Actinic keratosis (AK) is a precursor to cutaneous squamous cell carcinoma (SCC),and molecular mechanisms of transformation from AK to SCC have been a research hotspot.This review focuses on four aspects of the molecular mechanisms,including chromosomal variation,gene mutations,signaling pathways and other factors,summarizes advances in selective mutations in chromosomes 3p,9p,9q,13q,17p and 17q,heterozygous deletion mutations in chromosome 18q,mutations of p53,p16 and Ras genes,abnormality of the transforming growth factor β1 signaling pathway and Fas/FasL signaling pathway,and aberrant expression of matrix metalloproteinases in the transformation from AK to SCC,which will provide a reference for further researches.

Objective To investigate if distribution of stone composition and onset age in the upper urinary tract changed during the past 12 years in China.Methods There were 1 878 urolithiasis patients of the upper urinary tract in our hospital from 2003 to 2014 enrolled in present cross-sectional study.There were 1 300 male and 578 female patients with a median onset age of 46 (6-95) years.Stone composition was measured by infrared spectrophotometry.All the patients were divided into 3 groups according to the onset year:Year 2003-2006,Year 2007-2010 and Year 2011-2014.The distributions of stone types were compared among the 3 groups.Age and gender were included as potential confounders.Chi square test,P trend test,Kruskal-Wallis test and logistic regression were employed in the statistical analysis.Results Calcium oxalate was the most common type with a dominant proportion of 78.1％ (1 466/1 878),while uric acid had a small proportion of 4.8％ (91/1 878).The proportions of uric acid in the 3 groups were 2.7％ (12/441),5.1％ (39/758) and 5.9％ (40/679),showing an increasing trend (P ＜0.05).Multivariate analysis showed that year group was independently correlated with the proportion of uric acid,with an OR of 1.385 (95％ CI,1.027-1.867).From 2003 to 2014,the proportion of uric acid calculus increased by 0.42％ (95％ CI,0.25％-0.59％) annually.The median ages of disease onset were 43,46 and 49 years respectively in those three groups,also showing an increasing trend with time (P ＜0.01).Conclusion From 2003 to 2014,the proportion of uric acid and onset age in patients of upper urinary tract calculi were increased in the present cohort.

Objective To investigate the proportion , risk factors and tendency of change of stone composition in recurrent urolithiasis .Methods Eighty-five recurrent urolithiasis patients from 2002 to 2014 were enrolled in this retrospective cohort study .There were 61 male and 24 female patients with a median age of 51 (21-89) years at initial events.Among those patients, 70 had two events, 12 had three events, and 3 had more than 3 events.Compositions of initial and recurrent stones were measured by infrared spectrophotometry.Stone type, recurrence interval and recurrence frequency were studied as potential risk factors for composition change . Chi square test and logistic regression analysis were employed in the statistical analysis.Results Stone composition changed during recurrence in 26 patients ( 30.6%) . Univariate analysis showed the risk ratio of composition change in the patients with recurrence interval of 1-5 years was 0.518 (95%CI, 0.277-0.967, P<0.05) when compared with those of less than 1 year or more than 5 years.Logistic regression analysis showed the odds ratio of recurrence interval of 1-5 years was 0.231 (95%CI, 0.075-0.707, P=0.010).The mutual conversion between calcium oxalate and infection stones was mostly observed when stone composition changed during recurrence .Twenty percent of calcium oxalate stones changed to infection stones and 29.2% of infection stones changed to calcium oxalate .
Conclusions Stone composition changes in about one third patients of recurrent urolithiasis .The mutual conversion between calcium oxalate and infection stones is the most common change .Recurrence interval is an independent risk factor to predict composition change .Repeated stone analysis should be suggested to patients with recurrent interval of less than 1 year or more than 5 years.

Objective:To explore the dissipation of hyperthermic intraperitoneal chemotherapy (HIPEC) drugs configured in the biological safety cabinet in the Operating Room.Methods:From February 2018 to October 2019, convenience sampling was used to select 60 patients with gastrointestinal malignancies who received HIPEC in the Operating Room of the Cancer Hospital of the Chinese Academy of Medical Sciences as the research object. Patients were divided into four groups according to the order of operation time, with 15 cases in each group. In the control group, there was no protection on the HIPEC configuration table for patients with gastrointestinal malignancies. In the isolation pad group, the HIPEC configuration table for patients with gastrointestinal malignancies was flat with an isolation pad of the same area as the table. In the medical gauze group, the HIPEC configuration table for patients with gastrointestinal malignancies was covered with medical gauze of the same area as the table. In the medical absorbent paper group, the HIPEC configuration table for patients with gastrointestinal malignancies was laid flat with medical absorbent paper of the same area as the table. The four groups all adopted conventional protection methods for the configuration staff, that was, the configuration staff routinely wore special clothing and hats of the Operating Room, wore disposable masks and latex gloves. The positive rate of chemotherapy drugs and the residual cisplatin concentration of each group of countertop samples, glove samples, auricle wipe samples and mask samples were compared.Results:There was a statistically significant difference in the positive rate of drug residues in countertop samples from different groups ( P<0.01) .Among them, the positive rates of countertop samples in the isolation pad group, medical absorbent paper group, and medical gauze group were lower than that of the control group, and the difference was statistically significant ( P<0.01) . There was no statistically significant difference in the positive rate of drug residues in glove samples, auricle wipe samples and mask samples in different groups ( P>0.05) .The difference of drug residue concentration in countertop samples of different groups was statistically significant ( P<0.01) . Among them, the concentration of drug residue in countertop samples of the isolation pad group, medical absorbent paper group, and medical gauze group was lower than that of the control group, and the difference was statistically significant ( P<0.01) .There was no significant difference in drug residue concentration in glove samples, auricle wipe samples and mask samples in different groups ( P>0.05) . Conclusions:Covering the table with isolation pads, medical gauze and medical absorbent paper can effectively reduce the residual concentration of chemotherapy drugs on the biosafety countertop.

Objective To evaluate the impact of concurrent nursing intervention on the quality of life of gastric cancer patients undergoing radical gastrectomy and their family caregivers. Methods A total of 200 participants undergoing radical gastrectomy in Pancreatic Stomach Surgery Department of one hospital were divided observation group (n=100) and control group (n=100) by random number table method from October 2015 to April 2016. Patients in control group were treated with traditional overall nursing, whereas patients and their family caregivers of observation group received concurrent nursing intervention. Quality of life of patients and their family caregivers was investigated with QLQ-STO22 and QOL Scale-FAMILY respectively when the patients were admitted to hospital and one year after discharged. Results The total score and the score of each dimension of quality of life of patients and their caregivers of two groups had no difference when admitted (P> 0.05). The total score of QLQ-STO22 of observation group was higher than that of the control group [(48.72±13.92) vs. (25.37±5.96)] when one year after discharged with each dimension lower (P<0.05). The total score of QOL Scale-FAMILY of the caregivers of observation group was (255.93±27.79) and (229.17±30.14) for the control group. Scores of dimensions of physical health, mental health, social adaptation of the observation group were higher than those of the control group (P<0.05), but psychological health had no significant difference (P> 0.05). Conclusions Concurrent nursing intervention could improve the quality of life of patients undergoing radical gastrectomy and their family caregivers and should be applied in clinic.

There are different symptom clusters among lung cancer patients, influenced by physical, psychological and treatment factors, which may even threaten patients′ life. In this study, we reveal the survey results of symptom clusters among lung cancer patients through both qualitative research and quantitative research to provide theoretical basis for the practice of nursing intervention, so that we can further relieve patients′symptom burden and improve their life quality.

Objective To explore the clinical symptom clusters in breast cancer patients with anthracycline treatment, which could provide evidence for prevention. Methods The M.D.Anderson Symptom Inventory of Chinese version (MDASI-C) was applied to assess clinical symptoms in 506 breast cancer patients received anthracycline therapy during their 1stto 4thcycle chemotherapy.Thirteen symptoms were analyzed using main-component analysis and variance orthogonal rotation. The exploratory factor analysis was conducted to find factors value greater than 1. Results The number of symptoms with incidence rate more than 50% was 5, 6, 7 and 9 during the 1stto the 4thcycle, respectively. Fatigue, poor appetite, and nausea were the most common symptoms, and the incidence of these symptoms were 92.5% to 97.1% ,84.8% to 95.1% and 81.1% to 91.3% with the increasing cycle of chemotherapy.Three factors value greater than 1 were detected during the 1stto 2ndcycle chemotherapy by exploratory factor analysis.The cumulative variance contribution rates were 63.233% and 61.434% in the 1stand 2ndcycle, respectively. The main symptom clusters concentrate on fatigue and digestive tract symptoms, including fatigue, sleep disturbance, hypersomnia, nausea, vomit, poor appetite, dry mouth. Two factors value greater than 1 were detected during 3rdto4thcycle in chemotherapy. The cumulative variance contribution rates were 62.660% and 61.148% in the 3rdand 4thcycle, respectively. The main symptom clusters concentrate on psychological and nervous system symptoms including sadness, pain, dry mouth, numbness, hypersomnia, shortness of breath, amnesia and so on. The Cronbach α of cluster symptoms from the 1stto the 4thcycle chemotherapy was between 0.829 to 0.911. Conclusions Symptom clusters vary with the cycles of chemotherapy in breast cancer patients treated with anthracycline. Nurses should provide targeted intervention measures to improve symptom and enhance quality of life, according to specific situation.

Objective To investigate the effect of comprehensive nursing for pain,quality of life and satisfaction of hepatocellular carcinoma (HCC) patients after TACE.Methods A total of 180 patients with HCC treated with TACE were enrolled.The patients were equally divided into intervention group and control group (each n＝ 90).Comprehensive nursing was performed,including routine nursing care,psychological support,painful health education,nursing interventions with relaxation therapies and pressing acupoints combined with drug analgesia in intervention group.The control group was given routine nursing care.The numerical rating scale (NRS) scores for pain assessment,satisfaction and quality of life were compared between the two groups.Results NRS scores at the 1st,2nd,3rd day after operation in the intervention group at resting state and exercise state were all lower than those in the control group (all P＜0.05).The satisfaction rate of the intervention group (94.11％ [85/90]) was higher than that of the control group (76.67％ [69/90];X2 ＝63.47,P＜0.05).The quality of life in intervention group was also significantly higher than that in control group (X2 ＝7.476,P＜0.05).Conclusion In HCC patients,comprehensive nursing can effectively reduce the pain from TACE and improve the satisfaction and quality of life.

Patients with advanced cancer are often accompanied by a variety of symptoms due to disease or treatment,and it is necessary to choose a scientific assessment tool to assess and manage these symptoms. The Edmonton symptom assessment scale (ESAS)is a brief,easy to complete,and comprehensive assessment tool for the common symptoms of patients with advanced cancer. ESAS has been translated into many languages and it is widely used in many countries. In the course of using,the structure and contents of the original scale are adjusted,and the ESAS is more perfect,besides,its reliability and validity are validated,and it is used in the research of evaluation by others.

Objective:To observe the adverse effects of skin toxicity after the administration of programmed cell death protein 1 (PD-1) inhibitor, summarize the nursing measures, and provide a basis for taking corresponding management measures.Methods:Totally 94 patients who were treated with PD-1 inhibitor in Cancer Hospital of Chinese Academy of Medical Sciences between February and October 2019 were selected by convenient sampling, among whom 37 cases (39.4%) with skin toxicity reaction were included as the research subjects. Their skin toxicity was observed and assessed. Meanwhile, health education, psychological counseling and nursing care for skin toxicity reaction were provided to them.Results:Of the 37 patients, 34 (91.9%) had G1 skin toxicity and were not treated with drugs. After the rash subsided, they were treated according to the original plan. 2 (5.4%) had G2 skin toxicity, whose rash subsided after drug treatment, with scattered pigmentation. They were treated according to the original plan. 1 (2.7%) had G4 skin toxicity. The medical staff from the Dermatology Department and the Infection Department were consulted. The body temperature was normal, and the skin and mucous membranes were ruptured, crusted and detached. The patient was discharged after the condition was improved.Conclusions:After receiving PD-1 inhibitor immunotherapy, patients may have different degrees of immune-related skin toxicity reactions, which requires clinicians and nurses to carry out standardized treatment and care to improve their quality of life.