Objective To investigate the effect of methamphetamine(METH)on production of cytokines in RAW264.7 cells stimulated by lipopolysaccharide(LPS)and to explore the possible mechanism.Methods To study the effect of METH on the production of cytokines by LPS-stimulated RAW264.7 cells,the cells were divided into five groups:blank control group,LPS stimulation group,and three METH intervention groups at different concentrations(20,100,and 200 μmol/L),which were METH/LPS groups.To study the role of the dopamine D3 receptor(D3R)in the process,the D3R antagonist NGB2904 was used,and there were five groups:blank control group,LPS stimulation group,METH/LPS group,NGB2904/LPS group,and NGB2904/METH/LPS group.Cell viability was determined using the MTT assay.The levels of IL-6,IL-10,and TNF-α in the supernatants were determined using ELISA.The expressions of p-ERK1/2 and ERK1/2 were determined by Western blotting.Results Compared with the blank control group,the LPS stimulation group and the METH/LPS group had significantly increased cell viability,IL-6,IL-10,TNF-α,and ERK1/2 phosphorylation(P＜0.05).Compared with the LPS stimulation group,the METH/LPS group showed no obvious change in cell viability(P＞0.05),but significantly decreased levels of IL-6,IL-10,and ERK1/2 phosphorylation(P＜0.05).The inhibitory effect of METH showed a dose-dependent manner,with the highest inhibitory effect at METH 200 μmol/L.Furthermore,after the D3R antagonist was used,the results showed that compared with the LPS stimulation group,the cell activity was not significantly changed(P＞0.05),but the levels of IL-6,IL-10 and ERK1/2 phosphorylation were significantly decreased in the METH/LPS group and the NGB2904/LPS group(P＜0.05).Compared with the METH/LPS group or the NGB2904/LPS group,the levels of IL-6,IL-10 and ERK1/2 phosphorylation were further decreased in the NGB2904/METH/LPS group(P＜0.05).Conclusion METH might inhibit the phosphorylation of ERK1/2,thereby reducing the production of IL-6 and IL-10 in RAW264.7 cells stimulated by LPS.The immunosuppressive effect of METH is similar to the immune effect when D3R is antagonized.

Objective:To compare the safety, number of lymph nodes removed, rate of lymph node metastasis, and prognosis between proximal gastrectomy (PG) and total gastrectomy (TG) in patients with Siewert types II and III adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, clinical data of patients diagnosed with adenocarcinoma of the esophagogastric junction at Changzhi People's Hospital, affiliated with Changzhi Medical College, between December 2019 and November 2022, were collected. Patients who had received neoadjuvant therapy, had multiple malignant lesions in the stomach, had concomitant malignancies in other organs, had incomplete clinical data, or had been lost to follow-up were excluded. The study cohort comprised 308 patients, 99 in the PG group and 209 in the TG group. To reduce confounding bias, propensity score matching was performed, matching patients for age, sex, body mass index, tumor diameter, and pathological stage in a 1:1 ratio, resulting in 73 patients in each group. The primary outcomes assessed were operative details, number of lymph nodes dissected, rate of lymph node metastasis, postoperative complications, duration of hospital stay, and follow-up and survival outcomes.Results:The PG group had a significantly shorter median operative time than did the TG group (250 vs. 280 minutes, Z = -4.970, P<0.001), with fewer cases of intraoperative blood loss >100 mL (30.1%[22/73] vs. 46.6%[34/73], χ2=4.171, P=0.041), and a smaller number of lymph nodes removed (median 33 vs. 46, Z =-4.774, P<0.001); all of these differences are statistically significant (all P<0.05). Differences between the two groups in postoperative hospital stay and postoperative complications were not statistically significant (both P>0.05). Furthermore, no statistically significant differences were found between the PG and TG groups in the number of lymph nodes dissected or the lymph node metastasis rates at stations No. 1, No. 2, No. 3, No. 4sa, No. 4sb, and No. 7 (all P> 0.05). Among the 209 patients in the TG group, analysis of risk factors for metastasis to distal perigastric lymph nodes (No.4d, No.5, and No.6) showed that patients with tumor diameters ≤4 cm and T1–T3 stage disease had significantly lower rates of metastasis to these lymph nodes than did patients with tumor diameters >4 cm and/or T4 stage disease (0/78 vs. 12/131 [9.2%]); these differences are statistically significant ( P=0.014). The median duration of follow-up for the entire cohort was 26 months. The 3-year overall survival rates for the PG and TG groups were 62.5% and 63.3%, respectively; this difference is not statistically significant (χ 2=0.330, P = 0.565). Multivariate analysis showed that older age ( P = 0.035) and advanced pathological stage ( P = 0.018) were significant independent risk factors that affected overall survival in patients with Siewert type II and III adenocarcinoma of the esophagogastric junction. Conclusions:PG is safe and feasible for patients with Siewert types II and III adenocarcinoma of the esophagogastric junction. The number of lymph nodes dissected and metastasis status were similar in the TG and PG groups.

Objective To investigate the effect of methamphetamine(METH)on production of cytokines in RAW264.7 cells stimulated by lipopolysaccharide(LPS)and to explore the possible mechanism.Methods To study the effect of METH on the production of cytokines by LPS-stimulated RAW264.7 cells,the cells were divided into five groups:blank control group,LPS stimulation group,and three METH intervention groups at different concentrations(20,100,and 200 μmol/L),which were METH/LPS groups.To study the role of the dopamine D3 receptor(D3R)in the process,the D3R antagonist NGB2904 was used,and there were five groups:blank control group,LPS stimulation group,METH/LPS group,NGB2904/LPS group,and NGB2904/METH/LPS group.Cell viability was determined using the MTT assay.The levels of IL-6,IL-10,and TNF-α in the supernatants were determined using ELISA.The expressions of p-ERK1/2 and ERK1/2 were determined by Western blotting.Results Compared with the blank control group,the LPS stimulation group and the METH/LPS group had significantly increased cell viability,IL-6,IL-10,TNF-α,and ERK1/2 phosphorylation(P＜0.05).Compared with the LPS stimulation group,the METH/LPS group showed no obvious change in cell viability(P＞0.05),but significantly decreased levels of IL-6,IL-10,and ERK1/2 phosphorylation(P＜0.05).The inhibitory effect of METH showed a dose-dependent manner,with the highest inhibitory effect at METH 200 μmol/L.Furthermore,after the D3R antagonist was used,the results showed that compared with the LPS stimulation group,the cell activity was not significantly changed(P＞0.05),but the levels of IL-6,IL-10 and ERK1/2 phosphorylation were significantly decreased in the METH/LPS group and the NGB2904/LPS group(P＜0.05).Compared with the METH/LPS group or the NGB2904/LPS group,the levels of IL-6,IL-10 and ERK1/2 phosphorylation were further decreased in the NGB2904/METH/LPS group(P＜0.05).Conclusion METH might inhibit the phosphorylation of ERK1/2,thereby reducing the production of IL-6 and IL-10 in RAW264.7 cells stimulated by LPS.The immunosuppressive effect of METH is similar to the immune effect when D3R is antagonized.

Objective:To compare the safety, number of lymph nodes removed, rate of lymph node metastasis, and prognosis between proximal gastrectomy (PG) and total gastrectomy (TG) in patients with Siewert types II and III adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, clinical data of patients diagnosed with adenocarcinoma of the esophagogastric junction at Changzhi People's Hospital, affiliated with Changzhi Medical College, between December 2019 and November 2022, were collected. Patients who had received neoadjuvant therapy, had multiple malignant lesions in the stomach, had concomitant malignancies in other organs, had incomplete clinical data, or had been lost to follow-up were excluded. The study cohort comprised 308 patients, 99 in the PG group and 209 in the TG group. To reduce confounding bias, propensity score matching was performed, matching patients for age, sex, body mass index, tumor diameter, and pathological stage in a 1:1 ratio, resulting in 73 patients in each group. The primary outcomes assessed were operative details, number of lymph nodes dissected, rate of lymph node metastasis, postoperative complications, duration of hospital stay, and follow-up and survival outcomes.Results:The PG group had a significantly shorter median operative time than did the TG group (250 vs. 280 minutes, Z = -4.970, P<0.001), with fewer cases of intraoperative blood loss >100 mL (30.1%[22/73] vs. 46.6%[34/73], χ2=4.171, P=0.041), and a smaller number of lymph nodes removed (median 33 vs. 46, Z =-4.774, P<0.001); all of these differences are statistically significant (all P<0.05). Differences between the two groups in postoperative hospital stay and postoperative complications were not statistically significant (both P>0.05). Furthermore, no statistically significant differences were found between the PG and TG groups in the number of lymph nodes dissected or the lymph node metastasis rates at stations No. 1, No. 2, No. 3, No. 4sa, No. 4sb, and No. 7 (all P> 0.05). Among the 209 patients in the TG group, analysis of risk factors for metastasis to distal perigastric lymph nodes (No.4d, No.5, and No.6) showed that patients with tumor diameters ≤4 cm and T1–T3 stage disease had significantly lower rates of metastasis to these lymph nodes than did patients with tumor diameters >4 cm and/or T4 stage disease (0/78 vs. 12/131 [9.2%]); these differences are statistically significant ( P=0.014). The median duration of follow-up for the entire cohort was 26 months. The 3-year overall survival rates for the PG and TG groups were 62.5% and 63.3%, respectively; this difference is not statistically significant (χ 2=0.330, P = 0.565). Multivariate analysis showed that older age ( P = 0.035) and advanced pathological stage ( P = 0.018) were significant independent risk factors that affected overall survival in patients with Siewert type II and III adenocarcinoma of the esophagogastric junction. Conclusions:PG is safe and feasible for patients with Siewert types II and III adenocarcinoma of the esophagogastric junction. The number of lymph nodes dissected and metastasis status were similar in the TG and PG groups.

Objective: To explore the status and associated factors of the knowledge and health education needs about child sexual abuse of middle school students by sex, so as to provide a basis for targeted safety education of preventing child sexual abuse. Methods: From June to July 2023, 1 256 junior high school students from 2 middle schools in southern area of Shaanxi Province were selected by a convenience sampling method. A selfdesigned general information questionnaire, Childrens Sexual Assault Cognition Questionnaire, and Health Education Needs Questionnaire were used for questionnaire survey. Group comparisons were conducted using ttests, analysis of variance, and Chisquare tests. Multiple linear regression analysis was used to explore the factors related to cognitive scores of sexual assault, and binary Logistic regression analysis was used to explore the factors related to the willingness of middle school students to receive sexual assault safety education. Results: The correct response rate of the participants for knowledge of sexual assault cognition (CSA) was (80.97±12.09)%. For each item, the correct response rate ranged 46.7%-97.2%. The correct rate (78.98±12.23)% of male students knowledge of CSA was lower than female students (83.17±11.55)% statistically (t=-6.23, P<0.01). The factors influencing the participants knowledge of CSA included gender (β=0.16), mothers occupation (β=0.07) and experience of CSA safety education (β=0.10) (P<0.05). Most students (92.7%) were willing to receive CSA education. Girls (OR=1.72, 95%CI=1.06-2.77) and students who previously received CSA education (OR=6.98, 95%CI=4.44-10.96) had more willingness to receive CSA education (P<0.05). A total of 71.8% of middle school students preferred their parents as educators, while 43.4% of students chose onsite instruction as the preferred method of CSA education. Conclusions Middle school students have a strong willingness to accept CSA safety education. Knowledge of CSA and willingness to receive CSA safety education are related to gender and previous educational experience.

Objective:To investigate the status of transition shock, career adaptation and professional identity among nursing interns, and to explore the mediating effect of professional identity on career adaptation and transition shock.Methods:In February 2022, 500 nursing students from 18 nursing colleges in Henan province and Shaanxi province were selected as the research subjects by convenient sampling method. General data questionnaire, Professional Identity Questionnaire of Nursing Students, Career Adaptability Scale of college students and Chinese version of Transition Impact Assessment Scale of Nursing Undergraduate Interns were used to conduct the questionnaire survey.Results:The career adaptability score of nursing intern was (133.59 ± 22.58); professional identity score was (63.35 ± 14.06); transition impact score was (45.18 ± 10.17). Transition shock was negatively correlated with career adaptation and professional identity ( r=-0.328, -0.484, both P<0.01). Occupational identity had a partial mediating effect on career adaptation and transition shock, accounting for 64.29% of the total effect. Conclusions:The transition shock of nursing interns is at medium level. Nursing educators can reduce the degree of transition shock by improving their professional identity to nursing and their own career adaptation, so as to better adapt to the professional role.

Objective:To evaluate the application effect of task-based teaching combined with formative evaluation in the teaching of Nursing Research. Methods:A total of 56 nursing students from Batch 2016 were selected as the research objects. The task-based teaching method and formative evaluation were applied in the teaching of Nursing Research to guide the students to participate in and complete the whole nursing research process. The changes of students' autonomous learning ability, learning behavior and innovation ability before and after the course were investigated by questionnaires, so as to evaluate the teaching effect. SPSS 24.0 was used for t test and chi-square test. Results:There were significant differences in the scores of students' independent learning ability before the course (90.43±9.45) and that after the course (94.73±9.64) ( t=-11.87, P<0.05), especially in the aspects of information ability, learning and cooperation ability ( P<0.05). There were significant differences in the score of students' innovation ability before the course (73.64±10.12) and that after the course (77.34±12.31) ( t=-3.05, P<0.05), especially in the aspects of innovative thinking ability and innovative practice ability ( P<0.05). In addition, the students' learning behavior also changed significantly, which was manifested in the increased action of preview, review and questioning. Conclusion:Task-based teaching method combined with formative evaluation can improve students' autonomous learning ability, learning behavior and innovation ability.

Objective To carry out the comprehensive simulation and design of experiment teaching in pediatric nursing based on putting the students at the center position and evaluate the teaching effect . Methods Four classes from 6 parallel classes of undergraduate students of nursing major in 2010 Grade were chosen and randomly divided into the control group (n=90) and the experimental group (n=107).The control group received the traditional experiment teaching , and the experimental group received the comprehensive simulation and design of experiment teaching .The score of theoretical test and practical ability were evaluated , and the feeling in the comprehensive simulation and design of experiment teaching was investigated in two students.Results The score of theoretical test was (88.81 ±10.19) in the experimental group, and was (85.12 ±13.14) in the control group, and the difference was statistically significant (t=2.25, P<0.05).The scores of 8 kinds of pediatric nursing comprehensive experimental examination in the experimental group were better than those of the control group .Most students gave affirmation to the comprehensive simulation and design of experiment teaching .Conclusions The comprehensive simulation and design of experiment teaching in pediatric nursing based on putting the students at the center position can improve the students ’ learning effect .

Objective To investigate the abnormal expressions of immunoglobulin light chains kappa(Igκ)and Lambda(Igλ)in malignant tumors.Methods The concentrations of the Igκ and Igλ in serum were measured by rat nephelometry in 60 cases of malignant tumors and 15 cases of healthy people.Results The liver tumor patients had a higher concentration of Igκ and Igλ in serum than normal people(P＜0.01).There wre not significant differences between the levels of Igκ,Igλ and κ/λ ratio in the stomach tumor,lung tumor,proctologic/colonic tumor,mammary tumor,oesophagus tumor and normal peoples(P＞0.05).Conclusion The measurment of Igκ,Igλ and κ/λ ratio in serum would be helpful for the diagnosis of the liver tumor.By continous observation with Igκ,Igλ and κ/λratio in serum could predict the development of disease.