Objectives　To evaluate prospectively the bone markers of serum osteocalcin (BGP),bone-specific alkaline phosphatase (BAP),C-terminal peptide of type I collagen (CICP),urinary pyridinoline (PYD),urinary calcium to creatinine value (uCa/Cr),and hydroxyprolin to creatinine ratio (uHOP/Cr),and to assess their responsiveness to subtle changes of bone metabolism,and furthermore to compare which of the bone markers are more sensitive to estrogen shortage caused by menopause.Methods　Markers of above bone formation and bone resorption were measured in 146 women classified into three groups: group I: 51 normal premenopausal women,group II:42 postmenopausal women,and group III: 53 bilateral ovariectimized women.Correlation analysis was made between these indexes and bone mineral density (BMD).Results　The mean values of the four bone markers of BGP,BAP,CICP,PYD in group II and III were significantly higher than those in group I (P<0.05).All correlations between the biochemical markers of BGP,BAP,CICP and PYD for bone turnover were highly significant and exhibited a significant connection to BMD.The best correlation was found between BGP and PYD,BGP and BAP.However,the levels of Ca/Cr and HOP/Cr made no difference in the three groups,and there was no correlation with any other indexes.Conclusion　In postmenopausal women (natural menopause and surgical menopause) suffering from severe E2 dificiency,BGP,BAP,CICP and PYD are significantly increased,indicating a clear correlation between E2 diffciency and these markers of bone turnover,so they are clinically useful in the assessment of bone turnover during changes of the estrogen status that modify the metabolic activity of the skeleton.But the traditional markers of Ca/Cr and HOP/Cr have limitations in gynecological practice because of lack of sensitivity and specificity.

Objective To investigate the factors affecting the stability of the volatile oil extracted fromYinqiaosan Decoction.Methods The main chemical compositions and the extraction repetitiveness of the compound volatile oil were determined by GC-MS, and the stability of multiple extracted volatile oil was studied. Absorbance of the compound volatile oil was used as the evaluation index, and the factors affecting the stability of the of the compound volatile oil were investigated, such as illumination, temperatures and pH values of volatile oil solution and metal ions.Results The results of the GC-MS chromatograph indicated that the main chemical compositions of the compound volatile oil extracted fromYinqiaosan Decoction twice were the same. The results of the stability of the volatile oil showed that the preservation temperature and illumination affected the stability of the volatile oil to a certain extent. The absorbance values of the compound volatile oil changed slowly when it was stored at a relatively low temperature (4℃) and shielded from light, and it was less stable when stored in normal temperature and under illumination. Meanwhile, the absorbance of the compound volatile oil changed quickly in acid or alkaline solutions and was in instability. The metal ions, such as Cu2+ and Fe3+, have chemical reactions with the compositions of the compound volatile oil and there was a big change in the UV-Vis spectrum of the compound volatile oils.Conclusion The compound volatile oil should be stored at a relatively low temperature (4℃) and shielded from light. At the same time, it should be stored avoiding acids, alkaline and the metal ions, such as Cu2+ and Fe3+, to guarantee its stability. This study provides a reference for the preservation conditions and the preparation conditions of the compound volatile oil extracted fromYinqiaosan Decoction.

Objective To explore the effect of applying personal digital assistant(PDA)in documenting medical orders and monitoring vital signs.Method There was significant diffenence the between two groups in dicumenting,inedical orders,monitoring vital signs(P<0.05).Result BPDA needed significantly shorter time for documenting medical orders and monitoring vital signs than the traditional method(P<0.05).Conclusions PDA may shorten the time for documenting medical orders and monitoring vital signs. It reduces the repetition of nursing routines,optimizes the work flow sheet so that nurses have more time for patients and the quality of nursing is improved.

Objectives To understand the effects of different doses of vitamin D supplementation on serum calcium,phosphorus,alkaline phosphatase and 25-hydroxyvitamin D levels in very low birth weight infants (VLBWI) and to provide guidance for early prevention of metabolic bone disease in VLBWI.Methods A total of 90 VLBWI hospitalized in the Department of Neonatology,Huzhou Maternal and Child Healthcare Hospital between January 2014 and January 2016 were enrolled and randomly divided into two groups:highdose group and low dose group.High-dose group was given vitamin D 900 U/d orally and low-dose group was given 400 U/d since the eighth day after birth.Serum calcium,phosphorus and alkaline phosphatase levels were detected at 1,7,21 and 42 days of age and serum 25-hydroxyvitamin D levels were detected at 7,21and 42 days of age.Two-sample t-test,Chi-square test,one-way analysis of variance and LSD or Dunnett's T3 test were used for statistical analysis.Results No significant differences in serum calcium,phosphorus and alkaline phosphatase levels were found between the two groups at 1 and 7 days of age,nor were found in serum 25-hydroxyvitamin D level at 7 days of age (all P＞0.05).At 21 days of age,high dose group had higher serum calcium,phosphorus and 25-hydroxyvitamin D levels than low-dose group [(2.38 ± 0.09) vs (2.04 ± 0.15) mmol/L,t=2.421;(1.80±0.50) vs (1.71 ±0.60) mmol/L,t-0.637;(45.58± 18.43) vs (42.53± 16.33) nmol/L,t=0.421],but lower alkaline phosphatase level [(505.12± 185.61) vs (588.32± 168.72) U/L,t=5.314] (all P＜0.05).The same trends were found at 42 days of age.In high-dose group,serum calcium level increased at 7,21 and 42 days of age as compared with that at 1 day of age [(2.43±0.13),(2.38±0.09),(2.39±0.08) vs (2.06±0.57) mmol/L];serum phosphorus level at 7 days of age was lower than that at 1,21 and 42 days of age [(1.31 ±0.26) vs (1.89±0.39),(1.80±0.50),(1.98±0.30) mmol/L];serum alkaline phosphatase level at 7,21 and 42 days of age was higher than that at 1 day of age [(475.18± 133.73),(505.12± 185.61),(538.43 ± 168.16) vs (296.15 ± 99.41) U/L] and a significant increase was observed at 42 days of age as compared with that at 7 days of age;serum 25 hydroxyvitamin D level at 21 days of age was higher than that at 7 days of age,and that at 42 days of age was higher than that at 7 and 21 days of age [(73.55±23.65) vs (30.63± 12.66) and (45.58 ± 18.43) nmol/L];the differences were all statistically significant (LSD or Dunnett's T3 test,all P＜0.05).Conclusions Vitamin D supplementation from the eighth day after birth can improve calcium and phosphorus metabolism in VLBWI and the dose of 900 U/d is more effective than 400 U/d.

ObjectiveTo investigate the effect of Glutamine (Gln) on the expression of PCNA in intestinal tissue of neo-natal rats with necrotizing enterocolitis (NEC), and to explore the protective mechanism of Gln in intestinal mucosa.Methods Forty-eight neonatal rats at the age of 48 hours were selected, and divided into 4 groups, control group, Gln group, NEC group, NECGln group. Each group had 12 rats. Control group were fed mice milk substitutes; Gln group were fed mice milk substitutes mixed with Gln; NEC group were fed mice milk substitutes and had cold/ hypoxia exposure twice a day for 3 days; NECGln group were exposed to cold stress, hypoxia and treated with Gln mixed in the milk. The expression of PCNA was detected using immunohistochemical method.Results Compared with control group were and Gln group, the general condition was worse, and the weight was decreased in NEC and NECGln group. The inifltrated inlfammatory cells, congestion, edema, intrinsic layer separation were observed in intestinal mucosa in NEC and NECGln group. The intestinal villus was lost in severe in NEC and NECGln group. The PCNA index was 34.17±5.78, 34.42±5.38, 15.00±1.94, 30.67±3.14 in control, Gln, NEC and NECGln group respectively, with signiifcant difference between each groups (H=24.32,P=0.000). The expression of PCNA in NEC group was lower than that in normal, Gln, and NECGln group (P<0.008). The expression of PCNA had no signiifcant difference among normal, Gln, and NECGln group (P>0.008).Conclusions The expression of PCNA in intestinal mucosa was decreased in NEC rats. Gln supplement could raise the expression of PCNA in intestinal mucosa of NEC rats, and accelerate the speed of intestinal mucosa repair.

Objective To investigate the relationship of HSP27 expression with treatment response ,remission rate ,prognosis in multiple myeloma(MM) patients .Methods Eighty‐six patients with MM first diagnosis and 27 relapse cases were collected re‐spectively .Control was defined as non‐hematological malignance .The MM patients divided into first diagnosis ,relapse conventional chemotherapy group and bortezomib group .HSP27 expression and protein level were measured on pre‐and post 1 ,2 and 3 treatment circles .Results The tendency of HSP expression and protein level:relapse‐MM patients> first‐diagnosis MM patients> control . HSP27 expression and level in Ⅲ phase was higher than those in Ⅱ phase for first‐diagnosis MM patients .Bortizomib‐containing chemotherapy protocol showed more effectively decrease on HSP27 than chemotherapy treatment only .At post‐1 treatment circle , HSP27<1 showed higher survival rate than HSP27>1 and delayed the relapse time .Conclusion BMMNC‐HSP27 expression and protein level is associated with staging ,treatment response and prognosis in MM patients .

This paper is a follow-up study of 329 children in factory-run nurseries in urban Shanghai. The investigation lasted for a period of one year for each index-child, focusing on the conditions of nutrition, development and diseases of the children of various ages.Comparison between nutritionl findings and RDA of China disclosed that calorie intake of most of the index-child groups were 80-85% of RDA, the only exception being the 6-12 months group where the average calorie intake showed 90%. Protein intake of all groups was over 80% of RDA. Fe intake was lower than RDA, except for 18-month-old and over.Weight and height of the children were compared with the anthropo-metric data established in 1985 (1985 data) for Shanghai children under six years of age. It was found that the average weight and height appeared differently according to their age. Average weight of children under one year old was slightly higher than 1985 data, while average height was lower than 1985 data once the children reached 10 months old. Average weight, however, became lower than the 1985 data after the children were two years old. Over 60% of the index between 6-18 months old suffered from anemia (IDA).Accordingly, it is requested that calorie and iron intake should be supplemented.

BACKGROUNDTo elucidate relationship between amino acid sequence of non-structural protein 5A (NS5A) and outcome of HCV (1 b) patients after interferon (IFNa) therapy.

METHODSSera of 24 patients were collected before, during and after IFNa therapy. Pretreatment RNA levels and the sequences of HCV NS5A interferon sensitivity determining region (ISDR) were determined. NS5A full-length sequences of 5 HCV isolates from 3 patients with different response types were also analyzed. Phylogenetic tree analysis and protein secondary structure prediction were undertaken.

RESULTSPretreatment RNA levels of sustained response group were significantly lower than that of non-response group and relapse group (4.50X104 copies/ml versus 1.82X107 copies/ml, P < 0.01).ISDR sequences of NS5A from pretreatment sera were compared with HCV-J strain (prototype). Thirteen of 24 isolates were wild type,11 of 24 were intermediate type and none of them was mutant type. 3 of 6 sustained responders were infected with wild-type isolates, the rest with intermediate type isolates. Phylogenetic tree based on NS5A full-length sequences classified 5 isolates with 3 different response types into 3 groups. Non-response isolates belonged to the same group as HCV-J. Secondary structure prediction of 5 isolates revealed significant differences existing in 2 255- 2 289. This region was partly overlapped with PKR-binding domain.

CONCLUSIONSLow HCV RNA levels in serum are associated with favorable outcome of IFNa therapy. ISDR sequence alone could not predict outcome of IFN treatment. Combination of determination of HCV RNA levels in serum with sequence analysis of PKR-binding domain may be helpful in predicting the efficacy of IFN therapy.

Amino Acid Sequence ; Antiviral Agents ; therapeutic use ; Hepacivirus ; drug effects ; genetics ; Hepatitis C, Chronic ; drug therapy ; virology ; Humans ; Interferon-alpha ; therapeutic use ; RNA, Viral ; blood ; Viral Nonstructural Proteins ; genetics

Objective:To explore the current situation of knowledge, attitude and practice in the prevention and treatment of lymphedema after tumor treatment among nurses in cancer hospitals, and analyze its influencing factors.Methods:This study is a cross-sectional study. From October to November 2021, convenience sampling was used to survey 478 nurses from Hunan Cancer Hospital using the self-made Lymphedema Prevention and Treatment Knowledge, Attitude and Practice Questionnaire, which included 41 items from three dimensions of knowledge, attitudes and practice. The influencing factors of nurses' knowledge, attitude and behaviors related to lymphedema were studied using univariate analysis and multiple linear regression analysis.Results:The knowledge, attitude and practice scores and the total score of nurses in the cancer hospital regarding the prevention and treatment of lymphedema after tumor treatment were (17.05±9.81) , (49.96±6.03) , (30.51±11.03) , and (97.53±21.52) , respectively. The score rate of knowledge dimension was the lowest at 42.63%, while the score rate of attitude dimension was the highest at 90.84%. Multiple linear regression showed that working with lymphedema patients, participation in lymphedema training, training forms (on-the-job continuing education, school studies, self-study) , and the nurses' department being the breast or gynecological oncology department were the influencing factors for the nurses' knowledge, attitude, and practice in the prevention and treatment of lymphedema ( F=15.801, P<0.01) . Conclusions:Nurses in the cancer hospital generally have a moderate level of knowledge, attitude and practice in the prevention and treatment of lymphedema after tumor treatment. They have poor knowledge mastery and need to improve their behavioral, but their attitude is relatively positive. Nursing managers in cancer hospitals should strengthen training on lymphedema related knowledge among nurses from departments other than breast and gynecological oncology, strengthen nurses' knowledge and behavior in the prevention and treatment of lymphedema, and cultivate lymphedema therapists and specialized nurses. At the national level, policies should be introduced to establish a complete lymphedema rehabilitation training system, and improve nurses' ability to prevent and treat lymphedema in clinical practice.

Objective:To compare the dosimetric characteristics of helical tomotherapy (HT) and volumetric modulated arc therapy (VMAT) after left breast conserving surgery.Methods:Twenty-four patients with left breast cancer after breast-conserving surgery who were admitted to the Department of Radiation Oncology of Tumor Hospital of Yunnan Province from May 2016 to May 2019 were selected. The HT plan and the VMAT plan were designed for the same patient. The target dose and the dose volume parameters of organs at risk were compared and analyzed in the two radiotherapy plans.Results:There were significant differences in the D 2% [(59.68±0.46) Gy vs. (60.06±0.20) Gy, t=-4.229, P<0.001], D 98% [(57.46±0.44) Gy vs. (57.20±0.07) Gy, t=2.912, P<0.001], conformity index (CI) (0.80±0.05 vs. 0.76±0.04, t=4.079, P<0.001) and homogeneity index (HI) (0.04±0.01 vs. 0.05±0.00, t=-5.505, P<0.001) of the planning gross tumor volume (PGTV) between the HT and VMAT plans. However, there was no significant difference in the D 50% [(58.77±0.46) Gy vs. (58.75±0.11) Gy, t=0.179, P=0.859]. There were significant differences in the D 50% [(51.99±0.39) Gy vs. (52.39±0.36) Gy, t=-5.278, P<0.001], D 98% [(49.46±0.29) Gy vs. (48.35±0.46) Gy, t=9.538, P<0.001] and HI (0.19±0.01 vs. 0.21±0.01, t=-7.538, P<0.001) of the planned target volume (PTV) between the two plans. However, there were no significant differences in the D 2% [(59.13±0.64) Gy vs. (59.09±0.46) Gy, t=0.511, P=0.614] and CI (0.83±0.04 vs. 0.82±0.04, t=1.637, P=0.115). In terms of organs at risk, there were significant differences in the V 5 [(57.90±1.42)% vs. (52.40±5.74)%, t=4.812, P<0.001], V 20 [(22.40±2.17)% vs. (18.40±3.16)%, t=5.573, P<0.001] and D mean [(12.71±0.55) Gy vs. (11.46±1.26) Gy, t=4.963, P<0.001] of left lung, D mean of right lung [(3.42±0.27) Gy vs. (2.49±0.24) Gy, t=13.310, P<0.001], D mean of right breast [(4.41±0.50) Gy vs. (3.12±0.65) Gy, t=10.326, P<0.001], V 30 [(0.55±0.37)% vs. (1.24±1.11)%, t=-4.020, P=0.001] and D mean of heart [(4.68±0.62) Gy vs. (3.83±0.88) Gy, t=7.335, P<0.001], D mean of left atrium [(2.53±0.31) Gy vs. (2.16±0.28) Gy, t=5.488, P<0.001], D mean of right atrium [(2.77±0.43) Gy vs. (2.20±0.30) Gy, t=7.103, P<0.001], D mean of right ventricle [(5.10±0.72) Gy vs. (3.72±0.94) Gy, t=9.802, P<0.001] and D 2% of spinal cord [(14.79±2.73) Gy vs. (5.42±2.23) Gy, t=14.788, P<0.001] between HT and VMAT plans. There was no significant difference in the D mean of left ventricle [(5.10±1.19) Gy vs. (4.80±1.54) Gy, t=1.250, P=0.224]. Conclusion:Both the HT plan and the VMAT plan can meet the treatment requirements. The HT plan can provide better target area conformity and dose uniformity. The VMAT plan has more advantages in terms of organs at risk. The HT plan shows an advantage only in exposure to high-dose area.