Objective:To investigate the interactive effects of loss of the only child and childhood trauma on brain structure, function, and structure-function coupling, and to analyze their association with clinical symptom.Methods:A total of 112 parents who lost their only child and participated in the psychological aid project organized by Local Civil Affairs Department in Sunan aear of Jiangsu Province in China from April 2021 to July 2021 and 36 healthy controls recruited from the community during the same period were selected. Based on childhood trauma questionnaire scores, parents who had lost their only child were divided into those with childhood trauma (group A, n=55) and those without childhood trauma (group B, n=57); similarly, the healthy controls were divided into a group with childhood trauma (group C, n=12) and a group without childhood trauma (group D, n=24). All participants were evaluated by clinical scales such as Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Mini-Mental State Examination (MMSE). MRI 3D-T1 structural images and resting-state functional magnetic resonance imaging data were collected; gray matter volume (GMV) and degree centrality (DC) were calculated by standardized image preprocessing procedure, and ratio of DC to GMV within each voxel was computed to obtain the structure-function coupling map. A two-factor analysis of variance was used to analyze the independent effect and interactive effect of loss of the only child and childhood trauma on GMV, DC, and DC/GMV coupling value. Spearman rank correlation analysis was used to evaluate the associations of above indicators in brain regions with significant difference in independent effect and interactive effect with clinical scale scores. Results:(1) Compared with the participants without childhood trauma (group B+group D), the participants with childhood trauma (group A+group C) showed significantly reduced GMV in the left middle temporal gyrus and right dorsolateral superior frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, Gaussian random field [GRF] corrected). A significant interactive effect of loss of the only child and childhood trauma on GMV in the right precuneus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (2) Compared with the healthy controls, parents who had lost their only child exhibited significantly increased DC in the left middle frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). Compared with participants without childhood trauma, participants with childhood trauma showed significantly increased DC in the right thalamus (voxel-level P<0.01, cluster-level P< 0.05, GRF corrected). A significant interactive effect of loss of the only child and childhood trauma on DC in the left dorsolateral superior frontal gyrus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (3) Compared with the healthy controls, parents who had lost their only child showed significantly decreased DC/GMV coupling value in the left middle frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). Compared with participants without childhood trauma, participants with childhood trauma showed significantly increased DC/GMV coupling value in the right thalamus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). A significant interactive effect of loss of the only child and childhood trauma on DC/GMV coupling value in the left dorsolateral superior frontal gyrus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (4) Correlation analysis revealed that GMV in the right precuneus with significant interactive effect of loss of the only child and childhood trauma was positively correlated with MMSE score ( r s=0.317, P=0.010, Bonferroni corrected). GMV in the left middle temporal gyrus with significant independent effect of childhood trauma was positively correlated with both HAMD score and HAMA score ( r s=0.362, P=0.006; r s= 0.349, P=0.008, Bonferroni corrected). Conclusion:Loss of the only child and childhood trauma can interact to jointly affect the brain structure, function, and structure-function coupling; and some of these brain structure alterations are closely associated with clinical symptoms.

Objective To investigate the effect of long noncoding RNAMCTP1-AS1 on the proliferation and invasion of cervical cancer cells and its related mechanisms.Methods The Cancer Genome Atlas database was used to analyze the expression of MCTP1-AS1 in cervical cancer tissues and normal cervical tissues,and the correlation between the expression level of MCTP1-AS1 and the pathological stage of cervical cancer patients was analyzed.The expression of MCTP1-AS1 in cervical cancer cell lines HCC1106,HCC94,SiHa,Hela,C33A and normal cervical epithelial cells H8 was detected.Hela cells were transfected with pcDNA-Ctrl plasmid(Ctrl group)and pcDNA-MCTP1-AS1 plasmid(MCTP1-AS1 group),respectively.the proliferation and invasion ability of Hela cells were detected,respectively.the expression of proliferation proteins CDK2 and Cyclin A and invasion proteins N-cadherin and ZEB1 in Hela cells were detected,the targeting relationship between MCTP1-AS1 and miR-10a-5p were verified.The expression of miR-10a-5p in Hela cells was detected.Results Compared with normal cervical tissue,the expression of MCTP1-AS1 in cervical cancer tissue was significantly decreased(P＜0.01).The expression level of MCTP1-AS1 was negatively correlated with the pathological stage of cervical cancer patients(P＜0.01).Compared with H8 cells,the expression of MCTP1-AS1 in cervical cancer cell lines HCC1106,HCC94,SiHa,Hela,and C33A were significantly decreased(P＜0.01).Compared to Ctrl group,overexpression of MCTP1-AS1 significantly reduced the levels of proliferative proteins CDK2 and Cyclin A,as well as invasive proteins N-cadherin and ZEB1 in Hela cells.MCTP1-AS1 directly binds to miR-10a-5p(P＜0.01).Compared to Ctrl group,MCTP1-AS1 group showed a significant decrease in miR-10a-5p expression in Hela cells(P＜0.01).Conclusion MCTP1-AS1 expression is downregulated in cervical cancer tissues and cells,and MCTP1-AS1 expression is negatively correlated with the pathological stage of cervical cancer patients.MCTP1-AS1 inhibits the proliferation and invasion of cervical cancer cells by targeting miR-10a-5p.

Objective To construct a decision support education program for the family members of patients with advanced cancer and to investigate its application effects,so as to improve understanding and acceptance of hospice care for family members of advanced cancer patients.Methods Using the Ottawa Decision Support Framework as a theoretical guide,the program was initially drafted based on a literature review,qualitative interview and expert consultation.From September 2023 to January 2024,a convenience sampling method was used to select patients' families in a tertiary-level hospital in Tianjin as the research subjects,and they were randomly divided into an experimental group and a control group.The experimental group received the decision support education program in addition to routine care,while the control group received routine care.Family members' knowledge about hospice,the scores on the Death Attitude Profile Scale,and their willingness to choose hospice care were compared before and after the interventions.Results The program finally included 4 first-level items,15 second-level items,and 59 third-level items.During the program implementation phase,4 cases withdrew from the study,resulting in 46 cases in the experimental group and 47 cases in the control group.After intervention,the experimental group had higher scores on hospice knowledge and positive attitude towards death than the control group,while scores on negative attitude towards death were lower(P＜0.05);their willingness to choose hospice care for themselves and for the patients was higher than that of the control group(P＜0.05).Conclusion The hospice care decision support education program is scientific,feasible and practical,which can improve the knowledge of hospice care of the family members,improve their attitude towards death,and ultimately improve their willingness to choose hospice care.

Objective To construct a decision support education program for the family members of patients with advanced cancer and to investigate its application effects,so as to improve understanding and acceptance of hospice care for family members of advanced cancer patients.Methods Using the Ottawa Decision Support Framework as a theoretical guide,the program was initially drafted based on a literature review,qualitative interview and expert consultation.From September 2023 to January 2024,a convenience sampling method was used to select patients' families in a tertiary-level hospital in Tianjin as the research subjects,and they were randomly divided into an experimental group and a control group.The experimental group received the decision support education program in addition to routine care,while the control group received routine care.Family members' knowledge about hospice,the scores on the Death Attitude Profile Scale,and their willingness to choose hospice care were compared before and after the interventions.Results The program finally included 4 first-level items,15 second-level items,and 59 third-level items.During the program implementation phase,4 cases withdrew from the study,resulting in 46 cases in the experimental group and 47 cases in the control group.After intervention,the experimental group had higher scores on hospice knowledge and positive attitude towards death than the control group,while scores on negative attitude towards death were lower(P＜0.05);their willingness to choose hospice care for themselves and for the patients was higher than that of the control group(P＜0.05).Conclusion The hospice care decision support education program is scientific,feasible and practical,which can improve the knowledge of hospice care of the family members,improve their attitude towards death,and ultimately improve their willingness to choose hospice care.

Objective To investigate the effect of long noncoding RNAMCTP1-AS1 on the proliferation and invasion of cervical cancer cells and its related mechanisms.Methods The Cancer Genome Atlas database was used to analyze the expression of MCTP1-AS1 in cervical cancer tissues and normal cervical tissues,and the correlation between the expression level of MCTP1-AS1 and the pathological stage of cervical cancer patients was analyzed.The expression of MCTP1-AS1 in cervical cancer cell lines HCC1106,HCC94,SiHa,Hela,C33A and normal cervical epithelial cells H8 was detected.Hela cells were transfected with pcDNA-Ctrl plasmid(Ctrl group)and pcDNA-MCTP1-AS1 plasmid(MCTP1-AS1 group),respectively.the proliferation and invasion ability of Hela cells were detected,respectively.the expression of proliferation proteins CDK2 and Cyclin A and invasion proteins N-cadherin and ZEB1 in Hela cells were detected,the targeting relationship between MCTP1-AS1 and miR-10a-5p were verified.The expression of miR-10a-5p in Hela cells was detected.Results Compared with normal cervical tissue,the expression of MCTP1-AS1 in cervical cancer tissue was significantly decreased(P＜0.01).The expression level of MCTP1-AS1 was negatively correlated with the pathological stage of cervical cancer patients(P＜0.01).Compared with H8 cells,the expression of MCTP1-AS1 in cervical cancer cell lines HCC1106,HCC94,SiHa,Hela,and C33A were significantly decreased(P＜0.01).Compared to Ctrl group,overexpression of MCTP1-AS1 significantly reduced the levels of proliferative proteins CDK2 and Cyclin A,as well as invasive proteins N-cadherin and ZEB1 in Hela cells.MCTP1-AS1 directly binds to miR-10a-5p(P＜0.01).Compared to Ctrl group,MCTP1-AS1 group showed a significant decrease in miR-10a-5p expression in Hela cells(P＜0.01).Conclusion MCTP1-AS1 expression is downregulated in cervical cancer tissues and cells,and MCTP1-AS1 expression is negatively correlated with the pathological stage of cervical cancer patients.MCTP1-AS1 inhibits the proliferation and invasion of cervical cancer cells by targeting miR-10a-5p.

Objective:To investigate the interactive effects of loss of the only child and childhood trauma on brain structure, function, and structure-function coupling, and to analyze their association with clinical symptom.Methods:A total of 112 parents who lost their only child and participated in the psychological aid project organized by Local Civil Affairs Department in Sunan aear of Jiangsu Province in China from April 2021 to July 2021 and 36 healthy controls recruited from the community during the same period were selected. Based on childhood trauma questionnaire scores, parents who had lost their only child were divided into those with childhood trauma (group A, n=55) and those without childhood trauma (group B, n=57); similarly, the healthy controls were divided into a group with childhood trauma (group C, n=12) and a group without childhood trauma (group D, n=24). All participants were evaluated by clinical scales such as Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Mini-Mental State Examination (MMSE). MRI 3D-T1 structural images and resting-state functional magnetic resonance imaging data were collected; gray matter volume (GMV) and degree centrality (DC) were calculated by standardized image preprocessing procedure, and ratio of DC to GMV within each voxel was computed to obtain the structure-function coupling map. A two-factor analysis of variance was used to analyze the independent effect and interactive effect of loss of the only child and childhood trauma on GMV, DC, and DC/GMV coupling value. Spearman rank correlation analysis was used to evaluate the associations of above indicators in brain regions with significant difference in independent effect and interactive effect with clinical scale scores. Results:(1) Compared with the participants without childhood trauma (group B+group D), the participants with childhood trauma (group A+group C) showed significantly reduced GMV in the left middle temporal gyrus and right dorsolateral superior frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, Gaussian random field [GRF] corrected). A significant interactive effect of loss of the only child and childhood trauma on GMV in the right precuneus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (2) Compared with the healthy controls, parents who had lost their only child exhibited significantly increased DC in the left middle frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). Compared with participants without childhood trauma, participants with childhood trauma showed significantly increased DC in the right thalamus (voxel-level P<0.01, cluster-level P< 0.05, GRF corrected). A significant interactive effect of loss of the only child and childhood trauma on DC in the left dorsolateral superior frontal gyrus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (3) Compared with the healthy controls, parents who had lost their only child showed significantly decreased DC/GMV coupling value in the left middle frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). Compared with participants without childhood trauma, participants with childhood trauma showed significantly increased DC/GMV coupling value in the right thalamus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). A significant interactive effect of loss of the only child and childhood trauma on DC/GMV coupling value in the left dorsolateral superior frontal gyrus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (4) Correlation analysis revealed that GMV in the right precuneus with significant interactive effect of loss of the only child and childhood trauma was positively correlated with MMSE score ( r s=0.317, P=0.010, Bonferroni corrected). GMV in the left middle temporal gyrus with significant independent effect of childhood trauma was positively correlated with both HAMD score and HAMA score ( r s=0.362, P=0.006; r s= 0.349, P=0.008, Bonferroni corrected). Conclusion:Loss of the only child and childhood trauma can interact to jointly affect the brain structure, function, and structure-function coupling; and some of these brain structure alterations are closely associated with clinical symptoms.

Objective:To observe the clinical effect of Shenfu injection in preventing septic cardiomyopathy (SIC) in septic patients.Methods:From June 2022 to January 2023, patients with sepsis or septic shock who did not develop SIC were randomly divided into treatment group and control group according to the ratio of 1:1. In the treatment group, Shenfu injection (50 mL) was pumped intravenously once every 12 hours for 5 days. In the control group, 50 mL of normal saline was pumped intravenously once every 12 hours, and the course of treatment was 5 days. The primary end point was the incidence of SIC in the first 5 days. The secondary end points were the application time of vasoactive drugs, fluid balance in the previous week, hospitalization time in ICU, total ventilation time and 28-day mortality.Results:112 patients were randomly divided into two groups. Seven patients in the treatment group were excluded twice, and finally 49 patients were included in the analysis, while six patients in the control group were excluded twice and 50 patients included in the analysis. The total incidence of SIC in the treatment group within 5 days was significantly lower than that in the control group (42.9% vs. 64.0%, P = 0.035). Among them, the left ventricular systolic dysfunction in the treatment group was significantly lower than that in the control group (24.5% vs 52.0%, P=0.005), and there was no significant difference in the incidence of left ventricular diastolic dysfunction between the two groups. The incidence of right ventricular dysfunction in the control group was 28.0%, which was significantly higher than 10.2% in the treatment group ( P = 0.025). The duration of using vasoconstrictors in the treatment group was 75(48, 97) hours, which was significantly lower than 97(66, 28) hours in the control group ( P = 0.039). The duration of inotropic drugs use in the treatment group was 32(18, 49) h, which was also significantly shorter than 44(25, 61) h in the control group ( P=0.046). The fluid balance of the control group in the first week was (1 260±850) mL, which was significantly higher than (450±520) mL in the treatment group ( P=0.008). There was no statistical difference in ICU stay, total ventilation time and 28-day mortality between the two groups (all P > 0.05). Conclusion:Early application of Shenfu injection can significantly reduce the incidence of SIC, accompanied by less use of vasoactive drugs and positive fluid balance, which has a good clinical application prospect.

Objective:Partial stereotactic ablative boost radiotherapy(P-SABR)is a method to deliver SABR boost to the gross tumor boost volume(GTVb), followed by conventionally fractionated radiotherapy to the whole tumor area(GTV). GTVb is the max volume receiving SABR while ensuring the critical organ-at-risk(OAR)falloff to 3 GyE/f. We investigated the potential advantage of proton therapy in treating bulky non-small cell lung cancer(the tumor length greater than 8 cm).Methods:Nine patients with bulky NSCLC treated with photon P-SABR in our institute were selected. For the treatment planning of proton therapy, the GTVb target area was gradually outwardly expanded based on the photon GTVb target area until the dose to critical OARs reached 3 GyE/f. The GTV and CTV areas remained the same as photon plan. A proton intensity-modulated radiation treatment plan(proton-IMPT), a photon intensity-modulated radiation treatment plan(photon-IMRT)and a photon volumetric modulated arc therapy(photon-VMAT)were created for each patient, respectively. The dosimetric parameters of different treatment plans were compared.Results:The volume ratio of GTVb-photon and GTVb-proton to GTV was(25.4±13.4)% and(69.7±30.0)%,respectively( P<0.001). In photon-IMRT, photon-VMAT, and proton-IMPT plan groups, the mean dose of CTV was(76.1±4.9)Gy, (78.2±3.6)Gy, and(84.7±4.9)Gy, respectively; the ratio of tumor volume with Biologic Effective Dose(BED)≥ 90 Gy to GTV volume was(70.7±21.7)%, (76.8±22.1)%,and(97.9±4.0)%,respectively. The actual dose and BED to the tumor area of the proton-IMPT plan group were significantly higher than those of the photon plan group(both P<0.05). Besides, the OARs dose was significantly decreased in the proton-IMPT group, with(49.2±22.0)%, (56.8±19.0)% and(16.1±6.3)% of the whole lung V5 for photon-IMRT, photon-VMAT and proton-IMPT, respectively(all P<0.001). Conclusions:Larger GTV boost target volume, higher BED and reduced OARs dose can be achieved in proton plans compared with photon plans. Proton P-SABR is expected to further improve the local control rate of bulky NSCLC with fewer adverse effects.

Objective:To develop a training system for head and neck oncology nurses to improve the emergency response competency to recognize and response to acute and critical medical conditions.Methods:Based on literature review and semi-structured interviews with 12 nurses, two rounds of consultation with 15 head and neck cancer care specialists from 6 Tertiary hospitals using Delphi method were conducted to establish the training system for head and neck oncology nurses.Results:The authority coefficients of experts were 0.87 and 0.89, respectively. The coefficient of variation of each item ranged from 0 to 0.167. The coefficients of concordance ranged from 0.243 to 0.403 ( P<0.01). There was statistical significance after Chi-square test ( χ2 values were 14.60-436.64, all P<0.01). In the final training system, training aims included 5 first-level indicators and 16 second-level indicators; training contents included 5 first-level indicators, 16 second-level indicators, and 60 third-level indicators. Conclusions:The authority coefficients and the coefficients of concordance of the experts for the training system were both high. The training system can be applied to improve the emergency response competency of head and neck oncology nurses.

Objective:To develop the screening checklist of brief interview for autism disorder suitable for Chinese children and evaluate its reliability and validity.Methods:Based on existed research results and diagnostic criteria for autism spectrum disorder of DSM-5, the screening checklist of brief interview for autism spectrum disorder(SCAD) was developed. A sample of 238 children were selected for investigation and 28 of them were retested for test-retest reliability with 2-4 weeks interval. Cronbach's α coefficient, split-half correlation coefficient, test-retest reliability, and evaluator consistency were used to test the reliability of the scale. Content validity, construct validity and empirical validity were used to test the validity of the scale.All statistical analysis were conducted by SPSS 22.0 and AMOS 17.0.Results:The SCAD contains two components and six dimensions, with a total of 25 items. The Cronbach's α coefficient was 0.936 for the total scale and were 0.938, 0.771 for the two components. The split-half coefficient for the total scale and the two components were 0.962, 0.938 and 0.794. The test-retest reliability for the total scale and the two components were 0.806, 0.795 and 0.766. The Kendall coefficient for the total scale and the two components were 0.968, 0.982 and 0.950. The SCAD item-level content validity index (I-CVI) ranged from 0.66 to 0.98 and the Kappa value ranged from 0.66 to 0.98. The scale-level content validity S-CVI/UA and S-CVI/Ave were 0.89 and 0.94. The correlations between SCAD and calibration tests such as ABC, CARS and M-CHAT were 0.54, 0.53 and 0.87, and the correlation coefficients with the M-CHAT-R/F between the two components were 0.87 and 0.76 respectively (both P<0.01). The result of CFA demonstrated that the model fitted the data with well construct validity(χ 2/ df=0.910, RMR=0.049, AGFI=0.974, RMSEA=0.010, PNFI=0.530, PCFI=0.533, NFI=0.994, RFI=0.988, CFI=1.000). The correlation coefficient of the two components was 0.88 and that with the total scale were 0.97 and 0.90, each dimensions with the total scale ranged from 0.72 to 0.93. Conclusion:The SCAD has a good reliability and validity, and it can be used as a clinical screening tool for children with autism spectrum disorder.