Objective To explore the curative effect and safety of of Entecavir ( ETV) combined Liuweiwul-ing Pian in the treatment of chronic hepatitis B patients with HBeAg +.Methods 124 patients according to the ran-dom number table were divided into the two groups ,which respectively used ETV combined Liuweiwuling Pian treat-ment and ETV.The liver function and index of viral replication of the two groups were compared .Results The effec-tiveness of the observation group was 91.94%,which of the control group was 82.26%,the difference between the two groups had statistical significance(Ridit=32.251,P=0.000);Since 24 week treatment,HBV DNA of the observa-tion group was lower than the control group,the difference was statistically significant (t =2.365,4.595,all P<0.05);After treatment,ALT,AST of the observation group decreasing degree was higher than the control group ,the difference was statistically significant (t=78.512,62.145,all P<0.05);after treatment,the ALT rate,effective rate and bounce rate in the two groups was statistically significant differences (χ2 =25.621,46.241,11.512, all P<0.05);After treatment,the HBV DNA and HBeAg positive in two groups was below cut-off test cases,differences was statistically significant(χ2 =17.265,21.264,all P<0.05).Conclusion Entecavir combined Liuweiwuling Pian in the treatment of chronic hepatitis B patients with HBeAg +can reduce liver fibrosis , and has obvious detoxification and anti-viral.

Objective To explore the relationship between nonalcoholic fatty liver (NFALD)and apolipoprotein E (ApoE)gene polymorphism in Shanghai undergraduate students. Methods A cross-sectional survey was performed in 4 148 students from Shanghai Tongji University. Quesgionary, physical measurement, ultrasonography and biochemical parameters were used to diagnose NFALD. In patients with NAFLD and 200 healthy subjects (served as control), ApoE genotypes were determined by PCR-RFLP. Results (1)Totally 398 subjects were diagnosed as NAFLD (prevalence 9.6%). Body mass index, waist-to-hip ratio, triglycerides, total cholesterol, alanine transaminase, aspartate aminotransferase and γ-glutamyltransferase in NAFLD group were higher than those in control, which were related to the degree of NAFLD (P＜0.01). (2)ApoE genotypes distributions were significantly different between two groups (χ2=10.52, P＜0.01). In NAFLD,E4/4 genotype frequency (5.5%)increased, and E3/3 (61.8%)decreased . (3)Unconditional logistic regression showed that E4/4 were closely associated with lipid profiles. Conclusion ApoE point mutations 112 and 158 may cause different dyslipidosis. E4/4 genotype seems to be one of the genetic predisposition factors of NAFLD.

Objective:To analyze the expression of histone methyltransferase SETD1A and SETD5 in breast cancer and its correlation with the clinicopathological characteristics of patients.Methods:A total of 80 breast cancer patients were included in the study. GSCA website screened SET domain family members, predicted their expression in breast cancer tissues, and verified them with immunohistochemical SP method. Chi-square test and Logistic regression model were used to analyze the correlation between SETD1A, SETD5 and clinicopathological characteristics of patients.Results:The GSCA website showed that the expressions of SETD1A and SETD5 of the SET domain family were up-regulated in breast cancer tissues compared with normal tissues (all P<0.05). Immunohistochemical SP method showed that the positive expression rates of SETD1A and SETD5 in breast cancer tissues were 73.8% and 68.8% respectively, which were significantly higher than the positive expression rates of SETD1A and SETD5 in paracancerous tissues 38.8% ( χ2=19.91, P<0.001) and 32.5% ( χ2=21.03, P<0.001). Chi-square test results showed that the expression of SETD1A was significantly correlated with lymph node metastasis and vascular invasion, and the expression of SETD5 was significantly correlated with nerve invasion (all P<0.05). Logistic regression model showed that SETD1A expression was correlated with lymph node metastasis ( OR=0.07, 95% CI: 0.01-0.25, P<0.001) and molecular type ( OR=0.04, 95% CI: 0.00-0.48, P=0.022), SETD5 expression was correlated with neural invasion ( OR=6.41, 95% CI: 1.45-46.65, P=0.029) . Conclusion:The expressions of histone methyltransferases SETD1A and SETD5 are up-regulated in breast cancer tissues, and they are correlated with pathological features such as lymph node metastasis, vascular invasion, and neural invasion.

This paper searches and summarizes related concepts of quality control circle and its application situation in the field of nursing in China,describes the existing problems and solution.This paper offers references for improving the quality management of nursing.

Objective To study the morphologic features,immunophenotype and significance of expression of JAZF1-SUZ12 and YWHAE-FAM22 fusion genes in endometrial stromal sarcoma (ESS).Methods Fifty-three cases of ESS were retrieved and the pathologic features were reviewed.Immunohistochemical study for estrogen receptor,progesterone receptor,CD10,cyclin D1,smooth muscle actin,desmin and H-caldesmon were carried out using tissue microarray technology.Reverse transcriptionpolymerase chain reaction (RT-PCR) was applied for detection of expression of JAZF1-SUZ12 and YWHAEFAM22 fusion genes in 47 cases of ESS and 12 cases of other spindle cell neoplasia in uterus (including 2 cases of undifferentiated sarcoma,3 cases of leiomyosarcoma,3 cases of leiomyoma,4 cases of adenosarcoma and 2 cases of uterine tumor resembling ovarian sex cord tumor).Results The 53 cases of ESS studied included 43 cases of low-grade ESS and 10 cases of high-grade ESS.As for low-grade ESS,in addition to the classic morphologic features,smooth muscle differentiation was present in 7 cases (16.3％),sex cord-like differentiation in 2 cases (4.7％),rhabdoid differentiation in 1 case (2.3％),clear cellchanges in 1 case (2.3％) and schwannoma-like palisading pattern in 1 case (2.3％).As for high-grade ESS,sex cord-like differentiation (1 case),mucinous microcystic changes (1 case) and focal clear cell changes (1 case) were also observed.The expression rate of estrogen receptor,progesterone receptor,CD10,cyclin D1,smooth muscle actin,desmin and H-caldesmon was 86.0％,81.4％,74.4％,2.3％,23.3％,23.3％ and 4.7％ in low-grade ESS,respectively,and was 1/10,6/10,6/10,7/10,1/10,1/10 and 0 in high-grade ESS,respectively.RNA extraction was successful in 47 cases of ESS,including 39 cases of low-grade ESS and 8 cases of high-grade ESS.The positive rate of JAZF1-SUZ12 fusion gene was 30.8％ (12/39) in low-grade ESS.The positive rate of YWHAE-FAM22 fusion gene was 12.5％ (1/8) in high-grade ESS.The 14 control cases were all negative for JAZF1-SUZ12 and YWHAE-FAM22 fusion genes.Conclusions As uncommon pathologic pattern may occur in both low-grade ESS and high-grade ESS,detection of JAZF1-SUZI and YWHAE-FAM22 fusion genes by RT-PCR would be helpful in diagnosis and differential diagnosis of ESS,especially for those tumors which lack typical morphologic features.

Objective:To explore the clinical training needs for postgraduates with master's degree in oral nursing based on job competency, so as to provide a basis for improving the postgraduate training system and enhancing the job competency of postgraduates with master's degree in oral nursing.Methods:This study was descriptive and qualitative. From March to April 2023, purposive sampling was used to select 8 postgraduates with master's degree in oral nursing for semi-structured in-depth interviews. The targeted content analysis method was used for data sorting and analysis.Results:The clinical training needs for postgraduates with master's degree in oral nursing based on job competency were summarized into four themes and 13 sub-themes, namely self-awareness (understanding of oral nursing, understanding of postgraduates with master's degree in oral nursing, understanding of the current training model for postgraduates with master's degree in oral nursing), ability traits (self-learning ability, reform and innovation ability, interpersonal communication ability), learning motivation (self-improvement, career development, serving society), and clinical training needs (theoretical knowledge, skill operation, scientific research and innovation ability, evidence-based practice ability) .Conclusions:Universities should collaborate with hospitals to develop clinical training plans and carry out theoretical and practical education for postgraduates with master's degree in oral nursing, and pay attention to the cultivation of the research innovation and evidence-based practice abilities of postgraduates with master's degree in oral nursing, in order to help them further improve their job competency.

Objective:To analyze the current status, development trends, and gaps in studies on symptom clusters in patients with head and neck tumors using bibliometric methods.Methods:Relevant literature on symptom clusters in patients with head and neck tumors was retrieved from databases including China National Knowledge Infrastructure, WanFang data, China Biology Medicine disc, Web of Science Core Collection, PubMed, and Scopus. A visual analysis of the literature content was conducted.Results:A total of 37 studies were included. The studies primarily focused on patients with nasopharyngeal carcinoma. Symptom clusters in patients with head and neck tumors demonstrated dynamic variability. Emerging trends in this field include nutrition-related symptom clusters, symptom interventions, and the identification of core symptoms. However, current studies still exhibit limitations, such as using singular research tools and clustering methods and a lack of exploration of internal mechanisms.Conclusions:Future research should focus on improving study design through multidisciplinary collaboration, utilizing data mining techniques to systematically explore the internal mechanisms of symptom clusters in patients with head and neck tumors, identifying symptom intervention targets, and conducting high-quality intervention studies to verify the reliability and effectiveness of these targets and interventions.

Objective This study aimed to investigate the incidence and severity of surgical fear in patients with oral and maxillofacial tumors.Methods The survey participants were composed of patients with oral and maxillofacial tu-mors,who were scheduled to undergo surgery.A general information questionnaire,the Surgical Fear Questionnaire(SFQ),the Patient Health Questionnaire(PHQ)-9,and the Generalized Anxiety Disorder(GAD)-7 score were used for the investigation.Results A total of 203 patients were investigated.Among them,85.22%had fear of surgery.The me-dian score of SFQ was 20,and the quartile was(6,36).The patients were categorized into none,mild,moderate,and severe groups according fear level.Gender,diabetes,obvious discomfort before surgery,PHQ-9,and GAD-7 scores were the variables with statistical difference in each fear level.Multifactor analysis showed that women were more likely to have moderate and severe fear than men(OR=2.19,P=0.03;OR=2.72,P=0.01),patients with obvious preoperative discomfort symptoms were more inclined to have no fear(OR=4.73,P=0.02),and patients with diabetes were more likely to have severe fear(OR=3.33,P=0.02).The incidence rates of depression and anxiety were 31.03%and 24.63%,respectively.The incidence of anxiety and de-pression in patients with severe fear was 40.00%.Surgical fear was moderately positively correlated with anxiety(r=0.491,P<0.001)and depression(r=0.514,P<0.001).Conclusion The fear of surgery in patients with oral and maxillo-facial tumors is common and distributed in all levels.Medical staff can screen and assess patients with moderate and se-vere fear of surgery in accordance with the influencing factors and implement targeted interventions to reduce fear of sur-gery,anxiety,and depression on the basis of the source of fear.