Objective To analyse the concept of subjective financial distress in cancer patients.Methods Papers in regarding the subjective financial distress were retrieved from the databases such as China National Knowledge Infrastructure(CNKI),Wangfang Database,PubMed,Cochrane Library,Web of Science,CINAHL,and Embase from the inceptions to 16th October,2022.Walker and Avant's concept analysis was performed to analyse the acquired articles.Results A total of 48 articles were retrieved and included in the study.Walker and Avant's concept analysis showed that the subjective financial distress in the patients was subject to the 3 defining attributes:perceived economic risk,coping behaviours,and negative emotional reactions.The antecedents of this distress included individual factors,disease and treatment factors,and social factors.The consequences of them were the increase in negative health behaviours and poorer quality of life.Conclusions The attributes,antecedents and consequences of subjective financial distress,as identified through the conceptual analysis,can serve as a reference for subsequent researches.In future studies,it would be beneficial by further exploring the connotation by considering China's healthcare system.

Financial toxicity is widely present among caregivers of cancer patients and has adverse effects on the health outcomes of patients and their caregivers. This article reviews the relevant concepts, current status and impacts, evaluation tools, influencing factors, and interventions of financial toxicity of caregivers for cancer patients, aiming to provide a basis for the research on financial toxicity of caregivers for cancer patients.

This paper is to clarify the concept of caregiver mutuality,introduce the main measuring tools of caregiver mutuality,analyze its influencing factors and its impact on caregivers. It elaborates the intervention measures of caregiver mutuality,in order to provide basis for better research.

Objective:To explore the mutuality among main caregivers of pancreatic cancer patients with surgery, and its correlations with the perceived social support and resilience.Methods:From March to July 2019, this study selected 150 main caregivers of pancreatic cancer patients with surgery of the First Affiliated Hospital with Nanjing Medical University as subjects by convenience sampling. All of patients were investigated with the General Information Questionnaire, the Mutuality Scale (MS) , Perceived Social Support Scale (PSSS) and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) . A total of 150 questionnaires were sent out and 144 valid of them were collected.Results:Among 144 main caregivers of pancreatic cancer patients after surgery, the total average score of MS was (2.75±0.73) . Pearson correlation analysis results showed that the mutuality of main caregivers had positive correlations with the perceived social support and resilience with statistical differences ( P<0.05) . Hierarchical regression analysis showed that the genders, income, perceived social support and resilience went into the regression equation; except for the general information, the perceived social support and resilience could explain 24.5% of the variation. Conclusions:Main caregivers of pancreatic cancer patients with surgery have the above medium level of mutuality which has close correlations with the perceived social support and resilience. Medical staff should pay attention to maintaining the positive relations between caregivers and patients so as to promote the physical and mental health of caregivers.

Objective:To systematically evaluate and summarize the real care experience of family caregivers of pancreatic cancer patients.Methods:We searched The Cochrane Library, Joanna Briggs Institute (JBI) , PubMed, Embase, Institute for Scientific Information (ISI) Web of Science, PsycINFO, CINAHL, China Biology Medicine, China National Knowledge Infrastructure (CNKI) and VIP databases through computer systems to collect qualitative studies on care experience of family caregivers of patients with pancreatic cancer, and the search time was from the database establishment to October 2019. With reference to the Critical Appraisal Tool of Australian JBI Evidence-based Health Care Center (2016) for qualitative research, the collection integration method was used to integrate the existing conclusions.Results:A total of 7 literatures were included, and 44 complete and defined findings were extracted. The similar results were summarized into 10 new categories, and were combined into two integrated results including that the family caregivers of patients with pancreatic cancer experienced self-adjustment and showed positive feelings and responses during care, and they still faced difficulties and challenges in care which affecting their life trajectory.Conclusions:Family caregivers of patients with pancreatic cancer have both negative and positive experiences throughout the care process. Medical staff should be committed to promoting the growth of the personal role of caregivers, adapting and coping, and addressing the existing unmet needs.

With the development of minimally invasive surgery, many open surgery has been replaced by intracavity surgery. In laparoscopic surgery, an electric fibroid morcellator must be used to remove large tissue specimens from a small abdominal incision. Of course, there are some complications in the use, in order to follow the principle of no tumor, the doctor used the laparoscopic pouch in clinical operation to reduce the risk of spreading potential tumor tissue. There are various kinds of pouches, which are classified according to their existing state before use, it can be classified into two categories:overlapping and non-overlapping. The advantages and disadvantages of different bags and pockets are also analyzed. It provides a theoretical basis for technological innovation and equipment improvement.
Laparoscopy ; instrumentation ; Minimally Invasive Surgical Procedures

Objective To investigate CT and MRI findings of primary malignant fibrous histiocytoma (MFH)in the kidney. Methods The clinical data and imaging findings of 7 patients with primary renal MFH proved by histopathology were reviewed retrospectively.Results Tumors were unilateral in all patients,in which 5 cases were in the left kidney and 2 cases in the right kidney.The maximum diameter of the lesions ranged from 3.5 to 17.1 cm,with a mean of (8.7±3.9)cm.All the masses showed shallow lobulated or oval, with obscure boundary.On CT plain scan,heterogeneous isodensity/hypodensity were showed in 7 cases,necrosis occured in 7 cases, intratumoral hemorrhage in 2 cases and calcification in 3 cases.MRI also showed heterogeneous signal intensity.No obvious pseudocapsule was found in 6 cases.On dynamic contrast enhancement scan mild-moderate progressive enhancement was showed in corticomedullary and parenchymal phase in all 7 cases.In delay phase slightly decreased enhancement were showed in 5 cases,and similar or slightly higher enhancement corresponding to the parenchymal phase was showed in 2 cases.However,lower enhancement was showed in the tumors on all 3 phases than that in the renal cortex.Besides,the tumors invaded the renal vein (n=1)and the adjacent structure (n=3).Conclusion No specific imaging findings of primary renal MFH are found.The dynamic contrast enhancement might be helpful for its diagnosis to some extent,and clinical data should be integrated with imaging findings together to differentiate renal MFH from other renal neoplasms.The final diagnosis relies on pathology and immunohistochemistry examination.

BACKGROUND:Bone marrow mesenchymal stem cells (BMSCs) have been induced to differentiate into cardiomyocyte-like cells in vitro.OBJECTIVE:To explore the association between GATA-4, Nkx-2.5 and α-myosin heavy chain (α-MHC) expression and cell morphological changes and structure formation in the process of BMSCs differentiation into cardiomyocyte-like cells.METHODS:By using myocardial lysate, BMSCs were induced to differentiate into cardiomyocytes.Immunocytochemistry staining was used to detect cardiac troponin T (cTnT) and connexin43, for the identification of cardiomyocytes. In the process of directional differentiation, RT-PCR was used to detect the expression of GATA-4,Nkx2.5 and α-MHC.RESULTS AND CONCLUSION:During the directional differentiation of BMSCs, the cells were changed from long fusiform to short rod, forming protrusions that were interconnected to form mesh-like, bamboo-like or myotube-like structure. When the cells were interconnected like a bamboo, cTNT and connexin43 positive cells were visible, and then the number of positive cells increased with the presence of myotube-like structure. RT-PCR results showed that during the induced directional differentiation of BMSCs, GATA-4, Nkx2.5 and α-MHC mRNA levels increased continuously. When interconnected cells formed a mesh-like structure, GATA-4 expression reached the peak and then kept a high level. When adjacent cells were fused into a myotube-like structure, α-MHC reached the peak. Additionally, the expression of Nkx2.5presented a time-dependent increase trend. Overall, during the induced differentiation of BMSCs into cardiomyocyte-like cells, the expression of cardiomyocyte specific genes, characterized by temporality and spatiality, is related to the changes of cell morphology and special structure formation.

Background:The prognostic values of staging parameters require continual re?assessment amid changes in diag?nostic and therapeutic methods. This study aimed to identify the prognostic factors and failure patterns of non?meta?static nasopharyngeal carcinoma (NPC) in the intensity?modulated radiotherapy (IMRT) era. Methods:We reviewed the data from 749 patients with newly diagnosed, biopsy?proven, non?metastatic NPC in our cancer center (South China, an NPC endemic area) between January 2003 and December 2007. All patients under?went magnetic resonance imaging (MRI) before receiving IMRT. The actuarial survival rates were estimated using the Kaplan–Meier method, and survival curves were compared using the log?rank test. Multivariate analyses with the Cox proportional hazards model were used to test for the independent prognostic factors by backward eliminating insigniifcant explanatory variables. Results:The 5?year occurrence rates of local failure, regional failure, locoregional failure, and distant failure were 5.4, 3.0, 7.4, and 17.4%, respectively. The 5?year survival rates were as follows: local relapse?free survival, 94.6%; nodal relapse?free survival, 97.0%; distant metastasis?free survival, 82.6%; disease?free survival, 75.1%; and overall survival, 82.0%. Multivariate Cox regression analysis revealed that orbit involvement was the only signiifcant prognostic fac?tor for local failure (P=0.011). Parapharyngeal tumor extension, retropharyngeal lymph node involvement, and the laterality, longest diameter, and Ho’s location of the cervical lymph nodes were signiifcant prognostic factors for both distant failure and disease failure (allP<0.05). Intracranial extension had signiifcant prognostic value for distant failure (P=0.040). Conclusions:The key failure pattern for NPC was distant metastasis in the IMRT era. With changes in diagnostic and therapeutic technologies as well as treatment modalities, the signiifcant prognostic parameters for local control have also been altered substantially.

OBJECTIVETo investigate changes in gene expression that occur upon treatment with human umbilical cord mesenchymal stem cells (UC-MSCs) for hepatic cirrhosis using a rat model system.

METHODSHepatic cirrhosis was induced in Sprague-Dawley rats by subcutaneous injection of carbon tetrachloride and oral administration of alcohol.UC-MSCs were isolated from human umbilical cord and the cells' immunophenotype and differentiation towards osteogenic and adipogenic lineages were confirmed.The UC-MSC sample or vehicle alone (phosphate buffered saline, PBS) was transplanted by intravenous injection.Histopathological staining and serological testing were used to compare the liver morphology and function among the different groups.The gene expression in the PBS group and UC-MSC group were detected by gene microarray and differences between the groups were statistically analyzed by t-test.

RESULTSTransplantation of the UC-MSCs improved liver function in the hepatic cirrhosis rats.Comparison of the gene expression profiles of the PBS group and the UC-MSC group showed that the latter had up-regulation of the genes related to the complement and coagulation cascades and down-regulation of the genes related to cell proliferation, cell cycle, and collagen synthesis.

CONCLUSIONUC-MSC therapy might improve liver function in cirrhosis by increasing the expression of genes related to the complement and coagulation cascades and by decreasing genes involved in cell proliferation and collagen deposition.

Animals ; Carbon Tetrachloride ; Cell Differentiation ; Cell Proliferation ; Down-Regulation ; Gene Expression Profiling ; Humans ; Liver Cirrhosis ; Mesenchymal Stromal Cells ; Rats ; Rats, Sprague-Dawley ; Transcriptome ; Umbilical Cord ; Up-Regulation