Diagnostics is an important professional medical course concerning basic theory,basic skill and basic approach of diagnosis.Using standardized patients in clinical scene can relieve the shortage of clinical teaching resources and strained doctor-patient relationship as well as improve the clinical skills and doctor-patient communication of students.However,there were many problems in using the standardized patient;therefore,discussions were needed to find a better solution.

Objective To investigate illness uncertainty state and explore its influencing factors in hospitalized children and adolescents with cancer.Methods A cross-sectional survey was performed in 112 children and adolescents with cancer aged 7～18 years old from two hospitals with the Chinese version of Uncertainty Scale for Kids-20 and the self-designed demographic questionnaire.Results The mean total scores of illness uncertainty was (45.16±6.67) points.The results of single-factor analysis showed that the factors influencing the uncertainty in illness of children and adolescents with cancer were as follows:age,personality characteristics,course of disease,the methods of treatment,current disease status,absence from school or not,the times of hospitalization,family monthly income,and the extent of parents' understanding about the disease-related knowledge.Multi-factor stepwise regression analysis showed that the main influencing factors of the uncertainty in illness were the current condition,family monthly income,absence from school or not and the extent of parents' understanding about the disease-related knowledge.Conclusions Illness uncertainty is common in children and adolescents with cancer.Nurses should attach importance to the impacts of illness uncertainty,and take effective interventions to decrease it,alleviate psychological pressure and improve quality of life in children and adolescents with cancer.

Objective To discuss the effect of QGY/CDDP hepatoma lines multi-drug resistance (MDR) reversed by gene transfection of mdr1,mrp-ASODN+ultrasound contrast agent+ultrasound.Methods The QGY/CDDP cells were transfected by mdr1,mrp ASODN+ultrasound contrast agent+ultrasound irradiation respectively and detected of the various indicators:cell adhesion rate,cell sensitivity to cell drug-resistance,the mRNA expression of mdr1 and mrp gene,the expression of P-gp and MRP protein. Results After mdr1-ASODN transfection,the drug sensitivity and expression of P-gp,MRP protein of QGY/CDDP cells were smaller changes(P＞0.05),and the rate of cells adherent and expression of resistance gene mRNA were obvious changes(P＜0.05).After mrp-ASODN transfection,the cells adherent rate,the drug sensitivity,the expression of resistance gene mRNA and P-gp,MRP protein were obvious changes respectively(P＜0.05),the experiment group(group 2')had bigger effects(P＜0.05).Conclusions mdr1. mrp-ASODN+ultrasound contrast agent+ultrasound irradiation could safely partly reverse MDR of hepatoma cells,which is a potential new approach for gene therapy.

To investigate the anticancer effects of ring C in 18β-glycyrrhetinic acid (GA), a series of GA derivatives featured with 9(11)-ene moiety in ring C were designed and synthesized. The structures were confirmed by IR, LC-MS and 1H NMR. Their inhibitory effects towards human prostate cancer PC-3 and leukemia HL-60 cell lines were determined. Most of the derivatives displayed stronger antiproliferative activities than GA. Particularly, compound 14 showed promising anticancer activity with the GI50 values of 4.48 µmol · L(-1) and 1.2 µmol · L(-1) against PC-3 and HL-60 cells respectively, which is worth further study.

Objective:To analyze the significance of empowerment intervention for main caregivers of stomach neoplasm patients undergoing chemotherapy on fear of cancer recurrence, psychological capital.Methods:Using convenient sampling method, the 90 patients with stomach neoplasm treated with chemotherapy from January to December 2021 were randomly divided into control group (45 cases) and observation group (45 cases), and one main caregiver was selected for each patient.The control group was given the routine nursing scheme of stomach neoplasm patients undergoing chemotherapy, and the observation group was given the intervention mode of empowering the main caregivers on the basis of the routine nursing scheme of stomach neoplasm chemotherapy. The fear of cancer recurrence, psychological capital and quality of life of the two groups before intervention and after three chemotherapy cycles were statistically compared by using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Positive Psychological Capital Questionnaire (PPQ) and Functional Assessment of Cancer Thearpy-General model(FACT-G).Results:Finally 44 cases in the observation group and 43 cases in the control group were included. The total scores of FCR, PPQ and FACT-G in the observation group were (39.7 ± 3.2), (112.8 ± 16.9), (84.2 ± 9.1) points before intervention respectively, and(31.1 ± 2.5), (134.7 ± 15.6), (94.1 ± 9.6) points after intervention respectively.The differences were statistically significant( t=20.02, 8.94, 7.02, all P<0.05). The total score of FCR in the observation group was significantly lower than that in the control group after intervention, which were (31.1 ± 2.5) points and (37.7 ± 2.8) points respectively, the difference was statistically significant ( t=11.60, P<0.05). The total score of PPQ in the observation group was (134.7 ± 15.6) points after intervention, which was significantly higher than that in the control group (114.8 ± 15.8) points after intervention, the difference was statistically significant ( t=5.91, P<0.05). The total FACT-G score of the observation group was (94.1 ± 9.6) points, which was higher than that of the control group (86.5 ± 9.0) points, the difference was statistically significant ( t=3.81, P<0.05). Conclusions:The implementation of empowerment intervention for main caregivers of stomach neoplasm patients undergoing chemotherapy can reduce the fear of cancer recurrence, improve psychological capital, and improve the quality of life.