Qualitative Study on the Psychological Experience of Cancer Patients after Withdrawing from Drug Clinical Trials / 中国医学伦理学

【Objective:】 To understand the real psychological feelings of cancer patients after withdrawing from drug clinical trials, and provide reference for clinical healthcare professionals to serve personalized care for patients in the transitional period after withdrawing from drug clinical trials. 【Methods:】 With the descriptive phenomenology method, 11 subjects who withdrew from drug clinical trials in the oncology department of a tertiary hospital in Shandong Province were selected by intentional sampling method to conduct semi-structured in-depth interviews. Colaizzi seven-step analysis method was used to analyze and sort out records, and refine themes. 【Results:】 The psychological experiences of cancer patients after withdrawing from drug clinical trials were summarized into four themes: benefits of participating in clinical trials, losses of withdrawing from clinical trials, attitudes towards future treatment, and expectations of receiving help. 【Conclusion:】 Cancer patients face great psychological pressure after withdrawing from drug clinical trials and require deep emotional support and humanistic care. Nursing staff should take personalized care measures to meet the special problems of patients’ psychological needs, so as to help patients smoothly pass through the withdrawal stage and enter subsequent treatment.

Willingness and influencing factors of antiviral treatment of HIV/AIDS patients in a prison / 公共卫生与预防医学

Objective To explore the ART willingness and influencing factors of male HIV/AIDS patients in a special prison area in Shanghai. Methods The information was collected from face-to-face questionnaire survey of HIV/AIDS patients conducted from July 1, 2019, to December 31, 2019. Data was analyzed by univariate and multivariate analysis. The influence of social demographic characteristics, basic situation of detention, AIDS epidemiology, knowledge of AIDS ART, and family awareness on the willingness of anti-virus treatment was investigated. Results A total of 121 HIV / AIDS patients were investigated in this study. The results of multivariate analysis showed that HIV / AIDS patients who were less likely to receive ART included patients with multiple custody, patients with ART knowledge score less than 8, patients whose family members were unaware of their HIV infection, patients thought that they met the treatment standard but had no symptoms and did not need to take medicine, and patients thought that they could discontinue taking medicine at will. Conclusion A variety of factors have an impact on ART willingness of HIV/AIDS patients in custody. It is suggested that HIV / AIDS patients should be provided with more targeted ART knowledge training and social care and family support as far as possible.

The strategies of nurse participating in informing the truth disclosure to cancer patients / 中华行为医学与脑科学杂志

Truth disclosure of cancer patients is becoming more and more recognized in the world.Truth disclosure is usually regarded as the doctor's responsibility.However,the nurse has become an active participant in the truth disclosure of cancer patients both intentionally and inadvertently.This article systematically reviewed the role of nurses at home and abroad in informing patients with cancer the truth so as to provide guidance for the clinical practice.In April 2017,we retrieved articles in Pubmed,Chinese CNKI,Wanfang database,VIP database,and retrieval time is not restricted.A total of 92 literatures were retrieved and 8 articles were retrieved by manual searching.Finally,23 articles were included.Through systematic review of the literature,nurses are found to play an important role in informing cancer patients the truth.Compared with physicians,nurses have a more positive attitude for truth disclosure.Nurses have the most contact with patients and family members,if the nurses have plans to communicate with the families on telling the truth to cancer patients,there will be a positive impact on the truth disclosure attitude of family members.It is necessary to explore the strategy of truth disclosure for cancer patients with integrated medical staff in the future.

The strategies of nurse participating in informing the truth disclosure to cancer patients / 中华行为医学与脑科学杂志

Truth disclosure of cancer patients is becoming more and more recognized in the world.Truth disclosure is usually regarded as the doctor's responsibility.However,the nurse has become an active participant in the truth disclosure of cancer patients both intentionally and inadvertently.This article systematically reviewed the role of nurses at home and abroad in informing patients with cancer the truth so as to provide guidance for the clinical practice.In April 2017,we retrieved articles in Pubmed,Chinese CNKI,Wanfang database,VIP database,and retrieval time is not restricted.A total of 92 literatures were retrieved and 8 articles were retrieved by manual searching.Finally,23 articles were included.Through systematic review of the literature,nurses are found to play an important role in informing cancer patients the truth.Compared with physicians,nurses have a more positive attitude for truth disclosure.Nurses have the most contact with patients and family members,if the nurses have plans to communicate with the families on telling the truth to cancer patients,there will be a positive impact on the truth disclosure attitude of family members.It is necessary to explore the strategy of truth disclosure for cancer patients with integrated medical staff in the future.

Fabricating periodontal tissue engineering compound by gene modified gingival fibroblasts and acellular dermal matrix / 中国组织工程研究

BACKGROUND:Previous studies have found that human platelet-derived growth factor-B (PDGF-B)-transfected gingival fibroblasts are capable of rapid proliferationin vitro, which can secrete platelet-derived growth factor BB proteins. OBJECTIVE:To explore the ability of PDGF-B-modified gingival fibroblasts in the acelular dermal matrixin vivo to form periodontal tissue engineering compound. METHODS: Gingival fibroblasts from Beagle dogs transfected with or without PDGF-B gene were implanted into the acelular dermal matrix. Cel growth on the acelular dermal matrix was observed. PDGF-B gene-transfected gingival fibroblasts/acelular dermal matrix composite (experimental group), gingival fibrobalsts/acelular dermal matrix composite (control group) and acelular dermal matrix (blank group) were implanted subcutaneously into the nude mice, respectively. At 2, 4, 8 weeks after implantation, skin tissues were taken and observed histologicaly. RESULTS AND CONCLUSION: PDGF-B gene-modified gingival fibroblasts and non-transfected gingival fibroblasts both grew and proliferated wel in the acelular dermal matrix. At 8 weeks after implantation, in the blank group, the surrounding cels largely entered into the acelular dermal matrix, but produce less new colagen fibers, and the cels only grew on the original colagen scaffold; in the control group, a great amount of colagen fibers formed, the original colagen fibers in the acelular dermal matrix were replaced by newly formed colagens, but the original colagen structure was reserved; in the experimental group, a large scale of permineralization formed, and mineralized nodes were arranged along the original colagen scaffold. These findings indicate that PDGF-B gene modified gingival fibroblasts can acquire osteoplastic abilities in the acelular dermal matrix in vivo.

The establishment of a radiation-resistant small cell lung cancer subline / 中国比较医学杂志

Objective To establish a radiation-resistant cell subline from a human small cell lung cancer ( SCLC) cell line NCI-H446, providing a pairing research tool for investigating mechanism of radiation tolerance and the reverse strategy in lung cancer .Methods The NCI-H446 cell was radiated repeatedly by increased dose of radiation gradually (total 7500cGy) and a radiation-resistant cell substrain was induced and selected from the survival of cells .The doubling time and cell cycle distribution of the substrain were detected by ATP kit and flow cytometry Assay respectively ;Radiation biology parameters were calculated and analyzed by cell survival curve fitting from multi -target model, SF=1-(1-e-D/D0) N.Results Comparing with the control , The resistant substrain radiobiology parameter values were D 0 ( 1.9673, 2.2756), N(1.0016,2.6008), Dq (0.6783,1.6860)and SF2(0.3623,0.7134) respectively.Cell morphology is more slender and has more tentacles .The SF2 value of radiation-resistant subline is 1.97 times more than that of wild cell line . The proportion of radiation-resistant cells in G2/M-phase was down to 7.84%, compared with the 18.52%of wild cells. Conclusions A radiation-resistant SCLC subline NCI-H446-R is established and may be a useful tool for studying resistant to radiation of SCLC in the future .

Comparison of the Effects of Acarbose and TZQ-F, a New Kind of Traditional Chinese Medicine to Treat Diabetes, Chinese Healthy Volunteers.

Ethnopharmacological Relevance. TZQ-F has been traditionally used in Traditional Chinese Medicine as a formula for the treatment of diabetes. Aim of the Study. This study aims to compare the pharmacologic effects and gastrointestinal adverse events between TZQ-F and acarbose. Methods. The double-blind randomized placebo-controlled fivefold crossover study was performed in 20 healthy male volunteers. Plasma glucose, plasma IRI, and plasma C-peptide were measured to assess the pharmacologic effects. Flatus and bowel activity were measured to assess the adverse event of gastrointestinal effect. Results. 3 and 4 tablets of TZQ decreased the C max of plasma glucose compared with that of the previous day and with placebo. 3 tablets also decreased C max of plasma C-peptide compared with placebo. 4 tablets increased C max of plasma insulin after breakfast and the AUC of plasma C-peptide after breakfast and dinner. 2 tablets did not decrease plasma glucose and elevated the C max and AUC of C-peptide after breakfast and dinner, respectively. Acarbose 50 mg decreased the C max of plasma insulin and C-peptide after breakfast and the C max of plasma glucose and C-peptide after dinner. The subjects who received TZQ did not report any abdominal adverse events. Conclusions. 3 tablets of TZQ have the same effects as the acarbose.

Application of fluorescence probe marked by quantum dots to detect early submandibular lymph node metastasis in a nude mouse model / 华西口腔医学杂志

<p><b>OBJECTIVE</b>A fluorescence probe marked with a specific angle protein antibody by using quantum dots QDs605-CK (AE1/AE3) was utilized to detect metastasis and micrometastasis rates of early submandibular lymph node metastatic carcinoma in a nude mouse model. The method was compared with traditional immunohistochemistry (IHC) staining and hematine-eosin (HE) staining to explore a new method for early diagnosis and treatment of tongue squamous cell carcinoma.</p><p><b>METHODS</b>Human tongue Tca8113 cells were cultured and inoculated in 18 nude mice tongue body tissues (except the midline) to establish submandibular lymph node metastasis in tumor-bearing nude mice models. The nude mice were sacrificed, and the mandibular lymph node was dissected after injecting tumor cells for six weeks. One lymph node was divided into two parts: one was used to create a serial section embedded by paraffin then detected in HE staining and IHC staining; the other was immediately frozen in liquid nitrogen and detected using the fluorescence probe marked with a specific angle protein antibody by using quantum dots. Lymph node metastasis and micrometastases rates were calculated.</p><p><b>RESULTS</b>The rates of metastasis in the submandibular lymph node via quantum dot immunofluorescence staining, IHC staining, and HE staining showed positive values of 66.7%, 61.1%, and 27.8%, respectively. The micrometastases rates were 38.9% and 33.3% via quantum dot immunofluorescence staining and IHC staining, respectively. The positive rates of detecting lymph nodes metastasis with quantum dot labeled keratin CK (AEl/AE3) immunofluorescence and keratin CK (AE1/AE3) IHC staining were higher than that of conventional HE staining ('=6.379, P<0.05). The two methods showed no statistical difference (chi2 = 0.120, P > 0.05).</p><p><b>CONCLUSION</b>Quantum dots fluorescent probe marked with the angle protein antibody CK (AE1/ AE3) can precisely locate the submandibular lymph node metastasis tumor cell of the nude mice tongue squamous cell carcinoma, and the emitted red fluorescence showed strong specificity, high resolution, and a clear background. The method could be utilized to detect submandibular lymph node metastasis and micrometastasis of tongue squamous cell carcinoma in nude mice.</p>

Outcomes of peripheral blood stem cell transplantation in patients from human leukocyte antigen matched or mismatched unrelated donors / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Allogeneic peripheral blood stem cell transplantation from unrelated donors (UR-PBSCT) is an alternative treatment for many hematologic diseases due to lack of human leukocyte antigen (HLA)-identical sibling donors. This study aimed to evaluate the impact of the degree of the HLA match on the clinical efficacy of UR-PBSCT.</p><p><b>METHODS</b>Patients who underwent UR-PBSCT from September 2003 to September 2012 were retrospectively investigated. They were divided into three groups according to high-resolution molecular typing. SPSS version 17.0 was used to analysis and compare the statistics of engraftment, incidence of GVHD, other complications and survival among the groups.</p><p><b>RESULTS</b>One hundred and eleven patients received UR-PBSCT, 60 of them with an HLA matched donor (10/10), 36 of them with a one locus mismatched donor (9/10), and 15 of them with a two loci mismatched donor (8/10). Similar basic characteristics were found in the three groups. No differences were found in engraftment of myeloid cells or platelets in the three groups (P > 0.05). Two-year cumulative incidence of relapse, overall survival (OS) and disease-free survival (DFS) among those three groups were similar (P > 0.05). The cumulative incidence of 100-day III-IV aGVHD in the HLA matched group and the one HLA locus mismatched group were significantly lower than that in the two HLA loci mismatched group (3.3%, 8.6%, and 26.7%, P = 0.009). The occurrence rate of new pulmonary infections in the HLA matched group was lower than in the two HLA mismatched groups (26.67%, 52.78%, and 41.18%, P = 0.035). The cumulative incidence of 100-day and 2-year transplantation related mortality (TRM) in two HLA loci mismatched group was higher than in the HLA matched group and in the one HLA locus mismatched group, (8.4%, 11.8% and 33.3%, P = 0.016) and (12.3%, 18.7% and 47.5%, P = 0.002).</p><p><b>CONCLUSIONS</b>HLA mismatch will not significantly impact the engraftment or 2-year survival after UR-PBSCT, but two mismatched HLA loci may increase the cumulative incidence of severe aGVHD and TRM.</p>

An n-of-1 Trial Service in Clinical Practice: Testing the Effectiveness of Liuwei Dihuang Decoction for Kidney-Yin Deficiency Syndrome.

Objective. To describe the clinical use of n-of-1 RCTs for kidney-Yin deficiency syndrome that is a traditional Chinese medicine syndrome in publicly clinical practice in China. Methods. Our study included patients with kidney-Yin deficiency syndrome, using a within-patient, randomized, double-blind, crossover comparison of Liuwei Dihuang decoction versus placebo. Outcome Measures. Primary outcome measures included number of individual completion rates, response rate, and post-n-of-1 RCTs decisions. Secondary measures were the whole group score of individual Likert scale, SF-36 questionnaire. Results. Fifty patients were recruited and 3 were not completed. Forty-seven patients completed 3 pairs of periods, 3 (6.38%) were responders, 28 (59.57%) were nonresponders, and 16 (34.05%) were possible responders. Doctors and patients used the trial results to making decision. Three responders stayed on the medication management, 28 nonresponders ceased the LDD, 7 patients of the 16 possible responders could not give clear decision, and the others kept the same medication station. Among the whole group, neither the individual Likert score nor the SF-36 showed any statistical differences between LDD and placebo. Discussion. More attention should be paid to choose experienced TCM doctor as investigator and keep the simulant same with test medication in n-of-1 RCTs of TCM and sufficiently biological half-life period of Chinese medicine compound.

Predicting clinical chemo-sensitivity of primary ovarian cancer using adenosine triphosphate-tumor chemosensitivity assay combined with detection of drug resistance genes / 中华妇产科杂志

Objective To predict clinical chemotherapy sensitivity of primary ovarian cancer by jointing adenosine triphosphate(ATP) - tumor chemo-sensitivity assay(TCA) method in vitro and detection of drug resistance genes, provide reference for clinical treatment. Methods Forty-seven primary epithelial ovarian tumor samples were collected from the patients who received cytoreductive surgery. Viable ovarian cancer cells obtained from malignant tissue were tested for their sensitivity to carboplatin (CBP), cisplatin (DDP), paclitaxel(PTX) and CBP + PTX using ATP-TCA method in vitro; at same time, real-time quantitative PCR was used to analysis BRCA1 and ERCC1 mRNA relative expression in forty-six specimens (1 frozen tumor samples mRNA were not detected due to serious degradation). The relationship between ATP-TCA test results, clinical indicators, and the effectiveness of the joint prediction on clinical chemosensitivity by combining these two methods were statistically analyzed using chi-square test. Results (1)The results showns that three programs of DDP,CBP and PTX + CBP were significantly related with clinical results(P<0.05) in vitro, in which the compliance rate in PTX + CBP program was the highest 83%(39/47) ,and the predictive sensitivity, predictive specificity, positive predictive value, negative predictive value and predictive accurate rate were 90%,71%,84% and 80% ,respectively.PTX + CBP combined in vitro test results was also related with residual tumor size and neoadjuvant chemotherapy, which was more prone to drug resistance with residual tumor larger than 2 cm (P = 0. 023) and with neoadjuvant chemotherapy (P = 0.011). (2) BRCA1 mRNA expression levels in the clinical-resistant group and the clinical-sensitive group was 0.673 ± 2.143 and - 1.436 ± 2.594 (P=0.008), ERCC1 mRNA expression levels in the clinical-resistant group and the clinical-sensitive group was -0.529 ± 1.982 and - 3.188 ±2.601 (P =0.001). There were also significant correlation among the expression levels of BRCA1 ,ERCC1 mRNA and clinical efficacy (P<0.01). (3)ATP-TCA and detection of drug resistance genes combined to predict the clinical application of PTX + CBP resistance may occur in 8/9 cases. Conclusions ATP-TCA may be an ideal method of in vitro drug sensitivity testing method, which could effectively predict clinical chemotherapy sensitivity. Combination of the drug-resistant associated genes detection method and the ATP-TCA method can increase the predictive effectiveness of ovarian cancer chemosensitivity and guide individual chemotherapy of ovarian cancer.

Clinical analysis of acute cerebral vascular accident related factors of patients with nosocomial infection / 中国基层医药

Objective To explore acute cerebral vascular accident factors in patients with nosocomial infection. Methods Clinical data with 680 cases with acute cerebral vascular accident were retrospectively analyzed,and the patients with hospital flu infected as the observation group, selected in accordance with 1 ∶ 1 over the same period without cerebrovascular accident combined hospital patients feel as control group. The patient age,gender,state of consciousness , invasive operation, dehydrating agent application time, whether use of antibiotics and other differences were compared . Results In 680 cases of patients with acute cerebral vascular accident, there were 90 cases of hospital infection; two groups gender, dehydrating agent application time had no difference(P ＞ 0. 05 ); the observation group compared with the control group older, unconscious, to implement invasive operation to prevent high proportion of antibiotics(P ＜0. 05), hospital infection-related factors. Conclusion Acute cerebral vascular accident patients should have a higher incidence of nosocomial infection, and be related with many factors. Taking corresponding measures against the relevant factors could prevent hospital infection.

Progress of Clinical Study on Treatment of Hyperlipidemias with Acupuncture / 针灸推拿医学（英文版）

Objective: To summarize the clinical study on acupuncture treatment of hyperlipidemia for figuring out the existing issues and guiding the future study. Methods:Obtained by searching the scientific and technological journals database with computer, the relevant literature on acupuncture treatment of hyperlipidemia in the recent ten years is summarized and analyzed. Results and Conclusion: Forty-two pieces of the articles in conformity to the criteria of recruitment mainly refer to acupuncture, moxibustion, and simultaneous application of acupuncture and moxibustion, catgut-embedding method of the acupoints, external application of herbal products on the acupoints, and acupoint-injecting method, mostly by the acupoints of the Spleen and Stomach Meridians. But, the methods to select the acupoints by pattern identification, the application of the needling techniques and design of the test plans need to be further amended.

The Construction, Expression and Purification of Therapeutic Adjuvant-free Protein Vaccine——HPV16z-Hsp65-E6/E7 / 中国生物工程杂志

Objective: To develop a therapeutic adjuvantfree protein vaccine against HPV16 which is closely related to cervical cancer of China. Method: First the E6/E7 gene by PCR technology from HPV16z virus strain was isolated in the highrisk cervical cancer area of Shanxi province of China in1990s, and again got the gene segment of Hsp65 from BCG by the same method, mutated the transforming codes in sequences of HPV 16 E6/E7 genes and thus constructed the expression vector pET28aHsp65E6/E7, expressed the Hsp65E6/E7 fusion protein in E.coli BL21(DE3) strain and researched optimal protein purification procedures. Results: The expression vector pET28aHsp65E6/E7 was constructed successfully and E6/E7 gene was mutated correctly. Hsp65E6/E7 fusion protein was renatured and purified on the affinity chromatography column simultaneously. The protein purity achieved 95% after the anionic exchange chromatograph purification. conclusions: This research laid a foundation for further functional study of the therapeutic adjuvantfree protein vaccine——Hsp65E6/E7.

Evaluation of chemosensitivity of human colorectal cancer determined by APT-TCA assay in vitro / 中华检验医学杂志

Objective To investigate the heterogeneity of chemosensitivity in colorectal cancer using an ATP-tumor chemosensitivity assay (ATP-TCA) and the feasibility of individual chemotherapy.Methods An ATP-TCA were used to determine the effect of 16 single or combined cytotoxic drugs in surgical specimens from 50 patients with colorectal cancer.Results There were considerable differences in chemosensitivity between individuals.The most active single drugs in the assay was identified as Navelbine, Hydroxycamptothecin, 5-Fluorouracil and Paclitaxel; 34.1%, 31.6%, 27.6% and 24.3% of specimens showed sensitivity to them, respectively.5-Fluorouracil+Mitomycin+Aytarabine was found to be the most effective combination, for 100% (11/11)specimens were sensitive to this regimen.5-Fluorouracil+Cisplatin+Adriamycin and Gemcitabine+Cisplatin were moderately active regimens.Conclusions There was the heterogeneity of the in vitro chemosensitivity in colorectal cancer.The use of the ATP-TCA provides a method of selecting appropriate anti-cancer drugs in colorectal cancer.

Study and Explore on Improving Teaching Quality on Health Statistics in Information Age / 中华医学教育探索杂志

This article discusses how to improve teaching quality of health statistics from four main aspects: paying attention to training statistical thinking,paying attention to understanding basic concepts and methods,paying attention to modernistic teaching instrumentality,and paying attention to intercommunion between teachers and students.Practice indicates it facilitates impoving teaching quality.

Study of therapeutic adjuvant-free protein vaccine-HPV16Z-Hsp65-E6/E7 / 中国肿瘤生物治疗杂志

Objective: To study the biological effects of the HPV16Z-Hsp65-E6/E7 fusion protein vaccine on the tumor associated with HPV16 infection. Methods: We tested the cellular immune responsive intensity to the vaccine by the lymphocyte proliferation and CTL response, and studied the therapeutic effect of the vaccine on mouse TC-1 cell transplanted cancer in vivo and the influence on mouse lifetime. Results: The spleen lymphocytes from the C57BL/6 mouse immunized by the Hsp65-E6/E7 vaccine could proliferate obviously in the presence of the protein and TC-1 tumor cell could be lysed specifically by immune activated lymphocytes in vitro. This animal therapeutic experiment in vivo showed that the vaccine suppressed the growth of TC-1 cell transplanted tumor remarkably. Conclusion: The recombined vaccine can induce specific cellular immune response in vitro and suppress HPV16 positive TC-1 tumor cell growth obviously in vivo.