Objective:To investigate the intervention effect of binary coping strategy based on systemic interaction model on the postoperative survival quality of patients with oral cancer.Methods:A total of 99 patients with oral cancer admitted to the Department of Oral and Maxillofacial Surgery of a tertiary hospital from Jun 2021 to Jun 2022 was selected.They were randomly divided into the control group(50 cases)and the observation group(49 cases)with random number table method.The control group received routine nursing for oral cancer.On this basis,the observation group also received the binary coping strategy based on the systemic interaction model.The scores of UW-QOL quality of life scale and binary coping scale were compared between the two groups before surgery,at the 3rd and 9th weeks after surgery.Results:The UW-QOL scores of both groups at the 3rd and 9th weeks after surgery were lower than those at admission,and the UW-QOL score in the control group was lower than that in the observation group(P＜0.05).At the 3rd week after surgery,the score of coping with the partner in the observation group was higher than that in the control group(P＜0.05).At the 9th week after surgery,the total score,negative coping,stress communication,coping together,and supportive coping scores in the observation group were higher than those in the control group(P＜0.05).Repeated measures analysis of variance showed that there was an interaction between time and group for the total score of binary coping scale(P＜0.05).And there was a significant main effect of time and group on the total score of binary coping scale(P＜0.05).Conclusions:The quality of life of patients with oral cancer is poor.The binary coping strategy based on the systemic interaction model can improve the quality of life of patients,enhance the intimacy of patients with their partners,and contribute to the disease recovery of patients with oral cancer.

[摘 要] 目的：探讨miR-203a-3p对胰腺癌BxPC-3细胞增殖、迁移和侵袭能力的影响。方法：运用癌症基因组图谱（TCGA）数据库筛选胰腺癌组织和癌旁组织中差异表达的miRNA，分析miRNA高表达与低表达时胰腺癌患者的生存率和临床分期；利用TarBase数据库分析miRNA与癌症相关的GO功能与KEGG通路，利用DIANA Tools、miRDB和TargetScan网站预测miR-203a-3p的靶基因。将miR-203a-3p mimic及NC mimic、miR-203a-3p inhibitor及NC inhibitor转染至BxPC-3细胞，用qPCR法检测胰腺癌细胞和胰腺正常上皮细胞HPNE中miR-203a-3p、miR-192-5p和miR-451a表达水平，以CCK-8法、Transwell小室法和克隆形成实验分别检测BxPC-3细胞的增殖、迁移、侵袭和集落形成能力。结果：通过TCGA数据库筛选出18个胰腺癌组织中差异表达的miRNA，其中miR-203a-3p、miR-192-5p、miR-451a具有物种保守性，且其与胰腺癌临床癌症分期、细胞周期和患者生存率相关（均P<0.05）；生物信息学网站预测显示miR-203a-3p的候选靶基因是PPM1A，PPM1A与多基因存在相互作用。miR-203a-3p、miR-192-5p和miR-451a在BxPC-3和Aspc-1细胞中均高表达（均P<0.01）。miR-203a-3p mimic组BxPC-3细胞中miR-203a-3p表达水平以及细胞增殖、迁移和侵袭能力均显著提高（均P<0.01）；miR-203a-3p inhibitor组细胞中miR-203a-3p表达水平以及细胞增殖、迁移和侵袭能力均显著降低（均P<0.01）。结论：miR-203a-3p在胰腺癌组织及细胞中均高表达，其表达与患者生存和临床分期相关，可调控BxPC-3细胞的增殖、迁移和侵袭能力。

Objective: To investigate the effect of early multi-dimensional cardiac rehabilitation (CR) nursing mode on patients after percutaneous coronary intervention (PCI). Methods: From August 2017 to July 2018, 100 patients with coronary heart disease (CHD) underwent PCI in the Department of Cardiology, the Third Affiliated Hospital of Sun Yat-sen University were selected as subjects. According to the random number table, the patients were divided into control group and observation group, 50 in each group. The control group received routine CR nursing intervention, and the observation group was given early multi-dimensional CR nursing mode for intervention. All patients were followed up for 6 months. The incidence of major cardiovascular adverse events (MACE) was observed 1 month and 6 months of follow-up. Patients with somatization were evaluated on the 2nd day after PCI and in the first month of follow-up using the Somatic Self-rating Scale (SSS). In the first month and the 6th month of follow-up, patient compliance was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Results: During the study period, 3 patients were detached from each group, and there were 47 patients in both groups who completed the study. The incidence of MACE in the control group in 1 month and 6 months was 8.51% (4/47) and 4.26% (2/47), respectively. The incidence of MACE in the observation group was 10.64% (5/47) and 4.26%, (2/47) respectively. There was no significant difference in the incidence of MACE between the two groups (χ² value was 0.123, 0.000, P>0.05). In the first month of follow-up, the SSS scores of the control group (34.32±6.59) and the observation group (31.04±7.04) were lower than those of the second day after surgery (37.21±6.19, 37.43±7.29), and the difference was statistically significant (t value was 4.633, 2.660, P<0.05). The SSS scores of the observation group were lower than those of the control group, and the difference was statistically significant (t value was 2.330, P<0.05). In the first month of follow-up, there was no significant difference in MMAS-8 score between the two groups (P>0.05). In the 6th month of follow-up, the MMAS-8 score (5.72±0.62) in the control group was lower than the first month of follow-up (6.93±0.54), and the difference was statistically significant (t value was 10.028, P<0.05). The MMAS-8 score of the control group was lower than that of the observation group (6.89±0.58), and the difference was statistically significant (t value was 9.490, P<0.05). There was no significant difference in MMAS-8 score between the observation group in the first month of follow-up and the sixth month of follow-up (P>0.05). Conclusion Early multi-dimensional CR nursing mode has a limited effect on improving the incidence of MACE in patients after PCI, but it can effectively reduce the somatization symptoms of patients and maintain good medication compliance.

Objective: To investigate the impact of transitional care based on IMB model on caregivers of patients with hematological malignancies. Methods: A total of 200 patients with hematological neoplasms who were treated with chemotherapy in our hospital from May 2017 to September 2018 were selected, their caregivers were also selected as the research objects, and they were randomly divided into the study group with 82 cases and control group with 85 cases. The study group used a transitional care based on IMB model to intervene the patient caregivers, and the control group received routine nursing care. The general data questionnaire, the Caregiver Positive Feeling Scale (PAC), the Chinese version of Benefit Finding Scale (BFS), the nursing quality satisfaction questionnaire were used to investigate the caregivers. Results: After nursing intervention, the self-affirmation and self-expected dimension scores of PAC in the study group were 18.41±5.65, 18.87±4.23, which were higher than those in the control group (14.56±5.83, 15.24±4.59), the difference was statistically significant (t=2.476, 5.287, P<0.05 or 0.01). The acceptance, family relationship, personal growth, social relations and health behaviors dimension scores of BHS scale in the study group were 10.41±3.12, 9.87±3.93, 22.41±5.12, 10.22±3.52, 9.65±3.17, which were higher than those in the control group 9.06±3.87, 8.14±4.19, 19.51±5.24, 8.47±3.61, 7.52±3.74, the difference was statistically significant (t=2.476-3.963, P<0.05 or 0.01). The nursing satisfaction degree of caregivers in the study group was 75.61% (62/82), which was higher than that in the control group 42.35% (36/85), the difference was statistically significant (χ²=19.039, P < 0.01). Conclusions Transitional care based on the IMB model can improve the positive feelings in hematological neoplasms caregivers, enhance their benefit findings, and improve the quality of nursing care.

Objective To summarize and analyze the contrast-enhanced ultrasonographic findings of intraductal papilloma and to explore the clinical value and percutaneous transhepatic cholangial drainage (PTCD) strategy of contrast-enhanced ultrasonography in the diagnosis of intraductal papilloma.Methods We retrospectively analyzed 32 cases with intraductal papilloma confirmed by surgery,conventional ultrasound,transvascular contrast-enhanced ultrasound,intrahepatic contrast echocardiography to gather the diagnostic coincidence rate of conventional ultrasound and contrast-enhanced ultrasound in bile duct papilloma,thus making a summary of PTCD experience of intraductal papilloma.Results The diagnostic accuracy of conventional ultrasound and contrast-enhanced ultrasound in the diagnosis of intraductal papilloma were 43.8％ (14/32) and 93.8％ (30/32) respectively,and the differences were statistically significant (P =0.037).Conclusions Conventional ultrasound combined with double contrast ultrasound and cholangiography can improve the diagnostic accuracy of intraductal papilloma.Ultrasound-guided PTCD is a real-time,convenient procedure.Choosing a biliary drainage tube as thick as possible and repeatedly doubling the tube can maintain bile drainage and smooth flow,thus can effectively improve the efficacy of serum bilirubin reduction and protect liver function.

Objective To evaluate the clinical efficacy of arthrography in the treatment of lateral condylar fracture of humerus with displacement of ≤ 2 mm in children.Methods A retrospective study was performed in the 21 children with lateral condylar fracture of humerus who had received arthrography in their surgery at Department of Pediatric Orthopedics,Honghui Hospital,Xi'an Jiaotong University College of Medicine from April 2015 to December 2016.They were 14 boys and 7 girls,aged from 5 to 12 years (average,8.6 years).Their primary diagnosis was made within one week from injury and they all had a displacement of ≤ 2 mm.Of them,2 were treated by plaster fixation because intraoperative arthrography found no fracture of articular cartilage (group A),11 by simple closed pining because intraoperative arthrography found fracture of articular cartilage involving the joint space (group B),and 8 by open reduction and fixation with kirschner wire because intraoperative arthrography found displacement of the involved articular surface (group C).The therapeutic efficacy was evaluated at final follow-ups by the Dhillon scoring system.Results All the 21 children were followed up from 9 to 23 months (average,16 months).The fracture union time ranged from 8 to 10 weeks (average,9 weeks) for groups A and B and from 11 to 13 weeks (average,12 weeks) for group C.By the Dhillon scores at final follow-ups,the therapeutic efficacy was evaluated as excellent in one and as good in one in group A,as excellent in 8 cases,as good in 2 cases and as fair in one in group B,and as excellent in 6 cases,as good in one and as fair in one in group C.No early closure of epiphysis,osteonecrosis or fishtail deformity was found in either group A or group B;one case of partial limitation of elbow flexion or extension,one case of fishtail deformity and one case of femoral head necrosis were observed in group C.No infection or skin necrosis was found in any of the 3 groups.Conclusions Because intraoperative arthrography can definitely judge whether the articular surface is intact or unstable,it can make up for the insufficiency of X-rays in judging integrity of the articular surface.In combination with closed reduction,percutaneous puncture or open reduction and internal fixation,intraoperative arthrography can contribute to an increased rate of successful surgery,and reduced complications due to redisplacement.

Objective To investigate the expression of IL-24 in patients with non-small cell lung cancer (NSCLC),and to evaluate its influence on the bioactivity of NSCLC cells. Methods Thirty-nine patient with NSCLC (23 patients with adenocarcinoma and 16 patients with squamous carcinoma) and 17 healthy subjects were enrolled in this study. Serum samples and lung cancer tissues were collected. IL-24 expression in the serum samples was measured using enzyme-linked immunosorbent assay. Its expression at mRNA level in the lung cancer tissues was measured using reverse transcriptional real-time PCR. Adenocar-cinoma cell line A549 and squamous carcinoma cell line NCI-H520 were stimulated with recombinant human IL-24 (10 ng/ml and 100 ng/ml) for 24 hours. Cell proliferation was measured using CCK-8 method. Ap-optosis and cell cycle were measured using flow cytometry. Cell invasion was measured using Transwell as-say. Results Serum IL-24 was significantly elevated in patients with NSCLC in comparison with that in healthy subjects [(144.10±64.43) vs(48.47±18.00) pg/ml]. No significant difference in IL-24 expres-sion was found between patients with adenocarcinoma and squamous carcinoma. IL-24 expression at mRNA level in lung cancer tissues of patients with NSCLC was also significantly increased with an approximately 5-fold enhancement in comparison with that in normal lung tissues. Stimulation with low concentration of re-combinant IL-24(10 ng/ml) promoted the proliferation and suppressed the apoptosis of A549 and NCI-H520 cells. In contrast, high concentration of recombinant IL-24 (100 ng/ml) stimulation notably inhibited the proliferation and enhanced the apoptosis of lung cancer cell lines. No remarkable changes in cell cycle of the two kinds of lung cancer cells in response to IL-24 stimulation were observed. Moreover,low concentration of recombinant IL-24 (10 ng/ml) did not affect the invasion of A549 and NCI-H520 cells,while high concen-tration of recombinant IL-24 (100 ng/ml) significantly inhibited the invasion of lung cancer cells. Conclu-sion IL-24 might influence the bioactivity of NSCLC cells in a concentration-dependent manner. High con-centration of IL-24 might counteract the invasion and metastasis of NSCLC,which is important to prevent dis-ease promotion.

Objective To investigate the effects of immune system and immuno-related miRNAs expression in low-dose benzene and its homologue mixed-exposed workers in a short time. Methods A total of 40 workers were recruited from a petrochemical factory ,and their blood samples were collected before and after work to detect the levels of IgA,IgG,IgM,IFN-γ,IL-1β,IL-2,IL-8,TNF-αin serum and miRNA-146a,-155 expression in the peripheral blood mononuclear cell. In the meanwhile ,we measured the individual benzene and its homologue exposure level of recruited workers. Results According to the concentration of benzene ,the subjects were divided into benzene-exposed group(20 workers)and control group(20 workers). And toluene exposure level in benzene-exposed group was significantly higher than that in control group(P<0.05). Significant decrease of IgG was found in benzene-exposed workers after one work shift,compared with control group(P<0.05). Moreover,the interaction between benzene and toluene was significant correlated with the decrease of IL-1β and TNF-α(P < 0.05). Additionally,the interaction between miRNA-155 and miRNA-146a was significant correlated with the decrease of TNF-α(P<0.05). Conclusions:Occupational exposure to low-dose benzene and toluene in a short time could decrease immune function. And there may be an effect of miRNAs in the regulation of cytokine.

Objective To evaluate the relationship between endothelin-1 (ET-1) and p38 mitogenactivated protein kinase (p38 MAPK) and phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathways during mechanical stretch-induced enhancement of adhesion of rat pulmonary microvascular endothelial cells (PMVECs).Methods Rat PMVECs were seeded in the culture plate at a density of 0.5×105 cells/ml (2 ml/well) and divided into 5 groups (n=24 each) using a random number table:control group (group C),mechanical stretch group (group MS),mechanical stretch plus specific PI3K inhibitor LY294002 group (LY group),mechanical stretch plus specific p38 MAPK inhibitor SB203580 group (SB group),and mechanical stretch plus selective ETA receptor blocker BQ123 group (BQ group).Cells were exposed to 20％ cyclic stretch at 0.3 Hz for 4 h using a sine wave.In LY,SB and BQ groups,LY294002,SB203580 and BQ123 at the final concentration of 10 μmol/L were added,respectively,after mechanical stretch,cells were incubated for 10 min,and then extracted and purified rat polymorphonuclear neutrophil leukocytes (PMNs,5× 105 cells/well) were added and co-incubated with PMVECs for 30 min and then washed out.The concentrations of ET-1 and interleukin-6 (IL-6) in the culture medium were determined using enzyme-linked immunosorbent assay.The expression of phosphorylated p38 MAPK (p-p38 MAPK) and phosphorylated Akt (p-Akt) was detected by Western blot.Adhesion of PMNs was measured by immuno-histochemistry,and the adhesion rate was calculated.The expression of P-selectin mRNA was detected using real-time polymerase chain reaction.Results Compared with group C,the concentrations of IL-6 and ET-1 in the culture medium were significantly increased,the expression of p-p38 MAPK,p-Akt and P-selectin mRNA was up-regulated,and the adhesion rate of PMNs was increased in the other four groups (P＜0.05).Compared with group MS,the concentration of IL-6 in the culture medium was significantly decreased,the expression of p-Akt and P-selectin mRNA was down-regulated,and the adhesion rate of PMNs was decreased in LY,SB and BQ groups,the concentration of ET-1 in the culture medium was significantly decreased in group BQ,and the expression of p-p38 MAPK was significantly down-regulated in SB and BQ groups (P＜0.05).Conclusion The signaling mechanism underlying ET-1-mediated enhancement of rat PMVEC adhesion may be related to activating p38 MAPK and PI3K/Akt signaling pathways.

Objective To evaluate the efficacies of upfront simultaneous integrated boost-intensity-modulated radiation therapy (SIB-IMRT) and epidermal growth factor receptor (EGFR) etyrosine kinase inhibitor (TKI) in patients with epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancers who developed brain metastasis (BM).Methods Sixty-eight patients diagnosed as having EGFR-mutant non-small-cell lung cancer developed BM were recruited in our hospital from July 2012 to January 2016.Of these patients,45 received upffont EGFR-TKI gefitinib and 23 accepted SIB-IMRT.The clinical data of these patients were recorded;the viability curve and encephalic progressive cumulative incidence curve were compared between the two groups.Cox multiple-factor analysis was performed to analyze the influencing factors of prognoses.Results The median survival time in the SIB-IMRT group was shorter than that in upfront EGFR-TKI group (18.9 months [95％ CI:16.5-21.4 months] vs.27.5 months [95％CI:21.6-33.5 months]).Log-rank test indicated that the survival rate of patients from SIB-IMRT group was significantly higher than that of patients from EGFR-TKI group (P＜0.05);in the patients from SIB-IMRT group,61％ patients had encephalic progressive changes,with the median survival time of 20.7 months (95％CI:9.6-14.2 months);in the patients from EGFR-TKI group,89％ patients had encephalic progressive changes,with the median survival time of 11.9 months (95％CI:19.7-49.2 months).The encephalic progressive cumulative incidence in patients from EGFR-TKI group was significantly higher than that in patients from SIB-IMRT group (P＜0.05).Multiple-factor analysis indicated that initial therapeutic schedule,prognosis evaluation and extra-cerebral metastasis were the key influencing factors of prognoses.Conclusion The patients accepted upfront EGFR-TKI treatment has longer overall survival and progression free survival than those accepted upfront SIB-IMRT in patients with EGFR-mutant non-small-cell lung cancer who develop BM.