Objective:To investigate the mid- and long-term training effect of deliberate practice combined with intensive training in cardiopulmonary resuscitation (CPR) teaching for nurses receiving standardized training.Methods:A total of 160 nurses who received the first year of standardized training in Guangdong Provincial Hospital of Traditional Chinese Medicine from July 2020 to March 2021 were enrolled as subjects, and they were randomly divided into experimental group and control group, with 80 nurses in each group. The nurses in the control group received the mode of single deliberate practice, and those in the experimental group received deliberate practice combined with intensive training at months 0, 3, and 6. Assessment was performed for the two groups before and after training,with objective indicators and subjective evaluation as the assessment criteria. Objective score was determined by the immediate objective feedback provided by the electronic display of Resusci Anne ? QCPR, and subjective score was determined by the same group of examiners based on the evaluation of cardiopulmonary resuscitation performed by trainees,including environment evaluation, judgment of consciousness, judgment of respiration, initiation of emergency treatment system, re-evaluation after resuscitation, and overall evaluation. SPSS 18.0 was used for the independent samples t-test, the non-parametric test, and the chi-squares test. Results:After training, there were significant differences between the experimental group and the control group in the objective indicators of the percentage of correct compression (CC%) [85.500 (77.50, 93.00) vs. 81.00 (71.75, 89.00), Z=-2.49, P=0.013] and the proportion of correct ventilation (V%) [84.00 (75.00, 92.75) vs. 80.00 (64.00, 90.25), Z=-2.15, P=0.031]. Both groups had significant improvements in objective and subjective indicators after training (all P<0.05). Conclusions:Deliberate practice combined with intensive training at an interval of 3 months can effectively improve the mid- and long-term CPR skills of nurses receiving standardized training and is more suitable for high-level muscle memory training.

Hepatic fibrosis is a pathological process of chronic liver injury. Without timely intervention and treatment， liver fibrosis may eventually lead to liver cirrhosis and cancer. Janus kinase （JAK）/signal transducer and activator of transcription （STAT） signaling pathway is closely associated with the occurrence and development of liver fibrosis. Based on this， this paper summarized and analyzed the mechanism and effects of active ingredients and compounds of traditional Chinese medicine improving liver fibrosis based on JAK/STAT signaling pathway. It is found that the active ingredients and compounds of traditional Chinese medicine that promote blood circulation and remove blood stasis （ingredients such as ethanol extract of Euonymus alatus and paclitaxel， as well as compounds such as Ershiwuwei songshi pill and Ganfukang）， clear away heat and toxic material （ingredients such as betulinic acid， total flavonoids from Persicaria perfoliata， as well as compounds such as Pianzaihuang and Kehuang capsules）， and sooth the liver and promote qi circulation （ingredients such as fraxetin and cucurbitacin B， as well as compounds such as Chaihu shugan powder and Xiaochaihu decoction） can all relieve liver fibrosis by inhibiting the activity of the JAK/STAT signaling pathway， reducing inflammatory reactions， and inhibiting the proliferation of hepatic stellate cells.

OBJECTIVE: To evaluate the efficacy of Wen-Luo-Tong Granules (WLT) local administration in the treatment of patients with peripheral neuropathy (PN) induced by chemotherapy or target therapy. METHODS: This study is a randomized, double-blinded, and placebo-controlled trial. Seventy-eight patients with PN induced by chemotherapy or target therapy were enrolled from China-Japan Friendship Hospital between July 2019 and January 2020. They were randomly assigned to WLT (39 cases) and control groups (39 cases) using a block randomization method. The WLT group received WLT (hand and foot bath) plus oral Mecobalamin for 1 week, while the control group received placebo plus oral Mecobalamin. The primary endpoint was PN grade evaluated by the National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI-CTCAE). The secondary endpoints included quantitative touch-detection threshold, neuropathy symptoms, Quality of Life Questionnaire-Chemotherapy Induced Peripheral Neuropathy (QLQ-CIPN20), and Quality of Life Questionnaire-Core30 (QLQ-C30). RESULTS: After treatment, the PN grade in the WLT group was significantly lower than that in the control group (1.00 ± 0.29 vs. 1.75 ± 0.68, P<0.01). The total effective rate in the WLT group was significantly higher than that in the control group (82.05% vs. 51.28%, P<0.01). Compared with the control group, the touch-detection thresholds at fingertips, neuropathy symptom score, QLQ-CIPN 20 (sensory scale, motor scale, autonomic scale, and sum score), and QLQ-C30 (physical functioning, role functioning, emotional functioning, and global health) in the WLT group significantly improved after treatment (P<0.01 or P<0.05). CONCLUSION WLT local administration was significantly effective in the treatment of patients with PN induced by chemotherapy or target therapy. (Trial registration No. ChiCTR1900023862).
Antineoplastic Agents/adverse effects* ; China ; Humans ; Japan ; Peripheral Nervous System Diseases/drug therapy* ; Quality of Life/psychology* ; Surveys and Questionnaires

OBJECTIVE: To explore the protective effect of SBi4211 (heptamidine), an inhibitor of S100B, against central nervous system injury induced by HIV-1 envelope protein gp120. METHODS: In an RESULTS: In the cell co-culture system, SBi4211 treatment significantly inhibited gp120-induced expression of S100B, RAGE and GFAP in U251 cells ( CONCLUSIONS SBi4211 can protect neurons from gp120-induced neurotoxicity possibly by inhibiting the S100B/ RAGE-mediated signaling pathway.
Animals ; Astrocytes ; Blotting, Western ; Central Nervous System ; HIV Envelope Protein gp120 ; Mice ; Neurons ; S100 Calcium Binding Protein beta Subunit ; Signal Transduction

Objective:To investigate the incidence of acute kidney injury (AKI) following cardiac surgery and related risk factors in 4 878 patients.Methods:The information from patients who underwent cardiac surgery through March 2015 to October 2015 was collected retrospectively from the electronic database of Beijing Anzhen Hospital. A total of 4 878 patients were divided into AKI group and non-AKI group according to whether AKI occurred within 7 days after cardiac surgery. The incidence of AKI was calculated, and the AKI incidence in different types of cardiac surgeries were compared. Clinical data such as baseline clinical information, operation information, comorbidity, hospital stay time, life ability score in discharge from the hospital, and so on, were compared between AKI group and the non-AKI group using univariate analysis. Risk factors for AKI following cardiac surgery were analyzed using the binary multivariate logistic regression.Results:A total of 933 patients suffered from AKI (19.1%) following cardiac surgery. The time of stay in the hospital was longer in AKI group than that in the non-AKI group [(14.4±8.9) vs (13.7±7.7) d, P<0.05)]. The incidence of AKI in different types of cardiac surgeries varied significantly ( P<0.001). The logistic regression analysis showed that male, diabetes, hypertension, the elevated basic serum creatinine, cardiac dysfunction (NYHA grade≥Ⅲ), cardiopulmonary bypass, a combination of operations≥3, the rethoracotomy exploration and hemostasia, and using an invasive ventilator for over 96 hours were the independent risk factors for the AKI following cardiac surgery (all P<0.05), and the odds ratio (95% confidence interval) were 1.81(1.46-2.24), 1.29(1.03-1.62), 5.85(4.73-7.22), 1.81(1.36-2.40), 4.49(3.60-5.60), 1.84(1.49-2.27), 23.24(18.25-29.59), 2.34(1.45-3.77) and 1.94(1.09-3.43) respectively. Conclusions:The incidence of AKI after cardiac surgery in Beijing Anzhen Hospital is 19.1%. AKI following cardiac surgery prolongs the time of stay in the hospital. Independent risk factors for AKI following cardiac surgery are multiple, and one of the most critical factors is a combination of operations≥3.

OBJECTIVETo differentiate patients with esophageal cancer or premalignant lesions from the high-risk population for preliminary screening of esophageal cancer using a feature index determined by a computer-aided tongue information acquisition and processing system (DS01-B).

METHODSTotally, 213 patients diagnosed with esophageal cancer or premalignant lesions and 2,840 normal subjects were collected including primarily screened and reexamined, all of them were confirmed with histological examinations. Their tongue color space values and manifestation features were extracted by DS01-B and analyzed. Firstly, the analysis of variance was performed to differentiate normal subjects from patients with esophageal cancer and premalignant lesions. Secondly, the logistic regression was conducted using 10 features and gender, age to get a predictive equation of the possibility of esophageal cancer or premalignant lesions. Lastly, the equation was tested by subjects undergoing primary screening.

RESULTSSaturation (S) values in the HSV color space showed significant differences between patients with esophageal cancer and normal subjects or those with mild atypical hyperplasia (P<0.05); blue-to-yellow (b) values in the Lab color space showed significant differences between patients with esophageal cancer or premalignant lesions and normal subjects (P<0.05). Logistic regression analysis showed that the computer-aided tongue inspection approach had an accuracy of 72.3% (2008/2776) in identifying patients with esophageal cancer or premalignant lesions for preliminary screening in high-risk population.

CONCLUSIONComputer-aided tongue inspection, with descriptive and quantitative profile as described in this study, could be applied as a cost- and timeefficient, non-invasive approach for preliminary screening of esophageal cancer in high-risk population.

Objective To investigate the clinical manifestations and surgical effectiveness of the primary retroperitoneal teratoma in infants.Methods The records of 36 patients were retrospectively reviewed who were diagnosed as primary retroperitoneal teratoma and treated at the Department of Pediatric Oncology,Guangzhou Women and Children's Medical Center between August 2015 and August 2017.The related data were collected,including gender,age,operation time,operational bleeding and tumor weight.All patients took the ultrasound,computed tomography (CT) before surgery,alpha-fetal protein (AFP) and human chorionic gonadotrophin(HCG) were detected during peri-operation period.All cases were classified into 0 to Ⅲ grades according to the Norris classification (27 patients of 0 grade,1 patient of Ⅰ grade,4 patients of Ⅱ grade,4 patients of Ⅲ grade).Results There were 9 males and 27 females in the study.All patients were treated surgically at the age of 11.4 months (7 days-7 years) on the average;the mean weight of incised tumor was 736.47 g (7.90-2 355.00 g);operation time was 2.88 hours (1.08-7.06 hours);the amount of bleeding during operation was 29.11 mL (2-150 mL).All patients received follow-ups for 6.56 months (9 days-23 months) on the average.Radiographs found that tumors in 25 patients (69.4％) were located in the left side of the abdominal cavity,and the rest of them were located in the right side.In addition,tumors in 30 patients (83.3 ％) were big enough to pass across the mid-line of the body.Average pre-operation AFP was 7 593.1 μg/L(1.7-80 000.0 μg/L),post-operation AFP was 1 339.5 μg/L(1.4-16 519.6 μg/L),and the difference was statistically significant (P =0.001);pre-operation AFP of the mature group was 5 439.6 μg/L(1.7-80 000.0 μg/L),post-operation AFP of the mature group was 1 130.6 μg/L(1.4-16 519.6 μg/L),and the difference was statistically significant (P =0.001);pre-operation AFP of the immature group [11 182.3 μg/L(17.4-80 000.0 μg/L)] was higher than that of the mature group,and the difference was statistically significant(P =0.006).On the final follow-up,AFP was mean 38.3 μg/L (1.4-352.4 μg/L);among them,AFP of the mature group was mean 14.3 μg/L (1.4-43.3 μg/L),the immature group was 78.4 μg/L(1.7-325.4 μ g/L),and the difference was statistically significant(P =0.028);AFP of 4 patients in the immature group who underwent chemotherapy was 54.9 μg/L (2.6-116.6 μg/L)on the average,lower than those of post-operation AFP of 265.2 μg/L (206.8-384.1 μg/L),and the difference was statistically significant (P =0.042).All patients were treated surgically,and 3 cases of them received laparoscope technique;no significant relationship was proved between time of surgery and the tumor weight,location,and Norris classification(all P ＞ 0.05).The incidence rate of the surgical complications was 42.1％,such as tumor rupture (6 patients),vascular injury (5 patients),digestive tract damage (4 patients) and incomplete incision (1 patient).There was no death case in the serials.Conclusions Primary retroperitoneal teratoma can be completely incised.However,the complications of surgery could appear in many cases.As a predictive index for the recurrence retroperitoneal teratoma,AFP can be diminished by chemotherapy following the surgery.

Objective: To compare the consistency and accuracy of using 2 criteria for decision making of aspirin use for the primary prevention of ischemic cardiovascular disease (ISCVD) and explore the current status and related factors of aspirin use for the primary prevention of ISCVD in Chinese outpatients. Methods: This cross-sectional study enrolled 3 018 outpatients with hypertension, diabetes, or hypercholesterolemia, who visited the General Practice (GP) clinics of Anzhen hospital in Beijing from September to December 2015 were enrolled in. The information of risk factors for ISCVD and use of aspirin was collected. Both quantitative and qualitative criteria were used to make the decision of aspirin use for primary prevention of ISCVD in this patient cohort. Quantitative criteria were derived from the 2011 Chinese guideline of cardiovascular disease prevention: aspirin use for primary cardiovascular disease prevention in population with risk of ISCVD in the next 10 years≥10%. Qualitative criteria were derived from the Chinese expert consensus on the aspirin use issued in 2013: aspirin should be given for the purpose of primary ISCVD in population with≥3 risk factors:(1) men aged ≥50 years or postmenopausal women; (2) hypertensive subjects with blood pressure ≤150/90 mmHg(1 mmHg=0.133 kPa);(3) diabetes; (4) hypocholesteremia; (5) obesity with body mass index (BMI)≥28 kg/m²; (6) Smokers;(7) with familiar premature ISCVD history (male<55 years, female<65 years). Demographic data of participants were obtained by questionnaire, on-site measurements or screening previous medical records. Results: 67.1% participants (n=2 024) should be recommended to take aspirin as primary prevention medication using 10-year risk of ISCVD≥10% as the criteria, and 77.9% participants (n=2 350) should be recommended to take aspirin as primary prevention medication using number of risk factors≥3 as the criteria. With 10-year risk of ISCVD≥10% as the gold standard and risk factors≥3 as the evaluation criteria, the sensitivity was 97%, specificity was 61%, the consistency rate was 85%, Kappa value was 0.628 (U=35.824, P<0.001) , indicating that the consistency of the 2 criteria was good. The percentage of real-world aspirin use for primary prevention of ISCVD in this cohort was significantly higher for participants evaluated with the 10-year risk of ISCVD≥10% than that evaluated with 3 risk factors (53.1% vs. 49.2%, χ²=6.523, P=0.011). 12.7% participants with 10-year risk of ISCVD<10% and 6.6% participants with<3 risk factors took aspirin for the primary prevention of ISCVD in this cohort. Age, smoking, hypertension, diabetes and hypercholesterolemia were significantly related to the aspirin use in this cohort, relative ORs were 1.047 (95%CI 1.035-1.060) , 1.969 (95%CI 1.403-2.762) , 2.065 (95%CI 1.623-3.629) , 3.493 (95%CI 2.726-4.475, and 1.344 (95%CI 1.109-1.628) , respectively. Obesity and familial history of premature ISCVD were not related to the aspirin use, relative ORs were 1.137 (95%CI 0.828-1.562) and 0.986 (95%CI 0.767-1.266) . Conclusions The consistency of the 2 criteria for decision making of aspirin use for the primary prevention of ISCVD is good and about 50% participants who should be recommended to the use of aspirin for the primary prevention of ISCVD took the aspirin in the real-world scenario. The use of aspirin as primary prevention strategy for ISCVD in the real-world scenario is related to age, smoking, hypertension, diabetes and hypercholesterolemia.

OBJECTIVETo explore the safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing chemotherapy-induced neutropenia in patients with breast cancer and non-small cell lung cancer (NSCLC), and to provide the basis for clinical application.

METHODSAccording to the principle of open-label, randomized, parallel-group controlled clinical trial, all patients were randomized by 1∶1∶1 into three groups to receive PEG-rhG-CSF 100 μg/kg, PEG-rhG-CSF 6 mg, or rhG-CSF 5 μg/kg, respectively. The patients with breast cancer received two chemotherapy cycles, and the NSCLC patients received 1-2 cycles of chemotherapy according to their condition. All patients were treated with the combination chemotherapy of TAC (docetaxel+ epirubicin+ cyclophosphamide) or TA (docetaxel+ epirubicin), or the chemotherapy of docetaxel combined with carboplatin, with a 21 day cycle.

RESULTSThe duration of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg and PEG-rhG-CSF 6 mg groups were similar with that in the rhG-CSF 5 μg/kg group (P>0.05 for all). The incidence rate of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group, and G-CSF 5 μg/kg group were 69.7%, 68.4%, and 69.5%, respectively, with a non-significant difference among the three groups (P=0.963). The incidence rate of febrile neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg/kg group were 6.1%, 6.4%, and 5.5%, respectively, showing no significant difference among them (P=0.935). The incidence rate of adverse events in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg / kg group were 6.7%, 4.1%, and 5.5%, respectively, showing a non-significant difference among them (P=0.581).

CONCLUSIONSIn patients with breast cancer and non-small cell lung cancer (NSCLC) undergoing TAC/TA chemotherapy, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF at 48 hours after chemotherapy show definite therapeutic effect with a low incidence of adverse events and mild adverse reactions. Compared with the continuous daily injection of rhG-CSF 5 μg/kg/d, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF has similar effect and is more advantageous in preventing chemotherapy-induced neutropenia.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Breast Neoplasms ; drug therapy ; Carboplatin ; administration & dosage ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Cyclophosphamide ; administration & dosage ; adverse effects ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Incidence ; Induction Chemotherapy ; Lung Neoplasms ; drug therapy ; Neutropenia ; chemically induced ; epidemiology ; prevention & control ; Polyethylene Glycols ; Recombinant Proteins ; administration & dosage ; Taxoids ; administration & dosage ; adverse effects

Objective To investigate the efficacy and safety of modified endoscopic submucosal dissection (ESD) and rubber band ligation assisted endoscopic dissection for treatment of small gastric submucosal tumors (SMT) originating from the muscularis propria layer. Methods A total of ninety-two patients diagnosed as gastric SMT (6 mm≤diameter≤13 mm) originating from the muscularis propria layer by EUS in our hospital were enrolled in this study. With intravenous anesthesia and tracheal intubation in all patients, modified ESD was performed firstly to stripe the small tumors. After being exposed to a certain extent, the tumors were ligated by rubber band and snared for endoscopic dissection. The situation of bleeding, perforation in both intraoperative and postoperative, the integrity and size of the resected specimens were observed and recorded. The resected specimens were identified with histopathological detection and immunohistochemistry assay. At the 6-month and 12-month after the operation, all patients were reviewed by gastroscopy and EUS in our hospital. Results All the 92 tumors were resected completely and successfully. The mean operating time was (19.2±2.3) min and the mean blood loss in operation was (2.6±0.5) mL. Perforation after resection occurred in 3 cases, which were closed with metal hemostatic clips and nylon ropes. No delayed bleeding and perforation occurred in one week after the operation. The tumor sizes ranged from 6 mm × 5 mm to 13 mm × 12 mm. Seventy-three gastric stromal tumors (risk classification:all were very low risk), 18 gastric leiomyomas and 1 gastric neurofibroma were identified. There were no residue or recurrence in all cases during the 12-month follow-up period. Conclusion The modified ESD and rubber band ligation assisted endoscopic dissection are effective and safe for treatment of small gastric submucosal tumors originating from the muscularis propria layer. The tumors are resected completely and successfully, showing certain significance to assess the nature, degree of malignancy of the tumor and prognosis of the patients.