Objective To explore changes of topological properties and functional connectivity(FC)of global brain network in breast cancer(BC)patients accompanied by emotional disorders.Methods Forty-three female BC patients(BC group)and 43 age-and education-matched healthy controls(HC group)were prospectively enrolled.The scores of fear of cancer recurrence-total(FCR-total),fear of cancer recurrence inventory(FCRI),general anxiety disorder-7(GAD-7)and patient health questionnaire-9(PHQ-9)for 43 patients in BC group,as well as of anxiety sensitivity index-3(ASI-3),meta-cognitions about health questionnaire(MCQ-HA)and EuroQoL 5-dimension 5-level questionnaire(EQ-5D-5L)for 40 patients in BC group were obtained to evaluate emotional disorders.Meanwhile,the scores of GAD-7 and PHQ-9 were obtained in HC group to exclude for anxiety and depression.Using resting-state functional MRI(rs-fMRI),topological attributes and FC of global brain network were analyzed,and the topological attribute indicators of global brain network were compared between groups.Based on voxel-wise analysis,the regions in global brain related to FC strength(FCS)correlated with each clinical scale score in BC group were analyzed,and spatial similarity analysis of FCS was performed.The correlations of FCS at brain region level and clinical scale scores in BC group were observed.Results All patients in BC group were accompanied by emotional disorders.The clustering coefficient in BC group was lower than that in HC group(t=-2.261,P=0.027).Brain regions related to FCS values correlated with each clinical scale score in BC group were widely distributed in sensorimotor network and higher-order brain network,etc.,and their FCS values were correlated.FCS of ventrolateral nucleus of right thalamus and caudate nucleus were positively correlated with FCR-total(r=0.459,P=0.004)and FCRI(r=0.488,P=0.005).Conclusion BC patients with emotions disorders had dysfunction of brain functional segregation,as well as enhanced FCS in brain regions such as ventrolateral nucleus of right thalamus and caudate nucleus.

Objective To explore changes of topological properties and functional connectivity(FC)of global brain network in breast cancer(BC)patients accompanied by emotional disorders.Methods Forty-three female BC patients(BC group)and 43 age-and education-matched healthy controls(HC group)were prospectively enrolled.The scores of fear of cancer recurrence-total(FCR-total),fear of cancer recurrence inventory(FCRI),general anxiety disorder-7(GAD-7)and patient health questionnaire-9(PHQ-9)for 43 patients in BC group,as well as of anxiety sensitivity index-3(ASI-3),meta-cognitions about health questionnaire(MCQ-HA)and EuroQoL 5-dimension 5-level questionnaire(EQ-5D-5L)for 40 patients in BC group were obtained to evaluate emotional disorders.Meanwhile,the scores of GAD-7 and PHQ-9 were obtained in HC group to exclude for anxiety and depression.Using resting-state functional MRI(rs-fMRI),topological attributes and FC of global brain network were analyzed,and the topological attribute indicators of global brain network were compared between groups.Based on voxel-wise analysis,the regions in global brain related to FC strength(FCS)correlated with each clinical scale score in BC group were analyzed,and spatial similarity analysis of FCS was performed.The correlations of FCS at brain region level and clinical scale scores in BC group were observed.Results All patients in BC group were accompanied by emotional disorders.The clustering coefficient in BC group was lower than that in HC group(t=-2.261,P=0.027).Brain regions related to FCS values correlated with each clinical scale score in BC group were widely distributed in sensorimotor network and higher-order brain network,etc.,and their FCS values were correlated.FCS of ventrolateral nucleus of right thalamus and caudate nucleus were positively correlated with FCR-total(r=0.459,P=0.004)and FCRI(r=0.488,P=0.005).Conclusion BC patients with emotions disorders had dysfunction of brain functional segregation,as well as enhanced FCS in brain regions such as ventrolateral nucleus of right thalamus and caudate nucleus.

Objective:To investigate the mediating role of psychological capital between the perception of decent work and work engagement among Operating Room nurses, and to provide insights for improving their work engagement.Methods:From December 2023 to February 2024, a total of 307 Operating Room nurses from four class ⅢGrade A hospitals in Beijing, Chongqing, Dalian, and Zhuhai were recruited using convenience sampling. Data were collected using a general information questionnaire, Work Engagement Scale, Decent Work Scale, and Nurses' Psychological Capital Scale. Pearson correlation analysis was conducted to examine the relationships among psychological capital, perception of decent work, and work engagement. Structural equation modeling and mediation analysis were performed using AMOS 24.0 software.Results:A total of 307 questionnaires were distributed, and 301 valid responses were collected, with an effective response rate of 98.05%. The mean scores for work engagement, perception of decent work, and psychological capital were (41.01±10.76), (67.30±17.86), and (93.30±15.15), respectively. Work engagement was positively correlated with both the perception of decent work and psychological capital (all P<0.01), and the perception of decent work was positively correlated with psychological capital ( P<0.01). Psychological capital partially mediated the relationship between the perception of decent work and work engagement, with the mediating effect accounting for 62.63%. Conclusions:Psychological capital plays a partial mediating role between the perception of decent work and work engagement among Operating Room nurses. Nursing managers can enhance nurses' work engagement by improving their perception of decent work and strengthening their psychological capital.

Objective:To investigate the mediating role of psychological capital between the perception of decent work and work engagement among Operating Room nurses, and to provide insights for improving their work engagement.Methods:From December 2023 to February 2024, a total of 307 Operating Room nurses from four class ⅢGrade A hospitals in Beijing, Chongqing, Dalian, and Zhuhai were recruited using convenience sampling. Data were collected using a general information questionnaire, Work Engagement Scale, Decent Work Scale, and Nurses' Psychological Capital Scale. Pearson correlation analysis was conducted to examine the relationships among psychological capital, perception of decent work, and work engagement. Structural equation modeling and mediation analysis were performed using AMOS 24.0 software.Results:A total of 307 questionnaires were distributed, and 301 valid responses were collected, with an effective response rate of 98.05%. The mean scores for work engagement, perception of decent work, and psychological capital were (41.01±10.76), (67.30±17.86), and (93.30±15.15), respectively. Work engagement was positively correlated with both the perception of decent work and psychological capital (all P<0.01), and the perception of decent work was positively correlated with psychological capital ( P<0.01). Psychological capital partially mediated the relationship between the perception of decent work and work engagement, with the mediating effect accounting for 62.63%. Conclusions:Psychological capital plays a partial mediating role between the perception of decent work and work engagement among Operating Room nurses. Nursing managers can enhance nurses' work engagement by improving their perception of decent work and strengthening their psychological capital.

Objective:To systematically retrieve, evaluate, and summarize evidence on insomnia screening and assessment in adult malignant tumor patients.Methods:The clinical decisions, guidelines, and expert consensus on screening and assessing insomnia in malignant tumor patients were systematically searched in clinical decision support systems, guideline websites, literature databases, and professional association websites. This study conducted methodological quality evaluation and evidence extraction, translation, and integration.Results:A total of 8 articles were included, including three clinical decisions, two evidence-based guidelines, and three expert consensuses. After extracting and summarizing evidence, 38 pieces of evidence were obtained from three aspects of general management principles, insomnia screening, and insomnia assessment.Conclusions:The insomnia screening and assessment in adult malignant tumor patients should be standardized according to evidence-based standards and combined with specific clinical situations in China.

Objective To investigate the difference of Wechsler's cognitive test and its influencing factors in first-episode depression patients with and without sleep disorder.Methods 156 patients with de-pression were divided into two groups according to their sleep conditions,including sleep disorder group(n=77)and non-sleep disorder group(n=79).Wechsler Intelligence Scale(WAIS)and Wechsler Memory Scale(WMS)were used to assess the cognitive function,while Hamilton Depression Scale(HAMD-17) were used to assess depressive symptoms.Results (1)Sleep disorders group had lower scores on verbal IQ (95.51±16.45),performance IQ(90.94±13.87),FIQ scores(92.48±15.49)than those in the non-sleep disorder group((105.59±15.20),(96.19±13.62),(101.20±14.70)respectively),the differences were statistically significant(P<0.05).Sleep disorder group had lower scores in immediate memory(10.47 ± 3.88),short-term memory(49.87±14.35)and memory quotient(87.90±18.25)than those in the non-sleep disorder group((11.86±3.47),(56.52±13.03),(97.27±18.76)respectively),the differences were statisti-cally significant(all P<0.05).(2)Multivariate linear regression analysis showed that education and age ex-plained 24% of variance in verbal IQ(F=21.258,P<0.01).Education,sleep disorder factors explained 12.9% of variation in performance IQ(F=9.825,P<0.01).Education,sleep disorder factors explained 22.3% of variance in total IQ(F=22.847,P<0.01).Education,age,sleep disorder factors explained 28.4%of variation in short-term memory(F=23.850,P<0.01).Education and age explained 20.4% of variation in immediate memory(F=18.10,P<0.01).Education and sleep disorder factors explained 21.9% of variation in memory quotient(F=26.162,P<0.01).Conclusion The intelligence and memory impairment in first-epi-sode depression patients with sleep disorders is more serious,and the education,sleep disorder and age are the most important factors.

Objective To construct the DNA vaccine pIRES2-MLAA34-HSP70,and to detect its immune effect.Methods The acute monocytic leukemia associated antigen gene MLAA-34 and heat-shock protein (HSP)70 gene were extracted by using RT-PCR.The specific overlapping primer was designed,and the fusion gene MLAA34-HSP70 was amplified by using SOE-PCR technique.Then the DNA vaccine pIRES2-MLAA34-HSP70 was constructed,and BALB/c mice were immunized with this DNA vaccine.The splenic lymphocyte killing activity was detected by using MTT,levels of IL-2,IL-4 and IFN-γ were also detected by using ELISA.Results The MLAA34-HSP70 gene (2 956 bp) and the DNA vaccine pIRES2-MLAA34-HSP70 was amplified and constructed successfully.The killing efficiency of DNA vaccine pIRES2-MLAA34-HSP70 in U937 cells was significantly higher than that in other experimental groups and control group (P＜0.01),and levels of IL-4,IL-2 and IFN-γin DNA vaccine pIRES2-MLAA34-HSP70 group were significantly higher than those in the other experimental groups and control group (P＜0.01).Conclnsion The DNA vaccine pIRES2-MLAA34-HSP70 is constructed successfully.It is shown that the DNA vaccine induces strong humoral immunity,which could enhance immune responses to tumor cells and specificlly kill MLAA34 positive cells.

Objective To effectively combine the results of resting state regional homogeneity(ReHo) fMRI studies in depression.Methods Literatures between 2003-2016 on fMRI of depression in PubMed,Web of Knowledge,EBSCO host medline,CNKI,CQVIP and Wanfang Med Online were taken as research objects.Screening the relevant data according to the included and excluded standard,then,software of AES-SDM was employed to do Meta analysis,in addition,the age,gender,duration of disease,the year of education and treatment were also analyzed.Results 23 articles met the standard,including 1 036 cases,of which 507 for the depression group,529 for the control group.Meta analysis showed the significant ReHo abnormalities of Default Mode Network(DMN) which centers on left precuneus,left superior frontal gyrus and right cingulate gyrus,in addition,left lenticular nucleus,left postcentral gyrus,left cerebellum and left fusiform gyrus had significant ReHo differences.In the regression analysis,gender,age,duration of disease,years of education,disease severity were all affected factors.The difference of cingulate gyrus was the most stable,and the duration of the disease significantly affected cingulate gyrus (SDM =2.777).Conclusion The abnormalities of DMN which centers on left precuneus,left,medial superior frontal gyrus and right cingulate gyrus are the most consistent in depression,the DMN is closely related to depression.

Background and purpose:Radiotherapy and endocrine therapy are both important parts of adjuvant therapy for breast cancer, yet few studies have been conducted focusing on the interaction between radiation and endocrine therapy. Up to now, no conclusion has been drawn on the timing sequence of adjuvant radiation and endocrine therapy, which is indeed crucial in clinical practice. This study intended primarily to investigate the effect of concurrent or sequential exemestane combined with radiation on radiosensitivity of MCF-7 cells and its possible mechanism,and further to provide rationale for optimal clinical treatment modality.Methods:MCF-7 cells were arranged into three trial groups: the radiation group, exemestane sequenced with radiation group and exemestane followed radiation group. Radiosensitivity was evaluated by clonogenic assay, cell proliferation was measured by MTT assay, the ability to induce cell apoptosis was evaluated by DAPI staining assay, the changes of Bcl-2 and Bax were detected by Western blot.Results:Sensitive enhancement ratios (SER) were 1.51 and 1.37 in the exemestane sequenced with radiation group and exemestane followed radiation group, respectively. Compared with the radiation group, the percentage of cellular proliferation inhibition and apoptosis increased obviously in the exemestane sequenced with radiation group and exemestane followed radiation group. Exemestane combined with radiation made the Bax protein increase obviously and the Bcl-2 protein lowered significantly.Conclusion:Exemestane can enhance the radiosensitivity of MCF-7 cells, whose mechanism might be relevant to the promotion of cellular apoptosis. However,the treatment sequence does not affect the outcome.

Objective To delineate and measure the left anterior descending coronary artery (LAD) on CT angiography (CTA) and evaluate the dose delivered to LAD by different radiotherapy techniques for left-sided breast cancer.Methods Twenty-nine left-side breast cancer women with mean age of 54.71 years (range:30-80 years) were included.CTA was performed, and LAD was contoured and the distances were measured between LAD and chest wall (posteroanterior diameter,PD), between LAD and internal mammary artery (horizontal diameter,HD), between LAD and interventricular groove (oblique diameter,OD) at the level of T7-T8,T8-T9,T9-T10 and at level of nipple and lower boundary of the breast.The dose delivered to LAD was calculated on three-dimensional plans for two patients with mastectomy whose chest wall and internal mammary chain (IMC) were irradiated and one patient with breast-conserving surgery who received whole breast irradiation.Results The LAD arose at the level of the third rib in 40% of patients and at the fourth rib in 60% of patients.The mean length of LAD was 7.49±0.58 cm.At the level of T7-T8,T8-T9,T9-T10,the mean PD were 2.99±1.11 cm, 1.26±0.65 cm,0.68±0.39 cm, the mean HD were 2.27±0.84 cm, 2.81±0.65 cm, 3.37±1.21 cm, and the mean OD were 0.47±0.25 cm,0.38±0.21 cm,0.42±0.19 cm respectively.At the level of the breast nipple and the lower boundary of the breast, the mean PD were 2.94±1.06 cm, 0.79±0.46 cm, the mean HD were 2.45±0.89 cm, 3.31±1.22 cm,and the mean OD were 0.56±0.30 cm,0.57±0.24 cm respectively.The mean dose to the LAD was 5 Gy and 14 Gy for patients with mastectomy whose IMC was irradiated with 9 MeV electron and whose IMC was irradiated with 6 MV photon tangential beams.The mean dose to the LAD was 26 Gy for patients with breast conserving surgery.Conclusions To contour the LAD, the interventricular groove could be the reference point.Tangential technique can be giving a higher dose of LAD when compared with other radiation techniques