Objective To construct a training program for retuming to work after delivery based on Morrison's job adaptation theory in operating room nurses and to explore its application effect.Methods On the basis of literature research and Delphi expert consultation method,a training program of postpartum return of operating room nurses was constructed.From August 2021 to December 2022,the preliminary application of this research program was carried out,with 6 cases in an experimental group and 5 cases in a control group.The differences between the 2 groups were compared by Job Adaptation Scale,Psychological Resilience Scale and satisfaction evaluation,and the application effect was evaluated.Results After 2 rounds of correspondence,a training program for postpartum return of operating room nurses was formed,which included 4 first-level indicators(role adaptation,task adaptation,environment adaptation and cultural adaptation),and 32 second-level indicators.The authority coefficients of the 2 rounds of correspondence consultation were 0.908 and 0.917,and the Kendall W coefficients were 0.224 and 0.206,respectively(both P＜0.001).The preliminary application results showed that there were statistically significant differences in job adaptation and satisfaction evaluation between the 2 groups(both P＜0.05).There was no significant difference in psychological resilience score between groups(P＞0.05).Conclusion The postpartum retum training program for operating room nurses established in this study is scientific and practical to a certain extent.In the future,samples can be expanded and multi-center studies can be carried out to further test the practicability and effectiveness of the program.

Toxic Chinese materia medica has been highly valued by its specialized and effective effects， but its safe application has become an urgent clinical problem to be solved. Compatibility for toxic attenuation is an important method for the rational clinical application of toxic Chinese materia medica as well as the promotion of its therapeutic advantages. The theory of “heterogeneous medicinals mutual restriction” elaborated in this article has been formed through long-term clinical practice and cognition， and refinement of clinical experience， which means that the nature partiality of toxic Chinese materia medica can be adjusted， and the toxicity can be suppressed through reasonable combination with herbal medicinalsof different properties， flavors， and effects. This theory covers the modes of compatibility for toxicity attenuation and the interaction relationships， like the restriction of medicinals with different properties and flavors， restriction of medicinals with different effects， and inhibiting toxins by reinforcing healthy qi. The opposite and complementary effects of various medicinals combinations are an extension of the connotations of this theory， and the principles can be explained from material basis and mechanism of action. Under the guidance of this theory， it is possible to optimize the compound prescription strategies of toxic Chinese materia medica， and provide new strategies for the clinical combinations of toxic Chinese materia medica， thereby achieving the reduction of toxicity and enhancement of effectiveness of the compound formulas.

Background Benzo[a]pyrene (BaP) is neurotoxic and can cause neuronal damage by oxidative stress. Proanthocyanidin (PC) has antioxidant activity, and its mechanism may related to nuclear factor-erythroid 2-related factor 2 (Nrf2)-heme oxygenase-1 (HO-1) signaling pathway. Objective To explore potential protective effect of PC on hippocampal neuron injury induced by BaP oxidative stress. Methods Hippocampal neurons of neonatal SD rats delivered within 24 h were isolated and cultured, and cell activity was detected by cell counting kit-8 (CCK-8) method. According to the pre-experimental results, a control group and three BaP groups of 10, 20 and 40 µmol·L⁻¹ were set up for Stage I experiment. The length of neurites and number of branches of hippocampal neurons in each group were observed by immunofluorescence method. Reactive oxygen species (ROS) fluorescence probe method was used to measure ROS levels in cells. Real-time quantitative fluorescent polymerase chain reaction (qRT-PCR) and Western blotting were used to detect the mRNA and protein expression of Nrf2, Kelch-like epichlorohydrin associated protein-1 (Keap1), HO-1, B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X (Bax) in hippocampal neurons of each group, respectively. According to the results of Stage I experiment, three group were set up, including control group, BaP alone treatment group (BaP 20 µmol·L⁻¹), and PC intervention group (BaP 20 µmol·L⁻¹ + PC 2.5 µg·mL⁻¹) for Stage II experiment, with the same protocol as Stage I. Results For Stage I experiment, compared with the control group, the 10, 20, and 40 µmol·L⁻¹ BaP groups showed gradually shortened length of neurites [(177.60±3.49), (142.40±6.52), and (100.50±19.40) µm] (P<0.05) and decreased number of branches (8.00±1.00, 6.33±1.53, 4.33± 0.58) of hippocampal neurons (P<0.05); increased ROS production (2.38±0.33, 8.08±0.26, 9.86±0.19) (P<0.05); the qRT-PCR results showed that the mRNA expression levels of Nrf2 (0.35±0.03, 0.25±0.01, 0.13±0.03), Keap1 (0.70±0.01, 0.47±0.03, 0.15±0.02), HO-1 (0.77±0.02, 0.60±0.02, 0.32±0.01), and Bcl-2 (0.65±0.03, 0.47±0.02, 0.18±0.02) gradually decreased, and the mRNA expression level of Bax gradually increased (1.24±0.01, 2.25±0.15, 4.98±0.30) (P<0.05); the Western blotting results showed that the protein expression trends of Nrf2, Keap1, HO-1, Bcl-2, and Bax were consistent with the mRNA results. For Stage II experiment, compared with the BaP alone treatment group, the length of neurites in the PC intervention group became longer, (149.90±3.01) μm vs (202.00±4.45) μm (P<0.05), the number of branches increased, (4.67±0.58) vs (8.33±0.58) (P<0.05); the ROS production reduced, (10.81±0.63) vs (7.31±0.70) (P<0.05); the mRNA expression levels of Nrf2, Keap1, HO-1, and Bcl-2 increased (P<0.05), and the mRNA expression levels of Bax decreased (P<0.05); the Nrf2, Keap1, HO-1, and Bcl-2 protein expression levels increased (P<0.05), and Bax protein expression level decreased (P<0.05). Conclusion PC may exert neuroprotective effects by activating the Nrf2-HO-1 signaling pathway, inhibiting BaP-induced oxidative stress in neuronal cells, and reducing cytotoxicity.

Humans ; Neoplasms, Second Primary/epidemiology* ; Neoplasms/epidemiology* ; Risk Factors ; Prognosis

Objective:To observe the efficacy of traditional Qigong exercise combined with Tuina(Chinese therapeutic massage)manipulations in treating lower cervical disc herniation(CDH).Methods:A total of 120 CDH patients who met the inclusion criteria were randomly divided into an observation group and a control group,with 60 cases in each group.Patients in both groups were given the same Tuina manipulations.In addition,patients in the observation group practiced traditional Qigong exercise,and those in the control group did conventional neck exercise.After 8 weeks of treatment,the efficacy of the two groups was observed.Follow-up was conducted 3 months after the end of the treatment to record any recurrence.Results:The total effective rate of the observation group was higher than that of the control group(P＜0.05).The improvement in symptom scores was more significant in the observation group than in the control group(P＜0.05).There was inter-group statistical significance in comparing the cross-sectional area and fatty infiltration of certain cervical muscles(P＜0.05).In addition,the recurrence rate in the observation group was lower than that in the control group(P＜0.05).Conclusion:On the basis of the same Tuina manipulation treatment,the efficacy of traditional Qigong exercise in treating CDH is superior to that of conventional neck exercise,with more significant improvements in pain and quality of life and a lower recurrence rate.

Objective:To analyze the genomic characteristics and variations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) derived from an outbreak in inbound flight in Aug, 2022 in Beijing, and provide reference data for disease prevention and control and risk assessment.Methods:Fifty respiratory tract specimens from all cases in this outbreak were collected. The digital PCR (ddPCR) was used to determine the viral loads of the specimens. The full genome of the viruses were sequenced by Next-generation sequencing. Then analuses were performed on the genetic identity, variations and phylogenesis.Results:The median of viral loads in all 50 samples were 5.57×10 4 copies/ml and 5.85×10 4 copies/ml, for ORF1ab gene and N gene, respectively. A total of 46 SARS-CoV-2 genomes were obtained, which all belonged to Omicron/BA.5. Two genome clusters were observed, involving 21 and 7 cases, with a nucleotide sequence identities of 99.993% and 99.997%, respectively. Conclusions:The studied outbreak was composed of two main clusters and other individual cases with Omicron/BA.5 virus overseas.

Studies have shown that plasma apolipoprotein B (ApoB) has a good predictive value for ischemic stroke and plays an important role in the prevention and treatment of ischemic stroke. More and more guidelines and consensus opinions began to recommend ApoB as a routine intervention target. This article reviews the biological characteristics, clinical detection advantages, and role and treatment prospect of ApoB in the prevention and treatment of ischemic stroke.

OBJECTIVES: Microvascular invasion (MVI) is an important predictor of postoperative recurrence or poor outcomes of hepatocellular carcinoma (HCC). Radiomics is able to predict MVI in HCC preoperatively. This study aims to investigate the influence of different region of interest (ROI) sizes on CT-based radiomics model for MVI prediction in HCC. METHODS: Patients with HCC with or without MVI confirmed by pathology and those who underwent preoperative plain or enhanced abdominal CT scans in the Third Xiangya Hospital of Central South University from January 2010 to December 2020 were retrospectively and consecutively included. According to the ratio of 7 to 3, the patients were randomly assigned into a training set and a validation set. Clinical data were collected from medical records, and radiomics features were extracted from the arterial phase (AP) and portal venous phase (PVP) of preoperatively acquired CT in all patients. Six different ROI sizes were employed. The original ROI (OROI) was manually delineated along the visible borders of the tumor layer-by-layer. The OROI was expanded out by 1-5 mm. The OROI was combined with 5 different peritumoral regions to generate the other 5 ROIs, named Plus1-Plus5. Feature extraction, dimension reduction, and model development were conducted in 6 different ROIs separately. Supporter vector machine (SVM) was used for model construction. Model performance was assessed via receiver operating characteristic (ROC) curve. RESULTS: A total of 172 HCC patients were included, in which 83 (48.3%) were MVI positive, and 89 (51.7%) were MVI negative. Three hundred and ninety-six features based on AP or PVP images were extracted from each ROI. After feature selection and dimension reduction, 4, 5, 15, 11, 6, and 3 features of OROI, Plus1, Plus2, Plus 3, Plus4, and Plus5 were selected for model construction, respectively. In the training set, the sensitivity, specificity, and area under the curve (AUC) of OROI were 0.759, 0.806, and 0.855, respectively. The AUC values of Plus2 (0.979) and Plus3 (0.954) were higher than that of OROI. The AUC values of Plus1 (0.802), Plus4 (0.792), and Plus5 (0.774) were not significantly different from those of OROI. In the validation set, the sensitivity, specificity, and AUC value of OROI were 0.640, 0.630, and 0.664, respectively. The AUC value of Plus3 was 0.903, which was higher than that of OROI. The AUC values of Plus1 (0.679), Plus2 (0.536), Plus4 (0.708), and Plus5 (0.757) were not significantly different from that of OROI (P>0.05). CONCLUSIONS The size of ROI significantly inflluences on the performance of CT-based radiomics model for MVI prediction in HCC. Including appropriate area around the tumor into ROI could improve the predictive performance of the model, and 3 mm might be appropriate distance.
Carcinoma, Hepatocellular/pathology* ; Humans ; Liver Neoplasms/pathology* ; Predictive Value of Tests ; Retrospective Studies ; Tomography, X-Ray Computed/methods*

Purpose: This study aimed to investigate the changes in microRNA-130a (miR-130a) and its correlation with cardiotoxicity during epirubicin/cyclophosphamide followed by docetaxel plus trastuzumab (EC-D+T) adjuvant chemotherapy in human epidermal growth factor receptor-2-positive (HER2+) breast cancer patients. Methods: A total of 72 HER2+ breast cancer patients who underwent resection and were scheduled to receive EC-D+T adjuvant therapy were consecutively enrolled. The expression of miR-130a and cardiotoxicity (defined as any of the following situations: 1) absolute decline of left ventricular ejection fraction (LVEF) ≥ 10% and LVEF < 53%; 2) heart failure; 3) acute coronary artery syndromes; and 4) fatal arrhythmia) were assessed every 3 months throughout the 15-month EC-D+T treatment. Results: The accumulating cardiotoxicity rate was 12 (16.7%), of which the incidence of heart failure, acute coronary syndrome, life-threatening arrhythmias, ΔLVEF ≥ 10%, and LVEF < 53% was 0 (0.0%), 1 (1.4%), 0 (0.0%), and 12 (16.7%), respectively. Baseline miR-130a expression was negatively correlated with LVEF (%) and positively correlated with cardiac troponin I. The expression of miR-130a gradually increased in both cardiotoxicity and noncardiotoxicity patients during EC-D+T treatment, while the increment of miR-130a was more obvious in cardiotoxicity patients compared with non-cardiotoxicity patients. Further logistic regression and receiver operating characteristic curve analysis indicated that miR-130a was an independent predictive factor for increased cardiotoxicity risk. Conclusion MiR-130a increases constantly and predicts high cardiotoxicity risk during ECD+T adjuvant chemotherapy in HER2+ breast cancer patients.

Purpose: This study aimed to investigate the changes in microRNA-130a (miR-130a) and its correlation with cardiotoxicity during epirubicin/cyclophosphamide followed by docetaxel plus trastuzumab (EC-D+T) adjuvant chemotherapy in human epidermal growth factor receptor-2-positive (HER2+) breast cancer patients. Methods: A total of 72 HER2+ breast cancer patients who underwent resection and were scheduled to receive EC-D+T adjuvant therapy were consecutively enrolled. The expression of miR-130a and cardiotoxicity (defined as any of the following situations: 1) absolute decline of left ventricular ejection fraction (LVEF) ≥ 10% and LVEF < 53%; 2) heart failure; 3) acute coronary artery syndromes; and 4) fatal arrhythmia) were assessed every 3 months throughout the 15-month EC-D+T treatment. Results: The accumulating cardiotoxicity rate was 12 (16.7%), of which the incidence of heart failure, acute coronary syndrome, life-threatening arrhythmias, ΔLVEF ≥ 10%, and LVEF < 53% was 0 (0.0%), 1 (1.4%), 0 (0.0%), and 12 (16.7%), respectively. Baseline miR-130a expression was negatively correlated with LVEF (%) and positively correlated with cardiac troponin I. The expression of miR-130a gradually increased in both cardiotoxicity and noncardiotoxicity patients during EC-D+T treatment, while the increment of miR-130a was more obvious in cardiotoxicity patients compared with non-cardiotoxicity patients. Further logistic regression and receiver operating characteristic curve analysis indicated that miR-130a was an independent predictive factor for increased cardiotoxicity risk. Conclusion MiR-130a increases constantly and predicts high cardiotoxicity risk during ECD+T adjuvant chemotherapy in HER2+ breast cancer patients.