Objective:To explore the advantages of individualized 3D-printed vaginal cylinder template-guided interstitial brachytherapy (3D-p-VC-ISBT) in locally advanced cervical cancer, aiming to provide reference for clinical adaptive brachytherapy.Methods:Clinical data of 20 patients with locally advanced cervical cancer admitted to Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from September, 2021 to August, 2023 were retrospectively analyzed. The median age was 54 years old (32-69 years). Among them, 3 patients were diagnosed with adenocarcinoma and 17 cases of squamous cell carcinoma. According to the treatment method, all patients were divided into intracavitary brachytherapy group (ICBT-plan group, n=10) and 3D-p-VC-ISBT group (3D-p-VC-ISBT treatment-plan group, n=10). A pretreatment plan was designed for each patient undergoing 3D-p-VC-ISBT. The pretreatment plans were formed as the pretreatment-plan group. Dose volume histogram was used to evaluate dose distribution of the targets and organs at risk (OAR). Comparison between two groups was analyzed by Mann-Whitney test and comparison among three treatment plans (ICBT, 3D-p-VC-ISBT treatment-plan and 3D-p-VC-ISBT pretreatment-plan) was analyzed by Kruskal-Wallis test. Results:The mean D 90rel (representing the dose received by 90% volume of the target area divided by the prescription dose) of high-risk clinical target volume (HR-CTV) in 3D-p-VC-ISBT, pretreatment-plan and ICBT-plan groups were 100.47%, 104.66% and 85.91%, respectively. The conformity indexes were 0.66, 0.72 and 0.68, respectively. There was no significant difference in D 0.01 cm3, D 2 cm3 and D 5 cm3 of bladder, rectum and sigmoid colon among the three groups (all P>0.05). For the 3D-p-VC-ISBT treatment-plan group, the D 2 cm3 values of the small intestine at 6 Gy and 7 Gy prescription doses were 169.51 cGy and 111.93 cGy respectively, which were superior to those of the ICBT-plan group (343.07 cGy at 6 Gy prescription, P<0.01). Conclusions:Individualized 3D-p-VC-ISBT is superior to ICBT in terms of dose distribution of HR-CTV, and it can adaptively adjust the insertion plan according to changes in tumor volume and position, making the operation safer and more efficient.

Objective:To explore the advantages of individualized 3D-printed vaginal cylinder template-guided interstitial brachytherapy (3D-p-VC-ISBT) in locally advanced cervical cancer, aiming to provide reference for clinical adaptive brachytherapy.Methods:Clinical data of 20 patients with locally advanced cervical cancer admitted to Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from September, 2021 to August, 2023 were retrospectively analyzed. The median age was 54 years old (32-69 years). Among them, 3 patients were diagnosed with adenocarcinoma and 17 cases of squamous cell carcinoma. According to the treatment method, all patients were divided into intracavitary brachytherapy group (ICBT-plan group, n=10) and 3D-p-VC-ISBT group (3D-p-VC-ISBT treatment-plan group, n=10). A pretreatment plan was designed for each patient undergoing 3D-p-VC-ISBT. The pretreatment plans were formed as the pretreatment-plan group. Dose volume histogram was used to evaluate dose distribution of the targets and organs at risk (OAR). Comparison between two groups was analyzed by Mann-Whitney test and comparison among three treatment plans (ICBT, 3D-p-VC-ISBT treatment-plan and 3D-p-VC-ISBT pretreatment-plan) was analyzed by Kruskal-Wallis test. Results:The mean D 90rel (representing the dose received by 90% volume of the target area divided by the prescription dose) of high-risk clinical target volume (HR-CTV) in 3D-p-VC-ISBT, pretreatment-plan and ICBT-plan groups were 100.47%, 104.66% and 85.91%, respectively. The conformity indexes were 0.66, 0.72 and 0.68, respectively. There was no significant difference in D 0.01 cm3, D 2 cm3 and D 5 cm3 of bladder, rectum and sigmoid colon among the three groups (all P>0.05). For the 3D-p-VC-ISBT treatment-plan group, the D 2 cm3 values of the small intestine at 6 Gy and 7 Gy prescription doses were 169.51 cGy and 111.93 cGy respectively, which were superior to those of the ICBT-plan group (343.07 cGy at 6 Gy prescription, P<0.01). Conclusions:Individualized 3D-p-VC-ISBT is superior to ICBT in terms of dose distribution of HR-CTV, and it can adaptively adjust the insertion plan according to changes in tumor volume and position, making the operation safer and more efficient.

Objective:To investigate the characteristics of nosocomial infection and relative risk factors, and provide the basis for the management and control of nosocomial infection.Methods:A cross-sectional survey was conducted on all inpatients with nosocomial infection in the First Affiliated Hospital of Shandong First Medical University from 0:00 to 24:00 on September 18, 2018.Results:There were 2 766 inpatients in the survey day, and the detection rate was 100%. The number of nosocomial infections was 57, with a current incidence rate of 2.06% (57/2 766), and the number of infections was 60, with a secondary incidence rate of 2.17% (60/2 766). The departments with the highest infection rates were neurosurgery department and intensive care units (ICU), which were 9.92% (13/131) and 9.38% (6/64) respectively. The lower respiratory tract at the infected site was the first, accounting for 50.00% (30/60). The main pathogens of nosocomial infection were gram-negative bacteria. The incidence of nosocomial infection was higher in patients with age ≥60 years ( χ2 value was 18.22 , P<0.001), ventilator( χ2 value was 37.84 , P<0.001), urinary tract intubation ( χ2 value was 180.57 , P<0.001), diabetic nephropathy ( χ2 value was 34.71 , P<0.001), and hemodialysis ( χ2 value was 368.60 , P<0.001) with statistically significant differences (all P<0.05). Conclusions:The focus should be on the prevention and treatment of lower respiratory tract infection inpatients in the intensive care unit of neurosurgery, and medic should develop preventive measures to avoid the occurrence of nosocomial infection according to the risk factors of patients with age ≥60 years, ventilator, urinary tract intubation, diabetic nephropathy, and hemodialysis to shorten hospital stay and costs.

Objective:To evaluate and summarize the best evidence for exercise scheme after bariatric and metabolic surgery in obese patients at home and abroad.Methods:We used "obesity" " bariatric and metabolic surgery" "sleeve gastrectomy" "gastric bypass surgery" "banding surgery" "exercise" "physical activity" "exercise therapy" "guideline" "expert consensus" "systematic review" "Meta-analysis" and "evidence summary" as keywords, and searched databases such as UpToDate, Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI) , Wanfang Data, and the guide network and professional association platforms by computer. Literature retrieved included guidelines, expert consensus, best clinical practice, clinical decision-making, systematic reviews, and the search time limit was from the database establishment to July 18, 2020. Two researchers evaluated the quality of literature and extracted evidence, and the evidence was revised and perfected through expert consultation.Results:A total of 4 systematic reviews and Meta-analysis articles, 2 clinical decision-making articles, 4 guidelines, and 1 expert consensus were included. The evidence was collected from 7 aspects, namely the importance of exercise, pre-exercise evaluation, exercise style, exercise intensity and duration, exercise safety, exercise follow-up, exercise effect evaluation, and finally 33 best evidences were summed up.Conclusions:Evidence of exercise scheme after bariatric and metabolic surgery in obese patients is comprehensive. Medical institutions and clinical medical and nursing staff can combine the institutional environment to transform and apply the evidence.

Purpose: Nurses’ musculoskeletal diseases (MSDs) are worldwide prevalent and are considered to be a costly occupational injury. This study aims to investigate the relationship between exposure to occupation-related psychosocial factors, physical workload, and upper body musculoskeletal diseases among hospital nurses. Methods: An electronic search was implemented using nine databases with June 2019 as the latest search date. English and Chinese studies were chosen, and data were independently and separately extracted by two investigators. Pooled odds ratio (OR) and its 95% confidence interval (CI) were estimated for each subset, using the fixed or random-effects model, following heterogeneity between studies for research synthesis. The source of heterogeneity was explored through subgroup, sensitivity, and meta-analyses. Results: Eighteen studies were included in the meta-analysis. Most participants were women (51.4%–100.0%), aged between 20 and 60. A correlation was found between high job demand and the prevalence of low back pain (OR = 1.41; 95% CI = 1.23-1.62). Total job strain was related to the risk of low back pain (OR = 1.71; 95% CI = 1.15-2.55), neck pain (OR = 1.67; 95% CI = 1.26-2.20), shoulder pain (OR = 1.62; 95% CI = 1.06-2.48) and back pain (OR = 1.45; 95% CI = 1.10-1.91). Furthermore, the physical workload was significantly associated with the prevalence of low back pain (OR = 1.76; 95% CI = 1.32-2.35), neck pain (OR = 1.17; 95% CI = 1.08-1.27), shoulder pain (OR = 1.59; 95% CI = 1.37-1.85) and back pain (OR = 1.66; 95% CI = 1.45-1.90). Conclusion There were significant associations between occupational strain, more physical workload and upper body MSDs, but the evidence advocating a growth risk in MSDs due to low levels of social support is quite weak.

Purpose: Nurses’ musculoskeletal diseases (MSDs) are worldwide prevalent and are considered to be a costly occupational injury. This study aims to investigate the relationship between exposure to occupation-related psychosocial factors, physical workload, and upper body musculoskeletal diseases among hospital nurses. Methods: An electronic search was implemented using nine databases with June 2019 as the latest search date. English and Chinese studies were chosen, and data were independently and separately extracted by two investigators. Pooled odds ratio (OR) and its 95% confidence interval (CI) were estimated for each subset, using the fixed or random-effects model, following heterogeneity between studies for research synthesis. The source of heterogeneity was explored through subgroup, sensitivity, and meta-analyses. Results: Eighteen studies were included in the meta-analysis. Most participants were women (51.4%–100.0%), aged between 20 and 60. A correlation was found between high job demand and the prevalence of low back pain (OR = 1.41; 95% CI = 1.23-1.62). Total job strain was related to the risk of low back pain (OR = 1.71; 95% CI = 1.15-2.55), neck pain (OR = 1.67; 95% CI = 1.26-2.20), shoulder pain (OR = 1.62; 95% CI = 1.06-2.48) and back pain (OR = 1.45; 95% CI = 1.10-1.91). Furthermore, the physical workload was significantly associated with the prevalence of low back pain (OR = 1.76; 95% CI = 1.32-2.35), neck pain (OR = 1.17; 95% CI = 1.08-1.27), shoulder pain (OR = 1.59; 95% CI = 1.37-1.85) and back pain (OR = 1.66; 95% CI = 1.45-1.90). Conclusion There were significant associations between occupational strain, more physical workload and upper body MSDs, but the evidence advocating a growth risk in MSDs due to low levels of social support is quite weak.

To investigate the material basis and mechanism of Liupao tea on preventing COVID-19 by network pharmacology and molecular docking.The active ingredients and targets of Liupao tea were searched through the literature and the TCMSP databases and the network between the two was built by Cytoscape 3.7.1.Then using GenCards platform to predict the disease targets,mapping the common targets between Liupao tea and disease.The common targets were imported into the STRING database for exploring the protein-protein interaction.Core targets were enriched by gene ontology (GO) enrichment analysis and KEGG (kyoto encyclopedia of genes and genomes) pathway enrichment analysis using DAVID database etc..Finally,the screened active components were docked with the receptor protein SARS-CoV-2 3CL hydrolase (Mpro).Six active ingredients of Liupao tea were screened,such as (-)-epigallocatechin gallate (EGCG),(+)-catechin,(-)-catechin gallate,α-spinasterol,pelargonidin chloride and squalene,and 156 targets were identified.Among them,there were 112 common targets and 38 core targets with COVID-19.GO enrichment analysis (P<0.01) involved lipopolysaccharide,cell response to hypoxia,etc..And the KEGG pathway enrichment analysis (P<0.01)was conducted to obtain the HIF-1,IL-17,T cell receptor and other signaling pathways associated with COVID-19.The results of molecular docking showed that the active ingredients of Liupao tea were well bound to the receptor protein Mpro.The active ingredients of Liupao tea may control HIF-1,IL-17,T cell receptors signaling pathways by binding Mpro hydrolase and acting on inflammation and immune related targets such as MAPK1,TNF to prevent COVID-19.The EGCG of Mpro activity was determined ,and the IC50 was 3.4 μmol/L,which confirmed that EGCG was a certain inhibition effect on Mpro.

Objective To evaluate the anti-HBV effect of hypericin from the cellular level and to preliminarily explore its po-tential drug target point.Methods Liver cell line HepG2.2.15 cells secreting HBV particles were selected as the experimental ob-jects.Hypericin served as the HY group,lamivudine was taken as 3TC group and deionized water as the blank control group.The cells were grouped and administrated.The HBV-DNA copy level was measured at72 h after medication by Southern blot and fluo-rescent quantitative PCR;the inhibition rate of HBsAg and HBeAg was detected by using ELISA assay;the pgRNA expression level was tested by using Northern blot and fluorescent quantitative PCR;Western blot and fluorescent quantitative PCR were adopted to detect the expression of regulatory factors including HNF3β,HNF4α,PPARαand RXRα.Results Compared to the blank control group,both hypericin and lamivudine had significant inhibiting effect on HBV DNA and expression level of HBsAg and HBeAg in HepG2.2.15 cells (P <0.05).Hypericin could significantly decrease the pgRNA expression compared with the blank control group (P <0.05),while lamivudine had no obvious change (P <0.05).Moreover,hypericin exhibited significant effects on the expression of HNF3βand regulatory factor HNF4αcompared with the blank control group and 3TC group(P <0.05).Conclusion Hypericin represents a strong anti-HBV effect,moreover could increase the negative regulatory factor HNF3βn expression and decreases the positive factor HNF4αexpression,prompting that its drug target point could be pgRNA.

Objective: To investigate the efficacy and safety of the recombinant human tumor necrosis factor receptor Ⅱ-IgG Fc fusion protein (rhTNFR: Fc, etanercept) for the treatment of occupational medicamentosa-like dermatitis induced by trichloroethylene (OMLDT) . Methods: In September 2011 to February 2016, 12 patients with OMLDT were treated with etanercept 25 mg, subcutaneous injection, twice per week, doubling of first dose. The course of treatment was 6 weeks. The drug eruption area and severity index (DASI) score, the proportion of patients achieving a 50%, 75% and 90% reduction in DASI (DASI50, DASI75, DASI90) and the serum level of TNF-α were used to assess the efficacy at different times. Adverse reactions were also recorded and evaluated. The results were statistically analyzed by nonparametric Friedman test and repetitive measurement ANOVA using the software SPSS19.0. Results: After 4 weeks treatment, the DASI score decreased form 56.33±7.02 to 0.50±0.91 (P<0.01) . The DASI50, DASI75 and DASI90 were all increased to 12 (100%) . The serum level of TNF-α decreased form (43.74±41.62) pg/ml to (3.03±0.47) pg/ml (P<0.01) . Statistically significant difference was observed from the above indexes. There were no adverse reactions in clinical application. Conclusion Recombinant human tumor necrosis factor receptor Ⅱ-IgG Fc fusion protein may be a safe and effective drug in the treatment of OMLDT.

Objective:To analyze the clinicopathological features, diagnosis, and treatment of anorectal malignant melanoma (ARMM), and to explore its prognostic factors and misdiagnosis. Methods:A total of 36 patients with ARMM were enrolled in this study from January 2000 to November 2016 in Nanfang Hospital, Zhujiang Hospital, and Guangdong Provincial Hospital of Traditional Chinese Medicine. Results: The clinical manifestations of ARMM were not specific. The odds of misdiagnosis were as high as 52.8% in this study. The 1-and 3-year survival rates were 75%and 35%, respectively, with median survival time of 24.51 months. Survival rate was correlated with tumor size, invasion depth, clinical stage, and lymph node metastasis (P<0.05), but was not related to patient age and gender. The median survival time of the three groups of patients (surgery alone, surgery-based combination therapy, untreated) were 39.21, 26, and 15 months. The difference was not statistically significant. No difference in survival was found between patients under-going abdominoperineal resection and wide local excision. Conclusion:ARMM has poor prognosis and is easily misdiagnosed as a ma-lignant tumor. The prognostic factors are tumor size, invasion depth, clinical stage, and lymph node metastasis. Surgical treatment can extend survival. To avoid misdiagnosis and prolong survival, early diagnosis and early treatment are recommended.