Ferroptosis is a way of cell death with lipid peroxides as the core.Cells can reduce ferroptosis sensitivity by relying on glutathione peroxidase 4(GPX4)/glutathione(GSH)antioxidant systems.Triple-negative breast cancer(TNBC)cells are more dependent on the intracellular antioxidant mechanism than normal cells,thus induction of ferroptosis based on the GPX4/GSH system has shown bright anti-TNBC prospects.This paper reviews the recent research on TNBC treatment with ferroptosis in the background of GPX4/GSH,in order to provide references for the clinical treatment of TNBC.

Objective:To compare and analyze the efficacy and safety of intraoperative radiotherapy (IORT) combined with conventional therapy (surgery combined with radiochemotherapy) and conventional therapy alone for pancreatic cancer.Methods:Literature review was conducted from PubMed, Cochrane Library, Web of Science, Embase, Chongqing VIP, CNKI, Wanfang Data and China Biomedical Literature Service System (SinoMed). The literatures that met the inclusion criteria were screened and the data were extracted. Meta-analysis was carried out by RevMan 5.4 software.Results:A total of 11 studies consisting of 813 patients were included. According to the combined results, compared with conventional therapy, IORT combined with conventional therapy could improve the overall survival rate of pancreatic cancer ( HR=0.66, 95% CI=0.54-0.81, Z=4.03, P<0.001), and did not increase the treatment-related side effects ( OR=1.00, 95% CI=0.69-1.46, Z=0.01, P=0.99), but failed to bring benefit to the local control rate ( HR=0.56, 95% CI=0.31-1.01, Z=1.93, P=0.05). Conclusions:The overall survival rate in the IORT combined with conventional therapy group is significantly better than that in the conventional therapy group. No significant difference is found in the treatment-related adverse reactions between two groups. IORT combined with conventional therapy is worthy of clinical application.

Objective:To investigate the efficacy and safety of daratumumab in relapsed and refractory multiple myeloma (RRMM).Methods:The efficacy and adverse events (AEs) of daratumumab based regimens were retrospectively analyzed in 37 patients with RRMM from Peking University People′s Hospital, Beijing Hospital and Fu Xing Hospital affiliated to Capital Medical University in China. The deadline for inclusion was December, 2019.Results:Among the 37 patients, 35 patients were available for response evaluation. The overall response rate (ORR) was 68.6%, which was better in patients receiving 16 mg/kg daratumumab than in those with fixed doses of 800 mg daratumumab [ORR: 78.3%(18/23) vs. 40.0%(4/10)]. The percentage of infusion related reactions of daratumumab was 27.0%(10/37). The most common hematological AEs were lymphocytopenia and thrombocytopenia, with the incidences of grade 3 or more severe 59.5%(22/37) and 43.2%(16/37) respectively. Pulmonary infections(37.8%, 14/37) were the most common non-hematological AEs. One patient with positive hepatitis B surface antigen (HBsAg) and two patients dependent on dialysis were safely treated with daratumumab.Conclusion:Daratumumab is highly effective in relapsed and refractory multiple myeloma. Adverse reactions are mild and well tolerable.

Amniotic fluid embolism(AFE) is a fatal intrapartum complication. Typical AFE is characterized by respiratory and circulatory failure, followed by disseminated intravascular coagulation(DIC), while atypical AFE, which had a higher survival possibility, presents with unexplained DIC only. Recent findings support an anaphylactoid inflammatory mechanism underlying the pathophysiology of AFE. Milrinone is currently the first choice for AFE due to its several functions, such as reducing pulmonary artery pressure, and improving right ventricular function through lowering heart rate and positive inotropic action. A multidisciplinary team is required in the rescue of AFE and medical staff who are skilled in critical medicine (such as anesthesiologists) often play a pivotal role.

Objective To evaluate the risk factors and sonographic findings of pregnancies complicated by placenta increta or placenta percreta. Methods Totally, 2219 cases were retrospectively analyzed from 20 tertiary hospitals in China from January 2011 to December 2015. The data were collected based on the original case records. All cases were divided into two groups, the placenta increta (PI) group (79.1％, 1755/2219) and the placenta percreta (PP) group (20.9％, 464/2219), according to the degree of placental implantation. The risk factors and sonographic findings of placenta increta or percreta were analyzed by uni-factor and logistic regression statistic methods. Results The risk factors associated with the degree of placental implantation were age, gravida, previous abortion or miscarriage, previous cesarean sections, and placenta previa (all P<0.05), especially, previous cesarean sections (χ2=157.961) and placenta previa (χ2=91.759). Sonographic findings could be used to predict the degree of placental invasion especially the boundaries between placenta and uterine serosa, the boundary between placenta and myometrium, the disruption of the placental-uterine wall interface and loss of the normal retroplacental hypoechoic zone(all P<0.01). Conclusions Previous cesarean sections and placenta previa are the main independent risk factors associated with the degree of placenta implantation. Ultrasound could be used to make a prenatal suggestive diagnosis of placenta accreta spectrum disorders.

Microsphere as a drug delivery system with broad prospect for development and application has always been a research focus in pharmaceutics for its. Though literature survey of related papers published in domestic and foreign journals by Chinese authors in 2016, the research advances of materials of microspheres, which can be divided into natural polymer materials, synthetic polymer materials and inorganic materials, were summarized. Microsphere products at home and abroad were also analyzed. This review will provide some reference for correlative researchers.

OBJECTIVE:To reduce the incidence of irrational medical orders for parenteral nutrition,and promote the rational use of parenteral nutrition. METHODS:The medical orders for parenteral nutrition of the first quarter of 2016 in general surgery de-partment of our hospital were collected,and the number and types of its irrational medical orders were summed up. Then FO-CUS-PDCA(Find-organize-clarify-understand-select-plan-do-check-act)cycle management was adopted to analyze and improve the existing problems in issuing medical orders for parenteral nutrition. The improved(the third quarter of 2016)medical orders for par-enteral nutrition were collected,the number and types of its irrational medical orders were summed up,and management effect was evaluated. RESULTS:Establishing nutrition support group,strengthening the training and communication of medical staff,adding prescription evaluation module for parenteral nutrition in hospital information system and a number of measures had made the inci-dence of irrational medical orders for parenteral nutrition in general surgery department declined from 48.25%(1433/2970)before improvement to 5.67%(120/2118)after improvement. The incidences of cation excess,inappropriate selection of drugs and inap-propriate compatibility in irrational types were 0. CONCLUSIONS:FOCUS-PDCA cycle management can reduce the irrational rate of medical orders for parenteral nutrition and promote the rational use of parenteral nutrition in hospital.

Objective To introduce the development strategy of“Internet Plus”AIDS prevention services and its implementation results from 2010 to 2015 in Guangzhou, China. Methods A gay men's health column was created for an active website aimed at men who have sex with men (MSM), in collaboration with local community organizations and the Guangzhou CDC. We designed intervention tools (including scenario-based applications and HIV risk self-assessment systems) and an online HIV testing service platform, integrated with applied psychology and behavioral theory as well as the“Internet Plus”concept, to intervene in HIV infection risk factors among MSM. Data of clients who accessed the“Internet Plus”AIDS services from 2010 to 2015 were used to evaluate service operation. Six-year consecutive surveys, conducted between April and July of each service year, were collected using a national AIDS sentinel surveillance questionnaire. For each year of surveillance, information on HIV prevalence, HIV interventions received during the past year, unprotected anal intercourse in the past 6 months, and HIV testing in the past year were compared using the chi-squared (χ2) test, to roughly reflect the effect of“Internet Plus”AIDS prevention services. Results As of 31 December 2015, a total of 34 395 MSM had received“Internet Plus”services and HIV testing. The number of MSM tested increased from 2 338 in 2010 to 8 054 in 2015. From 2010 to 2015, newly identified HIV cases in each year were 59, 166, 312, 283, 291, and 270, which accounted for 25.0%, 32.8%, 38.8%, 35.1%, 30.5%, and 23.2% of MSM HIV cases of Guangzhou, respectively. Sentinel surveillance data showed that during the study period, 3 047 MSM were investigated, with 405, 400, 401, 633, 608, and 600 each year, respectively. The proportion of participants who had received any HIV intervention during the past year was 74.3% (301), 70.8% (283), 83.3% (334), 85.0%(538), 69.1%(420), and 83.8%(503) each year, respectively (trend χ2=6.53, P=0.011). HIV testing done during the past year accounted for 44.0%(178), 44.3%(177), 49.4%(198), 53.4%(338), 56.1%(341), and 60.2%(361) each year, respectively (trendχ2=40.83, P<0.001). Unprotected anal intercourse in the past 6 months accounted for 59.3% (240), 62.0% (248), 56.6% (227), 57.0% (361), 48.4% (294), and 43.7%(262) each year, respectively (trend χ2=42.21, P<0.001). Conclusion The“Internet Plus”AIDS prevention services in this study represent a manner to enhance traditional HIV prevention strategies. We found these services to be effective in implementation of the national AIDS control and prevention strategy, especially for the expansion of intervention, testing, and case identification among high-risk populations.

Objective To introduce the development strategy of“Internet Plus”AIDS prevention services and its implementation results from 2010 to 2015 in Guangzhou, China. Methods A gay men's health column was created for an active website aimed at men who have sex with men (MSM), in collaboration with local community organizations and the Guangzhou CDC. We designed intervention tools (including scenario-based applications and HIV risk self-assessment systems) and an online HIV testing service platform, integrated with applied psychology and behavioral theory as well as the“Internet Plus”concept, to intervene in HIV infection risk factors among MSM. Data of clients who accessed the“Internet Plus”AIDS services from 2010 to 2015 were used to evaluate service operation. Six-year consecutive surveys, conducted between April and July of each service year, were collected using a national AIDS sentinel surveillance questionnaire. For each year of surveillance, information on HIV prevalence, HIV interventions received during the past year, unprotected anal intercourse in the past 6 months, and HIV testing in the past year were compared using the chi-squared (χ2) test, to roughly reflect the effect of“Internet Plus”AIDS prevention services. Results As of 31 December 2015, a total of 34 395 MSM had received“Internet Plus”services and HIV testing. The number of MSM tested increased from 2 338 in 2010 to 8 054 in 2015. From 2010 to 2015, newly identified HIV cases in each year were 59, 166, 312, 283, 291, and 270, which accounted for 25.0%, 32.8%, 38.8%, 35.1%, 30.5%, and 23.2% of MSM HIV cases of Guangzhou, respectively. Sentinel surveillance data showed that during the study period, 3 047 MSM were investigated, with 405, 400, 401, 633, 608, and 600 each year, respectively. The proportion of participants who had received any HIV intervention during the past year was 74.3% (301), 70.8% (283), 83.3% (334), 85.0%(538), 69.1%(420), and 83.8%(503) each year, respectively (trend χ2=6.53, P=0.011). HIV testing done during the past year accounted for 44.0%(178), 44.3%(177), 49.4%(198), 53.4%(338), 56.1%(341), and 60.2%(361) each year, respectively (trendχ2=40.83, P<0.001). Unprotected anal intercourse in the past 6 months accounted for 59.3% (240), 62.0% (248), 56.6% (227), 57.0% (361), 48.4% (294), and 43.7%(262) each year, respectively (trend χ2=42.21, P<0.001). Conclusion The“Internet Plus”AIDS prevention services in this study represent a manner to enhance traditional HIV prevention strategies. We found these services to be effective in implementation of the national AIDS control and prevention strategy, especially for the expansion of intervention, testing, and case identification among high-risk populations.

Objective The investigation was done in one level three class A cancer hospital in Henan province to understand the nurses′master level of cancer pain and whether nurse have the right concept of cancer pain management. Methods Through cluster sampling, self-designed nurses pain knowledge questionnaire was used to investigate 580 nurses for the master level of cancer hospital in a level three class A cancer hospital in Henan province. Results Among 580 nurses, the cancer related knowledge investigation score were 318 nurses acquired excellent (54. 8%), 27 nurses acquired pass (35. 7%) and 55 nurses obtained fall (9. 5%). There were 373 nurses ( 64. 34%) understood the cancer three stages pain management plan. The nurse′s ages, occupational titles and work experiences of cancer nursing had positive correlation with the score of cancer related knowledge (r=0. 211, 0. 268, 0. 207;P<0. 01). Conclusions At present, the cancer hospital nurse′s master of knowledge related cancer pain is not enough, so we should enhance nurse′s pain related knowledge level, establish the correct concept of pain management, promote cancer patient′s quality of life by the continuous study and updated concept, knowledge and practice, so as to meet the demands of clinical.