OBJECTIVE To evaluate the quality of Euscaphis japonica from different habitats. METHODS The relative correction factors of gallic acid， protocatechuic acid， ellagic acid， isoquercitrin， astragalin and apigenin were calculated with quercetin as the internal reference； the relative correction factors of euscaphic acid， oleanolic acid， stigmasterol and β-sitosterol were also calculated with ursolic acid as the internal reference. The contents of 12 components in 18 batches of samples were calculated by QAMS method and were compared with external standard method. At the same time， the contents of water-soluble extract， alcohol-soluble extract， total ash and acid-insoluble ash were detected. The quality of E. japonica was evaluated by principal component analysis （PCA）， orthogonal partial least squares-discriminant analysis （OPLS-DA）， and weighted technique for order preference by similarity to ideal solution （TOPSIS） method. RESULTS There was no significant difference between the results of QAMS method and external standard method for the 12 components in the 18 batches of samples. However， notable content variations were observed among different batches of samples. The results of PCA and OPLS-DA showed that S1-S7， S8- S12， and S13-S18 were clustered into one category respectively. Seven key characteristic components variable importance in projection values ＞1， euscaphic acid， ursolic acid， protocatechuic acid， apigenin， β-sitosterol， isoquercitrin， and oleanolic acid， respectively. The analysis results of the weighted TOPSIS method revealed that the relative closeness for evaluating the quality of 18 batches of samples ranged from 0.283 5 to 0.644 1， with the samples of E. japonica from Fengjie， Chongqing， demonstrating the highest quality. CONCLUSIONS The established method is accurate and feasible， which can be used for the quality evaluation of E. japonica combined with chemometrics and weighted TOPSIS model.

Objective:To compare four postmastectomy radiotherapy plans with different arc angles for left-sided breast cancer prepared using deep inspiration breath hold (DIBH) technique, in order to explore the feasibility of selecting optimal arc angles based on the parameters of patients′ anatomical structures.Methods:A total of 51 patients who underwent postmastectomy radiotherapy for left-sided breast cancer using DIBH at the Second Affiliated Hospital of Guangxi Medical University and the First Affiliated Hospital of Guangzhou Medical University were selected. Among these, 40 patients selected using simple random sampling were treated with four radiotherapy plans with different arc angles, labeled as SV120, SV100, SV80, and SV60, while the remaining 11 patients were treated with only the SV60 plans. The dose parameters of the target volumes (TVs) and organs at risk (the heart, lungs, and contralateral breast), as well as the beam-on times of individual arcs, in these plans were compared. The parameters of the anatomical structures (i.e., the heart, lung, and breast) of the 51 patients, including PHeart, PLungl, and PBreast, were extracted. Taking these parameters as independent variables and the quality of the SV60 plans as the dependent variable, fitting was conducted using P(SV60)—a multivariate logistic regression model—based on a training set (45 patients) and a testing set (six patients). The classification threshold of the plans was set at 0.5. Results:As the arc angle increased, the plans exhibited improved modulation capabilities for TVs and the left lung. However, the V5 of the right lung and the average beam-on time of a single arc also increased. The SV120 plans demonstrated significantly better V107% of planning target volume (PTV; 6.84%), homogeneity index (HI; 0.13), conformity index (CI; 0.81), and mean dose to the left lung (1 330.97 cGy) compared to the other three types of plans, with statistically significant differences ( W = 0-99, P < 0.001). The SV60 plans displayed lower mean doses to the contralateral breast (198.97 cGy) and the heart (440.35 cGy) and lower V5 of the right lung (0.27%) than the other three types of plans, with significant differences in V5 of the right lung and the mean dose to the contralateral breast ( W = 0-157, P < 0.001). In contrast, no significant difference was observed in these parameters (except for V5 of the right lung) among the other three types of plans. The four types of plans exhibited average beam-on times of individual arcs of 22.0, 19.1, 16.1, and 14.4 s, respectively, with statistically significant differences ( χ2= 93.0, P < 0.001). A multivariate logistic regression model revealed that PLungl, PHeart, and PBreast were negatively correlated with the quality of the SV60 plans ( t = -64.84, -28.20, -24.45, P<0.001). This model yielded an accuracy of 93.33% and a precision of 92.86% in the training set, while its accuracy and precision reached 100% in the testing set. Conclusions:For patients treated with postmastectomy radiotherapy for left-sided breast cancer using DIBH, it is feasible to select appropriate arc angles based on patients’ anatomical structures.

Objective:To compare four postmastectomy radiotherapy plans with different arc angles for left-sided breast cancer prepared using deep inspiration breath hold (DIBH) technique, in order to explore the feasibility of selecting optimal arc angles based on the parameters of patients′ anatomical structures.Methods:A total of 51 patients who underwent postmastectomy radiotherapy for left-sided breast cancer using DIBH at the Second Affiliated Hospital of Guangxi Medical University and the First Affiliated Hospital of Guangzhou Medical University were selected. Among these, 40 patients selected using simple random sampling were treated with four radiotherapy plans with different arc angles, labeled as SV120, SV100, SV80, and SV60, while the remaining 11 patients were treated with only the SV60 plans. The dose parameters of the target volumes (TVs) and organs at risk (the heart, lungs, and contralateral breast), as well as the beam-on times of individual arcs, in these plans were compared. The parameters of the anatomical structures (i.e., the heart, lung, and breast) of the 51 patients, including PHeart, PLungl, and PBreast, were extracted. Taking these parameters as independent variables and the quality of the SV60 plans as the dependent variable, fitting was conducted using P(SV60)—a multivariate logistic regression model—based on a training set (45 patients) and a testing set (six patients). The classification threshold of the plans was set at 0.5. Results:As the arc angle increased, the plans exhibited improved modulation capabilities for TVs and the left lung. However, the V5 of the right lung and the average beam-on time of a single arc also increased. The SV120 plans demonstrated significantly better V107% of planning target volume (PTV; 6.84%), homogeneity index (HI; 0.13), conformity index (CI; 0.81), and mean dose to the left lung (1 330.97 cGy) compared to the other three types of plans, with statistically significant differences ( W = 0-99, P < 0.001). The SV60 plans displayed lower mean doses to the contralateral breast (198.97 cGy) and the heart (440.35 cGy) and lower V5 of the right lung (0.27%) than the other three types of plans, with significant differences in V5 of the right lung and the mean dose to the contralateral breast ( W = 0-157, P < 0.001). In contrast, no significant difference was observed in these parameters (except for V5 of the right lung) among the other three types of plans. The four types of plans exhibited average beam-on times of individual arcs of 22.0, 19.1, 16.1, and 14.4 s, respectively, with statistically significant differences ( χ2= 93.0, P < 0.001). A multivariate logistic regression model revealed that PLungl, PHeart, and PBreast were negatively correlated with the quality of the SV60 plans ( t = -64.84, -28.20, -24.45, P<0.001). This model yielded an accuracy of 93.33% and a precision of 92.86% in the training set, while its accuracy and precision reached 100% in the testing set. Conclusions:For patients treated with postmastectomy radiotherapy for left-sided breast cancer using DIBH, it is feasible to select appropriate arc angles based on patients’ anatomical structures.

Objective To explore the correlation between the immune related adverse(irAEs)reactions in patients treated with pembrolizumab and traditional Chinese Medicine(TCM)constitution.Methods A total of 110 patients diagnosed with non-small cell lung cancer for the first time were selected.When receiving pembrolizumab immunotherapy for the first time,a general information questionnaire,a TCM constitution classification and judgment scale,an immune related adverse reaction follow-up record book,and a patient's self-perception diary were used to investigate and analyze the TCM syndrome and adverse reactions of the patients.Results Among non-small cell lung cancer patients,there were more than four TCM constitutions,with 48 cases(43.64%)having a calm constitution,20 cases(18.18%)having a biased constitution,30 cases(27.27%)having a yang deficiency constitution,and 12 cases(10.91%)having a yin deficiency constitution.Qi deficiency and Yang deficiency were more prone to fatigue,while Yang deficiency was more prone to rash;Qi deficiency and Yin deficiency were more prone to itching;Yang deficiency was more prone to diarrhea;Non-small cell lung cancer patients with mild constitution were less prone to immune related adverse reactions.Conclusion TCM constitution is related to irAEs,which could predict the occurrence of immune related adverse reactions from the perspective of TCM constitution and intervene in adverse reactions early.

Objective:To explore the effect of comprehensive nursing based on empowerment theory in patients with chronic pulmonary heart disease complicated with heart failure.Methods:From April 2018 to April 2021, convenience sampling was used to select 87 patients with chronic obstructive pulmonary disease and heart failure in Liaocheng People's Hospital as the research object. The patients were divided into the observation group (43 cases) and the control group (44 cases) by random number table method. The control group received routine nursing, and the observation group received comprehensive nursing based on empowerment theory. Before the intervention and 8 weeks after the intervention, the knowledge of heart failure and cardiopulmonary function of the two groups were evaluated.Results:The improvement of cardiopulmonary function in the observation group was better than that in the control group, and the difference was statistically significant ( P<0.05) . Before nursing and 8 weeks after nursing, the total score and of each dimension scores of the Atlanta Heart Failure Knowledge Test-V2 (AHFKT-V2) in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Comprehensive nursing based on empowerment theory can improve heart failure knowledge and cardiopulmonary function in patients with chronic pulmonary heart disease complicated with heart failure.

Objective:To study the effect of MYD88 L265P mutation on the expression of PD-L1 in tumor cells and tumor microenvironment in diffuse large B-cell lymphoma (DLBCL), and to provide theoretical basis for immunotherapy for patients.Methods:Multiplex ligation-dependent probe amplification (MLPA) was used to detect the frequency of MYD88 L265P mutation in 72 cases of DLBCL diagnosed by pathologists in Cancer Hospital of Chinese Academy of Medical Sciences from August 2008 to May 2010. Expression of PD-L1 in tumor cells and tumor microenvironment in all samples was evaluated using PD-L1 (22C3) and PD-L1 (SP142) with Ventana automatic immunohistochemical (IHC) platform. The relationship between MYD88 L265P mutation and the expression of PD-L1 in DLBCL tumor cells and tumor microenvironment was assessed.Results:Of the 72 cases of DLBCL, MYD88 L265P mutation was detected in 15 (20.8%) cases. Nine cases with JAK2 amplification were excluded, and the remaining 63 cases of DLBCL were divided into MYD88 L265P mutant group ( n=14) and MYD88 L265P wild-type group ( n=49). IHC results showed that among the 14 cases of MYD88 L265P mutant groups, PD-L1 (22C3) was positive in 7 cases (7/14) of tumor cells and PD-L1 (SP142) was positive in 4 cases (4/14) of tumor microenvironment. Among the 49 cases of MYD88 L265P wild-type group, 9 cases (18.4%) were positive for PD-L1 (22C3) in tumor cells, and 38 cases (77.6%) were positive for PD-L1(SP142) in tumor microenvironment. In addition, among the 16 cases with PD-L1(22C3) expression in tumor cells, only 2 of the 7 cases with MYD88 L265P mutation were positive for PD-L1 (SP142) in tumor microenvironment. All 9 cases with wild-type MYD88 L265P were positive for PD-L1 (SP142) in tumor microenvironment. Statistical analysis showed that the expression level of PD-L1 (22C3) in tumor cells in the MYD88 L265P mutant group was significantly higher than that in the MYD88 L265P wild-type group ( P=0.017). The expression level of PD-L1 (SP142) in tumor microenvironment in the MYD88 L265P mutant group was significantly lower than that in the MYD88 L265P wild-type group ( P=0.001). Conclusions:MYD88 L265P mutation may play an important role in the regulation of PD-L1 expression in DLBCL tumor cells and tumor microenvironment. Further studies will provide a theoretical basis for immunotherapy of DLBCL patients with MYD88 L265P mutation.

Objective:To systematically review the effects of the traditional Chinese medicine compound based on astragalus and angelica on bone marrow suppression after chemotherapy.Methods:Randomized controlled trials (RCTs) about the traditional Chinese medicine compound based on astragalus and angelica for bone marrow suppression after chemotherapy for malignant tumors were retrieved from Cochrane Library, PubMed, Web of Science, CINAHL, OVID, SinoMed, CNKI, VIP, and Wanfang Databases. The search period was from the establishment of the database to September 2019. The literatures were screened and the data were extracted independently by two researchers and RevMan 5.3 was used for Meta-analysis.Results:Totally 15 RCTs were included, involving 1 019 patients. Meta-analysis results showed that there were statistically significant differences in peripheral blood leukocytes [ SMD=1.32; 95% CI (0.76, 1.89) ; P<0.000 01], platelets [ MD=25.05; 95% CI (8.00, 42.10) ; P=0.004], hemoglobin [ MD=24.14; 95% CI (16.34, 31.94) ; P<0.000 01] and clinical symptoms [ RR=1.38; 95% CI (1.25, 1.52) ; P<0.000 01] between the chemotherapy group, the chemotherapy combined with the western medicine group and the traditional Chinese medicine compound group. Conclusions:The traditional Chinese medicine compound based on astragalus and angelica can improve the level of peripheral blood cells, reduce bone marrow suppression, and improve clinical symptoms and quality of life of patients with cancer after chemotherapy. However, due to the low quality of the included literature and the large heterogeneity of some of the results, more rigorously designed high-quality RCTs are needed for further verification.

Objective:To understand the current situation and trend of nursing cost research in China so as to provide a reference for researchers in the field of nursing cost research.Methods:We retrieved literature on nursing cost from January 1, 1990 to December 13, 2019 in China National Knowledge Infrastructure (CNKI) . CiteSpace software was used for visual analysis.Results:A total of 463 related literature were obtained, and the number of publications was on the rise as a whole, and research institutions had little cooperation. Nursing economics, nursing human resources, nursing management, cost analysis were the main research directions at present. Long-term care insurance with the highest emergent word intensity was the research frontier in the field.Conclusions:We should strengthen the cooperation in scientific research institutions, and rely on big data, computers and other means to establish a nursing cost accounting model, and extend the scope of research to communities and homes so as to provide a quantitative basis for Chinese long-term care insurance compensation standards.

Objective To explore the clinical characteristics and risk factors of occult pneumonia in advanced elderly patients.Methods A total of 170 advanced elderly patients with community-acquired pulmonary infection in geriatric department of Xijing hospital from January 2014 to October 2017 were enrolled.Patients were divided into two groups:the observation group (with occult pneumonia,n=80)and the control group(without occult pneumonia,n =90).Clinical data of patients were collected,and clinical characteristics and related risk factors of occult pneumonia in elderly patients were analyzed.Results There was no statistically significant difference in the positive rate of sputum culture and the distribution of pathogenic bacteria between the two groups (P ＞ 0.05).Gram-negative bacteria predominated in pathogenic bacteria.The hospitalization time was longer in the observation group than in the control group[(17.3 ± 3.0) d vs.(10.3 ± 3.9) d,P ＜ 0.05].The mortality rate was higher in the observation group than in the control group(10.0 ％ vs.3.3 ％,P ＜ 0.05).The age was older in the observation group than in the control group[(87.0± 1.7) years vs.(82.0± 2.4) years,P ＜ 0.05].The incidences of diabetes,Alzheimer's disease,hypothyroidism and long-term bed rest were higher in the observation group than in the control group (P ＜ 0.05).Multivariate logistic regression analysis showed that age (OR =6.93),dementia (OR =4.32),hypothyroidism(OR =4.89) were independent risk factors for occult pneumonia (P ＜ 0.05).Conclusions The pathogenic bacteria in advanced elderly patients with occult pneumonia are mainly gram-negative bacteria.The positive rate of CT scan confirmed-occult pneumonia is much higher than that by chest X-ray.The advanced elderly patients with occult pneumonia have longer hospitalization time and higher mortality rates.Old age,senile dementia and hypothyroidism are independent risk factors for occult pneumonia in advanced elderly patients.

Objective To explore the effects of silencing H2AX gene on esophageal cancer ECA109 cell xenograft growth and sensitivity to radiotherapy in nude mice.Methods BALB/c nude mice models were established by subcutaneously inoculating differently treated ECA109 cells into nude mice.By random number table method 60 nude mice were divided into six groups,including blank group,irradiation group,negative group,negative with irradiation group,silence group and silence with irradiation group.The nude mice were irradiated with 15 Gy of 6 MV X-rays 21 d after inoculation.After irradiation 48 h,half of each mice group was terminated.The tumor specimens were processed by Western blot,RT-PCR and flow cytometry were used to detect the change in protein levels,RNA levels,and cell cycle.Results The tumor volume was (42.76 ±4.40) mm3 in silence group,significantly smaller than that of the blank group (73.18±8.80) mm3 and the negative group(71.27 ±8.40) mm3(F=67.8,P＜0.01).H2AX protein expression level in the silence group was also significantly lower (0.12 ±0.03 vs.1.12 ±0.11,1.16 ± 0.08,F =34.27,P ＜ 0.01).Relative H2AX mRNA expression level in the silence group was (0.85 ± 0.31),significantly lower than that of the blank group (1.86 ± 0.26) and the negative group (1.82 ±0.24,F =39.45,P ＜ 0.01).Co-immunoprecipitation assay showed that γ-H2AX and MDC1,53BP1 obvious interaction after irradiation,which would be weakened through silencing H2AX.The tumor volumes at different groups had significant difference after irradiation (F =13.56,P ＜ 0.01).The apoptosis rate in the silence group was significantly higher than that of the blank group and the negative group [(24.15±2.25) ％ vs.(13.26±1.54) ％,(12.78±1.47) ％ (F=54.33,P＜0.01)].G2/M phase arrested in the silence with irradiation group lower than that of the radiation group (F =10.21,P ＜ 0.01).Conclusions Silencing H2AX gene expression could inhibit the growth of esophageal cancer ECA109 cell xenograft and increase the radiosensitivity of tumor.