Objective:To summarize the best evidence for preventing and managing radiotherapy-induced oral mucositis in patients with head and neck cancer.Methods:The clinical decisions, best practices, guidelines, expert consensus, systematic reviews, and evidence summaries regarding the prevention and management of radiotherapy-induced oral mucositis in patients with head and neck cancer were retrieved from UpToDate, British Medical Journal (BMJ) Best Practice, Agency for Healthcare Research and Quality, Medlive, National Comprehensive Cancer Network, European Society for Medical Oncology, Cochrane Library, Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc and so on. The search period was from database establishment to November 30, 2023.Results:A total of 18 articles were included, involving six guidelines, two expert consensus, eight systematic reviews, and two evidence summaries. Thirty-four best pieces of evidence were summarized from six aspects of assessment: drug prevention, non-drug prevention, anti-infection and analgesic management, health education, and multidisciplinary team management.Conclusions:This study summarizes the best evidence for preventing and managing radiotherapy-induced oral mucositis in patients with head and neck cancer. Medical and nursing staff should consider the patient's characteristics, disease condition, and willingness when selecting and applying evidence.

Cancer anorexia/cachexia syndrome (cancer anorexia cachexia syndrome, CACS) is a common complication in advanced cancer patients, which is characterized by reduced feeding, sustained weight loss, general fatigue and weakness. CACS related symptoms make patients suffer from a series of adverse psychosocial effects, such as anxiety, pain and social isolation, thus bringing serious adverse effects on patients′ individuals, families and society. This paper reviewed the symptoms associated with CACS and their psychosocial effects, as well as the interventions related to adverse psychosocial effects, in order to provide theoretical reference for alleviating psychosocial distress and improving health-related quality of life of patients with CACS.

Objective:To translate the Health Literacy of Caregivers Scale-Cancer (HLCS-C) into Chinese and test its reliability and validity.Methods:The British translation model was used to translate and back translate the English version scale, and the Chinese version scale was initially verified and revised through expert consultation and pre-test. From June to September 2021, 242 caregivers of cervical cancer patients admitted to Shandong Cancer Hospital were selected by convenient sampling. The revised Chinese version of HLCS-C was used to investigate the caregivers for reliability and validity test. A total of 242 questionnaires were distributed and 226 valid questionnaires were recovered.Results:There were 44 items in the Chinese version of HLCS-C. The exploratory factor analysis showed that the scale included 8 dimensions, namely cancer information collection, cancer information mastery, social support, cancer related communication with patients, understanding of patients' needs and preferences, health and healthcare service use, health information processing, and active participation with medical and nursing staff, with a cumulative variance contribution rate of 73.448%. The scale-level content validity index ( S- CVI) was 0.981, and the item-level content validity index ( I- CVI) was 0.833 to 1.000. The total Cronbach's α coefficient of the scale was 0.946, and Cronbach's α coefficient of each dimension was 0.700 to 0.945. The total half-reliability coefficient of the scale was 0.791, and the half-reliability coefficient of each dimension was 0.635 to 0.867. Conclusions:The Chinese version of HLCS-C has good reliability and validity, and can be used as an assessment tool for the health literacy of cervical cancer caregivers.

Objective    To assess the feasibility and safety of ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy in selected patients with primary palmar hyperhidrosis. Methods    From March 1, 2018 to February 1, 2021, 90 patients with primary palmar hyperhidrosis who underwent ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy at the Thoracic Surgery Department of the University of Hong Kong-Shenzhen Hospital. There were 47 males and 43 females, with a median age of 26.0 (22.0, 31.0) years. During the operation, T3 and/or T4 thoracic sympathetic nerve chain was transected using an ultra-micro 5 mm single-port incision near the areola or under the axilla. The surgical data of the patients were retrospectively reviewed and analyzed. Results     All patients successfully completed the operation without major bleeding during the operation and no conversion to thoracotomy. There was no death or serious complication during the perioperative period. The operation time was 43.0 (23.0, 60.0) min, and the intraoperative blood loss was 2.0 (1.0, 2.0) mL. In the perioperative period, only one patient needed a tiny chest tube indwelling. The symptoms of hyperhidrosis on the hands all disappeared after the operation. The pain score on the postoperative day was 2.0 (2.0, 2.0) points. The hospital stay after surgery was 1.0 (1.0, 1.0) d. In the first month after the operation, the symptoms of hyperhidrosis on the hands were significantly relieved compared with those before the operation. The surgical incisions healed well, the wounds were concealed, and there was no wound infection or poor healing. The patients' satisfaction with the surgical incisions was 100.0%. After the operation, 14 (15.6%) patients had mild compensatory hyperhidrosis, 5 (5.6%) patients had moderate compensatory hyperhidrosis, and no patient had severe compensatory hyperhidrosis. Overall satisfaction rate was 94.0%. Conclusion     The clinical application of ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy in selected patients with primary palmar hyperhidrosis is safe and feasible. The surgical wound is extremely small and hidden, the operation time is short, the pain is very slight, and the clinical outcome is good. It can fully meet the patients' pursuit of beauty.

Objective: Abstract: Objective: cancer cells and its effects on the proliferation and migration of gastric cancer cells. Methods: The expression level of LINC00473 in gastric cancer cells was verified by qRT-PCR system. LINC00473 siRNA segment and overexpression vector were separately transfected into gastric cancer cells by the method of lipofection. The proliferation and migration abilities of gastric cancer cells with LINC00473 knockdown or overexpression in vitro were evaluated by cell counting kit-8 (CCK8) assay, colony formation assay and Transwell migration assay. The expression levels of proteins involved in epithelial-mesenchymal transition (EMT) were examined by western blot analysis. Results: The expression levels of LINC00473 were decreased in gastric cancer cells compared with that in human gastric epithelial cell strain GES-1 (P＜0.05). LINC00473 knockdown cells showed significant increased ability for cell growth (F=163.10, P＜0.01) and colony formation (t=3.29, P＜0.05) compared with the knockdown cells in scramble control. The results of Transwell migration assay showed that LINC00473-knockdown enhanced the migratory abilities of gastric cancer cells (t=4.68, P＜0.05). The knockdown of LINC00473 downregulated E-cadherin expression (t=4.08, P＜0.05) and upregulated N-cadherin (t=5.06, P＜0.01), Snail (t=7.69, P＜0.01) and Vimentin (t=3.82, P＜0.05) expression. Compared with the control group, LINC00473 overexpression cells showed significantly decreased cell growth (F=186.00, P＜0.01) and colony formation ability (t=3.22, P＜0.05). The results of Transwell migration assay showed that LINC00473-overexpression reduced the migratory ability of gastric cancer cells (t=5.52, P＜0.05). The overexpression of LINC00473 enhanced E-cadherin expression (t=2.90, P＜0.05) and reduced the expressions of N-cadherin (t=7.44, P＜0.01), Snail (t=2.78, P＜0.05) and Vimentin (t=4.64, P＜0.01). Conclusion The knockdown of LINC00473 may promote gastric cancer cell proliferation and migration in vitro by regulating EMT.

Objective: To investigate the function of virD4 gene in Helicobacter pylori clinical strain SBK. Methods: The virD4 gene segment was obtained through T-A cloning method. The prokaryotic expression vector pET-28a(＋)-virD4 was constructed and transformed into E. coli Rosetta for the expression by induction of IPTG. The recombinant proteins were obtained and purified by KCl dyeing with gel cutting method, and identified via SDS-PAGE analysis. The purified recombinant virD4 protein was used to immunize mice to produce polyclonal antibodies. The titer of the polyclonal antibodies was tested by ELISA and the antigenic specificity was identified by western blot. The purified recombinant virD4 proteins were co-cultured with GES-1 cells followed by detecting the expression of inflammatory cytokines secretion and the ability of cell proliferation. Results: The full length of virD4 gene was 1 728 bp. The sequence shared quite high homology with the virD4 gene of isolate Shi470. The recombinant prokaryotic expression plasmid pET-28a(＋)-virD4 was successfully constructed. The recombinant virD4 proteins were obtained by IPTG induction and purified via KCl dyeing method. SDS-PAGE showed that the relative molecular weight of recombinant virD4 protein was 63 000. The purified proteins were used to immunize mice to obtain the anti-virD4 polyclonal antibodies with the titer 512 000. The reaction between anti-virD4 polyclonal antibodies and recombinant virD4 proteins was highly specific. The recombinant virD4 protein induced inflammatory cytokines secretion and promoted GES-1 cell proliferation. Conclusion The virD4 gene was successfully cloned and highly expressed in prokaryotic expression system, and its antibodies were prepared. The recombinant virD4 protein can induce cytokine secretion and cell proliferation.

BACKGROUND:How to make more transplanted bone marrow stem cel s stay and differentiate in the liver is an important issue, which is also crucial for treatment of liver cirrhosis via the hepatic artery.
OBJECTIVE:To investigate the therapeutic effect of autologous bone marrow stem cel transplantation via the hepatic artery on liver cirrhosis.
METHODS:Thirty New Zealand white rabbits were equivalently randomized into normal control, stem cel transplantation and model groups. Animal models of liver cirrhosis were made in the latter two groups. Then, model rabbits in the stem cel transplantation group were subjected to autologous bone marrow stem cel transplantation via the hepatic artery. Liver function of rabbits was detected in 1, 2, 4, 8, 10 weeks after cel transplantation, and pathological detection of the liver was performed in the 10th week.
RESULTS AND CONCLUSION:At 10 weeks after cel transplantation, the liver function of the rabbits was improved significantly compared with the model group, including reduced activities of serum alanine aminotransferase, total bilirubin and aspartate aminotransferase, shortened activated partial thromboplastin time, and increased albumin level (P<0.05). Pathological examination of the liver showed that the liver cel s in the stem cel transplantation group were intact with no obvious edema and stil had the structure of the pseudolobule, and compared with the model group, the degree of liver fibrosis was significantly reduced in the stem cel transplantation group. Our experimental results show that the transplantation of autologous bone marrow stem cel s via the hepatic artery has a certain therapeutic effect on liver cirrhosis by increasing the body albumin content in a short time and improving the liver function.

BACKGROUNDHemoptysis is a significant clinical entity with high morbidity and potential mortality. Both medical management (in terms of resuscitation and bronchoscopic interventions) and surgery have severe limitations in these patients population. Bronchial artery embolization (BAE) represents the first-line treatment for hemoptysis. This article discusses clinical analysis, embolization approach, outcomes and complications of BAE for the treatment of hemoptysis.

METHODSA retrospective analysis of 344 cases, who underwent bronchial arteriography at Tianjin Haihe Hospital between 2006 and 2013. Several aspects of outcome were analyzed: Demographics, clinical presentation, radiographic studies, results, complications and follow-up of BAE.

RESULTSThree hundred and forty-four consecutive patients underwent bronchial arteriography, 336 of 344 patients (97.7%) performed BAE; there were 1530 coils for 920 arteries embolized; the main responsible sources for bleeding were right bronchial artery (29.7%), left bronchial artery (21.6%), combined right and left bronchial trunk (18.4%), right intercostal arteries (13.3%); 61 patients (17.7%) had recurrent hemoptysis within 1 month after undergoing BAE, 74 patients (21.5%) had recurrent hemoptysis over 1 month after undergoing BAE; The common complications of BAE included subintimal dissection, arterial perforation by a guide wire, fever, chest pain, dyspnea, etc. The follow-up was completed in 248 patients, 28 patients had been dead, 21 patients still bleed, 92 patients had lost to follow-up.

CONCLUSIONSThe technique of BAE is a relatively safe and effective method for controlling hemoptysis . The complications of BAE are rare. Although the long-term outcome in some patients is not good, BAE may be the only life-saving treatment option in patients who are poor surgical candidates.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bronchial Arteries ; Embolization, Therapeutic ; methods ; Female ; Hemoptysis ; therapy ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective To evaluate the serum 25-hydroxyvitamin D [25 (OH)D3] levels in non-diabetic people in Taiyuan community,and its relationship with obesity and abdominal obesity.Methods This crosssectional study enrolled 417 non-diabetic people in Tainyuan community from July to September in 2011 [225 males and 192 females,mean age (47.6 ±7.8) years].For all the enrolled subjects,we collected data about anthropometric indexes,medical history,blood glucose,lipid profile,25 (OH) D3,fasting insulin (Fins) level,homeostasis model assessement for insulin resistance (HOMA-IR),body fat content (％) measured with dualenergy X-ray absorptiometry (DEXA),and intra-abdominal adipose tissue (IAAT) and abdominal subcutaneous adipose tissue (SCAT) calculated based on magnetic resonance imaging at the 4th to 5th lumbar disc level (IAAT≥80 cm2 was considered abdominal obesity).Correlation analysis was performed to assess the relationships of serum 25 (OH) D3 levels with biochemical and body fat indexes.Results The average serum level of 25 (OH) D3 was 44.5 nmol/L in the 417 people,with vitamin D deficiency in 261 cases (62.6％) and vitamin D insufficiency in 109 cases (26.1％).Of the vitamin D deficient and insufficient people,77.6％ had abdominal obesity according to IAAT (IAAT ≥ 80 cm2).According to Pearson analysis result,lg 25 (OH)D3 was negatively correlated with lg Fins,lg HOMA-IR,waist circumference,systolic blood pressure,diastolic blood pressure,total abdominal adipose tissue (TAAT),IAAT (all P ＜0.05).It was also negatively correlated with waist-to-hip-ratio,body mass index (BMI),and body fat content (％),but without statistical significance (all P ＞0.05).In stepwise multiple linear regression model,lg HOMA-IR (t =-4.278,P =0.001) and TAAT (t =-5.146,P =0.002) were independently correlated with lg 25 (OH) D3.Conclusions About 90％ of all non-diabetic population in Taiyuan community have vitamin D deficiency or insufficiency,of whom 4/5 have abdominal obesity.Serum 25 (OH)D3 level is negatively correlated with abdominal adipose tissue,but not significantly associated with BMI.HOMA-IR and TAAT are independent risk factors for vitamin D deficiency.

Background and purpose:At present, the relationship between tumor length and prognosis of esophageal carcinoma patients has been a controversial topic, and there have been few studies describing the effect of tumor length on clinicopathology and prognosis of node-negative esophageal carcinoma patients. The purpose of this study was to investigate the effect of the tumor length on clinicopathology and prognosis of node-negative esophageal carcinoma patients.Methods:The clinicopathological characteristics and survival time of 686 node-negative esophageal carcinoma patients, conifrmed by surgical pathology specimens in the First Afifliated Hospital of Nanjing Medical University from Jan. 2008 to Dec. 2010, were retrospectively analyzed. The optimal cut-off value was determined by decision tree model. Univariate and multivariate methods were used to analyze the prognostic factors of node-negative esophageal carcinoma patients.Results:In decision tree analysis, esophageal tumor length was correlated with an increasing hazard ratio for death with a cut-off value at 3 cm. No signiifcant differences were found in gender, onset age, lesion site and pathological type between 2 groups which were patients with tumor length≤3 cm and tumor length >3 cm (P>0.05). The only 1 difference between 2 groups was T stage (P<0.001), and tumor length had a positive correlation with T stage (r=0.373). The 1-, 3- and 5-year survival rates of patients with tumor length≤3 cm and tumor length >3 cm were 95.7%, 84.4%, 76.1% and 88.3%, 57.8%, 46.5% respectively, and the difference was statistically signiifcant (P<0.001). Tumor length was signiifcantly associated with overall survival in univariate and multivariate analyses.Conclusion:Tumor length has close relationship with T stage in node-negative esophageal carcinoma patients. Tumor length≤3 cm could be considered as T1-2 and >3 cm as T3. Tumor length is an important prognostic factor for esophageal carcinoma patients without lymphatic metastasis.