Humans ; Melanoma/therapy* ; Skin Neoplasms/therapy* ; Methylation ; Prognosis ; Immunotherapy ; RNA ; Biomarkers, Tumor ; Melanoma, Cutaneous Malignant

Objective:To study the clinical features of neonatal hyperthyroidism.Methods:From September 2013 to September 2020, clinical data of neonates with hyperthyroidism admitted to the neonatal intense care unit of our hospital were retrospectively collected and analyzed.Results:A total of 7 neonates were included. The average gestation age was (35.8±2.3) weeks with 5 cases had GA<37 weeks. The median age of diagnostic was 16 d (7~18 d). The common clinical manifestations included tachycardia, irritability, low-grade fever, hyperhidrosis, bulimia, poor weight gain, diarrhea and jaundice. The levels of serum free triiodothyronine (FT 3) and thyroxine (FT 4) were elevated in all 7 cases and thyroid stimulating hormone (TSH) were decreased. The Doppler ultrasound of thyroid gland in two neonates revealed enlarged thyroid gland with abundant blood flow. All 7 mothers had hyperthyroidism with 4 mothers provided the history of hyperthyroidism and the other 3 were also confirmed after their infants were diagnosed. All 7 infants were treated with anti-thyroid drugs (ATD) and 2 were additionally given β-blockers to control heart rate. The median ATD duration was 40 d (7~58 d). 2 cases (both preterm infants) had slight decrease in FT 4 during medication. FT 4 of all 7 cases returned to normal before TSH. Conclusions:Neonatal hyperthyroidism has various and nonspecific clinical manifestations. Early diagnosis and timely treatment are important to prevent short-term and long-term adverse outcomes. Whether their mothers provide definite history of thyroid disorder or not, the thyroid function of the suspected neonates should be carefully monitored.

Objective:To explore the effect of health education based on theory of planned behavior combined with stepped care model on negative emotion, psychological flexibility and quality of life in patients with lung cancer undergoing chemotherapy.Methods:From October 2020 to December 2021, 108 chemotherapy patients who underwent lung cancer surgery in Affiliated Hospital of Weifang Medical College and had anxiety or depression that scores was greater than 7 in any dimension of the Hospital Anxiety and Depression Scale (HADS) were selected as the study subjects. The study subjects were divided into observation group ( n=46) and control group ( n=48) by random digits table method. Routine care was implemented in the control group. The observation group implemented health education based on the theory of planned behavior combined with stepped care model intervention. The HADS scale was used every 4 weeks to assess negative emotion in both groups. In observation, patients with negative emotion relief stop the next stage of nursing intervention, and patients without relief continue the next stage of higher intensity nursing intervention. Results:Before the intervention, there were no significant difference in the scores of negative emotion, psychological flexibility and quality of life between the two groups ( P>0.05). After intervention, the scores of all dimensions of negative emotion and the total score in the observation group were significantly lower than those in the control group, and the differences had statistical significance ( t=4.86, 3.19 and 4.53, all P<0.05). After the intervention the scores of psychological flexibility and quality of life dimensions and the total score in the observation group were higher than those in the control group, the differences had statistical significance (t values were -6.01--2.89, all P<0.05). After the intervention, there was no significant difference in the remission rate of negative emotions between the clinical observation stage of the observation group and the concurrent control group ( P>0.05). The remission rates of guided self-help, problem-solving therapy, psychological or drug therapy and total negative emotions in the observation group were 38.46%(15/39), 33.33%(8/24), 6/16 and 78.26%(36/46), respectively, which were higher than those in the control group, and the differences had statistical significance ( χ2 values were 7.04 - 13.80, all P<0.05). Conclusions:Health education based on the theory of planned behavior combined with stepped care model can effectively alleviate the negative emotions of lung cancer patients undergoing chemotherapy and improve psychological flexibility and quality of life.

Objective:To investigate the prognoses of pulmonary adenocarcinoma patients with leptomeningeal metastases (LM) and explore their influencing factors.Methods:A retrospective analysis was performed. The clinical data, imaging features and treatment plans of pulmonary adenocarcinoma patients with LM admitted to our hospital from January 2010 to June 2021 were collected. Overall survival (OS) was used as the prognostic evaluation criterion and patients were divided into good prognosis group (OS≥6 months) and poor prognosis group (OS<6 months) accordingly. Logistic regression analysis was used to evaluate the influencing factors for prognoses of pulmonary adenocarcinoma patients with LM. These patients were grouped according to different Karnofsky performance status (KPS) scores and different treatment methods, and survival curves were drawn to compare their OS.Results:A total of 173 pulmonary adenocarcinoma patients with LM were enrolled in the study, including 75 with good prognosis and 87 with poor prognosis. There were significant differences in the KPS scores, pulmonary adenocarcinoma lesion controlled status, giving third generation tyrosine kinase inhibitor (TKI) therapy or not, giving systemic chemotherapy and/or whole brain radiotherapy or not between the two groups ( P<0.05). Multivariate Logistic regression analysis showed that KPS scores and pulmonary adenocarcinoma lesion controlled status were independent influencing factors for prognoses ( OR=4.186, 95%CI: 1.583-11.070, P=0.004; OR=4.198, 95%CI: 1.499-11.760, P=0.006). Survival curves showed median OS of 8.2 months for all patients ( 95%CI: 6.5-9.8). The OS in patients with low-risk(KPS scores≥60) was significantly higher than that in patients with high-risk(KPS scores<60), that in patients accepted TKI treatment was significantly higher than that in patients not accepted TKI treatment, and that in patients accepted TKI and systemic chemotherapy was significantly higher than that in patients accepted TKI alone ( P<0.05). Conclusion:Patients with high KPS scores and controlled pulmonary adenocarcinoma can have relatively good prognosis; TKI treatment and combination therapy may prolong OS of these patients.

Objective To investigate the expression of Scinderin(SCIN myoprotein) in breast cancer tissues and adjacent tissues,and to explore the relationship between the expression of Scinderin and different molecular subtypes of breast cancer as well as the clinical factors.Methods Immunohistochemical staining method was used to detect the expression of SCIN in 120 cases of breast carcinoma and 30 adjacent tissues.The relation between SCIN expression in breast cancer tissue and molecular subtypes,pathologic stage,age,tumor size,lymph node metastasis was analyzed.Results SCIN expression level in breast cancer tissue was lower than in the tissues adjacent to carcinoma (6.06±3.32 vs 7.77±3.32,P＜0.05).SCIN expression was associated with breast cancer molecular subtypes (P＜0.05),and it was irrelevant with age,tumor size,histological grade,lymph node metastasis,or clinical stage (P＞0.05).Conclusions The expression of SCIN in breast cancer tissues was lower than in the adjacent tissues.It is associated with breast cancer molecular subtypes.SCIN could become the protein markers of breast cancer molecular targeted therapy.

AIM:To explore the effect of Delta-like ligand 4 (Dll4)-Notch signaling pathway blockade on the development of Thelper 17(Th17) cells in the asthmatic mice.METHODS:Male BALB/c mice were randomly divided into 5 groups:control group, asthma group, normal saline group, anti-Dll4 antibody group, and immunoglobulin G group.The protein expression of Dll4 was detected by immunohistochemical staining.The proportion of Th17 cells in mouse spleen isolated CD4+ T cells was measured by flow cytometry.The protein expression of Th17 transcription factor retinoid-related orphan receptor γt (RORγt) was determined by Western blot.The serum level of interleukin (IL)-17 was measured by enzyme-linked immunosorbent assay (ELISA).RESULTS:The expression of Dll4 in the lung tissues from asthma group significantly increased as compared with anti-Dll4 antibody group.The proportion of Th17 cells in CD4+ T cells was significantly down-regulated, and the protein expression of RORγt in the lung tissues was significantly reduced in anti-Dll4 antibody group compared with asthma group (P<0.05).Moreover, the serum level of IL-17 in anti-Dll4 antibody group was significantly reduced compared with asthma group (P<0.01).CONCLUSION:The blockade of Dll4-Notch signaling pathway inhibits the differentiation of Th17 cells in asthmatic mice.

OBJECTIVE:To provide reference for rational drug use in elderly patients with depression. METHODS:A total of 96 elderly outpatients and inpatients with depression were selected from 39 mental health institutions of Hebei province during Jul. 2nd to 9th,2012. The drug use were surveyed by using self-made questionnaires on the basis of prescriptions/medical orders. The results of investigation were analyzed statistically. RESULTS:In this study,96 questionnaires were distributed and all were collect-ed with effective recovery rate of 100%. Among 96 respondents,95 elderly patients used a new type of antidepressants,mainly by selective serotonin reuptake inhibitors(SSRIs),accounting for 75.0% of the total. The top 5 drugs in the list of use frequency were sertraline(23 cases,24.0%,daily dose:25-200 mg),paroxetine(22 cases,22.9%,daily dose:20-60 mg),escitalopram(20 cas-es,20.8%,daily dose:5-40 mg),venlafaxine (13 cases,13.5%,daily dose:75-300 mg),mirtazapine (12 cases,12.5%,daily dose:8-30 mg). Among all respondents,22 patients (22.9%) were treated with mono-antidepressant and the other 74 patients (77.1%) were treated with drug combination therapy among which 47 cases were treated with two antidepressant drugs,22 were treated with three drugs,4 were treated with four drugs and 1 was treated with five drugs. 6 cases combined with mood stabilizers, 21 cases with antipsychotic,50 cases with benzodiazepine(6 of them combined with two benzodiazepine),2 cases with other hyp-notic drugs,14 cases with anxiolytic drugs and 2 cases with anticholinergic drugs. CONCLUSIONS:The drug use of elderly pa-tients with depression in mental health institutions of Hebei province basically in line with current trends. However,there are still the phenomenon of irrational drug use as drug dose meets or exceeds the prescribed maximum dose;many varieties are used in combination therapy;route of administration is improper.

Cirrhotic portal hypertension can lead to serious complications including esophageal variceal bleeding. Hepatic venous pressure gradient (HVPG) and upper gastrointestinal endoscopy can be used to evaluate the severity of portal hypertension and predict the risk of bleeding. However, both methods are invasive, which limits their clinical practice. Therefore, noninvasive techniques for the evaluation of portal hypertension will have certain advantages in clinical practice. This article introduces the noninvasive methods for the measurement of spleen stiffness, including transient elastography, acoustic radiation force impulse, real-time tissue elastography, and magnetic resonance elastography, as well as the value of these methods in evaluation of portal hypertension and influencing factors. It is pointed out that the difference in the diagnostic efficiency of spleen stiffness measured by these methods in portal hypertension needs to be verified by further studies.

Objective To investigate the work, training and living status of carers in Zhejiang, and analyze the main issues, so as to provide the corresponding measures of strengthening nursing team construction and improving elderly service quality. Methods Using cross section survey, the self design questionnaire investigated the work, training and living status of carers in 26 county areas. Results We handed out 1 200 questionnaire and collected 1 107 effective questionnaire with effective rate 92. 3%. The middle and old age for carers occupied 85. 1% (942/1 107), and middle school or below education background were 81. 8% (906/1 107);they mainly undertook the work of elderly daily life care including feeding, bathing and changing cloths;only 35. 7% (395/1 107) carer had certificate and 45. 4% (503/1 107) received training; 26. 9%(298/1 107) carer satisfied the current living status. Conclusions The carer team is the aging, has low income and benefits, and low professional quality and restricted social function, and so on problems, so we should enhance the carer′s pay and benefits, perfect professional system, and enhance their quality of life, so as to improve carer team′s whole quality.

Objective To compare the efficacy and safety of a new low-dose oral contraceptive pill (YAZ) containing drospirenone 3 mg and ethinylestradiol 20 μg with placebo in reducing symptoms of premenstrual dysphoric disorder (PMDD). Methods This multicenter, double-blind, randomized clinical trial consisted of 2 run-in and 3 treatment cycles (84 days) with daily symptom charting; 187 women with symptoms of PMDD were randomized to either placebo group (n=94) or YAZ group (n=93), and assessed with daily record of severity of problems scale (DRSP) and clinical global impressions scale (CGI) before, during and after the treatments. Hormones were administered for 24 days, followed by 4 days of inactive pills. Results Compared with baseline level of DRSP, both groups got improvement after treatment; the YAZ group (median-28.7, range:-82.5 to 2.3) had greater improvement than that in the placebo group (median-23.7, range:-86.0 to 11.8), while there was not significant difference (P>0.05). The main adverse effects of YAZ included intermenstrual bleeding [13% (12/93) versus 3% (3/94)], menorrhagia [9% (8/93) versus 1%(1/94)], nausea [5%(5/93) versus 4%(4/94)] and skin rash [4%(4/93) versus 2%(2/94)]. Conclusions YAZ could improve symptoms of PMDD better than placebo, while without statistic significance in this study. The most common adverse effects are intermenstrual bleeding, menorrhagia, nausea and rash.