Objective To observe the value of intratumoral tertiary lymphoid structure(TLS)for predicting prognosis of soft tissue sarcomas(STS)after cryoablation combined with immunotherapy.Methods Forty-three STS patients who underwent cryoablation were retrospectively enrolled,including 38 cases underwent cryoablation combined with but 5 cases without immunotherapy,among them 6 cases with but 37 cases without intratumoral TLS.The progression free survival(PFS)were compared between those with and without immunotherapy,as well as those with and without intratumoral TLS.The value of intratumoral TLS for predicting prognosis of STS after cryoablation combined with immunotherapy was analyzed with Cox regression and receiver operating characteristic curves.Results No significant difference of PFS was found between STS patients undwerwent cryoablation combined with and without immunotherapy(P＜0.05).Among 38 cases underwent cryoablation combined with immunotherapy,6 cases were found with but 32 cases without intratumoral TLS,and the median PFS of the former was longer than that of the latter(6 months vs.3 months,P＜0.05).Univariate and multivariate Cox regression analysis revealed that intratumoral TLS and interleukin 2 receptor(IL-R2)were both independent influencing factors of PFS of STS patients after cryoablation combined with immunotherapy(both P＜0.05).The area under the curve(AUC)of intratumoral TLS for predicting PFS of STS patients at 3,6 and 9 months was 0.550,0.577 and 0.699,of IL-R2 was 0.658,0.742 and 0.583,respectively,while of combination of the above two was 0.762,0.787 and 0.881,respectively,all higher than of each intratumoral TLS and IL-R2 alone(all P＜0.05).Conclusion Intratumoral TLS could be used to predict prognosis of STS after cryoablation combined with immunotherapy.Combining with IL-R2 might further improve its predictive efficacy.

Objective:To systematically evaluate the qualitative study of perinatal bereavement care by obstetric nurses and midwives, and explore the barriers to perinatal bereavement care, so as to promote the development of domestic perinatal bereavement care services.Methods:Systematic search of qualitative studies on the experience of obstetric nurses and midwives in caring for perinatal bereaved mothers in PubMed, Web of Science, Embase, Cochrane Library, PsycINFO, CINAHL, China Biomedical Literature Service System, CNKI, Wanfang Database, and VIP database were searched from the establishment until June 30, 2024. The qualitative research quality evaluation was conducted using the 2016 version of the qualitative research quality assessment tool of the Joanna Briggs Institute Evidence-Based Health Care Centre in Australia, and the results of the study were summarized and integrated using the pooled integration method.Results:A total of 14 studies were included, with 3 Chinese literatures and 11 English literatures. A total of 55 themes were extracted, which were summarized and combined into 8 new categories, and 3 integrated results were summarized: insufficient bereavement care ability, insufficient bereavement care confidence, and imperfect allocation of bereavement care resources.Conclusions:The knowledge popularization and training of bereavement care should be strengthened, the organizational support should be strengthened, the confidence of obstetric nurses and midwives in bereavement care should be enhanced, a special perinatal bereavement care team should be set up, and multidisciplinary resources should be integrated to ensure the continuity and coordination of perinatal bereavement care.

Objective To observe the value of intratumoral tertiary lymphoid structure(TLS)for predicting prognosis of soft tissue sarcomas(STS)after cryoablation combined with immunotherapy.Methods Forty-three STS patients who underwent cryoablation were retrospectively enrolled,including 38 cases underwent cryoablation combined with but 5 cases without immunotherapy,among them 6 cases with but 37 cases without intratumoral TLS.The progression free survival(PFS)were compared between those with and without immunotherapy,as well as those with and without intratumoral TLS.The value of intratumoral TLS for predicting prognosis of STS after cryoablation combined with immunotherapy was analyzed with Cox regression and receiver operating characteristic curves.Results No significant difference of PFS was found between STS patients undwerwent cryoablation combined with and without immunotherapy(P＜0.05).Among 38 cases underwent cryoablation combined with immunotherapy,6 cases were found with but 32 cases without intratumoral TLS,and the median PFS of the former was longer than that of the latter(6 months vs.3 months,P＜0.05).Univariate and multivariate Cox regression analysis revealed that intratumoral TLS and interleukin 2 receptor(IL-R2)were both independent influencing factors of PFS of STS patients after cryoablation combined with immunotherapy(both P＜0.05).The area under the curve(AUC)of intratumoral TLS for predicting PFS of STS patients at 3,6 and 9 months was 0.550,0.577 and 0.699,of IL-R2 was 0.658,0.742 and 0.583,respectively,while of combination of the above two was 0.762,0.787 and 0.881,respectively,all higher than of each intratumoral TLS and IL-R2 alone(all P＜0.05).Conclusion Intratumoral TLS could be used to predict prognosis of STS after cryoablation combined with immunotherapy.Combining with IL-R2 might further improve its predictive efficacy.

Objective:To systematically evaluate the qualitative study of perinatal bereavement care by obstetric nurses and midwives, and explore the barriers to perinatal bereavement care, so as to promote the development of domestic perinatal bereavement care services.Methods:Systematic search of qualitative studies on the experience of obstetric nurses and midwives in caring for perinatal bereaved mothers in PubMed, Web of Science, Embase, Cochrane Library, PsycINFO, CINAHL, China Biomedical Literature Service System, CNKI, Wanfang Database, and VIP database were searched from the establishment until June 30, 2024. The qualitative research quality evaluation was conducted using the 2016 version of the qualitative research quality assessment tool of the Joanna Briggs Institute Evidence-Based Health Care Centre in Australia, and the results of the study were summarized and integrated using the pooled integration method.Results:A total of 14 studies were included, with 3 Chinese literatures and 11 English literatures. A total of 55 themes were extracted, which were summarized and combined into 8 new categories, and 3 integrated results were summarized: insufficient bereavement care ability, insufficient bereavement care confidence, and imperfect allocation of bereavement care resources.Conclusions:The knowledge popularization and training of bereavement care should be strengthened, the organizational support should be strengthened, the confidence of obstetric nurses and midwives in bereavement care should be enhanced, a special perinatal bereavement care team should be set up, and multidisciplinary resources should be integrated to ensure the continuity and coordination of perinatal bereavement care.

ObjectiveTo reveal the molecular mechanism of Angong Niuhuangwan（AGNH） in improving traumatic brain injury（TBI） based on single cell sequencing. MethodSeventy-five male SD rats were randomly divided into the sham group， model group， piracetam group（3.6 g·kg^-1）， AGNH low- and high-dose groups（0.09， 0.27 g·kg^-1）， with 15 rats in each group. In addition to the sham group， the other 4 groups used the modified Feeney free-fall impact method to prepare TBI model， and the drugs were administered by gavage immediately after modeling， 24 hours later， the modified neurological deficit score（mNSS） was performed， and brain tissue was isolated to determine the degree of cerebral edema. Hematoxylin-eosin（HE） staining was used to observe the injury degree in the cortex， CA1 region and CA3 region of brain tissue. The expression levels of cyclooxygenase-2（COX-2）， interferon regulatory factor 1（IRF1）， Janus kinase 2（JAK2） and suppressor of cytokine signaling 3（SOCS3） were observed by immunofluorescence（IF） staining. The levels of interleukin（IL）-6， IL-18， IL-1β， IL-17A， tumor necrosis factor-α（TNF-α）， Caspase-1 and nucleotide binding oligomerization domain（NOD）-like receptor heat protein domain associated protein 3（NLRP3） inflammasome were determined by enzyme-linked immunosorbent assay（ELISA）. The regulation of AGNH on each cell population was analyzed by single cell sequencing， and differentially expressed genes were analyzed by Gene Ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG）， which led to construct microglia differentially expressed gene network to search for the key targets， and validated by ELISA and IF. ResultCompared with the sham group， the mNSS and brain water content were significantly increased in the model group（P<0.01）. Compared with the model group， mNSS and brain water content in the low and high dose AGNH groups were decreased（P<0.05，P<0.01）. HE staining results showed that compared with the sham group， the cells in the cerebral cortex and hippocampus of rats in the model group were seriously lost， and the cells were arranged loosely（P<0.01）. Compared with the model group， AGNH could significantly increase the density of neurons in the CA1 and CA3 regions of the cerebral cortex and hippocampus， making the arrangement more compact， as well as improved cell morphology（P<0.05，P<0.01）. ELISA and IF staining showed that AGNH could reduce the levels of Caspase-1， IL-17A， TNF-α， NLRP3 and COX-2 in brain tissue of TBI rats（P<0.05， P<0.01）. A total of 13 cell subsets were identified by single cell sequencing， among which microglia played an important role in neuroimmunity. The results of GO enrichment analysis of differentially expressed genes in microglia showed that AGNH improved TBI in response to inflammation and TNF-α. KEGG enriched IL-17 signaling pathway， TNF signaling pathway， Toll-like receptor signaling pathway， etc. The results of network analysis showed that the key targets of AGNH in regulating TBI might be IL-6， IL-1β， JAK2， SOCS3， IRF1. IF and ELISA verification results showed that compared with the sham group， SOCS3 expression in microglia was decreased in the model group， and the expressions of IL-6， IL-1β， JAK2 and IRF1 were increased（P<0.01）. Compared with the model group， AGNH could increase the expression of SOCS3， decrease the expression of IL-6， IL-1β， JAK2， IRF1 （P<0.05， P<0.01）. ConclusionAGNH can reduce the degree of brain edema and brain injury， decrease the expression of inflammatory factors， and inhibit the expression of NLRP3 and its downstream Caspase-1 in TBI rats， which may act on the targets of IL-6， IL-1β， JAK2， IRF1 and SOCS3 in microglia.

Objective:To investigate the characteristics of multi-slice spiral CT images in lung cancer with cystic lesions and improve the accuracy of diagnosis.Methods:The clinical data of 27 cases of cystic lung cancer confirmed by pathological results of surgery or puncture who received treatment during 2012-2019 in Tongde Hospital of Zhejiang Province, China were collected. The clinical stages, pathological results and the characteristics of multi-slice spiral CT images were analyzed.Results:All 27 cases were diagnosed with peripheral lung cancer. Type VI peripheral lung cancer occurred in 12 (44.44%) cases, and adenocarcinoma in 17 (62.96%) cases. Stage Ia lung cancer occurred in 18 (66.67%) patients. Above 70% of CT images showed irregular cystic structure [70.37% (19/27)], polycystic structure [74.07% (20/27)], and vessels passing through the cysts [70.37% (19/27). Over 90% of CT images displayed unsmooth inner wall of the cysts [92.59% (25/27)] and fuzzy margin of the cysts [96.30% (26/27)].Conclusion:It is very difficult to diagnose lung cancer with cystic lesions. This kind of atypical lung cancer should be considered when the imaging features of peripheral lung cancer appear including thickened cystic wall, fuzzy cystic margin, vascular bundle sign and pleural indentation sign.

Objective:To investigate the current situation of kinesiophobia in patients with knee osteoarthritis and its influencing factors, in order to provide basis for clinical intervention.Methods:Totally 230 patients with knee osteoarthritis were selected from 2 tertiary hospital in Ji′nan by convenience sampling method, the self-designed general data questionnaire, Tampa Scale for Kinesiophobia, Numerical Rating Scale, Self-efficacy for Managing Chronic Disease, Hospital Anxiety and Depression Scale were used as research tools. Logistic regression analysis was used to analyze the influencing factors.Results:A total of 219 valid questionnaires were collected. Kinesiophobia occurred in 166 patients, with an incidence of 75.80% (166/219). Logistic regression analysis showed that gender, education level, chronic complications, pain and self-efficacy were the main influencing factors of kinesiophobia in patients with knee osteoarthritis ( P<0.05). Conclusion:The incidence of kinesiophobia in patients with knee osteoarthritis is relatively high, and medical staff should pay attention to the evaluation of kinesiophobia symptoms in this population, early identify the high-risk factors, provide timely health education, implement the appropriate intervention measures to reduce the occurrence of kinesiophobia.

Integrins are cell adhesion receptors, which consists of several transmembrane glycoproteins. They are widely distributed on the cell surface and involved in signal transduction pathways. As a heterodimer, each integrin is composed of one α subunit and one β subunit. Integrins are mainly expressed on lepidopteran hemocytes and involved in cell immune response. The full-length cDNA sequence of BmIntegrin β2 was obtained by PCR and RACE, including 2 434 bp. BmIntegrin β2 was predicted to be a transmembrane protein. The BmIntegrin β2 expression profile was detected by qRT-PCR at L4D3 or L5D3 larval stage, and it was highly expressed in hemocyte and hematopoietic organ. Anti-BmIntegrin β2 polyclonal antibody was generated following prokaryotic expression, protein purification and animal immunization, which is highly specific and effective for recognizing BmIntegrin β2 protein through Western blotting. The results of plasmatocytes adhesion experiment showed that BmIntegrin β2 plays an important role on the adhesion and spreading of plasmatocytes to foreign surfaces. This study provides a foundation for further research of the biological function of BmIntegrin β2 gene.

Glycyrrhizae Radix et Rhizoma is one of the traditional herbal medicine used in China, study on the correlation between the cross-section color and HPLC fingerprints of them have important significance for promoting the development of traditional disciplines. Quantitative analysis of the color of sample cross section was carried out by color digital method, fingerprint analysis was carried out by HPLC, and the canonical correlation analysis was carried out between them. The results showed that there was a significant correlation between the color of Glycyrrhizae Radix et Rhizoma cross section and the information of HPLC fingerprinting. Results indicated that, The digitized indexes of color of cross section could reflect the result of fingerprint analysis to some extent.

Objective: To analyze the clinical characteristics of allergic reactions in patients with colorectal cancer after routine premed-ication with dexamethasone (5 mg) before chemotherapy with an oxaliplatin-containing regimen and to provide a reference for reduc-ing the risk of oxaliplatin allergy. Methods: Retrospective analysis of 242 patients with colorectal cancer who received chemotherapy with an oxaliplatin-containing regimen at the Changzhou Cancer Hospital of Soochow University from January 2014 to October 2017 was performed, and the incidence of allergic reactions was calculated. The associations between multiple factors and allergic reactions were then assessed using univariate analysis. The independent factors of allergic reactions were assessed using multivariate Logistic analysis, and the treatment outcome of oxaliplatin rechallenge in allergic patients was discussed. Results: A total of 242 patients were studied. They received routine premedication with dexamethasone (5 mg) before chemotherapy with an oxaliplatin-containing regi-men. Twelve (4.9%) patients had type I allergic reactions, with a median onset time of 6 (5.5-10.5) cycles and a median cumulative dose of 895 (716.5-1 075.0) mg. Multivariate analysis identified undergoing an oxaliplatin-free interval as an independent risk factor (P=0.04). Rechallenging patients with prophylactic agents was successful in 1 (33.3%) of 3 patients who completed their treatment. Conclusions: Routine low-dose dexamethasone premedication before oxaliplatin administration is safe and exhibited a lower inci-dence of hypersensitivity reactions than that reported in literature. An oxaliplatin-free interval may increase the risk of hypersensitivity reactions. Caution should be exercised while rechallenging allergic patients with oxaliplatin.