Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is a kind of targeted drug for the treatment of non-small cell lung cancer (NSCLC),but almost all patients develop EGFR-TKI resistance.In Chinese medicine,it is believed that Yang deficiency is the leading cause of tumor,which could end up with the internal formation of cancer toxin and promote the formation of tangible excess pathogens.Clinical and experimental studies have shown that the Chinese medicine treatment based on Yang-warming method can inhibit EGFR-TKI resistance and improve the therapeutic effect of EGFR-TKI.The mechanism may be related to the regulation of miRNA gene and estrogen receptor expression,being against tumor heterogeneity and the regulation of tumor microenvironment.Therefore,Yang deficiency is the key pathogenesis of the EGFR-TKI resistance in NSCLC,and the method reinforcing Yang and suppressing Yin is the basic therapeutic way in Chinese medicine to overcome EGFR-TKI resistance.

Objective: To study the roles of N methyl D aspartate acid (NMDA) receptors of glutamate in mediating the arterial baroreceptor reflex (ABR)in rostral ventrolateral medulla (RVLM) in rats. Methods: The blood pressure, heart rates and ABR were observed after the bilateral microinjection of 0.1 ?l 50 mmol/L ketamine into RVLM of ureth anesthetized rats. Results: Bilateral microinjection of ketamine into RVLM induced decrease of the blood pressure and heart rate ( P

Objective To investigate the status of nursing professional values and its influencing factors to make contribution for nursing managers to improve nursing professional values.Methods 280 registered nurses selected by convenient sampling method were investigated by demographic questionnaires and the Revised Nursing Professional Values Scale (NPVS-R).Results The score of nursing professional value was (100.70 ± 6.36) points,the highest scoring dimension wasprofessional characteristic ,followed by trust, behavioristand providing care.The scores of protecting patients privacy,being trusted by patients,constantly improving professional ability,etc.were higher.The scores of involving in research,peer review and public decision,etc.were lower.Medical department,profession and interest,job satisfaction were the influencing factors,F values were 2.575,3.750 and 2.909.Conclusions The nursing professional value was higher than middle level and unbalanced development.Nursing managers should take individualized approach to improve nursing professional values based on the characteristics of departments and lower score parts.

Objective To investigate the clinical effect of IFNα combined with mannan peptide in treatment of patients with HBeAg-positive chronic hepatitis B ( CHB ). Methods Eighty HBeAg-positive CHB patients with HBV DNA quantity ranging from 10 to 10 eopies/mL were enrolled and randomized into the treatment group and the control group ( n = 40 for each ). Patients in treatment group were given daily subcutaneous injection of IFNα-2b 5,000,000 U for 52 weeks, and received mannan peptide 10 mg per intravenous injection or 2. 5 mg per intramuscular injection for a total of 2 to 3 treatment courses (12 weeks for each). The control group received only IFNα-2b treatment. Liver function, serum markers of hepatitis B, HBV DNA quantity and blood tests were performed before the treatment and at 2, 4, 8, 16, 26 and 52-week during the treatment; and the adverse effects were recorded. Results The rates for ALT normalization, negative HBsAg, negative HBeAg, HBeAg seroconversion and negative HBV DNA were 91. 8% , 17. 5% , 52. 5% , 27. 5 % and 47. 5% at 52nd week in the treatment group, while those in the control group were 80. 0% , 12. 5% , 30. 0% , 10. 0 % and 25. 0% , respectively. There were significant differences in HBeAg-negative, HBeAg-seroeonversion and HBV DNA-negative rates between two groups (χ2 = 4. 178, 4.021 and 4.381, P < 0. 05 ) , and these indexes in the treatment group were increased to 57. 5% , 30. 0% and 50. 0 respectively at 52nd week after drug withdraw. White blood cells began to be elevated at 4th week and were restored to the normal levels at 8th week in the treatment group, while the count in the control was lower than the normal value even at 52nd week of the treatment with the average of (3.45±1. 18)×109/L. Conclusion Alpha-interferon combined with mannan peptide therapy is effective for patients with HBeAg-positive CHB, which may restore the declined peripheral WBC counts induced by interferon and improve the compliance.

OBJECTIVE To explore the effect and mechanism of limonin on liver fibrosis in rats. METHODS Forty-two SD male rats were randomly divided into normal group， model group， positive control group （colchicine， 0.1 mg/kg）， low-dose group of limonin （12.5 mg/kg） and high-dose group of limonin （50 mg/kg）， with 9 rats in normal group and model group， and 8 rats in other groups. Except for normal group， the model of liver fibrosis was established by carbon tetrachloride. After modeling， normal group and model group were given distilled water intragastrically， and administration groups were given relevant medicine intragastrically，once a day，for consecutive 4 weeks. After the last medication， the serum contents of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， hyaluronic acid （HA） and laminin （LN） in rats were detected by enzyme-linked immunosorbent assay （ELISA） method. HE and Masson staining were used to observe the pathological changes and fibrotic change of liver tissue. Western blot assay was used to detect the protein expressions of protein kinase B （Akt）， phosphorylated-protein kinase B （p-Akt）， E-cadherin and vimentin in liver tissue； ratio of p-Akt/Akt was calculated. RESULTS Compared normal group， the serum contents of ALT， AST， HA and LN in rats were all increased significantly in model group （P＜0.01）； HE and Masson staining showed that a large number of fibrous tissue hyperplasia， protein expressions of Akt， p-Akt and vimentin as well as p-Akt/ Akt ratio in liver tissue were significantly increased （P＜0.01）， while E-cadherin protein expression was significantly decreased （P＜0.01）. Compared with model group， the degree of fibrosis hyperplasia in liver tissue was relieved in high-dose group and low- dose group of limonin， and other indexes were all reversed significantly except for LN and E-cadherin in the low-dose group of limonin （P＜0.01 or P＜0.05）. CONCLUSIONS Limonin can improve liver fibrosis in rats， the mechanism of which may be related to the inhibition of Akt phosphorylation and reversal of epithelial-mesenchymal transition process.

Objective:To investigate the application value of oral stimulation combined with maternal milk sucking in the pain caused by PICC in children with congenital digestive tract malformations.Methods:Using convenience sampling method, 80 children with congenital digestive tract malformations who were admitted to Hunan Children's Hospital from July 2018 to December 2019 were selected and divided into the experimental group and the control group of 40 cases in each group according to the random number table method. The control group was given routine nursing mode, while the experimental group was given oral stimulation combined with maternal milk sucking intervention on the basis of routine nursing. The intervention effects were evaluated by the Neonatal Infant Pain Scale (NIPS), the onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face, and indicators such as heart rate, respiratory rate and SpO 2. Results:The NIPS scores of children in the experimental group were (5.60 ± 1.24) and (4.10 ± 0.31) in the puncture period and the recovery period, which were significantly lower than those in the control group (6.10 ± 0.84), (4.93 ± 0.35), the differences were statistically significant (t = 2.12, 3.00, both P<0.05). The heart rate and respiratory rate of the children in the experimental group were (151.10 ± 12.37), (147.00 ± 12.16) times/min and (47.48 ± 7.59), (45.58 ± 6.51) times/min in the puncture period and the recovery period, which were significantly lower than those in the control group (159.75 ± 13.81), (156.05 ± 12.99) times/min and (52.38 ± 8.12), (49.75 ± 7.59) times/min, the differences were statistically significant (t values were 2.64-3.22, all P<0.05). The SpO 2 in the experimental group were 0.980 5 ± 0.009 0, 0.982 5 ± 0.010 8 in the puncture period and the recovery period, which were significantly higher than those in the control group 0.970 8 ± 0.014 2, 0.971 8 ± 0.018 1, the differences were statistically significant (t = 3.66, 3.23, both P<0.05). The onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face in the experimental group were (41.55 ± 6.38), (22.05 ± 4.47), (35.08 ± 5.94), (24.65 ± 5.46) s, significantly shorter than those in the control group (46.58 ± 5.26), (29.50 ± 6.48), (44.68 ± 13.31), (30.65 ± 9.42) s, the differences were statistically significant (t values were 2.63-5.98, all P<0.05). Conclusions:Oral stimulation combined with maternal milk sucking can effectively relieve the pain caused by PICC in children with congenital digestive tract malformation, and reduce the physiological stress response of children.

OBJECTIVE To investigate the improvement effects of glycyrrhizin （GL） on Helicobacter pylori （HP）-associated gastritis in rats and its mechanism. METHODS HP-associated gastritis rat model was induced by inoculating with 1×109 cfu/mL HP. The model rats were randomly divided into model group， positive control group （HP standard quadruple group）， GL low-dose， medium-dose and high-dose groups （5， 20， 50 mg/kg）， with 12 rats in each group. Another 12 healthy rats were selected as normal control group. Except the normal control group and model group were given constant volume of normal saline intragastrically， the other groups were given corresponding drugs intragastrically， once a day， for 30 consecutive days. After administration， rats received 13C urea breath test， and delta-over-baseline （DOB） was recorded； the pathological and cellular morphological changes of gastric mucosa in rats were observed， and pathological scoring was performed； the levels of interleukin-8 （IL-8）， IL-1β， tumor necrosis factor-α （TNF-α）， reactive oxygen species （ROS） and malondialdehyde （MDA） were detected in gastric mucosa of rats； mRNA expressions of high mobility group box-1 protein （HMGB1） and nuclear factor-κ-B （NF-κB）， relative expressions of nitric oxide synthases （iNOS） and HMGB1， the phosphorylation level of NF- κBp65 were also detected in rats. RESULTS Compared with normal control group， the DOB value， histopathological score of gastric mucosa， the levels of IL-8， IL-1β， TNF-α， ROS and MDA， relative expressions of HMGB1 and NF- κB mRNA， relative expressions of iNOS and HMGB1 protein and the phosphorylation level of NF-κB p65 were all increased significantly in model group （P＜0.05）； the epithelial cells of gastric mucosa in rats were incomplete in structure and decreased in the number， with an increase in cell fragments and vacuoles， and significant cell pyknosis. Compared with model group， the changes of the above indexes in GL groups and positive control group were significantly reversed （P＜0.05）； the changes in the above indicators in the GL high-dose group were more significant than GL low-dose and medium-dose groups （P＜0.05）； the pathological changes of gastric mucosal cells in rats had all improved. CONCLUSIONS GL may inhibit inflammation and oxidative stress by inhibiting the activation of HMGB1/NF-κB pathway， thus relieving HP-induced gastric mucosal injury.