Objective To analyzes the current status and hot spots of nursing of adverse drug reactions in chemotherapy for cancer patients,and provides reference for future research.Methods Literature related to the nursing of chemotherapy adverse drug reactions in cancer patients from 2018 to 2022 was retrieved from CNKI,Wanfang and VIP databases,and statistical analysis was conducted using bibliometrics.CiteSpace information visualization software was used to describe and analyze high-frequency keywords and to describe their graphs.Results A total of 1112 literatures were included,distributed in 256 domestic journals,and 537 literatures were co-authored,with a co-authored rate of 48.29％.Gastrointestinal reaction,cancer-induced fatigue,traditional Chinese medicine nursing,evidence-based nursing,negative emotion are the hot issues in this field.Conclusion The future nursing intervention for adverse reactions of cancer patients should adopt evidence-based nursing method to develop intervention programs.The research in this field has the problems of small sample size and single institution.It is suggested that the cooperation between authors and institutions should be strengthened in the future research,so as to build a closer cooperation network and a stable cooperation group.To construct nursing intervention plan and effect evaluation criteria suitable for nursing of adverse reactions of chemotherapy drugs in cancer patients.To ensure the safety of the intervention process,we should actively carry out multidisciplinary collaboration.

Objective To observe the clinical effect of the preventive device for foot stress injury in bedridden patients with stroke.Methods A total of 166 patients with stroke who were hospitalized in the department of intensive care unit(ICU)of Hangzhou First People's Hospital from March 2021 to March 2022 were selected as the study subjects.The experimental design of the quantitative study was adopted,and the patients were divided into the control group(ICU 4th floor patients)and the observation group(ICU 5th floor patients)according to the different ward of ICU,with 83 cases in each group.Nurses were also grouped according to this method(41 in observation group,43 in control group).Both groups received conventional treatment and nursing care to prevent pressure injury.The control group was depressurized by sponge ring or existing pillow,and the foot sagging was prevented by T-shoe lined towel.The observation group used the self-designed and developed foot pressure injury prevention device for bedridden patients.The incidence of foot stress injury and foot drop,as well as the satisfaction of patients with using the preventive device for foot stress and the satisfaction of nurses with operating the preventive device for foot stress were observed.Results The incidence of foot pressure injury and foot drop in the observation group was significantly lower than that in the control group[incidence of foot pressure injury:3.61%(3/83)vs.8.43%(7/83),the incidence of foot drop:9.64%(8/83)vs.16.87%(14/83),both P<0.05].The satisfaction of patients in the observation group was significantly higher than that in the control group[91.6%(76/83)vs.79.5%(66/83),P<0.05],and nurse satisfaction in the observation group was higher than that in the control group[95.1%(39/41)vs.86.0%(37/43)],but there was no significant difference between the two groups(P>0.05).Conclusion The foot stress injury prevention device is suitable for patients with severe stroke in bed,which can effectively reduce the incidence of stress injury and foot drop,improve the satisfaction of patients and operators,and is worthy of clinical promotion.

Objective To analyze the hot spots and trends of digital intelligence technology research in intensive care unit(ICU).Methods ICU digital intelligence technology related literature collected in Web of Science core database,China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP Chinese Journal Service Platform were searched,and the retrieval period is from the establishment of the database to December 12,2023,and visualized analysis was performed by CiteSpace software.Results 700 Chinese literatures and 1705 English literatures were included.Conclusion A total of 18 clusters were formed in Chinese literature,including smart phones,data mining,ventricular premature beats,sepsis,etc.A total of 17 clusters were formed in English literature,including deep learning,expert systems,natural language processing,physiological characteristics,etc.Among them,risk prediction model and clinical decision support are the trends of future research.Conclusion By broadening the scope of diseases and populations,joint artificial intelligence research and development of wearable devices and intelligent detection cloud systems,robots,etc.,is the development trend of the future application field of ICU digital intelligence technology.

Bladder cancer remains the 10th most common cancer worldwide. In recent years, metformin has been found to have potential anti-bladder cancer activ-ity while high concentration of IC50 at millimolar level is needed, which could not be reached by regular oral administration route. Thus, higher efficient agent is urgently demanded for clinically treating bladder cancer. Here, by conjugating artesunate to metformin, a novel artesunate-metformin dimer triazine derivative AM2 was designed and synthesized. The inhibitory effect of AM2 on bladder cancer cell line T24 and the mechanism underlying was determined. Anti-tumor activity of AM2 was assessed by MTT, cloning formation and wound healing assays. Decreasing effect of AM2 on lipogenesis was determined by oil red O staining. The protein expressions of Clusterin, SREBP1 and FASN in T24 cells were evaluated by Western blotting. The results show that AM2 significantly inhibited cell proliferation and migration at micromolar level, much higher than parental metformin. AM2 reduced lipogenesis and down-regulated the expressions of Clusterin, SREBP1 and FASN. These results suggest that AM2 inhibits the growth of bladder cancer cells T24 by inhibiting cellular lipogenesis associated with the Clusterin/SREBP1/FASN signaling pathway.

Background::To date, there is no effective medicine to treat coronavirus disease 2019 (COVID-19), and the antiviral efficacy of arbidol in the treatment for COVID-19 remained equivocal and controversial. The purpose of this study was to evaluate the efficacy and safety of arbidol tablets in the treatment of COVID-19.Methods::This was a prospective, open-label, controlled and multicenter investigator-initiated trial involving adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients were stratified 1:2 to either standard-of-care (SOC) or SOC plus arbidol tablets (oral administration of 200 mg per time, three times a day for 14 days). The primary endpoint was negative conversion of SARS-CoV-2 within the first week. The rates and 95% confidential intervals were calculated for each variable.Results::A total of 99 patients with laboratory-confirmed SARS-CoV-2 infection were enrolled; 66 were assigned to the SOC plus arbidol tablets group, and 33 to the SOC group. The negative conversion rate of SARS-CoV-2 within the first week in patients receiving arbidol tablets was significantly higher than that of the SOC group (70.3% [45/64] vs. 42.4% [14/33]; difference of conversion rate 27.9%; 95% confidence interval [CI], 7.7%-48.1%; P = 0.008). Compared to those in the SOC group, patients receiving arbidol tablets had a shorter duration of clinical recovery (median 7.0 days vs. 12.0 days; hazard ratio [HR]: 1.877, 95% CI: 1.151-3.060, P = 0.006), symptom of fever (median 3.0 days vs. 12.0 days; HR: 18.990, 95% CI: 5.350-67.410, P < 0.001), as well as hospitalization (median 12.5 days vs. 20.0 days; P < 0.001). Moreover, the addition of arbidol tablets to SOC led to more rapid normalization of declined blood lymphocytes (median 10.0 days vs. 14.5 days; P > 0.05). The most common adverse event in the arbidol tablets group was the elevation of transaminase (5/200, 2.5%), and no one withdrew from the study due to adverse events or disease progression. Conclusions::SOC plus arbidol tablets significantly increase the negative conversion rate of SARS-CoV-2 within the first week and accelerate the recovery of COVID-19 patients. During the treatment with arbidol tablets, we find no significant serious adverse events.Trial registration::Chinese Clinical Trial Registry, NCT04260594, www.clinicaltrials.gov/ct2/show/NCT04260594?term= NCT04260594&draw=2&rank=1

ObjectiveTo investigate the mechanism of action of Sini powder in the treatment of liver cancer based on network pharmacology and molecular docking. MethodsTraditional Chinese Medicine Systems Pharmacology Database and Analysis Platform was used to obtain the compound and target of Sini powder, and the corresponding gene Symbol was obtained through Uniprot. The disease genes of liver cancer were obtained from Human Genome Database, and the genes with intersection with the target genes of Sini powder were screened out. Cytoscape3.7.1 software was used to draw the map of “traditional Chinese medicine (TCM)-compound-target” network. STRING was used to construct a protein-protein interaction (PPI) network, R studio software was used to conduct gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses on therapeutic targets, and then the results were visualized. The active component with the highest number of targets was selected as the ligand, and the target with the highest degree in the PPI network was selected as the receptor, so as to predict the structure of receptor-ligand complex and the amino acid residues that bind to each other. ResultsIn this study, 91 core targets and 141 relevant active components of Sini powder were screened out, among which quercetin and kaempferol were the main active components in the treatment of liver cancer. TP53 and HSP90AA1 were the main therapeutic targets. The GO enrichment analysis obtained 1007 items which met the screening criteria, which were mainly involved in the biological processes of antioxidation reaction, activity regulation of protein serine and threonine kinase, and cellular stress response. The KEGG enrichment analysis obtained 102 pathways, which mainly regulated the hepatitis B pathway and the PI3K-Akt signaling pathway in the prevention and treatment of liver cancer. The results of molecular docking showed a synergistic antitumor effect between the crystal structure domains VAL147, CYS220, GLU221, and PRO222 of quercetin-TP53. ConclusionThis study reveals the mechanism of action of Sini powder in the treatment of liver cancer by acting on multiple targets and signaling pathways, which provides a theoretical basis for biological experiments.

OBJECTIVE： To investigate the potential pharmacological mechanism of the seed of Draba nemorosa， and to provide reference for further development， utilization and clinical application. METHODS： Effective components and related target proteins of D. nemorosa were screened and identified by using TCMSP and STRING database. Cytoscape 3.7.0 software was used to construct a visual network of effective components and target proteins for the seed of D. nemorosa， and the network topology analysis was performed. The targeting protein-protein interaction （PPI） network was constructed and analyzed by STRING database and Cytoscape 3.7.0 software. KEGG pathway enrichment of target proteins was analyzed by DAVID bioinformatics resource database. RESULTS： A total of 9 effective components were screened from the seed of D. nemorosa， including quercetin， kaempferol， β-sitosterol， etc. Totally 174 target proteins were obtained， mainly including PTGS2， NCOA2， PGR， etc. Among them， JUN and MAPK1 were core proteins in PPI network. KEGG enrichment pathway included PI3K/Akt signaling pathway， TNF-α signaling pathway， HIF-1 signaling pathway， Toll-like receptor signaling pathway and thyroid hormone signal pathway， etc. CONCLUSIONS： Effective components from the seed of D. nemorosa such as quercetin， kaempferol and β-sitosterol may act on PTGS2， JUN and MAPK1 target proteins through PI3K-Akt signaling pathway and TNF-α signaling pathway， thus exert the effects of purging lung， relieving asthma， promoting edema and reducing edema.

AIM:To investigate the role of anti-miR-21 oligonucleotide ( AMO) in the anti-leukemic activity of decitabine (DCA) in vitro.METHODS:AMO and scramble oligonucleotide (SCR) were constructed and transfected into HL-60 cells.The miR-21 expression was analyzed by real-time PCR to identify the transfection efficiency .The cells were treated with DCA at gradient concentrations (0.5, 2.0 and 4.0 μmol/L) for 48 h.The mRNA expression of human period circadian protein 3 (hPer3) was detected by real-time PCR.The early apoptotic rates were determined by flow cy-tometry with Annexin V/PI staining.Mean fluorescence intensities ( MFI) of CD117 and CD11b were also measured by flow cytometry.RESULTS:The miR-21 relative expression level in AMO group was significantly lower than that in blank group and SCR group (P<0.01).IC50 of DCA in AMO group was significantly lower than that in blank group and SCR group (P<0.01).With the same concentration of DCA, the early apoptotic rate, the mRNA expression of hPer3 and the MFI of CD11b in AMO group were significantly higher than those in blank group and SCR group (P<0.01).The MFI of CD117 in AMO group were significantly lower than those in blank group and SCR group ( P<0.01 ) .CONCLUSION:Activation of hPer3 expression plays an important role in enhanced anti-leukemic activity of decitabine by AMO in vitro.

Objective To analysis the incidence and management of monozygotic twin (MZT) conceived by assisted reproductive techniques (ART). Methods A retrospective analysis of clinical pregnancies and MZT that resulted from ART was performed in Reproductive Medical Center,the First Affiliated Hospital,Wenzhou Medical University between January 2011 and January 2014. Results A total of 5 908 pregnancies were diagnosed: 2 012 twins, 157 high-order multiple pregnancy (HOMP), including 4 quadruplets. Overall, 51 MZT pregnancies were identified of them including 32 cases HOMP and 19 cases MZT. The incidence of MZT resulting from cleavage-stage embryo transfer was similar to blastocyst transfer (P=0.960). The percent of MZT resulting from in vitro fertilization [0.93% (28/3 022)], frozen-thawed embryo transfer [0.87% (13/1 502)] and intracytoplamic sperm injection [0.72% (10/1 384)] did not show statistical significance (P=0.794). The expectantly managed MZT was associated with a significantly greater likelihood of miscarriage [6/19 vs 5.11% (101/1 976)], and low birth weight infant [73.91% (17/23) vs 42.89% (1 453/3 388), P<0.01], when compared with dizygotic twin (DZT) did not undergo selective embryo reduction(SER). In monozygotic (MZ)-triplets with SER to 2 fetuses or to 1 fetus, there was no cases of preterm birth or low birth weight infant observed in MZ-triplets with SER to 1 fetus;when compared with MZ-triplets with SER to 2 fetuses, the low birth weight infant [56.00% (14/25), P=0.021] has statistical significance. The likelihood of the survival of two babies was lower in MZ-triplets with SER to 2 fetuses when compared with non-MZ triplets with SER to 2 fetuses [42.86%(9/21)vs 75.21%(91/121), P=0.003]. Conclusions The incidence of MZT pregnancies following ART is high. It plays a significant role in the occurrence of HOMP. MZT pregnancies are at an increased risk of adverse outcomes , it should transform to a single embryo thansfer (SET) program to reduce them incideuce. Reduction of MZT contained in multiple pregnancies appears to be a safe option.

The connotation and extension of the acupuncture changes along with the development of science and technology. Working out the principle on the connotation and extension of acupuncture at present will contribute to better inherit and development of acupuncture. In this paper, through literature analysis, the study on the process of formation and development of acupuncture, we believe connotation of acupuncture and moxibustion mainly include the basic theory of TCM, meridians theory, diagnosis, techniques, clinics, and literatures of acupuncture and moxibustion;and its extension include basic integrated medicine of acupuncture and moxibustion, physiology, pathology, and theories, techniques and clinics derived from modern science.