Objective To explore the molecular mechanism of Xiaojin Pills in the treatment of breast cancer using an integrated network pharmacology and experimental verification.Methods The chemical components and potential targets of Xiaojin Pills were obtained from TCMSP,TCM-ID,ETCM and SwissTargetPrediction databases.Breast cancer related targets were collected from GeneCards,OMIM and KEGG databases.The overlapped targets were imported into STRING database to analysis a protein-protein interaction(PPI).The key targets of PPI networks were screened based on node topology parameter values through Cytoscape 3.8.0.DAVID database was used to analyze the GO and KEGG pathway enrichment to build drug-chemical components-key targets-signaling pathway network.The breast cancer cell lines MDA-MB-231 and SK-BR-3 were used to study the effects of Xiaojin Pills extract on cell apoptosis,migration and invasion,and to verify the key pathway obtained by enrichment analysis.Results Totally 181 chemical components in Xiaojin Pills were obtained,including quercetin,myricetin,pinocembrin and β-sitosterol.615 potential targets were identified for the anti-breast cancer effects of Xiaojin Pills.After overlapping,170 key targets against breast cancer were identified based on the topological analysis,which included SRC,ERK1/2,AKT1,EGFR,etc.KEGG analysis enriched pathways including pathways in cancer,MAPK signaling pathway,endocrine resistance,PI3K-AKT signaling pathway,EGFR tyrosine kinase inhibitor resistance,apoptosis,and HIF-1 signaling pathway,which may play important roles in the therapeutic effects of Xiaojin Pills against breast cancer.GO enrichment was involved in protein phosphorylation,inflammatory response,negative regulation of apoptosis,and positive regulation of ERK1 and ERK2 cascades.Cell experiments showed that Xiaojin Pills further induced mitochondria-dependent apoptosis by inhibiting the activation of MAPK and PI3K-AKT pathways.At the same time,the expressions of ZO-1 and β-catenin increased,and the epithelial-mesenchymal transformation process was reversed to inhibit the metastasis of breast cancer cells.Conclusion The key targets and signaling pathways of Xiaojin Pills in the treatment of breast cancer are studied through network pharmacology combined with in vitro experiments,which provided a basis for further study of its pharmacodynamic material basis,mechanism of action and clinical application.

ObjectiveTo investigate the therapeutic effect of Ganmai Dazao Tang on breast cancer-related depression and explore the mechanism of the decoction in regulating immune inflammation and neurotransmitters via the mitogen-activated protein kinase （MAPK）/nuclear factor-κB （NF-κB） pathway. MethodBALB/c mice were randomized into control， model， fluoxetine （5 mg·kg^-1·d^-1）， and low- and high-dose （crude drug 20 and 40 g·kg^-1， respectively） Ganmai Dazao Tang groups （n=10）. The mouse model of 4T1 orthotopic transplantation-induced breast cancer-related depression-like behavior was established. The depression-like behavior of mice was assessed by the tail suspension test and the forced swimming test. RT-qPCR was employed to determine the mRNA levels of interleukin （IL）-17A， forkhead box P3 （FoxP3），IL-1β， IL-6， and tumor necrosis factor-α （TNF-α） in the cerebral cortex. Flow cytometry was employed to measure the proportions of immune cell subsets in the spleen and thymus. HPLC-MS/MS was employed to measure neurotransmitter levels in the cerebral cortex. Western blotting was employed to detect the activation of the MAPK/NF-κB pathway. ResultCompared with the model group， administration of Ganmai Dazao Tang at a dose of 40 g crude drug·kg^-1 continuously for 4 weeks shortened the immobility time of modeled mice in the tail suspension and forced swimming tests （P<0.05）， down-regulated the mRNA levels of IL-1β， IL-17A， and TNF-α （P<0.05）， increased the proportions of T cells， CD4⁺ T cells， B cells， helper T 17 （Th17） cells， and regulatory T （Treg） cells， and reduced the proportion of CD8⁺ T cells （P<0.05）. Furthermore， it lowered the levels of 5-hydroxyindoleacetic acid （5-HIAA） and kynurenine （Kyn）， decreased the kynurenine/tryptophan （Kyn/Trp） ratio （P<0.05）， increased the content of 5-hydroxytryptamine （5-HT）， and down-regulated the protein levels of phosphorylated extracellular signal-regulated kinase （p-ERK）， phosphorylated p38 MAPK， and phosphorylated nuclear factor-κB p65 （P<0.05）. ConclusionGanmai Dazao Tang can down-regulate the expression of inflammatory cytokines such as IL-1β， IL-17A， and TNF-α， restore 5-HT metabolism and Kyn/Trp balance， increase the 5-HT content， and reduce the activation of p38 MAPK， ERK， and the MAPK-mediated NF-κB signaling pathway to reduce neuroinflammation in the treatment of cancer-related depression.

Objective:To form the expert consensus on screening and evaluation of dysphagia with oral cancer patients (abbreviated as Consensus) , so as to standardize the relevant contents of screening and evaluation of dysphagia in the whole cycle of oral cancer. Methods:By referring to domestic and foreign literature related to dysphagia, combining with the specialty characteristics of oral cancer and the clinical experience of experts, a preliminary consensus was formed through in-depth interviews with experts. A total of 21 experts were selected for three rounds of expert letter consultation and expert meeting, the corresponding items were sorted out, analyzed and modified based on expert opinions, and the Consensus was finally formed. Results:The effective recovery rates of the three rounds of correspondence were 100.00% (21/21) , the expert authority coefficient was 0.91, the variation coefficient of each item was 0.04-0.20, and Kendall's harmony coefficient was 0.05 ( P<0.05) . The final consensus included four aspects, such as the effect of oral cancer on swallowing, the clinical manifestations of dysphagia, the basic procedures of screening and evaluation and the prevention and treatment of complications during evaluation. Conclusions:This Consensus is scientific and practical, which can provide clinical guidance for the screening and evaluation of dysphagia in the whole cycle of oral cancer.

Objective:To study the application value of WeChat video teaching mode in clinical teaching of digestive endoscopy nurses.Methods:The study selected 126 nursing trainees taking an internship in the Department of Gastroenterology in our hospital from January 2018 to June 2020 as the teaching objects, and they were randomized into two groups, Control Group and Experimental group, with 63 cases in each group. The control group adopted traditional teaching and the experimental group took traditional teaching combined with WeChat video teaching. The internship time of both groups was 4 weeks. The scores of comprehensive ability assessment after practice were compared between the two groups, and the critical thinking ability scale and nursing students' clinical practice satisfaction scale were used to evaluate the critical thinking ability and satisfaction of practice nurses of the two groups before and after teaching. SPSS 19.0 was used for statistical analysis of the research data. Continuous variables were expressed as (mean ± standard deviation), t test was performed, categorical variables were expressed as percentage, four-grid test was conducted, and the test level was α=0.05. Results:The scores of comprehensive ability, theoretical knowledge and operation skills of the experimental group were significantly higher than those of the control group ( P<0.05). After teaching, the scores of seeking truth, opening mind, systematization ability, analytical ability, curiosity, cognitive maturity and total scale score of the two groups were significantly higher than those before teaching ( P<0.05), and there was no significant difference in the score of thinking self-confidence before and after the teaching ( P>0.05). The scores of seeking truth, opening mind, systematization ability, analytical ability, curiosity, cognitive maturity and total scale score of the experimental group were significantly higher than those of the control group ( P<0.05), and there was no significant difference in the score of thinking self-confidence between the two groups ( P>0.05). The experimental group's practice management, practice environment, teaching content, practice effect score and total scale score were significantly higher than those of the control group ( P<0.05), and compared with the control group, the score of teaching quality was poorer, without significant differences ( P>0.05). Conclusion:The application of WeChat video teaching mode in clinical teaching of digestive endoscopy nurses can improve the performance and satisfaction of comprehensive ability assessment of practice nurses, and enhance their ability of critical thinking.

Objective:To explore the effects of health education on the knowledge and awareness of hypertension in primary and secondary school students.Methods:Twenty seven primary and secondary schools in Emin County of Xinjiang Uygur Autonomous Region were selected in 2014 as study sites; among which 24 schools were randomly assigned as the intervention group and 3 schools were assigned as control group. According to the education methods (classroom teaching, publicity manual, hypertension class reports and the combination of the three) and the frequency of education (1, 2, 3 times per semester), the intervention group were further randomly divided into 12 subgroups with 2 schools in each group. The intervention study was carried out for 3 years.Results:A total 13 402 students were involved in the study, and there were 11 333 students in the intervention group and 2 069 students in the control group. The awareness rates of hypertension concept [41.8% (4 738/11 333) vs. 24.6% (511/2 069), χ 2=154.86, P<0.01], the adverse consequences of hypertension [85.8% (9 735/11 333) vs. 75.4% (1 561/2 069),χ 2=25.80, P<0.01], the hypertension risk factors [84.3% (9 564/11 333) vs. 72.5%(1 501/2 069), χ 2=12.83, P<0.01), and the health behaviors after hypertension [84.9% (9 629/11 333) vs. 67.7%(1 402/2 069), χ 2=187.24, P<0.01] in intervention group were all significantly higher than those in control group. The stratified analysis showed that among students in elementary school, junior high school and high school, there were significant differences in the awareness rate of adverse consequences [94.4% (2 019/2 138) vs. 81.6% (3 829/4 690), 86.2% (3 887/4 505), χ 2=199.31, P<0.01], awareness rate of risk factor [86.8% (1 857/2 138) vs.86.1% (4 038/4 690), 81.4% (3 669/4 505) , χ 2=49.96, P<0.01); and awareness rate of correct behavior [89.9% (1 923/2 138) vs. 86.1% (4 037/4 690), 81.4% (3 669/4 505) χ 2=89.77, P<0.01]. Up to 95.9% (10 868/11 333) students in the intervention group liked the hypertension health education. Conclusion:Based on the school health education curriculum, the intervention measures of hypertension health education are effective, and the awareness rate of hypertension related knowledge among senior high school students is significantly improved.

Objective:To evaluate the reliability and validity of the Chinese version of the Ohkuma questionnaire.Methods:The Ohkuma questionnaire was translated and revised, before it was used to investigate 70 elderly patients. Cronbach′s alpha coefficient, Cohen′s kappa coefficient and Pearson correlation were used to evaluate the scale′s internal reliability, sub-item retest reliability and total score retest reliability. KMO and Bartlett tests were used to evaluate the validity. The correlation between the Chinese version of the Ohkuma questionnaire and ratings from video fluoroscopy before and after treatment was used to evaluate the scale′s discrimination ability.Results:The Cronbach′s alpha of the Chinese version of Ohkuma questionnaire was 0.831, with 0.814 in the initial evaluation and 0.808 in a second evaluation. The Cohen′s kappas of the 15 sub-items ranged from 0.728 to 1.000. The Pearson correlation coefficient of the total score was 0.914. The scale′s KMO value was 0.701. A t-test of the Ohkuma scores before and after treatment showed a statistically significant difference.Conclusion:The revised Chinese Ohkuma questionnaire has good reliability, validity and discriminatory power. It can be used to screen for dysphagia among the elderly.

Objective: To study the preventive effect of Timosaponin BⅡ (T-BⅡ) -loaded temperature/ion-sensitive nasal in situ hydrogels (ISGs) on Alzheimer's disease (AD), its preparation technology, characteristics and in vivo effects were evaluated.Methods: The morphological and rheological properties were evaluated. The preventive effects of T-BⅡ ISG on scopolamine-induced AD in mice were determined with the index of muscarinicreceptor 1 (M1) expression and pathological changes. Results: Results revealed that T-BⅡ ISG significantly increased the content of M1 choline receptors in the hippocampus of mice and ameliorated the damage incurred to the hippocampal cornu ammonis 1 (CA1) area. Conclusion: T-BⅡ ISGs is a reasonable and convenient method of exerting an obvious preventive effect on mice with AD induced by scopolamine. This, thereby, lays forth a new treatment option for preventing AD.

Objective:To evaluate the effect of early screening and multidisciplinary management for elderly patients with dysphagia.Methods:All of the elderly patients who were hospitalized during January 2018 to December 2019, were divided into control group ( n=16 273) and intervention group ( n=18 853) according to the order of inpatient. Patients in control group received routine care, and those in intervention group received early screening and multidisciplinary management. The difference of detection, rehabilitation, indwelling, pneumonia and the professional level of nurses were compared between two groups. Results:The positive rate of intervention group was 14.10% (2 659/18 853), which was higher than 10.81% (1 759/16 273) of control group ( χ2 value was 66.11, P<0.01). The rehabilitation rate was increase from 67.08% (1 180/1 759) to 78.68% (2 092/2 659) ( χ2 value was 17.88, P<0.01) . The rate of indwelling nasogastric tube was decreased from 21.49% (378/1 759) to 19.33% (514/2 659) ( χ2 value was 8.52, P<0.01). The incidence of pneumonia was decreased from 10.18% (179/1 759) to 4.25% (113/2 659) ( χ2 value was 37.27, P<0.01). And dysphagia related knowledge ( t value was 7.549, P<0.01) and skills ( t value was 7.413, P<0.01) of the nurses were improved. Conclusion:Implementation of early screening and hierarchical management based on the form of multidisciplinary cooperation for dysphagia in elderly inpatients can enhance the positive outcome of patient and improve dysphagia related knowledge and skills of nurse.

Objective:To explore the effect of high-flow airway humidification on aspiration and residues in cases of dysphagia after a tracheotomy.Methods:Seventeen persons with dysphagia after a tracheotomy were asked to swallow 5ml of a thick liquid when their tracheal cannula was either connected to a high-flow airway humidification system or blocked, or the cuff was empty or full. Endoscopic evaluation was then used to grade the residue and aspiration in the different conditions.Results:There were significant differences in the residuals grading and aspiration among the four conditions. The average penetration-aspiration scale grade was significantly lower when the subject was connected to high-flow airway humidification than in the other three conditions. The grade of residuals was also significantly lower.Conclusion:High-flow airway humidification can effectively improve the swallowing of persons with dysphagia after a tracheotomy.

Objective:To explore the value of flexible endoscopic evaluation of swallowing (FEES) in guiding the decannulation of neurological disease patients with dysphagia after a tracheotomy.Methods:The FEES results of 188 neurological disease patients with dysphagia who had undergone a tracheotomy were analyzed retrospectively. The utility of FEES evaluation indexes (including glottis activity, the classification of pharyngeal secretions and residues as well as penetration-aspiration grade) for predicting the success of decannulation was explored.Results:One hundred and nine of the patients (the success group) were decannulated successfully and 79 (the failure group) were not, a success rate of 57%. The abnormal glottis activity rate among the failure group was 55%, significantly higher than among the success group (21%). The pharyngeal secretion classifications and penetration-aspiration grades among the success group were also significantly lower than among the failure group, on average. The average course of recovery from the tracheotomy was 184 days in the success group, significantly shorter than that of the failure group (292 days). No significant differences in residues were observed.Conclusion:The glottis activity, secretions and intake aspiration evaluated using FEES are of great value for guiding the decannulation of neurological disease patients with dysphagia after a tracheotomy.