Objective:To systematically integrate qualitative research on the real experience and management of cancer pain in adult cancer patients, so as to provide reference for improving the management of cancer pain in adult cancer patients and reducing their cancer pain.Methods:Qualitative research literature on the real experience and management of cancer pain in cancer patients was systematically searched in Cochrane Library, PubMed, Web of Science, CINAHL, Embase, ProQuest, Scopus, China Biomedical Database, China National Knowledge Infrastructure, Wanfang Data, and VIP. The search period was from database establishment to August 2023. The literature was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center. The aggregation Meta-synthesis method was used to integrate and summarize research results.Results:A total of 16 articles were included, and 78 results were extracted to form 11 categories, which were summarized into four integrated results of the cognitive status of adult cancer patients towards cancer pain, the impact of cancer pain on patients, self-management strategies for cancer pain, and medical experiences related to cancer pain.Conclusions:Adult cancer patients face obstacles in alleviating cancer pain, such as lack of awareness of cancer pain, negative impacts, inadequate self-management strategies, and poor medical experience. Patients need to improve their self-management strategies, and the country and medical institutions should provide comprehensive support to enable patients and clinical medical and nursing staff to manage cancer pain.

Objective To explore the protective effect and mechanism of modified Buyang Huanwu Decoction and Shenqi Dihuang Decoction on diabetic kidney disease(DKD)mice based on the regulation of VEGF-C/VEGFR3 pathway inhibiting lymphangiogenesis.Methods Twenty-four male db/db mice were randomly divided into model group,Chinese medicine group(modified Buyang Huanwu Decoction combined with Shenqi Dihuang Decoction,crude drug 24.44 g·kg-1)and western medicine group(Irbesartan,13.5 mg·kg-1),with eight mice in each group.Eight db/m mice were selected as control group.Intragastric administration was given once a day for 12 consecutive weeks.Fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),urinary albumin/creatinine ratio(ACR)and kidney index were measured.The pathological changes of renal tissue were observed by HE and Masson staining.The expressions of fibronectin(FN),type I collagen(Col I),Vimentin,α-smooth muscle actin(α-SMA),transforming growth factor-β1(TGF-β1),vascular endothelial growth factor receptor 3(VEGFR3),vascular endothelial growth factor-C(VEGF-C),lymphatic endothelial hyaluronic acid receptor 1(LYVE-1),podoplanin(PDPN),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)in renal tissue were detected by immunohistochemistry.The protein expressions of Col I,Vimentin,α-SMA,TGF-β1,VEGFR3,VEGF-C,LYVE-1,TNF-α and IL-1β in renal tissue were detected by Western Blot.The mRNA expressions of FN,Col I,TGF-β1,VEGF-C,VEGFR3,TNF-α and IL-1β in renal tissue were detected by Real-time PCR.Results Compared with the control group,the levels of serum FBG,TG,TC,ACR and kidney index in the model group were significantly increased(P＜0.05).Glomerular hypertrophy,mesangial matrix increased,basement membrane thickening,cystic cavity narrowing,renal tubular epithelial cell degeneration and necrosis,interstitial infiltration of a large number of inflammatory cells,renal tubular atrophy;the level of renal fibrosis was significantly increased(P＜0.05).The protein expressions of FN,Col I,Vimentin,α-SMA,TGF-β1,VEGFR3,LYVE-1,TNF-α,IL-1β in renal interstitium,the expression of VEGF-C protein in cytoplasm and the expression of VEGFR3 and PDPN protein around renal tubular capillaries were significantly up-regulated(P＜0.05).The protein expressions of Col I,Vimentin,α-SMA,TGF-β1,VEGFR3,VEGF-C,LYVE-1,TNF-α and IL-1β in renal tissue were significantly up-regulated(P＜0.05).The mRNA expression levels of FN,Col I,TGF-β1,VEGF-C,VEGFR3,TNF-α and IL-1β in renal tissue were significantly increased(P＜0.05).Compared with the model group,the levels of serum TG,TC and ACR in the Chinese medicine group were significantly decreased(P＜0.05).Renal tissue injury was improved to varying degrees,renal inflammatory cell infiltration was reduced to a certain extent,and renal tissue fibrosis was significantly reduced(P＜0.05).The protein expressions of FN,Col I,Vimentin,α-SMA,TGF-β1,VEGFR3,LYVE-1,TNF-α,IL-1β in renal interstitium,the protein expression of VEGF-C in cytoplasm and the protein expressions of VEGFR3 and PDPN around renal tubular capillaries were significantly down-regulated(P＜0.05).The protein expressions of Col I,Vimentin,α-SMA,TGF-β1,VEGFR3,VEGF-C,LYVE-1,TNF-α and IL-1β in renal tissue were significantly down-regulated(P＜0.05).The mRNA expression levels of FN,Col I,TGF-β1,VEGF-C,VEGFR3,TNF-α and IL-1β in renal tissue were significantly decreased(P＜0.05).Conclusion Modified Buyang Huanwu Decoction combined with Shenqi Dihuang Decoction can reduce the level of inflammation and fibrosis in renal tissue of DKD mice,and its mechanism may be related to the regulation of VEGF-C/VEGFR3 pathway to inhibit lymphangiogenesis.

The purpose of this study is to describe the principles in selection and application of antidepressants in patients with depression complicating glaucoma or at high risk of glaucoma. With the aim of providing a partial reference for relevant issues， this paper elaborated a case of major depression after glaucoma surgery receiving 6 weeks of treatment with escitalopram oxalate and sulpiride achieved significant improvement in depressive and psychotic symptoms without triggering or exacerbating glaucoma.

Objective:To explore the relationship between the expression of neuropilin-1 (NRP-1) on Treg cells and its ligands semaphorins-3A (Sema3A) , transforming growth factor-β 1 (TGF-β 1) as well as the balance of type 1 helper T cells (Th 1) and type 2 helper T cells (Th 2) cells. Methods:This study enrolled 62 patients with immune thrombocytopenia (ITP; 33 and 29 newly diagnosed and chronic ITP, respectively) from March 2014 to May 2015. Consequently, 30 healthy people in the same period were selected as the normal control group. The expression of NRP-1 in Treg cells was detected via flow cytometry. The Sema3A, TGF-β 1, IFN-γ, and IL-4 levels in plasma were detected by enzyme-linked immunosorbent assay. The real-time polymerase chain reaction technique was used to detect the mRNA expression levels of NRP-1, Sema3A, and TGF-β 1. The one-way analysis of variance and independent sample t-test was used for comparison between three and two groups, respectively. Correlations among the mRNA expression levels of NRP-1, Sema3A, and TGF-β 1 were assessed via Spearman correlation coefficients. Results:Treg cells in the newly diagnosed ITP group significantly increased compared with those in the chronic ITP and normal control groups. The expression of NRP-1 decreased[ (0.15 ± 0.03) %, (0.33 ± 0.15) %, and (0.46 ± 0.06) %; P<0.01], the plasma Sema3A level increased[ (8.10 ± 1.32) μg/L, (7.41±1.30) μg/L, and (2.88±0.82) μg/L; P<0.01], and the plasma TGF-β 1 level decreased[ (16.50±3.36) μg/L, (35.17±10.26) μg/L, and (41.00±10.02) μg/L; P<0.01]. Moreover, the level of plasma IFN-γ increased[ (17.21+2.80) ng/L, (10.23+1.59) ng/L, and (8.18+3.27) ng/L; P<0.01], and the ratios of Th 1/Th 2 (IFN-γ/IL-4) increased (1.29±0.30, 0.72±0.16, and 0.61±0.27; P<0.01) . The mRNA expressions of NRP-1 and Sema3A in the newly diagnosed ITP and chronic ITP groups were lower than that in the normal control group ( P<0.01) . Consequently, the NRP-1 mRNA expression was positively correlated with Sema3A and TGF-β 1 mRNA expression in the newly diagnosed ITP group. Conclusion:NRP-1 played an essential role in the pathogenesis of ITP.

Objective: To investigate the implementation and application effect of 1-hour bundle in the treatment of patients with sepsis. Methods: A convenient sampling method was conducted. 102 patients with sepsis admitted to central intensive care unit (ICU) of Henan Provincial People's Hospital from January 2018 to February 2019 were enrolled. Thirty-five patients with 3-hour and 6-hour bundle from January to September in 2018 were served as the control group, and 67 patients who received 1-hour bundle from October 2018 to February 2019 were served as the observation group. The patients in the control group was treated with 3-hour and 6-hour bundle according to 2012 international guidelines for the diagnosis and treatment of severe sepsis and septic shock; and those in the observation group were treated and nursed according to the 1-hour bundle published by Surviving Sepsis Campaign (SSC) update 2018, and the sepsis cluster treatment medical team was established. The team members were trained in relevant knowledge and discussed the possible obstacles within the team and propose feasible measures. The implementation of the 1-hour bundle in the observation group was recorded. The general data of the patients in both groups including gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), etc. were collected, and the outcome indicators [duration of mechanical ventilation, length of ICU stay, 28-day mortality] were observed. Results: In the observation group, 37 of 67 patients receiving 1-hour bundle met the target, with the overall achievement rate of 55.2% (37/67). Of the 37 eligible patients, 5 patients receiving 1-hour bundle met the target before the training of 1-hour bundle, accounting for only 33.3% (5/15) of the 15 patients who received 1-hour bundle during the same period. With the extension of training time, the achievement rate of sepsis 1-hour bundle was gradually increased [the achievement rate at 1 week and 4 weeks of training was 40.0% (4/10) and 52.4% (11/21), respectively], and increased to 81.0% (17/21) at the end of 12 weeks training. Thirty-seven patients who received 1-hour bundle and met the criteria were enrolled and compared with the control group. There was no significant difference in gender, age, or APACHEⅡ score between the two groups. Compared with the control group, the duration of mechanical ventilation and length of ICU stay of the observation group were significantly shortened (days: 6.15±0.49 vs. 7.24±0.53, days: 8.21±1.49 vs. 9.51±1.92), and the 28-day mortality was decreased significantly [10.8% (4/37) vs. 31.4% (11/35)], with statistically significant differences (all P < 0.05). Conclusions Through teamwork, discussion and improvement, the achievement rate of sepsis 1-hour bundle can be significantly improved. The use of sepsis 1-hour bundle can effectively decrease the duration of mechanical ventilation and length of ICU stay, and reduce the 28-day mortality.

Objective To explore the difference in efficacy between multiparametric MRI (Mp-MRI) based on prostate imaging reporting and data system version 2 (PI-RADS v2) and abbreviated biparametric MRI (Bp-MRI) in detecting prostate cancer (PCa) and clinically significant prostate cancer (csPCa), and to evaluate the consistency of image interpretation between different readers. Methods The imaging, pathological and clinical data of patients with prostatic Mp-MRI in our hospital from February 2015 to June 2018 were retrospectively analyzed. At the beginning, 250 patients were randomly selected. Two radiologists visually evaluated the images of those patients using two 5-point scoring schemes based on Mp-MRI and Bp-MRI. The remaining cases were independently proceeded by one of the radiologists using two schemes respectively. Weighted Kappa test was used to assess the consistency of the results interpreted by the two radiologists. The receiver operating characteristic (ROC) curve was used to evaluate the efficiency of the two scoring schemes in detecting PCa and csPCa, and with Z test to investigate whether there was any difference in detection efficiency between the two schemes. Results Nine hundred and seventy eight patients were eventually enrolled in the study. The results of the consistency assessment showed that there was good agreement between the two radiologists, whether using Mp-MRI or Bp-MRI, with the weighted Kappa coefficient of 0.800 and 0.812, respectively. The ROC curve analysis showed that the area under the curve (AUC) of PCa detected by Mp-MRI and Bp-MRI was 0.873 and 0.879, respectively, and the AUC of csPCa detected was 0.922 and 0.932, respectively. In addition, there was no statistically significant difference between the AUC of PCa and csPCa detected by the two schemes (P>0.05). Conclusion The Bp-MRI scoring scheme has good stability in the evaluation of benign and malignant prostate, and its detection efficiency of PCa or csPCa is not lower than that of standard Mp-MRI based on PI-RADS v2.

OBJECTIVE: To investigate the implementation and application effect of 1-hour bundle in the treatment of patients with sepsis. METHODS: A convenient sampling method was conducted. 102 patients with sepsis admitted to central intensive care unit (ICU) of Henan Provincial People's Hospital from January 2018 to February 2019 were enrolled. Thirty-five patients with 3-hour and 6-hour bundle from January to September in 2018 were served as the control group, and 67 patients who received 1-hour bundle from October 2018 to February 2019 were served as the observation group. The patients in the control group was treated with 3-hour and 6-hour bundle according to 2012 international guidelines for the diagnosis and treatment of severe sepsis and septic shock; and those in the observation group were treated and nursed according to the 1-hour bundle published by Surviving Sepsis Campaign (SSC) update 2018, and the sepsis cluster treatment medical team was established. The team members were trained in relevant knowledge and discussed the possible obstacles within the team and propose feasible measures. The implementation of the 1-hour bundle in the observation group was recorded. The general data of the patients in both groups including gender, age, acute physiology and chronic health evaluation II (APACHE II), etc. were collected, and the outcome indicators (duration of mechanical ventilation, length of ICU stay, 28-day mortality) were observed. RESULTS: In the observation group, 37 of 67 patients receiving 1-hour bundle met the target, with the overall achievement rate of 55.2% (37/67). Of the 37 eligible patients, 5 patients receiving 1-hour bundle met the target before the training of 1-hour bundle, accounting for only 33.3% (5/15) of the 15 patients who received 1-hour bundle during the same period. With the extension of training time, the achievement rate of sepsis 1-hour bundle was gradually increased [the achievement rate at 1 week and 4 weeks of training was 40.0% (4/10) and 52.4% (11/21), respectively], and increased to 81.0% (17/21) at the end of 12 weeks training. Thirty-seven patients who received 1-hour bundle and met the criteria were enrolled and compared with the control group. There was no significant difference in gender, age, or APACHE II score between the two groups. Compared with the control group, the duration of mechanical ventilation and length of ICU stay of the observation group were significantly shortened (days: 6.15±0.49 vs. 7.24±0.53, days: 8.21±1.49 vs. 9.51±1.92), and the 28-day mortality was decreased significantly [10.8% (4/37) vs. 31.4% (11/35)], with statistically significant differences (all P < 0.05). CONCLUSIONS Through teamwork, discussion and improvement, the achievement rate of sepsis 1-hour bundle can be significantly improved. The use of sepsis 1-hour bundle can effectively decrease the duration of mechanical ventilation and length of ICU stay, and reduce the 28-day mortality.
APACHE ; Humans ; Intensive Care Units ; Prognosis ; Sepsis/therapy* ; Shock, Septic

Objective To investigate the consistency of fetal gallbladder volume (FGV) during middle-late pregnancy with three-dimensional ultrasonic virtual organ computer-aided analysis (VOCAL) technique at different rotation angles,and to analyze the correlation between FGV and gestation age.Methods A total of 157 healthy pregnant women underwent prenatal screening were included.The reference range of FGV was measured with three-dimensional ultrasonic VOCAL at 30°,18° and 12° rotation angle,respectively.The correlation between FGV and gestation age was observed,and the consistency of FGV values measured with VOCAL at different rotation step angles was compared.Results The correlations between FGV values measured with VOCAL at 30°,18°,12° rotation step angles and gestation age were all excellent (r=0.92,0.88,0.90;all P＜ 0.001).The consistency of FGV values measured with VOCAL at different rotation step angles was very good (30° and 18°,ICC=0.94;30° and 12°,ICC=0.97;18° and 12°,ICC=0.94).Conclusion Three-dimensional ultrasonic VOCAL can be used to establish the reference range of fetal gallbladder volume in middle-late pregnancy.The consistency of FGV values measured with VOCAL at different rotation step angles was very good,and the correlation between FGV and gestation age was excellent.

Abstract BACKGROUND: As an emerging technology, tissue-engineered skin has great application prospects. Keratinocyte growth factor (KGF) is proved to promote the proliferation of epidermal cels. OBJECTIVE: To evaluate the effect and characteristics of tissue-engineered skin carrying KGF nanocapsules in repairing skin defects of nude mice. METHODS:(1) The acelular dermal matrix loading KGF (KGF-ADM) was constructed. The human epidermal stem cel population and fibroblasts were captured and cultivated, and then identified. Epidermal stem cels were cultivated on the KGF-ADM and their growth was observed. The tissue-engineered skin loading KGF nanocapsules was transplanted onto the ful-skin defects on the back of nude mice compared with a blank group without keratinocyte growth factor nanocapsules and a control group with skin autograft. In 2, 4 and 6 weeks after transplantation, the contraction and histological healing of the skin were observed respectively. Then anti-human keratin 10-FITC and β1-integrin-Cy3 immunofluorescence were applied to detect the origin, growth and differentiation of stem cels in the epidermis and dermis. RESULTS AND CONCLUSION: The epidermal stem cel population grew wel on the surface of KGF-ADM and attached tightly. There were smal round epidermal stem cels and polygonal terminaly-differentiated cels, which presented with partly cloning growth and a tendency of merging into pieces. The results of tissue-engineered skin with KGF nanocapsules in repairing the skin defects were better than those of the blank group and the control group in 2, 4 and 6 weeks after transplantation. The transplanted skin could fuse with adjacent skin completely, but stil showed some contraction. Under the microscope, they showed good epidermis with layers and normal keratose stratum, and meanwhile, there were stil some β1-integrin+ cels at 8 and 10 weeks, which were epidermal stem cels or transient amplifying cels identified by immunofluorescence. These findings indicate that the tissue-engineered skin carrying KGF nanocapsules has good outcomes in repairing skin defects of nude mice, which is better than common tissue-engineered skin without KGF nanocapsules and autogeneous skin transplantation.

The presence of insufficient bone volume affects the implant healing and success. The aim of this study was to evaluate osteogenic capacity of dental pulp stem cells (DPSCs) on micro-arc oxidation (MAO) titanium surface. DPSCs were challenged at MAO and smooth titanium surface separately for different durations, and the bone marrow mesenchymal stem cells (BMSCs) served as the positive controls. The osteogenic capacity of DPSCs on MAO titanium surface was assessed by using scanning electron microscopy, energy dispersive spectroscopy, biochemical tests and real-time quantitative PCR. Data showed that DPSCs differentiated into osteoblasts and expressed bone morphogenetic genes on MAO titanium surface. The results of this study revealed that DPSCs had good potential to generate mineralized tissue on MAO titanium plates. The differential potential of DPSCs may be regulated by MAO titanium surface. The osteogenesis potential of DPSCs on the MAO titanium was similar with BMSCs.
Animals ; Cells, Cultured ; Dental Pulp ; drug effects ; physiology ; Male ; Osteogenesis ; drug effects ; physiology ; Rats ; Rats, Sprague-Dawley ; Stem Cells ; drug effects ; parasitology ; Titanium ; pharmacology