The role of glutamine metabolism in castration-resistant prostate cancer / 亚洲男科学杂志(英文版)

Reprogramming of metabolism is a hallmark of tumors, which has been explored for therapeutic purposes. Prostate cancer (PCa), particularly advanced and therapy-resistant PCa, displays unique metabolic properties. Targeting metabolic vulnerabilities in PCa may benefit patients who have exhausted currently available treatment options and improve clinical outcomes. Among the many nutrients, glutamine has been shown to play a central role in the metabolic reprogramming of advanced PCa. In addition to amino acid metabolism, glutamine is also widely involved in the synthesis of other macromolecules and biomasses. Targeting glutamine metabolic network by maximally inhibiting glutamine utilization in tumor cells may significantly add to treatment options for many patients. This review summarizes the metabolic landscape of PCa, with a particular focus on recent studies of how glutamine metabolism alterations affect therapeutic resistance and disease progression of PCa, and suggests novel therapeutic strategies.

Research advances in hemorrhage after endoscopic retrograde cholangiopancreatography / 临床肝胆病杂志

Although hemorrhage after endoscopic retrograde cholangiopancreatography （ERCP） is mostly mild and self－limited， sometimes blood transfusion and endoscopic hemostasis are still needed. However， rebleeding may occur after conventional endoscopic hemostasis and thus requires interventional vascular embolization or surgical intervention， which might significantly increase the risk of death associated with post－ERCP bleeding. This article discusses the risk factors for post－ERCP bleeding， including disease－specific factors， patient－related factors， and operation－related factors， and elaborates on different measures for the prevention and treatment of post－ERCP bleeding， so as to provide a reference for identifying the high－risk population for bleeding and developing precise surgical strategies in clinical practice.

Curative effects of levodopa and benserazide hydrochloride combined with pramipexole on Parkinson's disease in 30 patients / 中国基层医药

Objective:To investigate the efficacy of levodopa and benserazide hydrochloride combined with pramipexole in the treatment of Parkinson's disease in 30 patients and their effects on neurotransmitters and oxidative stress response.Methods:A total of 90 patients with Parkinson's disease admitted to Jinhua People's Hospital from January 2020 to February 2022 were included in this study. They were randomly assigned to undergo treatment with levodopa and benserazide hydrochloride (levodopa and benserazide hydrochloride group), pramipexole (pramipexole group), or their combination (combined therapy group), with 30 patients in each group. All patients were treated for 12 consecutive weeks. Clinical efficacy, levels of brain neurotransmitters (dopamine, 5-hydroxytryptamine, norepinephrine, and substance P), and oxidative stress response (superoxide dismutase, malondialdehyde, homocysteine levels) were compared among the three groups.Results:Total response rate in the combined therapy group was 96.67% (29/30), which was significantly higher than 66.67% (20/30) in the levodopa and benserazide hydrochloride group and 76.67% (23/30) in the pramipexole group ( χ2 = 8.65, P < 0.05). After treatment, dopamine, 5-hydroxytryptamine, norepinephrine, substance P, superoxide dismutase, malondialdehyde, and homocysteine levels in the combined therapy group were (9.05 ± 1.24) ng/mg, (89.49 ± 10.69) μg/L, (15.16 ± 1.36) ng/mg, (102.8 ± 15.36) μg/L, (88.40 ± 10.04) kU/L, (5.5 ± 2.31) μmol/L, and (9.20 ± 3.36) μmol/L, respectively, which were superior to (6.61 ± 1.02) ng/mg, (68.52 ± 9.52) μg/L, (12.33 ± 1.24) ng/mg, (151.64 ± 16.03) μg/L, (74.99 ± 7.28) kU/L, (9.27 ± 3.07) μmol/L, and (13.52 ± 3.64) μmol/L in the levodopa and benserazide hydrochloride group and (7.22 ± 1.09) ng/mg, (79.52 ± 10.20) μg/L, (13.92 ± 1.31) ng/mg, (131.30 ± 15.65) μg/L, (80.59 ± 8.24) kU/L, (7.53 ± 2.93) μmol/L, (11.35 ± 3.71) μmol/L in the pramipexole group ( F = 38.53, 32.05, 35.49, -73.42, 18.42, -22.65, -12.13, all P < 0.05). Conclusion:Levodopa and benserazide hydrochloride combined with pramipexole are highly effective on Parkinson's disease. The combined therapy can effectively improve brain neurotransmitters and regulate oxidative stress response.

A study on the correlation among clinical ability, professional commitment, and academic self-efficacy of nursing undergraduate interns / 中华医学教育探索杂志

Objective:To understand the current situation of clinical ability, professional commitment, and academic self-efficacy of undergraduate nursing interns, explore the correlation among them, and provide theoretical basis for improving the clinical competence of undergraduate nursing students.Methods:The method of convenient sampling was adopted to select 325 nursing undergraduates who had internships in a three-A hospital from July 2018 to July 2020 as the research objects. General data questionnaire, nursing mini-clinical exercise assessment scale, college student professional commitment survey scale and academic self-efficacy scale were used to investigate and evaluate the students at the end of their practice. SPSS 19.0 was used to conduct Pearson correlation analysis and multiple stepwise regression analysis.Results:The total scores of clinical ability, professional commitment and self-efficacy were (51.46±7.64) points, (88.11±5.02) points and (74.20±7.95) points respectively. The results of correlation analysis showed that the clinical ability of nursing undergraduates was significantly positively correlated with professional commitment and academic self-efficacy ( P<0.05). The multiple stepwise regression analysis further showed that the latter two factors had a positive predictive effect on clinical ability, and professional commitment was the strongest factor. Conclusion:Clinical practice teaching should pay attention to the cultivation of the professional commitment and academic self-efficacy of nursing undergraduates and thus promote the development of their clinical ability.

Relationship between homocysteine metabolizing enzyme gene polymorphism and prognosis of multiple myeloma in Han nationality / 中国医师进修杂志

Objective:To investigate the clinical relationship between homocysteine (Hcy) metabolizing enzyme gene polymorphism and poor prognosis of multiple myeloma (MM) in Han nationality.Methods:One hundred and twenty-eight MM patients of Han nationality admitted to the First Affiliated Hospital of Hebei North University from February 2018 to March 2020 were selected as the disease group, and 120 healthy volunteers of Han nationality were recruited as the control group at the same time. Blood samples were taken to detect plasma Hcy level and Hcy metabolizing enzyme gene polymorphism, including methylenetetrahydrofolate reductase(MTHFR) C677T, MTHFRA1298C, methionine synthase reductase(MTRR) A66G, cystathionine beta-synthase(CBS) 844ins68 and methionine synthase (MS) A2756G. The patients in the disease group were treated with conventional methods , followed up for 1 year after treatment, and the incidence of poor prognosis was counted. Plasma Hcy level, genotype distribution and allele frequency of Hcy metabolic enzymes were compared between the two groups. Logistic multiple regression analysis was used to analyze the association of Hcy metabolizing enzyme gene polymorphism with MM poor prognosis in Han nationality.Results:The plasma Hcy level in the disease group was higher than that in the control group: (15.01 ± 2.98) μmol/L vs. (8.45 ± 1.69) μmol/L, there was statistical difference ( P<0.05). The frequency of TT genotype and T allele of MTHFRC677T locus in the disease group were higher than those in the control group : 26.56% vs. 6.67% , 29.30 vs. 16.25%; while the frequency of CT genotype in the disease group was lower than that in the control group: 5.47% vs. 19.17% , there were statistical differences ( P<0.05). There were no significant differences in genotype distribution and allele frequency of other gene loci between the two groups ( P>0.05). The incidence of poor prognosis in the disease group was 49.22%(63/128). Age, platelet count, serum β 2 microglobulin level, serum κ light chain level, plasma Hcy level and TT genotype of MTHFRC677T locus were the influencing factors of poor prognosis in the disease group ( OR = 7.286, 0.545, 6.841, 6.284, 8.117 and 8.440; P<0.05). Conclusions:The plasma Hcy level, TT genotype and T allele frequency of MTHFRC677T locus in MM patients of Han nationality are higher than those in healthy people, while the CT genotype frequency is lower than that in healthy people. The poor prognosis of MM in Han nationality is related to plasma Hcy level and TT genotype of MTHFRC 677T locus.

Application of flipped classroom combined with case workshop in general surgical practice teaching of undergraduate nursing students / 中华医学教育探索杂志

Objective:To explore the application of flipped classroom combined with case workshop in general surgical practice teaching of undergraduate nursing students.Methods:The subjects of this study were nursing undergraduates practicing in general surgery department of a "three A" hospital. The experimental group included 44 interns from July 2019 to January 2020 who were taught by the flipped classroom combined with case workshop teaching mode. The control group included 45 interns from July 2018 to January 2019 who were given the traditional teaching mode. The two groups of students were evaluated for their clinical ability before and after the internship, and their out-department theoretical and operational performances were assessed and the survey of internship satisfaction was conducted. SPSS 19.0 was used for t test and chi-square test. Results:Before the internship, there was no statistical significance in the scores of clinical ability between the two groups ( P > 0.05). After the internship, the overall evaluation scores of clinical ability of the experimental group were (7.11±0.54) points, which were significantly higher than that of the control group (6.42±0.58) points ( t=-5.81, P < 0.001); the total satisfaction scores of the experimental group were (3.46±0.25) points, which were significantly higher than that of the control group (3.09±0.32) points ( t=-6.04, P < 0.001). The operation scores of the experimental group were (90.22±4.70) points, which were significantly higher than that of the control group (86.99±7.39) points ( t=-2.46, P=0.024). Conclusion:The teaching mode of flipped classroom combined with case workshop in nursing undergraduate general surgery practice can improve students' clinical ability and internship satisfaction, and improve the teaching effect of internship effectively.

Network Meta-analysis of the impact of different non-pharmacological interventions on blood glucose management in children and adolescents with type 1 diabetes / 中国实用护理杂志

Objective:To evaluate and rank the effects of different non-pharmaceutical interventions on the management of blood glucose in children and adolescents with type 1 diabetes by Bayesian network Meta-analysis.Methods:Computer search for PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China Biomedical Literature Database, China Knowledge Network, Wangfang Data and VIP Database, China and the United States Clinical Registration Center, the search time limit is from the establishment of each database to December 2020. Use WinBUGS, GeMTC, Stata software for blood glucose management data analysis.Results:Finally, 37 articles were included, with a total of 4 188 cases, involving 14 non-pharmaceutical intervention programs. The results of the network Meta-analysis showed that when different non-pharmacological interventions were used, the effectiveness of blood glucose management in children and adolescents with type 1 diabetes was ranked as follows: peer support education first, cognitive behavioral therapy second, advanced diabetes education third, family support intervention fourth, self guided intervention (GSD-Y) fifth, case training sixth, positive psychological intervention seventh, mobile phone based remote intervention eighth, diabetes education ninth, supportive consultation tenth, network based remote intervention eleventh position, multi-system therapy multi system therapy twelfth, conventional nursing thirteenth, motivational interview fourteenth.Conclusions:The available evidence shows that peer support education and cognitive behavioral therapy show certain advantages in blood glucose management in children and adolescents with type 1 diabetes, while motivational interviews perform the worst. Future research will further consider other potential benefits of non-pharmacological interventions, such as emotional health and diabetes self-management behavior.

Systematic review of efficacy and safety of fondaparinux in the treatment of non-ST-elevation acute coronary syndrome in China / 中国药房

OBJECTIVE To systematically evaluate the efficacy and safety of fondaparinux versus low molecular weight heparin（nadroparin，enoxaparin）in the treatment of non-ST-elevation acute coronary syndrome （NSTE-ACS）. METHODS The computer searched PubMed ，Medline，Embase，EBSCO，CNKI，Wanfang medical network ，VIP Chinese Journal Full-text Database and relevant clinical trial registration network for the clinical retrospective cohort study （RCS）of fondaparinux （as trial group）and low molecular weight heparin （natroparin，enoxaparin）（as control group ）in the treatment of NSTE-ACS. The retrieval time limit was from the establishment of the database to August 2021. Newcastle Ottawa scale （NOS）was used to evaluate the quality of literature. Outcome indicators included primary efficacy indicators （incidence of acute myocardial infarction and recurrent angina pectoris during hospitalization ），secondary efficacy indicators [revascularization of target vessels during 话：0835-2862024。E-mail：xiexingxing07@163.com hospitalization， prothrombin time （PT）， activated partial thromboplastin time （APTT）]，safety indicators （incidence of serious cardiovascular events ，severe bleeding ，slight bleeding and severe puncture site co mplications during hospitalization ），combined endpoint indicators （30 and 180 days combined endpoint）. RevMan 5.3 software was used for Meta-analysis of each effect index. RESULTS Finally，17 RCS articles were included，involving 4 946 patients with NSTE-ACS ，including 2 507 in the trial group and 2 439 in the control group.The results of NOS literature quality evaluation showed that there were 8 high-quality studies ，accounting for 47.06％ . The results of Meta-analysis showed that there was no significant difference in the incidence of acute myocardial infarction ，recurrent angina pectoris，revascularization of target vessels ，PT and serious cardiovascular events between 2 groups （P＞0.05）；there was significant difference in the APTT （MD＝1.34，95％CI of 0.22-2.45，P＜0.05），the incidence of severe bleeding （RR＝0.47， 95％CI of 0.30-0.74，P＜0.05），the incidence of slight bleeding （RR＝0.48，95％CI of 0.32-0.71，P＜0.05），the incidence of severe puncture site complications （RR＝0.48，95％CI of 0.25-0.95，P＜0.05），30 day combined endpoint （RR＝0.57，95％CI of 0.46-0.72，P＜0.05），180 days combined endpoint （RR＝0.73，95％CI of 0.54-0.98，P＜0.05）. CONCLUSIONS Fondaparinux in the treatment of NSTE-ACS in China has the same efficacy as low molecular weight heparin （nadroparin，enoxaparin），and has more obvious advantages in drug safety such as bleeding ，severe puncture site complications.

Correlation between Serum Homocysteine Level, MTHFR Gene Polymorphism and Patients with Hematological Diseases Complicated with Coronary Heart Disease / 中国实验血液学杂志

OBJECTIVE@#To observe the expression level of serum homocysteine (Hcy) and methylenetetrahydrofolate reductase (MTHFR) gene polymorphism in patients with hematological diseases complicated with coronary heart disease, and analyze the relationship between serum Hcy level, MTHFR gene polymorphism and coronary heart disease.@*METHODS@#The medical records of 80 patients with coronary heart disease who completed treatment of hematological diseases during the period from March 2018 to March 2020 were selected as observation group. In addition, the medical records of 92 patients with hematological diseases who completed treatment in our hospital during the same period were selected as control group. Venous blood samples of the two groups were collected to detect serum Hcy level and MTHFR gene polymorphism. The serum Hcy levels of the two groups with different MTHFR genotypes were compared, and the effects of the above indicators on hematological diseases complicated with coronary heart disease were analyzed.@*RESULTS@#The detection rates of MTHFR gene TT and TC in the observation group were higher than those in the control group, while the distribution frequency of MTHFR genotype CC was lower (P<0.05). The serum Hcy levels of the patients with MTHFR genotype TT and TC in the observation group was higher than the control group (P<0.05). Binary logistic regression analysis showed that MTHFR gene TC/CC genotype serum Hcy overexpression may be influencing factor which induced coronary heart disease in patients with hematological diseases (OR=2.107/OR=1.634, P<0.05). ROC curves showed that the AUC of serum Hcy level of MTHFR gene TC/CC genotype and hematological disease complicated with coronary heart disease were both > 0.8. When MTHFR gene TC reaching the optimal threshold of 22.165 μmol/L, the sensitivity was 0.950 and the specificity was 0.837, While MTHFR gene CC reached the optimal threshold of 19.630 μmol/L, the sensitivity was 0.938 and the specificity was 0.826, the best predictive value could be obtained.@*CONCLUSION@#The changes of serum Hcy and MTHFR gene polymorphisms may be involved in the pathological process in patients with hematological diseases complicated with coronary heart disease. In the future, early detection of serum Hcy levels and MTHFR gene polymorphisms in patients with hematological diseases can be used to predict the risk of coronary heart disease.

Intra-abdominal aortic balloon occlusion in the management of placenta percreta / 中华医学杂志(英文版)

BACKGROUND@#Massive bleeding is the main concern for the management of placenta percreta (PP). Intra-abdominal aortic balloon occlusion (IABO) is one method for pelvic devascularization, but the efficacy of IABO is uncertain. This study aims to investigate the outcomes of IABO in PP patients.@*METHODS@#We retrospectively reviewed the clinical data of PP cases from six tertiary centers in China between January 2011 and December 2015. PP cases with/without the use of IABO were analyzed. Propensity score matching analysis was performed to reduce the effect of selection bias. Postpartum hemorrhage (PPH) and the rate of hysterectomy, as well as neonatal outcomes, were analyzed.@*RESULTS@#One hundred and thirty-two matched pairs of patients were included in the final analysis. Compared with the control group, maternal outcomes, including PPH (68.9% vs. 87.9%, χ2 = 13.984, P < 0.001), hysterectomy (8.3% vs. 65.2%, χ2 = 91.672, P < 0.001), and repeated surgery (1.5% vs. 12.1%, χ2 = 11.686, P = 0.001) were significantly reduced in the IABO group. For neonatal outcomes, Apgar scores at 1 minute (8.67 ± 1.79 vs. 8.53 ± 1.68, t = -0.638, P = 0.947) and 5 minutes (9.43 ± 1.55 vs. 9.53 ± 1.26, t = 0.566, P = 0.293) were not significantly different between the two groups.@*CONCLUSIONS@#IABO can significantly reduce blood loss, hysterectomies, and repeated surgeries. This procedure has not shown harmful effects on neonatal outcomes.

Adolescent pregnancy outcomes in minority areas / 中华围产医学杂志

Objective:To analyze the pregnancy complications and outcomes in adolescent women in minority areas in China and the factors affecting the pregnancy outcomes.Methods:This retrospective study enrolled 697 singleton pregnant women who were younger than 20 years old and delivered at Sanjiang Dong Autonomous County People's Hospital of Liuzhou City from January 1, 2014, to December 31, 2018, as the case group. Meanwhile, 2 592 cases aged between 20 to 25 years and delivered during the same period were selected as the control group in an allocation ratio of 1∶4. Chi-square test, t test and binary logistic regression were used for comparing the differences of general characteristics, pregnancy complications, comorbidities and pregnancy outcomes between the two groups. Results:(1) The body mass index before delivery of the case group was lower than that of the control group [(24.7±3.4) vs (25.1±3.1) kg/m 2, t=－2.062, P=0.039]. The proportion of Dong minority was accounted for 48.06%(335/697) in the case group and 52.04%(1 349/2 592) in the control group. The proportion of women with junior school education or lower was higher in the case group than that in the control group [95.41% (665/697) vs 90.27% (2 340/2 592), χ2=45.086, P<0.001]. (2) The case group was noted for higher incidence of anemia [24.25% (169/697) vs 15.20% (394/2 592), χ2=31.683], premature delivery [7.17% (50/697) vs 4.55% (118/2 592), χ2=7.786], premature rupture of membranes [13.34% (93/697) vs 9.10% (237/2 592), χ2=10.731] and oligohydramnios [9.76% (68/697) vs 7.02% (182/2 592), χ2=5.848] than the control group (all P<0.05). (3) The incidence of cesarean section [27.26% (190/697) vs 38.04% (986/2 592), χ2=27.791, P<0.001] and the neonatal birth weight [(3 047.29±453.46) vs (3 131.01±472.44) g, t=－4.188, P<0.001] in the case group were lower, but the incidence of episiotomy [40.17% (280/697) vs 8.72% (226/2 592)] and the proportion of neonatal intensive care unit admission[10.76% (75/697) vs 3.82% (99/2 592)] were higher when comparing to the control group ( χ2=417.439 and 52.816, both P<0.001). (4) Multivariate binary logistic regression analysis showed that the risk of cesarean section ( aOR=0.62, 95% CI: 0.51-0.75) was reduced in adolescent women, but the risks of episiotomy ( aOR=6.20, 95% CI: 4.99-7.71) and neonatal intensive care unit admission ( aOR=2.68, 95% CI: 1.92-3.75) increased. Conclusions:Most of the pregnant adolescents are less-educated and ethnic minorities in this study, among which the Dong minority was predominant. Adolescent pregnancies are at a higher risk of anemia, preterm birth and premature rupture of membranes. Therefore, enhanced perinatal management of adolescent pregnancy is recommended to reduce adverse pregnancy outcome.

Application of SPOC teaching mode in nursing graduation internship of surgery department / 中华医学教育探索杂志

Objective:To explore the application effect of small private online course (SPOC) teaching mode in nursing graduation internship of surgery department.Methods:The Batch 101 undergraduate nursing students who participated in the graduation internship of surgery department were randomly divided into control group ( n = 36) and experimental group ( n = 36), and all nursing students signed the informed consent form. The control group adopted the traditional practice teaching mode, and the experimental group adopted the SPOC teaching mode containing four modules: teaching ward-rounds and specialized disease knowledge, common basic nursing operation videos, testing, and expanded learning, and online and offline mixed teaching methods were adopted. SPSS 22.0 was used for t test and chi-square test. Results:At the end of the internship, the experimental group's theoretical assessment score, bedside nursing procedure ability assessment score, and comprehensive quality evaluation were better than the control group's ( P < 0.05). The questionnaire survey of the experimental group nursing students showed a good acceptance of the SPOC teaching mode. Conclusion:The SPOC teaching mode is helpful to improve the comprehensive quality of nursing students and their post competency, which is worthy of further promotion in nursing graduation internship.

Kangaroo care for mothers and fathers of premature infants: a non-inferiority study / 中国实用护理杂志

Objective:To explore the effect of kangaroo care for mothers and fathers on preterm infants' heart rate, blood oxygen, body temperature and so on, and to explore the influence of kangaroo care on the anxiety of the implementers.Methods:Totally 132 cases of preterm infants and their parents from September 2017 to September 2018 in Shengjing Hospital of China Medical University were randomly divided into mother group (67 cases) and father group (65 cases) by envelope method. The intervention lasted for two hours. State Anxiety Inventory(SAI) was used to evaluate the anxiety status of the implementers before and after the intervention, and the heart rate, oxygen saturation and body temperature of preterm infants were recorded 15 minutes before and at the end of the intervention.Results:Before the intervention, the SAI scores of the two groups were 35.00(30.00, 45.00) in the mother group and 33.00(30.00, 43.00) in the father group, with no significant difference ( Z value was -0.645, P>0.05); after the intervention, the SAI score of the mother group was 29.00(23.00, 32.00) and that of the father group was 25.00(21.50, 28.00), with significant difference ( Z value was -3.518, P<0.01). Before and after the intervention, the changes of heart rate ( δ1=- 4.25), blood oxygen saturation ( δ2=1.45), body temperature ( δ3=0.20) of preterm infants before and after the intervention were tested by non inferiority test, and the difference was statistically significant ( t values were -6.370, 5.343, 12.612, P<0.01). Conclusions:The effect of kangaroo care on preterm infants' heart rate, blood oxygen and body temperature are no less than that of mothers. Compared with mother, kangaroo care can reduce father's anxiety better.

Identifying the role of apolipoprotein A-I in prostate cancer / 亚洲男科学杂志(英文版)

Although localized prostate cancer (PCa) can be cured by prostatectomy and radiotherapy, the development of effective therapeutic approaches for advanced prostate cancer, including castration-resistant PCa (CRPC) and neuroendocrine PCa (NEPC), is lagging far behind. Identifying a novel prognostic and diagnostic biomarker for early diagnosis and intervention is an urgent clinical need. Here, we report that apolipoprotein A-I (ApoA-I), the major component of high-density lipoprotein (HDL), is upregulated in PCa based on both bioinformatics and experimental evidence. The fact that advanced PCa shows strong ApoA-I expression reflects its potential role in driving therapeutic resistance and disease progression by reprogramming the lipid metabolic network of tumor cells. Molecularly, ApoA-I is regulated by MYC, a frequently amplified oncogene in late-stage PCa. Altogether, our findings have revealed a novel indicator to predict prognosis and recurrence, which would benefit patients who are prone to progress to metastasis or even NEPC, which is the lethal subtype of PCa.

Analysis of risk factors for gallbladder polyps in shift work nurses / 中国实用护理杂志

Objective:To analyze the detection of gallbladder polyps among shift nurses in Shengjing Hospital of China Medical University in physical examination and its related influencing factors, so as to provide scientific basis for shift nurses to prevent gallbladder polyps.Methods:A total of 1 119 shift nurses who had physical examination in Shengjing Hospital of China Medical University from January 1 to March 31, 2018 were selected. The patients with gallbladder polyps diagnosed by ultrasound were included in the case group, and those without gallbladder polyps were taken as the control group. Age, gender, body mass index (BMI), night shift frequency, education level, Department, meal regularity, drinking history, smoking history, serum triglyceride, serum total cholesterol, hepatitis B surface antigen, serum alanine aminotransferase and serum aspartate aminotransferase levels were compared between the two groups.Results:Univariate analysis showed that age ( P<0.001), gender ( P=0.028), BMI ( P=0.005), night shift frequency ( P=0.021) were the factors with statistically significant difference between the case group and the control group. There were no statistically significant differences between the case group and the control group in terms of education level, department, dining regularity, drinking history, smoking history, hepatitis B surface antigen, serum triacylglycerol, serum total cholesterol, serum alanine aminotransferase, serum aspartate aminotransferase levels ( P>0.05). Logistic regression analysis showed that age, BMI and night shift frequency were the influencing factors in the regression equation ( P<0.05). Conclusion:Age, BMI and night shift frequency may be related risk factors of gallbladder polyps in shift nurses.

Clinical Study on Calcitriol Combined with Sirolimus in the Treatment of Chronic Primary Immune Thrombocytopenia Patients / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical efficacy of calcitriol combined with sirolimus in the treatment of chronic primary immune thrombocytopenia (cITP) patients.@*METHODS@#A total of 146 adult cITP patients reated in the First Affiliated Hospital of Hebei North University from March 2017 to March 2020 were randomly divided into observation group (73 cases) and control group (73 cases) according to random number table. The control group was treated with oral sirolimus capsule, the observation group was treated with oral calcitriol capsule combined with sirolimus capsule, and the curative effect of the 2 groups was evaluated after continuous treatment for 6 weeks. The changes of World Health Organization (WHO) bleeding grade, laboratory related index, including peripheral blood regulatory T cell (Treg), serum 1,25-dihydroxy-vitamin D@*RESULTS@#The total effective rate of the observation group was 79.5% (58/73), which was significantly higher than 64.4% (47/73) of the control group (P<0.05). The revised WHO bleeding grades after treatment were significantly better than those before treatment in the 2 groups (P<0.05), but the observation group was improved more significantly than the control group (P<0.05). After treatment, platelet count (PLT), peripheral blood Treg cell ratio, and serum 1,25(OH)@*CONCLUSION@#The overall efficacy of calcitriol combined with sirolimus in the treatment of cITP in adults is satisfactory, which can effectively alleviate patient's condition, improve the quality of life, further increase the platelet level and decrease the expression of VDR in peripheral blood lymphocyte, the mechanism may be related to increasing the level of serum 1,25(OH)

Analysis of scoring system of twin pregnancy vaginal delivery / 中华妇产科杂志

Objective:To Analyze the prenatal factors and forecast the success rate of vaginal delivery of twin pregnancy.Methods:Totally, 114 cases of twin pregnant women who were under the systematic antenatal care and had deliveries in Beijing Obstetrics and Gynecology Hospital from January 2017 to March 2019 were collected. The inclusive criteria were uncomplicated twin pregnancy with head downward position of the first fetus, not monochorioallantoic twin twins, and the willingness for vaginal delivery. Two groups were classified based on their successful vaginal delivery. 96 cases in vaginal delivery group (study group) and 18 cases in the comparison groupwhich were transferred to Caesarean sections during trial delivery. The evaluated prenatal factors included: (1) Fetal factors: the chorionicity of the twin pregnancy, position of the second fetus, fetal weights and the weight difference of two fetuses. (2) Maternal factors:the maternal age, delivery gestational age, parity, body mass index (BMI), reasonability of weight gain during pregnancy, pregnancy complications, such as gestational diabetes mellitus (GDM), hypertensive disorder of pregnancy, and the application of assisted reproductive technology. (3) The technical title of the delivery doctor, modes of labour (spontaneous labor or induced labour and its mode) and the application of labor analgesia, etc. Single-factor logistic analysis and multiple-factor logistic regression were used to do statistical analysis and nomograms were plotted, finally receiver operating characteristic (ROC) curves and standard curves were formed for internal verifications and Youden index were utilized to determine the cut-off values.Results:Five variables:maternal age,complicated GDM, reasonability of weight gain during pregnancy, parity, and the weight of the second fetus is less than the firsthad obvious influence on the success rate of vaginal delivery in twin pregnancy. After quantifying the influence weight, the influence of each factor was as follows:the age of the mother <35 years old: 64; no GDM: 100, no insulin application in GDM: 47, and application of insulin: 0; reasonability of weight gain during pregnancy: 82; parity≥2: 58; and the weight of the second fetus was less than the first: 57. The ROC curve was plotted and the area under the curve (AUC) is 0.856 1, which were able to forecast the success rates well, the maximum value of the Youden index was 0.564 7 and the corresponding score was 168. Conclusions:maternal age, reasonability of weight gain during pregnancy, the complication of GDM, parity, and the weight of the second fetus less than the first are the influential prenatal factors on vaginal delivery of twin pregnancy. After assigning the influence weight of each influencing factor, when the total score reaches 168 the success rate of vaginal delivery is significantly improved.

The investigation and influencing factors analysis of analgesia and sedation nursing behavior of pediatric intensive care unit nurses in Northeast China and Inner Mongolia / 中国小儿急救医学

Objective:Based on a cross-sectional survey about the status of analgesia and sedation nursing behavior of PICU nurses in Northeast China and Inner Mongolia, to analyze the influencing factors and to provide reference for further constructing standardized training programs and developing standardized for analgesia and sedation nursing process.Methods:The self-designed questionnaire was made for investigation from 435 PICU nurses in 18 hospitals in Northeast China and Inner Mongolia.Results:The average questionnaire score of the analgesia and sedation nursing behavior of PICU nurses was(70.54±13.63)in Northeast China and Inner Mongolia.The behavioral scores were different in each group between different age, nursing age, PICU nursing age, educational background, professional title, and whether was the intensive care unit nurse, whether trained in analgesia and sedation, whether have experience in caring children with analgesia and sedation, and the differences were all statistically significant( P<0.05). The main factors influencing the analgesia and sedation behavior of PICU nurses were whether have received training in analgesia and sedation, whether have experience in caring children with analgesia and sedation treatment and their attitude score to analgesia and sedation. Conclusion:There is still much space for development in analgesia and sedation nursing behavior of PICU nurses in Northeast China and Inner Mongolia.The more analgesia and sedation training PICU nurses take participate in, the more experience and positive attitudes they have in nursing children with analgesia and sedation, their clinical nursing practice ability could become more stronger.

Influence of pars plana vitrectomy on ocular surface using noninvasive Keratograph 5M / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the influence of pars plana vitrectomy(PPV)on ocular surface using Keratograph 5M. <p>METHODS: Totally 30 consecutive patients(30 eyes)undergoing primary 23G PPV were recruited in the study. Ocular Surface Disease Index(OSDI)questionnaire was performed. Ocular surface parameters, including tear meniscus height(TMH), noninvasive tear break up time(NITBUT)and bulbar redness score were obtained preoperatively, in 2, 4, 8 and 12wk postoperatively by Keratograph 5M. Correlations between all the clinical parameters were analyzed further.<p>RESULTS: The percentages of both photophobia and gritty within 4wk after PPV were significantly higher than preoperation, while they decreased to the preoperative levels in both 8wk and 12wk postoperatively. The percentage of sore eyes in the first week postoperatively was significantly higher than preoperation, but there were no significant differences between the percentages of preoperation and 2, 4, 8 and 12wk postoperatively. OSDI score increased significantly within 4wk postoperatively, but it returned to the preoperative level in 8 and 12wk. TMH increased with 2wk postoperatively, but there were no significant differences compared with preoperation. Both NITBUT-first and NITBUT-average shortened significantly within 8wk postoperatively, but they gradually improved to the preoperative levels in 12wk. Bulbar redness score was significantly higher than the preoperative level within 4wk postoperatively, but it returned to the preoperative level in 8wk. NITBUT-first and NITBUT-average had a significant positive correlation at each visit. TMH had a significant positive correlation with NITBUT-average in the first week postoperatively.<p>CONCLUSION: Keratograph 5M can provide a reliable noninvasive method to assess the influence of PPV on the ocular surface. PPV may cause various changes in both symptoms and signs of ocular surface damages at the early stage, while all these changes will return to preoperative levels gradually in 12wk postoperatively.

Research progress on the role of TGF-β signaling pathway in fibrotic diseases / 解放军医学杂志

Fibrotic disease is a type of disease in which the body is affected by various stimulating factors, which causes the activation or phenotypic transformation of myofibroblasts, increases the expression of collagen and excessive deposition of extracellular matrix, resulting in damage to the structure and function of organs. Transforming growth factor-β (TGF-β) is currently recognized as a signal transduction pathway involved in the occurrence of fibrotic diseases, and plays an important role in regulating the occurrence and development of fibrotic diseases such as lung, liver, myocardium, kidney and pancreas. In recent years, many studies have explored the role of TGF-β signaling pathway in the occurrence and development of fibrotic diseases, while to inhibit the activation of TGF-β signaling pathway might have anti-fibrosis effects, but the mechanism has not been fully understood. Therefore, the research progress of the role of TGF-β signaling pathway in such fibrotic diseases as lung, liver, myocardium, kidney and pancreas, and so on, has mainly been reviewed in present paper, so as to provide new strategies for the selection of therapeutic targets for fibrotic diseases.