OBJECTIVE To investigate the effects of ginsenosides as P-glycoprotein(P-gp)substrates in combination with paclitaxel on the proliferation and migration of colon cancer Caco-2 cells.METHODS Bio-layer interferometry(BLI)technology was used to detect the constants of ginsenosides and P-gp.Network molecular docking was adopted to predict the binding affinity energy of ginsenosides and P-gp.Caco-2 cells were divided into paclitaxel 0,6.25,12.5,25,50,100 and 200 mg·L-1 groups,ginsenoside Rg3 0,6.25,12.5,25,50,100 and 200 mg·L-1 groups,and paclitaxel 5 mg·L-1+ginsenoside Rg3 0,25,50,100 and 200 mg·L-1 groups.After 48 h of incubation,the growth inhibition rate of Caco-2 cells was detected by MTT assay,and the interaction between the two drugs was quantitatively evaluated using the"one-belt,one-line"modle.Caco-2 cells were divided into the cell control group,paclitaxel 5 mg·L-1 group,ginsenoside Rg3 50 and 100 mg·L-1 groups,and paclitaxel 5 mg·L-1+ginsenoside Rg3 50 and 100 mg·L-1 groups.After 24 h of incubation,the proliferation and migration ability of the cells were detected by colony assay and Transwell migration assay.Caco-2 cells were then divided into the cell control group,quinidine 12.5 mg·L-1 group,and ginsenoside Rg3 6.25 and 12.5 mg·L-1 groups.After 4 h of incubation,the expression levels of P-gp and total protein were detected by ELISA.RESULTS The affinity constants of ginsenoside Rb1,Rg3,Rg5 with P-gp were all less than 10-3 mol·L-1,while that of ginsenoside CK with P-gp was 10-2 mol·L-1.There was no typical binding dissociation curve between ginsenoside Re and P-gp.The absolute binding affinities of ginsenosides Rg3 and Rg5 to P-gp were determined to be 8.5 kcal·mol-1 and 7.6 kcal·mol-1,respectively.Ginsenosides mixed with PTX 5 mg·L-1 inhibited the growth of colon cancer cells through synergy and addition,and the dose range of the syner-gistic effect was[0+5,43.15+5]mg·L-1;[164.51+5,200+5]mg·L-1,the additive effect dose ranged from[43.15+5,164.51+5]mg·L-1.The combination of the two drugs could significantly reduce the proliferation and migration ability of Caco-2 cells(P<0.01).The ELISA results showed a decrease in total protein and P-gp content in both the ginsenoside and quinidine groups(P<0.05).CONCLUSION Ginsenoside bind to and inhibit the activity of P-gp,synergizing with paclitaxel to reduce the proliferative and migratory abili-ties of Caco-2 cells.The combination of ginsenosides and paclitaxel enhances the sensitivity of Caco-2 cells to paclitaxel induced inhibition.The combined use of these two substances is expected to achieve better anticancer effects compared to paclitaxel alone.

OBJECTIVE To investigate the effects of ginsenosides as P-glycoprotein(P-gp)substrates in combination with paclitaxel on the proliferation and migration of colon cancer Caco-2 cells.METHODS Bio-layer interferometry(BLI)technology was used to detect the constants of ginsenosides and P-gp.Network molecular docking was adopted to predict the binding affinity energy of ginsenosides and P-gp.Caco-2 cells were divided into paclitaxel 0,6.25,12.5,25,50,100 and 200 mg·L-1 groups,ginsenoside Rg3 0,6.25,12.5,25,50,100 and 200 mg·L-1 groups,and paclitaxel 5 mg·L-1+ginsenoside Rg3 0,25,50,100 and 200 mg·L-1 groups.After 48 h of incubation,the growth inhibition rate of Caco-2 cells was detected by MTT assay,and the interaction between the two drugs was quantitatively evaluated using the"one-belt,one-line"modle.Caco-2 cells were divided into the cell control group,paclitaxel 5 mg·L-1 group,ginsenoside Rg3 50 and 100 mg·L-1 groups,and paclitaxel 5 mg·L-1+ginsenoside Rg3 50 and 100 mg·L-1 groups.After 24 h of incubation,the proliferation and migration ability of the cells were detected by colony assay and Transwell migration assay.Caco-2 cells were then divided into the cell control group,quinidine 12.5 mg·L-1 group,and ginsenoside Rg3 6.25 and 12.5 mg·L-1 groups.After 4 h of incubation,the expression levels of P-gp and total protein were detected by ELISA.RESULTS The affinity constants of ginsenoside Rb1,Rg3,Rg5 with P-gp were all less than 10-3 mol·L-1,while that of ginsenoside CK with P-gp was 10-2 mol·L-1.There was no typical binding dissociation curve between ginsenoside Re and P-gp.The absolute binding affinities of ginsenosides Rg3 and Rg5 to P-gp were determined to be 8.5 kcal·mol-1 and 7.6 kcal·mol-1,respectively.Ginsenosides mixed with PTX 5 mg·L-1 inhibited the growth of colon cancer cells through synergy and addition,and the dose range of the syner-gistic effect was[0+5,43.15+5]mg·L-1;[164.51+5,200+5]mg·L-1,the additive effect dose ranged from[43.15+5,164.51+5]mg·L-1.The combination of the two drugs could significantly reduce the proliferation and migration ability of Caco-2 cells(P<0.01).The ELISA results showed a decrease in total protein and P-gp content in both the ginsenoside and quinidine groups(P<0.05).CONCLUSION Ginsenoside bind to and inhibit the activity of P-gp,synergizing with paclitaxel to reduce the proliferative and migratory abili-ties of Caco-2 cells.The combination of ginsenosides and paclitaxel enhances the sensitivity of Caco-2 cells to paclitaxel induced inhibition.The combined use of these two substances is expected to achieve better anticancer effects compared to paclitaxel alone.

Objective:To understand the current situation of psychological crisis vulnerability among elderly individuals with multimorbidity and analyze the factors that influence it, to provide insights for improving their coping abilities.Methods:A cross-sectional survey design was conducted at Renmin Hospital of Wuhan University from May 1 to November 30, 2022.The attitudes toward aging, sense of meaning of life, and vulnerability to psychological crisis were analysed among outpatients and inpatients.Statistical analysis was performed on the questionnaire results, and the influencing factors of vulnerability to psychological crisis in elderly patients with co-morbidities were analyzed using one-way linear regression and multivariate linear regression.Additionally, the correlation between aging attitudes, sense of meaning of life, and vulnerability to psychological crisis was examined using Pearson correlation analysis.Results:A total of 685 questionnaires were distributed, and 602 valid questionnaires were collected, resulting in a valid recovery rate of 87.9%.The total score for the sense of meaning of life in elderly co-morbid patients was(39.2±8.3), while the total score for aging attitudes was(80.2±13.5).The total score for psychological crisis vulnerability was(69.4±12.8), indicating a medium-high level of vulnerability.The results of multiple linear regression analysis revealed that the factors influencing psychological crisis vulnerability in elderly multimorbidity, in descending order, were residence status, economic situation, marital status, age, type of chronic disease, and hospitalization history in the past six months.Psychological crisis vulnerability in elderly multimorbidity showed a negative correlation with the sense of meaning of life and the attitude of aging( r=-0.315, -0.264, both P<0.01), while the attitude of aging exhibited a positive correlation with the sense of meaning of life( r=0.515, P<0.01). Conclusions:The vulnerability of elderly individuals with multimorbidity to psychological crises is influenced by several factors.Healthcare professionals should prioritize individuals who are elderly, residing in nursing institutions, widowed, financially disadvantaged, experiencing multiple illnesses, and not currently hospitalized.

Objective:To explore the application effect of reproductive alliance referral mechanism and referral full-time reception nurses in patients with assisted reproductive technology.Methods:From March 2023 to September 2023, the demographic data of patients attending the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were retrospectively summarized. This included patients referred for combined ovarian stimulation, patients referred without combined ovarian stimulation, and a control group consisting of self-visit patients. The number of visits, ovulation induction protocols, and outcomes among the three groups were compared.Results:The study included a total of 425 patients, comprising 99 patients in combined ovarian stimulation, 98 patients in no combined ovarian stimulation, and 228 patients in control group. The baseline data did not show any significant differences among the three groups (all P>0.05). The number of hospital visits was 1.79±1.20 in the referral+ovulation induction group, 5.48±2.24 in the referral non-ovulation induction group, and 5.77±1.72 in control group, with a significant difference among the three groups ( P<0.001). The results of LSD multiple comparison method revealed statistically significant differences in the number of visits between the referral+combined ovarian stimulation group and the referral non-combined ovarian stimulation group, as well as the control (all P<0.001). The protocol, dosage and duration of gonadotropin-releasing hormone agonist used and the duration and dosage of gonadotropin used were no significant differences among the three groups (all P>0.05). The numbers of oocytes retrieved, two pronuclei, available embryos, MⅡ, high-quality embryos, transferable embryos, frozen embryos, blastocyst culture, blastocyst formation, and available blastocysts were not significantly different among the three groups (all P>0.05). Conclusion:The alliance ovulation induction referral model demonstrates a favorable clinical application effect in patients undergoing assisted reproduction, alleviating the burden of patients having to visit multiple locations.

Objective:To explore the application effect of reproductive alliance referral mechanism and referral full-time reception nurses in patients with assisted reproductive technology.Methods:From March 2023 to September 2023, the demographic data of patients attending the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were retrospectively summarized. This included patients referred for combined ovarian stimulation, patients referred without combined ovarian stimulation, and a control group consisting of self-visit patients. The number of visits, ovulation induction protocols, and outcomes among the three groups were compared.Results:The study included a total of 425 patients, comprising 99 patients in combined ovarian stimulation, 98 patients in no combined ovarian stimulation, and 228 patients in control group. The baseline data did not show any significant differences among the three groups (all P>0.05). The number of hospital visits was 1.79±1.20 in the referral+ovulation induction group, 5.48±2.24 in the referral non-ovulation induction group, and 5.77±1.72 in control group, with a significant difference among the three groups ( P<0.001). The results of LSD multiple comparison method revealed statistically significant differences in the number of visits between the referral+combined ovarian stimulation group and the referral non-combined ovarian stimulation group, as well as the control (all P<0.001). The protocol, dosage and duration of gonadotropin-releasing hormone agonist used and the duration and dosage of gonadotropin used were no significant differences among the three groups (all P>0.05). The numbers of oocytes retrieved, two pronuclei, available embryos, MⅡ, high-quality embryos, transferable embryos, frozen embryos, blastocyst culture, blastocyst formation, and available blastocysts were not significantly different among the three groups (all P>0.05). Conclusion:The alliance ovulation induction referral model demonstrates a favorable clinical application effect in patients undergoing assisted reproduction, alleviating the burden of patients having to visit multiple locations.

Objective:To summarize the experience of the whole process management of fertility preservation in patients with malignant tumor.Methods:The clinical data and the whole-process management of 24 fertility preservation procedures in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from December 2019 to September 2022 were retrospectively analyzed. The key points of fertility preservation patient management included decision support for initial diagnosis, specially-assigned reception, privacy protection, whole-process inspection escort, humanized management at the stage of drainage promotion, infection prevention, psychological assessment and counseling, and professional health education.Results:After the whole process of careful treatment and nursing, all the 24 patients successfully completed fertility preservation, and no complications such as infection, bleeding after egg extraction occurred.Conclusion:When caring for patients with fertility preservation, the physical and psychological conditions of patients should be considered comprehensively, so as to provide more targeted nursing services to meet the needs of patients and achieve the best clinical results.

Objective:To compare perinatal outcomes of singleton live births between human assisted reproductive technology (ART) and spontaneously conceived (SC).Methods:This study was a retrospective cohort study, collecting data on patients who delivered and obtained singleton live birth in the Obstetrics Department of the Third Affiliated Hospital of Zhengzhou University between 2008 and 2019. A total of 1 727 ART patients were included in this study, and 5 181 SC patients who delivered during the same day were matched at a ratio of 1∶3. After matching according to delivery time, the baseline data of the two groups were matched using 1∶1 propensity score matching (PSM), and finally 1 439 patients were included in the ART and SC groups, respectively. The primary outcome measure was the healthy baby rate, and the secondary outcome measures were perinatal outcomes such as the incidences of hypertensive disorders of pregnancy, gestational diabetes and preterm delivery rate.Results:After PSM, healthy baby rate was lower in the ART group compared with the SC group [77.28% (1 112/1 439) vs. 70.67% (1 017/1 439), P<0.001]. Pregnancy complications, including the incidence of gestational diabetes, intrahepatic cholestasis syndrome during pregnancy, abnormal thyroid function during pregnancy, oligohydramnios, placenta previa, cesarean delivery, and placental efficiency, were statistically different between the two groups (all P<0.05). The neonatal outcomes, including gestational age, preterm delivery rate, very preterm delivery rate, incidence of small for gestation age and neonatal intensive care unit admission rate were statistically different between the two groups (all P<0.05). The results of multivariate logistic regression analysis showed that ART and pregnancy complications were risk factors for healthy baby ( OR=0.81, 95% CI:0.67-0.97, P=0.020), however, placental efficiency was a protective factor for healthy baby ( OR=1.73, 95% CI:1.59-1.88, P<0.001). Conclusion:Perinatal outcomes were safer in the SC group than in the ART group.

Objective:To summarize the experience of the whole process management of fertility preservation in patients with malignant tumor.Methods:The clinical data and the whole-process management of 24 fertility preservation procedures in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from December 2019 to September 2022 were retrospectively analyzed. The key points of fertility preservation patient management included decision support for initial diagnosis, specially-assigned reception, privacy protection, whole-process inspection escort, humanized management at the stage of drainage promotion, infection prevention, psychological assessment and counseling, and professional health education.Results:After the whole process of careful treatment and nursing, all the 24 patients successfully completed fertility preservation, and no complications such as infection, bleeding after egg extraction occurred.Conclusion:When caring for patients with fertility preservation, the physical and psychological conditions of patients should be considered comprehensively, so as to provide more targeted nursing services to meet the needs of patients and achieve the best clinical results.

Objective:To compare perinatal outcomes of singleton live births between human assisted reproductive technology (ART) and spontaneously conceived (SC).Methods:This study was a retrospective cohort study, collecting data on patients who delivered and obtained singleton live birth in the Obstetrics Department of the Third Affiliated Hospital of Zhengzhou University between 2008 and 2019. A total of 1 727 ART patients were included in this study, and 5 181 SC patients who delivered during the same day were matched at a ratio of 1∶3. After matching according to delivery time, the baseline data of the two groups were matched using 1∶1 propensity score matching (PSM), and finally 1 439 patients were included in the ART and SC groups, respectively. The primary outcome measure was the healthy baby rate, and the secondary outcome measures were perinatal outcomes such as the incidences of hypertensive disorders of pregnancy, gestational diabetes and preterm delivery rate.Results:After PSM, healthy baby rate was lower in the ART group compared with the SC group [77.28% (1 112/1 439) vs. 70.67% (1 017/1 439), P<0.001]. Pregnancy complications, including the incidence of gestational diabetes, intrahepatic cholestasis syndrome during pregnancy, abnormal thyroid function during pregnancy, oligohydramnios, placenta previa, cesarean delivery, and placental efficiency, were statistically different between the two groups (all P<0.05). The neonatal outcomes, including gestational age, preterm delivery rate, very preterm delivery rate, incidence of small for gestation age and neonatal intensive care unit admission rate were statistically different between the two groups (all P<0.05). The results of multivariate logistic regression analysis showed that ART and pregnancy complications were risk factors for healthy baby ( OR=0.81, 95% CI:0.67-0.97, P=0.020), however, placental efficiency was a protective factor for healthy baby ( OR=1.73, 95% CI:1.59-1.88, P<0.001). Conclusion:Perinatal outcomes were safer in the SC group than in the ART group.

Objective:To evaluate the influence on the results and safety of double-balloon enteroscopy (DBE) at different combination time.Methods:Patients who received combined DBE procedures in Nanjing Drum Tower Hospital from April 2019 to August 2020 were divided into the one-day combination group and the non-one-day combination group. The complete enteroscopy rate, time of anterograde approach, time of retrograde approach, total time of combined approach, adverse events, hospital stay and cost were compared.Results:Among 119 patients who received DBE, 23 patients were excluded due to small intestinal stenosis. The complete enteroscopy rate was 92.9% (39/42) in the one-day group and 74.1% (40/54) in the non-one-day group, showing significant difference ( χ2=4.390, P=0.036). There were significant differences in the time of retrograde approach (35.59±23.29 min VS 55.10±19.04 min, t=-4.080, P<0.001), total time of combined approach (89.10±27.82 min VS 114.20±24.55 min, t=-4.254, P<0.001), hospital stay (9.24±3.76 d VS 11.76±4.41 d, t=-2.599, P=0.011) between the two groups. There were no significant differences in the time of anterograde approach, hospital cost or adverse events between the two groups. Conclusion:Combined DBE on one day yields a higher complete enteroscopy rate, less examination time and less hospital stay, which is worth of clinical application.