Immune suppression in the tumor microenvironment (TME) is closely related to abnormal glycolysis. Tumor cells gain metabolic advantages and suppress immune responses through the "Warburg effect". Traditional Chinese medicine (TCM) has been shown to regulate key glycolysis enzymes (such as HK2 and PKM2), metabolic signaling pathways (such as PI3K/AKT/mTOR, HIF-1α) and non-coding RNAs at multiple targets, thus synergistically inhibiting lactate accumulation, improving vascular abnormalities, and relieving metabolic inhibition of immune cells. Studies have shown that TCM monomers and formulas can promote immune cell infiltration and functions, improve metabolic microenvironment, and with the assistance by the nano-delivery system, enhance the precision of treatment. However, the dynamic mechanism of the interaction between TCM-regulated glycolysis and TME has not been fully elucidated, for which single-cell sequencing and other technologies provide important technical support to facilitate in-depth analysis and clinical translational research. Future studies should be focused on the synergistic strategy of "metabolic reprogramming-immune activation" to provide new insights into the mechanisms of tumor immunotherapy.
Humans ; Tumor Microenvironment/immunology* ; Glycolysis/drug effects* ; Neoplasms/drug therapy* ; Medicine, Chinese Traditional ; Signal Transduction ; Drugs, Chinese Herbal/pharmacology*

Objective:To explore the characteristics of intestinal flora in children with asthma from the theory of "lung and large intestine being interior-exterior" , and to provide an experimental basis for the study of "lung and intestine axis" .Methods:Based on 16S rDNA high-throughput sequencing technology, stool samples from children with 30 asthma and 28 healthy children were enrolloed and sequenced. All patients are from january 2018 to April 2018, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University Medical College and Oriental Hospital Affiliated to Tongji University. Statistical methods such as Principal component analysis (PCA), LEfSe analysis, linear discriminant analysis (LDA), and non-metric multidimensional scale analysis (NMDS) were used to analyze intestinal flora characteristics of asthma children.Results:The number of Intestinal flora operating taxon unit (OTU) in asthmatic group (141.96 ± 27.42 vs. 164.54 ± 50.58, P=0.048), Shannon index (2.49 ± 0.51 vs. 2.80 ± 0.56, P=0.044) were significantly lower than those of healthy children group, and Simpson index (0.18 ± 0.06 vs. 0.13 ± 0.07, P=0.010) was significantly higher than that of healthy children. There was no significant difference in intestinal flora abundance between asthmatic children and healthy children ( P>0.05), but there was a decreasing trend. Further differential intestinal flora analysis showed that there were differences in bacterial abundance between children with asthma and healthy children. Conclusion:Children with asthma showed high related with intestinal flora disorders, referring that asthma maybe treated when intestinal flora is treated, which provides a reference for the study of the relationship between lung and intestine from the perspective of intestinal flora.

With the rapid development of computing methods and computing power, the ability of artificial intelligence in problem modelling and analysis has been improved rapidly. Artificial intelligence has been gradually introduced into the field of medical care and nursing, and played an important role in assisting medical care and nursing. This paper mainly discusses the progress of artificial intelligence technology in nursing, and analyzes the existing problems and challenges, in order to provide new ideas for artificial intelligence in supporting the development of nursing more effectively.

Objective:To investigate the effect of Roy adaptation model-based intervention on fatigue and posttraumatic growth in patient with malignant lymphoma during chemotherapy.Methods:A total of 110 malignant lymphoma patients who undergoing chemotherapy were randomly divided into study group and control group, with 59 cases in each group. The control group received routine nursing method, the study group carried out Roy adaptation model-based intervention. The post-traumatic growth inventorynventory (PTGI) and the revised piper fatigue scale (PFS-R) was evaluated the effect of intervention, respectively.Results:Before and after chemotherapy, the new possibilities, relating to others, personal strength, appreciation of life, spiritual change and total PTGI scores were (8.90±1.00), (17.27±3.66), (15.11±2.63), (15.23±4.19), (4.16±0.87), (60.45±6.49) and (9.64±1.38), (21.49±4.43), (17.78±4.17), (19.31±5.82), (4.95±0.89), (73.16±8.85), in addition, those index scores in the control group were [(8.74±1.40), (17.13±3.86), (15.46±3.55), (15.80±2.81), (4.26±1.15), (61.43±6.93) and (9.14±1.86), (18.44±4.31), (16.34±2.77), (17.97±3.18), (4.74±1.07), (66.63±6.68)]. There was no significant difference in PTGI scores between study group and control group ( P>0.05), however, relating to others, personal strength and total PTGI scores were significantly increased in the study group compared to the control group ( P<0.05). Before and after chemotherapy, the sensory, emotional, knowledge, behavioral and total PFS-R scores were (5.68±0.82), (4.80±1.06), (4.27±0.81), (4.16±0.47), (5.05±0.74) and (2.43±0.73), (4.27±0.61), (2.44±0.45), (4.07±0.73), (3.89±0.77), in addition, those index scores in the control group were [(5.73±1.23), (4.85±0.64), (4.37±0.74), (4.17±0.38), (4.98±0.82) and (4.48±0.72), (4.90±0.75), (3.45±0.53), (4.23±0.81), (4.60±0.57)]. There was no significant difference in PFS-R scores between study group and control group ( P>0.05), however, sensory, emotional, knowledge and total PFS-R scores were significantly decreased in the study group compared to the control group ( P<0.05). Conclusion:Roy adaptation model-based intervention can effectively alleviate fatigue and promote post-traumatic growth in patient with malignant lymphoma during chemotherapy.

Objective: To analyze the clinical efficacy and pregnancy outcomes of fertility- preserving re-treatment in patients with recurrent atypical endometrial hyperplasia (AEH) and early stage endometrial carcinoma (EEC) after achieved complete remission (CR) of primary fertility-preserving therapy. Methods: There were 104 cases of AEH and EEC collected from 9 hospitals in the multi-center research network platform of fertility-preserving therapy of endometrial carcinoma in China from January 2005 to May 2019. Thirth-one cases of them relapsed from four hospitals mentioned above,who achieved CR after primary fertility-preserving therapy,was analyzed retrospectively. Of the 31 cases, 27 cases chose fertility-preserving re-treatment. The demographic characteristics, re-treatment effect, clinical factors and pregnancy outcomes were observed. Results: (1) There were 16 AEH cases and 11 ECC cases among 27 recurrent patients who chose fertility-preserving therapy again. After re-treatment, CR was found in 13 out of 16 cases of AEH and 9 out of 11 cases of EEC. The overall CR rate was 81% (22/27). (2) After CR of recurrence, 5 cases (23%, 5/22) of re-recurrence were found after with a median time of 33 months (range 21-80 months). There were 4 cases underwent comprehensive surgical staging, and 1 patient chose the third round of fertility preservation therapy with fully informed consent, and CR was reached after 15 months. (3) There were 16 cases with pregnancy intention, with a total of 12 pregnancies, including 5 cases were natural pregnancy and 7 cases were assisted reproductive technology pregnancy. There were 5 live births. The follow-up time was up to May 2019, and the median follow-up time was 73 months (range 0-123 months). All 27 patients had disease free survival. Conclusions Recurrent patients with AEH and EEC after achieving successful fertility-preserving therapy could choose fertility-preserving therapy again with comprehensive assessment and fully informed consent. After re-treatment, there is a certain tumor CR rate and pregnancy rate, while the close follow-up is required during treatment.

No abstract available.
Gynecology* ; Obstetrics*

Objective: To investigate the relationship between workplace bullying and posttraumatic stress disorder (PTSD) in nursing staff, and to analyze the role of psychological capital between workplace bullying and PTSD. Methods: From December 2014 to June 2015, convenience sampling was used to collect 496 nurses from 5 grade A tertiary hospitals in a province of China. Their workplace bullying, psychological capital, and PTSD status were assessed using the Negative Acts Questionnaire, Psychological Capital Questionnaire, and Posttraumatic Stress Disorder Self-Rating Scale, respectively. The correlation between variables was analyzed using a structural equation model. Results: Among these nurses, the scores of negative acts, psychological capital, and PTSD were 37.15±12.83, 78.81±16.54, and 34.56±12.52, respectively. The score on each dimension of negative acts was positively correlated with that on each dimension of PTSD (P<0.01) ; the score on each dimension of psychological capital was negatively correlated with that on each dimension of PTSD and negative acts (P<0.01). Negative acts had a positive predictive effect on PTSD (β=0.539, P<0.01) , which was reduced after inclusion of psychological capital (β=0.513, P<0.01). The path coefficient was 0.62 for the effect of negative acts on PTSD, -0.18 for the effect of negative acts on psychological capital, and -0.11 for the effect of psychological capital on PTSD (P<0.05) . Conclusion Workplace bullying is a predictive factor for PTSD, and psychological capital plays a mediating role between workplace bullying and PTSD. The manager should reduce workplace bullying to improve the psychological capital in nursing staff and to prevent and reduce PTSD.

Objective To explore the relationship between posttraumatic stress disorder and nurses′ psychological capital. Methods By convenient sampling, totally 550 nurses in 5 first-class upper level general hospitals in Zhejiang province were investigated by the posttraumatic stress disorder (PTSD)Cheeklist-Civilan Version (PCL-C) and Nurses Psychological Capital Questionnaire Revision (NPCQR), and the results were analyzed. Results 18.35%investigated nurses showed a certain degree of PTSD symptoms and 13.71% showed obvious PTSD symptoms. The positive rate was 32.06%.The overall score of nurses′psychological capital was 78.81 ± 16.54, which was in the middle level, and the dimension scores from high to low were self-efficacy (23.80±5.35), hope (23.36±5.24), resilience (19.66 ±4.29), and optimism (11.99 ± 3.21). The nurses′psychological capital had a negative effect on posttraumatic stress disorder (P<0.01). Conclusions Psychological capital of nurses is a negative predictor of PTSD symptoms, which suggested that managers should pay more attention to the development of nurses′psychological capital to reduce and prevent the occurrence of posttraumatic stress disorder,then to improve nursing service quality.

BACKGROUND: A simple use of antibiotic drugs as anti-infection therapy after joint replacement is not enough for subsequent debridement and secondary revision surgeries. Therefore, our team intended to confirm the feasible use of controlled-release microspheres in the local anti-infection treatment.OBJECTIVE: To prepare the Human beta defense 3 (HBD-3)/poly(lactic-co-glycolic acid) (PLGA) micro-spheres and to investigate the microsphere physicochemical properties and drug release profile in vitro.METHODS: With PLGA as a carrier,HBD-3/PLGA controlled-release microspheres were prepared by using double emulsion-solvent evaporation method. Scanning electron microscopy was used to observe its surface morphology.The size of each microsphere was accurately determined using scaleplate. Drug loading capacity and encapsulation efficiency of HBD-3/PLGA controlled-release microspheres were calculated using spectrophotometer. HBD-3/PLGA microsphere controlled-release time was determined in order to analyze the drug release profile of the microsphere. RESULTS AND CONCLUSION: The HBD-3/PLGA controlled-release microsphere possessed smooth surface, uniform distribution and good liquidity.The average particle size was 219.49 nm, the drug loading capacity of HBD-3 was (20.67±0.17)% and the encapsulation efficiency was (54.52±1.31)%. The cumulative release percentage of HBD-3 was(74.12±0.43)%. The HBD-3/PLGA controlled-release microsphere has well controlled-release performance in vitro. In theory, the purpose of antibacterial controlled-release can be achieved,laying a foundation for subsequent animal antibacterial experiments.