Objective To study the role of adiponectin (ADP)post-conditioning in alleviating myocardial ischemia reperfusion injury (MIRI) in 3-week old rats.Methods SD rats (3-week old) were randomly divided into 4 groups by random digits table (n =6):sham group was processed identically except that the left anterior descending coronary artery(LAD) was not ligated;MIRI group was subjected to occlusion of the LAD followed by reperfusion,occlusion for 30 min and reperfusion for 120 min;ADP group was subjected to injection of ADP into femoral vein before reperfusion;LY294002 group (ADP post-conditioning and LY294002) was subjected to injection of ADP and LY294002 into femoral vein before reperfusion.The titer of lactate dehydrogenase(LDH),cardiac troponin I(cTnl) and malondialdehyde(MDA) in plasma were observed.The levels of superoxide dismutase (SOD)and MDA in myocardial tissue were observed.Results The levels of LDH,cTnI and MDA in plasma of MIRI group was (732.11 ± 111.29) IU/L,(38.05 ± 6.17) g/L and (4.49 ± 0.17) nmol/L,respectively,compared with sham group,the levels of LDH,cTnI and MDA in plasma of MIRI group increased obviously(all P ＜ 0.05);the levels of LDH,cTnI and MDA in plasma of ADP group were (581.72 ± 68.41) IU/L,(20.70 ± 5.43) g/L and (3.10 ± 0.20) nmol/L,respectively;compared with MIRI group,the levels of LDH,cTnⅠ and MDA in plasma of ADP group declined significantly (all P ＜0.05);the levels of LDH,cTnI and MDA in plasma of LY294002 group were (701.10 ±99.59) IU/L,(33.13 ± 4.32) g/L and (4.19 ± 0.46) nmol/L,compared with ADP group,the levels of LDH,cTnI and MDA in plasma of group LY294002 increased remarkably (t =2.477,1.804,2.961,all P ＜ 0.05).Compared with sham group,the SOD level decreased and the MDA level increased in myocardial tissue of MIRI group(all P ＜ 0.05);compared with MIRI group,the SOD level increased and the MDA level decreased in myocardial tissue of ADP group (all P ＜ 0.05);compared with ADP group,the SOD level decreased and the MDA level increased in myocardial tissue of LY294002 group (all P ＜ 0.05).Conclusions ADP postconditioning is perhaps a protective factor for alleviating myocardial ischemia reperfusion injury in 3-week-old rats,the protective effect is perherps related to alleviating the damage of the lipid peroxidation by signaling pathway of adiponectin/phosphoinositide-3 kinase/protein kinase B.

Objective To study the role of adiponectin (ADP) postconditioning on myocardial ischemia reperfusion injury (MIRI) in rats .Methods SD rats were divided randomly into 3 groups :⑴Group Sham were processed identically except the left anterior descending coronary artery(LAD) and was not ligated;⑵ Group MIRI were subjected to LAD occlusion for 30 min and reperfusion for 120 min;⑶ Group ADP were subjected to ADP injection before reperfusion .The titer of lactate dehydrogenase (LDH) ,cardiac troponin I(cTnI) and malondialdehyde(MDA)in plasma were observed .The levels of superoxide dismutase(SOD) and malondialdehyde(MDA)in myocardial tissue were observed .The results of HE staining and electrocardiograms(ECG) was ob‐served .Results Compared with Group Sham ,LDH ,cTnI and MDA in plasma in Group MIRI increased (P<0 .05);Compared with Group MIRI ,LDH ,cTnI and MDA in plasma in Group ADP declined (P<0 .05);Compared with Group Sham ,SOD decreased and MDA increased in myocardial tissue in Group MIRI (P<0 .05);Compared with Group MIRI ,SOD increased and MDA decreased in myocardial tissue in Group ADP (P<0 .05) .The myocardial injury was serious in Group MIRI while it was lightened in Group ADP .There were acute ischemia ECG change in Group MIRI while it was slight in Group ADP .Conclusion ADP postconditioning is a protective factor against MIRI in rats ,it is related to eliminating free radicals and alleviating the damage of lipid peroxidation .

Objective To observe the short- and long-term efficacies of acupuncture in treating metabolic syndrome (MS). Method A hundred MS patients were randomized into an acupuncture group and a Western medication group. In addition to basic treatment, acupuncture was used in the acupuncture group, while Western medication was adopted in the Western medication group. The fasting plasma glucose (FPG), high-density lipoprotein (HDL), insulin (INS), triglyceride (TG), blood pressure (BP), weight circumference (WC), body mass index (BMI), and MS score were evaluated before and after treatment, and a month and 3 months after the treatment. Result There was no significant difference in comparing the short-term therapeutic efficacy between the two groups after treatment, while the long-term therapeutic efficacy of the acupuncture group was superior to that of the Western medication group (P<0.01); the FPG, INS, TG, HDL, BP, and MS score were significantly improved after treatment and a month after the treatment in both groups (P<0.01); the acupuncture group had significant improvements in WC and BMI after treatment and a month after the treatment (P<0.01), significantly superior to the Western medication group (P<0.01); the acupuncture group showed marked improvement in INS, HDL, WC, and BMI 3 months after the treatment (P<0.01), significantly superior to the Western medication group (P<0.01,P<0.05). Conclusion Acupuncture can produce a similar short-term but a better long-term therapeutic efficacy compared to Western medication. Hence, acupuncture can be taken as an assistant intervention for MS.

ObjectiveTo investigate the symptoms and symptom clusters in patients with advanced hepatocellular carcinoma (HCC) receiving molecular-targeted therapy with lenvatinib, as well as the clinical significance of the management of symptoms and symptom clusters in reducing lenvatinib-related grade 3 or above adverse events (AEs) and AEs leading to treatment termination. MethodsA total of 98 patients with advanced HCC who were treated with lenvatinib in The Fifth Medical Center of Chinese PLA General Hospital from May 2017 to December 2018 were enrolled. The AEs associated with lenvatinib were observed according to National Cancer Institute Common Toxicity Criteria, and the primary endpoint was the number of cases with a reduced dose or interruption of lenvatinib or treatment termination due to lenvatinib-related AEs after the management of symptoms or symptom clusters. ResultsAll 98 patients completed the whole procedure. As for the lenvatinib-related AEs with an incidence rate of ＞20%, hypertension had the highest incidence rate of 42.9%, followed by diarrhea (33.6%), hepatic encephalopathy (30.6%), anorexia (30.6%), proteinuria (25.5%), fatigue (25.5%), hand-foot syndrome (22.4%), hoarseness (20.4%), and weight loss (20.4%). The incidence rate of grade 3 or 4 AEs was 55.1% (54/98); the most common grade 3 AEs were hypertension (8.2%) and hepatic encephalopathy (6.1%), and grade 4 AE was observed in 1 patient (1%). The most common symptom clusters included hypertensive proteinuria (56.1%), digestive tract syndrome (50%), and pain syndrome (36.7%). Among the 98 patients, 41 (41.8%) had a reduced dose or interruption of lenvatinib due to lenvatinib-related AEs after the management of symptoms and symptom clusters and 4(4.1%) experienced treatment termination, which was lower than the percentages of 52.9% and 8.8% in the REFLECT study. ConclusionHypertension and diarrhea are common AEs associated with lenvatinib. Hypertensive proteinuria, digestive tract syndrome, and pain syndrome are the main symptom clusters. Symptom cluster management is an effective means to reduce lenvatinib-related AEs leading to treatment termination.

Objective: To classify the characteristics of circadian type among clinical nurses and examine their relationships with presenteeism and work-related flow. Methods: Using a cross-sectional design, 568 nurses were recruited through convenience sampling in January 2021 from three hospitals in Shandong Province, China. The data were collected using self-report measures, including the 11-item Circadian Type Inventory, Stanford Presenteeism Scale-6, and Work-Related Flow Inventory. Latent class analysis was performed to identify any clustering of circadian types. One-way analysis was performed to compare the differences between presenteeism and work-related flow in different circadian types. Results: Four latent classes were identified, including high response class (14.4%), high flexible class (20.1%), high languid class (51.1%), and low response class (14.4%). Regarding presenteeism, the high languid class had higher scores than others. Regarding work-related flow, the scores of high flexible class were higher than those of high languid class, while the differences in all three dimensions were statistically significant. Conclusion Although the shift work mode is not expected to change, nursing managers could use circadian type as a predictive index to select and employ individuals for shift work to enhance work performance and provide sufficient support to staff who are intolerant to shift work.

Objective To explore the susceptible factors of fever and infection among hepatocellular carcinoma (HCC) patients who received cryo-ablation (CA) therapy,and to propose intervention countermeasures accordingly.Methods The fever and infection status of totally 428 HCC patients who received CA therapy was examined systematically;then the influencing factors were analyzed by single factor analysis and logistic regression analysis;and finally,nursing strategies were proposed accordingly.Results Totally 229 patients developed fever (53.5%),and 6 suffered from complicated infection (1.4%) after CA therapy;tumor size,CA area,Child-Pugh classification and preoperative leukocyte level were factors that contributed to the fever of HCC patients who received CA therapy.Conclusions We should attach importance to the susceptible factors of fever and infection among HCC patients who received CA therapy,and scientific intervention and nursing are the key to reducing the possibilities of fever and infection among patients who received CA therapy.

BACKGROUND:Hepatocyte transplantation has attracted more and more attention as a therapeutic measure for liver failure and genetic metabolic liver diseases.OBJECTIVE:TO evaluate the efficacy and safety of human hepatocyte transplantation in treating hepatitis B related liver failure in one case by a 2-year follow-up.DESIGN:A case-report of 2-year follow-up.SETTING:No.9 Department of Infectious Diseases,Bioengineering Research Room,the 302 Hospital of Chinese PLA.PARTICI PANT:One inpatient with hepatitis B related liver failure was selected from the 302 Hospital of Chinese PLA.and she was diagnosed according the laboratory tests.The transplanted hepatocytes were originated frOm the healthy liver of a 24-year-old man,who had signed the protocol for liver donation before death.METHODS:The hepatocyte transplantation was completed in the Department of Radiology,the 302 Hospital of Chinese PLA in December 2004.Liver was isolated to obtain human primary hepatocytes, and then cryopreserved.The hepatocytes were transplanted into recipient spleen via femoral vein after resuscitation.The clinical symptoms,changes of blood biochemical indexes,and changes of spleen MRI signals were observed before and after operation.The patient was reexamined every half a year after operation, including liver function, blood coagulation function,B-mode ultrasonography,gastroscopy and MRI,and she was followed up for 2 years. MAIN OUTCOME MEASURES:Liver function,blood coagulation function, imaging indexes, immunological indexes,complication and rejection.RESULTS:①Totally(1-2)×1010 hepatocytes were harvested,and the viability of rewarmed hepatocytes was 60%,and finally 2×109 hepatocytes were transplanted.②Two months later,the clinical symptoms of the recipient were obviously ameliorated,and serum bilirubin and aspartate aminotransferase(AST)were obviously decreased,while prothrombin activity was markedly increased.20 months later,the MRI results showed that there was hepatocyte image in spleen.Two years after operation.the total bilirubin level was 20 μmol/L,direct bilirubin level was 7 μmol/L, alanine aminotransferase was 416.75 nkat/L,AST was 533.44 nkat/L,albumin was 37 g/L,prothrombin activity was 90%,which were all obviously ameliorated as compared with those before operation(474.5 μmol/L,340.3 μmol/L,400.08 nkat/L,1 200.24 nkat/L,38 g/L,25%).The patient left the hospital 2 months later and could do light-burdened job.No complications of hydroperitonia and liver function failure, etc.were observed,and no rejection occurred.Several reexaminations by B-mode ultrasonography all indicated the further aggravations of liver cirrhosis and esophageal varices.She was admitted to hospital for twice because of esophageal varices bleeding,and cured by endoscopic variceal sclerosis therapy.CONCLUSION:Hepatocyte transplantation can ameliorate liver function without rejection,but it cannot relieve portal hypertension.

Objective:To detect the status of PIK3CA in triple-negative breast cancer (TNBC) , and to analyze the relationships between PIK3CA mutation and clinical features and its impact on prognosis.Methods:From January 1, 2016 to December 31, 2018, 50 patients with primary TNBC admitted to Xinxiang Central Hospital of Henan Province were collected. The PIK3CA mutation status was detected, and the relationships between PIK3CA mutation and clinical characteristics of patients with TNBC and its impact on prognosis were analyzed.Results:PIK3CA gene mutation was detected in 9 of 50 TNBC patients, with a mutation frequency of 18.0%. H1047R mutation was found in 4 cases, E545K mutation in 3 cases and E542K mutation in 2 cases. PIK3CA gene mutation was not associated with age ( χ2=3.55, P=0.060) , tumor location ( χ2=1.01, P=0.315) , tumor size ( χ2<0.01, P>0.999) , lymph node status ( χ2=0.76, P=0.385) , clinical stage ( χ2=0.65, P=0.420) , Ki-67 value ( χ2<0.01, P>0.999) , P53 status ( χ2=0.02, P=0.894) and human epidermal growth factor receptor-2 (HER-2) status ( χ2=1.65, P=0.200) . Prognostic analysis showed that 3-year disease-free survival rates of wild-type PIK3CA patients was significantly higher than that of mutant PIK3CA patients (80.5% vs. 11.1%, χ2=28.23, P<0.001) . Conclusion:The frequency of PIK3CA gene mutation is higher in TNBC patients. There is no correlation between PIK3CA mutation and clinicopathologic features in TNBC patients. PIK3CA gene mutation may be significantly associated with poor prognosis of TNBC patients.

ABSTRACT:Objective To assess the effect of nurse intervention of urea-based cream (UBC)on sorafenib-induced hand-foot skin reaction (HFSR)in patients with advanced hepato-cellular carcinoma(HCC).Methods 202 advanced HCC patients were randomly divided into 2 groups.101 patients in the urea-based cream group were applied with 10% UBC three times dai-ly and best nursing while 110 patients in the control group were applied basic nursing alone.The treatment lasted for 12 weeks.HFSR was assessed every 2 weeks.Once HFSR occurred,patients were allowed any cream,including UBC.Results After the nursing,the incident rate of HFSR and incidence of grade ≥2 HFSR in the UBC group were lower that than in the BNC group.The Median time to first occurrence of HFSR was 1.63 times of UBC group.UBC did not affect the adjustment of sorafenib dose,response or disease control.Conclusion UBC nurse intervention of advanced HCC patients could reduce HFSR rate,extend the time of first occurrence of HFSR and improve the quality of life of patients.

Objective To evaluate the performance of magnetic resonance imaging(MRI)multi-sequence feature imputation and fusion mutual model based on sequence deletion in differentiating high-grade glioma(HGG)from low-grade glioma(LGG).Methods We retrospectively collected multi-sequence MR images from 305 glioma patients,including 189 HGG patients and 116 LGG patients.The region of interest(ROI)of T1-weighted images(T1WI),T2-weighted images(T2WI),T2 fluid attenuated inversion recovery(T2_FLAIR)and post-contrast enhancement T1WI(CE_T1WI)were delineated to extract the radiomics features.A mutual-aid model of MRI multi-sequence feature imputation and fusion based on sequence deletion was used for imputation and fusion of the feature matrix with missing data.The discriminative ability of the model was evaluated using 5-fold cross-validation method and by assessing the accuracy,balanced accuracy,area under the ROC curve(AUC),specificity,and sensitivity.The proposed model was quantitatively compared with other non-holonomic multimodal classification models for discriminating HGG and LGG.Class separability experiments were performed on the latent features learned by the proposed feature imputation and fusion methods to observe the classification effect of the samples in two-dimensional plane.Convergence experiments were used to verify the feasibility of the model.Results For differentiation of HGG from LGG with a missing rate of 10%,the proposed model achieved accuracy,balanced accuracy,AUC,specificity,and sensitivity of 0.777,0.768,0.826,0.754 and 0.780,respectively.The fused latent features showed excellent performance in the class separability experiment,and the algorithm could be iterated to convergence with superior classification performance over other methods at the missing rates of 30%and 50%.Conclusion The proposed model has excellent performance in classification task of HGG and LGG and outperforms other non-holonomic multimodal classification models,demonstrating its potential for efficient processing of non-holonomic multimodal data.