The current situation and influencing factors of breast cancer patients′ anxiety about the upbringing of minor children / 中国实用护理杂志

Objective:To study and analyze the status quo and influencing factors of breast cancer patients′ concern about the upbringing of their minor children, and to provide a reference for clinical improvement of the level of breast cancer patients′ concern about parenting.Methods:A total of 247 breast cancer patients in the daytime ward of Tianjin Medical University Cancer Hospital from March to May 2023 were selected by convenience sampling. The General Information Questionnaire, Parenting Concerns Questionnaire, Parenting Sense of Competence Scale were selected for cross-sectional investigation. The multiple linear regression model was used to analyze the influencing factors of breast cancer patients′ worries about the upbringing of their minor children.Results:Finally, 240 valid questionnaires were ultimately collected. There were 12 patients with breast cancer aged 20-29 years old, 76 patients aged 30-39 years old, 117 patients aged 40-49 years old, and 35 patients aged ≥50 years old. The total score of breast cancer patients′anxiety about minor children′s rearing was (37.34 ± 2.56) points. The scores of each dimension were in order of (15.14 ± 1.02) worry about the actual impact on children, (11.15 ± 0.83) worry about the emotional impact on children, and (11.05 ± 0.71) worry about the parents of children. The total score of parenting competence (66.54 ± 11.68) points. Multiple linear regression analysis showed that parenting competence, educational level, number of underage children, per capita monthly income of families, and TNM stage (T: tumor primary lesion; N: regional lymphnode involvement; M: remote metastasis situation) affected parenting anxiety ( t values were -15.24-8.56, all P<0.05), which could explain 81.2% of the total variation in parenting anxiety level. Conclusions:Breast cancer patients′ concern about the upbringing of minor children is at a medium level, so medical staff should give relevant intervention measures to breast cancer patients with different characteristics, in order to provide reference for reducing the level of concern about the upbringing of minor children.

Application of Ancient Books in Clinical Practice Guidelines and Expert Consensus of Traditional Chinese Medicine： Current Status and Methodological Recommendations / 中医杂志

ObjectiveTo explore the current status and issues regarding the application of ancient books in clinical practice guidelines and expert consensus of traditional Chinese medicine （TCM） published in China， and to provide methodological recommendations for the incorporation of ancient books in the development of TCM guidelines. MethodsWe searched China National Knowledge Infrastructure （CNKI）， WanFang Data， VIP， SinoMed， PubMed， Embase， as well as six industry websites including China Association of Chinese Medicine， National Group Standards Information Platform， and Chinese Association of the Integration of Traditional and Western Medicine，etc. TCM clinical practice guidelines or expert consensus issued during January 1st， 2017， to November 26th， 2022 were searched. Clinical practice guidelines or expert consensus that explicitly referred to ancient books were included， and the content regarding the searching for ancient books， sources of access to ancient books， methods of evaluating the level of evidence， methods of evaluating the level of recommendation， and methods of evaluating the evidence for the ancient books were analysed. ResultsA total of 1,215 TCM clinical practice guidelines or expert consensus were retrieved， with 442 articles explicitly mentioning the application of ancient books， including 300 （67.87%） clinical practice guidelines and 142 （32.13%） expert consensus. Sixty of the 442 publications explicitly reported that ancient books searching had been conducted （13.57%）； among these 60 publications 27 （45.00%） explicitly reported ancient books searching strategies， and the most frequent method was manual searching with a total of 24 articles （40.00%）. The most popular search source was Chinese Medical Dictionary， a TCM classics database， with a total of 18 articles. 197 articles （44.57%） explicitly reported the evaluation criteria for the level of evidence， of which 141 articles （71.57%） involved the evaluation criteria for the ancient books； 413 articles （93.44%） mentioned ancient books in the recommendations， and only the source of formula name was mentioned in 409 （99.03%） of the publications. ConclusionThe current application of ancient books in TCM clinical practice guidelines and expert consensus is limited， with issues of non-standard searching and evaluation methods. Standar-dization and uniformity are needed in evidence grading and recommendation standards. Future research should clarify the scope and methods of applying ancient book， emphasize their integration with modern research evidence， and enhance their value and quality in the development of TCM clinical practice guidelines.

Correlation between metabolic syndrome and hyperuricemia in perimenopausal women / 中华内分泌代谢杂志

Objective:To assess the prevalence of metabolic syndrome(MS) and its relationship with hyperuricemia(HUA) in perimenopausal women in Anning city, Yunnan province.Methods:This is a cross-sectional survey. In May 2021, a multi-stage stratified sampling method was used to collect demographics and clinical data [ethnicity, living community, height, weight, waist circumference, blood pressure, fasting plasma glucose, triglycerides(TG), serum uric acid, high density lipoprotein-cholesterol(HDL-C), alanine transaminase(ALT), etc] in a total of 6 721 perimenopausal women aged 45-60 years.Results:A total of 6 721 perimenopausal women were included in this study. The prevalences of MS and HUA were 14.05%(95% CI 13.22%-14.88%) and 6.46%(95% CI 5.88%-7.07%), respectively. The average age, HDL-C, urea, direct bilirubin, and albumin levels in the perimenstrual HUA population were lower than those in the non-HUA population while the levels of TG, ALT, heart rate, body mass index(BMI), and creatinine were higher(all P<0.05). The prevalence of HUA in perimenopausal women with ethnic minorities and family history of chronic diseases was higher than that in Han nationality and without family history of chronic diseases. The prevalence of MS in perimenopausal women was increased with the increase of serum uric acid( Z=-15.313 8, P<0.001). Multivariate logistic regression model showed that HUA was positively correlated with MS( OR=1.526, 95% CI 1.192-1.954) after adjusting for covariates such as BMI and ethnicity, and the incidence of MS in perimenopausal women in HUA group was 1.526 folds higher than that in non-hyperuricemia group. Conclusion:HUA is highly positively correlated with MS in perimenopausal women. The management of uric acid level in perimenopausal women should be strengthened.

Spectrum-effect relationship of total anthraquinone extract of Cassia seeds against fluorouracil-induced liver injury in mice / 南方医科大学学报

OBJECTIVE@#To investigate the spectrum-effect relationship between the total anthraquinone extract of Cassia seeds and fluorouracil (5-Fu)-induced liver injury in mice and identify the effective components in the extract.@*METHODS@#A mouse model of liver injury was established by intraperitoneal injection of 5-Fu, with bifendate as the positive control. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and myeloperoxidase (MPO), superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) in the liver tissue were detected to investigate the effect of the total anthraquinone extract of Cassia seeds (0.4, 0.8 and 1.6 g/kg) on liver injury induced by 5-Fu. HPLC fingerprints of 10 batches of the total anthraquinone extracts were established to analyze the spectrum- effectiveness of the extract against 5- Fu- induced liver injury in mice and screen the effective components using the grey correlation method.@*RESULTS@#The 5- Fu- treated mice showed significant differences in liver function parameters from the normal control mice (P < 0.05), suggesting successful modelling. Compared with those in the model group, serum ALT and AST activities were decreased, SOD and T- AOC activities significantly increased, and MPO level was significantly lowered in the mice treated with the total anthraquinone extract (all P < 0.05). HPLC fingerprints of the 31 components in the total anthraquinone extract of Cassia seeds showed good correlations with the potency index of 5-Fu-induced liver injury but with varying correlation strengths. The top 15 components with known correlations included aurantio-obtusina (peak 6), rhein (peak 11), emodin (peak 22), chrysophanol (peak 29) and physcion (peak 30).@*CONCLUSION@#The effective components in the total anthraquinone extract of Cassia seeds, including aurantio-obtusina, rhein, emodin, chrysophanol, and physcion, are coordinated to produce protective effects against 5-Fu-induced liver injury in mice.

Application of Press-Z-track-Turn intramuscular injection in the injection of Fluvastatin / 中国实用护理杂志

Objective:To investigate the application effect of Press-Z-track-Turn (PZT) intramuscular injection on the extravasation, local reaction, local pain after injection and patient satisfaction after Fulvestrant injection.Methods:Used a self-controlled study, 63 patients who underwent bilateral intramuscular injection of Fluvastatin in the outpatient injection room of Tianjin Medical University Cancer Hospital from August to October 2022 were conveniently selected. The observation time was two treatment cycles after inclusion in this study. Before the injection of the first treatment cycle, a coin toss was used to randomly decide to use traditional intramuscular injection and PZT intramuscular injection method for injection and record. After 28 days, another injection method was used, with a total of 126 injections per injection method. Observed the extravasation of drug solution and local reactions at the injection site within 7 days after injection using two injection methods, as well as the pain and satisfaction of patients within 7 days after injection.Results:The extravasation rate of drug solution for the PZT intramuscular injection was 1.59% (2/126), which was lower than 7.14% (9/126) for the traditional intramuscular injection, and the difference was statistically significant ( χ2=4.66, P<0.05); the incidence of mild and moderate local reactions for the PZT intramuscular injection was 3.97% (5/126) and 1.59% (2/126), respectively, lower than that for the traditional intramuscular injection 11.11% (14/126) and 5.56% (7/126), and the difference was statistically significant ( χ2=8.26, P<0.05); the pain score of the PZT intramuscular injection was (2.08 ± 0.85) points, lower than that of the traditional intramuscular injection (5.03 ± 1.06) points, and the satisfaction score of the PZT intramuscular injection was (23.68 ± 1.64) points, higher than that of the traditional intramuscular injection (20.10 ± 2.58) points. The difference was statistically significant ( t=-17.24, 9.16, both P<0.01). Conclusions:PZT intramuscular injection can effectively reduce the overflow rate, the incidence of grade 1 and 2 local reactions and the degree of pain of patients, and improve patient satisfaction, which is worthy of clinical application.

Current situation and countermeasures of acute postoperative pain management / 中国医师杂志

Pain caused by surgery is an important clinical issue that seriously affects postoperative rehabilitation and health-related quality of life. Failure to effectively manage postoperative pain not only leads to a decrease in patient quality of life, increases medical expenses, but also has a negative impact on patient recovery. Therefore, it is of great clinical significance to address the challenges of acute postoperative pain management, find effective management strategies, and improve the quality of pain management. This article summarizes the current status of acute postoperative pain management in recent years, including the mechanism of pain occurrence, pain assessment methods, drug and non drug management strategies, and predictive factors for chronic postoperative pain. It also looks forward to future research directions and application prospects.

COPD identification using maximum intensity projection of lung field CT images and deep convolution neural network / 中华健康管理学杂志

Objective:To propose a model using the maximum intensity projection (MIP) of lung field computed tomography (CT) images and deep convolution neural network (CNN) and explore its value in identifying chronic obstructive pulmonary disease (COPD).Methods:A total of 201 subjects were selected from the Second Hospital of Dalian Medical University from January 2010 to May 2021. All subjects were included according to the inclusion criteria and were divided into COPD group (101 cases) and healthy controls group (100 cases). Each patient underwent a high-resolution CT scan of the chest and pulmonary function test. First, the lung field was extracted from CT images and the intrapulmonary MIP images were acquired. Second, with these MIP images as input, the model for identifying COPD was constructed based on a modified residual network (ResNet). Finally, the influence of the number of residual blocks on the performance of the models was investigated. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value, receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the identification efficiency.Results:The accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of ResNet26 was 76.1%, 76.2%, 76.0%, 76.2%, and 76.0%, respectively; and the AUC of the test was 0.855 (95% CI: 0.799-0.901). The accuracy, sensitivity, specificity, PPV, NPV of ResNet50 was 77.6%, 76.2%, 79.0%, 78.6%, and 76.7%, respectively; and the AUC of the test was 0.854 (95% CI: 0.797-0.900). The accuracy, sensitivity, specificity, PPV, NPV of ResNet26d was 82.1%, 83.2%, 81.0%, 81.6%, and 82.7%, respectively; and the AUC of the test was 0.885 (95% CI: 0.830-0.926). Conclusions:The COPD identification model via MIP images from CT images within the lung and deep CNN is successfully constructed and achieves accurate COPD identification. And it can provide an effective tool for COPD screening.

Advances in the diagnosis and treatment of occult inguinal hernia / 国际外科学杂志

With the advent of laparoscopic inguinal hernia repair, occult inguinal hernias not reported by physical examination are frequently found during surgery. Occult inguinal hernia is an early inguinal hernia, which is easy to be ignored because its clinical symptoms are not obvious. Currently, the best diagnostic method for occult inguinal hernia is laparoscopy, Noninvasive tests such as ultrasound and MRI should be performed in patients with first symptoms. With the increase of age, abdominal wall strength decrease, and the proportion of occult inguinal hernia requiring treatment will also increase, doctors need to choose a reasonable treatment plan according to the actual situation of patients. The key to the diagnosis and treatment of occult inguinal hernia lies in making clear its definition and establishing uniform diagnostic criteria. Through reasonable and accurate preoperative examination combined with laparoscopic techniques and the adjustment of surgical approaches, occultic defects can be found and repaired. Individualized treatment for different populations can avoid future symptoms and reduce additional surgical risks.

Regulations of RLM1 gene affect the anti-autolytic ability of lager yeast / 生物工程学报

The autolysis of brewer's yeast seriously affects the quality of beer and the quality of yeast is considered as one of the key factors in beer brewing. Previous studies on brewer's yeast autolysis showed that RLM1 gene, an important transcription factor in cell integrity pathway, is closely related to the autolysis of yeast. In this study, RLM1 was knocked out and overexpressed in a haploid brewer's yeast. RLM1 disruption resulted in poor anti-autolysis performance of yeast, whereas overexpression of RLM1 contributed to the anti-autolytic ability of yeast. In addition, RLM1 gene knockout affected the osmotic stress resistance, cell wall damage resistance, nitrogen starvation resistance and temperature tolerance of yeast strain. The transcriptional level of GAS1 involved in cell wall assembly and DNA damage response was regulated along with the expression of RLM1, whereas other genes in CWI pathway did not show apparent regularity. RLM1 might mainly affect the expression of GAS1 so as to improve the stress resistance of lager yeast in harsh environment. The result from this study help further understand the mechanism of yeast autolysis and lay a foundation for breeding brewer's yeast strain with better anti-autolytic ability.

Research on the status and influencing factors of spiritual nursing needs of cancer patients / 中华护理杂志

Objective To preliminarily explore the level of spiritual needs from nurses in cancer patients,and to analyze its influencing factors.Methods Convenience sampling was applied to recruit 153 inpatients from a tertiary general hospital and a tumor hospital from December 2015 to April 2016.The Chinese version of the Nurse Spiritual Therapeutics Scale (NSTS) was administered to assess the level of spiritual needs from nurses in cancer patients.Results The total score of NSTS was (32.10-±7.68).Regression results showed that educational level and religion belief were influencing factors.Conclusion The level of spiritual needs from nurses in cancer patients was at middle level.With different educational level and religion status,the level of spiritual needs was different.

Simultaneous Content Determination of Multiple Indicator Ingredients in Diefferent Grades of Phellodendron amurense Decoction Piece by HPLC / 中国药房

OBJECTIVE:To establish a method for the simultaneous content determination of berberine hydrochloride,phello-dendrine hydrochloride and magnoflorine in Phellodendron amurense decoction piece,and to campare the contents of the 3 ingredi-ents in different grades of P. amurense decoction piece. METHODS:HPLC was performed on the column of Phenomenex Luna C18 with mobile phase of acetonitrile-0.05 mol/L KH2PO4 (gradient elution) at a flow rate of 1 ml/min,the detection wavelength was 280 nm,the column temperature was 30 ℃,and injection volume was 5 μl. RESULTS:The linear ranges were 0.387 0-7.740 μg for berberine hydrochloride(r=0.999 9),0.044 4-0.888 0 μg for phellodendrine hydrochloride(r=0.999 8)and 0.048 0-0.960 0 μg for magnoflorine(r=0.999 9);RSDs of precision, stability and reproducibility tests were lower than 3%, recoveries were 95.61%-103.22%(RSD=2.80%,n=6),96.18%-102.80%(RSD=1.84%,n=6) and 97.93%-102.78%(RSD=1.84%,n=6). CONCLUSIONS:The method is simple and accurate,and can be used for the contents determination of berberine hydrochloride, phellodendrine hydrochloride and magnoflonine in P. amurense. The contents of berbenine hydrochloride and phellodendrine hydro-chloride in the first-grade decation piece are higher than those in the second-grade decoction piece,and the content of magnoflorine in both decoction pieces shows no discernible differences.

Teaching practice and teachingof cell biology experiments for oversea medical students / 中华医学教育探索杂志

The teaching practiceof cell biology experiments for oversea medical students in School of Medicine of Tongji University was reported in the present article, and the teaching principles of careful plan, clear contents, concise textbook, flexible scheme, full preparation, earnest trial-lecture, orderly implementation and formative assessment were put forward.Based on the different teaching object, the paper mainly explained the differences and the basis of the experimental teaching process of the foreign students and the domestic medical students to provide experience for improving the teaching mode of this kind of course.

Study on the effects of different pacing modes of cardiac resynchronization therapy on dogs with heart failure / 中国医师杂志

Objective To evaluate advantages and disadvantages of different pacing modes of cardiac resynchronization therapy (CRT).Methods Twelve dogs with heart failure were performed in every dog at random,and the pacing modes employed in the test included right atrium-different sites of ventricle,and ventricular sites included right ventricular bifocal (RV-Bi),biventricular (Bi-V),left ventricular (LV).The pacing frequency was 180 times per minute,and the results were measured before pacing and after 15 minutes when the pacing became stable in Color Doppler echocardiography,including left ventricular enddiastolic diameter (LVEDd),left ventricular ejection fraction (LVEF),interventricular mechanical delay (IVMD),interventricular septum and left ventricular posterior wall motion delay (SPWMD),left ventricular 12-segment peak time standard deviation (Ts-SD).Results (1)Compared with before pacing,at the RV-Bi,Bi-V,and LV pacing modes,LVEDd,IVMD,SPWMD,and Ts-SD decreased,LVEF increased,the difference was statistically significant [(42.42 ± 3.94) mm vs (34.00 ± 4.07) mm,(34.17 ± 3.95)mm,(33.75 ±4.18)mm; (28.08 ±4.01)mm vs (13.00 ±3.64) mm,(11.95 ±2.54)mm,(12.08 ±3.51) mm; (75.00 ± 10.22)mm vs (51.75 ±9.84) mm,(20.66 ±7.41) mm,(20.75 ±7.56) mm; (25.08±4.16)mm vs (14.91 ± 3.31)mm,(7.50 ±4.24) mm,(7.41 ±3.39)mm;(32.91 ±4.46)mm vs (41.50 ±4.16)mm,(42.00 ±4.63) mm,(42.41 ±4.99)mm,P ＜0.05].(2)Compared with RV-Bi pacing mode,at the Bi-V,LV pacing modes,SPWMD and Ts-SD decreased,the difference was statistically significant(P ＜ 0.05); there was no significant difference among LVEDd,IVMD,and LVEF (P ＞0.05).(3)There was no significant difference in LVEDd,IVMD,SPWMD,Ts-SD and LVEF between LV and Bi-V pacing (P ＞ 0.05).Conclusions The hemodynamic effects of RV-Bi and LV pacing modes were similar to that of Bi-V pacing,and they can be used as CRT biventricular pacing alternative modes; however,the mechanisms of improving ventricular synchronization are not identical in above pacing modes.