25.90± 3.88), the difference was statistically significant (t=5.395, 7.473, P<0.01 or 0.05). At the end of the 8th week, the group T (21.00±2.18) and the group N had a HAMD scale score (19.30±2.45) lower than the pre-intervention (25.77±2.93, 25.90±3.26), and were lower than the group C (24.80±3.56), the difference was statistically significant (t=6.192, 7.323, P<0.05 or 0.01). Conclusions CBT can improve the anxiety and depressive symptoms of patients with acute leukemia, and it is worthy of popularization and application.

Objective To explore the application effect of project management in preventing the lost of hospitalized senile dementia patients. Methods The project management team to prevent the lost of senile dementia hospitalized patients was founded;the plan of project management to prevent senile dementia patients get lost was made;the goal were set and was link to medical comprehensive office, comprehensive administrative office and integrated logistics office in the treating area of hospitals to carry out the implementation. Analysis and feedback were regular given. We compared the lost rate of senile dementia patients before and after the implementation of the project management and the effects of the lost on patients. Results After the implementation of project management, the lost rate of senile dementia patients decreased from 18. 49% to 2.44% (χ2=15.16, P<0.005);the effluence rate of loss on patients decreased from 40.91% to 33.33% (χ2=8.643, P<0.005).Conclusions The project management can effectively prevent the lost of hospitalized senile patients with dementia and ensure the safety of the patients; it also can enhance departmental cooperation and coordination ability and team cohesion, and stimulate the innovation ability of the team. It is worthy to be popularized in the hospital for the geriatric wards, and retirement organizations.

Objective To develop a MOSAIQ Integration PlatformCHN (MIP) based on the workflow of radiotherapy (RT) and to meet the actual requirements in China and the special needs for the radiotherapy department.Methods MIP used C/S (client-server) structure mode running on the local network in the hospital and its database was based on the Treatment Planning System (TPS) and MOSAIQ database.Five network servers,as the core hardware,supplied data storage and network service based on cloud services.The core software was developed based on Microsoft Visual Studio Platform using C# network programming language.The MIP server could simultaneously offer network service for about 200 workstations,including entry,query,statistics,and print of data.Results MIP had 15 core function modules,such as Notice,Appointment,Billing,Document Management (application/execution),and System Management,which almost covered the whole workflow of radiotherapy.Up to June 2016,the recorded data in the MIP were as follows:13546 patients,13533 plan application forms,15475 RT records,14656 RT summaries,567048 billing records,and 506612 workload records.Conclusions The MIP based on the RT workflow has been successfully developed and used in clinical practice.It is an important part of radiotherapy information system construction with the advantages of intuitive operation,real-time performance,data security,and stable operation.It is digital,paperless,user-friendly,and convenient for the retrieval and statistics of data as well as information sharing and department management,and can significantly improve the efficiency of the department.More functions can be added or modified to enhance its potentials in research and clinical practice.