The high intra- and inter-tumor heterogeneity of gastric cancer leads to a great difference in the immunotherapy efficacy and the prognosis among patients. Several biomarkers, including programmed death-ligand 1, human epidermal growth factor receptor 2, the features of tumor microenvironment, the peripheral blood inflammatory markers and Claudin18.2 have predictive value in the immunotherapy efficacy and the prognosis of gastric cancer patients, which might help the clinicians find the potential patients who will benefit from immunotherapy, and achieve the goal of precision medicine.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.

Objective To demonstrate the role of clinical pharmacists in nutritional support for a patient with malignant obstructive jaundice and to provide a reference for the clinical application of nutritional supplements in patients during the perio-perative period.Methods Clinical pharmacists evaluated the nutritional status of an obstructive jaundice patient with nutrition risk screening tool and developed nutrition support programs perioperatively.The daily dose of 30% long-chain fat emulsion 250 ml was replaced with 20% medium/long-chain fat emulsions 250 ml.Oral nutrition support was added.Pharmaceutical care was implemented for the patient during the perioperative period.Results During the perioperative period,parenteral nu-trition support was changed to enteral nutritional support.The patient′s nutritional status and jaundice were improved.The pa-tient recovered well from surgery with no complication.Conclusion Clinical pharmacists work closely with physicians in devel-oping and adjusting nutritional support program to improve the nutritional status and pharmaceutical care for patients.

Objective To observe the clinical effects of eyehd reconstruction by regional flap combined with xenogeneic acellular dermal matrix transplantation for eyelid defect after malignant tumor excision.Methods Thirty-five cases (35 eyes) in our hospital were selected as the objects.Among them,basal cell carcinoma was 21 cases,meibomian gland carcinoma was 13 cases,squamous cell carcinoma was 1 cases;12 cases of upper eyelid and 23 case of lower eyelid were involved.All patients were subjected to intraoperative frozen,and the incision margin was determined according to the frozen results.After resection of the tumor,the eyelid had full-thickness defects in different degrees.The xenogenic acellular dermal matrix was used to replace the conjunctival tarsal tissue,and the adjacent flap or transposition flap was used to repair the eyelid defect according to the size of skin defect.The healing of flap,oral repair film,eyelid closure and adhesion were observed.Results After half a year follow-up,the acellular dermal matrix were completely dissolved by crawling the conjunctival epithelium covering,the flap healed with no flap necrosis.28 patients recovered well after operation without hypophasis and entropion,ectropion.4 patients had mild hypophasis,and there was no case of exposure keratitis.3 patients were with mild symblepharon.Conclusion The acellular dermal matrix can replace tarsal conjunctival tissue,which combined with regional flap has good clinical curative effect for eyelid defect after malignant tumor excision.This treatment can reduce the pain of patients who take oral mucosa and avoid the reoperation of eyelid reconstruction.

Objective To observe the clinical efficacy of Yishen Huayu Decoction for decreased ovarian reserve (DOR). Methods Eighty cases of DOR were randomly divided into 2 groups, with 40 cases in each group. The treatment group was treated with oral administration of Yishen Huayu Decotion, one dose a day. The control group was given DHEA, a time of 1 tablet, 3 times a day. 2 groups were observed for 3 menstrual cycles. The levels of basic follicle stimulating hormone (bFSH), basal estradiol (bE2), luteinizing hormone (LH) and serum anti-Müllerian hormone (AMH) were measured. The number of basal follicles and the peak systolic velocity (PSV) were monitored by transvaginal sonography. Quality of life assessment and basal body temperature were measured. Results The total effective rate was 85.00% (34/40) in the treatment group and 62.50% (25/40) in the control group, with statistical significance (P<0.05). After treatment, the levels of bE2 and bFSH decreased, and the levels of AMH, ovarian antral follicles and PSV increased, which were significantly different from those before treatment (P<0.05). After treatment, the levels of bE2 and bFSH in the treatment group were lower than those in the control group, and the levels of AMH, ovarian antral follicle and PSV were higher than those in the control group, with statistical significance (P<0.05). The recovery rate of basal body temperature was 77.50%(31/40) in the treatment group and 52.50%(21/40) in the control group, with statistical significance (P<0.01). After treatment, the scores of four dimensions of life quality, daily activities, health status and self-perception were significantly improved (P<0.01), and the treatment group was higher than the control group (P<0.01). Conclution Yishen Huayu Decotion can improve the ovarian reserve function and the life quality of patients with DOR.

Objective: To investigate the effect of overexpression of wild-type phosphatase and tensin homolog (PTEN) deleted on chromosome 10 and its mutant G129E (exhibiting the activity of protein phosphatase and losing the activity of lipid phosphatase) on F-actin in activated hepatic stellate cells (HSCs) cultured in vitro. Methods: The activated hepatic stellate cell-T6 (HSC-T6) cells were cultured in vitro, and activated HSCs were transfected with adenovirus that carried wild-type PTEN gene and G129E gene using transient transfection. The HSCs were divided into the following groups: control group, which was transfected with DMEM medium instead of virus solution; Ad-GFP group, which was transfected with the empty adenovirus vector with the expression of green fluorescent protein (GFP); Ad-PTEN group, which was transfected with the recombinant adenovirus with wild-type PTEN gene and GFP expression; Ad-G129E group, which was transfected with the recombinant adenovirus with G129E gene and GFP expression. Western blot and quantitative real-time PCR were used to measure the protein and mRNA expression of PTEN in activated HSCs; under a laser scanning confocal microscope (LSCM), phalloidine labeled with the fluorescein tetramethylrhodamine isothiocyanate (TRITC) was used to observe the morphology of HSCs, distribution and fluorescence intensity of F-actin, and changes in pseudopodia and stress fibers, and a calcium fluorescence probe (Rhod-2/AM) was used to measure the changes in Ca²⁺ concentration in HSCs. A one-way analysis of variance was used for comparison between multiple groups, and the least significant difference test was used for comparison between two groups. Results: Wild-type PTEN and G129E genes were highly expressed in activated HSCs. In the control group and the Ad-GFP group, HSCs had a starlike or polygonal shape, F-actin was reconfigured and formed a large number of stress fibers which stretched across the whole cell, and layered pseudopodia were seen around the cell. In the Ad-PTEN group and the Ad-G129E group, the HSCs had a fusiform shape, F-actin was mainly seen around the cell, a small number of stress fibers were seen inside the cell, and layered pseudopodia around the cell disappeared. The Ad-PTEN group and the Ad-G129E group had significant reductions in the fluorescence intensity of F-actin compared with the control group and the Ad-GFP group (357.67±13.39/377.25±14.55 vs 961.87±27.33/954.68±20.71, F = 1783.486, P < 0.05), while there were no significant differences between the Ad-PTEN group and the Ad-G129E group, as well as between the control group and the Ad-GFP group (P > 0.05). The Ad-PTEN group and the Ad-G129E group had significant reductions in the relative concentration of Ca²⁺ compared with the control group and the Ad-GFP group (251.60±90.88/352.18±146.01 vs 1953.95±132.99/1937.57±115.17, F = 834.988, P < 0.05), while there were no significant differences between the Ad-PTEN group and the Ad-G129E group, as well as between the control group and the Ad-GFP group (P > 0.05). Conclusion The overexpressed wild-type PTEN and its mutant G129E can significantly inhibit the formation and reconfiguration of cytoskeletal protein F-actin and reduce the concentration of Ca2+ in activated HSCs in vitro. In addition, there are no significant differences in the above effects between wild-type PTEN and G129E.

Objective To investigate the effects of CD147/MMP-9 pathway on early left ventricular remodeling Methods 30 healthy eight-week male SHR were divided into 3 groups (n = 10 for each group). SHR group received tail vein injections of normal saline weekly; CD147 group received CD147 of 600 ng·kg-1 weekly; and CD147+DOX group received CD147 of 600 ng/kg weekly and intragastric administration of DOX ( doxycycline ) of 30 mg/kg daily . 10 healthy eight-week male Wistar-Kyoto rats (WKY group) were treated as SHR group. Echocardiography, myocardial sections microscopy examination (HE and VG stain), and Western blot (for assessing levels of MMP-9, TIMP-1, CD147, and collagen I and Ⅲin myocardial tissues) were performed on day 56. Left ventricular weight index (LVWI)was measured and calculated. Collagen volume fractions (CVF) were obtained by image analysis. Results As compared with WKY group , levels of CD147 , MMP-9 , and MMP-9/TIMP-1 were lower but TIMP-1 and collagenⅠand Ⅲ were significantly higher in SHR group. The abundance of CD147 and MMP-9 protein and the ratio of MMP-9/TIMP-1 were obviously increased in CD147 group than in SHR group (P < 0.05). Levels of CD147, MMP-9, and MMP-9/TIMP-1 did no differ between CD147+DOX group and CD147 group. LVWI and contents of collagenⅠand Ⅲ were obviously declined in CD147 group as compare with SHR group. Cardiomyocyte hypertrophy , partial myocardial fibre rupture , myocyte dissolution and fuzzy myocardial fibre boundaries , more abundant of collagen fibers, and higher CVF were found in SHR group. Cardiac fibrosis was significantly improved after CD147 intervention, but the action was suppressed as DOX was administrated simultaneously. Conclusions Early ventricular remodeling may be involved in the inhibition of CD147/MMP-9 pathway in SHR. Input of CD147 to upregulate the pathway can improve the remodeling.

BACKGROUND:The correlation between blood stasis syndrome and non-blood stasis syndrome of lumbar intervertebral disc protrusion remains unclear.
OBJECTIVE:To construct serum protein pattern model for diagnosing blood stasis syndrome of lumbar intervertebral disc protrusion.
METHODS:A total of 180 cases were included in this study and divided into treatment group (120 patients with lumbar intervertebral disc protrusion) and control group (60 healthy cases from physical examination). Furthermore treatment group was equal y assigned into blood stasis syndrome subgroup and non-blood stasis syndrome subgroup, with 60 cases in each subgroup. The involved cases were wel matched in nations, genders and ages. Serum samples of peripheral blood from the 180 cases were col ected. Surface-enhanced laser desorption/inionation time of flight mass spectrometry and ProteinChip technology were employed to detect and plot protein mass spectrum. The protein peak values were identified using Biomarker Wizard software. Then serum diagnosis model of blood stasis syndrome of lumbar intervertebral disc protrusion was established. The obtained models were verified through double blind method. The differential proteins were searched by ExPASy data.
RESULTS AND CONCLUSION:We detected that peak values of eleven proteins had statistical significance (P<0.05) from the involved 180 cases. Among them, two proteins were highly expressed while the other nine proteins were lowly expressed. Serum protein pattern model for diagnosing blood stasis syndrome of lumbar intervertebral disc protrusion was established through Biomarker Patterns software, and the sensibility was 86.667%, the specificity was 94.167%, the positive predictive value was 88.136%. There are a variety of abnormal y expressed proteins in the serum of the patients with blood stasis syndrome of lumbar intervertebral disc protrusion. The serum protein pattern model involved eleven different proteins can be used to diagnose blood stasis syndrome of lumbar intervertebral disc protrusion.

Objective Mild hypothermia provides protection for the brain and improves prognosis in the treatment of severe traumatic brain injury, which is widely acknowledged.The article aimed to analysis the prognosis and complications of long-term and short-term mild hypothermia on patients with severe traumatic brain injury. Methods According to the cochrane systematic review methods, thorough search was carried out in databases including Cochrane, Pubmed, Embase, CBM, CNKI, Wanfang and VIP.Eval-uation was made on the quality of selected documents, and Revman5.2 software was applied for meta analysis after data extraction. Results Long-term mild hypothermia achieved improved prognosis compared to short-term mild hypothermia ( GOS score 4 ~5 ) [RR=1.37, 95%CI (1.14, 1.64), P=0.0006].No significant difference was found between these two therapies in pneumonia in-cidence (P=0.94), arrhythmia incidence ( P=0.54) and stress ulcer incidence (P=0.99). Conclusion In comparison to short-term hypothermia therapy, long-term mild hypothermia therapy improved the prognosis of patients with severe traumatic brain inju-ry without obvious increase in the incidence of pneumonia, arrhythmia and stress ulcer.

Objective To study the function of vascular endothelial growth factor (VEGF) in type 2 diabetes model rats and its effect on focal cerebral ischemia induced by middle cerebral artery occlusion in these rats. Methods Focal cerebral ischemia was induced by middle cerebral artery occlusion for 6 hours in type 2 diabetes rats and normal control rats.Blood vessels morphology was examined by ink perfusion,infarct size was measured by TTC and expression of VEGF and CD34 were evaluated by immunohistochemistry staining. Results Ink perfusion revealed increased number of small vessels in type 2 diabetes rats. Infarct size was significantly smaller in type 2 diabetes rats ( ( 80. 07 ± 11.21 ) mm3 ) than that in normal controls ((98. 91 ± 14. 86) mm3,t = 2.48,P = 0. 0326). There were more hemorrhage lesions in the ischemic hemisphere in type 2 diabetes rats when comparing with the controls. VEGF and CD34 showed significantly higher expression in type 2 diabetes rats than in normal controls. Conclusions High expression of VEGF and CD34 are found in type 2 diabetes rats after middle cerebral artery occlusion. There is cerebrolvascular remodeling in diabetes rats. While this diabetes-induced remodeling appears to prevent infarct expansion,the changes also increase the risk of hemorrhagic transformation. The latter may result in poor prognosis.