OBJECTIVE To evaluate the cost-effectiveness of fluzoparib monotherapy versus combination with apatinib as second-line or later-line treatment for patients with germline BRCA1 / 2 -mutated human epidermal growth factor receptor 2-negative （HER2－） metastatic breast cancer， from the perspective of the Chinese healthcare system. METHODS Based on the FABULOUS trial， a partitioned survival model was developed to simulate disease progression， with a cycle length of 21 days and a time horizon of 10 years. A discount rate of 4.5% per annum was applied. Model outputs included total costs and quality-adjusted life years （QALYs）. Cost-utility analysis was conducted by comparing the incremental cost-effectiveness ratio （ICER） between the two regimens against a willingness-to-pay （WTP） threshold set at twice China’s per capita gross domestic product in 2025 （199 330 yuan/QALY）. Robustness of the base-case results was tested through one-way sensitivity analysis， probabilistic sensitivity analysis， and scenario analyses. RESULTS For patients with germline BRCA1/2 -mutated HER2－ metastatic breast cancer， fluzoparib combination with apatinib provided greater health benefits （1.91 QALYs vs. 1.69 QALYs） and incurred lower total costs （1 634 119.3 yuan vs. 1 855 264.2 yuan） compared with fluzoparib monotherapy， thus representing a dominant strategy. One-way sensitivity and probabilistic sensitivity analyses confirmed the robustness of the base-case findings. Scenario analyses showed that the conclusion remained robust when the time horizon was shortened to 5 years or when the discount rate was changed to 3%； however， the results reversed when the extrapolation distribution model was altered. CONCLUSIONS Under the current WTP threshold， compared with fluzoparib monotherapy， the combination of fluzoparib and apatinib is more cost-effective as a second-line or later-line treatment for Chinese patients with germline BRCA1 / 2 -mutated HER2－ metastatic breast cancer.

With the transformation of the biopsychosocial medical model, psychological problems and related interventions for breast cancer patients have received more and more attention. Patients often have various psychological problems, in diagnosis, treatment, and even in the state of disease-free survival, such as anxiety and depression, which not only seriously reduces the quality of life, but also affects the follow-up treatment and increases the risk of recurrence and metastasis. Therefore, physicians should perform routine psychological screening and appropriate intervention for patients. In recent years, psychological intervention has gradually become an important part of comprehensive breast cancer treatment, in which cognitive behavior therapy can alleviate patients′ anxiety and sleep disorders, mindfulness therapy can treat patients′ anxiety, depression and fear of cancer recurrence, and psychoeducational support is mainly used to address patients′ mood disorders and sexual dysfunction. Improving patients′ compliance with treatment and quality of life is the main goal of psychological intervention for breast cancer patients.

With the transformation of the biopsychosocial medical model, psychological problems and related interventions for breast cancer patients have received more and more attention. Patients often have various psychological problems, in diagnosis, treatment, and even in the state of disease-free survival, such as anxiety and depression, which not only seriously reduces the quality of life, but also affects the follow-up treatment and increases the risk of recurrence and metastasis. Therefore, physicians should perform routine psychological screening and appropriate intervention for patients. In recent years, psychological intervention has gradually become an important part of comprehensive breast cancer treatment, in which cognitive behavior therapy can alleviate patients′ anxiety and sleep disorders, mindfulness therapy can treat patients′ anxiety, depression and fear of cancer recurrence, and psychoeducational support is mainly used to address patients′ mood disorders and sexual dysfunction. Improving patients′ compliance with treatment and quality of life is the main goal of psychological intervention for breast cancer patients.

Objective:To explore the effects of strengthening night professional nursing of patients with open fractures of the lower extremities.Methods:From January 2019 to June 2020, convenience sampling was used to select 397 patients with open fractures of the lower extremities from the First Orthopedic Trauma, the Third Hospital of Hebei Medical University. Patients were randomly assigned to a control group and an observation group, respectively, to receive general nursing (control group) and strengthening night professional nursing (observation group). The control group was equipped with a regular number of nurses. In the observation group, an additional night nurse was assigned for patients undergoing surgery for open fractures of the lower extremities. The nighttime period was from 18∶00 to 8∶00 the next day. The night nurse arranged compensatory time off for the rest of the time or performance rewards. The hospital stay, hospitalization expenses, incidence of complications during hospitalization and half a year after surgery of the two groups were compared.Results:In the control group, there were 196 patients with open fractures of the lower extremities, and 46 patients underwent night surgery. In the observation group, there were 201 patients with open fractures of the lower extremities, and 40 patients underwent night surgery. There were no statistically significant differences between two groups in terms of surgical time, incidence of complications during hospitalization and half a year after surgery ( P>0.05). The hospital stay in the observation group was shorter than that in the control group, and the hospitalization expense was lower than that in the control group, with statistically significant differences ( P<0.05) . Conclusions:Strengthening night professional nursing can help shorten the hospital stay of patients undergoing surgery for open fractures of the lower extremities and reduce medical expenses.

ObjectiveTo perform a visualized analysis on the relevant literature about rehabilitation in pelvic floor dysfunction (PFD) domestic and abroad, and summarize the current hot spots and frontiers in this field. MethodsThe literature related to PFD rehabilitation from January, 2012 to June, 2022 was searched and screened from the databases of CNKI and Web of Science, and the CiteSpace software was used to analyze the trends of publications, authors, institutions and key words. ResultsA total of 2 448 articles were included. Relatively few high-quality domestic researches were published. In terms of research hotspots, both domestic and international researches focused on causes, mechanisms, rehabilitation techniques and evaluation indicators of PFD, but domestic researches had not paid enough attention to evaluation indicators and prevention of PFD. The key words constantly appeared in 2022 were mechanisms of PFD due to pregnancy, treatment of postoperative complications in prostate cancer patients, the role of pelvic floor muscle training, and quality of life studies in women. ConclusionResearch related to the field of PFD rehabilitation is increasing. There is still a large gap for future development in China.

【Objective】 To research the effect of the Fc, Fab and F(ab′)2 fragments of immunoglobulin G, the main components of Human Immunoglobulin(pH4) for Intravenous Injection(IVIG), on the phagocytic function of macrophages derived from THP-1 cells. 【Methods】 First of all, IVIG was digested with papain and pepsin to obtain Fc, Fab and F(ab′)2, and these components were then identified by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Afterwards, propylene glycol monomethyl ether acetate (PMA) was used to induce THP-1 cells to differentiate into M0 macrophages. Finally, the sensitized erythrocytes were labeled with carboxy fluorescein succinimidyl ester (CFSE), and the effect of the above components on the phagocytic ability of M0 macrophages to engulf sensitized erythrocytes was detected by flow cytometry. 【Results】 The identification results of SDS-PAGE showed that the prepared IgG fragments met the requirements of subsequent experiments. Flow cytometry performs showed that the phagocytosis model of M0 macrophages had been successfully established. When the concentration of Fc increased from 0.1μg/ mL to 10μg/ mL, the phagocytosis rate of erythrocytes sensitized by M0 macrophages decreased from (24.21±0.58) % to (12.27±0.19) %. When the concentration of IVIG protein increased from 0.1 μg/ml to 10 μg/ml, the phagocytosis rate decreased from (20.57±0.39) % to (0.20±0.03) %. Meanwhile, at the same protein concentration (10 μg/ml), the inhibitory effect of Fc on phagocytosis was only half that of IVIG. In addition, Fab, F(ab′)2, and human serum albumin could not inhibit phagocytosis of M0 macrophages. 【Conclusion】 IVIG can effectively inhibit the phagocytosis of THP-1 derived M0 macrophages, which is mainly dependent on the Fc, but not related to the Fab of IgG and F (ab′)2.

Objective: To investigate the expression of CARD10 in hepatocellular carcinoma (HCC) tissues, and the roles of CARD10 in HCC progression especially apoptosis inhibition. Methods: The expression of CARD10 was examined in pared non-tumor liver tissues and HCC tissues using qRT-PCR, and their correlation with HCC TNM stage was analyzed using Spearman’s rank correlation assay in SPSS 17.0. In HCC cells with CARD10 overexpression or knockdown, cytometry using Annexin-V/PI labeling was used to measure apoptosis, and Western blotting was used to determine the activation of NF-κB pathway. Results: CARD10 expression was significantly increased in HCC tissues as compared to that in pared non-tumor liver tissues (P<0.01), and the increased CARD10 in HCC was positively correlated with TNM staging (P<0.01). The apoptosis of HCC cell lines SMMC-7721 and BEL-7402 was inhibited by CARD10 overexpression while promoted by CARD10 knockdown, and the pro-survival NF-κB pathway was also enhanced by CARD 10 over-expression while suppressed by CARD10 knockdown. Conclusion: CARD10 expression is increased in HCC tissues and positively correlated with HCC progression. CARD10 inhibits HCC apoptosis by promoting the activation of NF-κB pathway. [Key words] hepatocellular carcinoma (HCC); caspase recruitment domain family member 10 (CARD10); apoptosis; NF-κB

Objective To investigate the influence of perioperative standardized nursing on the pain and rehabilitation of fracture children after surgery.Methods A total of 360 fracture children in our hospital were randomly divided into two groups according to the time of admission.The experimental group was given standardized nursing process,the control group used traditional care method.The incidence of complications,quality of life,hospitalization costs,hospital stay in two groups were compared,and standardized nursing process was comprehensively evaluated.Results The average pain scores of the observation group at different time points after operation was lower than that of the control group (P ＜ 0.05).The incidences of postoperative complications (limb swelling,pulmonary complications and adverse drug reactions) in the observation group were lower than that in the control (P ＜ 0.05).The observation group was better in pain relief,satisfaction score,quality of life score,hospitalization time and hospitalization cost than the control group (P ＜ 0.05).Conclusion Perioperative standardized nursing can effectively relieve the postoperative pain in children with fracture,reduce the incidence of postoperative complications,improve postoperative quality of life,shorten the hospitalization time and save hospitalization cost,so it is worthy of clinical application.

Objective To investigate the influence of perioperative standardized nursing on the pain and rehabilitation of fracture children after surgery.Methods A total of 360 fracture children in our hospital were randomly divided into two groups according to the time of admission.The experimental group was given standardized nursing process,the control group used traditional care method.The incidence of complications,quality of life,hospitalization costs,hospital stay in two groups were compared,and standardized nursing process was comprehensively evaluated.Results The average pain scores of the observation group at different time points after operation was lower than that of the control group (P ＜ 0.05).The incidences of postoperative complications (limb swelling,pulmonary complications and adverse drug reactions) in the observation group were lower than that in the control (P ＜ 0.05).The observation group was better in pain relief,satisfaction score,quality of life score,hospitalization time and hospitalization cost than the control group (P ＜ 0.05).Conclusion Perioperative standardized nursing can effectively relieve the postoperative pain in children with fracture,reduce the incidence of postoperative complications,improve postoperative quality of life,shorten the hospitalization time and save hospitalization cost,so it is worthy of clinical application.

Objective To evaluate laparoscopic radical cholecystectomy for T2 gallbladder cancers.Methods A retrospective analysis was made on 44 patients with pathology confirmed T2 gallbladder cancer undergoing laparoscopic vs open radical cholecystectomy.The clinicopathological and follow-up data were compared.Results Laparoscopic cholecystectomy was performed in 32 patients,the implantation metastasis rate of this approach has no statistical differences compared with the open cholecystectomy (P =1.000).26 patients underwent laparoscopic radical resection and the remaining 18 patients underwent open radical resection.There was no statistical difference in operation time (P =0.953),blood loss (P =0.193)and postoperative complications (P =1.000),but the laparoscopic radical resection group is superior to the open group on postoperative pain grading (P =0.022),ambulation time (P =0.000),nothing per mouth time (P =0.000) and length of hospital stay (P =0.048).The mean number of lymph nodes retrieved was 5 ±4 (range 1-12) in the laparoscopic radical group and 6 ± 3 (range 1-12) in the open group (P =0.983);the 1,3,5 year survival rates was 92.3％,70.3％,61.5％ and 92.3％,76.3％,69.3％,respectively(P =0.473).Conclusions Initial laparoscopic cholecystectomy does not increase the rate of seeding metastasis in the context of intact gallbladder carcinoma.Totall laparoscopic radical resection is feasible in selected T2 gallbladder cancer patients.