Atypical placental site nodules (APSN) are a rare form of trophoblastic disease in pregnancy. There is limited research on APSN, and treatment methods are controversial, with unclear prognosis. This study collected clinical and prognostic data of 5 patients diagnosed with APSN at Xiangya Hospital of Central South University from June 2008 to June 2023, aiming to provide a better understanding of the prognosis of APSN patients and offer scientific evidence for clinical treatment. The average age of the 5 APSN patients was 32.60 years, and all patients underwent dilation and curettage or hysteroscopic surgery or hysteroscopic surgery without hysterectomy. Except for one patient who was lost to follow-up after 30 days, the remaining 4 patients were followed up for 1.36 to 4.61 years. During the follow-up, gynecological ultrasound did not show abnormalities, and serum human chorionic gonadotropin (HCG) tests were negative, with no evidence of malignancy. A search of both English and Chinese databases yielded 8 articles reporting the diagnosis, treatment, and follow-up outcomes of APSN, with 37 cases cumulatively followed up. Among them, 2 (5.41%) cases developed epithelial trophoblastic tumors or placental site trophoblastic tumors during follow-up, but there is insufficient evidence to determine whether these tumors directly originated from APSN or were secondary to APSN. Currently, there is no direct evidence suggesting that APSN has the potential for malignant transformation. Patients with APSN who have completed their childbearing may consider preserving their uterus, but close follow-up is needed to further evaluate the prognosis.
Humans ; Female ; Pregnancy ; Adult ; Trophoblastic Tumor, Placental Site/pathology* ; Uterine Neoplasms/diagnosis* ; Prognosis ; Dilatation and Curettage ; Chorionic Gonadotropin/blood*

Objective:To improve the skin toxicity management model of tumor targeted drugs based on evidence-based practice method and apply it to clinical practice.Methods:Using the evidence-based practice method of Joanna Briggs Institute, evidence of skin toxicity management of tumor targeted drugs was formed by searching relevant guidelines and evidence-based medical literature at home and abroad, and conducting interviews and surveys with nurses and patients. Based on the evidence and in consultation with evidence-based medicine, nursing and clinical experts, the evidence was transformed into management improvement plans, and the skin toxicity checklist and care checklist were developed. The improvement scheme was applied to clinical practice, the training of nurses was strengthened, the nursing process was standardized and improved, and various forms of health education were provided to patients. Patients with skin toxicity who received targeted drug therapy in the Department of Oncology of Anhui Cancer Hospital from May to August 2023 were collected. Implementation of various management indicators by nurses before and after management improvement were compared. The occurrence and severity of skin toxicity in patients were compared to verify the effect of the improvement.Results:A total of 35 tumor patients with skin toxicity to targeted drugs were entered, including 26 males and 9 females, with age (60±10) years. Compared with before, the implementation rate of the 5 indicators after the management improvement, including the evaluation of skin toxicity and risk factors by nurses using the common terminology criteria for adverse events version 5.0, the qualified status of related nursing documents, the health education of skin care, and regular follow-up of patients, were significantly increased (from 0-31.4% up to 80%-100%), the differences were statistically significant (all P<0.05). After improvement, the incidence and severity of skin rash, skin dryness, skin reaction of hands and feet, and paronychia were significantly reduced, the score of skin care knowledge questionnaire was significantly increased [6.00(5.00, 8.00) vs. 8.00(7.00, 9.00), P=0.002], and the dermatology life quality index was significantly decreased [8.00(6.00, 9.00) vs. 6.00(5.00, 8.00), P=0.033]. The differences in anxiety and depression scores were not statistically significant (both P>0.05). Conclusion:The skin toxicity management of targeted drugs based on JBI evidence-based practice method can standardize the clinical nursing practice of nurses, improve the severity of skin toxicity in tumor patients, and improve their quality of life.

Objective:To improve the skin toxicity management model of tumor targeted drugs based on evidence-based practice method and apply it to clinical practice.Methods:Using the evidence-based practice method of Joanna Briggs Institute, evidence of skin toxicity management of tumor targeted drugs was formed by searching relevant guidelines and evidence-based medical literature at home and abroad, and conducting interviews and surveys with nurses and patients. Based on the evidence and in consultation with evidence-based medicine, nursing and clinical experts, the evidence was transformed into management improvement plans, and the skin toxicity checklist and care checklist were developed. The improvement scheme was applied to clinical practice, the training of nurses was strengthened, the nursing process was standardized and improved, and various forms of health education were provided to patients. Patients with skin toxicity who received targeted drug therapy in the Department of Oncology of Anhui Cancer Hospital from May to August 2023 were collected. Implementation of various management indicators by nurses before and after management improvement were compared. The occurrence and severity of skin toxicity in patients were compared to verify the effect of the improvement.Results:A total of 35 tumor patients with skin toxicity to targeted drugs were entered, including 26 males and 9 females, with age (60±10) years. Compared with before, the implementation rate of the 5 indicators after the management improvement, including the evaluation of skin toxicity and risk factors by nurses using the common terminology criteria for adverse events version 5.0, the qualified status of related nursing documents, the health education of skin care, and regular follow-up of patients, were significantly increased (from 0-31.4% up to 80%-100%), the differences were statistically significant (all P<0.05). After improvement, the incidence and severity of skin rash, skin dryness, skin reaction of hands and feet, and paronychia were significantly reduced, the score of skin care knowledge questionnaire was significantly increased [6.00(5.00, 8.00) vs. 8.00(7.00, 9.00), P=0.002], and the dermatology life quality index was significantly decreased [8.00(6.00, 9.00) vs. 6.00(5.00, 8.00), P=0.033]. The differences in anxiety and depression scores were not statistically significant (both P>0.05). Conclusion:The skin toxicity management of targeted drugs based on JBI evidence-based practice method can standardize the clinical nursing practice of nurses, improve the severity of skin toxicity in tumor patients, and improve their quality of life.

Objective To investigate the early clinical characteristics and radiographic changes in confirmed Novel coronavirus pneumonia (NCP) and excluded NCP patients. Methods Twenty-four patients with suspected NCP admitted to Shanghai Jiao Tong University Affiliated Sixth People’s Hospital and Jinshan Branch Hospital between January and February, 2020 were chosen as our research subjects. Early clinical features and radiographic changes were analyzed in 10 patients of confirmed NCP and 14 patients of excluded NCP. Results In the early stage, all 24 suspected patients were mild, and had normal blood gas analysis. Of 10 diagnosed patients, 50% were male. All the 10 patients had fever and fatigue, with body temperature between 37.5℃ and 38.5℃. Only 1 patient had dry cough. 2 patients had no clear epidemiological exposure history, the other 8 had a clear epidemiological exposure, with a possible incubation period of 1-10 days. From CT imaging, lesions were characterized as ground glass shadow ( n =9), which could be unilateral ( n =1) or bilateral ( n =9), and were mainly close to the pleura ( n =9), with nodule shadow ( n =1) and without focal necrosis, and could combined with pleural effusion ( n =1. Among patients excluded NCP, all 14 patients had a clear history of epidemic exposure, with an onset time of 1 to 13 days. 12 patients had fever , including 4 with temperature > 38.5°C, 8 with temperature 37.3-38.5°C, and 2 without fever. All patients had fatigue , 7 patients had dry cough and 2 patients had chest pain. From CT imaging, ground glass shadow appeared in 4 patients , lesions were unilateral in 10 patients and bilateral in 4 patients , and the lesions were relatively sporadic, without necrosis or pleural effusion. Conclusion 1．Not all patients with NCP have a direct history of epidemiology exposure, some patients may be infected unknowingly. 2. According to CT imaging, NCP seems to have no special manifestations different from other viral pneumonia. 3. NCP is more common among middle-aged people.

Objective To observe the therapeutic effect of discontinuation pyeloplasty in children with hydronephrosis.Analyze the factors that affect the recovery of postoperative renal function.Methods A retrospective analysis was performed on 125 children with hydronephrosis caused by unilateral ureteropelvic junction obstruction from January 2014 to December 2015 in Hunan Children's Hospital.Preoperative and postoperative renal pelvis anteroposterior diameter,renal parenchymal thickness,segmental artery resistance index,glomerular filtration rate (GFR),blood urea nitrogen,serum creatinine and other indicators were observed.The measurement data were expressed as mean ± standard deviation (Mean ± SD),and paired t-test was used for inter-group comparison,and Chi-square test was used for inter-group comparison of counting data.Logistic regression analysis was performed on the factors such as sex,age,hydronephrosis location and hydronephrosis degree before operation,and the important factors affecting postoperative renal function recovery were screened out.Results Postoperative renal pelvis anteroposterior diameter (1.87 ± 1.02) cm,renal parenchyma thickness (6.34 ± 1.41) mm,segmental arterial resistance index (0.68 ± 0.05),GFR (40.54 ± 3.25) ml/min,blood urea nitrogen (2.18 ± 1.24) mmol/L and serum creatinine (27.54 ± 6.21) μg/ml and other indicators were better than preoperative,the difference were statistically significant (P ＜ 0.05).Multivariate logistic regression analysis showed that the degree of hydronephrosis,age and level of renal function were the influencing factors of renal function recovery (P ＜ 0.05).The postoperative recoveryof renal function was not related to gender,location of hydronephrosis,surgical methods and other factors (P ＞ 0.05).Conclusions Pyeloplasty is good for children with hydronephrosis,it can improve the degree of patients with hydronephrosis,improve renal function recovery.Preoperative patients with age,degree of hydronephrosis and sub-renal function levels affect postoperative renal function recovery.

Objective: To analyze the relationship between the expression of homeobox A13 (HOXA13), epidermal growth factor (EGF) and epidermal growth factor receptor (EGFR) gene in prepuce tissue of children with congenital hypospadias, discuss the relationship and significance of HOXA13, EGF and EGFR genes in congenital hypospadias and to understand their role in the pathogenesis of hypospadias. Methods: 65 cases of hypospadias were selected as the experimental group and 42 cases of phimosis as the control group. Hematoxylin-eosin (HE) staining was used to observe the pathological characteristics of prepuce tissues in the two groups. Immunohistochemistry, real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) and Western blot were used to detect the expression of HOXA13, EGF and EGFR in the two groups. Results: ⑴ HE staining showed that the epidermis of hypospadias was composed of keratinized stratified flat epithelium and epidermis of penile skin. The prepuce of phimosis children showed only infiltration of inflammatory cells in the superficial layer of the inner prepuce, blood vessel congestion, no obvious appendage structure, mostly fibroblasts. ⑵ Immunohistochemistry: The positive expressions of HOXA13, EGF and EGFR in the control group were significantly higher than those in the experimental group (P<0.01). ⑶ qRT-PCR: The expression levels of HOXA13, EGF and EGFR in the control group were 53.447±33.471, 80.012±20.430, 75.012±14.339, and the expression levels of HOXA13, EGF and EGFR in the experimental group were 9.128±5.996, 45.521±18.242, 32.043±10.215, respectively. The expression of HOXA13, EGF and EGFR in the control group was significantly higher than that in the experimental group (P<0.01). ⑷ Western blot: The expression levels of HOXA13, EGF and EGFR in the experimental group were lower than those in the control group. Conclusions The expression of HO-XA13, EGF and EGFR in prepuce tissue of children with hypospadias is low, which may be related to hypospadias.

Objective:To investigate the prevalence of vitamin D insufficiency/deficiency among 3-5 years old overweight and obese children in Yuelu district of Changsha and to give scientific suggestion for children health promotion.Methods:Based on the stratified cluster sampling method,2 872 children aged 3-5 years old from Yuelu district were enrolled from Oct to Dec 2015.All participants have received biochemical and physical examination.According to the body mass index,the prevalence rates of vitamin D insufficiency [serum 25(OH)D level 20-＜30 ng/mL] and deficiency [serum 25(OH)D level＜20 ng/mL] among normal weight,overweight/obese children were calculated,respectively.Multivariate logistic regression was used to evaluate the association between overweight/obese and vitamin D insufficiency/deficiency.Results:The prevalence rates of vitamin D insufficiency/deficiency among children aged 3-5 years old were 39.6％ (95％ CI37.8％ to 41.4％) and 19.5％ (95％ CI 18.1％ to 21.0％),respectively.Compared to children with normal weight,overweight/obese children had higher prevalence rate of vitamin D insufficiency [48.6％ (95％ CI 44.4％ to 52.9％)] and deficiency [24.6％ (95％ CI 21.1％ to 28.4％)] (P＜0.017).After adjustment with confounding variables,the associations between overweight/obese and vitamin D insufficiency/deficiency were still statistically significant [for insufficiency ORadj=1.17 (95％ CI 1.06 to 1.43);for deficiency ORadj=1.22 (95％ CI 1.12 to 1.51)].Conclusion:Compared with normal weight children,overweight/obese children have higher prevalence rate of vitamin D insufficiency/deficiency.More attention should be paid to those populations for prevention of vitamin D insufficiency/deficiency.

Objective To detect the infection of human papillomavirus (HPV)in patients with non-small cell lung cancer (NSCLC)and explore the relationship between HPV infection and clinicopathological features.Methods HPV detection and genotyping in 156 cases of NSCLC were performed using a new liquid chip based on Luminex.Patient clinical characteristics were also recorded,and the relationship between HPV infection and clinicopathological features was studied.Results Of the 156 tumor-DNA samples tested,40 (25.6%)cases showed presence of HPV-DNA,of which 37 cases were of a high-risk HPV type (16,18,33, 58).The differences were statistically significant between the HPV-positive and HPV-negative groups in gender (χ2 =4.387,P =0.036),smoking (χ2 =8.130,P =0.004),histologic type (χ2 =4.075,P =0.044)and lymph node metastasis (χ2 =7.082,P =0.008).The differences were not statistically significant between the HPV-positive and HPV-negative groups in age (χ2 =0.013,P =0.910),differentiated degree (χ2 =1.727, P =0.189),clinical stages (χ2 =0.179,P =0.672),distant metastasis (χ2 =3.012,P =0.083).Logistic regression analysis revealed that lymph node metastasis alone was an independent predictive factor of HPV infection in NSCLC (OR =0.384,95%CI:0.153-0.967,P =0.042),and gender (OR =1.402,95%CI:0.522-3.769,P =0.503),smoking (OR =0.506,95%CI:0.194-1.322,P =0.506),histologic type (OR =0.393,95%CI:0.133-0.161,P =0.091)were not independent predictive factors of HPV infection. Conclusion The infection of HPV presents in part of Chinese NSCLC patients,and HPV infection may be connected with occurrence and development of lung cancer.

OBJECTIVETo establish three-dimensional finite element model of two-piece post crown to the mandibular first molar residual roots, and analyze the stress distribution characteristic to the residual roots with different adhesives, so as to get the best combination under different conditions.

METHODSThe complete mandibular first molar in vitro was selected, the crown was removed along the cemento-enamel junction, then the residual roots were scanned by CT. CT images were imported into a reverse engineering software, and the three-dimensional finite element model of the mandibular first molar residual roots was reconstructed. Titanium two-piece post crown of the mandibular first molar residual roots was produced, then was scanned by CT. The model was reconstructed and assembled by MIMICS. The stress distribution of the root canal and root section under the vertical load and lateral load with different bonding systems were analyzed.

RESULTSThree-dimensional finite element model of two-piece post crown to the mandibular first molar residual roots was established. With the increasing of elastic modulus of the adhesives, the maximum stress within the root canal was also increasing. Elastic modulus of zinc phosphate was the biggest, so the stress within the root canal was the biggest; elastic modulus of Superbond C&B was the smallest, so the stress within the root canal was the smallest. Lateral loading stress was much larger than the vertical load. Under vertical load, the load on the root section was even with different bonding systems. Under lateral load, the maximum stress was much larger than the vertical load. The stress on the root section was minimum using zinc phosphate binder, and the stress on the root section was maximum using Superbond C&B.

CONCLUSIONIn two-piece post crown restorations, there is significant difference between different adhesives on tooth protection. When the tooth structure of the root canal orifices is weak, in order to avoid the occurrence of splitting, the larger elastic modulus bonding system is the first choice, such as zinc phosphate binder. When the resistance form of the root canal orifices is good enough but the root is too weak, it is suggested that the smaller elastic modulus bonding system is the first choice, such as Superbond C&B.

Cytokine-induced killer (CIK) cells are T lymphocytes which have natural killer cell activity and antitumor activity.It is found that CIK cells play an important role in killing tumor cells by secreting cytotoxic granules and cytokines,activating NKG2D receptor and regulating oncogene expression.CIK cells can not only kill the tumor cells,but also can improve immune system and the quality of life of patients.A large number of studies have shown that CIK treatment is a new mode of cancer treatment without obvious adverse reactions and can be widely applied in clinical treatment.