Feasibility of an oral health promotion program among older people in geriatric care facilities, Shanghai, China: a pre/post-implementation study.

BACKGROUND: The oral health of older people is closely related to their overall health. Timely and effective intervention in oral issues is necessary to maintain their overall health. This study aimed to evaluate the feasibility and effectiveness of an Oral Health Promotion Program (OHPP) in Geriatric Care Facilities (GCFs). METHODS: The OHPP was implemented in two GCFs and evaluated using a pre/post-design. Questionnaires on self-efficacy and attitude for providing oral care were sent to 42 nurse participants before and three months after the implementation of the OHPP. Outcomes of 295 patient participants were assessed at four time points (T1-baseline, T2-one month, T3-two months, and T4-three months post-implementation) including Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Oral Health Assessment Tool (OHAT). RESULTS: The oral health and daily activity ability of patient participants showed an improving trend at four time points pre/post-implementation of the OHPP. The proportion of patients with healthy mouths (OHAT: 0-3 points) increased from 29.8 to 67.8% and their scores of OHAT and ADL were significantly better at T4 compared to T1, T2, and T3 (p < 0.001). Self-efficacy (SE-PMC: T1 = 18.93 ± 3.18, T4 = 28.83 ± 6.56, p < 0.001) and attitude (A-PMC: T1 = 18.78 ± 3.09, T4 = 28.20 ± 6.03, p < 0.001) for oral care among nurse participants improved after the implementation of the OHPP. CONCLUSIONS: This study highlights the feasibility of implementing OHPP within GCFs, potentially enhancing the oral health and daily living activities of older individuals. Integrating the OHPP into routine care in geriatric settings is not only practical but also widely acceptable, offering a proactive approach to address oral health disparities among older residents. Stakeholders can maximize the impact of the OHPP by fostering collaboration among healthcare professionals, administrators, and residents, ultimately improving oral health outcomes and overall quality of life of older residents. TRIAL REGISTRATION: ChiCTR2000035236 (registration date: 04/08/2020).

Factors associated with nurses' attitudes for providing oral care in geriatric care facilities: a cross-sectional study.

BACKGROUND: The world's population is getting older. This issue is accompanied by a rise in the number of older people suffering from dementia and disability, for whom oral hygiene care is challenging. Nurses' attitudes toward providing oral care (POC) are critical for the elderly, while few studies have investigated the determinant factors of nurses' attitudes by identifying the current work pressure, resilience and self-efficacy in geriatric care facilities (GCFs). It is of great significance to explore the nurses' attitudes toward POC and associated influencing factors related to psychological aspects including resilience, self-efficacy, and stress from the workplace. METHODS: Attitudes for Providing Mouth Care (A-PMC) in Chinese version were used in this cross-sectional study with 160 nurses in 2 GCFs. Data were collected using online questionnaires and analyzed by multiple linear regression analysis. Statistically significant values were considered at p < 0.05. RESULTS: A total of 160 nurses participated in this study, with an average age of 32.86 ± 7.43. The mean score for the A-PMC was 2.81 ± 0.47. The score of A-PMC was negatively correlated with work pressure (r=-0.332, p < 0.01), and positively correlated with resilience (r = 0.735, p < 0.01) and self-efficacy (r = 0.425, p < 0.01) respectively. Multiple linear regression analyses identified that the potential influencing factors of A-PMC were education background, work hours every shift, self-efficacy, work pressure and resilience. CONCLUSIONS: The study results indicate nurses' attitudes regarding PMC were at a low level, which is influenced by many factors. To improve nurses' attitudes toward PMC and the oral hygiene (OH) of the elderly in GCFs, it is necessary to increase nurses' education and training, establish a reasonable and effective incentive mechanism to improve nurses' work motivation and other intervention measures to reduce work pressure.

Prolonged usage of fosaprepitant for prevention of delayed chemotherapy-induced nausea and vomiting(CINV) in patients receiving highly emetogenic chemotherapy.

BACKGROUND: Even though chemotherapy-induced nausea and vomiting (CINV) can be well controlled in the acute phase, the incidence of delayed CINV remains high. In this study, we intend to investigate whether prolonged use of NK-1 receptor antagonist (RA) in addition to 5-HT3 RA and dexamethasone (DEX) was more effective in preventing delayed CINV. METHODS: This randomised, open-label, controlled study was designed to compare the efficacy and safety of fosaprepitant 150 mg given on days 1,3 (prolonged group) versus on day 1 (regular group) in patients receiving highly emetogenic chemotherapy (HEC). All patients also treated with palonosetron on day 1 and DEX on days 1-3. The primary endpoint was the incidence of delayed nausea and vomiting. The second endpoint was AEs. All the above endpoints were defined according to CTCAE 5.0. RESULTS: Seventy-seven patients were randomly assigned to prolonged group and seventy-nine to regular group. Prolonged group demonstrated superiority in controlling delayed CINV to regular group, with statistically significant lower incidence of nausea (6.17% vs 12.66%, P = 0.0056), and slightly lower incidence of grade 1 vomiting (1.62% vs 3.80%, P = 0.0953) in the delayed phase. In addition, prolonged use of fosaprepitant was safe. No significant difference was found between the two groups regarding constipation, diarrhea, hiccough, fatigue, palpitation and headache in delayed phase. CONCLUSIONS: Prolonged use of fosaprepitant can effectively and safely prevent delayed CINV in patients receiving HEC.

Stress load and volunteer motivation of patient volunteers in Fangcang shelter hospitals in Shanghai, China during the COVID-19 pandemic: a cross-sectional survey.

OBJECTIVES: This study aims to assess the volunteer motivation and stress load of patient volunteers in the Fangcang shelter hospitals (FSHs), examine their associations, and explore the potential influence factors of volunteer motivation. DESIGN: Cross-sectional online survey conducted from 21 April to 20 May 2022. SETTING: Questionnaires were collected from patient volunteers selected by random cluster sampling in the FSHs in Shanghai, China. PARTICIPANTS: 197 participants who met the inclusion criteria as patients who were asymptomatic or presenting with mild symptoms in the FSHs and who volunteered to assist with routine work under quarantined settings. OUTCOME MEASURES: We investigated sociodemographic information, stress load and volunteer motivation through an online survey using the Volunteer Function Inventory and the Stress Overload Scale. Comparisons between groups were conducted by applying t-tests or analysis of variance. The correlation between volunteer motivation and stress was analysed by Pearson correlation. Influencing factors of volunteer motivation were determined by multivariable linear regression models. A value of p<0.05 was used to declare statistical significance. RESULTS: The mean score of volunteer motivation of patient volunteers was 73.24 (SD 12.00), while that of stress load was 46.08 (SD 21.28). The mean scores of the personal vulnerability (PV) and event load (EL), two dimensions of stress load, were 26.99 (SD 12.46) and 19.09 (SD 9.63), respectively. The majority of the participants (136, 69.04%) were grouped in the low (PV)-low (EL) stress category. Participants' volunteer motivation was negatively correlated with stress load (r=-0.238, p<0.001), as well as PV (r=-0.188, p<0.01) and EL (r=-0.283, p<0.001). Multivariable linear regression analysis identified that the potential influencing factors of volunteer motivation were occupation (B=1.100, 95% CI 0.037 to 2.164, p=0.043), health condition (B=-3.302, 95% CI -5.287 to -1.317, p<0.001) and EL (B=-0.434, 95% CI -0.756 to -0.111, p=0.009). Participants who worked in the public sector, had better health conditions and had lower EL were more likely to have higher volunteer motivation. CONCLUSIONS: Our study suggested that reducing stress load might be a possible pathway to encourage and maintain volunteerism in the FSH context. Implications and suggestions for future research on patient volunteer recruitment and management could be drawn from our findings.

Retrospective study of EGFR-mutant lung adenocarcinoma with bone metastatic clinical features.

BACKGROUND: With more and more target medicine application in lung cancer, lots of patients take medicine at home, the treatment bone metastasis and screen of bone metastasis always has been neglected until skeletal-related events (SREs) such as bone pain, hypercalcemia of malignancy and pathologic fractures emerging which significantly impairs the patients' daily activity ability, seriously lower quality of life. AIM: To identify the clinical characteristics of patients which influence the overall survival (OS) of EGFR-TKIs effective in EGFR-mutant NSCLC with bone metastasis (BM) and the bone metastatic image features. METHODS: We conducted a retrospective study in patients (treated with EGFR-TKIs ≥6 months) of lung adenocarcinoma with BM in our hospital from October 2014 to October 2017. The Kaplan-Meier survival curves were calculated using the log-rank univariate test. Multivariate regression analysis was conducted using Cox's regression model. Comparison between the different subgroups of bone metastasis was conducted using Pearson Chi-Square test. RESULTS: A total of 79 patients were diagnosed as EGFR-mutant lung adenocarcinoma with bone metastases. At univariate analysis, age < 65 years (p = .024), heavy smoking (p = .005), Osteolytic BM (p = .034), number of bone metastasis ≥3 (p = .032), EGFR-L858R mutated (p = .018) and bisphosphonate times <6 (p = .046), were significantly associated with worse overall survival (OS). At multivariate analysis, EGFR 19del was an independent predictor of better OS (p = .035). Osteolytic BM was more likely to occur in EGFR-mutant patients (osteolytic vs. sclerotic vs. mixed: 45.57% vs. 34.18% vs. 20.25%). Patients who had received bisphosphonate ≥6 times were less suffer from SRE compared to those treated with bisphosphonate <6 times (p = .019). CONCLUSION: In conclusions, this retrospective study suggests that for the patients, treated with EGFR-TKIs ≥6 months, EGFR exon 19 del, osteogenic bone metastasis, bisphosphonate application times ≥6, smoking <400/day and the number of BM <3 were predictors of better OS (p < .05). Bisphosphonate times ≥9 should be considered to the patients with BM. SPECT-CT would be an effective correction of SPECT in the patient's bone metastasis examination. During the whole follow-up process, we found by chance that the change of bone mineral density in the follow-up process suggested that bisphosphonates need to be used for more than 1 year or more, and we can use local CT in the follow-up clinical practice to confirm the bone density changes to decide when we could stop or reduce bisphosphonate application.

Self-efficacy and attitudes of nurses providing oral care in geriatric care facilities: A cross-sectional study in Shanghai.

AIMS: To investigate nurses' self-efficacy and attitudes of providing oral care in geriatric care facilities (GCFs) and compare differences between individuals, facilities and countries. DESIGN: A cross-sectional and multicentre study. METHODS: Data were collected from 852 nurses in 42 GCFs using two scales, "Self-Efficacy for Providing Mouth Care" (SE-PMC) and "Attitudes for Providing Mouth Care" (A-PMC), and analysed using t-test and ANOVA. RESULTS: Totally 852 nurses (844 females, 99%) participated in this study with an effective response rate of 85.2%. Scores of SE-PMC and A-PMC of nurses varied significantly among GCFs with different sizes, types and years of establishment and differentiated among staff about the length of employment (p < .05). Nurses (N = 434) in North Carolina scored higher than nurses in Shanghai both in SE-PMC and A-PMC (p < .05). Establishment and implementation of Oral health promotion programmes were desired based on characteristics of different institutions and nurses' clinical ladder.

A cross-sectional survey on nurses in burn departments: Core competencies and influencing factors.

BACKGROUND: Nurses of burn departments play a vital role in caring for and rehabilitating burn patients. However, the situation of nurses in burn departments is seldomly reported. The current study aims to identify the status and influencing factors of nurses in burn departments' core competencies nationwide. METHODS: This is a cross-sectional and multicenter study. Purposive sampling was used to recruit registered nurses who worked in burn departments of 12 tertiary hospitals in Mainland China. We issued an online survey including structured questionnaires consisting of socio-demographic information and the Self-rating Scale for Core Competencies. RESULTS: Totally 267 nurses in burn departments participated in our study. The mean score of nurses in burn departments' core competencies was (3.81 ± 0.53), with a scoring rate of 76.22%. Professional title, length of employment and experiences in burn intensive care units (BICUs) were influencing factors of NBDs' core competencies (P < 0.05), explaining 21.0% of the total variance. CONCLUSIONS: Our findings indicate that the core competencies of nurses in burn departments were at a moderate level generally. Moreover, this study highlights that nursing administrators and educators should promote the specialized knowledge and skills, teaching skills and critical thinking of nurses in burn departments.

TP53 Mutation Mapping in Advanced Non-Small Cell Lung Cancer: A Real-World Retrospective Cohort Study.

BACKGROUND: TP53 is frequently mutated in solid tumors, but its basic mutation mapping is mixed, particularly in aggressive-stage lung cancer. EXPERIMENTAL DESIGN: We curated a total of 139 advanced non-small cell lung cancer (NSCLC) patients who harbored wild-type TP53 (TP53wt) or mutated TP53 (TP53mut) based on next-generation sequencing (NGS) to analyze multiple-dimensional data types, including tumor mutation burden (TMB), programmed death receptor ligand 1 (PD-L1) expression, co-mutant alterations, hotspot mutations distribution, and therapy response. RESULTS: TP53 was evident in 125 mutations and significantly associated with male sex, adenocarcinoma differentiation, smoking history, PD-L1 tumor proportion score, and TMB level. The most frequent mutations were distributed on exon 8, but there were no distinct hotspot mutations. After outlining the co-mutation genes, it is interesting to note that DNA damage repair (DDR) genes were frequent alterations in the mutated TP53 cohort. Even though there was no significant difference between the TP53wt and TP53mut cohorts on therapy response, patients with nucleotide variation in G>T achieved a relatively higher durable clinical benefit (DCB) rate. CONCLUSIONS: This real-world retrospective study suggests that molecular stratification on the basis of TP53 mutations should be deeply explored for NSCLC to optimize and modify clinical therapy choices.

Translation, cross-cultural adaptation, and validation of the Chinese version of self-efficacy and attitudes for providing Mouth Care scale.

BACKGROUND: In recent years, oral care for older people has received extensive attention in long-term care facilities. The Self-Efficacy for Providing Mouth Care (SE-PMC) and Attitudes for Providing Mouth Care (A-PMC) scale evaluated the self-efficacy and attitude of nursing staff while providing oral care. However, whether this scale is valid and reliable for Chinese nursing staff in China remains unverified. This study aims to translate the English version of SE-PMC and A-PMC into Chinese and determine their reliability and validity. METHODS: After obtaining the author's consent, the procedure for a double-back translation and cross-cultural adaptation was conducted to develop the Chinese version of SE-PMC and A-PMC. The validity and reliability of the Chinese version of SE-PMC and A-PMC were evaluated in a cross-sectional observational study with 852 nurses from 42 Geriatric Care Facilities (GCFs). Exploratory factor analysis (EFA) (n = 427) and confirmatory factor analysis (CFA) (n = 425) were conducted to test the construct validity and quality of the factor structures. We applied the item discrimination test and homogeneity test for item analysis. Cronbach's alpha coefficient and split-half coefficient were adopted to evaluate internal consistency. RESULTS: The Chinese version of SE-PMC (11 items, 3 factors) and A-PMC (11 items, 2 factors) included 22 items, reflecting adequate construct validity and reliability. In addition, test-retest reliability was 0.809 for SE-PMC and 0.811 for A-PMC, evincing good stability. The Cronbach's α coefficient of SE-PMC was 0.831, with each factor ranging from 0.793~0.906. The Cronbach's α coefficient of the A-PMC was 0.768, with each factor ranging from 0.814~0.824. Item-Content Validity Index (I-CVI) of SE-PMC and A-PMC ranged from 0.84 ~1.00 and 0.82~1.00, respectively. CONCLUSION: The Chinese version of SE-PMC and A-PMC was validated as a reliable assessment tool to evaluate the self-efficacy and attitude of nursing staff in GCFs for providing oral care in China.

Stress load of Chinese nurses in Fangcang Shelter Hospitals during the COVID-19 pandemic: A latent profile analysis.

The Omicron wave of the COVID-19 pandemic significantly affected Shanghai, China, from March to June 2022. Numbers of Fangcang Shelter Hospitals (FSHs) were conversed from stadiums and exhibition centers to tackle the pandemic. This study aimed to identify the stress load profiles of nurses working in FSHs and explore the characteristics and factors influencing stress load profiles. Totally, 609 out of 700 FSH nurses (with an effective response rate of 87%) participated in an online survey investigating their socio-demographic information, work-related stressors, and stress load. Results of the latent profile analysis identified four classes of stress load, which were labeled as the low (Class 1), mild (Class 2), moderate (Class 3), and high (Class 4) stress load class. Maternity status and self-perceived health condition were significantly different between the four stress load classes by comparisons using the Chi-square test and the Kruskal-Wallis test. The contributors to the stress load profiles were determined by the multinomial logistic regression analysis, including age, education, maternity status, self-perceived health condition, working time in FSHs, and the four dimensions of work-related stressors. Participants who were less healthy (OR = 0.045, 95% CI:0.012,0.171), worked longer time in FSHs (OR = 40.483, 95% CI: 12.103,135.410), faced with more workload (OR = 3.664, 95% CI: 1.047,12.815), and worse working environment (OR = 12.274, 95% CI: 3.029,49.729) were more likely to be classified to the high stress load class. The task arrangement and working environment for FSH nurses should be optimized, and psychological training should be conducted routinely.

Symptom clusters in patients with colorectal cancer after colostomy: a longitudinal study in Shanghai.

OBJECTIVE: Research is lacking regarding the experiences of patients after colostomy, which is needed so as to take necessary specific actions. In this study, we aimed to describe the trajectory of symptom clusters experienced by patients after colostomy over time. METHODS: This was a longitudinal observational study using data from 149 patients with colorectal cancer after colostomy. We investigated symptoms and symptom clusters at 2 weeks, 1 month, 3 months, 6 months, and 1 year after colostomy. RESULTS: Four main symptom clusters were identified, including a psychological symptom cluster, digestive and urinary symptom cluster, lack of energy symptom cluster, and pain symptom cluster in patients after colostomy in the first year after surgery. We further explored the symptom trajectory. CONCLUSIONS: We explored symptom clusters and the trajectory of symptom resolution in patients after colostomy during the first year after surgery. Four stages were proposed to describe the different statuses of symptom clusters experienced by patients. Our findings may provide insight into how to improve symptom management and postoperative quality of life for patients after colostomy.

Effects of comprehensive care on complications, oxygenation indexes and guardian's psychological mood of children with neonatal respiratory distress syndrome.

OBJECTIVE: To observe the effects of comprehensive care on complications, oxygenation indexes of children with neonatal respiratory distress syndrome (NRDS), as well as their guardian's psychological mood. METHODS: Totally 205 cases of children with NRDS admitted to our hospital from February 2018 to December 2019 were recruited and divided into two groups according to different nursing interventions. Cases receiving comprehensive care were included in the research group (RG, n=108), and cases receiving routine care were included in the control group (CG, n=97). The curative effect, improvement of clinical symptoms, complications during nursing process, improvement of oxygenation indexes, degree of lung injury, improvement of physiological health were observed and compared, as well as the improvement of parents' psychological mood and their satisfaction with this nursing intervention. RESULTS: After care, RG had significantly better improvement of clinical indexes than that in CG, with notably lower PaCO2 and higher PaO2 and SaO2. Besides, children in RG showed remarkably lower Murray score and APACHE-II score, and the patients of children in RG also had lower SAS and SDS scores. The overall response rate (ORR) of children in RG was evidently higher than that in CG, the incidence of total complications in RG was evidently lower than that in CG, and the nursing satisfaction of parents in RG was evidently higher than that in CG. CONCLUSION: Comprehensive care is effective for children with NRDS, which can improve oxygenation indexes and lung injury, reduce the incidence of complications, and improve the psychological mood of parents.

MiR-17-5p downregulation alleviates apoptosis and fibrosis in high glucose-induced human mesangial cells through inactivation of Wnt/ß-catenin signaling by targeting KIF23.

Diabetic nephropathy (DN) remains the major cause of end-stage renal disease. MicroRNAs (miRNAs) have been reported to perform biological functions in many diseases. This investigation elucidated the biological role of miR-17-5p in DN. In this study, high glucose-cultured human mesangial cells (HMCs) were used as a cell model of DN. The miR-17-5p and KIF23 expression was measured by RT-qPCR. Cell apoptosis was detected by flow cytometry. The protein levels of apoptosis markers, fibrosis markers, and Wnt/ß-catenin signaling-related genes were assessed using western blotting. The interaction of miR-17-5p with KIF23 was tested by a luciferase reporter assay. We found that miR-17-5p was upregulated in both DN patients and high glucose-treated HMCs. Silencing miR-17-5p attenuated the apoptosis and fibrosis in high glucose-treated HMCs. MiR-17-5p binds to KIF23 3'UTR and negatively regulates KIF23 expression. KIF23 knockdown could suppress the role of miR-17-5p inhibition in high glucose-treated HMCs. Additionally, inhibition of miR-17-5p activated Wnt/ß-catenin signaling in HMCs through upregulating KIF23 expression. Suppression of Wnt/ß-catenin signaling antagonized the effect of miR-17-5p in HMCs. In conclusion, miR-17-5p inhibition alleviates the apoptosis and fibrosis in high glucose-treated HMCs by targeting KIF23 activating Wnt/ß-catenin signaling.

Oral health matters in cognitive impaired aged residents in geriatric care facilities: A cross-sectional survey.

AIMS: To investigate the oral health status of aged residents and explore the possible factors associated with oral health and the effect of cognitive impairment (CI) on it in geriatric care facilities (GCF) using oral health assessment tool (OHAT) in Shanghai, China. BACKGROUND: Oral health is closely associated with overall health. Problems like missing teeth, dental caries, dental pain, periodontal diseases, oral infections and dysphagia are common in GCFs. Furthermore, residents in GCFs with CI are becoming a dominant group and this prevalence increases with age. Detection of oral problems earlier and taking oral care actions is required for these special populations. METHODS: The study was an observational cross-sectional study conducted in 42 GCFs. Data were collected from 657 subjects, including oral health assessment (OHAT), cognitive impairment (Mini-Mental State Examination, MMSE) and respondents' characteristics. The subjects were divided into CI group and non-CI group based on MMSE. Oral health conditions were compared between the two groups. RESULTS: Oral health status in the CI group was significantly worse than that in the non-CI group (p < .001) with four OHAT dimensions (tongue (p = .0007), saliva (p = .0011), natural teeth (p = .0155) and oral cleanliness (p < .001)). The worst dimension was natural teeth. Debris and plaque index (p < .001), oral odour (p < .001), chewing function (p = .0151) and swallowing function (p = .0405) were worse in CI group than those in non-CI group. In the CI group, providing oral care was a protective factor in oral health (OR = 0.600 95CI% (0.39-0.92)) and wearing dentures was a risk factor (OR = 2.09, 95CI% (1.31-3.32)), while the similar effects were not found in non-CI group. CONCLUSIONS: Oral health status among aged residents in GCFs in China was worse among individuals with CI. Caregivers in GCFs should focus more on seniors' oral health with CI. RELEVANCE TO CLINICAL PRACTICE: Residents who are suffering from CI are more vulnerable to have oral problems. Regular and proper oral health check-ups in daily nursing work to define oral problems of residents are significant. Nursing staff should pay more attention to oral assessment and effective intervention.

Dual variable of drug loaded micelles in both particle and electrical charge on gastric cancer treatment.

Gastric cancer is a malignant tumour characterised by the uncontrolled cell growth. The incidence and mortality of gastric cancer remain high for the invasion and metastasis. We are urgently seeking a risk-free and effective treatment strategy for gastric cancer. In this study, paclitaxel and tetrandrine were encapsulated in the inner core of micelles, and DSPE-PEG2000-CPP and HA were modified on the micellar surface. HA/CPP modified paclitaxel plus tetrandrine micelles had a suitable particle size (90 nm) for permeating tumour tissue. The zeta potential of the targeting micelles was 8.37 mV after hydrolysis by HAase solution. Results of in vitro experiments indicated that HA/CPP modified paclitaxel plus tetrandrine micelles + HAase could enhance the intracellular uptake, inhibit the formation of neovascularization, block the process of EMT and destroy the invasion and metastasis. In vivo assays indicated that HA/CPP modified paclitaxel plus tetrandrine micelles could be selectively accumulated into tumour sites and exhibited the strong antitumor activity with negligible toxicity. These results suggested that HA/CPP modified paclitaxel plus tetrandrine micelles might provide a new strategy for treating gastric cancer.

Totally implantable venous access devices: The supraclavicular percutaneous approach and early complications.

BACKGROUND: The background of this study was to explore the success rate and early complications concerning the implantation of totally implantable venous access devices (TIVADs) by percutaneous venipuncture and management strategies for early complications. MATERIALS AND METHODS: This was a retrospective study of 1923 patients who received TIVAD implantation by percutaneous venipuncture (mostly via the supraclavicular route). The percutaneous access sites were internal jugular vein (810 patients; right/left: 158/652) or proximal right internal jugular vein, brachiocephalic vein, and proximal subclavian vein (1113 patients). Success rates and early complications related to TIVAD placement techniques were summarized, and strategies for managing complications were also analyzed. RESULTS: In 627 patients, TIVAD implantation was first performed by interventional radiologists using a "blind" approach relying on anatomical landmarks, having a 91.9% success rate. In contrast, there was a 100% success rate among the remaining 1296 patients who received ultrasound-guided implantation, a difference which was statistically significant (P < 0.05). Ultrasound-guided implantation was also successful for the 51 patients for whom the first attempt failed using the blind technique. Further, we found that the incidence of early complications was 5.41% (104/1923) and that the occurrence of immediate complications was significantly higher in the blind technique group compared to the ultrasound-guided group (37 vs. 12; P < 0.05). CONCLUSIONS: It is safe and feasible to implant TIVADs by supraclavicular venipuncture. Ultrasound guidance combined with X-ray monitoring during operation significantly improves the surgery success rate and reduces the risk of early complications. Unclear anatomical landmarks and vascular variation are the main factors affecting success using a blind (nonguided) technique.

[Molecular Mechanism and Progression of Primary Resistance to EGFR-TKI
- Analysis of 2 Cases].

Tyrosine kinase inhibitor (TKI) have been proved to be effective in the treatment of advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) sensitive mutation, which is superior to chemotherapy. However, there are still some patients with sensitive mutations have primary drug resistance. It may be related to the coexistence of susceptible and resistant mutations of EGFR gene, downstream mutations of EGFR pathway, MET amplification and BIM deletion polymorphism. We present 2 cases of primary drug resistance and analyze the reasons.
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Retrospective study of the efficacy and toxicity of lobaplatin-etoposide chemotherapy in small cell lung cancer.

BACKGROUND: A retrospective study was conducted to assess the efficacy and toxicity of lobaplatin-etoposide (EL) chemotherapy for small cell lung cancer (SCLC). METHODS: The clinical data of 50 patients treated in our department from May 2014 to March 2018 were obtained. Untreated patients with SCLC administered LBP intravenously (IV) at 30 mg/m2 on day 1 and etoposide IV at 100 mg/m2 on days 1, 2, and 3 were enrolled. The treatment was cycled every 21 days. RESULTS: The median overall and progression-free survival rates of the 50 patients were 11.67 (range: 7.30-16.04) and 6.8 (range: 5.25-8.35) months, respectively, with an overall response rate of 66% and a disease control rate of 90%. The most frequent drug-related adverse effects were leukopenia and neutropenia, and no grade 3/4 hepatotoxicity or nephrotoxicity was observed. CONCLUSION: These results indicate that LBP-containing chemotherapy is effective and tolerable for SCLC in terms of response and survival.

Shenqi Fuzheng Injection Reverses Cisplatin Resistance through Mitofusin-2-Mediated Cell Cycle Arrest and Apoptosis in A549/DDP Cells.

The goal of this evaluation was to examine the mechanisms of Shenqi Fuzheng injection (SFI), an extract made from the plants Radix Astragali and Radix Codonopsis, in the process of chemotherapy sensitivity in non-small-cell lung cancer (NSCLC) cells. We investigated the expression of mitofusin-2 (Mfn2), a mitochondrial GTPase that may be related to chemoresistance, and found that Mfn2 expression was lower in human cisplatin-resistant lung carcinoma A549/DDP cells than in cisplatin-susceptible A549 cells. Chemosensitivity to cisplatin was restored in A549/DDP cells following supplementation in conjunction with SFI treatment, the effect of which we evaluated via cell cycle, apoptosis, and cell signaling analysis. We found that the combined use of A549/DDP cells with SFI and cisplatin enhanced cell cycle arrested in the G2/M phase, which was accompanied by upregulation of p53 and p21 protein expression and induced mitochondrial apoptosis in conjunction with the upregulation of Bax and the downregulation of Bcl-2 protein expression. Moreover, cell cycle arrest and mitochondrial apoptosis coincided with the upregulation of Mfn2 expression, which, in turn, was related to the increased mitochondrial membrane permeabilization and elevated reactive oxygen species. In summary, our findings suggest that the effect of SFI in increasing chemotherapy sensitivity in cisplatin resistance of NSCLCs occurs through cell cycle arrest and the initiation of mitochondrial apoptosis involved in the upregulation of Mfn2 expression.

MicroRNA array analysis of the regulation of microRNAs in rats exhibiting hyperplasia of mammary glands.

Hyperplasia of mammary glands (HMG) is also termed mammary dysplasia. In China, the number of patients suffering from breast hyperplasia is increasing annually. MicroRNAs (miRNAs; length, 19-24 nucleotides), a group of small endogenous non-coding RNAs, post-transcriptionally regulate gene expression via RNA interference and gene silencing pathways. The cause of disease of HMG because remains unclear. Thus, the aim of the present study was to establish comprehensive profile of drug treatments following at different time intervals on rat models of differentially expressed miRNAs, using miRNA microarray data. After scanning the chip, 13 up-regulated and 20 down-regulated miRNAs were identified. MiR-31 and miR-30 exhibited different expression levels between rats exhibiting mammary gland hyperplasia treated with or without Jiedu Capsule water solution once a day for 4 weeks, and the two demonstrated a strong association with HMG and breast cancer. Therefore, the functions of these miRNAs may provide the basis for further investigation of HMG.