Objective To explore the application value of sensitive index of nursing quality in nursing management of patients with cancer pain.Methods One hundred and eight patients with cancer pain in the First Affiliated Hospital of Xinxiang Medical University from February 2014 to March 2015 were selected as the control group;one hundred and eight patients with cancer pain in the First Affiliated Hospital of Xinxiang Medical University from April 2015 to June 2016 were selected as the study group.The traditional cancer pain nursing quality evaluation criterion was taken in the control group,and the improved cancer pain nursing quality evaluation criterion was taken in the study group to evaluate the nursing quality.The accuracy of pain assessment,awareness rate of cancer pain knowledge,degree of satisfaction to the nursing work were compared between the two groups.Results The accuracy of pain assessment of patients in the study group (90.7％,98/108)was significandy higher than that in the control group (45.4％,49/108) (x2 =51.16,P ＜ 0.05);the awareness rate of cancer pain knowledge of patients (98.1％,106/108) in the study group was significantly higher than that in the control group (72.2％,78/108) (x2 =28.83,P ＜ 0.05);the satisfaction rate of the patients in the study group (100.0％,108/108) was significantly higher than that in the control group (85.2％,92/108) (x2 =17.38,P ＜ 0.05).Conclusion The overall quality of cancer pain care can be improved by strengthening the quality evaluation of the pain assessment accuracy and the awareness rate of cancer pain knowledge in patients with cancer pain.

Objective To detect the effects of siRNA targeting CDX2 gene expression on of BCR-ABL, caspase and Bax expressions, and the mechanisms thereof. Methods According to the earlier experiments, siRNA specifically targeting CDX2 gene (CDX2-siRNA) and the negative control sequence (CDX2-siRNA-NC) were selected, and then were transfected into K562 cells by Roche X-tremeGENE HP DNA Transfection Reagent. The flow cytometry analysis was used to detect the effects of siRNA on cell apoptosis. The expressions of BCR-ABL, caspase-9, Bax mRNA and protein were tested by RT-PCR and Western blot assay. Results MTT and flow cytometry analysis showed that after the silence of CDX2 gene expression, the proliferation of K562 cells was prohibited and the apoptotic rate of K562 cells was distinctly increased compared with that of normal cell group, but the negative control group had no significant change. According to the RT-PCR and Western blot assay, in comparison with the normal cell group and the negative control group, the expression levels of BCR-ABL mRNA and protein were obviously decreased, and the difference was statistic significance. On the other hand, the expressions of caspase-9 and Bax mRNA and protein were significantly higher than those of other two groups (P<0.05). Conclusion CDX2-siRNA can promote apoptosis of K562 cells obviously, and the mechanism is related with the down-regulation of BCR-ABL and the up-regulation of caspase-9 and Bax.

Objective To investigate the feasibility of evaluating the pancreatic fat deposition with ultrasound,and analyze the relationship of pancreatic fat deposition with the risk factors for diabetes.Methods Two hundred and ninety-four subjects were recruited in the diabetes epidemic survey of Shanghai Sixth Peoples' Hospital,Shanghai Jiaotong University from Oct 2015 to Jan 2016,including 111 diabetes mellitus (DM) cases,54 sugar metabolic abnormalities (IGR) cases,and 129 healthy cases as control group.The general data were collected.Biochemical indicators including ALT,AST and insulin in fasting blood samples were detected,and insulin resistance index (HOMA2-IR) and insulin secretion index (HOMA-IS) were calculated.The pancreatic fat deposition was evaluated by the ultrasound,and pancreas echoes were divided into three levels (1,2,3),by comparing with the echo of the rectus.The Chi-square test was used to analyze the pancreatic fat deposition rate,while the Logistic regression was used to figure out the diabetes high-risk factors influencing the pancreatic fat deposition.Results Forty-two subjects were found to have the pancreatic fat deposition in the healthy group (33.3％),of whom 19 cases,16 cases and 8 cases were categorized into level 1,2 and 3,respectively.Thirty subjects were found to have the pancreatic fat deposition in the IGR group (55.6％),of whom 14 cases,11 cases and 5 cases were categorized into level 1,2 and 3,respectively.Sixty-seven subjects were found to have the pancreatic fat deposition in the DM group (60.4％),of whom 37 cases,18 cases and 12 cases,were categorized into level 1,2,3,respectively.The pancreatic fat deposition rates of the 3 groups were statistically significantly different (P＜0.01).Multivariate Logistic regression analysis showed that body mass index (BMI),HOMA2-IR,high triglycerides (TG),and total cholesterol (TC) may be the-risk factors for the pancreatic fat deposition in IGR and T2DM patients.Conclusions The ultrasound evaluation on pancreatic fat deposition was feasible,and the pancreatic fat deposition was related to multiple high-risk factors for diabetes.

Objective:To explore application of targeted contrast enhanced ultrasonography in diagnosis of early stage vascular endothelial injury and diabetic nephropathy.Methods:Targeted SonoVue-TM microbubble was prepared by attaching anti-TM monoclonal antibody to the surface of ordinary micro-bubble SonoVue by biotin-avidin bridge method and ultrasonic instrument was used to evaluate the developing situation of targeted microbubble in vitro. Twenty 12-week-old male GK rats and 20 Wistar rats were enrolled in this study, and were randomly divided into targeted angiography group and ordinary angiography group. Targeted microbubbles SonoVue-TM or general microbubble SonoVue were rapidly injected to the rats via tail vein; the developing situation of the two contrast agents in rats kidneys was dynamically observed. Time intensity curve was used to analyse rat kidney perfusion characteristics in different groups. Results:Targeted ultrasound microbubble SonoVue-TM was successfully constructed, and it could be used to develop an external image. Targeted microbubbles SonoVue-TM enabled clear development of experimental rat kidney. Time intensity curve shapes of rat kidney of the two groups showed as single apex with steep ascending and slowly descending branch. Compared with the control group, the rising slope of the GK rat renal cortex, medulla in targeted angiography group increased(P<0.05); the peak intensity of medulla increased (P<0.05), and the total area under the curve of medulla increased (P<0.05). Compared with control group, the ascending branch of the GK rat in renal cortex, medulla in ordinary angiography group increased (P<0.05). The peak intensity of the curve increased (P<0.05), and the total area under the curve increased (P<0.05). Compared with the ordinary angiography group, the peak of GK rat medullacurve in targeted angiography group intensity increased (P<0.05), and the total area under the curve increased (P<0.05).Conclusions:Targeted microbubbles SonoVue-TM can make a clear development of experimental rat kidney, its stable performance meet the requirement of ultrasonic observation time limit, and it can reflect early changes of blood perfusion in GK rat kindey.

To observe the incidence of varicella vaccine after breaking through the case of varicella vaccine , immunization strategy ,popularized in the city.Inoculation Population living in the Binhai New Area of full age to 12 years old children in December,has been vaccinated or who have had chickenpox varicella vaccine except .Controls were four districts around the city girls without varicella in children.Methods: Implementation of vaccination for the target population.All vaccinees was observed from 42 days to 2 and a half years later ,the incidence of varicella break cases.In the observation group and the control group was observed in two groups of varicella vaccine protection rate calculation.Results: The gelatin free attenuated varicella vaccine breakthrough in 134 cases,the incidence rate was 0.35%;no gelatin attenuated varicella vaccine protection rate of 80.92%, with domestic and foreign reports consistent.Conclusion:After vaccination from 42 to 2 and a half years ,varicella vaccine can effectively protect children from the onset, while reducing the prevalence of children 's pain and the economic burden of the family.Varicella vaccine is still a breakthrough occurred ,therefore to consider two inoculations ,with further observation of two times after inoculation the body to produce antibody level and epidemiological protection effect.

Objective: To investigate the blood lead level of children living around lead-zinc mining areas, in order to analyze its distribution features of the population. Methods: In August 2016, three natural villiages around lead-zinc mines were selected randomly as survey sites, which were grouped A, B and C according to each distances from the center field, totally 1 379 children from the three villages were selected by cluster random sampling method as the investigation subjects, and their elbow peripheral vein blood samples were collected to determine the blood lead level by graphite furnace atomic absorption spectrometry. The distribution features of blood lead in different district, gender and age groups were compared and analyzed. Results: The median and quartile range of blood lead were 0.066 and 0.058 mg/L respectively. The blood lead levels of 341 children were esceeding 100 μg/L and that account for 24.73%. The median blood lead showed statistical significant differrnce among three groups (P<0.01) , and the medians from high to low were: 0.075 mg/L (A) , 0.065 mg/L (B) and 0.059 mg/L (C) respectively. The average blood lead of male was higher than that of female (P<0.01) . There was significant difference in blood lead levels among different aged groups (P<0.01) , and the high blood lead rate dicreased with the increase of age (P<0.01) . Results of multivariate logistic regression analysis showed that there was a high risk of excessive lead in the blood lead of boys aged 1-6 years from the center of the area. Conclusion The blood lead level of children living around lead-zinc mining areas is relatively high. There are difference in district distribution, gender and age.

OBJECTIVETo investigate the changes in hemodynamics and depth of anesthesia under monitored anesthesia care (MAC) in patients undergoing percutaneous dilatational tracheostomy (PDT).

METHODSForty-six patients with oral cancer were divided into two groups with 23 cases each: Local anesthesia group (group L) and MAC group (group M). Local and intratracheal surface anesthesia were performed with 2% lidocaine in group L. Midazolam, propofol and fentanyl were added to group M after local and intratracheal surface anesthesia, then PDT was carried out. During the induction, observer's assessment of alertness/sedation(OAA/S) scale was used to assess the depth of sedation. Mean arterial blood pressure (MAP), heart rate (HR), state entropy (SE) and response entropy (RE) were recorded before anesthesia (basal value, T1), after local anesthesia (T2), after intravenous administration/before incision (T3), during incision (T4), during dilating with stretching pliers (T5) and endotracheal intubation (T6). A postoperative follow-up was taken in group M.

RESULTSMAP and HR increased significantly at T4-T6 in group L and decreased at T3 (P < 0.05) with no change at T4-T6 in group M compared with those in T1. MAP and HR at T3-T6 in group M were obviously lower than those in group L. SE and RE at T3-T6 in group M were obviously lower than those at T1 or in group L (P < 0.01) and decreased significantly with the reduction of OAA/S scale (P < 0.05) during the induction. Intraoperative awareness in group M was not found through postoperative follow-up.

CONCLUSIONPatients undergoing PDT under MAC has more comfortability, more stable hemodynamics and no memory, so MAC is a better anesthesia for PDT than local anesthesia.

Purpose: Drug resistance is one of the main causes of chemotherapy failure in patients with small cell lung cancer (SCLC), and extensive biological studies into chemotherapy drug resistance are required. Materials and Methods: In this study, we performed lncRNA microarray, in vitro functional assays, in vivo models and cDNA microarray to evaluate the impact of lncRNA in SCLC chemoresistance. Results: The results showed that KCNQ1OT1 expression was upregulated in SCLC tissues and was a poor prognostic factor for patients with SCLC. Knockdown of KCNQ1OT1 inhibited cell proliferation, migration, chemoresistance and promoted apoptosis of SCLC cells. Mechanistic investigation showed that KCNQ1OT1 can activate transforming growth factor-β1 mediated epithelial-to-mesenchymal transition in SCLC cells. Conclusion Taken together, our study revealed the role of KCNQ1OT1 in the progression and chemoresistance of SCLC, and suggested KCNQ1OT1 as a potential diagnostic and prognostic biomarker in SCLC clinical management.

Objective:To study the value of sound touch elastography (STE) linear combined with ultrasound score (US) in the diagnosis of chronic hepatitis B (CHB) liver fibrosis, and to investigate whether their combination can improve the diagnostic efficiency of subdividing the degree of CHB liver fibrosis. Furthermore, a comparison with STE linear combined with the serological model was performed to seek the optimal linear combination model.Methods:A total of 313 subjects were enrolled from September 2018 to December 2021 in Shenzhen Third People′s Hospital Affiliated to Guangdong Medical University, including 259 patients with CHB who had completed liver biopsy and 54 healthy volunteers. CHB patients were divided into liver fibrosis group (F1-F4 group) according to METAVIR classification standard, and healthy volunteers were used as the control group. All subjects underwent liver ultrasound examination, STE and blood biochemical indexes of liver function. The US was performed according to the liver ultrasound examination, and the liver stiffness measurement (LSM) was measured by STE, aspartate aminotransferase and platelet ratio index (APRI) was calculated by blood biochemical index. Fisher discriminant analysis was used to establish the linear combination (LC) diagnostic marker of US and LSM, and the linear combination (LC2) diagnostic marker of LSM and APRI, successively. Spearman rank correlation coefficient was used to analyze the correlations between US, LSM, APRI, LC2, LC and pathological results. The ROC curves of US, LSM, APRI, LC2 and LC for diagnosing CHB liver fibrosis were plotted, and the diagnostic efficiency of above diagnostic markers was evaluated according to the accuracy, sensitivity, specificity and area under the ROC curve (AUC).Results:The formula for the linear combination of US and LSM was LC=0.986 0×US+ 0.166 7×LSM, and LC was highly positively correlated with pathological findings ( rs=0.851, P<0.001), higher than US, LSM, LC2 and APRI ( rs=0.825, 0.775, 0.802, 0.586, all P<0.001). LC showed the best diagnostic efficiency. The AUCs for diagnosing ≥F1, ≥F2, ≥F3 liver fibrosis and =F4 cirrhosis were 0.945, 0.911, 0.954, 0.955, respectively, which superior to the AUCs of US (0.913, 0.879, 0.934 and 0.916, respectively), the AUCs of LSM (0.860, 0.871, 0.934 and 0.952, respectively) and the AUCs of LC2(0.899, 0.883, 0.941, 0.946, respectively). Compared with US, the AUC of LC diagnosis of ≥F1, ≥F2, ≥F3 liver fibrosis and =F4 cirrhosis increased by 3.2%, 3.2%, 2.0% and 3.9%, respectively, with all significant differences ( P<0.05). Compared with LSM, the AUC of LC increased by 8.5%, 4.0%, 2.0% and 0.3%, respectively, with significant difference ( P<0.05) except for stage =F4 cirrhosis.Compared with LC2, the AUC of LC increased by 4.6%, 2.8%, 1.3% and 0.9%, respectively, and there were significant differences in the diagnosis of ≥F1 and ≥F2 liver fibrosis ( P<0.05). Moreover, the overall efficiency of LC2 was not significantly improved than LSM, the difference was not significant ( P>0.05). Conclusions:US, LSM, LC2 and LC can be used to diagnose the degree of CHB liver fibrosis, but LC is better than US or LSM and LC2 alone, especially in the subdivision of mild liver fibrosis, which is a promising new diagnostic marker to subdivide the degree of CHB liver fibrosis.

Objective:To explore the clinical application values of a nomogram based on preoperative breast MRI and axillary ultrasonography imaging parameters for predicting the risk of sentinel lymph node (SLN) metastasis in early-stage breast cancer patients.Methods:Three hundred and ninty-seven female patients (mean age 48.0±10.7 years old, range 25-81 years old) who admitted to Sun Yat-sen University Cancer Center from May 2007 to December 2017 were enrolled in this study. All patients were diagnosed as primary unilateral invasive early-stage breast cancer confirmed by surgical pathology. Preoperative breast MRI, axillary ultrasonography and clinical pathological data of enrolled patients were retrospectively analyzed. According to the pathological results of sentinel lymph node biopsy (SLNB), the cases were divided into negative SLN group ( n=200) and positive SLN group ( n=197). Clinicopathologic data, MRI and axillary ultrasound features were analyzed and compared between two groups. Logistic regression analysis was used to select independent risk factors. Then a predictive model was constructed and a nomogram was made for visualizing the associations between the predictive factors and SLN metastasis. Goodness-of-fit of the model was evaluated by using the Hosmer-Lemeshow test. Predictive performance was assessed based on the receiver operating characteristic (ROC) curves. Bootstrap resampling was performed for internal validation. Results:Significant differences were found in patient age, lymphovascular invasion status, PR status, HER2 status and molecular subtype between negative and positive SLN groups (all P<0.05); MRI features including tumor size, mass margin, long and short diameter, as well as the ratio of long to short diameter of LNs, LN margin, presence or absence of LN hilum, and axillary LNs symmetry were found significantly different between negative and positive SLN groups (all P<0.05); as for the axillary LN ultrasonography parameters, the interface between cortex and medulla, presence or absence of cortical thickening, and LN hilum were significantly different between negative and positive SLN groups (all P<0.05). Logistic regression analysis results showed that several factors could be identified as predictors of SLN metastasis, including patient age, MRI features (lymph node margin, presence or absence of lymph node hilum, and lymph node symmetry), axillary ultrasonography descriptors (presence or absence of cortical thickening) and pathological factors (lympovascular invasion, PR and HER2 status). The nomogram with patient age and the above imaging factors showed good,prediction performance with the area under the ROC as 0.778. Combining with the pathological parameters, the prediction performance of the nomogram model was significantly improved, yielding the area under the ROC of 0.866. Conclusions:The nomogram based on breast MRI and axillary ultrasonography can be applied as a noninvasive quantitative tool to predict the risk of SLN metastasis in early-stage breast cancer, which may facilitate decision-making for axillary treament strategy preoperatively.