Objective:To systematically integrate qualitative researches on the financial toxicity experience of cancer patients, so as to provide reference for formulating intervention strategies for financial toxicity in cancer patients.Methods:Qualitative studies on financial toxicity experience of cancer patients were searched in Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, Wanfang data, and China Biology Medicine disc, with a search period from database establishment to August 31, 2023. The quality of the included literature was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence Based Health Care Center in Australia. The aggregation integration method was used to integrate the results.Results:A total of 12 articles were included, and 68 research results were extracted and categorized into 15 new categories. Four integrated results were obtained, including anxiety and stress under financial difficulties, relying on family members to start a new in adversity, and dancing together with treatment and life to write a new article, and great expectations for the future.Conclusions:Pay attention to the financial toxicity of cancer patients, actively seek response strategies, and bring benefits to cancer patients.

Objective : To examine the diagnostic and prognostic value of long non-coding RNA (lncRNA) JPX in mesothelioma, so as to provide insights into diagnosis and prognosis of mesothelioma. Methods: Patients with clinically definitive diagnosis of mesothelioma from 2015 to 2019 that were sampled from asbestos processing plants in Zhejiang Province from 2015 to 2019 were recruited in the mesothelioma group, while healthy residents without asbestos exposure or asbestos-related diseases in the same area served as controls. Participants' demographics, pathologic diagnosis and imaging features were collected, and the expression of blood lncRNA JPX was detected using lncRNA microarrays. The diagnostic value of lncRNA JPX for mesothelioma was evaluated using the receiver operating characteristic (ROC) curve, and the correlation between lncRNA JPX expression and prognosis was examined among mesothelioma patients using survival analysis. Results: There were 17 subjects in the mesothelioma group, with a mean age of (65.71±8.36) years, and 34 subjects in the controls, with a mean age of (64.24±8.70) years. LncRNA microarray detected significantly high lncRNA JPX expression in mesothelioma patients, and higher blood lncRNA JPX expression was detected in the mesothelioma group than in the control group [median (interquartile range), 1.10 (1.31) vs. 0.89 (0.54); t'=-2.300, P=0.034]. The area under the ROC curve was 0.673 (95%CI: 0.507-0.839, P=0.046), and if the cutoff was 1.759, the sensitivity and specificity were 35.3% and 100.0%, respectively. Survival analysis showed no significant difference in the survival rate of mesothelioma patients between the high lncRNA JPX expression group and the low expression group (χ2=0.212, P=0.645). Conclusions LncRNA JPX overexpression is detected in the blood of patients with mesothelioma, and lncRNA JPX expression presents a diagnostic value for mesothelioma; however, it shows little prognostic value for mesothelioma.

Objective:To investigate the current situation and influencing factors of humanistic care needs of family members of pregnant women in maternal intensive care unit, and to explore the relationship between humanistic care needs of family members of pregnant women in maternal intensive care unit, relocation stress level and perceived social support ability, so as to provide a basis for clinical nursing staff to implement targeted humanistic care for family members of pregnant women in maternal intensive care unit.Methods:From July to December 2022, 267 family members of pregnant women who were observed in the Maternal Intensive Care Unit of Maternity Hospital Affiliated to Nanjing Medical University/Nanjing Maternal and Child Health Hospital were selected as the research objects by the convenient sampling method. The general information questionnaire, Humanistic Care Needs Scale for Family Members of Pregnant Women in the Obstetric Intensive Care Unit, Family Relocation Stress Scale for Intensive Care Unit Patients and Perceived Social Support Scale were used to carry out a cross sectional investigation.Results:The scores of humanistic care needs, relocation stress scale and perceived social support scale were (175.32 ± 16.04), (35.12 ± 8.11), (57.30 ± 15.43) points, respectively. The length of maternal intensive care unit stay ( B=1.301, P<0.05), the family′s role changed for the first time ( B=2.328, P<0.05), the delivery mode doesn′t match the family′s expectations ( B=-2.407, P<0.05), maternal admission to maternal intensive care unit due to childbirth complications ( B=3.228, P<0.05), relocation stress level of intensive care unit patients′ family members ( B=0.891, P<0.05), and family members′ perceived social support ability ( B=0.461, P<0.05) were the influencing factors of humanistic care needs of maternal family members in maternal intensive care unit factors, which explained 83.2% of the total variation. Conclusions:The humanistic care needs of family members of pregnant women in maternal intensive care unit are at a high level. Medical staff should pay more attention to the family members of pregnant women who stay in maternal intensive care unit for a long time, undergo role change for the first time, have unexpected delivery mode and stay in maternal intensive care unit due to childbirth complications, so as to provide them with more comprehensive humanistic care and establish multiple support system, in order to improve the level of humanistic care for the family members of maternal intensive care unit.

Objective : To investigate the status of occupational stress and analyze its influencing factors among frontline employees working in a chemical fiber manufacturing enterprise, so as to provide insights into the development of occupational stress interventions. Methods : The frontline employees working in a chemical fiber manufacturing enterprise were selected as the study subjects using a cluster sampling method in October 2018. The status of occupational stress was investigated using the Chinese version of the effort-reward imbalance ( ERI ) questionnaire. The influencing factors for occupational stress were identified using a multivariable logistic regression model. Results : A total of 1 780 questionnaires were sent out, and 1 115 valid ones ( 62.64% ) were recovered. Among the 1 115 respondents, there were 427 men ( 38.30% ) and 688 women ( 61.70% ), and 71.22% were at ages of 21 to 39 years. There were 561 respondents with < 1 year of service ( 50.31% ), and the longest length of service was 11 years. In addition, there were 1 069 respondents ( 95.87% ) exposed to high noise, and 346 respondents ( 31.03% ) were diagnosed at a high occupational-stress state and 769 ( 68.97% ) at a low state. Multivariable logistic regression analysis identified 5 years or longer of service ( OR=1.540, 95%CI: 1.057-2.245 ) and exposure to high noise ( OR=1.917, 95%CI: 1.004-3.659 ) as risk factors for occupational stress among frontline employees in the chemical fiber manufacturing enterprise. Conclusions There are 31.03% of frontline employees at a high occupational-stress state in the chemical fiber manufacturing enterprise, and a high occupational-stress state is associated with exposure to high noise and 5 years or longer of service.

Objective : To analyze the survival of patients with malignant mesothelioma, so as to provide insights into the management of malignant mesothelioma. Methods : Totally 36 patients with malignant mesothelioma admitted to Cixi Third People’s Hospital from October 2012 to January 2021 were enrolled, and the demographic features, exposure to asbestos, and diagnosis and treatment were retrospectively reviewed. The survival rate and median survival time were calculated with the life-table method, and the factors affecting the survival rate of malignant mesothelioma were identified using the Kaplan-Meier estimate and log-rank test. Results : The 36 patients with malignant mesothelioma included 6 men ( 16.67% ) and 30 women ( 83.33% ), and had a median age of 61 ( interquartile range, 14 ) years. There were 30 cases with pleural malignant mesothelioma ( 83.33% ) and 6 cases with peritoneal malignant mesothelioma ( 16.67% ), 32 cases ( 88.89% ) with a history of occupational exposure to asbestos, and 26 cases ( 72.22% ) receiving palliative treatment. The 1-, 2- and 3-year cumulative survival rates were 30%, 15% and 3%, respectively, and the median survival time was 0.71 years. In addition, there were no significant differences in the survival period among patients with malignant mesothelioma in terms of gender, age, route of asbestos exposure, duration of asbestos exposure, pathogenic site and treatment regimens ( P>0.05 ). Conclusion The 36 patients with malignant mesothelioma had a median survival period of 0.71 years, and no association was found between the survival period and asbestos exposure or pathogenic site.

The quality control problems of 49 institutional level medical device clinical trials in hospital from 2016 to 2021 were summarized, and the causes of the problems were analyzed from the perspective of all parties involved in the clinical trial. The improvement measures were discussed, which including improving the management system, strengthening the training of researchers and optimizing the selection method, strengthening the responsibility and regulation consciousness of applicants, and formulating the selection basis of applicants and so on. All the above aims to ensure the quality of clinical trials and provide reference for clinical trial managers and implementers.
Quality Control ; Research Design

Objective To analyze the occurrence of arthralgia in patients with breast cancer treated with aromatase inhibitors,and to evaluate the impact of arthralgia on patients' quality of life.Methods One hundred and eighty seven patients with breast cancer treated with aromatase inhibitors in our hospital from December 2013 to December 2015 were selected.The occurrence and severity of arthralgia in patients were evaluated by using visual analogue scale method.The 36-item short-form health survey (SF-36) was used to evaluate patients' quality of life.The occurrence of arthralgia in patients was analyzed.In addition,the quality of life of breast cancer patients with and without arthralgia and those with different degree of arthralgia was compared.Results The incidence of arthralgia was 77.5％ (145/187) among 187 patients,of which 30.3％ was mild (44/145),40.0％ was moderate (58/145) and 29.7％ was severe (43/145).The scores of the rolephysical (16.73 ±7.34 vs.39.73 ± 12.54;t =9.18,P =0.02),physiological function (53.63 ± 12.91 vs.77.18 ± 9.82;t =7.49,P =0.04),mental health (53.18 ± 14.76 vs.75.14 ± 17.21;t =14.96,P =0.01),role-emotional (46.23 ± 14.30 vs.68.75 ± 15.93;t =12.17,P =0.02),bodily pain (40.35 ± 18.49 vs.91.48 ± 19.67;t =16.28,P =0.01),social function (60.14 ± 12.57 vs.89.22 ± 10.16;t =13.07,P =0.02),general health (45.52 ± 14.61 vs.60.78 ± 18.45;t =15.77,P =0.01) and vitality (55.31 ± 13.69 vs.68.22 ± 18.43;t =15.84,P =0.01) of patients with arthralgia were all lower than those of patients without arthralgia,with statistically significant differences.The scores of the role-physical (F =6.67,P =0.03),physiological function (F =10.94,P =0.02),mental health (F =11.32,P =0.02),role-emotional (F =11.49,P =0.02),bodily pain (F =15.71,P =0.01),social function (F =14.92,P =0.01),general health (F =9.98,P =0.02) and vitality (F =7.36,P =0.03) of different degree of arthralgia in patients with breast cancer had also statistical significance differences.Conclusion Arthralgia is more likely to occur in the treatment of breat cancer with aromatase inhibitors.Arthralgia and its severity can affect the patients' quality of life.

Objective To investigate curative efficacy of ginkgo biloba extract dripping pills in treatment of acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI) and its effects on platelet aggregation rate(PAR), activated clotting time(ACT) and antithrombin(AT)Ⅲ. Methods 90 patients of ACS treated with PCI who received therapy from January 2014 to October 2016 in Zhejiang green town cardiovascular hospital were selected and randomly divided into the observation group and the control group , 45 cases in each group.The control group was treated with routine treatment after PCI, while the observation group was combined with ginkgo biloba extract dripping pills.After treatment of seven days, the changed of PAR, ACT, ATⅢ and adverse cardiovascular events were compared, after treatment three months, the seattle angina scale were compared. Results After treatment, the levels of PAR in the observation group were significantly lower than that of the control group, and the levels of ACT and ATⅢ were significantly higher than that of the control group, the difference was statistically significant (P<0.05), the total incidence of adverse cardiovascular events in the observation group was significantly lower than that of the control group , the difference was statistically significant ( P<0.05), in the seattle angina scale, the scores of stable state of angina pectoris, the attack of angina pectoris, physical activity limitation, treatment satisfaction in the observation group were significantly better than that of the control group, the difference was statistically significant (P<0.05). Conclusion Ginkgo biloba extract dripping pill is well for ACS after PCI, which can effectively relieve clinical symptoms, to improve the expression of PAR, ACT and ATⅢ, helps to reduce the incidence of adverse cardiovascular events.

Objective To investigate the therapeutic effect of levosimendan on acute decompensated heart failure and its effect on SDNN and SDANN values.MethodsThe clinical data of patients with acute decompensated heart failure treated in Zhejiang Greentown Cardiovascular Hospital from January 2014 to August 2016 were retrospectively analyzed.According to their treatment methods, they were divided into control group and observation group.There were 49 cases in the control group and 71 cases in the observation group.The control group was given conventional drug treatment, the observation group was given levosimendan treatment on the basis of the control group.The therapeutic effects of the two groups were observed.The difference of cardiac function, SDNN, SDANN value and adverse reaction between the two groups were compared before and after treatment.ResultsAfter treatment, the observation group efficiency was 98.59%, significantly higher than the control group;the observation group LAD, RAD, LVESD, LVEDD and BNP lower than the control group, the level of LVEF was higher than the control group, the difference was statistically significant (P<0.05);the observation group SDNN, SDANN, RMSSD and PNN50 (%) was higher than that of the control group, the difference was statistically significant (P<0.05).ConclusionLevosimendan has good therapeutic effect on acute decompensated heart failure, can significantly improve the level of SDNN, SDANN, and the incidence of adverse reactions is low.

Objective To evaluate the application effect of mind map in health education among patients with chronic obstructive pulmonary disease ( COPD ) . Methods Seventy patients with COPD were equally divided into control group and intervention group according to their admission orders. Patients in the control group received health education in the form of traditional oral communication, whereas patients in the intervention group received mind-map-based health education. COPD related knowledge assessment questionnaire and COPD assessmenttest ( CAT) questionnaire ( Chinese version) were assessed at base line and after health education while quality of life, FEV1% predication and FEV1/FVC were assessed at base line and 6 months after health education. Results COPD related knowledge assessment questionnaire score was (96. 7 ± 4. 9),CAT questionnaire score(16. 39 ± 3. 52),FEV1%predicted(69. 18 ± 13. 05), FEV1/FVC(74. 83 ± 3. 29)of the intervention group all improved better than [(82. 8 ± 8. 4),(19. 72 ± 5. 32),(53. 81 ± 17. 63), (63. 71 ± 7. 63)] in the control group,and the differences were statistically significant ( t =8. 05, -2. 96, 4. 00,7. 59;P<0. 05). Conclusions Application of mind-map in health education among COPD patients can improve patients′COPD related knowledge level and rehabilitation skills, as well as quality of life and pulmonary function level.