Objective To search,evaluate and summarise the best evidence on non-drug intervention for nipple pain or injury in breastfeeding mothers.Methods Based on the"6S pyramid"evidence model,desktop searches were conducted on databases of UpToDate,Joanna Briggs Institute evidence-based practice database(JBI),National Guideline Clearinghouse(NGC),National Institute for health and Care Excellence(NICE),Guidelines International Network(GIN),Registered Nurses'Association of Ontario(RNAO),American College of Obstetricians and Gynecologists(ACOG),Medlive,Chinese Medical Association(CMA)website,Breastfeeding Medical Association(BMA),CNKI,Wanfang Data,SinoMed,Cochrance Library,PubMed,Embase,Web of Science,and CINAHL for literature in non-drug interventions for nipple pain or injury in breastfeeding women.The literature included clinical guidelines,decisions,recommended practices,evidence summaries,expert consensus,systematic reviews and randomized controlled trials(RCTs).The searched databases spanned from 1st January,2013 to 30th April,2024.Two researchers who were trained in evidence-based nursing independently evaluated the methodological quality,extracted and integrated evidence from eligible literature.Results A total of 15 documents were included,consisting of 5 clinical guidelines,2 clinical decisions,1 expert consensus,6 systematic evaluations and 1 RCT.Thirty-one pieces of evidence were summarised across 4 categories:accurate perinatal assessment,feeding guidance,non-drug intervention and health education.Conclusion The summarised best evidence on non-drug intervention for nipple pain or injury in breastfeeding women provides an evidence-based basis for clinical healthcare professionals.

This paper provides a review on the concept, current status, assessment tools, influencing factors, and intervention strategies regarding the compliance of lymphedema prevention behaviors in postoperative breast cancer patients. The aim is to improve the compliance of lymphedema prevention behaviors in these patients, reduce the incidence of lymphedema, and provide a reference for future clinical intervention studies in this field.

Objective To search,evaluate and summarise the best evidence on non-drug intervention for nipple pain or injury in breastfeeding mothers.Methods Based on the"6S pyramid"evidence model,desktop searches were conducted on databases of UpToDate,Joanna Briggs Institute evidence-based practice database(JBI),National Guideline Clearinghouse(NGC),National Institute for health and Care Excellence(NICE),Guidelines International Network(GIN),Registered Nurses'Association of Ontario(RNAO),American College of Obstetricians and Gynecologists(ACOG),Medlive,Chinese Medical Association(CMA)website,Breastfeeding Medical Association(BMA),CNKI,Wanfang Data,SinoMed,Cochrance Library,PubMed,Embase,Web of Science,and CINAHL for literature in non-drug interventions for nipple pain or injury in breastfeeding women.The literature included clinical guidelines,decisions,recommended practices,evidence summaries,expert consensus,systematic reviews and randomized controlled trials(RCTs).The searched databases spanned from 1st January,2013 to 30th April,2024.Two researchers who were trained in evidence-based nursing independently evaluated the methodological quality,extracted and integrated evidence from eligible literature.Results A total of 15 documents were included,consisting of 5 clinical guidelines,2 clinical decisions,1 expert consensus,6 systematic evaluations and 1 RCT.Thirty-one pieces of evidence were summarised across 4 categories:accurate perinatal assessment,feeding guidance,non-drug intervention and health education.Conclusion The summarised best evidence on non-drug intervention for nipple pain or injury in breastfeeding women provides an evidence-based basis for clinical healthcare professionals.

This paper provides a review on the concept, current status, assessment tools, influencing factors, and intervention strategies regarding the compliance of lymphedema prevention behaviors in postoperative breast cancer patients. The aim is to improve the compliance of lymphedema prevention behaviors in these patients, reduce the incidence of lymphedema, and provide a reference for future clinical intervention studies in this field.

Objective To construct a management program for upper limb lymphedema prevention in postopera-tive breast cancer patients and to evaluate its effectiveness.Methods The first draft of the upper limb lymphede-ma prevention and management protocol for postoperative breast cancer patients was constructed on the basis of ev-idence summaries and qualitative interviews,and 2 rounds of correspondence were conducted in December 2022.Using the convenience sampling method,patients undergoing surgery for malignant tumours in the breast surgery de-partment of a tertiary-level hospital in Zhengzhou City were selected as the study subjects,and 58 patients admitted from January to March 2023 were included in the experimental group according to the time of their first visit.57 patients admitted from July to December 2022 were included in the control group and were given routine care.The rates of lymphedema occurrence,upper limb function score and patients'adherence to lymphedema prevention be-haviours after 1,3,and 6 months of intervention were compared between the 2 groups.Results The valid ques-tionnaire recovery rates of the 2 rounds of expert correspondence were 92.59％and 100％,and the authority coeffi-cients of the experts were 0.940 and 0.950,and the Kendall's harmony coefficients were 0.228 and 0.254,respec-tively(P＜0.00 1).The coefficients of variation of the 2nd round of correspondence were 0.07～0.24.The final draft of the programme included 5 first-level entries,12 second-level entries,and 32 third-level entries.During the appli-cation of the programme,a total of 5 cases were dislodged,and 55 cases were finally included in each of the ex-perimental and control groups.The results of repeated measures ANOVA showed that there was an interaction ef-feet between the upper limb function scores and lymphedema prevention behavior compliance scores before inter-vention and at 1,3,and 6 months after discharge between the 2 groups(P＜0.05).Simple effects analysis showed that at 1,3,and 6 months after discharge,the upper limb function score and lymphedema prevention behavior com-pliance score of the experimental group were better than those of the control group,and the differences were sta-tistically significant(P＜0.05).At 6 months post-intervention,the difference in the occurrence of lymphedema was statistically significant when comparing the 2 groups(P=0.032).Adverse events such as subcutaneous bruising and falls did not occur in either group.Conclusion The upper limb lymphoedema prevention and management pro-gramme for postoperative breast cancer patients constructed in this study is scientific,feasible and safe,and can ef-fectively reduce the incidence of lymphoedema in patients and improve their quality of life.

Objective:To investigate the characteristics of the CD8+T cells infiltration from the 4 sub-types in medulloblastoma(MB),to analyze the relationship between CD8+T cells infiltration and prog-nosis,to study the function of C-X-C motif chemokine ligand 11(CXCL11)and its receptor in CD8+T cells infiltration into tumors and to explore the potential mechanism,and to provide the necessary clinico-pathological basis for exploring the immunotherapy of MB.Methods:In the study,48 clinical MB sam-ples(12 cases in each of 4 subtypes)were selected from the multiple medical center from 2012 to 2019.The transcriptomics analysis for the tumor of 48 clinical samples was conducted on the NanoString Pan-Cancer 10360?Panel(NanoString Technologies).Immunohistochemistry(IHC)staining of formalin-fixed,paraffin-embedded sections from MB was carried out using CD8 primary antibody to analyze diffe-rential quantities of CD8+T cells in the MB four subtypes.Through bioinformatics analysis,the relation-ship between CD8+T cells infiltration and prognosis of the patients and the expression differences of various chemokines in the different subtypes of MB were investigated.The expression of CXCR3 receptor on the surface of CD8+T cells in MB was verified by double immunofluorescence staining,and the under-lying molecular mechanism of CD8+T cells infiltration into the tumor was explored.Results:The charac-teristic index of CD8+T cells in the WNT subtype of MB was relatively high,suggesting that the number of CD8+T cells in the WNT subtype was significantly higher than that in the other three subtypes,which was confirmed by CD8 immunohistochemical staining and Gene Expression Omnibus(GEO)database analysis by using R2 online data analysis platform.And the increase of CD8+T cells infiltration was posi-tively correlated with the patient survival.The expression level of CXCL11 in the WNT subtype MB was significantly higher than that of the other three subtypes.Immunofluorescence staining showed the presence of CXCL11 receptor,CXCR3,on the surface of CD8+T cells,suggesting that the CD8+T cells might be attracted to the MB microenvironment by CXCL11 through CXCR3.Conclusion:The CD8+T cells infiltrate more in the WNT subtype MB than other subtypes.The mechanism may be related to the activation of CXCL11-CXCR3 chemokine system,and the patients with more infiltration of CD8+T cells in tumor have better prognosis.This finding may provide the necessary clinicopathological basis for the regulatory mechanism of CD8+T cells infiltration in MB,and give a new potential therapeutic target for the future immunotherapy of MB.

Objective To establish a rat model of ischemic cardiomyopathy(ICM),to explore whether propranolol can improve the ICM by regulating VCAM1/NF-κB signaling pathway.Methods Fifty SD rats were randomly divided into Control group(control group),ischemic cardiomyopathy group(ICM group),Propranolol group(Propranolol group),propranolol+overexpression control group(Propranolol+ov-NC group)and propranolol+overexpression VCAM1 group(Propranolol+ov-VCAM1 group),with 10 rats in each group.RT-qPCR was used to detect the expression of VCAM1 mRNA in rat myocardial tissue;Western blot was used to detect the expression of VCAM1,p-NF-κB and NF-κB protein in rat myocardium.HE staining was used to observe the pathological changes of myocardial tissue in rats.Masson staining was used to observe the degree of myocardial fibrosis in rats.The ratio of M1/M2 macrophages in rat myocardium was observed by immunofluorescence.The contents of IL-1β,IL-6 and IL-10 in myocardial tissue of rats were detected by ELISA.Results In the control group,the myocardial fibers were arranged neatly,no edema was found in the myocardial interstitium,and almost no collagen fibers were distributed in the myocardium.In ICM group,there were disordered fiber arrangement,interstitial edema and a large number of uneven collagen fibers in the myocardium of rats.Myocardial injury and fibrosis were improved in propranolol group and propranolol+ov-NC group.Myocardial injury and fibrosis in propranolol+ov-VCAM1 group were more serious than those in propranolol group and propranolol+ov-NC group.Compared with the control group,the expression of VCAM1 mRNA and protein and the phosphorylation level of NF-κB in the myocardial tissue of rats in ICM group increased significantly,and the proportion of M1-type macrophages and the contents of IL-1β and IL-6 increased significantly,while the proportion of M2-type macrophages and the content of IL-10 decreased significantly.Compared with ICM group,the expression of VCAM1 mRNA and protein and the phosphorylation level of NF-were arranged neatly,no edema was found in tl group and Propranolol+ov-NC group decreased significantly,while the proportion of M1 type macrophages and the contents of IL-1β and IL-6 decreased significantly,while the proportion of M2 type macrophages and the content of IL-10 increased significantly.Compared with Propranolol group and Propranolol+ov-NC group,the expression of VCAM1 mRNA and protein and the phosphorylation level of NF-κB in myocardial tissue of rats in Propranolol+ov-VCAM1 group increased significantly,while the proportion of M1 type macrophages and the contents of IL-1β and IL-6 increased significantly,while the proportion of M2 type macrophages and the content of IL-10 decreased significantly.Conclusion Propranolol treatment can improve myocardial injury and fibrosis in ICM rats by down-regulating VCAM1 expression,and its mechanism may be related to inhibiting the polarization of M1 macrophages mediated by NF-κB phosphorylation.

Objective To establish a rat model of ischemic cardiomyopathy(ICM),to explore whether propranolol can improve the ICM by regulating VCAM1/NF-κB signaling pathway.Methods Fifty SD rats were randomly divided into Control group(control group),ischemic cardiomyopathy group(ICM group),Propranolol group(Propranolol group),propranolol+overexpression control group(Propranolol+ov-NC group)and propranolol+overexpression VCAM1 group(Propranolol+ov-VCAM1 group),with 10 rats in each group.RT-qPCR was used to detect the expression of VCAM1 mRNA in rat myocardial tissue;Western blot was used to detect the expression of VCAM1,p-NF-κB and NF-κB protein in rat myocardium.HE staining was used to observe the pathological changes of myocardial tissue in rats.Masson staining was used to observe the degree of myocardial fibrosis in rats.The ratio of M1/M2 macrophages in rat myocardium was observed by immunofluorescence.The contents of IL-1β,IL-6 and IL-10 in myocardial tissue of rats were detected by ELISA.Results In the control group,the myocardial fibers were arranged neatly,no edema was found in the myocardial interstitium,and almost no collagen fibers were distributed in the myocardium.In ICM group,there were disordered fiber arrangement,interstitial edema and a large number of uneven collagen fibers in the myocardium of rats.Myocardial injury and fibrosis were improved in propranolol group and propranolol+ov-NC group.Myocardial injury and fibrosis in propranolol+ov-VCAM1 group were more serious than those in propranolol group and propranolol+ov-NC group.Compared with the control group,the expression of VCAM1 mRNA and protein and the phosphorylation level of NF-κB in the myocardial tissue of rats in ICM group increased significantly,and the proportion of M1-type macrophages and the contents of IL-1β and IL-6 increased significantly,while the proportion of M2-type macrophages and the content of IL-10 decreased significantly.Compared with ICM group,the expression of VCAM1 mRNA and protein and the phosphorylation level of NF-were arranged neatly,no edema was found in tl group and Propranolol+ov-NC group decreased significantly,while the proportion of M1 type macrophages and the contents of IL-1β and IL-6 decreased significantly,while the proportion of M2 type macrophages and the content of IL-10 increased significantly.Compared with Propranolol group and Propranolol+ov-NC group,the expression of VCAM1 mRNA and protein and the phosphorylation level of NF-κB in myocardial tissue of rats in Propranolol+ov-VCAM1 group increased significantly,while the proportion of M1 type macrophages and the contents of IL-1β and IL-6 increased significantly,while the proportion of M2 type macrophages and the content of IL-10 decreased significantly.Conclusion Propranolol treatment can improve myocardial injury and fibrosis in ICM rats by down-regulating VCAM1 expression,and its mechanism may be related to inhibiting the polarization of M1 macrophages mediated by NF-κB phosphorylation.

OBJECTIVETo study the radiobiological characteristics of a HepG2 cell line with mitochondrial DNA (mtDNA) deletion.

METHODSHepG2 cells were cultured in a medium containing ethidium bromide, acetylformic acid and uracil. The HepG2 cell line with mtDNA deletion (ρ(0)HepG2 cells) were acquired after 30 subcultures by limited dilution cloning. The cell survival was then observed in the absence of acetylformic acid and uracil, and the total mtDNA deletion in the cells was confirmed by PCR. The radiosensitivity of HepG2 and ρ(0)HepG2 cells was evaluated by exposure to gradient doses of 6 MV X ray irradiation. The cell apoptosis was assessed following a 2 Gy X-ray exposure with Hochest33342 staining, and the invasiveness of ρ(0)HepG2 cells was measured by Transwell assay.

RESULTSHepG2 cells could survive 30 subcultures in the presence of ethidium bromide, and massive cell death occurred after removal of acetylformic acid and uracil from the medium. PCR confirmed total mtDNA deletion from ρ(0)HepG2 cells, whose α/β value was significantly lower than that of HepG2 cells. ρ(0)Hep-G2 cells showed an obviously lowered cell apoptosis rate following X-ray exposure with enhanced cell invasiveness.

CONCLUSIONHepG2 cells can be induced by ethidium bromide into ρ(0)HepG2 cells with an increased radiation resistance, anti-apoptosis ability and cell invasiveness.

Apoptosis ; Culture Media ; chemistry ; DNA, Mitochondrial ; genetics ; Ethidium ; chemistry ; Hep G2 Cells ; radiation effects ; Humans ; Radiation Tolerance ; genetics ; Sequence Deletion ; X-Rays

Objective To study the radiobiological characteristics of a HepG2 cell line with mitochondrial DNA (mtDNA) deletion. Methods HepG2 cells were cultured in a medium containing ethidium bromide, acetylformic acid and uracil. The HepG2 cell line with mtDNA deletion (ρ0HepG2 cells) were acquired after 30 subcultures by limited dilution cloning. The cell survival was then observed in the absence of acetylformic acid and uracil, and the total mtDNA deletion in the cells was confirmed by PCR. The radiosensitivity of HepG2 andρ0HepG2 cells was evaluated by exposure to gradient doses of 6 MV X ray irradiation. The cell apoptosis was assessed following a 2 Gy X-ray exposure with Hochest33342 staining, and the invasiveness of ρ0HepG2 cells was measured by Transwell assay. Results HepG2 cells could survive 30 subcultures in the presence of ethidium bromide, and massive cell death occurred after removal of acetylformic acid and uracil from the medium. PCR confirmed total mtDNA deletion fromρ0HepG2 cells, whoseα/βvalue was significantly lower than that of HepG2 cells.ρ0Hep-G2 cells showed an obviously lowered cell apoptosis rate following X-ray exposure with enhanced cell invasiveness. Conclusion HepG2 cells can be induced by ethidium bromide intoρ0HepG2 cells with an increased radiation resistance, anti-apoptosis ability and cell invasiveness.