Predictors for Fear of Cancer Recurrence in Breast Cancer Patients Referred to Radiation Therapy During the COVID-19 Pandemic: A Multi-Center Cross-Section Survey.

OBJECTIVE: The outbreak of COVID-19 pandemic has greatly impacted on radiotherapy (RT) strategy for breast cancer patients, which might lead to increased distressing psychological symptoms. We performed a multi-center cross-section survey to investigate prevalence of fear of cancer recurrence (FCR) and predictors for FCR in patients referred to RT during pandemic. METHODS: 542 patients were consecutively enrolled from three regions in China including Yangtze Delta River Region, Guangdong and Shanxi province. Patients' characteristics were collected using an information sheet, Fear of progression questionnaire-short form, Hospital Anxiety/Depression Scale and EORTC QLQ-C30. The hierarchical multiple regression models were performed. RESULTS: 488 patients with complete data were eligible. The RT strategy was affected in 265 (54.3%) patients, including 143 with delayed RT initiation, 66 believing to have delayed RT initiation but actually not, 24 with RT interruptions, 19 shifting to local hospitals for RT and the remaining 13 influenced on both RT schedule and hospital level. The model explained 59.7% of observed variances in FCR (p<0.001) and showed that influence of RT strategy had significantly impacted on FCR (△R2 = 0.01, △F=2.966, p=0.019). Hospitals in Shanxi province (ß=-0.117, p=0.001), emotional function (ß=-0.19, p<0.001), social function (ß=-0.111, p=0.006), anxiety (ß=0.434, p<0.001) and RT interruption (ß=0.071, p=0.035) were independent predictors. CONCLUSIONS: RT strategy for breast cancer patients was greatly influenced during pandemic. RT interruption is an independent predictor for high FCR. Our findings emphasize the necessity to ensure continuum of RT, and efforts should be taken to alleviate FCR through psychological interventions.

Predictive model for acute abdominal pain after transarterial chemoembolization for liver cancer.

BACKGROUND: Transarterial chemoembolization (TACE) is the first-line treatment for patients with unresectable liver cancer; however, TACE is associated with postembolization pain. AIM: To analyze the risk factors for acute abdominal pain after TACE and establish a predictive model for postembolization pain. METHODS: From January 2018 to September 2018, all patients with liver cancer who underwent TACE at our hospital were included. General characteristics; clinical, imaging, and procedural data; and postembolization pain were analyzed. Postembolization pain was defined as acute moderate-to-severe abdominal pain within 24 h after TACE. Logistic regression and a classification and regression tree were used to develop a predictive model. Receiver operating characteristic curve analysis was used to examine the efficacy of the predictive model. RESULTS: We analyzed 522 patients who underwent a total of 582 TACE procedures. Ninety-seven (16.70%) episodes of severe pain occurred. A predictive model built based on the dataset from classification and regression tree analysis identified known invasion of blood vessels as the strongest predictor of subsequent performance, followed by history of TACE, method of TACE, and history of abdominal pain after TACE. The area under the receiver operating characteristic curve was 0.736 [95% confidence interval (CI): 0.682-0.789], the sensitivity was 73.2%, the specificity was 65.6%, and the negative predictive value was 92.4%. Logistic regression produced similar results by identifying age [odds ratio (OR) = 0.971; 95%CI: 0.951-0.992; P = 0.007), history of TACE (OR = 0.378; 95%CI: 0.189-0.757; P = 0.007), history of abdominal pain after TACE (OR = 6.288; 95%CI: 2.963-13.342; P < 0.001), tumor size (OR = 1.978; 95%CI: 1.175-3.330; P = 0.01), multiple tumors (OR = 2.164; 95%CI: 1.243-3.769; P = 0.006), invasion of blood vessels (OR = 1.756; 95%CI: 1.045-2.950; P = 0.034), and TACE with drug-eluting beads (DEB-TACE) (OR = 2.05; 95%CI: 1.260-3.334; P = 0.004) as independent predictive factors for postembolization pain. CONCLUSION: Blood vessel invasion, TACE history, TACE with drug-eluting beads, and history of abdominal pain after TACE are predictors of acute moderate-to-severe pain. The predictive model may help medical staff to manage pain.

Contingency management strategies of the Nursing Department in centralized rescue of patients with coronavirus disease 2019.

OBJECTIVES: This article aims to summarize a series of contingency management strategies of the Nursing Department in the centralized treatment of patients with coronavirus disease 2019 (COVID-19). METHODS: The strategies of the Nursing Department included an early warning for prevention and control, taking functions of vertically commanding and horizontally coordinating, and reasonably allocating nursing workforce, to facilitate centralized treatment work in the in-hospital fever clinic, isolation wards and ICU, and referral and admission of critical patients. Five special groups were established in charge of training and examination, management and supervision, psychological support, logistical support, and reporting and publicity, respectively. RESULTS: It was achieved that no deaths from critical patients and no medical staff, no other patients were infected. CONCLUSION: Through the implementation of these strategies, safe and efficient centralized treatment was ensured timely, orderly and sustainably.

Using the Delphi method to establish nursing-sensitive quality indicators for ICU nursing in China.

In this study, the Delphi method was used to develop evidence-based indicators of intensive care unit (ICU) nursing quality of care in China. Nursing quality indicators reflect elements of patient care that are directly affected by nursing practice. A comprehensive literature search identified 2,857 potentially relevant articles. From the 50 articles that were included in this study, researchers identified 38 commonly used nursing quality indicators. A panel of experts reduced these to 20, which were then subjected to two rounds of Delphi discussion by a different panel, and a final consensus was achieved. The 20 indicators were grouped into three dimensions: structure, process, and outcome (including adverse consequences). The agreement among the experts for the 20 indicators was high. These evidence-based nursing quality indicators provide for ease in data collection and a basis for clinical application and improvement in the quality of ICU nursing throughout China.

Development of evidence-based nursing-sensitive quality indicators for emergency nursing: A Delphi study.

AIMS AND OBJECTIVES: To establish evidence-based nursing-sensitive quality indicators for emergency nursing in China. BACKGROUND: China lacks nursing-sensitive quality indicators necessary for assessing the quality of emergency nursing and essential to nursing management. DESIGN: Prospective. METHODS: A literature search for relevant evidence-based studies was performed using several databases from January 2009-May 2014. Previously reported quality indicators were identified as appropriate for assessment by a panel of 40 experts in emergency medicine and nursing. Two successive rounds of Delphi surveys were conducted using questionnaires designed by the experts. Kendal's W coordination coefficients were calculated for indicator importance, rationality of calculation and feasibility of data collection. RESULTS: Thirty-three quality indicators were initially proposed for expert evaluation. After round 1 of expert discussion, Kendal's W coordination coefficients were .152 for importance, .092 for rationality and .141 for feasibility of data collection (all p < .001). Seven unsuitable items were discarded in round 1 and 11 discarded in round 2, which also added one new item. Finally, the experts reached consensus on 16 items established as appropriate nursing-sensitive quality indicators for emergency nursing care. CONCLUSION: Evidence-based nursing-sensitive quality indicators were established through a consensus of experts in emergency nursing and medicine. RELEVANCE TO CLINICAL PRACTICE: The current findings may provide a theoretical basis for establishing an emergency nursing quality database and improving the quality of emergency nursing care in China.

A Singular Value Decomposition Method for Tunable Diode Laser Absorption Spectroscopy System to Remove Systematic Noises.

Detection of gas concentration with tunable diode laser absorption spectroscopy (TDLAS) techniques is affected by baseline drift and high-frequency noise. Therefore, how to remove the systematic noises has been a hot spot. This paper analyzes the significance of singular value decomposition (SVD) in TDLAS detection system with two different methods of constructing a matrix, and it discusses the differences of processing results for different noises. The second harmonic signal is arranged in a matrix and decomposed. We select the appropriate threshold and putthose singular values smaller than the threshold into zero, then reconstruct the matrix. Experiments show that SVD method does not require additional system components or pass into the zero gas to subtract background. This method is able to remove noises of TDLAS system quickly and effectively. We found that the method of constructing a hankel matrix is suitable for removing high-frequency noise. However, the method of constructing a continuous-cutoff-signal matrix is suitable for removing baseline drift. For example, we set up a TDLAS system to measure the concentration of NH3 while the noise removal rate of the second harmonic curve is up to 80% with this method.

Evaluation of efficacy of resin hemoperfusion in patients with acute 2,4-dinitrophenol poisoning by dynamic monitoring of plasma toxin concentration.

OBJECTIVE: The intoxications caused by 2,4-dinitrophenol (2,4-DNP), even death, have been frequently reported in recent years. This study aims to investigate the dynamic changes of plasma toxin concentration and explore the clinical value of resin hemoperfusion (HP) in the treatment of patients with acute 2,4-DNP poisoning. METHODS: We reported 16 cases of acute 2,4-DNP poisoning through occupational exposure due to ignoring the risk of poisoning. The blood samples were collected from the 14 survivors. According to the different treatments of resin HP, the survivors were divided into routine HP (n=5) and intensive HP (n=9) groups. Ultra high performance liquid chromatography/ tandem mass spectroscopy (UPLC-MS/MS) was used to detect the 2,4-DNP concentration in plasma in this study. RESULTS: The 14 survivors recovered very well after treatment. The initial plasma 2,4-DNP concentrations (C1) of survivors ranged from 0.25 to 41.88 µg/ml (mean (12.56±13.93) µg/ml). A positive correlation existed between initial plasma 2,4-DNP concentration (C1) and temperature. The elimination of 2,4-DNP was slow and persistent, and the total clearance rates of plasma toxin from the 1st to 3rd day (R3), the 3rd to 7th day (R3-7), and the 1st to 7th day (R7), were only (53.03±14.04)%, (55.25±10.50)%, and (78.29±10.22)%, respectively. The plasma toxin was cleared up to 25 d after poisoning in most of the patients. The R3, R3-7, and R7 in the intensive HP group were all apparently higher than those in the routine HP group, with statistical significance (P<0.05). Simultaneously, the elimination half-life (t1/2) of 2,4-DNP in the intensive HP group was apparently shorter than that in the routine HP group, with statistical significance (P<0.05). CONCLUSIONS: The clinicians should be aware of this slow and persistent process in the elimination of plasma 2,4-DNP. Higher initial plasma toxin concentration resulted in a more severe fever for the patient. According to the limited data, longer and more frequent resin HP may accelerate to eliminate the poison.

[Changes in muscle spindle afferent discharge activities in rat soleus following hindlimb immobilization].

OBJECTIVE: To investigate the changes in the afferent discharge activities of the sensory nerve endings in muscle spindles of rats with hindlimb immobilization. METHODS: Plaster cast was used immobilize the hindllimbs of rats. Using air-gap technique, the spontaneous discharge of the muscle spindles and its responses to perfusion with succinylcholine (0.05 mg/ml) and suspension in an extended position were observed in isolated muscle spindles from rats with hindlimb immobilization for 3, 7, and 14 days. RESULTS: The muscle spindles of rat soleus showed a sharp decrease in spontaneous discharge frequency (P<0.01) and response to succinylcholine perfusion after 3 days of hindlimb immobilization (P<0.05). Significant changes of the firing rate in an extended position was observed in rats after a 14-day immobilization (P<0.01). The duration of individual spikes was significantly prolonged following hindlimb immobilization (P<0.01). CONCLUSION: Muscle spindle discharges decrease significantly in rats following hindlimb immobilization, which might be related to reduced contractile properties of the muscle spindle.

[Research Progress of Proton Transfer Reaction Mass Spectrometry in the Field of Breathing Gas Detection].

Breathing gas carries important physiological information. Technology for detection of breathing gas has become a research focus because of the advantages of nondestructive sampling and convenient operation. Proton transfer reaction mass spectrometry (PTR-MS) plays an irreplaceable role because of the advantages of high sensitivity, fast response and good specificity. In this paper, the principle of PTR-MS is introduced first, followed by research progress of PTR-MS in the field of breathing gas detection. Factors influencing the test results are analyzed. Finally, future prospects of development for PTR-MS in the field of breathing gas detection are discussed.

[A New Method for Eliminating Background Signal Drift to Improve the Detection Precision in Continuous Harmonic Detection].

To overcome the second harmonic background signal drift in gas continuous detection based on tunable diode laser absorption spectroscopy(TDLAS), a new method of background elimination was proposed by changing center current of the laser. This method can eliminated the effects of background signal drifting on concentration inversion. Based on the wavelength modulation theory, the theoretical expression of the second harmonic of the background signal is derived. In addition, the second harmonic background signal components and the factors that affect it are described. In different working temperatures, the relationship curve between thelaser current and output light intensity. In the process of continuous detection, we analyzes the feasibility ofchangingthe laser center current extraction of background signal. Combined with the principle of the background signal searching, the LabView flow chart was designed to search background center current. Ammonia (NH3) was detected by the TDLAS experimental system, which demonstrated the feasibility of the new method. The range of experiment parameters and the range of background center current searches were determined, in the situation that there was only one absorption line in the full laser workspace. The experimental results showed that this method realizes background signal extraction, reduces the error of concentration inversion and the effects of concentration inversion bybackground signal. Thus it improved the detection accuracy of the concentration. In the continuous detection experiment, the standarddeviation of inversion concentration reduced from 2.688 3 to 1.856 1, which demonstrated. that the degree of dispersion of detected concentration is reduced, even eliminate the effects of background signal drifting on concentration inversion and the accuracy of detection is improved. This method provides an effective background drifting elimination approach for improving the detection accuracy of the concentration.

Induction of B7-H1 expression by human cytomegalovirus in extravillous cytotrophoblast cells and role of MAPK pathway.

OBJECTIVE: This paper is aimed at to evaluate B7-H1 expression as induced by human cytomegalovirus (HCMV) in extravillous cytotrophoblast cell line HPT-8 and possible underlying mechanism. METHOD: Real time PCR and flow cytometry were used to determine B7-H1 mRNA and protein before and after HCMV infection in HPT-8 cells. Western blot analysis was used to determine the level of MAPK phosphorylation in HPT-8 cell lines infected with HCMV. RESULTS: 100TCID50 was found to be the most effective dose, capable of stimulating B7-H1 mRNA and protein expression in HPT-8 cells. When empty control group was considered to have a B7-H1 mRNA value of 1, B7-H1 mRNA was 4.32 in 100TCID50 group. In flow cytometry study, mean fluorescence intensity (MFI) of 100TCID50 group was 16.14, while empty control group was 1.34. Both mRNA and protein expression were found to be significantly increased (P<0.05) in 100TCID50 group compared to empty control group. The result of Western blot analysis showed increase in B7-H1 expression caused by the extracellular signaling that was related to ERK activation and the ERK inhibitor U0126 was found to reverse this increase. CONCLUSION: HCMV upregulates B7-H1 expression in human extravillous cytotrophoblast cell line HPT-8, which is related to MAPK activation. Our result would be helpful in finding better therapies against intrauterine HCMV infection.

Detection of mutations by fill-in ligation reaction with enzyme-linked immunosorbent assay for rapid medical diagnosis.

Several approaches for parallel genotyping have been developed with increasingly available information on DNA variation. However, these methods require either complex laboratory procedures or expensive instrumentation. None of these procedures is readily performed in local clinical laboratories. In this study, we developed a flexible genotyping method involving fill-in ligation reaction with enzyme-linked immunosorbent assay successfully applied to detect important single-nucleotide polymorphisms (SNPs) for EGFR c.2573T > G (L858R), EGFR c.2582T > A (L861Q), and EGFR c.2155G > T (G719C). This assay exhibited excellent specificity, with a sensitivity as low as 0.5%. Eight out of 62 clinical samples were identified as heterozygotes for the SNP site of L858R, whereas only two samples were identified as heterozygotes by direct sequencing. The developed method enabled accurate identification of SNP in a simple and cost-effective manner adapted to routine analysis.

[Research on optimization of mathematical model of flow injection-hydride generation-atomic fluorescence spectrometry].

Flow injection-hydride generation-atomic fluorescence spectrometry was a widely used method in the industries of health, environmental, geological and metallurgical fields for the merit of high sensitivity, wide measurement range and fast analytical speed. However, optimization of this method was too difficult as there exist so many parameters affecting the sensitivity and broadening. Generally, the optimal conditions were sought through several experiments. The present paper proposed a mathematical model between the parameters and sensitivity/broadening coefficients using the law of conservation of mass according to the characteristics of hydride chemical reaction and the composition of the system, which was proved to be accurate as comparing the theoretical simulation and experimental results through the test of arsanilic acid standard solution. Finally, this paper has put a relation map between the parameters and sensitivity/broadening coefficients, and summarized that GLS volume, carrier solution flow rate and sample loop volume were the most factors affecting sensitivity and broadening coefficients. Optimizing these three factors with this relation map, the relative sensitivity was advanced by 2.9 times and relative broadening was reduced by 0.76 times. This model can provide a theoretical guidance for the optimization of the experimental conditions.

[The noise filtering and baseline correction for harmonic spectrum based on wavelet transform].

The problem of noise and baseline drift is a hot topic in infrared spectral harmonic detection system. This paper presents a new algorithm based on wavelet transform Mallet decomposition to solve the problem of eliminating a variety of complex noise and baseline drift in the harmonic detection. In the algorithm, the appropriate wavelet function and decomposition level were selected to decomposed the noise, baseline drift and useful signal in the harmonic curve into different frequency bands. the bands' information was analysed and a detecting band was set, then the information in useful frequency was reserved by zeroing method of treatment and the coefficient of the threshold. We can just use once transform and reconstruction to remove interference noise and baseline from double-harmonic signal by applying the wavelet transform technique to the harmonic detection spectrum pretreatment. Experiments show that the wavelet transform method can be used to different harmonic detection systems and has universal applicability.

[Method of isolation of intrafusal fibres of muscle spindle in soleus of rats].

Capsule restricts the further study on muscle spindle function and the involved mechanism. The aim of this study was to establish the isolation method of intrafusal fibres from the isolated rat muscle spindle. Intrafusal fibres were harvested from muscle spindle of soleus muscle in rats using neutrase-collagenase digestion. A variety of incubation mediums have been tested to find out an appropriate medium of intrafusal fibers in vitro. Trypan blue staining was used to detect cell death, and patch clamp was used to record resting potential. The results showed that the intrafusal fibres incubated with amine acid-saline solution were almost all dead. DMEM could maintain good condition of the fibres, but excess CO2 ventilation would induce cellular swelling or even death. While Leiboviz's 15 (L-15) medium can guarantee 1-2 h of physiological condition of the intrafusal fibres. Coverslips treated with gelatin, polylysine and serum was the better interfaces for the intrafusal fibres to adhere easily, compared with regularly treated coverslip. The resting potential of intrafusal fibres was (-45.3 ± 5.1) mV, consistent with others obtained from in vivo muscle spindle from cats and frogs. These results suggest that the isolation method of the intrafusal fibres has been successfully established in the present study, providing a new approach in better understanding of muscle spindle activities and the involved mechanism.

[Relationship between simulated weightlessness-induced muscle spindle change and muscle atrophy].

One of the most important and urgent issues in the field of space medicine is to reveal the potential mechanism underlying the disused muscle atrophy during the weightlessness or microgravity environment. It will conduce to find out effective methods for the prevention and treatment of muscle atrophy during a long-term space flight. Increasing data show that muscle spindle discharges are significantly altered following the hindlimb unloading, suggesting a vital role in the progress of muscle atrophy. In the last decades, we have made a series of studies on changes in the morphological structure and function of muscle spindle following simulated weightlessness. This review will discuss our main results and related researches for understanding of muscle spindle activities during microgravity environment, which may provide a theoretic basis for effective prevention and treatment of muscle atrophy induced by weightlessness.

TRPV1 channel-mediated bilateral allodynia induced by unilateral masseter muscle inflammation in rats.

Pain in masticatory muscles is among the most prominent symptoms of temperomandibular disorders (TMDs) that have diverse and complex etiology. A common complaint of TMD is that unilateral pain of craniofacial muscle can cause a widespread of bilateral pain sensation, although the underlying mechanism remains unknown. To investigate whether unilateral inflammation of masseter muscle can cause a bilateral allodynia, we generated masseter muscle inflammation induced by unilateral injection of complete Freund's adjuvant (CFA) in rats, and measured the bilateral head withdrawal threshold at different time points using a von Frey anesthesiometer. After behavioral assessment, both right and left trigeminal ganglia (TRG) were dissected and examined for histopathology and transient receptor potential vanilloid 1 (TRPV1) mRNA expression using quantitative real-time PCR analysis. A significant increase in TRPV1 mRNA expression occurred in TRG ipsilateral to CFA injected masseter muscle, whereas no significant alteration in TRPV1 occurred in the contralateral TRG. Interestingly, central injection of TRPV1 antagonist 5-iodoresiniferatoxin into the hippocampus significantly attenuated the head withdrawal response of both CFA injected and non-CFA injected contralateral masseter muscle. Our findings show that unilateral inflammation of masseter muscle is capable of inducing bilateral allodynia in rats. Upregulation of TRPV1 at the TRG level is due to nociception caused by inflammation, whereas contralateral nocifensive behavior in masticatory muscle nociception is likely mediated by central TRPV1, pointing to the involvement of altered information processing in higher centers.

[Effects of tetramethylpyrazine on nitric oxide synthase activity and calcium ion concentration of skeletal muscle in hindlimb unloading rats].

OBJECTIVE: To explore the effects of tetramethylpyrazine on the nitric oxide synthase activity and calcium ion concentration in skeletal muscle fiber and decipher the possible mechanisms of anti-muscle atrophy function of tetramethylpyrazine in hindlimb unloading rats. METHODS: Hindlimb unloading (HLU) rats were used as a muscle atrophy model to study the activity of nitric oxide synthase by colorimetry. The concentration of intracellular calcium ion was measured by laser scanning confocal microscope. A total of 18 female rats were randomly divided into 3 groups: control (CON), hindlimb unloading with water (HLU + W) and hindlimb unloading with tetramethylpyrazine (HLU + Tmp) (n = 6 each). RESULTS: (1) Compared with CON, the activity of nitric oxide synthase decreased by 28% in HLU + W (P < 0.05) and decreased by 46% in HLU + Tmp (P < 0.01). The activity of nitric oxide synthase less decreased in HLU + Tmp than that in HLU + W, but it was not statistically significant (P > 0.05). (2) Compared with CON, the concentrations of intracellular calcium ion in HLU + W and HLU + Tmp increased by 330% and 86% respectively (P < 0.01). Compared with HLU + W, the concentration of intracellular calcium ion decreased by 130% in HLU + Tmp (P < 0.01). CONCLUSION: The activity of nitric oxide synthase decreases and the concentration of calcium ion increases in hindlimb unloading rats. And tetramethylpyrazine may suppress the calcium ion overloading but not the activity of NOS associated with disuse muscular atrophy.

Prolonged hindlimb unloading leads to changes in electrophysiological properties of L5 dorsal root ganglion neurons in rats after 14 days.

INTRODUCTION: The purpose of this study was to evaluate the electrophysiological changes observed in dorsal root ganglion (DRG) neurons in a simulated weightlessness rat model and to assess the mechanisms involved in these changes. METHODS: The simulated weightlessness model was created by hindlimb unloading (HU). Whole-cell patch-clamp recordings, conduction velocity measurement, and ultrastructural observation were performed. RESULTS: In the HU rats, the action potentials had a longer duration and slower falling rate, but there was no significant effect on amplitude or rate of rise. HU also induced lowering of rheobase and of the threshold potential, making the cells more excitable. The conduction velocities in the proximal branches of ganglion cells were also decreased, and some degenerative changes in the myelin sheath were noted. CONCLUSIONS: This study provides evidence of plasticity of DRG neurons induced by HU. The changes observed might contribute to impaired motor performance in rats submitted to HU.