Objective To understand the level of neonatal pain knowledge and attitudes of neonatal and obstetric department nurses, in order to supply the clinical basis for neonatal pain management. Methods Self-designed questionnaires to fill out on-site were distributed to 107 neonatal and obstetric department nurses (of which 40 were from neonatal department, 67 from obstetric department) for neonatal pain knowledge and attitudes. Results About question of neonatal pain, the average percentage of correct answers in the neonatal group was 75.5%, higher than 66.3% of the obstetric group, in the neonatal group, correct rate of seven questions was more than 80%,while in the obstetric group the correct rate of only one question was more than 80%, and 5 questions correct response rate was significantly lower than that of the neonatal group, the difference was significant. All nursing staff considered it essential or necessary to carry out the nursing knowledge of pain-related training. 95.0%(38/40) of neonatal nurses believed that they could properly assess the extent of neonatal pain, but only 83.6% (56/67) for the obstetric group, the difference between the two groups was significant. 97.5% (39/40) of neonatal nurses believed that they could make the right judgments on neonatal crying, and only 85.1%( 57/67) in the obstetric nurses, the difference between the two groups was significant.Conclusions Neonatal pain has gradually been recognized and paid attention to by the clinical front-line medical staff, they believe that it is necessary to receive training on neonatal pain, knowledge of neonatal pain of neonatal nurses is better than obstetric nurses.

Objective To investigate the ability of decision-making under risk condition in benign epilepsy children with centrotemporal spikes (BECT).Method Seventy-eight BECT patients and seventyfive healthycontrols were studied by Iowa Gambling Task (IGT) with inexplicit probability and Game of Dice Test (GDT) with explicit probability.Results (1) There was a significant difference in IGT task scores between the two group (t=-2.56,P＜0.05).The total number of advantageous choices in IGT were lower in BECT group (49.35±5.38) than that in healthy control group (52.24±6.23).BECT group (-1.41 ± 10.60) performed worse on task than healthy control group (4.43±11.88),and the difference was statistically significant (t=-3.21,P＜0.05).The control group scored higher on Blockl,Block4 and Block5 than that of BECT group (P＜0.05).(2) There was no significant difference between the BECT group (4.42±7.74) and the control group(5.49±6.81) in the GDT test scores (t=-0.91,P=0.37).(3) Pearson correlation analysis showed that there was no significant correlation between the age,age of onset,education,seizure frequency and onset duration and the score of IGT and GDT (r =-0.091-0.274,all P ＞ 0.05).Conclusion There is no significant decision-making disability in children with BECT under the condition of certain risk probability,while there is significant impairment under the condition of uncertain risk probability.The decision-making disability may be associated with impaired frontal lobe function.

BACKGROUND: SSh as a Hedgehog signal protein can promote bone development, growth and remodeling.OBJECTIVE: To investigate the effect of bone marrow mesenchymal stem cells (BMSCs) combined with Shh modified nano-hydroxyapatite/collagen (nHAC) in the repair of femoral defects in rats.METHODS: Forty-eight Sprague-Dawley rats were randomly divided into four groups, and the model of femoral defects was established in these rats. At 14 days after modeling, experimental group was implanted with the BMSCs/Shh modified nHAC, scaffold group was implanted with simple nHAC, cell scaffold group was implanted with BMSCs/nHAC,and blank control group was without any implantation. At 3, 6, 9, 12 weeks after repair, X-ray examination, bone density measurement and bone biopsy in bone defect area were performed.RESULTS AND CONCLUSION: (1) X-ray examination: The Lane-Sandhu X-ray score and bone mineral density value in the experimental group at different time points after operation were significantly higher than those in the other three groups (P < 0.05). (2) Hematoxylin-eosin staining: 12 weeks after repair, a small amount of bone tissues but no bone marrow formed in the scaffold group; a small amount of bone tissues with absence of bone marrow formed in the cell scaffold group, and the residual scaffold was visible; in the experimental group, the scaffold was completely absorbed,and mature bone and medullary cavity formed with presence of bone marrow. (3) Scanning electron microscope observation: 12 weeks after repair, irregular arrangement of bone fibers and a large number of bone fossae were observed in the scaffold group; the cell scaffold group showed a large number of osteoblasts, but bone fibers still arranged irregularly; in the presence of the Haversian system, a large number of regularly arranged bone trabeculae were detective in the experimental group. These results elucidate that the Shh modified nHAC/BMSCs complex can promote the repair of bone defects.

Objective To explore the efficacy and prognostic factors of postoperative intensity?modulated radiotherapy ( IMRT) with or without chemotherapy in rectal cancer. Methods A retrospective analysis was performed on the clinical data of 218 patients with rectal cancer, who underwent postoperative IMRT in our hospital from January 2009 to December 2013. The Kaplan?Meier method was used to calculate survival rate;the log?rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis. Results The follow?up rate was 97. 7%. The 1?and 3?year overall survival rates were 90. 8% and 75. 2%, respectively, the 1?and 3?year disease?free survival rates were 85. 3% and 70. 5%, respectively, and the 1?and 3?year locoregional recurrence?free survival rates were 96. 7% and 88. 1%, respectively. The incidence of grade 3?4 acute adverse reactions was 28. 4%, mainly manifested as leukopenia ( 13. 8%) and diarrhea ( 11. 0%) . Univariate prognostic analysis showed that preoperative carcinoembryonic antigen ( CEA) and CA199 levels, maximum tumor diameter, tumor location, degree of differentiation, depth of tumor invasion, number of lymph node metastases, TNM stage, perineural invasion, surgical procedure, total mesorectal excision, preoperative bowel obstruction, and preoperative anemia were the predictors of survival ( P=0. 006, 0. 000, 0. 000, 0. 017, 0. 000, 0. 016, 0. 000,0. 011,0. 001,0. 006,0. 037 and 0. 010) . Multivariate prognostic analysis showed that preoperative CEA level, tumor location, TNM stage, preoperative bowel obstruction, and preoperative anemia were the predictors of survival ( P=0. 000,0. 000,0. 000,0. 001 and 0. 001) . Conclusions Postoperative IMRT with or without chemotherapy is an effective method for rectal cancer with mild adverse reactions and high compliance. Preoperative CEA level, tumor position, TNM stage, preoperative bowel obstruction, and preoperative anemia are independent prognostic factors for the overall survival.

BACKGROUND: Polylactic acid copolymer bone scaffold has excellent biodegradability, and it is easy to be shaped and can promote the formation and growth of bone tissue and blood vessel.OBJECTIVE: To observe the effects of adipose-derived stem cells(ADSCs)/poly(lactic-co-glycolic acid) (PLGA) complex on the biomechanical properties after fracture healing in osteoporotic bone.METHODS: Sixty Sprague-Dawley rats were randomly divided into four groups: blank control group received no treatment; the bilateral tibial fracture model was made after 3 months of bilateral ovarian resection in model group; the bilateral tibial fracture model was made and ADSCs were implanted into the bone after 3 months of bilateral ovarian resection in cell therapy group; the bilateral tibial fracture model was made and the PLGA/ADSCs complex was implanted after 3 months of bilateral ovarian resection in combined treatment group.The bone mineral density, callus thickness, biomechanical parameters and the microstructure of the trabecular bone were detected.RESULTS AND CONCLUSION: (1) The bone density: The bone density of the model group was significantly lower than that of the blank control group (P < 0.05); the bone mineral density of the cell therapy group and the combined treatment group was higher than that of the model group (P < 0.05), but lower than that of the control group (P < 0.05); and the bone mineral density of the combination treatment group was higher than that of the cell therapy group (P < 0.05). (2)Thickness of the callus: The thickness of the callus in the cell therapy group and combined treatment group was higher than that of the model group and blank control group (P < 0.05); moreover, the thickness of the callus in the combined treatment group was higher than that of the cell therapy group (P < 0.05). (3) Biomechanical test: The failure load, stress and shear strength, elastic modulus were decreased in the model group compared with the blank control group (P < 0.05), while the shear strain increased (P < 0.05). Compared with the model group, the failure load, ultimate stress, shear strength, elastic modulus were increased in the cell therapy group and combined treatment group (P < 0.05), and the shear strain was decreased (P < 0.05). Moreover, the combined treatment group showed more changes in these biomechanical parameters (P < 0.05). (4) The trabecular bone microstructure: The model group presented with trabecular derangement, spacing increases, and even fracture and lacuna. After ADSCs or ADSCs/PLGA transplantation,the trabecular bones increased in number, thickness, and spacing, and the number of lacunae reduced. In conclusion,ADSCs combined with PLGA in the treatment of osteoporotic fracture can significantly improve the biomechanical parameters of bone tissue after healing.

The expression, amplification and rearrangement of c-myc and c-erbB-2 genes in thyroid tumor were studied. 32P-dATP-labelled probes of c-myc, c-erbB-2 and v-sis DNA fragments were used to hybridise with the cellular total RNA. We found that c-myc and c-erbB-2 oncogenes were expressed in all samples. The levels of c-myc RNA were three-to eleven-fold higher in 9 out of 15 cancer samples when compared with that in normal tissues. In 7 of 15 cancer samples, c-erbB-2 gene was overexpressed 10~50 times higher than normal. No v-sis RNA was detected in all the samples. Southern blot hybridisation showed that rearrangement of c-myc oncogene were observed in 4 cancer samples, of which one showed a 150-fold amplification of c-myc gene. No amplification or rearrangement of c-erbB-2 gene was detected. These data indicate that the activat.:on of c-myc and c-erbB-2 oncogenes may contribute to the development and/or maintenance of the malignant phenotype of the thyroid carcinomas.

Objective : To learn the characteristics of second-line drug resistance and related gene mutations of multidrug-resistant Mycobacterium tuberculosis ( MDR-TB ) Beijing genotype strains. Methods: The MDR-TB isolates in Hwa Mei Hospital from 2017 to 2019 were enrolled and detected using RD105 deletion-targeted multiplex polymerase chain reaction (PCR). The proportion method for drug susceptibility test was used to detect the drug-resistant profiles against kanamycin, amikacin, capreomycin, ofloxacin and levofloxacin. The gene sequencing of rrs, tlyA, eis, gidB, gyrA and gyrB was conducted by PCR compared with H37RV strain. The differences in the rates of drug resistance and mutation between Beijing and non-Beijing genotype strains were examined to understand the characteristics of Beijing genotype strains. Results: There were 106 Beijing genotype and 27 non-Beijing genotype strains in 133 MDR-TB isolates. The drug resistance rates of kanamycin, amikacin, capreomycin, ofloxacin and levofloxacin in Beijing genotype strains were 9.43%, 7.55%, 3.77%, 32.08% and 32.08%, respectively. The rates of quasi-extensive and extensive drug resistance in Beijing genotype strains were 30.19% and 7.55%. The gene mutation rates of rrs, tlyA, eis, gidB, gyrA and gyrB in Beijing genotype strains were 7.55%, 7.55%, 1.89%, 2.83%, 36.79% and 2.83%, respectively. There were no significantly differences between Beijing and Non-Beijing genotype strains in the factors above ( P>0.05 ). The gene rrs, tlyA, eis, gidB, gyrA and gyrB had 2, 1, 2, 2, 5 and 3 mutation types, respectively, with single base substitution as the main type. Conclusion Beijing genotype strains are dominant in MDR-TB, with high resistance to fluoroquinolones and mainly gyrA gene mutation.

Objective: To develop a magnetic solid-phase extraction combined with gas chromatography-tandem mass spectrometry (GC-MS/MS) based on pyrrole-modified magnetic nanoparticles to determine 16 types of phthalic acid esters (PAEs) in commercial liquors. Methods : Fe3O4 magnetic nuclei were prepared by hydrothermal synthesis, and the polypyrrole-modified magnetic nanomaterials were prepared with the chemical oxidation method. Magnetic solid-phase extraction of beer, grape wine, rice wine and Chinese spirits was performed at 10% alcohol by volume, extraction duration of 20 min and ethyl acetate elution of 10 min, followed by addition of 1 g NaCl for reduction of emulsification effect. The 16 types of PAEs were determined using GC-MS/MS with DB-5MS capillary column (30 m×250 μm, 0.25 μm) under the mode of electron impact ionization (EI) and dynamic multiple reaction monitoring (dMRM), with quantitative analysis using the external standard method. The standard curve, detection limit, spike recovery rate and precision of GC-MS/MS for determination of 16 types of PAEs were evaluated. Results: Pyrrole was successfully embedded onto the surface of magnetic nanoparticles in the form of polymer, and the magnetic nanoparticles modified by polypyrrole were well characterized, showing unapparent matrix and emulsification effects. There was a good linear relationship for the 16 types of PAEs at 50 to 5 000 ng/mL (r=0.999 5-0.999 9), and the spike recovery rate of 16 types of PAEs ranged from 71.61% to 110.50% at 100, 500 and 1 000 μg/kg, with relative standard deviations of 3.78% to 7.41%, detection limits of 0.02 to 1.47 μg/kg. PAEs were detected in 20 out of 50 liquor samples, with 30.00%, 60.00%, 40.00% and 70.00% detection rates in beer, grape wine, rice wine and Chinese spirits, respectively. Conclusions This method is sensitive to determine 16 types of PAEs in liquor samples, with unapparent matrix and emulsification effects, and the polypyrrole-modified magnetic composite nanoparticles present high adsorption of PAEs in liquor samples, which is feasible for monitoring of PAEs in multiple types of liquor samples.

Aim To study the mechanism of anti-tumor effect of PHⅡ-7 to K562 and K562/A02 cells.Methods The effects of individual and combined doxorubicin on K562 and K562/A02 cells were observed by MTT assay.The coefficient of drug interaction was used to analyse the synergistic effect of PHⅡ-7,obtaining the RNA from the cells stimulated by PHⅡ-7 with different doses to analyse the MDR1 gene expression level.Finally,the cumulation of doxorubicin was observed in K562 and K562/A02 cells after being coped with PHⅡ-7.Results PH Ⅱ-7 had anti-tumor effect with IC50 of (1.37?0.37) ?mol?L-1;(1.48?0.34) ?mol?L-1 for K562 and K562/A02,respectively.It could potentiate the anti-tumor effect of dororubicin with CDI of 0.22 and 0.09 for K562 and K562/A02,respectively.PHⅡ-7 could synergistically inhibit the proliferation of K562 and K562/A02 cells.The decrease of MDR1 expression level depended on the increase of dose of PHⅡ-7 acting on cells.PHⅡ-7 could also develop the cumulation of doxorubicin in cells.Conclusion PHⅡ-7 is not only a Cytotoxinic drug but also can synergistically inhibit the proliferation of K562 and K562/A02 cells with the decrease of MDR1 expression level,especially in K562/A02 cells.

Objective:To explore the effect of continuous nursing on the psychology and quality of life of patients with mild traumatic brain injury.Methods:A review of 120 patients with mild traumatic brain injury who were hospitalized in the Second Affiliated Hospital of Wenzhou Medical University from January 2016 to December 2019 were selected. According to the order of admission, sample numbers were drawn from the random number list and entered into groups. There were 60 cases in the control group and the intervention group. The control group received routine general nursing, and the intervention group received continuous nursing. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Quality of Life Scale (SF-36) were used to evaluate the psychology and quality of life of patients on the day of discharge and one week, one month, and three months after discharge.Results:There was no significant difference in the scores of HAMA, HAMD and SF-36 between the two groups on the day of discharge ( P>0.05). The HAMA scores at 1 week, 1 month and 3 months after the intervention of the intervention group were (18.2±8.6), (13.7±5.8) and (5.6±2.3), which were significantly lower than those of the control group (24.2±11.2), (20.4±8.2), (8.9±3.6), the differences were statistically significant ( t values were 2.32, 3.67, 4.13, P<0.05). The HAMD scores at 1 week, 1 month and 3 months after the intervention of the intervention group were (24.3±7.1), (10.9±4.2), (6.8±2.9), which were significantly lower than those of the control group (28.6±8.5), (15.3±8.3), (14.8±4.6), the differences were statistically significant ( t values were 2.11, 2.57, 7.99, P<0.05). The SF-36 scores at 1 week, 1 month and 3 months after the intervention of the intervention group were (77.2±8.9), (85.2±9.7), (87.8±12.9), which were significantly higher than those of the control group (72.3±8.2), (79.4±10.9), (81.0±11.5), the differences were statistically significant ( t values were -2.23, -2.14, -2.13, P<0.05). Conclusions:Continuing care can be extended to the patient's family, so that the health problems faced by the patient after discharge from the hospital can be effectively solved, relieve psychological pressure and improve the quality of life, and it is worthy of clinical application.