BACKGROUND:Photothermal therapy is a novel tumor treatment strategy that uses photothermal agents to transform light energy into heat energy to accomplish non-invasive tumor ablation.The rise of photothermal therapy and nanotechnology has provided a new perspective on breast cancer treatment.OBJECTIVE:To prepare a new type of near-infrared biomimetic nanoprobe that has been modified by breast cancer cell membrane,to investigate the effect of near-infrared fluorescence/ultrasound imaging in vitro,and to observe its targeting ability and photothermal therapy effect on homologous tumor cells in vitro.METHODS:Organic small molecule ITIC-4CI with A-D-A structure was used as photothermal agents;polylactic acid/glycolic acid copolymer as nanocarrier;4T1 cell membrane of mouse breast cancer cells as a surface modifier of nanoparticles;perfluorohexane(PFH)was loaded.A novel near-infrared biomimetic nanoprobe(4T1m/ITIC-4CI/PFH)was prepared by the double emulsion evaporation method and sonication method.The basic characterization of the nanoprobe and the homologous targeting ability were detected.The photothermal properties and photothermal stability of the probe were investigated,and the near-infrared fluorescence/ultrasound imaging effect of the probe under laser irradiation was observed.The CCK-8 assay and calcein/propidium iodide staining were used to assess the efficacy of photothermal therapy.RESULTS AND CONCLUSION:(1)The prepared 4T1m/ITIC-4CI/PFH nanoprobes had uniform size,high stability,and an average particle size of(92.7±2.3)nm.The probe's protein composition was identical to that of the 4T1 cell membrane.The nanoprobe's ability to target homologous 4T1 cells was validated by an in vitro cell uptake assay.(2)The nanoprobe had a red-shift absorption spectrum and tail emission extending to the near-infrared-Ⅱ,which emitted a bright near-infrared-Ⅱ fluorescence signal under laser irradiation.(3)After laser irradiation,the nanoprobe 4T1m/ITIC-4CI/PFH could be turned into microbubbles and enhanced ultrasound imaging.The results of CCK-8 assay and calcein/propidium iodide staining showed that the nanoprobe 4T1m/ITIC-4CI/PFH had an obvious photothermal killing effect on 4T1 cells.(4)The results show that the nanoprobe 4T1m/ITIC-4CI/PFH has the ability to target homologous tumors and enhance near-infrared-Ⅱ fluorescence imaging/ultrasound imaging and photothermal therapy effects.

Objective To explore the potential value of serum lipoxin A4 (LXA4) in monitoring bacterial load and anti-tuberculosis treatment progression in patients with pulmonary tuberculosis (PTB). Methods From January 2021 to January 2022, forty patients with active PTB, who were admitted to Shaanxi Provincial Tuberculosis Prevention and Control Hospital, were selected as the active PTB group, 38 patients with latent tuberculosis infection (LTBI) were selected as the LTBI group, and 28 healthy volunteers who underwent physical examination in our hospital during the same period were included as the healthy control group. The active PTB patients received a 2-month standard anti-tuberculosis chemotherapy, while the other two groups were untreated. Fasting venous blood was drawn from the three groups at enrollment (baseline), after 2 months of treatment, and upon the completion of 6 months of treatment in the active PTB group to measure serum LXA4 levels using enzyme-linked immunosorbent assay (ELISA). The relationship between serum LXA4 level and clinical manifestations, bacterial load, chest imaging manifestations, and treatment progress was analyzed. Results At baseline, serum LXA4 levels in the active PTB group, LTBI group, and healthy control group were [397.72 (210.68, 573.00)], [178.18 (108.17, 271.87)], and [131.06 (76.24, 166.04)] pg/mL, respectively. The levels in the active PTB and LTBI groups were significantly higher than those in the healthy control group, with statistical significance (P<0.01). According to the grading of acid-fast bacilli (AFB) sputum smears at diagnosis, baseline serum LXA4 level increased in the active PTB group with AFB sputum smear grade (P<0.001), and there was a positive correlation between serum LXA4 level and sputum smear grade (rs=0.209, P=0.003). After 6 months of treatment, the serum LXA4 level in the active PTB group was lower than the baseline value (P=0.002). The serum LXA4 level can predict treatment progress, with a baseline sensitivity of 55.0% (22/40), and after 6 months of treatment, 8 patients (20.0%) still showed positive serum LXA4 levels. Conclusions Serum LXA4 may be a useful biomarker for monitoring the progression of PTB treatment.

Objective To investigate the current status of nurses'knowledge,attitude and practice regarding sleep management of critically ill children in pediatric ICU,and to analyze its impact factors.Methods A self-designed questionnaire on general information and a questionnaire on knowledge and practical behaviors of pediatric ICU nurses on child's sleep management were used.In March 2023,902 pediatric ICU nurses from 24 hospitals in China were surveyed using a convenient sampling method,and the impact factors were analyzed using multiple stepwise linear regression.Results 893 valid questionnaires were collected and the recovery rate of valid questionnaires was 99.00％.Nurses in pediatric ICU scored(33.71±7.76)in knowledge dimension,(37.38±4.86)in attitude dimension and(80.60±16.78)in practice dimension,with a total score of(151.78±24.27).The scores of knowledge and attitude,knowledge and practice,attitude and practice are all positively correlated(r=0.393,P＜0.001;r=0.495,P＜0.001;r=0.320,P＜0.001).The results of multiple stepwise linear regression analysis showed that gender,region,whether they had received sleep management training were the influencing factors of pediatric ICU nurses'total score of knowledge,attitude and practice towards children's sleep management(P＜0.05).Conclusion Nurses in pediatric ICU are positive about sleep management for critically ill children,but their knowledge and practice levels need to improve.Nursing managers should strengthen the theoretical knowledge and practical behavioral training of pediatric ICU nurses on child sleep management,develop scientific sleep management plans,and guide nurses to make reasonable evaluation and interventions to improve children's sleep quality.

Objective:To investigate the effects of external application of Sanying Plaster on the size of thyroid nodules and the states of depression and anxiety in patients with benign thyroid nodules.Methods:A randomized controlled trial was conducted. A total of 120 patients with benign thyroid nodules from the outpatient clinic of the Department of Thyroid Diseases at Shanghai Traditional Chinese Medicine Hospital from June to December 2022 were selected as the subjects of the study. They were divided into two groups using the random number table method, with 60 patients in each group. The control group received lifestyle intervention treatment, while the treatment group received Sanying Ointment in addition to the treatment of the control group. Both groups were treated for 3 months. TCM syndrome scores were measured before and after treatment; the maximum diameter of thyroid nodules was measured using a color Doppler ultrasound transverse section; the quality of life was assessed using the short form 36 (SF-36); the degree of anxiety and depression was evaluated using the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS); adverse reactions during the treatment period were recorded, and the clinical efficacy was evaluated.Results:During the treatment period, 4 cases in the treatment group and 3 cases in the control group did not complete the treatment. Finally, 56 cases in the treatment group and 57 cases in the control group entered the efficacy evaluation. The total effective rate of the treatment group was 71.4% (40/56), and that of the control group was 14.0% (8/57), with a statistically significant difference between the two groups ( χ2=26.82, P<0.001). After treatment, the TCM syndrome score of the treatment group (10.02±3.65 vs. 16.65±3.44, t=-10.24) was lower than that of the control group ( P<0.001); the maximum diameter of thyroid nodules [11.00 (4.65, 19.93) mm vs. 15.00 (7.15, 28.50) mm, Z=-2.43] was lower than that of the control group ( P<0.05); the SF-36 score [121.83 (117.00, 130.00) vs. 114.42 (104.25, 127.50), Z=-2.62] was higher than that of the control group ( P<0.01); the SDS (46.72±4.59 vs. 57.02±5.99, t=14.80) and SAS (42.25±5.72 vs. 50.60±7.12, t=10.04) scores were lower than those in the control group ( P<0.001). The incidence of adverse reactions during the treatment period in the treatment group was 3.5% (2/57), and no adverse reactions occurred in the control group. Conclusion:The external application of Sanying Ointment helps to reduce the size of thyroid nodules in patients with benign thyroid nodules, improve the quality of life and anxiety and depression, and increase clinical efficacy with good safety.

Objective: To determine the active components of Eupolyphaga sinensis Walker (Tu Bie Chong) and explore the mechanisms underlying its fracture-healing ability. Methods: A modified Einhorn method was used to develop a rat tibial fracture model. Progression of bone healing was assessed using radiological methods. Safranin O/fast green and CD31 immunohistochemical staining were performed to evaluate the growth of bone cells and angiogenesis at the fracture site. Methylthiazoletetrazolium blue and wound healing assays were used to analyze cell viability and migration. The Transwell assay was used to explore the invasion capacity of the cells. Tubule formation assays were used to assess the angiogenesis capacity of human vascular endothelial cells (HUVECs). qRT-PCR was used to evaluate the changes in gene transcription levels. Results: Tu Bie Chong fraction 3 (TF3) significantly shortened the fracture healing time in model rats. X-ray results showed that on day 14, fracture healing in the TF3 treatment group was significantly better than that in the control group (P = .0086). Tissue staining showed that cartilage growth and the number of H-shaped blood vessels at the fracture site of the TF3 treatment group were better than those of the control group. In vitro, TF3 significantly promoted the proliferation and wound healing of MC3T3-E1s and HUVECs (all P < .01). Transwell assays showed that TF3 promoted the migration of HUVECs, but inhibited the migration of MC3T3-E1 cells. Tubule formation experiments confirmed that TF3 markedly promoted the ability of vascular endothelial cells to form microtubules. Gene expression analysis revealed that TF3 significantly promoted the expression of VEGFA, SPOCD1, NGF, and NGFR in HUVECs. In MC3T3-E1 cells, the transcript levels of RUNX2 and COL2A1 were significantly elevated following TF3 treatment. Conclusion TF3 promotes fracture healing by promoting bone regeneration associated with the RUNX2 pathway and angiogenesis associated with the VEGFA pathway.

Objective:To evaluate the predictive value of preoperative frailty combined with nutritional status for prolonged postoperative ileus (PPOI) in the patients with gynecological malignancies.Methods:Patients undergoing elective surgery for gynecological malignancies in the Affiliated Hospital of Jiangnan University from April 2022 to February 2023 were selected. The Frail scale was used to evaluate the frailty within 24 h of admission, and the nutritional status was evaluated by the Controlling Nutritional Status score. The general characteristics of patients and occurrence of PPOI were recorded, and the risk factors for PPOI were analyzed by multivariate logistic regression. The ability of frailty, nutritional status and their combination to predict PPOI was assessed by the receiver operating characteristic curve.Results:Two hundred and fourteen patients were finally included, 52 cases developed of PPOI, and 98 cases were frail patients. Preoperative frailty combined with moderate to severe malnutrition was an independent risk factor for PPOI in the patients with gynecological malignancies ( P<0.05), and the area under the curve in predicting the occurrence of PPOI was 0.796 (95% confidence interval 0.736-0.857) in the patients with gynecological malignancies. Conclusions:Preoperative frailty combined with moderate to severe malnutrition has a higher accuracy in predicting PPOI in the patients with gynecological malignancies.

Objective:To evaluate the efficacy of Qinggan Bupi Jiangtang Decoction combined with western medicine in the treatment of adult type 2 diabetes mellitus (T2DM) with with liver hyperactivity and spleen deficiency syndrome.Methods:Prospective cohort study. A total of 103 T2DM patients with liver hyperactivity and spleen deficiency syndrome in the Department of endocrinology of Shanghai Municipal Hospital of Traditional Chinese Medicine from February 2020 to February 2021 were randomly divided into the observation group (52 cases) and the control group (51 cases) according to random number table method. Both groups were treated with conventional western medicine, the control group was treated with sitagliptin phosphate on the basis of routine treatment, and the observation group was treated with Qinggan Bupi Jiangtang Decoction on the basis of routine treatment. Both groups were treated for 12 weeks. TCM symptom scores were performed before and after treatment. The FPG, 2hPBG, HbA1c and fasting insulin (FINS) were detected by dry chemistry method and Roche electroluminescence method, and insulin resistance index (HOMA-IR) was calculated. The clinical efficacy was evaluated by dynamic blood glucose monitoring indexes TIR (percentage of time when glucose was in the range of 3.9-10.0 mmol/L), TAR (percentage of time when glucose was higher than the target range ≥ 11.1 mmol/L) and TBR (percentage of time when glucose was lower than the target range <3.9 mmol/L).Results:The total effective rate was 92.3% (48/52) in the observation group and 56.9% (29/51) in the control group ( χ2=15.32, P<0.01). The score of TCM syndrome in the observation group was significantly lower than that of the control group ( t=6.30, P<0.01). The compliance rate of HbA1c in the observation group was 46.2% (24/52) and that of the control group was 23.5% (12/51). There was significant difference between the two groups ( χ2=5.80, P=0.016). Compared with the groups before treatment, MAGE, TAR, TBR significantly decreased and TIR significantly increased in both groups after treatment ( P<0.01), but there was no significant difference between the two groups after treatment ( t values were 0.78, 1.06, 0.22 and 1.45, respectively, P>0.05). Compared with the groups before treatment, the levels of FPG, 2 hPBG and HbA1c in the two groups significantly decreased after treatment ( P<0.01), but there was no significant difference between the two groups after treatment ( t values were 1.32, 0.18,1.50, respectively, P>0.05). Compared with the groups before treatment, the levels of FINS and HOMA-IR in the two groups significantly decreased after treatment ( P<0.01), but there was no significant difference between the two groups after treatment ( t values were 1.25, 0.51, respectively, P>0.05). There were no adverse reactions in the observation group, 2 cases of mild nausea and 1 case of transient diarrhea in the control group. There was no significant difference between the two groups ( χ2=3.15, P=0.118). Conclusion:Qinggan Bupi Jiangtang Decoction combined with routine treatment can improve the blood glucose level, TIR and blood glucose standard rates of adult T2DM with liver hyperactivity and spleen deficiency syndrome, and the curative effect is equivalent to sitagliptin phosphate tablets.

This article reviews the concept and content of eCASH concept as well as its application effect and influencing factors in sedation and analgesia nursing of patients with mechanical ventilation in ICU, so as to provide references for further implementation of the application of eCASH concept in patients with mechanical ventilation in ICU and improving patients' health outcome.

Objective:To investigate the status of satisfaction of postgraduates majoring in public health with the teaching material of The prevention and control of chronic non- communicable disease, so as to provide the basis for promoting the teaching and optimizing the reprint of the teaching material. Methods:An online survey was conducted among 180 public health postgraduates of Batch 2018 to Batch 2020 from China CDC who took the selective course of "prevention and control of chronic non-communicable diseases". The survey content included the overall satisfaction of the respondents with the teaching material and such four levels of satisfaction as primary indicators at the content level, thinking level, motivation level and arrangement level and 20 secondary indicators. The statistical analysis was made by SPSS 25.0.Results:The effective response rate was 90.56% (163/180), and the overall satisfaction of postgraduates with the teaching material was 88.96%. The satisfaction of "scientificity", "comprehensiveness", "internal coordination" and "hierarchy" at the content level, "systematic thinking" and "quality education" at the thinking level, "deepening the understanding and application of relevant knowledge in the field of chronic disease prevention and control" and "the content is convenient for self-study and helps guide the construction of new knowledge" at the motivation level, and "accurate words, fluent language and easy to read and understand" and "firm binding, good paper quality and clear printing" at the arrangement level of the teaching material was more than 90.00%. Only the satisfaction of "the critical thinking" at the thinking level and "stimulating learning enthusiasm" at the motivation level was less than 85.00%.Conclusion:The teaching material of The prevention and control of chronic non- communicable disease meets the learning needs of postgraduates majoring in public health, and students have high overall satisfaction evaluation on the teaching material. It is necessary to further optimize the two aspects of "the critical thinking" and "stimulating learning enthusiasm" in the revision of the teaching material.

Background Women face more reproductive health problems in their whole life cycle. Occupational exposure to harmful factors in the petrochemical industry may have a synergistic effect on women’s existing health problems. Objective To analyze the influencing factors of perimenopausal syndrome (PMS) in female workers in petrochemical industry, and establish a nomogram model of the risk of PMS in female workers, so as to provide a easy and quick health monitoring and evaluation method for female workers. Methods A total of 2653 perimenopausal female workers aged 45-55 years old were selected from a petrochemical enterprise. A questionnaire survey was conducted to collect information on demographic characteristics, occupational characteristics, psychological status, and reproductive health information. The prevalence of PMS of female workers was evaluated by the Kupperman Index Scale, the physical fatigue and mental fatigue were evaluated by the Fatigue Scale. A linear graph prediction model was established by multiple logistic regression. A nomogram was presented and C-index was used to verify the differentiation of the model. Then Bootstrap method was used for internal validation. Results Among the 2653 female worker, a total of 1306 cases (49.2%) presented PMS with a Kupperman score ≥7. The main symptoms were fatigue (79.95%), irritability (71.32%), and insomnia (66.79%). Significant differences in PMS prevalence were found among female workers of different age, body mass index, and working posture groups (P < 0.05). The participants with alcohol drinking, maternal premature or late menopause, hypertension, lack of physical exercise, heavy lifting, sick leave in the last 6 months, combined occupational exposures to dust, chemicals, noise [> 80 dB(A)], or electromagnetic field, and not wearing protective masks, gloves or protective earplugs reported higher prevalence rates of PMS (P < 0.05). The prevalence rate of PMS in female workers with sleep duration ≤ 6 h was higher than that with > 6 h (P < 0.05), and higher in female workers with physical and mental fatigue than in those without (P < 0.05). The results of logistic regression analysis showed that those with maternal premature or late menopause (OR=1.572, 95%CI: 1.320−1.872), hypertension (OR=1.579, 95%CI: 1.127−2.213), alcohol drinking (OR=1.286, 95%CI: 1.080−1.532), no physical exercise (OR=1.598, 95%CI: 1.330−1.920), sleep duration ≤ 6 h (OR=1.853, 95%CI: 1.518−2.263), sick leave in recent 6 months (OR=1.614, 95%CI: 1.226−2.123), physical fatigue (OR=2.384, 95%CI: 1.887−3.012), mental fatigue (OR=5.649, 95%CI: 4.382−7.283), combined exposure to occupational harmful factors (OR=1.329, 95%CI: 1.108−1.593), long-time sitting (OR=2.014, 95%CI: 1.271−3.190), and heavy lifting (OR=1.505, 95%CI: 1.178−1.923) showed a higher risk of reporting PMS (P<0.05). The C-index from the ROC curve of the nomogram model was 0.748 (95%CI: 0.729−0.766). The results of Bootstrap validation showed that the standard curve and the predicted curve almost overlapped, and the absolute error was 0.008, indicating that the model fitness was good. Conclusion PMS in female petrochemical workers may occur due to long-term exposures to multiple factors. The established nomogram model has good predictive ability and could be applied to monitor and evaluate female reproductive health in petroleum industry.