Objective To establish an optimal limiting dose for dose limiting rings placed in the anterior and posterior regions of the neck for reducing head and neck lymphedema under intensity-modulated radiation therapy(IMRT)for early nasopharyngeal carcinoma(NPC)from a dosimetric perspective.Method Fifteen newly diagnosed early-stage nasopharyngeal carcinoma patients who underwent CT localization for radiotherapy at the Cancer Hospital of Guangzhou Medical University from January to September 2022 were included in the study.Each case was designed with five sets of radiotherapy plans.Plan A consisted of conventional unlimited-field plans,while Plans B-E consisted of limited-field plans with dose constraints set at 20,18,16,and 14 Gy,respectively,with the remaining parameters consistent with Plan A.The impact on target coverage and organ-at-risk constraints was evaluated through variance analysis and pairwise multiple comparisons using a randomized block design to determine the optimal dose limits.Results The gradient of 16Gy was determined as the optimal dose limiting cutoff point for achieving the balance between target coverage and organ limiting dose.Compared with the conventional plan,The plans with the placement of a cervical anterior and posterior dose limiting ring(16Gy)did not change the target dose coverage(P>0.05),but only yielded a slight change in the homogeneity index(P<0.05).It did not cause any changes of the dosage in the inner ear,mandible,and brainstem(all P>0.05),but lead to statisti-cally significant reductions in the oral cavity,throat,and thyroid(all P<0.05).It caused a slight increase of the dose in the parotid gland and spinal cord(both P<0.05),but the increased dose was anyhow within the tolerance range.Conclusion The dosimetric investigation determines an optimal dose limit cutoff point for the cervical ante-rior and posterior dose limiting rings.It is expected to provide a design method for IMRT plans to reduce head and neck lymphedema after radiotherapy for early NPC.

Objective:To explore the differences in the clinical application of different brands of infrared ear thermometers in pediatric patients,and to guide the rational use of infrared ear thermometers.Methods:A total of 164 inpatients and outpatients who received treatment in the Children's Hospital of Zhejiang University School of Medicine from May 2023 to July 2023 were randomly selected,and three different brands of ear thermometers were used to measure the ear temperature of the children in the same measurement method.The differences in temperature and time measured by different brands of ear thermometers in children of different ages were compared.Results:The temperature and time measurements of the three ear thermometers were compared,the difference was statistically significant(F=5.007,264.988,P<0.05).The temperature of children aged≤3 months was measured by the three ear thermometers,and the difference was statistically significant(F=3.868,P<0.05).there was no difference in children aged over 3 months.Conclusion:For children of different ages,medical institutions can make choices based on the comprehensive consideration of the use cost,the speed of measurement time and other factors.For children aged over 3 months,choose product B with lower cost and faster measurement time,for children aged 0-3 months,it is recommended to choose product A with more accurate temperature measurement values.

Based on cognitive psychology, the business attributes of port health quarantine, the requirements for team building, the current status of skill training. This article proposes to strengthen the training of port health quarantine skills. Under the guidance of medical licensing examination for public health, it is recommended to enhance the construction of a standardized skill training practice system, establish a basic skill training center and a field operation training site, develop new skill training courses, innovate skills training and teaching methods, and build a team of high-quality skill training teachers, thereby constructing a standardized skill training and practice system for port health quarantine. The preliminary establishment of the skill training system for port health quarantine at Huangpu Customs shows the feasibility and effectiveness of the construction of skill training and practice system.

At present, acellular matrix is an effective replacement material for the treatment of skin damage, but there are few systematic evaluation studies on its performance. The experimental group of this study used two decellularization methods to prepare the matrix: one was the acellular matrix which sterilized with peracetic acid first (0.2% PAA/4% ethanol solution) and then treated with hypertonic saline (group A), the other was 0.05% trypsin/EDTA decellularization after γ irradiation (group B); and the control group was soaked in PBS (Group C). Then physical properties and chemical composition of the three groups were detected. Hematoxylin eosin (HE) staining showed that the acellular effect of group B was good. The porosity of group A and B were both above 84.9%. In group A, the compressive modulus of elasticity was (9.94 ± 3.81) MPa, and the compressive modulus of elasticity was (12.59 ± 5.50) MPa in group B. There was no significant difference between group A or B and group C. The total content of collagen in acellular matrix of group A and B was significantly lower than that of group C (1. 662 ± 0.229) mg/g, but there was no significant difference in the ratio of collagen Ⅰ/Ⅲ between group B and group C. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) showed that there was no significant difference in microstructure. Qualitative detection of fibronectin and elastin in each group was basically consistent with that in group C. Therefore, acellular matrix of group B had better performance as scaffold material. The experimental results show that the acellular matrix prepared by γ-ray sterilization and decellularization of 0.05% Trypsin enzyme/EDTA could be used for the construction of tissue-engineered skin. It could also provide reference for the preparation and mounting of heterogeneous dermal acellular matrix. It was also could be used for electrostatic spinning or three-dimensional printed tissue engineered skin scaffold which could provide physical and chemical parameters for it.
Acellular Dermis ; Cells, Cultured ; Extracellular Matrix ; Porosity ; Tissue Engineering ; Tissue Scaffolds

OBJECTIVE：To esta blish a UPLC fingerprint of Pyrrosia petiolosa from southwest China ，and to determine the contents of 4 kinds of phenolic acids （neochlorogenic acid ，caffeic acid ，chlorogenic acid and cryptochlorogenic acid ）. METHODS：The determination was performed on Waters Cortecs T 3 C18 column（100 mm×2.1 mm，1.6 μm）with mobile phase consisted of methanol- 0.1％ phosphoric acid （gradient elution ）at the flow rate of 0.35 mL/min. The detection wavelength was set at 326 nm. The column temperature was 30 ℃，and injection volume was 1 μL. UPLC method was used to establish the UPLC fingerprint of P. petiolosa in combination with the Similarity Evaluation System of TCM Chromatographic Fingerprints （2012 edition）. Cluster analysis and principle component analysis （PCA）were performed by using SPSS 20.0 software. The contents of 4 kinds of phenolic acids in 20 batches of P. petiolosa were determined by external standard method. RESULTS ：There were 9 common peaks for the UPLC fingerprint of P. petiolosa . Peaks 1，3，4，5 and 9 were identified as neochlorogenic acid ，caffeic acid，chlorogenic acid ，cryptochlorogenic acid and isochlorogenic acid C ，respectively. RSDs of the relative retention time of each peak in different batches of P. petiolosa were 0-0.68％，and the RSDs of the relative peak area were 0-62.35％. The similarities between the fingerprint of 20 batches of medicinal materials and the control chromatogram were not less than 0.990. The result of cluster analysis showed that P. petiolosa from different regions could be sorted into three species. Results of PCA showed the differences among P. petiolosa from different regions. The linear range of neochlorogenic acid ，caffeic acid ，chlorogenic acid and cryptochlorogenic acid were 0.61-61.41，0.18-17.60，2.00-200.11，0.62-61.51 μ g/mL （R2＞0.999 9）. RSDs of precision ， reproducibility and stability tests were all lower than 2.00％. The recoveries were 96.23％-98.17％（RSD＝0.96％-2.28％， n＝6）. Among 20 batches of samples ，the contents of above 4 kinds of phenolic acids were 0.385 3-1.891 9，0.018 0-0.129 5，2.569 5-10.676 0，0.563.5-1.860 5 mg/g. CONCLUSIONS ： The established UPL C fingerprint could reflect the main chemical constituents of P. pedunculata . Phenolic acids could be used as the main evaluation indexes for the quality of P. petiolosa . The quality order of P. petiolosa from southwest China was Chongqing product＞Sichuan product ＞Guizhou product.

OBJECTIVE：To provide reference for the identification of Chebulae Fructus and Chebulae Fructus Immaturus . METHODS：UPLC method was adopted. The determination was performed on Waters Cortecs T 3 C18 column with mobile phase consisted of acetonitrile- 0.2％ phosphoric acid solution （gradient elution ）at the flow rate of 0.35 mL/min. The column temperature was 30 ℃，and the detection wavelength was set at 270 nm. The sample size was 1 μL. Using gallic acid as reference，UPLC fingerprints of 17 batches of Chebulae Fructus and 14 batches of Chebulae Fructus Immaturus were established and their similarity was evaluated by TCM Chromatographic Fingerprint Similarity Evaluation System （2012 edition）. By comparing substance control ， UV absorption spectrum and related literaturs ，common peaks were identified. PCA and PLS-DA were performed by using SPSS 20.0 and SIMCA 14.1 software. The contents of main difference components in Chebulae Fructus and Chebulae Fructus Immaturus were determined by above UPLC method and compared. RESULTS ：There were 8 common peaks in UPLC fingerprint of Chebulae Fructus and Chebulae Fructus Immaturus ，i.e. chebulic acid （peak 1），gallic acid （peak 2），punicalagin A （peak 3），punicalagin B （peak 4），corilagin（peak 6），chebulagic acid （peak 7）and chebulinic acid （peak 8）. The similarities of 17 batches of Chebulae Fructus were from 0.92 to 0.99，while 14 batches of Chebulae Fructus Immaturus were all above 0.99. The similarity of control fingerprint between Chebulae Fructus and Chebulae Fructus Immaturus was 0.909. PCA demonstrated the differences between Chebulae Fructus and Chebulae Fructus Immaturus . The results of PLS-DA were consistent with those of PCA ，and the variable importance in projection （VIP）values of peak 5，4，7，3 and 2 were above 1 in the PLS-DA model. In 31 batches of samples ，the contents of gallic acid （peak 2），punicalagin A（peak 3），punicalagin B （peak 4）and chebulagic acid （peak 7）were 2.63-10.31， 5.37-44.63，8.02-60.77，44.07-162.98 mg/g；RSDs were 40.14％， 47.91％ ，53.97％ ，36.22％（n＝31）. There was statistical significance in the differences of the mentioned 4 components between Chebulae Fructus and Chebulae Fructus Immaturus 719412818@qq.com （P＜0.05）. CONCLUSIONS ：There are significant differences between Chebulae Fructus and Chebulae Fructus Immaturus gallic acid ，punicalagin A ，punicalagin B and chebulagic acid are the main difference components for identification.

Objective To assess the drug sensitivity of pancreatic cancer cells based on real-time cell analysis and provide a reference for individualized diagnosis and treatment of pancreatic cancer.Methods Three human pancreatic cancer cells lines SW1900, Capan-2 and PANC-1 were selected and treated with gemcitabine hydrochloride and tegafur gimeracil oteracil potassium capsules, respectively.After 24 hours of culture, the cells were treated with the two drugs in gradient concentration.The cell growth curves before and after the drug administration was monitored using a real-time cells analyzer and the growth inhibition rates (IC50) of the drugs of the pancreatic cancer cells were calculated.At the same time, the cells in the cell culture plate were treated with the drug, and acridine orange/ethidium bromide (AO/EB) staining and laser scanning confocal microscopy were performed to observe the changes of cells after the drug administration.Results 72 hours after the drug administration, IC50 values for the three cell lines were different.The IC50 values of gemcitabine hydrochloride for SW1900, Capan-2 and PANC-1 cells were 1.69 μmol/L, 10.05 μmol/L and 12.74 μmol/L, respectively.The IC50 values of tegafur capsule for SW1900, Capan-2 and PANC-1 cells were 180.29 μmol/L, 765.70 μmol/L and 95.57μmol/L, respectively.AO/EB staining confirmed the reliability of IC50.Conclusions SW1900 and Capan-2 cells can be used as the control for gemcitabine hydrochloride and tegafur gimeracil oteracil potassium capsules to establish cell models for drug screening in vitro, which provides a reference for the application of the technology in anticancer drugs screening.

Objective To describe the change of symptoms and quality of life among nasopharyngeal carcinoma patients who undergo radiotherapy, and analyze the correlation between them.Methods A total of 218 nasopharyngeal carcinoma patients who received radiotherapy were included by convenient sampling method and they were asked to finish the questionnaire of general information, Chinese Version of the M.D. Anderson Symptom Inventory(MDASI-C) and Quality of Life Instruments for Cancer Patients-Head and Neck (QLICP-HN) at five time points, which were beginning, intermediate (the volume of radiotherapy at 36-40 Gy), end of radiotherapy, three months and six months after radiotherapy.Results The severity of symptoms at five time points were (1.86±1.75),(3.20±1.75),(3.59±1.81),(0.65±0.59) and (0.52±0.50), presenting decreased gradually first, and then alleviated. The score of symptom severity at five time points were significantly different (F=182.86,P<0.05). Fatigue, appetite loss and dry mouth were the most sever and high-incidence symptoms during and within six months after radiotherapy. The quality scores of life were (65.39±10.90),(58.78±8.77),(57.82±9.20),(79.76±5.75) and( 76.79±4.78) at five time points, representing the same trend as the scores of symptom, and the difference were statistically significan(t F=129.75,P< 0.05). Spearman correlation analysissuggested that there were negative correlation between severity of symptoms and total score of quality of life (P < 0.05). Conclusions The symptoms of nasopharyngeal carcinoma patients exacerbates with dose of radiotherapy increase, and the quality of life is also decreased. Although most of symptoms disappear within six months after radiotherapy, fatigue, appetite loss and dry mouth persisted and influence patients' quality of life.Nurses should pay attention to patients' symptoms when they stay at hospital as well as discharged, and intervention is necessary to improve their quality of life.

Objective To develop a more convenient and stable method for assessment of drug sensitivity of prostate cancer based on real-time cell analysis system as a reference for clinical treatment.Methods Human prostate cancer VCaP, DU145, PC-3, PC-3M-2B4 and PC-3M-IE8 cells were chosen to detect the sensitivity to three drugs, docetaxel, cabazitaxel and abiraterone acetate.Serial dilutions of the three drugs were used to treat the cell culture for 24 hours.The drug-induced effects on the cell lines after an incubation of 24 hours were recorded by the real-time cell analysis system to determine the half maximal inhibitory concentration (IC50).Results Docetaxel showd IC50 of 8.81 nmol/L, 11.61 nmol/L, 1.78 nmol/L, 1.44 nmol/L, 8.69 nmol/L for VCaP, DU145, PC-3, PC-3M-2B4, PC-3M-IE8 cells, respectively.Cabazitaxel showed IC50 of 3.73 nmol/L, 3.96 nmol/L, 10.41 nmol/L, 5.43 nmol/L, and 7.37 nmol/L, respectively, for the five cell lines.Abiraterone acetate showed IC50 of 8.34 μmol/L, 8.60 μmol/L, 24.20 μmol/L, 8.59 μmol/L, and 13.21 μmol/L for the five cell lines.Conclusions PC-3M-2B4 and DU145, VCaP and PC-3 cells can be used as control for docetaxel, cabazitaxel and abiraterone acetate to establish cell models for the drug screening in vitro and to provide reference for clinical applications.

Objective To investigate the dynamic changes of symptom clusters among nasopharyngeal carcinoma patients receiving radiotherapy and provide evidence for intervention clinically.Methods The data were collected at three time points that were before radiotherapy,during the radiotherapy and after radiotherapy, by surveying 273 first visit of nasopharyngeal carcinoma patients from May 201 4 to January 201 5 with a self-designed general information questionnaire and the Chinese version of the M.D.Anderson symptom inventory and observing the changes of symptom clusters in our hospital.One-way analysis of variance and the exploratory factor analysis were applied to observe the incidence of symptoms and the changes of symptom clusters during radiotherapy.Results The statistics revealed that the incidence and intensity of all the symptoms at 3 time points were significantly increased(P <0.05),except the symptom of amnesia.There were 3 symptom clusters among 3 time points,named as gastrointestinal symptom cluster,sickness symptom cluster and somatic symptom cluster,but the composition and the variance were different at different time point.Gastrointestinal symptom cluster was made of nausea and vomiting,adding poor appetite only before radiotherapy.The gastrointestinal symptom cluster was most prominent before radiotherapy.Sickness symptom cluster consisted of drowsiness, numbness symptom before radiotherapy, while it consisted of shortness of breath, numbness, difficulty remembering symptoms in other time.Somatic symptom cluster mainly consisted of pain and fatigue,dry mouth symptom joining it during and after radiotherapy.Conclusions With the treatment of radiotherapy,the incidence and intensity of symptoms are significantly enhanced,and the constitution of symptom clusters is different at different stage.Therefore,it is important for clinical nurses to strengthen dynamic assessment of all symptoms,monitor the changes and composition of symptom clusters,thus establish corresponding management measures to improve patients′quality of life.