Objective To explore the nursing interventions of paronychia caused by Erlotinib therapy for advanced non-small-cell lung cancer patients. Methods A total of 78 patients who diagnosed as advanced non-small-cell lung cancer and treated by oral Erlotinib were selected. The occurrence of paronychia among them was observed and the curative effect of certain nursing interventions on paronychia was evaluated. Results Seven out of 78 cases occurred various degrees of paronychia,and certain nursing interventions could effectively prevent and treat paronychia. Conclusions Targeted drug Erlotinib in patients with advanced non-small cell lung cancer can cause adverse reactions like paronychia,but effective nursing interventions are capable of controlling the adverse reactions, thus further improve the quality of life and ensure the smooth progress of treatment.

Objective:To observe the clinical efficacy of long-time needle retaining at Baihui(GV20)on post-stroke cognitive impairment(PSCI)and its effects on the cognitive ability and living ability of the patients.Methods:A total of 62 PSCI patients were divided into a control group and an observation group by the random number table method,with 31 cases in each group.The control group was treated with routine treatment for stroke in the recovery period plus cognitive training.The observation group received additional acupuncture at Baihui(GV20)with long-time needle retaining based on the same intervention in the control group.The Montreal cognitive assessment(MoCA)was used to evaluate the cognitive ability of patients.The activities of daily living(ADL)scale was used to evaluate the living ability of patients.And the mini-mental state examination(MMSE)scale was used to evaluate the mental state,concentration,language,and abstraction cognition of patients.After 4 weeks,the curative efficacy was observed,and the scores of cognitive level,living ability,mental state and concentration,language,and abstraction understanding ability were compared between the two groups.Results:During the trial,1 patient in each group dropped out due to personal reasons and was unable to continue the treatment.After 4 weeks of treatment,the total effective rate was 83.3%in the observation group and 66.7%in the control group,and the difference between the two groups was statistically significant(P<0.05);the scores of MoCA,ADL,and MMSE,and scores of concentration,language ability,and abstraction understanding ability were all increased,and were statistically different from those before treatment in each group(P<0.05);the scores in the observation group were all higher than those in the control group,and the differences between the groups were statistically significant(P<0.05).Conclusion:On the basis of routine treatment and cognitive training,the clinical efficacy of additional acupuncture at Baihui(GV20)with long-time needle retaining in the treatment of PSCI is better than that of routine treatment plus cognitive training;the treatment can better improve the cognitive function and mental state of patients,and improve their living ability.

Objective To investigate the vasorelaxant effect and possible mechanism of niclosamide ethanolamine (NEN)on isolated rat coronary artery(RCA). Methods Wire myograph was used to record myogenic tone of vessels. The vasorelaxant effect of NEN was studied in RCA precontracted with either KCl or U46619. Study of related inhibitors was performed to investigate possible involvement of potassium channels and the mitogen-activated protein kinase(MAPK) signaling pathway in vasorelaxation. The effect of NEN on Ca2+mobilization was determined by observing vasoconstrictor-induced contractions in tissue solution deprived of Ca2+followed by Ca2+restoration. Results NEN(0.5-3.0 μmol/L) relaxed RCA precontracted with KCl or U46619 in a concentration-dependent manner. MAPK inhibitors(PD98059 and SB239063)reduced the relaxant effect of NEN,while the potassium-channel blockers(tetraethylamine,4-aminopyridine, BaCl2,and glibenclamide)did not significantly affect relaxation. NEN specifically inhibited the contraction component dependent on extracellular Ca2+influx in vessels stimulated with KCl and U46619, with a negligible effect on the component dependent on intracellular Ca2+release. Conclusions NEN exhibits vasodilator properties in RCA. Inhibition of extracellular Ca2+influx and activation of the MAPK signaling pathway may be involved in NEN-induced RCA vasorelaxation.

Mast cells are crucial effector cells in allergic reactions,where IgE is the most notably mechanism to trigger their degranulation and release large amounts of allergic mediators.However,IgE is not the only way to stimulate these cells to degranulate.There is a lot of stimuli,such as complement,neuropeptides,cytokines and other inflammatory products,which can directly trigger mast cell degranulation,and cause selective release of mediators.These mediators are closely related to many allergic and inflammatory diseases.The paper will focus on the activation of non-IgE stimulated human mast cells,and describe the allergic and inflammatory diseases briefly,and provide the theoretical basis for clinical detection,diagnosis and treatment.

Objective: To investigate the clinicopathologic and genetic features, pathologic diagnosis and differential diagnosis of angiofibroma of soft tissue(AFST). Methods: The clinicopathologic characteristics of 24 cases diagnosed at Fudan University Shanghai Cancer Center from 2011 to 2017 were analyzed; immunohistochemical staining and interphase fluorescence in situ hybridization (FISH) were performed, and the literatures were also reviewed. Results: There were 15 male and 9 female (male∶female=1.7∶1.0) patients with age of onset ranging from 8 to 68 years (mean, 45 years). Fourteen cases occurred in extremities, including upper limbs (n=3) and lower limbs (n=11); seven cases were in the trunk, and 1 case each was in the temporal region, retroperitoneum and liver, respectively. Clinically, the tumors usually presented as a slowly growing painless mass. Tumor sizes ranged from 0.8 to 14 cm (mean 4.6 cm). Microscopically, most lesions were well-circumscribed, with fibrous capsules. Few cases infiltrated the surrounding fibrofatty tissue focally. The tumors were mainly composed of sparse short spindle cells and numerous small, branching, thin-walled blood vessels distributed in amyxoid, fibromyxoid or collagenous matrix, often accompanied by medium-sized, round or irregular and ecstatic vessels at the tumor periphery.By immunohistochemistry, all tested cases expressed vimentin (5/5), and showed variable positivity for EMA (2/4), ER (1/2), PR (2/3), α-SMA (1/18)and desmin (1/10). Ki-67 proliferation index were all less than 5%. CD34, CD31 and ERG staining clearly outlined the contours of blood vessels in the stroma. Four cases were tested for NCOA2 gene rearrangement by FISH, of which three were positive. Follow-up data was available in 17 patients (range, 3 to 69 months; mean, 30 months) were all free of disease. Conclusions Soft tissue angiofibroma is a benign fibroblastic neoplasm characterized by a prominent and complex vasculature set in a myxoid-to-collagenous stroma, and cytogenetically a distinctive NCOA2 gene rearrangement. Caution should be exercised for the possibility of potentially misinterpretation of AFST as vascular tumors and other myxoid soft tissue tumors.

Objective:To investigate the prognosis of patients with initially resectable gastric cancer liver metastasis (GCLM) who were treated by different modalities, and analyze the influencing factors for prognosis of patients.Methods:The retrospective cohort study was conducted. The clinicopathological data of 327 patients with initially resectable GCLM who were included in the database of a nationwide multicenter retrospective cohort study on GCLM based on real-world data from January 2010 to December 2019 were collected. There were 267 males and 60 females, aged 61(54,68)years. According to the specific situations of patients, treatment modalities included radical surgery combined with systemic treatment, palliative surgery combined with systemic treatment, and systemic treatment alone. Observation indicators: (1) clinical characteristics of patients who were treated by different modalities; (2) prognostic outcomes of patients who were treated by different modalities; (3) analysis of influencing factors for prognosis of patients with initially resectable GCLM; (4) screening of potential beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to calculate survival rate and draw survival curve, and Log-Rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the COX proportional hazard regression model. The propensity score matching was employed by the 1:1 nearest neighbor matching method with a caliper value of 0.1. The forest plots were utilized to evaluate potential benefits of diverse surgical combined with systemic treatments within the population. Results:(1) Clinical characteristics of patients who were treated by different modalities. Of 327 patients, there were 118 cases undergoing radical surgery plus systemic treatment, 164 cases undergoing palliative surgery plus systemic treatment, and 45 cases undergoing systemic treatment alone. There were significant differences in smoking, drinking, site of primary gastric tumor, diameter of primary gastric tumor, site of liver metastasis, and metastatic interval among the three groups of patients ( P<0.05). (2) Prognostic outcomes of patients who were treated by different modalities. The median overall survival time of the 327 pati-ents was 19.9 months (95% confidence interval as 14.9-24.9 months), with 1-, 3-year overall survival rate of 61.3%, 32.7%, respectively. The 1-year overall survival rates of patients undergoing radical surgery plus systemic treatment, palliative surgery plus systemic treatment and systemic treatment alone were 68.3%, 63.1%, 30.6%, and the 3-year overall survival rates were 41.1%, 29.9%, 11.9%, showing a significant difference in overall survival rate among the three groups of patients ( χ2=19.46, P<0.05). Results of further analysis showed that there was a significant difference in overall survival rate between patients undergoing radical surgery plus systemic treatment and patients undergoing systemic treatment alone ( hazard ratio=0.40, 95% confidence interval as 0.26-0.61, P<0.05), between patients undergoing palliative surgery plus systemic treatment and patients under-going systemic treatment alone ( hazard ratio=0.47, 95% confidence interval as 0.32-0.71, P<0.05). (3) Analysis of influencing factors for prognosis of patients with initially resectable GCLM. Results of multivariate analysis showed that the larger primary gastric tumor, poorly differentiated tumor, larger liver metastasis, multiple hepatic metastases were independent risk factors for prognosis of patients with initially resectable GCLM ( hazard ratio=1.20, 1.70, 1.20, 2.06, 95% confidence interval as 1.14-1.27, 1.25-2.31, 1.04-1.42, 1.45-2.92, P<0.05) and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy were independent protective factors for prognosis of patients with initially resectable GCLM ( hazard ratio=0.60, 0.39, 0.46, 95% confidence interval as 0.42-0.87, 0.25-0.60, 0.30-0.70, P<0.05). (4) Screening of potentinal beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Results of forest plots analysis showed that for patients with high-moderate differentiated GCLM and patients with liver metastasis located in the left liver, the overall survival rate of patients undergoing radical surgery plus systemic treatment was better than patients undergoing palliative surgery plus systemic treatment ( hazard ratio=0.21, 0.42, 95% confidence interval as 0.09-0.48, 0.23-0.78, P<0.05). Conclusions:Compared to systemic therapy alone, both radical and palliative surgery plus systemic therapy can improve the pro-gnosis of patients with initially resectable GCLM. The larger primary gastric tumor, poorly differen-tiated tumor, larger liver metastasis, multiple hepatic metastases are independent risk factors for prognosis of patients with initial resectable GCLM and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy are independent protective factors for prognosis of patients with initially resectable GCLM.

Five patients after prosthetic tricuspid valve, who received pacemaker implantation via coronary sinus during Oct, 2011 and Jul, 2014, were enrolled. Pacemakers were implanted via coronary vein in 5 patients without complications. The stimulation thresholds keep stable and symptoms (such as short breath and fatigue) were disappeared during the follow-up. For patients after tricuspid valve replacement, implantation of pacemaker via coronary sinus provides a safe and invasive approach and avoids opening the chest again.
Cardiac Surgical Procedures ; Coronary Sinus ; Heart Valve Prosthesis Implantation ; Humans ; Pacemaker, Artificial ; Tricuspid Valve