Objectives To explore the establishment and effects of a multilevel and inter-disciplinary management scheme for specialist nurses.Methods The multilevel and inter-disciplinary management scheme included establishing the pyramid hierarchical training model,exploring superimposed training mechanism for specialist nurses with horizontal expansion,vertical extension,and deep development,and constructing stereoscopic clinical evaluation and quantitative assessment system.Four hundred-forty two specialized nurses have been recruited to join the multilevel and inter-disciplinary management scheme from July 2021 to August 2023.The core competencies of specialized nurses were compared before and after the implementation of management scheme.Results The quality development of specialized nursing have been improved,and the total scores and the scores of 3 dimensions(research innovation,management,and professional development)in core competencies of specialized nurses after the intervention of multilevel and inter-disciplinary management scheme were higher than those before(P＜0.05).Conclusion The multilevel and inter-disciplinary management scheme can effectively improve the core competencies of specialized nurses,and promote the high-quality development of specialized nursing.

ObjectiveTo clarify the therapeutic effect of Huashi Baidu prescription on pneumonia in mice caused by influenza A （H1N1） virus and explore its mechanism based on the transcriptome. MethodA mouse influenza viral pneumonia model was built by intranasal infection with influenza A virus， and mice were continuously administered the drug for five days， so as to investigate the general condition， lung index， viral load， pathological morphology of lung tissue， survival time， and prolongation rate of survival time of mice and clarify the therapeutic effect of Huashi Baidu prescription on influenza viral pneumonia. Transcriptome technology was used to detect the differentially expressed genes in the lung tissue of mice in the model group and the normal group， as well as the Huashi Baidu prescription group and the model group， and the potential core target of the Huashi Baidu prescription for the treatment of influenza viral pneumonia was screened. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to verify the effect of Huashi Baidu prescription on the mRNA expression level of core target genes. ResultCompared with the normal group， the lung index and viral load in the lung tissue of the model group were significantly increased （P<0.05， P<0.01）. Compared with the model group， the high-dose group of Huashi Baidu prescription significantly prolonged the survival time of mice infected with influenza A virus （P<0.05） and significantly reduced the lung index value of mice （P<0.05） and the viral load of lung tissue. The high-dose， medium-dose， and low-dose groups of Huashi Baidu prescription could significantly reduce lung tissue inflammation， blood stasis， swelling， and other pathological changes in mice （P<0.05， P<0.01）. Transcriptome analysis of lung tissue showed that core genes were mainly enriched in the nuclear transcription factor-κB （NF-κB） signaling pathway， interleukin-17 （IL-17） signaling pathway， cytokine-cytokine receptor interaction， and other pathways after the intervention of Huashi Baidu prescription. TRAF6， NFKBIA， CCL2， CCL7， and CXCL2 were the top five node genes with combined score values. Real-time PCR validation showed that Huashi Baidu prescription significantly downregulated the mRNA expression of key genes TRAF6 and NFKBIA in the NF-κB signaling pathway， as well as chemokines CCL2， CCL7， and CXCL2 （P<0.05， P<0.01）. ConclusionHuashi Baidu prescription has a therapeutic effect on influenza viral pneumonia， possibly by inhibiting the expression of key nodes TRAF6 and NFKBIA in the NF-κB signaling pathway and that of chemokines CCL2， CCL7， and CXCL2， reducing the recruitment of inflammatory cells and viral load， and exerting anti-influenza viral pneumonia effects.

A 15-year-old female was referred to the hospital with intermittent fever, where multiple systemic abnormalities were found, such as splenomegaly, secondary hypersplenism, retinitis pigmentosa, and ectodermal dysplasia. Medical history revealed that she had suffered recurrent respiratory infections, blurred vision at night, and dysplasia of teeth and nail beds since childhood. Then she was suspected to be experiencing ROSAH syndrome, a rare disease newly recognized in recent years, which was finally confirmed by gene sequencing results. During a course of treatment with tumor necrosis factor inhibitors, recurrent fever with elevated inflammatory markers reappeared, and the child developed headaches. To guide the comprehensive treatment and improve the patient's quality of life, the multidisciplinary team in Peking Union Medical College Hospital discussed together and directed the following treatment.

Objective:To analyze the effect of palliative care based on multidisciplinary collaboration on cancer-related fatigue, quality of life and social support of cancer patients and to evaluate its application value.Methods:From April 2019 to May 2021, a total of 682 terminal cancer patients who were admitted to Affiliated Cancer Hospital of Zhengzhou University were selected as the research objects by the convenient sampling method. According to the random number table method, they were divided into the control group and the observation group, with 341 cases in each group. The control group received traditional cancer hospice medical treatment and nursing management, while the observation group received multidisciplinary hospice care on this basis. The cancer-related fatigue, quality of life, nursing satisfaction, and the degree of family and social support were compared between the two groups.Results:There was no statistically significant difference in the score of cancer-related fatigue between the two groups before intervention ( P>0.05) . After intervention, the scores of cancer-related fatigue in the two groups decreased and that of the observation group was lower than the control group, and the differences were statistically significant ( P<0.05) . There was no statistically significant difference in quality of life score between the two groups before intervention ( P>0.05) . After intervention, the quality of life scores of the two groups were improved and that of the observation group was higher than the control group, and the differences were statistically significant ( P<0.05) . There were no statistically significant differences in family support, friend support and other support between the two groups before intervention ( P>0.05) . After intervention, the scores of family support, friend support and other support in the two groups were improved, and the scores of family support and other support in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The total nursing satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Palliative care based on multidisciplinary collaboration can improve cancer-related fatigue, quality of life, family and social support and nursing satisfaction of patients.

Objective:To analyze the effect of palliative care based on multidisciplinary collaboration on cancer-related fatigue, quality of life and social support of cancer patients and to evaluate its application value.Methods:From April 2019 to May 2021, a total of 682 terminal cancer patients who were admitted to Affiliated Cancer Hospital of Zhengzhou University were selected as the research objects by the convenient sampling method. According to the random number table method, they were divided into the control group and the observation group, with 341 cases in each group. The control group received traditional cancer hospice medical treatment and nursing management, while the observation group received multidisciplinary hospice care on this basis. The cancer-related fatigue, quality of life, nursing satisfaction, and the degree of family and social support were compared between the two groups.Results:There was no statistically significant difference in the score of cancer-related fatigue between the two groups before intervention ( P>0.05) . After intervention, the scores of cancer-related fatigue in the two groups decreased and that of the observation group was lower than the control group, and the differences were statistically significant ( P<0.05) . There was no statistically significant difference in quality of life score between the two groups before intervention ( P>0.05) . After intervention, the quality of life scores of the two groups were improved and that of the observation group was higher than the control group, and the differences were statistically significant ( P<0.05) . There were no statistically significant differences in family support, friend support and other support between the two groups before intervention ( P>0.05) . After intervention, the scores of family support, friend support and other support in the two groups were improved, and the scores of family support and other support in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The total nursing satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Palliative care based on multidisciplinary collaboration can improve cancer-related fatigue, quality of life, family and social support and nursing satisfaction of patients.

Objective To construct the diabetic home care platform and to explore its effects in follow-up man agement of patients with gestational diabetes mellitus.Methods The diabetic home care platform contained clientsides for both nurses and patients,who could use the platform via identification and binding technology.Totally 200 patients with gestational diabetes mellitus in outpatient department from November 2015 to December 2016 were recruited using convenience sampling.Patients were divided into the experimental group and the control group with 100 cases in each group based on the voluntary principle.Both groups received routine follow-up management,and the experimental group also used diabetic home care platform management.Results There were no differences in gestational weeks,mode of delivery,postpartum hemorrhage,other complications,fetal intrauterine distress,neonatal hypoglycemia,and deformity between two groups(P＞0.05).Rate of macrosomia in the experimental group was lower than that in the control group(P＜0.05),and rate of breastfeeding was higher than the control group(P＜0.05).The total score of Diabetes Self-Care Activeties-6 and scores of each dimension in the experiential group were higher than those in the control group 8 weeks after intervention(P＜0.001);the total score of Problem Areas in Diabetes Scale and scores of each dimension in the experimental group were lower than those in the control group(P＜0.05).Conclusion Application of diabetic home care platform is helpful for fetal weight control,and can improve rate of breastfeeding,promote women's self-management behavior and emotional disorders.

Objective To study the effect of black granule capsules(BGCs) on growth of transplanted mouse hepatocarcinoma cells, cell proliferation cycle and apoptosis.Methods KM mouse were subcutaneously inoculated with Hepatocarcinoma cells (H22) and randomly divided into the model control group, the positive control group, the low, medium and high does of BGC group after 24h. The positive control group received intraperitoneal injection with 30 mg/kg cyclophosphamide. Mice of BGC groups were intragastricaly with different dosage of BGC (400, 800, 1 600 mg/kg). The model control group received intragastricaly with normal saline. The drugs were administrated once a day for seven days. The tumor inhibition rate was calculated at 24 h after the last administration. Flow cytometry was used to detect changes of cell cycle and apoptosis in harvested H22 tumor cells.Results The group of high does showed significant inhibitory effect on the growth of transplanted H22 tumor cells withthe inhibitory rate 38.78% (male) and 43.57% (female). Compared with model control group, groups of different dosages decreased time of G0-G1 phase (58.06% ± 9.65%, 55.10% ± 5.89%, 61.36% ± 15.95%vs. 74.47% ± 2.63%), increased tiem of Sphase (33.96% ± 11.90%, 32.67% ± 4.04%, 33.89% ± 9.82%vs. 14.37% ± 4.92%), and increased the apoptosis rate (31.12% ± 1.85%, 31.89% ± 2.16%, 40.64% ± 0.55%vs.21.75% ± 2.64%).Conclusion BGC has antitumor effect on mouse hepatocarcinoma H22 tumor cells, and its mechanism was to regulate cell proliferation cycle and induce the apoptosis.

OBJECTIVETo explore the effect of the Hsp90 inhibitor anacardic acid on cell proliferation, invasion and migration of breast cancer MDA-MB-231 cells.

METHODSThe inhibitory effect of anacardic acid on Hsp90 was assessed with in vitro ATPase inhibition assay and ATP-sepharose binding assay. MTT assay was used to detect the growth inhibition induced by anacardic acid in MDA-MB-231 cells. Transwell assays were used to evaluate MDA-MB-231 cell invasion and migration. Western blotting was performed to assess the effect of anacardic acid in triggering the degradation of MMP-9, TIMP-1, Hsp90, and Hsp70.

RESULTSAnacardic acid exhibited a modest activity of ATPase inhibition with an IC50 value of 82.5 µmol/L. Anacardic acid significantly suppressed the proliferation of MDA-MB-231 cells in a dose-dependent manner (IC50 value of 29.3 µmol/L). Treatment with 12.5, 25, and 50 µmol/L anacardic acid for 36 h caused inhibition of cell invasion by 23.6%, 56.6%, and 67.0% in MDA-MB-231 cells, respectively (P<0.05), and anacardic acid treatment for 24 h inhibited the cell migration by 30.0%, 45.5%, and 77.5%, respectively (P<0.05). Anacardic acid dose-dependently induced MMP-9 degradation, but did not obviously affect Hsp90 or Hsp70 expressions.

CONCLUSIONAnacardic acid can significantly inhibit the proliferation, invasion, and migration of MDA-MB-231 cells, the mechanism of which may involve the inhibition of Hsp90 ATPse activity and down-regulation of MMP-9 expression.

Anacardic Acids ; pharmacology ; Breast Neoplasms ; pathology ; Cell Line, Tumor ; drug effects ; Cell Movement ; Cell Proliferation ; Down-Regulation ; HSP90 Heat-Shock Proteins ; antagonists & inhibitors ; metabolism ; Humans ; Matrix Metalloproteinase 9 ; metabolism ; Tissue Inhibitor of Metalloproteinase-1 ; metabolism

OBJECTIVETo improve the water solubility and biological activity of neoligans (magnolol and honokiol) and test the antitumor activity of the modified compounds.

METHODSThe glycosylated products of magnolol and honokiol were obtained by enzymatic synthesis using a UDP-glycosyltransferase (YjiC) from Bacillus. The products were characterized by high-performance liquid chromatography (HPLC), liquid chromatography-mass spectrometry (LC-MS), and nuclear magnetic resonance (NMR) analysis. MTT assay was used to detect the growth inhibition of 4 human cancer cell lines induced by the compounds.

RESULTSWe obtained two glucosides of neolignans (magnolol and honokiol) for the first time by enzymatic synthesis using a UDP-glycosyltransferase. Based on the spectroscopic data, the glucosides were identified as magnolol-2- O-β-D-glucopyranoside (1) and honokiol-4'-O-β-D-glucopyranoside (2). Compounds 1-4 exhibited moderate anti-proliferative activities against the 4 human cancer cell lines, with IC50 values ranging from 9.41 to 111.21 µmol/L.

CONCLUSIONThe glycoslated products show enhanced water solubility and drug sensitivity against SMMC7721 cells, suggesting their value as potential therapeutic drugs.

Antineoplastic Agents, Phytogenic ; chemistry ; Biphenyl Compounds ; chemistry ; Cell Line, Tumor ; Chromatography, High Pressure Liquid ; Glucosides ; chemistry ; Glycosylation ; Humans ; Lignans ; chemistry ; Magnetic Resonance Spectroscopy ; Mass Spectrometry

Objective To investigate the safety and clinical efficacy of recombinant human endostatin injection (endostar) continuous pumping combine with chemotherapy injection in the treatment of advanced malignancies . Methods 156 patients with advanced cancer were divided into the chemotherapy group (78 cases) and the chemotherapy combined with endostar group (78 cases). The two groups were similar in the tumor types, the neoplasm staging, the KPS and the chemotherapy agents. After two cycles chemotherapy, the efficacy was evaluated according to RECIST criteria and the quality of life (QOL) was assessed by KPS scores. Results The objective response rate (RR) of the chemotherapy combined with endostar group was 39.74%(31/78). The RR of the chemotherapy group was 17.95%(14/78). There was statistics significance in the RRs of the two groups (P<0.05). The QOL of 42 cases (53.8%) were improved, 26 cases (33.3%) were in stable and 10 cases (12.8%) were decreased in the chemotherapy combined with endostar group. The QOL were improved in 30 cases (38.5 %), stabled in 17 cases (21.8 %) and decreased in 31 cases (39.7 %) in the chemotherapy group. There were significant difference between the two groups (P< 0.05). The main adverse reactions were myelosuppression and digestive tract reaction in both groups (P>0.05), and all patients can tolerate. Conclusion The QOL of patients with advanced malignant tumors are improved by endostar combined with chemotherapy which is safe and effective. It is worthy further clinical observation.