Objective To evaluate accuracy of preoperative tumor grade and intracperative gross examination of myometrial invasion in patients with clinical stage Ⅰ endometriod adenocarcinoma for lymphadenectomy. Methods Clinic-pathological data were retrospectively collected from 687 patients with clinical stage Ⅰ endometriod adenocarcinoma who underwent operation in Women's Hospital, Zhejiang University School of Medicine from January 1999 to December 2008. According to postoperative histology diagnosis, accuracy of preoperative tumor grade by curettage and depth of myometrial invasion by intraoperative gross examination was evaluated, and clinic-pathological factors associated with accuracy were analyzed. Results Sensitivity, specificity, accuracy, false negative rate, false positive rate, and positive and negative predictive value for the prediction of needing for intraoperative lymphadenectomy in patients with clinical stage Ⅰ endometriod adenocarcinoma were 70. 4% ,80. 2% ,77.6% ,12.0%, 43.0%, 57.0% and 88.0%, respectively. Analysis of mutil-factors shown that patient age, tumor size, lymph node metastasis and extrauterine spread lesions were independent factors affected the accuracy of prediction(P ＜ 0. 05 ). Conclusion Prediction of needing for lymphadenectomy by preoperative tumor grade and intraoperative gross examination of myometrial invasion is reliable in clinical stage Ⅰ endometriod adenocarcinoma patients, while there is a highly false negative rate in prediction of not needing for lymphadenectomy, while other prognostic factors such as patient age, tumor size, lymph node metastasis and extrauterine spread lesion should be together considered.

Objective To observe a recombinant mutant of HBV core protein for dominant negative gene therapy against HBV encapsidation in vitro. Methods C gene and S gene of HBV were acquired through PCR and subcloned into pGEM T to construct pGEM T C and pGEM T S respectively. After digestion and ligation of these two plasmids, pGEM T CS was constructed. The cloned gene was inserted into pcDNA3.1 + to construct pcDNA3.1 + CS, which was identified by DNA sequencing. The recombinant plasmids were transformed into HepG2 cells, and screened with G418. The resistant HepG2 cell clones were chosen to test the expression of core surface protein by RT PCR, and the expressing HepG2 clones were cultured with 10% HBV DNA positive human serum for 72 hours. The intracellular HBV particles were extracted and the DNA was subjected to dot hybridization. Results The analysis showed that the HepG2 cells expressing mutant C protein had capabilities to resist HBV invasion in varied degrees. The mutant C protein had a dominant negative role in the encapsidation of HBV compared with the naive part of core protein. Conclusions The production of recombinant mutant core protein has a potential value for gene therapy against HBV infection.

Aim To investigate the effects of endogenous and exogenous hydrogen sulfide(H_2S)on the proliferation and apoptosis of human fetal lung fibroblasts.Methods Human fetal lung fibroblasts were cultured under 2% O2～93% N_2～5% CO_2 for 24 h to produce hypoxia.Cells were divided into 6 groups:(1)Hypoxia group(N_2);(2)N_2+600 μmol·L~(-1) NaHS group;(3)N_2+1 200 μmol·L~(-1) NaHS group;(4)N_2+6 400 μmol·L~(-1) NaHS group;(5)N_2+400 μmol·L~(-1) cysteine(Cys)group;(6)N_2+200 μmol·L~(-1) S-adenosyl-L-methionine(SAM)group.After they were cultured for 24 h, MTT assay was used to evaluate the cell proliferation, and flow cytometry was used to detect cell apoptosis.Results Compared with N_2 group, 600 and 1 200 μmol·L ~(-1) NaHS(H_2S donor)significantly reduced proliferation induced by hypoxia of human fetal lung fibroblasts(P <0.01)without effects on apoptotic rates of cells(P >0.05)and 6 400 μmol·L~(-1) NaHS increased apoptosis of human fetal lung fibroblasts during hypoxia significantly(P <0.05), although no effects were found on proliferation of cells(P >0.05).In addition, Cys, substrate of cystathionine β-synthetase(H2S synthase, CBS) or SAM(activator of CBS)did not affect proliferation of human fetal lung fibroblasts induced by hypoxia(P >0.05), whereas apoptotic rates were increased significantly compared with that of N_2 group(P <0.05).Conclusions Endogenous and exogenous hydrogen sulfide can inhibit proliferation induced by hypoxia and promote apoptosis of human fetal lung fibroblasts, suggesting endogenous hydrogen sulfide may play a protective role through lung fibroblasts by inhibiting the pulmonary vascular structural remodeling caused by hypoxia.

Objective To study the impact of earlier tracheotomy on the prevention and treatment of pulmonary infection for the patients with severe head injury.Methods The 68 patients with severe head injury(experimental group) received tracheotomy within 24h after emergency cerebrotomy,controlled by 68 patients(control group) who didn't receive tracheotomy within 24h after emergency cerebrotomy.The third generation cephalosporin and semi-benzylpenicillin were used to prevent infection in all the patients.The patients who had lung infection were taken sputum cultivation test to choose sensitive medicine for the treatment.Results A total of 68 patients occurred pneumonia.There were 35 patients occurred pneumonia in the experimental group and 20 patients were cured.The time of infection control was 4～11d(averaged 7.1 d).There were 53 patients occurred pneumonia in control group, and 21 of them were cured.The time of infection control was 9～21d(averaged 16.9 d).The rate of lung infection and the time of infection were significantly lower in the experimental group than those of the control group(P

Objective To evaluate the efficacy of caudal block with dexmedetomidine mixed with ropivacaine for the management of perioperative analgesia in children.Methods Sixty pediatric patients,aged 1-5 yr,of ASA physical status Ⅰ or Ⅱ,scheduled for elective hypospadias repair,were equally and randomly assigned into 2 groups using a random number table:ropivacaine group (group R) and dexmedetomidine mixed with ropivacaine group (group DR).Each patient received a single caudal dose of 0.25％ ropivacaine 1 ml/kg in group R.Each patient received a single caudal dose of 0.25％ ropivacaine 1 ml/kg mixed with dexmedetomidine 2 μg/kg in group DR.Postoperative analgesia was assessed using FLACC scale,and the degree of motor block was assessed using modified Bromage scale within 24 h after the end of operation.The duration of analgesia (the time from onset of caudal block to first requirement for the rescue analgesic) and development of side effects were recorded.Results Compared with group R,the duration of analgesia was significantly prolonged,and the incidence of bradycardia and oversedation was increased in group DR.Hypoxemia,hypotension and postoperative motor block were not found in either group.Conclusion Addition of dexmedetomidine 2 μg/kg to caudal ropivacaine can significantly optimize the efficacy of caudal block with ropivacaine alone for the management of perioperative analgesia in children.

Objective:To conduct a scoping review of mobile app-based weight management studies in patients with breast cancer.Methods:The studies related to weight management in patients with breast cancer based on mobile apps in nine Chinese and English databases, including PubMed, Embase, Cochrane, EBSCOhost, Scopus, Sinomed, VIP database, Wanfang Database and China National Knowledge Infrastructure (CNKI), were systematically searched with the terms of “breast cancer” “weight management” “mobile health” and “weight”. The search period was from the establishment of the databases to July 29, 2022. The literature was screened, and data were extracted and summarized based on the Omaha system.Results:A total of 7 literatures were included, all were in English. The mobile apps included in the studies varied with sample sizes, ranging from 10 to 356 cases. Six of the studies involved breast cancer patients who had completed surgery or chemoradiotherapy, and none of the studies involved breast cancer patients undergoing chemotherapy. Forms of intervention included exercise or diet alone and a combination of both exercise and diet, and most studies had shown good intervention effects. According to the Omaha intervention system, the most commonly extracted intervention component was self-management advice, which was offered to patients in six studies, and none of the intervention studies included intervention components related to case management.Conclusions:An intervention for weight management based on mobile apps in breast cancer patients has a good effect and is feasible. However, there is a limited number of related studies, and there is a lack of interventional research specifically targeting patients during chemotherapy, which still needs to be actively carried out.

Abstract Social network of adolescents is one of the important factors affecting the initiation and development of their unhealthy eating behaviors, and different types of social networks shows varied influences on adolescents eating behaviors through divergent mechanisms. In the context of the new media era, social networks of adolescents establish via social media appear more complex and extensive. Based on relevant previous literature, the paper explores the impact and possible mechanisms of social network on eating behavior of adolescents, as well as its development and application in the new media era to provide references for better intervention strategies and healthier eating behaviors among adolescents from the perspective of social network.

Objective To determine the expression pattern of macrophage-inducible c-type lectin (MINCLE)on Macrophage(Mφ),myeloid dendritic cell (mDC)and plasmacytoid DC(pDC)in peripheral blood (PB)and synovial fluid(SF)in patients with rheumatoid arthritis (RA).Methods For mRNA expression of MINCLE,253 RA patients and 71 healthy control subjects were enrolled.The mRNA level of MINCLE was determined by real-time PCR.For protein expression of MINCLE,18 patients with RA,5 patients with osteoarthritis(OA)and 12 healthy control subjects were enrolled.The expression of MINCLE on Mφ,mDC and pDC were detected by flow cytometry.The differences of MINCLE expressions in PB between RA patients,OA patients and healthy controls,or differences between PB and SF in RA patients were analyzed using Mann-Whitney U test or paired-samples t test.Results ①Compared to the healthy controls,RA patients showed elevated mRNA expression level of MINCLE in PBMCs[(1.65±0.36)vs (0.37±0.06),U=6057,P=2.75×10-5].②At protein level,MINCLE was hardly detected in Mφ,mDC and pDC in PB of OA patients and healthy controls.In SF,MINCLE was highiy expressed on mDC in RA patients,compared with that in OA patients[(34.8±4.4)%,U=0,P=2.6×10-3].In RA patients,the expression level of MINCLE was remarkably elevated in Mφ,mDC and pDC in SF compared with that in PB[Mφ(2.01±0.53)%vs(0.273±0.51)%,t=4.879,P=2.23×10-6;mDC(34.8±4.4)%vs(22.7±5.5)%t=2.535.P=0.017].Conclusion MINCLE is selectively expressed on Mφ.mDC and pDC in SF in RA patients.MINCLE may serve as a potential important marker,or even target,for RA and possibly even for inflammation in general.

Objective: To explore the status of care quality evaluation in the built-in type institution that integrating pension and health care service and analyze the focus on nursing service and management,it aims to provide theoretical basis for nurse managers to implement scientific nursing management. Methods: Descriptive phenomenological methodology was adopted in this study,a semi-structured interview was conducted with 8 nurse managers from 7 built-in type institutions that integrating pension and health care service.Data were analyzed based on Colaizzi′ s phenomenological research method. Results: Two themes were extracted, including the status of care quality evaluation in the built-in type institution that integrating pension and health care service; key indicators of nursing quality in the built-in type institution that integrating pension and health care service. Conclusions Through in-depth interviews with 8 nurse managers, we suggest that state should attach importance to the quality inspection of nursing care in the built-in type institution that integrating pension and health care service, and explore the evaluation criteria for nursing quality,in order to ensure the safety of elderly care, and it also can provide a basis for the comparison between inter-agency nursing quality and promote healthy competition among institutions.

Objective To systematically assess the clinical effect and safety of Poractant Alfa Injection and ambroxol hydro-chloride in treating neonatal respiratory distress syndrome (NRDS) .Methods The home and abroad randomized controlled trials ( RCTs ) on the comparison of clinical effect and safety of Poractant Alfa Injection and ambroxol hydrochloride in treating NRDS were retrieved by computer .The literature quality was evaluated by the modified JADAD scale .Rev Man5 .3 .1 software was used for conducting the meta analysis .Results Twenty-four RCT were included .The meta analysis results showed that compared with ambroxol hydrochloride ,Poractant Alfa Injection for treating NRDS could more significantly increase the PH value (MD= -0 .02 , 95% CI:-0 .03- -0 .01 ,P<0 .01) ,increased the PaO2 value(MD= -2 .92 ,95% CI:-4 .59 - -1 .26 ,P<0 .01) ,decreased the PaCO2 value (MD=0 .95 ,95% CI:0 .12-1 .77 ,P=0 .02) ,reduced the FiO2 value(MD=0 .03 ,95% CI:0 .01-0 .05 ,P<0 .01) ,en-hanced the Pa O2/FiO2 ratio (MD= -7 .62 ,95% CI:-10 .87 - -4 .37 ,P<0 .01) ,reduced the short term complications (RR=1 .67 ,95% CI:1 .31-2 .12 ,P<0 .01) and long-term complications (RR=2 .85 ,95% CI:1 .14-7 .07 ,P=0 .02) ,shortened the hos-pitalization days (RR=3 .03 ,95% CI:0 .94 -5 .11 ,P<0 .01) as well as decreased the mortality rate (RR=1 .96 ,95% CI:1 .15-3 .34 ,P=0 .01) .However ,there were no statistical differences in the durations of continuous positive airway pressure (CPAP) me-chanical ventilation ,oxygen inhalation time ,time of clinical symptom outcome ,incidence rate of NRDS and total effective rate of treatment between the two groups .Conclusion Currently published evidences show that Poractant Alfa Injection is superior to am-broxol hydrochloride in treating NRDS ,however ,due to limited number of included RCD and medium quality ,the conclusion needs large scale and multicenter RCT verification .