OBJECTIVE: To determine the content of lomustine in mouse tumor tissue. METHODS: Lomustine was separated and determined on a reverse-phase C18 5um column with a mobile phase of acetonitrile-H2O(54 : 46), detected at 254nm and no internal standard. RESULTS: The ca[ibration curve was 1ineaI(r = 0. 9 999) within the range of 0. 98- 15. 68ug/ml for lomus tine. The recovery ratio of lomustine was 68. 64% (n = 9). The relative standard deviation(RSD) was 0. 32%. CONCLUSION: This method is simple and accurate

Objective To investigate the effects of ramipril on nitric oxide(NO) concentration and endothelial nitric oxide synthase(eNOS) activation in lung of rats with pulmonary arterial hypertension induced by monocrotaline(MCT).Methods Sixty Sprague-Dawley rats were randomly divided into three groups: normal control group,MCT group and ramipril group.Rats in MCT group and ramipril group were subcutaneously injected with 60mg/kg of MCT.Then the rats in ramipril group received ramipril gavage and rats in MCT group received normal saline gavage for 4 weeks,respectively.Rats in control group were subcutaneously injected with normal saline first and then received normal saline gavage for 4 weeks.Right ventricular systolic pressure(RVSP) and right ventricle hypertrophy index(RVHI) were measured.The ratio of arteriol wall thickness/vascular external diameter(WT%) and wall area percentage(WA%) were evaluated.NO concentration in lung was determined.eNOS,P-Ser1177-eNOS and Akt phosphorylation were analyzed by Western blotting.Results The RVSP,RVHI,WT%,WA% were significantly increased,and NO concentration,the level of eNOS,P-Ser1177-eNOS,the state of Akt phosphorylation were significantly decreased in MCT group compared with that in control group(P

Objective:To systematically review the relationship between PTGER 4 genetic polymorphisms and the risk of inflam-matory bowel disease (IBD).Methods:All eligible case-control studies which published up to February 29,2016 were searched by PubMed,Embase,Web of Science.The studies in accordance with high quality were included in this study .We synthesized pooled odds ratio ( OR) and its 95%confidence interval ( CI) using STATA12.0.The sensitivity analysis was used to determine the stability of re-sults in meta-analysis.The Egger′s analysis was performed to evaluate the publication bias .Results:Twenty original publications invol-ving 44 case-control studies were included in this study ,in which 25179 patients with Crohn′s disease (CD),5261 patients with ulcer-ative colitis ( UC) and 44652 control subjects were detected .The allelic frequency ,additive model ,dominant model and recessive mod-el were used to analyze the association of rs 4613763 T/C polymorphism and CD ,and the pooled OR and 95%CI were as followings:1.24 (1.06-1.45),1.32 (1.06-1.64),1.25 (1.06-1.48),1.28 (1.03-1.59).For rs17234657T/G polymorphism and CD,the pooled OR (95%CI) of four genetic models were 1.35 (1.28-1.47),2.12 (1.70-2.63),1.46 (1.36-1.57) and 1.90 (1.54-2.35),re-spectively.For rs4495224A/C polymorphism and CD,the pooled OR(95%CI) were 1.05 (0.79-1.41),1.08 (0.62-1.88),1.12 (0.75-1.65) and 1.00 (0.67-1.49).And the pooled OR (95%CI) were 0.77 (0.67-0.88),0.59 (0.51-0.69),0.73 (0.61-0.87),0.68 (0.59-0.79) for rs9292777G/T polymorphism and CD.For rs1373692T/G polymorphism and CD,the pooled OR (95%CI) were 1.23 (0.96-1.57),1.39 (0.74-2.59),1.26 (0.74-2.13),1.31 (1.00-1.72).The pooled OR (95%CI) of allelic fre-quency , additive model , dominant model and recessive model for the association of rs 4613763 T/C polymorphism with UC were 1.30 (1.17-1.44 ), 1.73 ( 1.16-2.59 ), 1.32 ( 1.17-1.48 ), 1.64 ( 1.10-2.45 ), respectively.Conclusion: Polymorphisms of rs17234657T/G,rs4613763T/C and rs9292777G/T are associated with CD.Polymorphism of rs4613763T/C is associated with UC sus-ceptibility.

Objective To evaluate the influence of Jinsanzhen therapy (A 3-point acupuncture method created by prof.JIN) on the motor function and activities of daily life of the apoplectic hemiplegia patients.Methods Totally 135 apoplectic hemiplegia patients were randomized into three groups:Jinsanzhen group,Rehabilitation group,and Jinsanzhen plus rehabilitation group,with 45 cases in each.The degree of hemiplegia motor function and activities of daily life of the patients was assessed with Fugl-Meyer assessment (FM) and Barthel index before,14 and 28 days after treatment.Results After 14 and 28 days' treatment,the FM value and Barthel index score of all the three groups are significantly increased (P

Objective To explore clinical observation of the effect of severe blepharoptosis correction with modified frontalis muscle suspension.Methods Thirty three cases (41 eyes) with congenital severe blepharoptosis were treated with modified frontalis muscle suspension,and the operative effect was analyzed retrospectively.Double eyelid incision and concealauxiliary incision on partial-bitamporal of the superciliary arch were adopted.After taking the frontal muscle flap crossed through the subcutaneous tunnel between two incisions and fixed on the superior tarsus.Closed palpebral fissure with suture method after adjustment was satisfied.Results At 1 ～ 24 (9.76 ± 5.15) months post-operatively,all incisions of 33 cases were primary healing,eyelid radian satisfaction and no corneal exposure complication occurrence.The early postoperative reaction was mild,while only 1 case discovered subcu-taneoushematoma in superciliary arch.The satisfactory corrections were 30 cases,which undercorrections were 2 cases and 1 case was over correction.No palpebral and exposed keratotitislong-tern complication was found.Conclusions The operation of modified frontalis muscle suspension is satisfactory,safe and effective with little complications and less injury in intraoperative.

Objective To evaluate the effect about medication compliance for patients with chronic heart failure in outpatients using nursing intervention model based on Omaha system.Methods 100 patients were randomly divided into observation group(50 patients)and control group(50 patients).The two groups of patients were given routine nursing intervention,the observation group also used the Omaha system to develop care programs on this basis, and was given the implementation about continuity of care.Results On the point of the two or three months after the patients were discharged,the AHFKT -V2 questionnaire scores in the observation group[(17.690 ±1.892)points, (20.900 ±2.052)points]were significantly higher than the control group[(14.080 ±2.374)points,(18.450 ± 1.781)points],the differences were statistically significant (t =-8.488,-6.442,all P <0.05).However,the same as the points after the patients were discharged,Morisky questionnaire scores in the observation group[(1.036 ± 0.780)points,(0.487 ±0.260)points]were significantly lower than the control group[(1.54 ±1.182)points, (0.920 ±0.804)points],the differences were statistically significant(t =3.420,4.965,all P <0.05).Conclusion The use of Omaha system to develop the targeted continuity of care,can improve the patients medication compliance.

Objective:To explore the influences of neutrophilic granule protein (NGP) on nitric oxide (NO) production in lipopolysaccharide (LPS)-induced macrophages and the regulatory mechanism.Methods:NGP highexpression RAW264.7 cells (NGP/RAW) and negative control empty vector cells (NC/RAW), NGP knockout RAW264.7 cells (NGP KO/RAW) and wild-type cells (WT/RAW) were cultured in vitro. Cells in logarithmic phase were stimulated with 10 mg/L LPS (LPS group) or phosphate buffered saline (PBS group) respectively. The content of NO in the supernatant was detected by Griess method. The mRNA expression of inducible nitric oxide synthase (iNOS) was detected by quantitative reverse transcription-polymerase chain reaction (RT-qPCR). The protein expressions of iNOS and phosphorylated signal transducer and activator of transcription 1 (p-STAT1) were detected by Western blotting.Results:Compared with PBS group, iNOS mRNA and NO expression were significantly increased at different time after LPS stimulation, the mRNA expression of iNOS peaked at 12 hours after LPS stimulation (2 -ΔΔCt: 38.45±1.34 vs. 1.00±0.00 in NC/RAW cells, 56.24±2.41 vs. 1.45±0.30 in NGP/RAW cells, 37.84±1.52 vs. 1.00±0.00 in WT/RAW cells, 5.47±0.62 vs. 0.98±0.40 in NGP KO/RAW cells, all P < 0.05), and the production of NO peaked at 24 hours after LPS stimulation (μmol/L: 24.15±1.26 vs. 0.15±0.04 in NC/RAW cells, 58.80±2.11 vs. 0.18±0.02 in NGP/RAW cells, 25.04±1.80 vs. 0.16±0.02 in WT/RAW cells, 2.42±0.38 vs. 0.12±0.03 in NGP KO/RAW cells, all P < 0.05). After being stimulated by LPS, the expression of iNOS mRNA and NO in NGP/RAW cells were increased significantly compared with NC/RAW cells [iNOS mRNA (2 -ΔΔCt): 8.42±0.59 vs. 4.63±0.37 at 2 hours, 27.16±1.60 vs. 14.25±1.02 at 6 hours, 56.24±2.41 vs. 38.45±1.34 at 12 hours; NO (μmol/L): 4.12±0.25 vs. 2.23±0.17 at 6 hours, 16.50±1.52 vs. 6.35±0.39 at 12 hours, 58.80±2.11 vs. 24.15±1.26 at 24 hours, all P < 0.05]. At the same time, the protein expressions of p-STAT1 and iNOS were also significantly enhanced (p-STAT1/GAPDH: 4.26±1.84 vs. 1.00±0.32 at 0 hours, 20.59±4.97 vs. 0.93±0.21 at 2 hours, 141.99±10.99 vs. 11.17±2.11 at 6 hours; iNOS/GAPDH: 1.27±0.86 vs. 1.00±0.22 at 0 hours, 7.94±1.94 vs. 2.01±0.92 at 2 hours, 24.24±4.88 vs. 3.72±1.11 at 6 hours, all P < 0.05), indicating that NGP might increase the expression of iNOS by promoting the phosphorylation of the signal transducer and activator of transcription 1 (STAT1) pathway, thereby increasing the production of NO. After being stimulated by LPS, the expression of iNOS mRNA and NO in NGP KO/RAW cells were significantly lower than that of WT/RAW cells [iNOS mRNA (2 -ΔΔCt): 2.46±0.31 vs. 4.22±0.18 at 2 hours, 3.61±0.44 vs. 13.02±1.34 at 6 hours, 5.47±0.62 vs. 37.84±1.52 at 12 hours; NO (μmol/L): 1.22±0.19 vs. 2.01±0.12 at 6 hours, 1.60±0.44 vs. 5.15±0.62 at 12 hours, 2.42±0.38 vs. 25.04±1.80 at 24 hours, all P < 0.05]. It showed that iNOS activation was reduced after NGP knockout, which in turn reduced NO production. Conclusion:NGP can positively regulate NO production in activated macrophages by activating the STAT1/iNOS pathway.

Objective: To explore the effect of enterostomy on analgesic pattern in advanced digestive tract cancer. Methods: A retrospective cohort study was carried out, which was approved by the Ethics Committee of the Sixth Affiliated Hospital of Sun Yat-sen University (E2018026). Inclusion criteria were as follows: (1)age and gender were not limited; (2) all the gastrointestinal malignancies were confirmed histologically, and local recurrence or metastasis were confirmed by CT or MR; (3) numerical rating scale (NRS) ≥4 points, opioid analgesic drugs were required; (4) informed consents were signed by patients of their own. Exclusion criteria were as follows: (1) malignancies of early stage; (2) suspicious adverse mental states which might lead to poor administration compliance; (3) hypersensitivity or allergic reactions to opioids. Clinical data of patients with advanced gastrointestinal cancer receiving comprehensive treatment at the Medical Oncology Department of the Sixth Affiliated Hospital of Sun Yat-sen University from September 2016 to April 2017 were retrospectively collected. The patients were divided into the stoma group and the non-stoma group. The clinical findings of two groups were analyzed, including age, sex, ostomy status, pain location, presence or absence of intestinal obstruction, pain characteristics, selection of opioid analgesic agents, treatment of side effects of analgesics. Pain was assessed using brief pain inventory(BPI) table and NRS score. Strong opioids were prescribed for patients of NRS ≥4. Patients who were intolerant to opioids required opioid titration. The titration drugs included oral or IV morphine and oxycodone. After achievement of adequate pain control, long-acting opioids were administered, which included sustained-release morphine tablets, controlled release oxycodone and transdermal fentanyl. Criteria for pain relief included NRS≤3, breakthrough pain <3 times/day and duration of adequate pain control >3 days. The χ² test and the Wilcoxon signed rank sum test (nonparametric test) were used to analyze the clinical features of patients in the stoma and non-stomach groups. In order to find the factors associated with maintenance therapy and the use of laxatives, the variables were compared as well as in multivariate analysis with multiple regression models. For all the statistical tests, a value of P<0.05 in a two-tailed test was established as the alpha significance level. Result: A total of 123 patients were enrolled in this study, including 79 males (64.2%) and 44 females (35.8%) with a median age of 51 years. Fifty-two patients were in stoma group, including 30 (24.4%) of ileostomy and 22 (17.9%) of colostomy, and 71 patients were in non-stoma group. Pain of 40 (76.9%) patients in stoma group located in abdomenopelvic site while the pain of 44 (62.0%) patients in non-stoma group located in other sites. Compared with non-stoma group, cases in stoma group complained more abdominopelvic pain (73% vs. 62.0%, P<0.001).The median NRS pain score before treatment in the stoma group and the non-stoma group was 5.7 and 5.6, respectively, without statistically significant difference (P=0.741). After analgesic management, the above scores reduced to 2.1 and 2.3, respectively, without statistically significant difference as well (P=0.092). Analgesic treatment was effective in 111 cases (90.2%), including 49 cases (94.2%) in the stoma group, and 62 cases (87.3%) in the non-stoma group, and there was no statistically significant difference between the two groups (P=0.202). There was more application of fentanyl transdermal patch [34.6%(18/52) vs. 9.8%(7/71)] in the stoma group, while more application of lactulose laxative [78.9%(56/71) vs. 61.5%(32/52)](χ²=10.023, P=0.002) in the non-stoma group. Multivariate analysis revealed that ostomy (OR=0.290, 95%CI: 0.102-0.824, P=0.009) and pain site (OR=5.691, 95%CI:1.709-18.948, P=0.005) were independent factors affecting the choice of the first line opioid sustained release agent. Of the 123 patients with maintaining analgesia, 98 had available data of laxative use, of whom 46 used laxatives to prevent or treat constipation, and the proportion of laxatives in stoma group (21.2%, 11/52) was significantly lower than that in non-stoma group (49.3%, 35/71) (χ²=6.957, P=0.008). Multivariate analysis of the application of laxative use showed that age (OR=0.281, 95% CI: 0.123-0.684, P=0.010) and ostomy (OR=2.621, 95% CI: 1.033-6.687, P=0.045) were independent factors affecting the use of lactulose laxatives. Conclusions Enterostomy may affect the analgesic pattern in advanced digestive tract cancer. Patients with stoma are more likely to use fentanyl transdermal patches and younger patients with stoma do not need prophylactic use of laxatives.

Objective To establish management programs for hypothermia in trauma patients in emergency department,so as to guide clinical nursing practice and provide references for scientific management of post-traumatic hypothermia.Methods The first draft of management prograns was established by retrieval of trauma-related guidelines and original studies at home and abroad.Two rounds of expert consultation were conducted via Delphi method to finalize the management programs.Results The management programs consisted of 4 first-level items (hypothermia related assessment,prevention and graded intervention,evaluation,coordination with the team),15 second-level items and 36 third-level items.The expert authority scores of two rounds were 0.85 and 0.86.The expert coordination coefficients at all levels ranged between 0.257 and 0.347.Conclusion There were high levels of enthusiasm,authority and team coordination in experts.The management programs can be used as a basis for comprehensive evaluation and scientific management for hypothermia in trauma patients.

Objective:To study the roles of hepatoma-derived growth factor (HDGF), vascular endothelial growth factor (VEGF) and mucin 5B (MUC5B) in hepatolithiasis associated with intrahepatic cholangiocarcinoma (HICC).Methods:The clinical data and tissue specimens of 116 patients who underwent hepatectomy at the Third Affiliated Hospital of Wenzhou Medical University from October 1999 to October 2019 were retrospectively analyzed. There were 41 patients with HICC (the HICC group), 38 patients with intrahepatic cholangiolithiasis (the intrahepatic cholangiolithiasis group), and 37 patients with benign liver tumor who underwent hepatectomy (the control group). There were 47 males and 69 females, with age of (66.1±3.2) years old. The positive expressions of HDGF, VEGF and MUC5B in the three groups were compared. In 41 patients with HICC, the correlation between positive expressions of HDGF, VEGF and MUC5B with patients’ clinical characteristics were studied.Results:Compared with the control group, the positive expression rates of HDGF, VEGF and MUC5B in the HICC group and the intrahepatic cholangiolithiasis group were significantly increased, ( P<0.05). Compared with the intrahepatic cholangiolithiasis group, the positive expression rates of HDGF, VEGF and MUC5B in the HICC group were significantly increased ( P<0.05). Positive expression of VEGF in HICC patients was correlated with tumor differentiation, tumor local invasion, tumor length, tumor stage, tumor carbohydrate antigen CA19-9 level and lymph node metastasis ( P<0.05). Spearman correlation analysis showed that HDGF was positively correlated with VEGF expression in HICC tissues specimens ( r=0.935, P<0.01). Survival analysis showed that the cumulative survival rates (36.7%, 17.1%, 7.3%) of patients with positive expression of VEGF were significantly lower than that of patients with negative expression (51.2%, 26.8%, 19.5%) at 1, 3, 5 years after surgery ( P<0.01). The cumulative survival rate (34.1%, 17.1%, 4.9%) of patients with MUC5B positive expression were significantly lower than that of patients with negative expression (53.7%, 31.7%, 17.1%) at 1, 3, 5 years after surgery ( P<0.01). Conclusion:HDGF can be used as a reference indicator for early assessment of HICC. Overexpressions of VEGF and MUC5B can be used as important indicators for HICC in evaluating disease progression and prognosis.