Objective: To determine the predictive value of excision repair cross complement 1 (ERCC1) expression in non-small cell lung cancer (NSCLC) and the sensitivity of NSCLC to non-cisplatin based chemo-therapy and cisplatin based chemotherapy. Methods: The expression of ERCC1 was examined by immunohis-tochemical technique in 130 patients with advanced NSCLC seen in our hospital between February 1st 2006 and October 30th 2007. These 130 patients were divied into three groups. Patients in group A (n=68) had neg-ative ERCC1 expression and received cisplatin based chemotherapy. Patients in group B (n=31) had positive expression of ERCC1 and received non-cisplatin based chemotherapy. Patients in group C (n=31) had posi-tive expression of ERCC1 and received cisplatin based chemotherapy. Results: The expression rate of ER-CC1 was 62 of 130 (47.8%). The rate of ERCC1 in pulmonary adenocarcinoma was higher than that in squa-mous carcinoma. The response rates of chemotherapy in group A, B, and C group were 58.8 %, 51.6%, and 41.5%, respecitvely. There was no significant difference in the response rate between group A and group B (X~2=0.451, P=0.502). There was a significant difference in the response rate between group A and group C (X~2= 6.011, P=0.014). The response rate in group B was higher than that in group C (X~2=2.384, P=1.123). The average survival time in group A, group B, and group C were 12.0 months, 11.0 months, and 7.8 months, respecit-vely. There was no significant difference in patient survival between group A and group B (X~2=3.809, P=0.051). There was significant difference in patient survival between group A and group C (X~2=46.368, P=0.000). Con-clusion: ERCC1 may be an important indicator of the sensitivity of advanced NSCLC to cisplatin or non-cisplat-in based chemotherapy.

Objective We aimed to assess the sedative effects by intravenous injection of fentanyl on neonates with mechanical ventilation. Methods We divided 142 neonates with mechanical ventilation into the observation group (92 cases) and the control group (50 cases). The observation group received intravenous injection of fentanyl, while the control group was given no sedative medication. The pain and sedation was assessed before ventilation, 1 and 2 hours after ventilation and later every 4 hours by adoption of NPASS evaluation inventory. Results The scores of pain at different time points 2 hours after medication in the observation group were lower than those in the control group, especially 24 hours after medication. The mean airway pressure and oxygen concentration required by the observation group was lower than those of the control group. But no difference was seen in blood oxygen saturation between the two groups. Conclusions Intravenous injection of fentanyl was proper in the application of sedative treatment for neonates with mechanical ventilation. N-PASS inventory could effectively assess the pain and sedation condition and ensure the safe medication.

Objective To explore the effect of extracurricular activities based on specialist nursing clinic. Methods Thirty-four undergraduate nursing students of grade 2013 in the Capital Medical University were enrolled in the study. After learning of nursing theories for senile dementia, the extracurricular activities based onspecialist nursing clinicwere carried out. Before and after the second class activities, the caring ability inventory scale and self scale-rating for self-directed learning (SRSSDL) were used to assess 34 students. Result After the activities, students' caring ability and self-directed learning ability were statistically significantly improved (P<0.01). Conclusion The extracurricular activities based onspecialist nursing cliniccan stimulate the learning interest of nursing students and improve their self-directed learning ability and humanistic care ability.

Objective To investigate MRI findings of triple-negative breast cancer (TNBC) and correlation with Ki-67 index in Uygur women.Methods Totally 97 patients with pathologically confirmed TNBC were enrolled.Among them,28 patients were Uygur nationality (Uygur group;28 lesions) and 69 were Han nationality (Han group;70 lesions).MRI features of the two groups were observed and compared,and the correlation between MRI findings and Ki-67 index in Uygur group was analyzed.Results The pathological type of TNBC in Uygur group and Han group was both mainly invasive ductal carcinoma (grade 3).There was no statistical difference of Ki-67 index nor ADC value between the two groups (both P＞0.05).The Uygur patients were younger than Han patients (P＜0.05) and maximum diameter of lesions and early enhancement rate in Uygur group were higher than those in Han group (all P＜0.05).The margin and enhancement features of lesions were statistically different between the two groups (both P＜0.05).The dominated type of time-signal intensity curve (TIC) in Uygur group was wash-out type,while in Han group was plateau type (P＜0.001).The Ki-67 index was positively correlated with tumor shape and TIC type in Uygur group (r=0.464,0.606,both P＜0.05).Conclusion MRI features of Uygur women with TNBC is somewhat different from Han women,and part features are correlated with Ki-67 index.

Objective:To investigate the uncertainty level of caregivers of children with imperforate anus, and determine the influence factors.Methods:Two hundred and twenty-nine caregivers were enrolled from three tertiary children′s hospital in Eastern China. The caregivers completed the Perception of Uncertainty Scale, Parent Stigma Scale and Social Support Scale. The demographic information of caregivers and affected children were also collected during the survey.Results:The average score of uncertainty of caregivers was (72.58±14.06) points, and multiple analysis showed that education level, the acceptance level of disease, social support and stigma were independent determinants of uncertainty ( P<0.01), and these factors could account for 26.9% of the variance. Conclusions:The caregivers of children with imperforate anus experience a high level of uncertainty, especially those with low education level, share low acceptance level of disease, receive low social support and experience higher level of stigma.

Objective To Investigate the immune status and influencing factors of provincial polio network laboratory (PNL) workers in China so as to provide evidence for the development of related strategies to protect personnel working at the PNLs.Methods All the practitioners from the PNLs at the provincial centers for disease control,were selected as objects for this study,from October to December,2016,under a questionnaire survey.Information on status of immunity and influencing factors was collected,with SAS software,trend chi-square used for statistics analysis.Results A total of 77 workers were involved in this survey,with 60 (78％) of them completed the polio-based immune program but the rest 17 (22％) remained records unclear.66 people (about 86％) remembered clearly that they had received vaccination when engaging in the polio-lab work,but the rest 11 (14％) with only partial vaccination records.We also noticed that the Influencing factors realted to vaccination status were:age (x2 =2.48,P＜0.05),title (x2 =2.51,P＜0.05),years of employment (P＜0.000 1),education (x2 =0.74,P=0.46) and gender (x2 =0.46,P=0.50).Conclusion Immune status of the Chinese provincial PNL practitioners appeared fairly good as 86％ of all the workers had received polio-related vaccination,with 41％ of them completed a 3-time inoculation program,when started working in this field.

Objective:To analyze and summarize the clinical and genetic features of Noonan syndrome (NS) caused by mutations in the leucine zipper-like transcription regulator 1 ( LZTR1) gene. Methods:The retrospective study analyzed a patient who was examined at the Center of Prenatal and Hereditary Disease Diagnosis, Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University in January 2021 because of fetal nuchal translucency thickening and a previous history of problematic pregnancies. Subsequently, the patient was diagnosed with Noonan syndrome (NS) through whole exome sequencing. Using keywords such as "Noonan syndrome," "Leucine zipper-like transcription regulator 1", and " LZTR1", clinical and genetic characteristics of NS derived from LZTR1 mutations were summarized by extracting relevant literature from China National Knowledge Infrastructure, Wanfang Database, Yiigle, PubMed and Web of Science, covering from January 2013 to October 2022. Descriptive analysis was applied to the data. Results:(1) Case report: WES and Sanger sequencing showed the existence of the biallelic variants of LZTR1 gene c.842C>T and c.2248G>A in the fetus (Ⅱ-3) and the proband (Ⅱ-2) that inherited from the father and the mother, respectively. Based on the typical special facial appearance and short stature in the proband indicative of NS, the fetus and the proband were diagnosed with autosomal recessive inheritance (AR) NS. The pregnant woman terminated her pregnancy at 22 weeks due to severe edema of the fetus. At the age of three, the proband exhibited typical craniofacial features and short stature characteristics of NS when presented to our hospital. The proband received regular follow-ups in the pediatrics department of other hospitals, where recombinant human growth hormone was used to improve his height. He attended kindergarten at age four and can communicate and play with other children normally. (2) Literature review: 95 cases of NS associated with LZTR1 mutations have been retrieved and included. When including the fetus and the proband of this case, the total reached 97 cases, involving 79 different mutation sites. Forty-three cases (44.3%) were AR, and 54 (55.7%) were autosomal dominant inheritance (AD). Missense mutation was the most prevalent type of mutation, whereas nonsense mutation and frameshift mutation were more common in biallelic variants. Across all cases, the clinical manifestations encompassed multiple systems, primarily characterized by craniofacial dysmorphia, skeletal deformities, heart defects, and short stature. Developmental delay, learning disabilities, and mental retardation of varying degrees may accompany these symptoms. Eighteen cases described antenatal phenotypes, with 16 of them reporting biallelic AR variants. Ultrasound findings of 18 prenatal cases revealed 11 cases of fetal NT thickening, seven cases of cystic hygroma, four cases of fetal pericardium or pleural effusion, two cases of severe fetal edema, and 11 cases of cardiovascular defects. Conclusions:NS induced by LZTR1 mutations is an autosomal dominant or recessive inherited genetic syndrome with a broad spectrum of clinical phenotypes. The severity of the disease varies among children with the same genotype. NS should be considered when prenatal ultrasound indicates nonspecific manifestations, such as fetal NT thickening, cervical lymphatic hydrops, polyhydramnios, fetal edema, and congenital heart defects. Prenatal identification is crucial for evaluating the prognosis of children and assisting families in making clinical decisions.

Objective: To investigate whether topical mucopolysaccharide polysulfate (MPS) cream can reduce the incidence of eczema and skin atrophy in patients with moderate- or low-risk infantile hemangioma after the treatment with topical beta-blockers or 595-nm pulsed dye laser (PDL) , and to analyze factors influencing the occurrence of eczema and skin atrophy. Methods: A total of 722 patients aged 0- 1 years with moderate- or low-risk infantile hemangioma were enrolled from 5 Children′s Hospitals in China. According to the disease condition and therapy acceptability, these patients were divided into 6 groups to be treated with topical beta-blockers and MPS cream (blocker+ MPS group) , topical beta-blockers (blocker group) , 595-nm PDL and topical MPS cream (PDL+ MPS group) , 595-nm PDL (PDL group) , 595-nm PDL combined with topical beta-blockers and MPS cream (PDL+ blocker+ MPS group) , and 595-nm PDL and topical beta-blockers (PDL+ blocker group) , respectively. All the externally applied agents were applied twice a day, and PDL was performed once every 4 weeks. Efficacy and adverse reactions were evaluated after 3-month treatment. Univariate and multivariate Logistic regression analyses were carried out to analyze factors influencing the incidence of eczema and skin atrophy in patients with infantile hemangioma after treatment, and chi-square test was carried out to compare efficacy among the groups. Results: After 3-month treatment, multivariate Logistic regression analysis for comparing the blocker+ MPS group with blocker group showed that the risk factor for eczema on the surface of hemangiomas was no topical treatment with MPS cream (P= 0.007, OR= 3.887, 95% CI: 1.439-10.493) , while no correlations were observed between the occurrence of skin atrophy on the surface of hemangiomas and analyzed factors. Multivariate Logistic regression analysis for comparing the PDL+MPS group with PDL group showed that no topical treatment with MPS cream (P < 0.001, OR= 7.402, 95% CI: 2.604-21.042) and northern areas (P < 0.001, OR= 67.048, 95% CI: 7.977-563.518) were risk factors for eczema on the surface of hemangiomas, and risk factors for skin atrophy on the surface of hemangiomas included no topical treatment with MPS cream (P = 0.001, OR = 9.371, 95 CI: 2.590 - 33.900) and abundant blood supply of hemangiomas (P = 0.036, OR = 2.971, 95% CI: 1.075-8.208) . Multivariate Logistic regression analysis for comparing the PDL + blocker+ MPS group with PDL+ blocker group showed that risk factors for eczema on the surface of hemangiomas were no topical treatment with MPS cream (P= 0.005, OR= 3.426, 95% CI: 1.446-8.119) and northern areas (P < 0.001, OR= 31.704, 95% CI: 6.924-145.158) , and risk factors for skin atrophy on the surface of hemangiomas included no topical treatment with MPS cream (P < 0.001, OR= 6.011, 95% CI: 2.558-14.126) and southern areas (P= 0.022, OR= 3.021, 95% CI: 1.177-7.753) . After 3-month treatment, the response rate was significantly higher in the PDL group than in the PDL+ MPS group (χ²= 4.531, P= 0.033) , and significantly higher in the blocker group than in the blocker+ MPS group (χ²= 4.344, P= 0.037) . There were no significant differences in the response rate or cure rate among the other groups (all P > 0.05) . Conclusion During the treatment of moderate- or low-risk infantile hemangioma with topical beta-blockers or 595-nm PDL, the combination with topical MPS cream can reduce the occurrence of eczema and skin atrophy without affecting the therapeutic effect.