Yttrium-90 selective internal radiation therapy (⁹⁰Y-SIRT) is a treatment technique that delivers radioactive microspheres precisely to the arterial vascular bed of neoplasms, utilizing beta radiation to administer a high local dose of radiation to the neoplasm tissues. This technology has demonstrated significant efficacy in patients with unresectable pirmary liver cancers and liver metastases. This article systematically reviews the development history and clinical application status of ⁹⁰Y-SIRT in the treatment of liver cancer, and looks forward to future development directions.

Objective:To explore the therapeutic efficacy and factors influencing the sequential combination of nucleos(t)ide analogues (NAs) with pegylated interferon alpha (Peg-IFN-α) in the treatment of patients with chronic hepatitis B (CHB).Methods:144 CHB cases with NAs treatment for more than 1 year, HBV DNA < 20 IU/ml, hepatitis B surface antigen (HBsAg) quantification < 3 000 IU/ml, treated with a sequential combination of Peg-IFN-α treatment for 48 to 96 weeks, and followed up were selected from the Fifth Medical Center of the PLA General Hospital between May 2018 and May 2020. Intention-to-treat analysis was used to measure the HBsAg clearance rate at 96 weeks. The Kaplan-Meier method was used to compute the cumulative HBsAg clearance rate at 96 weeks. Univariate and multivariate logistic regression were used to analyze the factors influencing HBsAg clearance at 48 weeks of sequential combination therapy. Univariate and multifactorial COX proportional hazard models were used to analyze the factors influencing HBsAg clearance following 96 weeks of prolonged PEG-IFN-α treatment. The receiver operating characteristic curve was used to assess the predictive value of factors influencing HBsAg clearance. A Mann-Whitney U test was used to compare the measurement data between groups. The count data was compared using the χ2 test between groups. Results:41 (28.47%) cases achieved HBsAg clearance at 48 weeks of sequential combination therapy. The HBsAg clearance rate at 96 weeks was 40.28% (58/144) by intention-to-treat analysis. The Kaplan-Meier method computed that the cumulative HBsAg clearance rate at 96 weeks was 68.90%. Multivariate logistic regression analysis showed that HBsAg quantification at baseline ( OR = 0.090, 95% CI: 0.034-0.240, P < 0.001) and a 24-week drop in HBsAg level ( OR = 7.788, 95% CI: 3.408-17.798, P < 0.001) were independent predictors of HBsAg clearance in CHB patients treated sequentially in combination with NAs and Peg-IFN-α for 48 weeks. Receiver operating characteristic curve analysis showed that the baseline HBsAg quantification [area under the receiver operating characteristic curve (AUC), 0.911, 95% CI: 0.852-0.952)] and 24-week drop in HBsAg level (AUC = 0.881, 95% CI: 0.814-0.930) had equally good predictive value for 48-week HBsAg clearance, but there was no statistically significant difference between the two ( Z = 0.638, P = 0.523). The value of the combination of baseline HBsAg quantification and 24-week drop in HBsAg level (AUC = 0.981, 95% CI: 0.941-0.997) was superior to that of single baseline HBsAg quantification ( Z = 3.017, P = 0.003) and 24-week drop in HBsAg level ( Z = 3.214, P = 0.001) in predicting HBsAg clearance rate at 48 weeks. Multivariate COX proportional hazards model analysis showed that HBsAg quantification at 48 weeks ( HR = 0.364, 95% CI: 0.176-0.752, P = 0.006) was an independent predictor of HBsAg clearance with a prolonged course to 96 weeks of Peg-IFN-α treatment. Conclusion:The HBsAg clearance rate can be accurately predicted with baseline HBsAg quantification combined with a 24-week drop in HBsAg level in patients with CHB who are treated with a sequential combination of NAs and Peg-IFN-α therapy for 48 weeks. Prolonging the course of Peg-IFN-α treatment can enhance the HBsAg clearance rate's capability. An independent predictor of HBsAg clearance is HBsAg quantification at 48 weeks of sequential combination therapy with a prolonged course of 96 weeks of Peg-IFN-α treatment.

OBJECTIVE To establish the fingerprint of Zhuang medicine Jinmu granules and carry out chemometric analysis ， and determine the contents of three components . METHODS High performance liquid chromatography （HPLC） method was adopted. Using rutin as the reference ，HPLC fingerprints of 10 batches of Jinmu granules were drawn and similarity evaluation was performed by Similarity Evaluation of Chromatographic Fingerprint of Traditional Chinese Medicine （2012 edition）；the common peak was determined by comparing with mixed control ；SPSS 21.0 software was used for cluster analysis ，and SIMCA 14.1 software was used for principal component analysis and orthogonal partial least squares-discriminant analysis. The differential components affecting the quality of Jinmu granules were screened by taking the variable importance in projection （VIP）value ＞1 as the standard ；the HPLC method was used to determine the contents of astilbin ，polydatin and berberine hydrochloride in Jinmu granules. RESULTS There were 22 common peaks in 10 batches of Jinmu granules ，and the similarities were 0.962-0.997；five common peaks were identified ，namely gallic acid （peak 2），polydatin（peak 9），rutin（peak 11），astilbin（peak 13）and kaempferol （peak 20）. The results of cluster analysis showed that 10 batches of Jinmu granules could be clustered into 3 categories：S1 and S 3-S4 were grouped into one category ；S5-S6 and S 9 were grouped into one category ；S2，S7-S8 and S 10 were grouped into one category. The results of principal component analysis showed that the parameter of model interpretation was 0.951 and that of prediction ability was 0.723. The classification results were basically consistent with cluster analysis. The classifica tion results of orthogonal partial least squares- com discriminant analysis were also ba sically consistent with clus- ter analysis. The common peaks with VIP value ＞1 in the order were peak 7＞peak 11（rutin）＞peak 17＞peak 13（astilbin）＞ peak 3＞peak 8＞peak 6＞peak 16 respectively. The linear ranges of astilbin ，polydatin and berberine hydrochloride were 0.012 6- 1.225 0，0.010 8-1.052 5 and 0.020 0-1.562 5 mg/mL，respectively（all R 2＝0.999 9）. RSDs of precision ，stability（24 h）and repeatability tests were all less than 3％. The average recoveries were 99.48％（RSD＝2.67％，n＝9），98.57％（RSD＝1.77％，n＝ 9）and 100.84％（RSD＝2.49％，n＝9）. The contents were 1.221 0-7.011 6，2.251 1-4.462 9，1.252 4-3.328 7 mg/g，respectively. CONCLUSIONS Established fingerprint and the method of content determination are accurate ，stable and simple. Combined with chemometric analysis ，it can be used for the quality control and evaluation of Zhuang medicine Jinmu granules.

Objective:To investigate the effect of a short hairpin RNA (shRNA) targeting epidermal growth factor receptor (EGFR) combined with sirolimus on proliferation and apoptosis of the human cutaneous squamous cell carcinoma cell line Colo-16, and to explore underlying mechanisms.Methods:Cultured Colo-16 cells were divided into 5 groups: normal cell group receiving conventional culture and treatment with phosphate-buffered saline (PBS) , negative control group transfected with a shRNA-NC-expressing plasmid and treated with PBS, sirolimus group receiving conventional culture and sirolimus treatment, EGFR shRNA group transfected with an EGFR shRNA-expressing plasmid and treated with PBS, and combined group transfected with an EGFR shRNA-expressing plasmid and treated with sirolimus. Methyl thiazol tetrazolium (MTT) assay was performed to evaluate cellular proliferative activity in the above groups from 24 to 96 hours, and flow cytometry to detect cell apoptosis after 48-hour treatment. Semiquantitative RT-PCR was conducted to determine the mRNA expression of Bcl-2 and Bax, and Western blot analysis to determine the expression of apoptosis-related proteins cleaved caspase-3, cleaved caspase-9, Bcl-2, Bax, cell proliferation-related proteins phosphorylated mammalian target of rapamycin (p-mTOR) , phosphorylated protein kinase B (p-AKT) , phosphorylated 70-kDa ribosomal protein S6 kinase (p-P70S6k) , and cyclin D1. Comparisons among groups were carried out by using one-way analysis of variance, and multiple comparisons between 2 groups by using Student-Newman-Keuls q test. Results:MTT assay showed that the proliferative activity of Colo-16 cells was significantly lower in the sirolimus group, EGFR shRNA group and combined group during 24 - 96 hours than in the normal cell group (all P < 0.05) , and higher in the combined group than in the sirolimus group and EGFR shRNA group at 24-96 hours (all P < 0.001) , and there was no significant difference in the cellular proliferative activity at any time points between the normal cell group and negative control group (all P > 0.05) . Flow cytometry showed that the apoptosis rate was significantly higher in the sirolimus group, EGFR shRNA group and combined group (9.52% ± 0.25%, 12.65% ± 0.23%, 19.81% ± 0.31%, respectively) than in the normal cell group (3.33% ± 0.18%, q = 60.07, 78.08, 122.81, respectively, all P < 0.001) and negative control group (3.42% ± 0.19%, q = 59.90, 77.91, 122.64, respectively, all P < 0.001) , and was highest in the combined group. As RT-PCR and Western blot analysis revealed, the sirolimus group, EGFR shRNA group and combined group showed significantly decreased mRNA expression of Bcl-2 and protein expression of cyclin D1, p-AKT, p-mTOR, p-P70S6K and Bcl-2, but significantly increased mRNA expression of Bax and protein expression of cleaved caspase-3, cleaved caspase-9 and Bax compared with the normal cell group (all P < 0.05) . Compared with the sirolimus group and EGFR shRNA group, the combined group showed significantly decreased mRNA expression of Bcl-2 and protein expression of cyclin D1, p-AKT, p-mTOR, p-P70S6K and Bcl-2 (all P < 0.05) , but significantly increased mRNA expression of Bax and protein expression of cleaved caspase-3, cleaved caspase-9 and Bax (all P < 0.01) . Conclusion:EGFR shRNA and sirolimus exerted a synergistic effect in inhibiting the proliferation and promoting the apoptosis of Colo-16 cells, which may be related to the inhibition of the phosphoinositide 3-kinase (PI3K) /AKT/mTOR pathway.

Objective:To explore the effect of the hospital discharge readiness plan based on deep integration of medical nursing and rehabilitation in children with cerebral palsy.Methods:From January 2020 to September 2021, 60 children with cerebral palsy and their 60 parents admitted to the Children's Rehabilitation Department of Anhui Children's Hospital were selected as the research object. The children and parents were divided into the observation group and the control group by random number table, with 30 children and 30 parents in each group. The control group was given routine nursing, and the observation group was given the hospital discharge readiness plan based on the deep integration of medical nursing and rehabilitation. On the first day of admission and the day before discharge, the effects were evaluated using the Chinese version of the Chinese version of the Readiness for Hospital Discharge Scale (RHDS) -Parent Form, the Chinese version of the Quality of Discharge Teaching Scale (QDTS) -Parent Form, the Activities of Daily Living (ADL) Rehabilitation Nursing Rating Scale for Children with Cerebral Palsy.Results:After the intervention, the scores of the observation group were higher than those of the control group in terms of readiness for hospital discharge, quality of discharge teaching, and the differences were statistically significant ( P<0.05) . Conclusions:The hospital discharge readiness plan based on deep integration of medical nursing and rehabilitation in children with cerebral palsy can effectively improve their discharge readiness, the quality of discharge teaching and the ADL of children with cerebral palsy.

In order to reveal the mechanism of silicon (Si) fertilizer in improving nitrogen (N) and phosphorus (P) nutrient availability in paddy soil, we designed a series of soil culture experiments by combining application of varying Si fertilizer concentrations with fixed N and P fertilizer concentrations. Following the recommendations of fertilizer manufacturers and local farmers, we applied Si in concentrations of 0, 5.2, 10.4, 15.6, and 20.8 μg/kg. At each concentration of added Si, the availability of soil N and P nutrients, soil microbial activity, numbers of ammonia-oxidizing bacteria and P-decomposing bacteria which means that the organic P is decomposed into inorganic nutrients which can be absorbed and utilized by plants, and urease and phosphatase activity first increased, and then decreased, as Si was added to the soil. These indicators reached their highest levels with a Si application rate of 15.6 μg/kg, showing values respectively 19.78%, 105.09%, 8.34%, 73.12%, 130.36%, 28.12%, and 20.15% higher than those of the controls. Appropriate Si application (10.4 to 15.6 µg/kg) could significantly increase the richness of the soil microbial community involved in cycling of N and P nutrients in the soil. When the Si application rate was 15.6 μg/kg, parameters for characterizing microbial abundance such as sequence numbers, operational taxonomic unit (OTU) number, and correlation indices of microbial community richness such as Chao1 index, the adaptive coherence estimator (ACE) index, Shannon index, and Simpson index all reached maximum values, with amounts increased by 14.46%, 10.01%, 23.80%, 30.54%, 0.18%, and 2.64%, respectively, compared with the control group. There is also a good correlation between N and P mineralization and addition of Si fertilizer. The correlation coefficients between the ratio of available P/total P (AP/TP) and the number of ammonia-oxidizing bacteria, AP/TP and acid phosphatase activity (AcPA), AP/TP and the Shannon index, the ratio of available N/total amount of N (AN/TN) and the number of ammoniated bacteria, and AN/TN and AcPA were 0.9290, 0.9508, 0.9202, 0.9140, and 0.9366, respectively. In summary, these results revealed that enhancement of soil microbial community structure diversity and soil microbial activity by appropriate application of Si is the key ecological mechanism by which application of Si fertilizer improves N and P nutrient availability.

Objective To evaluate the influence of dynamic fixation (rotating and sliding pedicle screws) on stability of the atlantoaxial joint. Methods A series of in vitro biomechanical tests were performed using six fresh adult cervical spines (occipital bone-C4 segment) to simulate different conditions in surgery， including the intact state, the injury state, rigid fixation, rotating pedicle screw fixation, sliding pedicle screw fixation. The repeated measurement design was employed, and under intact, injury and different fixation states, the pure moment of 1.5 N·m in flexion-extension, left-right lateral bending, left-right axial rotation directions were applied using the spinal testing machine. The movement of atlantoaxial spine was measured consecutively by three-dimensional （3D） measurement system in order to analyze the range of motion (ROM) and neutral zone (NZ) of atlantoaxial joints. Results Under injury state, ROM of atlantoaxial joints was significantly larger than that under intact state during flexion, extension, lateral bending and rotation, leading to the instability of atlantoaxial joints. ROM of fixation segments was significantly reduced during flexion, extension, lateral bending and rotation after rigid and dynamic fixation. Compared with rigid fixation, dynamic fixation showed a significant ROM increase during lateral bending. NZs of fixation segments after dynamic fixation were significantly reduced. There were no significant ROM differences between rigid fixation and dynamic fixation. Conclusions The stability of atlantoaxial joints by dynamic fixation during flexion, extension and rotation was comparable to that by rigid fixation, but weaker during lateral bending. Dynamic screw fixation can maintain the relative stability of atlantoaxial joints.

Objective:To investigate the effects of meditation therapy on fear of disease progress and mental health among acute myocardial infarction (AMI) patients.Methods:Totally, 120 cases of acute myocardial infarction patients admitted to Affiliated Hospital of Jiangnan University were divided into experimental group and control group according to the enrolled time. 60 patients with AMI treated from June to November 2018 served as the control group and 60 patients with AMI treated from January to May 2019 served as the experimental group. The patients in the control group received routine nursing, the experimental group carried out 4-week meditation therapy based on the routine nursing. Before and after intervention, the effect was assessed by Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and Symptom Checklist-90 (SCL-90), respectively.Results:After intervention, the physical health and social family function dimension scores in FoP-Q-SF as well as total FoP-Q-SF scores were (12.78±3.47), (10.45±2.44), (23.24±4.25) points, significantly lower than in the control group (14.33±2.72), (11.59±2.82), (25.91±3.89) points, the difference was statistically significant ( t values were 2.623, 2.277, 3.499, P<0.05); the scores of somatization, compulsion, anxiety, depression and total SCL-90 were (1.26±0.19), (1.42±0.23), (1.19±0.28), (1.20±0.16) and (121.81±9.59) points, significantly lower than (1.83±0.25), (1.68±0.37), (1.82±0.41), (1.71±0.33) and (145.85±9.12) points in the control group, the difference was statistically significant ( t values were from 4.580 to 13.659, P<0.001). Conclusion:Meditation therapy can effectively decrease disease progress and promote mental health in patients with acute myocardial infarction.

Objective:To investigate the detection of neutrophil gelatinase related lipid carrier protein (NGAL), alpha fetoprotein (AFP), leucine aminopeptidase (LAP), alpha L fucosidase (AFU) in primary liver cancer (PHC) individually and jointly The diagnostic value of cancer (PHC).Methods:From January 2015 to December 2017, 124 patients with primary liver cancer from the third people′s Hospital of Yunnan Province were selected as PHC group, 53 patients with cirrhosis treated at the same time as benign group A, 37 patients with liver cyst as benign group B, and 64 healthy volunteers as healthy group. The serum AFU, LAP, NGAL and AFP of four groups of subjects were detected by rate method, immunoturbidimetric method and electrochemiluminescence method respectively. The diagnostic efficacy of PHC detected by different combinations of indicators was analyzed by receiver operating characteristic curve (ROC).Results:There were significant differences in serum AFP, AFU, LAP levels and positive expression rates between PHC group, benign group A, group B and healthy group( F values were 56.832, 38.209, 23.415, respectively; χ 2 values were 69.324, 72.568, 24.695, respectively; all P<0.05), and the serum AFP, AFU, LAP levels and positive expression rate were significantly higher in the PHC group than in the benign group A, group B and healthy group, the difference was statistically significant( all P<0.05); sensitivity of AFP+ AFU+ LAP combined detection(89.27% vs.72.17%, 73.52%, 76.31%, 81.35%, 80.69%, 86.87%), specificity(95.76% vs.81.58%, 82.79%, 84.16%, 86.95%, 94.23%, 93.29%) and the Yoden index (0.85 and 0.54, 0.56, 0.60, 0.68, 0.75, 0.80) are superior to their one indicator (LAP, AFU, AFP) and two indexes combined detection(LAP+ AFU, LAP+ AFP, AFU+ AFP). ROC curve analysis showed that the AUC(0.94) combined with AFP+ AFU+ LAP was greater than LAP+ AFU(0.78), LAP+ AFP(0.85) and AFU+ AFP(0.89). Conclusion:Combined detection of AFP, AFU and LAP can effectively improve the diagnosis efficiency of PHC and reduce missed diagnosis.

Objective? To observe the effect of life retrospective intervention on belief about medication and perceived happiness in elderly patients with chronic kidney disease (CKD). Methods? The convenience sampling method was used to select the elderly patients with Stage 3 and 4 CKD who were admitted to the Department of Nephrology of Xinxiang Central Hospital from June 2017 to June 2018. Among these patients, 51 admitted from June to December 2017 were assigned in the control group, 54 admitted from January to June 2018 were assigned in the observation group. The control group received routine care while the observation group were given life retrospective intervention. The levels of belief about medication and perceived happiness were measured and compared before and after intervention between the two groups using Belief about Medication Questionnaire (BMQ) and Memorial University of Newfoundland Scale of Happiness (MUNSH). Results? After the intervention, the belief about medication increased in the two groups, and that in the observation group was higher than the control group,and the differences were all statistically significant (P＜0.05). After the intervention, the perceived happiness did not significantly change in the control group (P＞0.05), while it increased in the observation group, and the difference was statistically significant (P＜ 0.05). After the intervention, the perceived happiness was higher in the observation group than the control group, and the difference was statistically significant (P＜0.05). Conclusions? Life retrospective intervention could improve belief about medication and perceived happiness in elderly patients with CKD, which could slow down the progress of CKD.