Objective To investigate the incidence and severity of symptoms in patients with gastric cancer who received chemotherapy,we constructed a symptom network to explore core symptoms and bridge symptoms.Furthermore,the study explores the association between core symptoms and Traditional Chinese Medicine(TCM)constitutions.Methods Patients with gastric cancer who received chemotherapy in the medical oncology and surgical oncology department from March to August 2023 were selected for the study using a convenience sampling method.The MD Anderson Symptom Inventory Gastrointestinal Cancer was used for evaluating gastrointestinal symptoms and their severity among patients receiving chemotherapy for gastric cancer,as well as assessing the classification of TCM constitution among patients.The symptom network model was constructed using the R programming language,and the central index was analyzed to determine the core symptoms and bridge symptoms.Binary logistic regression analysis was employed to assess the association between different physical conditions and the occurrence of core symptoms.Results A total of 346 electronic questionnaires were collected,with 340 valid ones,and the effective recovery rate was 98.3％.The 3 most prevalent and severe symptoms among the 340 patients with gastric cancer were fatigue(85.59％),lack of appetite(82.35％),and taste alteration(81.18％).The centrality index results indicated that grief exhibited the highest intensity,medium,and compactness centrality values(rs=8.23,rb=2.00,rc=0.03),making it the core symptom of this condition.Sleep disorders,lack of appetite,drowsiness,and taste alteration were identified as bridging symptoms with bridge intensities of 0.74,0.76,0.99,and 0.94 respectively.The results of Spearman correlation analysis showed that there was a positive correlation between sadness and qi-deficiency constitution,phlegm-dampness constitution(P＜0.05).The phlegm-dampness constitution was positively correlated with the taste alterations(P＜0.05).Conclusion In patients with gastric cancer,fatigue emerges as the most prominent symptom,while sadness assumes the core symptom.Additionally,sleep disorder,lack of appetite,drowsiness,and taste alteration are bridge symptoms.According to the principles of TCM constitution,qi-deficiency and phlegm-dampness are constitutions associated with a higher risk of experiencing sadness,and phlegm-dampness is a constitution associated with a higher risk of taste changes.Nurses can integrate core symptoms and TCM constitutions characteristics to optimize the strategies for symptom intervention.

To understand the current status of emergency nurses’ patient safety attitude cognition and its influencing factors, 746 emergency nurses from 34 hospitals were investigated with the revised Chinese version of the safety attitude questionnaire. The results showed that the total mean score of patient safety attitude of emergency nurses was (3.98±0.40) points, which was above the middle level. Among them, the mean scores of team cooperation, safety atmosphere, management perception, work satisfaction, working condition, and stress perception were (4.14±0.85) points, (3.85±0.81) points, (3.90±0.81) points, (3.91±0.85) points, (3.86±1.06) points, and (3.89±0.59) points, respectively. Multiple linear regression analysis showed that length of service and grade of hospital were the influencing factors of emergency nurses’ patient safety attitude (P<0.05). It is suggested that the managers should incorporate patient safety culture into the training and management of emergency nurses, especially strengthen the safety culture education for junior nurses; the secondary hospital should also focus on enhancing team cooperation training for emergency nurses and improving the working environment of them, so as to reduce unsafe behaviors in nursing work and ensure patients’ safety.

Objective To explore the systematic nursing intervention for patients with artificial anal bowel habit of effect.Methods Our hospital from May 2020 to select-treated 100 cases of artificial anal in May,2022 patients as the research object,the patients were randomly divided into control group and research group of consent of all the 50 cases,control group adopted routine nursing care,the team take systematic nursing intervention,compare the effect of two groups of patients with bowel movements.Results The team bowel habit each index compared with control group,difference has statistical significance(P<0.05).Conclusion Systematic nursing intervention to actively promote the use of clinical nursing work in the future.

Objective:To investigate the characteristic of social ability in children and adolescents with attention deficit hyperactivity disorder (ADHD) and its relationship with core symptoms, emotional and behavioral problems.Methods:Fifty-nine children with ADHD aged 6-13 for outpatient department from June 2019 to June 2021 were selected as the ADHD group, and 62 normal children matched in age and sex were recruited as the typical development group(TD group). The social responsiveness scale (SRS), SNAP-Ⅳ rating scale and strengths and difficulties questionnaire (SDQ) were used to evaluate the social ability, core symptoms and emotional and behavioral problems of the subjects.SPSS 26.0 was used for statistical analysis.Non parametric test was used to compare and analyze the differences in social ability, emotional and behavioral problems between the two groups.Spearman correlation analysis was used to analyze the relationship between social ability and core symptoms, emotional and behavioral problems of ADHD group.Generalized linear regression was used to analyze the impact of gender, age, IQ, core symptoms, emotional and behavioral problems of ADHD group on social ability.Results:In the ADHD group, the total score of SRS (65(42, 83)), social perception (10 (8, 13)), social cognition (13 (9, 19)), social communication (19 (11, 29)), and autism like behavior (9 (5, 14)) were significantly higher than those of TD group(38 (27.5, 59.5), 7 (4, 12.5), 8 (6, 15), 12 (6.5, 20), 4 (2, 11)) ( Z=-2.97, -2.75, -2.41, -3.01, -2.64, all P<0.05) .The total score of SDQ difficulty, influence factors, mood, hyperactivity, conduct and peer interaction were significantly higher than those of TD group ( Z=-5.80, -6.89, -2.82, -8.59, -2.52, -3.81, all P<0.05). The total score of SRS and the scores of each subscale in ADHD group were positively correlated with the total score of SNAP -Ⅳ and the scores of each subscale ( r=0.33-0.71, all P<0.05). The total score of SRS and the score of social communication scale were positively correlated with the total score of SDQ difficulty, influencing factors, emotion, hyperactivity, conduct and peer interaction subscale ( r=0.29-0.65, all P<0.05). Social perception was positively correlated with the total score of difficulty, hyperactivity and the scores of peer interaction subscale ( r=0.56, 0.32, 0.45, all P<0.05). The scores of social cognition and autism like behavior subscale were positively correlated with the total scores of difficulty, influencing factors, emotion and peer interaction subscale ( r=0.27-0.55, all P<0.05). The scores of social motivation subscale were positively correlated with the total scores of difficulty, emotion, hyperactivity, conduct and peer interaction subscale ( r=0.29-0.55, all P<0.05). The total score of SRS and the scores of each subscale were negatively correlated with the scores of prosocial behavior subscale ( r=-0.63--0.49, all P<0.05). The total score of SRS was positively affected by gender, age, opposites and disobedience, emotion, hyperactivity and peer interaction ( B=0.05-0.23, all P<0.05), and negatively affected by the prosocial behavior subscale ( B=-0.07, P<0.05). Conclusion:ADHD children often have obvious social ability defects, which are clearly related to core symptoms, emotional and behavioral problems.The risk factors are opposition and disobedience, emotions and peer relationships, and the protective factor is prosocial behaviors.

Objective:To prepare 99Tc m-hydrazinonicotinamide(HYNIC)-αCD8/Fab ( 99Tc m-αCD8/Fab), and explore the predictive value of 99Tc m-αCD8/Fab SPECT/CT imaging for the efficacy of anti-programmed death-1 (PD-1) immunotherapy. Methods:The αCD8/Fab was modified with HYNIC- N-hydroxysuccinimide (NHS) and IRDye800-NHS to form HYNIC-αCD8/Fab and IRDye800-αCD8/Fab (Dye-αCD8/Fab), respectively. 99Tc m-αCD8/Fab was prepared in sodium bicarbonate buffer (pH=8.5), with SnCl 2 being used as the reducing agent. The labeling yield and radiochemical purity of 99Tc m-αCD8/Fab and its stability in PBS and fetal bovine serum (FBS) were tested in vitro. The mouse spleen and human peripheral blood lymphocytes were isolated for cell-specific binding and blocking experiments of 99Tc m-αCD8/Fab in vitro. SPECT/CT imaging was used to analyze the specific binding ability of the 99Tc m-αCD8/Fab probe in CT26 colon cancer mouse models (BALB/c). The near infrared fluorescence imaging and SPECT/CT imaging were performed to detect the intra-tumoral CD8 + T cell infiltration after anti-PD-1 therapy in tumor bearing mice, and the results were further verified by HE and immunofluorescence staining. CD8 + T cell depletion study was performed to determine the role of CD8 + T cells in the tumor responses to anti-PD-1 therapy. Two-way analysis of variance was used to compare the data difference. Results:The labeling yield of 99Tc m-αCD8/Fab was 90% with a high radiochemical purity (95%) and good stability in vitro (radiochemical purity still more than 80% after 720 min in PBS and FBS). 99Tc m-αCD8/Fab could specifically bind to mouse CD8 + T cells ((10.30±0.81) percent added radioactive dose (%AD)/10 6 cells), compared with the binding ability in human peripheral blood lymphocytes group and CD8 antibody blocking group ((1.78±0.61) and (1.59±0.25) %AD/10 6 cells; F=10.07, P<0.001). SPECT/CT imaging showed that 99Tc m-αCD8/Fab had markedly higher tumor uptake in the CT26 colon cancer mouse models. Near-infrared fluorescence imaging showed that the tumor uptake of 99Tc m-αCD8/Fab in the responsive group was significantly higher than in the nonresponsive group after anti-PD-1 treatment ((8.9±1.1)% vs (7.1±0.8)%; F=4.69, P=0.024), and SPECT/CT imaging found the similar result. HE and immunofluorescence staining of tumor and lymph nodes showed that the proportion of lymphocyte infiltration was higher in the responsive group. Furthermore, CD8 + T cell depletion significantly reversed the therapeutic effect of anti-PD-1 immunotherapy in tumor-bearing mice. Conclusions:In this study, 99Tc m-αCD8/Fab was successfully obtained. CD8-specific SPECT imaging could sensitively visualize the tumor-infiltrating CD8 + T cells, suggesting the potential application value to predict and evaluate the efficacy of immunotherapy in the clinical settings.

Objective:To explore the differences between impaired perspective-taking and executive function in children with attention deficit hyperactivity disorder(ADHD).Methods:From January 2019 to December 2020, according to DSM-5 diagnostic criteria, thirty-two cases of ADHD children aged 6 to 16(ADHD group) and twenty-six cases of typical development children and adolescents matched with age and intelligence (TD Group) were included. The response time and accuracy rate in dilemma stage and probe stage to self-oriented, maternal perspective-taking and other perspective-taking were measured using perspective-shifting task, and the executive function was evaluated by the behavior rating inventory of executive function (BRIEF). Repeated measurement analysis of variance was used to compare the difference of response time and accuracy rate between the two groups. Pearson correlation analysis was used to explore the correlation between the perspective-taking behavior characteristics and the BRIEF total score and subscale scores of ADHD group.Results:The total score and subscale scores of BRIEF scale in ADHD group were significantly higher than those in TD group (all P<0.01). The interaction between group and task type was significant during the task dilemma stage of perspective-shifting task ( F(2, 106)=4.365, P<0.05). Simple effect analysis showed that in other-perspective-taking task, the response time of ADHD group ((2 305.48±464.27)ms) was significantly longer than that of TD group ((1 971.13±462.95)ms) and the difference was statistically significant ( t=2.870, P<0.01). Pearson correlation analysis showed that the response time of ADHD group to other perspective-taking in dilemma stage was positively correlated with working memory, organization and inhibition index in EF ( r=0.401, 0.432, 0.342, all P<0.01). Conclusion:The ability of the perspective taking is closely related to impaired executive function, which seem to share a common neuropsychological basis.

Fusidane-type antibiotics, represented by helvolic acid, fusidic acid and cephalosporin P

Objective To summarize the clinical features of patients with ovarian tumor associated anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis,and to explore the influence of operation patterns on the prognosis.Methods The clinical data of ovarian tumors with anti-NMDAR encephalitis in the Third Affiliated Hospital of Sun Yat-sen University from January 2009 to December 2018 were collected,and the clinical characteristics,treatment and prognosis were analyzed.Results A total of 110 patients with ovarian tumors and anti-NMDAR encephalitis were collected.All patients were positive for anti-NMDAR antibodies in serum and/or cerebrospinal fluid.The age of onset ranged from 10 to 35 years (24.6 ±5.7).About 60.9％ patients'initial symptom was psychosis.The main clinical features were psychosis (97.3％),seizures (83.6％),conscious disturbance (72.7％),autonomic dysfunction (64.5％),dyskinesia (64.5％),central hypoventilation (54.5％) and impaired memory (31.8％).Most patients'symptoms were relieved after surgery and immunotherapy.Postoperative pathological results revealed that ovarian teratoma accounted for 97.8％ of the ovarian tumor.The prognosis of patients with surgery was better than the patients without surgery,with statistically significant difference (P ＜ 0.05).The prognosis of patients with adnexectomy was better than the patients with ovarian tumor excision,with statistically significant difference (P ＜ 0.05).Conclusions Anti-NMDAR encephalitis,with psycho-neurological symptoms as dominant manifestation,is usually associated with ovarian tumor.For young female patients with psychosis,clinicians should be alert to the possibility of anti-NMDAR encephalitis and screen for tumor.Patients with adnexectomy and immunotherapy can get a better prognosis.

Objective To investigate the current distribution of hepatitis C virus (HCV) genotype in Southern China and to understand the HCV transmission and to infer its transmitting trend.Methods The HCV gene subtypes of 3 524 specimens from Southern China were detected and analyzed by polyonerase chain reaction (PCR)-fluorescence probe method or sequencing.The regular nested PCR and sequencing were used for the phylogenetic tree analysis when the fluorescence PCR inefficiently identifying virus isolates.Results Among 3 524 specimens,there were 2 922 cases from Guangdong,78 cases from Fujian,152 cases from Hainan and 372 cases from Guangxi.Genotype 1b comprised the majority (1 808/ 3 524,51.3％),followed by genotype 6a (925/3 524,26.2％),2a (298/3 524,8.46％),3a (246/ 3 524,6.98％),3b (200/3 524,5.68％) and 1a (27/3 524,0.77％).In addition,1 case wasgenotype 6e,1 case was genotype 6q,1 case was genotype 6r,3 case were genotype 6w,2 case were genotype 6xa,2 case were genotype 6n,and 1 case was genotype 6 with unclassified subtype.The genotype 1b accounted for the majority in most areas of 21 cities and counties in Guangdong Province,followed by genotype 6a.But in some areas,the major genotype was genotype 6a,followed by 1b.Genotype 4,genotype 5 and genotype 7 were not found in this study.Conclusions In the past two years,genotype 1b and 6a are still the epidemic genotypes in Guangdong,Guangxi and Hainan provinces.However,genotype 6a has replaced 1b as the dominant one in some areas in Guangdong Province.The distributions of HCV genotypes do not change significantly in Guangxi and Fujian provinces.

OBJECTIVE:To observe the efficacy and safety of oxaliplatin,mitomycin and doxorubicin combined with three-di-mensional conformal radiotherapy for patients with lack of blood supply hepatocellular carcinoma. METHODS:62 patients with lack of blood supply hepatocellular carcinoma who lose the opportunity of operation were randomly divided into control group(31 cas-es)and observation group(31 cases). Control group received puncture through the femoral artery by Seldiner,selectively interven-ing in hepatic arteries for DSA angiography,then intravenously injected 130 mg/m2 Oxaliplatin for injection via the catheter,once every 2 weeks+Mitomycin for injection 10 mg,intravenously,once every 1-3 week(s)+Doxorubicin for injection 1.2 mg/kg,once every 3 weeks,then giving Iodinated oil emulsifier and Gelatin sponge particle for hepatic artery embolization,appropriate Iodinat-ed oil emulsifier and Gelatin sponge particle once a month,for 3 times. Observation group was additionally received three-dimen-sional conformal radiotherapy 2 Gy,for 25-30 times with total dose of 50-60 Gy,once every 3 days. They were treated for 3-month. Clinical efficacy,the survival rate and median survival time after the first administration of drug for 1,2 and 3 years in 2 groups were observed,and the incidence of adverse reactions was recorded. RESULTS:The total effective rate,the survival rate and median survival time in 1,2 and 3 years in observation were significantly higher than control group,with statistical signifi-cance (P<0.05). The incidences of neutropenia,thrombocytopenia,hemoglobin decreased and radioactive disease in observation group were significantly higher than control group,with statistical significances(P<0.05). CONCLUSIONS:Oxaliplatin,mitomy-cin and doxorubicin combined with three-dimensional conformal radiotherapy have good efficacy for patients with hepatocellular lack of blood supply carcinoma,also can prolong the survival time,they show poor safety.