Objective:Investigating the correlation between postoperative stress levels and intraoperative sufentanil dosage in breast cancer patients.Method:A retrospective selection was made of 100 BC patients who underwent surgery at Shaanxi Cancer Hospital from Apr. 2023 to Apr. 2025 as the research subjects. According to the dosage of sufentanil during the operation, they were divided into low-dose ( n=33), medium-dose ( n=34), and high-dose ( n=33) groups. The general data and postoperative stress levels of the three groups were compared and analyzed. Based on the results of stress levels, BC patients were further divided into the normal group ( n=75) and the elevated group ( n=25). The clinical data, laboratory indicators, and intraoperative sufentanil dosage of the two groups were compared and analyzed. Binary Logistic regression was used to analyze the factors influencing the postoperative stress level of patients, and a nomogram was constructed. ROC and DCA were used to analyze the predictive value and net benefit of the nomogram. Pearson correlation analysis was used to analyze the correlation between the factors influencing the stress state of patients and the postoperative stress level. Results:The levels of endothelin-1 (ET-1), norepinephrine (NE), and cortisol (Cor) in the high-dose group after surgery were significantly lower than those in the low-dose group and the medium-dose group ( t=9.55, 11.07, 82.91, P<0.05). The stress levels and the levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), brain-derived neurotrophic factor (BDNF), and adrenocorticotropic hormone (ACTH) in the stress group were significantly higher than those in the normal group. However, the levels of sufentanil drug, glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) were lower than those in the normal group ( t=2.02, 2.04, 2.15, P<0.05). Multivariate analysis of binary logistic regression showed that the dosage of sufentanil ( t=2.02, 2.04, 2.15, P<0.05) ; Multivariate analysis of binary logistic regression showed that sufentanil dosage ( OR=0.58, 95 %CI: 0.24-0.93), SOD ( OR= 0.63, 95 %CI:0.41~0.84) were protective factors, and ACTH ( OR=1.57, 95%CI:1.23-1.92), CRP ( OR=1.53, 95 %CI: 1.06-2.00) 、BDNF ( OR=1.43, 95 %CI:1.11-1.75) were risk factors affecting the stress state of patients ( P<0.05) ; The construction of a risk nomogram model based on the above influencing factors and the ROC analysis indicated that its AUC=0.829, indicating a good predictive ability. The correction curve is close to the ideal curve, indicating that the model has good discrimination and consistency. DCA curve verification revealed that its predicted probability was 68%, indicating a positive net benefit. Correlation analysis showed that the intraoperative sufentanil dose, SOD, ACTH, CRP, BDNF were significantly correlated with the postoperative stress level-related indicators NE, ET-1, Cor. Among them, the intraoperative sufentanil dose and SOD were negatively correlated with NE, ET-1, Cor, while the other indicators were positively correlated with them ( P<0.05) . Conclusions:High levels of ACTH, CRP and BDNF are independent risk factors for postoperative stress in patients with BC, while sufentanil fibroids and SOD during the operation are protective factors. Moreover, the intraoperative sufentanil dose has a significant correlation with the related indicators of emergency levels. Clinically, this can be used as a biomarker for predicting postoperative stress in patients with BC and individualized intervention measures can be implemented, providing a new monitoring perspective for clinical prediction of the occurrence of stress.

Objective:Investigating the correlation between postoperative stress levels and intraoperative sufentanil dosage in breast cancer patients.Method:A retrospective selection was made of 100 BC patients who underwent surgery at Shaanxi Cancer Hospital from Apr. 2023 to Apr. 2025 as the research subjects. According to the dosage of sufentanil during the operation, they were divided into low-dose ( n=33), medium-dose ( n=34), and high-dose ( n=33) groups. The general data and postoperative stress levels of the three groups were compared and analyzed. Based on the results of stress levels, BC patients were further divided into the normal group ( n=75) and the elevated group ( n=25). The clinical data, laboratory indicators, and intraoperative sufentanil dosage of the two groups were compared and analyzed. Binary Logistic regression was used to analyze the factors influencing the postoperative stress level of patients, and a nomogram was constructed. ROC and DCA were used to analyze the predictive value and net benefit of the nomogram. Pearson correlation analysis was used to analyze the correlation between the factors influencing the stress state of patients and the postoperative stress level. Results:The levels of endothelin-1 (ET-1), norepinephrine (NE), and cortisol (Cor) in the high-dose group after surgery were significantly lower than those in the low-dose group and the medium-dose group ( t=9.55, 11.07, 82.91, P<0.05). The stress levels and the levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), brain-derived neurotrophic factor (BDNF), and adrenocorticotropic hormone (ACTH) in the stress group were significantly higher than those in the normal group. However, the levels of sufentanil drug, glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) were lower than those in the normal group ( t=2.02, 2.04, 2.15, P<0.05). Multivariate analysis of binary logistic regression showed that the dosage of sufentanil ( t=2.02, 2.04, 2.15, P<0.05) ; Multivariate analysis of binary logistic regression showed that sufentanil dosage ( OR=0.58, 95 %CI: 0.24-0.93), SOD ( OR= 0.63, 95 %CI:0.41~0.84) were protective factors, and ACTH ( OR=1.57, 95%CI:1.23-1.92), CRP ( OR=1.53, 95 %CI: 1.06-2.00) 、BDNF ( OR=1.43, 95 %CI:1.11-1.75) were risk factors affecting the stress state of patients ( P<0.05) ; The construction of a risk nomogram model based on the above influencing factors and the ROC analysis indicated that its AUC=0.829, indicating a good predictive ability. The correction curve is close to the ideal curve, indicating that the model has good discrimination and consistency. DCA curve verification revealed that its predicted probability was 68%, indicating a positive net benefit. Correlation analysis showed that the intraoperative sufentanil dose, SOD, ACTH, CRP, BDNF were significantly correlated with the postoperative stress level-related indicators NE, ET-1, Cor. Among them, the intraoperative sufentanil dose and SOD were negatively correlated with NE, ET-1, Cor, while the other indicators were positively correlated with them ( P<0.05) . Conclusions:High levels of ACTH, CRP and BDNF are independent risk factors for postoperative stress in patients with BC, while sufentanil fibroids and SOD during the operation are protective factors. Moreover, the intraoperative sufentanil dose has a significant correlation with the related indicators of emergency levels. Clinically, this can be used as a biomarker for predicting postoperative stress in patients with BC and individualized intervention measures can be implemented, providing a new monitoring perspective for clinical prediction of the occurrence of stress.

Objective To explore the correlation of MET status in patients with advanced prostatic acinar adenocarcinoma with the clinical pathological parameters and prognosis. Methods The specimen from 135 patients with advanced prostatic acinar adenocarcinoma was included. The expression of c-MET protein was detected via immunohistochemistry, and MET gene amplification was assessed by fluorescence in situ hybridization. The relationships of c-MET expression and gene amplification with clinicopathological features and prognosis were analyzed. Results The positive expression rate of c-MET was 52.60% (71/135). Compared with the c-MET expression in adjacent tissues, that in tumor tissues showed lower heterogeneous expression. Among the cases, 1.71% (2/117) exhibited MET gene polyploidy, but no gene amplification was detected. Positive c-MET expression was significantly correlated with high Gleason scores and grade groups (P=0.0073). However, no significant relationship was found between c-MET expression and progression-free survival or post-treatment t-PSA levels. Conclusion c-MET protein is expressed at a relatively low level in advanced prostatic acinar adenocarcinoma, suggesting that c-MET may not be a viable target for ADC drug development in prostatic acinar adenocarcinoma.

Objective To explore the influence of radiation protection knowledge-attitude-practice (RP-KAP) on occupational stress of radiation workers. Methods A total of 314 radiation workers from five hospitals in Shijiazhuang City were selected as the study subjects using the convenient sampling method. The Chinese version of the "Effort-Reward Imbalance (ERI) Questionnaire" and the "Radiation Protection Knowledge, Attitude, and Practice Questionnaire" were used for investigation. Results The detection rate of occupational stress in ERI model among the radiation workers was 74.5% (234/314). The RP-KAP practice dimension score of the population in the occupational stress group was lower than that in the non-occupational stress group (P<0.05). The results of binary logistic regression analysis showed that radiation workers with lower RP-KAP practice dimension score had a higher risk of occupational stress (P<0.01), and the risks of occupational stress among population of interventional radiology group and radiotherapy group were higher than that of X-ray diagnosis group and nuclear medicine group (both P<0.05), after controlling for confounding factors such as gender, age, type of work, professional title, daily working hours, weekly working hours and regular vacation. Conclusion RP-KAP is the influencing factor of occupational stress in the radiation workers. To improve the radiation workers' knowledge of radiation protection, protection awareness and compliance with protective behavior can effectively reduce or even eliminate occupational stress.

This study explores the effect of total secondary ginsenosides(TSG) on apoptosis and energy metabolism in H9c2 cells under hypoxia and its potential mechanisms. H9c2 cell viability was observed and the apoptosis rate was calculated to determine suitable intervention concentrations of TSG, antimycin A complex(AMA), and coenzyme Q10(CoQ10), along with the duration of hypoxia. H9c2 cells at the logarithmic phase were divided into a normal group, a model group, a TSG group, an AMA group, a TSG+AMA group, and a CoQ10 group. All groups, except the normal group, were treated with their respective intervention drugs and cultured under hypoxic conditions. Adenosine triphosphate(ATP) content and creatine kinase(CK) activity were measured using an ATP chemiluminescence assay kit and a CK colorimetric assay kit. Flow cytometry was used to assess apoptosis rates, and Western blot evaluated the expression levels of apoptosis-related proteins, including B-cell lymphoma 2(Bcl-2), Bcl-2-associated X protein(Bax), cysteinyl aspartate-specific protease(caspase)-3, caspase-8, and caspase-9, as well as mitochondrial biogenesis-related proteins peroxisome proliferator-activated receptor-γ coactivator 1α(PGC-1α), estrogen-related receptor-α(ERRα), nuclear respiratory factor(NRF)-1, NRF-2, peroxisome proliferator activated receptor-α(PPARα), and Na~+-K~+-ATPase. RT-PCR was employed to analyze the mRNA expression of mitochondrial biogenesis factors, including PGC-1α, ERRα, NRF-1, NRF-2, PPARα, mitochondrial transcription factor A(TFAM), mitochondrial cytochrome C oxidase 1(COX1), and mitochondrial NADH dehydrogenase subunit 1(ND1), ND2. The selected intervention concentrations were 7.5 μg·mL~(-1) for TSG, 10 μmol·L~(-1) for AMA, and 1×10~(-4) mol·L~(-1) for CoQ10, with a hypoxia duration of 6 h. Compared with the normal group, the model group showed decreased ATP content and CK activity, increased apoptosis rates, decreased Bcl-2 expression, and increased Bax, caspase-3, caspase-8, and caspase-9 expression in H9c2 cells. Additionally, the protein and mRNA expression levels of mitochondrial biogenesis-related factors(PGC-1α, ERRα, NRF-1, NRF-2, PPARα), mRNA expression of TFAM, COX1, and ND1, ND2, and protein expression of Na~+-K~+-ATPase in mitochondrial DNA, were also reduced. In the TSG and CoQ10 groups, ATP content and CK activity increased, and apoptosis rates decreased compared with those in the model group. The TSG group showed decreased protein expression of apoptosis-related proteins Bax, caspase-3, caspase-8, and caspase-9, increased protein and mRNA expression of mitochondrial biogenesis factors PGC-1α, ERRα, NRF-1, and PPARα, and increased NRF-2 protein expression and TFAM mRNA expression in mitochondrial DNA. Conversely, in the AMA group, ATP content and CK activity decreased, the apoptosis rate increased, Bcl-2 expression decreased, and Bax, caspase-3, caspase-8, and caspase-9 expression increased, alongside reductions in PGC-1α, ERRα, NRF-1, NRF-2, PPARα protein and mRNA expression, as well as TFAM, COX1, ND1, ND2 mRNA expression and Na~+-K~+-ATPase protein expression. Compared with the TSG group, the TSG+AMA group exhibited decreased ATP content and CK activity, increased apoptosis rates, decreased Bcl-2 expression, and increased Bax, caspase-3, caspase-8, and caspase-9 expression, along with decreased PGC-1α, ERRα, NRF-1, NRF-2, and PPARα protein and mRNA expression and TFAM, COX1, and ND1, ND2 mRNA expression. Compared with the AMA group, the TSG+AMA group showed increased CK activity, decreased apoptosis rate, increased Bcl-2 expression, and decreased Bax, caspase-8, and caspase-9 expression. Additionally, the protein and mRNA expression of PGC-1α, ERRα, NRF-1, PPARα, mRNA expression of TFAM, COX1, ND1, ND2, and Na~+-K~+-ATPase protein expression increased. In conclusion, TSG enhance ATP content and CK activity and inhibit apoptosis in H9c2 cells under hypoxia, and the mechanisms may be related to the regulation of PGC-1α, ERRα, NRF-1, NRF-2, PPARα, and TFAM expression, thus promoting mitochondrial biogenesis.
Apoptosis/drug effects* ; Ginsenosides/pharmacology* ; Energy Metabolism/drug effects* ; Mitochondria/metabolism* ; Animals ; Rats ; Cell Line ; Cell Hypoxia/drug effects* ; Organelle Biogenesis ; Adenosine Triphosphate/metabolism* ; Humans ; Cell Survival/drug effects*

The catheter self-management ability of carcinoma patients undergoing peripherally inserted central catheter (PICC) is closely related to the incidence of catheter complications. The lower the self-management level, the higher the incidence of catheter-related complications and adverse events. This paper mainly reviews the status quo, influencing factors, improvement approaches and evaluation methods of catheter self-management ability of carcinoma patients undergoing PICC so as to provide a reference for clinical medical staff to help carcinoma patients undergoing PICC improve catheter self-management abilities.

Hospitals today are confronted with new challenges in environmental hygiene management. Based on recent literatures and norms at home and abroad, this review analyzed such challenges and defects found in the environmental hygiene management of hospitals in China. The problems include but are not limited to the following: incomplete environmental management system and norms, insufficient staffing and funding support, lack of HR management mechanism in terms of employment, training, appraisal and reward/penalty, as well as poor hygiene awareness of hospital environmental services staff. In view of these problems in the hospitals, the authors provide specific countermeasures as follows: establishing new environmental hygiene management models, improving management mechanisms, creating positive and normalized cultural atmosphere for environmental infection control, and applying informatization to upgrade environmental hygiene quality. These measures are expected to serve as references for improving surrounding hygiene of patients.

A 32﹣year﹣old woman received IV infusion of doxorubicin hydrochloride liposomes injection 20 mg,added into 5% glucose injection 250 ml,for malignant lymphoma. About 1 minute after the initiation of the IV infusion,the patient developed facial flushing and itchy throat. Two minutes later,the patient developed sudden convulsions, loss of consciousness, binocular gaze, trismus, and urinary incontinence. Anaphylactic shock was diagnosed and the drug was discontinued immediately. Treatments such as intravenous injections of adrenaline hydrochloride injection,dexamethasone sodium phosphate injection,and methylprednisolone sodium succinate for injection,oxygen inhalation,intravenous injections of nikethamide injection,lobeline hydrochloride injection,and norepinephrine bitartrate injection,and cardiopulmonary resuscitation were given successively. However,the patient had been in a deep coma without spontaneous breathing and her blood pressure and urination needed to be maintained by drugs. On day 112 of hospitalization,cerebrovascular color ultrasound showed spectrum changes of brain death. On day 253,the patient was discharged at the request of his family members.

A 32﹣year﹣old woman received IV infusion of doxorubicin hydrochloride liposomes injection 20 mg,added into 5% glucose injection 250 ml,for malignant lymphoma. About 1 minute after the initiation of the IV infusion,the patient developed facial flushing and itchy throat. Two minutes later,the patient developed sudden convulsions, loss of consciousness, binocular gaze, trismus, and urinary incontinence. Anaphylactic shock was diagnosed and the drug was discontinued immediately. Treatments such as intravenous injections of adrenaline hydrochloride injection,dexamethasone sodium phosphate injection,and methylprednisolone sodium succinate for injection,oxygen inhalation,intravenous injections of nikethamide injection,lobeline hydrochloride injection,and norepinephrine bitartrate injection,and cardiopulmonary resuscitation were given successively. However,the patient had been in a deep coma without spontaneous breathing and her blood pressure and urination needed to be maintained by drugs. On day 112 of hospitalization,cerebrovascular color ultrasound showed spectrum changes of brain death. On day 253,the patient was discharged at the request of his family members.

Dysphagia is often associated with incoordination between breathing and swallowing, resulting in the occurrence of aspiration, cough and aspiration pneumonia. This article reviewed the specific physiological mechanisms of respiration and swallowing and their clinical applications, which aimed to focus on the relationship between respiration and swallowing systems in health and disease, and to explore its guiding value in the clinical treatment of dysphagia.