The relationship between serum interleukin-17A, chemokine ligand 19 levels and disease activity in patients with lupus nephritis / 中国医师进修杂志

Objective:To investigate the relationship between serum levels of interleukin-17A (IL-17A) and chemokine ligand 19 (CCL19) and disease activity in patients with lupus nephritis.Methods:A total of 100 patients with lupus nephritis admitted to Affiliated Hospital of Jining Medical College from June 2020 to February 2023 were collected as the disease group, according to the disease activity index, patients were grouped into inactive group (32 cases), mild active group (21 cases), moderate active group (29 cases), and severe active group (18 cases); another 100 healthy individuals who underwent physical examinations in our hospital during the same period were collected as the control group. Enzyme linked immunosorbent assay (ELISA) was applied to detect the expression levels of IL-17A and CCL19 in serum; Pearson method was applied to analyze the correlation between serum IL-17A, CCL19 and routine indicators in patients with lupus nephritis; receiver operating characteristic curve was applied to analyze the diagnostic value of serum IL-17A and CCL19 for moderate/severe lupus nephritis disease activity.Results:The expression levels of IL-17A and CCL19 in the serum of the disease group were obviously higher than those of the control group: (252.63 ± 64.47) ng/L vs. (123.27 ± 25.12) ng/L and (566.98 ± 73.36) ng/L vs. (275.63 ± 50.48) ng/L ( t = 18.70 and 32.72, P<0.05); the serum levels of IL-17A and CCL19 in the severe active, moderate active, and mild active groups were higher than those in the inactive group: (331.42 ± 87.46), (278.50 ± 74.19) and (232.34 ± 59.16) ng/L vs. (198.18 ± 46.22) ng/L; (662.33 ± 89.57), (606.14 ± 79.25) and (552.84 ± 68.36) ng/L vs. (487.13 ± 62.19) ng/L, and with the increase of disease activity, the levels of serum IL-17A and CCL19 gradually increased ( F = 17.86 and 25.35, P<0.05); the glomerular filtration rate, albumin, complement C 3 and complement C 4 in the active group were obviously lower than those in the inactive group: (69.17 ± 13.25) ml/(min·1.73 m 2) vs. (86.18 ± 14.16) ml/(min·1.73 m 2), (24.18 ± 5.11) g/L vs. (31.25 ± 6.35) g/L, (432.35 ± 95.22) mg/L vs. (675.42 ± 125.16) mg/L, (76.58 ± 17.51) mg/L vs. (121.42 ± 27.18) mg/L, while blood creatinine, urine protein and erythrocyte sedimentation rate were obviously higher than those in the inactive group: (92.34 ± 16.24) μmoI/L vs. (53.21 ± 9.17) μmoI/L, (3.43 ± 0.82) g/24 h vs. (1.26 ± 0.23) g/24 h, (66.37 ± 12.28) mm/1 h vs. (35.62 ± 8.67) mm/1 h ( t = 5.86, 5.97, 10.74, 9.93, 12.70, 14.67 and 12.74; P<0.05); serum IL-17A and CCL19 in patients with lupus nephritis were negatively correlated with glomerular filtration rate, albumin, complement C 3, and complement C 4, while positively correlated with blood creatinine, urine protein, and ESR ( P<0.05); the area under the curve (AUC) of the combined diagnosis of serum IL-17A and CCL19 for lupus nephritis disease activity was 0.961, which was superior to their respective individual diagnoses ( Z = 2.24 and 3.16, P = 0.025 and 0.002). Conclusions:The expression levels of IL-17A and CCL19 in serum gradually increase with the increase of disease activity in patients with lupus nephritis. The combined detection of the two has good diagnostic value for disease activity in lupus nephritis.

Clinical characteristics analysis of multiple clustered polyps in the ileocecal region(9 cases) / 中国内镜杂志

Objective To analyze the etiology and clinical characteristics of multiple clustered polyps in the ileocecal region.Methods Nine patients with multiple clustered polyps only in the ileocecal region found from 2017 to 2022 were retrospectively collected,and their etiology and clinical characteristics were analyzed.Results There were 9 patients with multiple clustered polyps in the ileocecal region in this group.There were 7 males and 2 females.The age of onset was 28～73 years old,52(40.0,62.5)years old.There were 8 cases of abdominal discomfort or abdominal pain,4 cases of chronic diarrhea,2 cases of mucous stool and 1 case of dry stool.The number of polyps ranged from 4～17,and the diameter of polyps ranged from 0.2～1.0 cm.Pathological examination showed chronic inflammation of ileocecal mucosa with polyp formation in 8 cases,and canalicular adenoma with mild dysplasia in 1 case.7 cases ate more red meat food or processed products.6 cases had repeat colonoscopy,and 3 cases had recurrence.Conclusion Multiple clustered polyps appearing only in the ileocecal region are a special type of polyps closely related to inflammation,and endoscopic surgery is recommended followed by attention to control inflammation.

Comparative effectiveness research of different testing methods in functional quality inspection of precision surgical instruments / 中国医学装备

Objective:To compare the testing effects of different testing methods in the functional inspection of precision surgical scissors and needle holders.Methods:By consulting relevant literature and professional books,three testing methods and materials for precision surgical scissors and needle holders were selected.The cutting performance of the precision surgical scissors were tested by gauze cloth,cotton wool,and silicone film method in the Interlock surgical instrument testing set.The clamping performance of precision needle holder was tested by using light,needle clips,and thread clamping method in the Interlock surgical instrument testing set.100 pieces of precision surgical scissors and needle holders which were qualified for cleaning and disinfection in the hospital were selected for effectiveness testing,and a self-made satisfaction questionnaire to investigate the satisfaction of surgeons with the use of instruments.Results:After 100 precision surgical scissors tested using three methods of gauze,cotton wool,and silicone film,the qualified number of cutting performance was 94,76,and 58,respectively,the difference was statistically significant(x2=36.526,P<0.05).The satisfaction rate of surgeons with the use of precision surgical scissors passed the silicone film test was the highest at 100%,followed by cotton wool cloth at 82.0%,and the gauze method at the worst at 67.0%,the difference was statistically significant(x2=48.439,P<0.05).After 100 precision needle holders were tested by using three methods of light irradiation,needle clamping,and wire clamping,the qualified number of clamping performance was 96,78,and 62,respectively,the difference was statistically significant(x2=38.160,P<0.05).The satisfaction rate of surgeons with the precision needle holders passed the clamp line test was the highest at 100.0%,followed by the clamp needle at 79.0%,and the worst under light at 62.0%,the difference was statistically significant(x2=57.705,P<0.05).Conclusion:The function and quality of precision surgical scissors and needle holders tested by the test objects in Interlock Surgical Instrument Test Suite can objectively and accurately reflect the functional status of surgical scissors and needle holders,provide reference for regular maintenance and upkeep of instruments,and ensure safe use of instruments.

FHL2 regulates THP-1 macrophage foaming through NF-κB signaling pathway / 基础医学与临床

Objective To determine whether four-and-a-half LIM-only protein 2(FHL2)can affect macrophage foa-ming by regulating nuclear factor kappa-B(NF-κB)signaling pathway.Methods FHL2 over-expression plasmids and siRNA of FHL2 were constructed and transfected into human monocyte/macrophages cell line THP-1.Western blot was used to detect the expression of FHL2.The cells were stimulated with oxidized low density lipoprotein(ox-LDL)and the expression of IL-6,IL-1β,TNF-α and other cytokines were detected by ELISA.Oil red O staining was used to detect the degree of cell foaming.The protein expression of NF-κB signaling pathway was detected by Western blot.Results The expression of FHL2 increased after transfected with FHL2 over-expression plasmids while decreased in si-FLH2 transfected cells.FHL2 down-regulated secretion of inflammatory cytokines.Down-regulation of FHL2 allevi-ated THP-1 macrophage foaming.The down-regulation of FHL2 inhibited activation of NF-κB signaling pathway,while the over-expression FHL2 showed an opposite trend.Conclusions FHL2 down-regulation inhibits the activation of NF-κB signaling pathway,reduces the secretion of inflammatory cytokines and alleviates foaming of macrophages.

Effects of maternal high-fat diet and exercise intervention on insulin sensitivity and the hypothalamic arcuate nucleus in male offspring mice / 中国组织工程研究

BACKGROUND:In the offspring of obese mothers,some metabolic genes are"silent"under certain environmental influences.These"silent"genes may be"awakened"under the acquired environment and then cause metabolic regulation disorders. OBJECTIVE:In the case of offspring with different diets,to explore the metabolic genetic effects of long-term high-fat and exercise intervention in female mice. METHODS:Seventy 3-week-old female C57BL/6 mice were divided into high-fat diet(HFD)and high-at exercise groups(high-fat diet+exercise,HFD-Ex),and they gave birth naturally after 16 weeks of intervention.After 4-week lactation,16 male offspring mice from each group were randomly selected.Totally 32 offspring mice were randomly divided into 4 subgroups and given high-fat diet or standard chow diet for 6 weeks:HFD-HFD,HFD-Ex-HFD,HFD-standard chow diet,and HFD-Ex-standard chow diet.The offspring mice were subjected to glucose tolerance test and insulin tolerance test in the 10th week,followed by body composition analysis and sacrifice.Western blot was used to determine the level of p-Akt in the liver.Immunofluorescence of the hypothalamic arcuate nucleus was used to analyze the expression of neuropeptide Y and pro-opiomelanocortion. RESULTS AND CONCLUSION:Under the high-fat diet,compared with the HFD group,the offspring of the HFD-Ex group had significantly improvements in glucose metabolism,body mass,and body composition(P＜0.05).Under the standard chow diet,compared with the HFD group,the expression of neuropeptide Y in the hypothalamic arcuate nucleus of the HFD-Ex group was significantly decreased(P＜0.05),and the expression of pro-opiomelanocortion was significantly up-regulated(P＜0.05).In the case of insulin(-),the expression of phosphorylated Akt(Ser473)protein in the liver showed no significant difference between the two groups,but in the case of insulin(+),there was a significant difference between the two groups(P＜0.05).In the high-fat diet mode,the metabolic protection effect of the maternal long-term exercise may gradually weaken with the prolongation of the offspring's high-fat exposure;in the standard chow diet mode,the maternal long-term exercise can improve the central regulation of energy metabolism and insulin sensitivity of the male offspring.

Study on Influencing Factors of Nurses’ Willingness to Participate in Humanistic Nursing Training / 中国医学伦理学

In order to understand nurses’ willingness to participate in humanistic nursing training and its influencing factors, and provide reference for managers to understand the current situation and improve nurses’ enthusiasm for humanistic nursing training. The convenience sampling method was used to investigate 23 707 nurses in 28 provinces (autonomous regions and municipalities directly under the central government) through a self-designed questionnaire distributed on the Internet. The results showed that 98.1% of nurses thought that participating in humanistic nursing related training was helpful to clinical work, but only 88.6% of the respondents were willing to participate in humanistic nursing training. Thirty factors were analyzed from four aspects of basic characteristics of individuals, cognitive relevant experience and organizational atmosphere. Fifteen factors had significant significance in binary Logistic regression analysis (P<0.05). Among them, the factors that had a positive impact on training willingness were: marriage, education, professional title, post establishment, agree with humanistic care is the basic duty of a nurse praised, experience of being praised at work, family support, rapport with patients, passion of colleagues to participate in training, sustained high-quality care demonstration activities, join the humanistic care related organization, hospital reimbursement of training expenses (OR value of 6.559~1.113, P<0.001). The OR value of humanistic nursing as a nurse’s responsibility was 6.559 and the 95%CI was 5.585~7.702. The factors that hindered nurses from participating in training were: work occupied most of time and energy, think humanistic nursing is abstract and difficult to understand, think the mastered humanistic knowledge and skills meet the needs of work (OR value of 0.657~0.722, P<0.001). Through the analysis, it is considered that nurses have a extremely consistent high recognition of the significance of humanistic nursing training, but their willingness to receive training is affected by many factors such as individual experience, cognitive attitude and organizational atmosphere. In order to realize nurses’ high recognition of humanistic nursing training to high enthusiasm of behavior, the aspects of individual cognition and organizational atmosphere must be discussed.

Research advances in the immunomodulatory mechanism of galectin-9 and its role in liver diseases / 临床肝胆病杂志

Galectin-9 （Gal-9） is a member of the galectin family that can specifically recognize and bind to galactosides. Recent studies have shown that Gal-9 is highly expressed in the liver and can help to maintain intrahepatic immune homeostasis and perform biological functions in various liver diseases. This article reviews the immunomodulatory functions of Gal-9 and its role in different liver diseases. Studies have shown that Gal-9 has important biological functions in different liver diseases through multiple pathways. Research on the specific immunomodulatory mechanisms and functions of Gal-9 may help to discover the therapeutic role of Gal-9 in liver diseases.

In vivo MRI study of the oxidative stress level in the white matter of patients with relapsing-remitting multiple sclerosis / 中华放射学杂志

Objective:To explore the oxidative stress of cerebral white matter lesion (WML) and normal-appearing white matter (NAWM) with in vivo proton exchange rate (k ex) MRI on relapse-remitting multiple sclerosis (RRMS) patients. Methods:Clinical and imaging data of 37 patients (case group) with RRMS patients of Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology were analyzed retrospectively from November 2018 to November 2021, including 11 males and 26 females aged 18-41 (29±7) years. Another 22 age-matched healthy volunteers (control group) were recruited for the same period, including 4 males and 18 females aged 23-44 years with a median age of 25 (24, 28.25) years. All subjects received conventional MR protocols and chemical exchange saturation transfer imaging. The manifestation of WML on the k ex map and T 1WI images were assessed while the k ex values of WML, NAWM and normal white matter (NWM) of control group were quantitatively evaluated. Student′s t test was used to compare the k ex difference of WML and NAWM in the case group, NAWM in the case group and NWM in the control group, low-signal and isosignal WML in T 1WI. Spearman rank correlation was used to analyze the correlation of the k ex values of WML with patients′ expanded disability status scale (EDSS) score. Results:A total of 272 WML were found in the 37 RRMS patients, and 25.4% (69/272) were T 1-hypointense. The k ex value of WML in the case group [(932±108) s -1] was higher than that of NAWM [(771±26) s -1], and the difference was statistically significant ( t=8.95, P<0.001); the k ex value of NAWM in the case group [(771±26) s -1 ] was higher than that of NWM [(745±26) s -1] in the control group, and the difference was statistically significant ( t=3.96, P<0.001). The k ex value [(1 039±110) s -1] of WML with low signal at T 1WI was higher than that of WML with equal signal [(895±79) s -1], with a statistically significant difference ( t=9.78, P<0.001). Correlation analysis showed that the k ex value of WML in the case group was positively correlated with the EDSS score ( r=0.54, P<0.001). Conclusions:The elevated k ex values of WML and NAWM reflect the cerebral oxidative stress of RRMS patients and are positively correlated to the severity of tissue damage, which suggests the role of oxidative stress in RRMS lesion formation and brain atrophy.

Relationship between the pelvic bone marrow dose-volume parameters and acute hematologic toxicity in neoadjuvant pelvic intensity-modulated radiotherapy for local advance rectal cancer / 中华放射医学与防护杂志

Objective:To analyze the correlation between the volume of irradiated pelvic bone marrow and acute hematologic toxicity (HT), in order to provide clinical data to reduce the risk of acute HT and optimize the radiotherapy plan.Methods:From October 2017 to May 2019, 41 LARC patients who received neoadjuvant concurrent chemoradiotherapy (CCRT) were retrospectively reviewed in our center. All patients were treated with 5-field intensity-modulated radiotherapy (IMRT), and the prescription dose delivered to PTV was 45-50.4 Gy in 25-28 fractions. Capecitabine or 5-fluorouracil (5-FU) wasadministered daily 5 days a week during radiotherapy. Different HTswere recorded according to National Cancer Institute Common Toxicity Criteria Version 5.0 (NCI-CTC.V5.0) based on laboratory tests. The volume of PBM or each site (coxal, sacrum, femoral) receiving more than x Gy refers to as TVx, CVx, SVx, and FVx, respectively. Logistic regression was performed to evaluate the association between the volume of irradiated pelvic bone marrow and different HT. Generalized additive model (GAM) and piecewise regression were used to further analyze the possible nonlinear relationship and threshold effect between them. Results:Multivariate logistic regression analysis showed that low-dose of irradiated total pelvic bone marrow volume ( TV5) and coxal bone marrow volume ( CV5, CV10) were significantly correlated with Grade ≥2 leukopenia( P<0.05). There was a significant negative correlation between the sacrum bone marrow volume ( SV5, SV10) and Grade ≥2 leukopenia ( P<0.05). A thresholdeffect has been observed between CV10 and Grade ≥2 leukopenia by Generalized additive model (GAM) and piecewise linear regression. The threshold between CV10 and Grade ≥2 leukopenia was 575 ml, OR (95% CI) was 1.85 (1.08, 3.16). Conclusions:In neoadjuvant IMRT of rectal cancer, CV is a better predictor of acute HT induced by CCRT than TV. The irradiated volume of CV associated with acute HT was mainly low-dose levels ( CV5, CV10). The thresholds of our study ( CV10= 575 ml) could be a good reference for the optimization of the radiotherapy plan.

A case of diabetes mellitus with glucokinase regulator gene mutation misdiagnosed as type 1 diabetes / 中华内分泌代谢杂志

We report a case of a female teenage with monogenic diabetes mellitus caused by glucokinase regulator (GCKR) gene mutation who presented with diabetic ketosis and misdiagnosed as type 1 diabetes. The patient was treated with insulin for 3 years since diagnosis. The islet function was well preserved, but polycystic ovary syndrome was developed. Whole-exome gene sequencing revealed a GCKR gene c. 69delG heterozygous mutation. After molecular diagnosis, the insulin dosage was gradually reduced to full cessation, and only metformin sustained-release tablets were taken to control blood glucose. It is necessary to regular evaluate islet function of patient with type 1 diabetes, and genetic test is of significance for accurate diagnosis and treatment.

Anatomy of the perforator propeller flap of superior lateral genicular artery and its clinical application in repair of soft tissue defect of anterolateral knee / 中华显微外科杂志

Objective:To study the anatomy of the perforator propeller flap of superior lateral genicular artery, and to explore a surgical method and clinical application in repair of the soft tissue defect of anterolateral knee with the flap.Methods:From September 2019 to September 2021, 8 knees of 4 chilled fresh specimen of adults were studied. The perforators of the superior lateral genicular artery were observed. The length, outer diameter of the perforators, and the locations of the skin perforation were recorded. The superior lateral genicular artery perforator propeller flaps were then applied clinically to 5 patients(3 males and 2 females) with soft tissue defects of anterolateral knee. Two of the patients had combined ligament injury and(or) bone joint exposure. The age of patients ranged from 25 to 48 years old, at 33.4 years old in average. The sizes of soft tissue defects ranged from 4.0 cm×4.0 cm to 8.0 cm×5.0 cm. The sizes of perforator propeller flaps of superior lateral genicular artery were 10.0 cm×5.0 cm to 13.0 cm×6.0 cm. The superior perforating vessels of the superior lateral genicular artery were found and marked at the points of skin perforation. Preoperative contrast-enhanced ultrasound were performed to confirm the dominant perforating vessels and had the skin perforating points marked. Intraoperative CDU were further performed to confirm the points of dominant perforating vessels. Perforator propeller flaps were designed depending on the size of the anterolateral soft tissue defect, and flaps were prepared and transferred to the defect sites. Postoperative follow-ups were conducted at outpatient clinic. The survival of the flap and knee function were observed according to the Bai-ly knee scoring.Results:The anatomy showed that an average pedicle length of the superior lateral genicular artery perforator was(8.2±0.9) cm, with an average starting outer diameter at(1.1±0.2) mm. All 5 flaps survived during the follow-up that lasted for 10 to 24 months, with an average of 15.3 months. All flaps healed in 2 weeks after surgery without complications such as soft tissue infection, bone and joint infection were observed. At the last follow-up, no obvious bloated appearance of the flaps were observed. The colour and elasticity of the flaps were similar to the surrounding skin. The knee function was assessed: 4 patients were in excellent and 1 in good. The range of knee flexion and extension was from 100° to 150°. The patients were satisfied with the appearance and function of the knees.Conclusion:The size of the perforator of superior lateral genicular artery and the pedicle length are ideal. The propeller flap can be used to repair the soft tissue defect around the anterolateral knee, with satisfactory functional recovery of a knee. It is a good method to repair the soft tissue defect around anterolateral knee.

Research Progress of Recurrent Acute Pancreatitis / 胃肠病学

Acute pancreatitis is a common acute abdominal disease in clinical practice,some of which can still recur after standardized treatment,known as recurrent acute pancreatitis(RAP).The etiology and mechanism of RAP are complicated,and there is still a lack of standardized evaluation,diagnosis and treatment.So,early identification of the cause and targeted intervention is important.In this review,we summarize the current progress in the research of RAP.

The effect and mechanism of PPP5C on the migration and invasion and tumor stemness of human lung adenocarcinoma H1299 cells / 安徽医科大学学报

Objective@#To investigate the effect and mechanism of phosphoprotein phosphatase 5 catalytic(PPP5C) on the migration , invasion and tumor stemness of human lung adenocarcinoma H1299 cells.@*Methods@#The PPP5C⁃pcDNA3. 1 overexpression vector was constructed. PPP5C⁃pcDNA3. 1 and pcDNA3. 1 were transfected into H1299 cells , and H1299 stable cell lines were screened with G418. The mRNA and protein expression levels of PPP5C were identified by qRT⁃PCR and Western blot. The proliferation activity of H1299 cells was detected by drawing cell growth curve and cell clonal formation assay. The wound⁃healing assay and transwell assay were used to test the migration and invasion abilities of H1299 cells , respectively. The stemness of H1299 cells was evaluated by sphere formation assay.@*Results@#The PPP5C⁃pcDNA3. 1 eukaryotic expression vector was successfully constructed and the expression levels of PPP5C significantly increased after transfection into H1299 cells. After overexpression of PPP5C in H1299 cells , the cell growth curve and clonal formation assay displayed that the proliferation ability was not affected , the migration and invasion of cells were significantly enhanced through wound⁃healing assay and transwell assay , accompanied by an increase in the expression of MMP9 , stem cell spheroid assay showed a significant increase in stemness of cells , accompanied by increased expression of SOX2. @*Conclusion@#The proliferation ability of cells is not affected , the migration and invasion and the stemness of cells are enhanced by regulating MMP9 and SOX2 respectively , after overexpression of PPP5C in human lung adenocarcinoma H1299 cells.

The role of mobile phone addiction and anxiety symptoms in the association between childhood psychological abuse and depressive symptoms among college students / 中国学校卫生

Objective@#To explore the role of mobile phone addiction and anxiety symptoms in the relationship between childhood psychological abuse and depressive symptoms among college students, in order to provide a basis for mental health promotion.@*Methods@#From February to May 2023, a stratified random sampling method was used to select 1 799 freshmen to juniors from a university in Wuhu City, Anhui Province. The questionnaire survey was conducted using the 2-item Patient Health Questionnaire (PHQ-2), Child Psychological Maltreatment Scale (CPMS), Mobile Phone Addiction Tendency Scale (MPATS), 2-item General Anxiety Disorder (GAD-2). Correlations among each variable were analyzed, and the chain mediating effect of mobile phone addiction and anxiety symptoms was explored.@*Results@#The detection rate of depressive symptoms among college students was 9.7%, and the positive detection rate of childhood psychological abuse was 28.6%. Depressive symptoms were positively correlated with childhood psychological abuse, mobile phone addiction and anxiety symptoms ( r =0.28, 0.32, 0.27, P <0.01). Childhood psychological abuse was positively correlated with mobile phone addiction and anxiety symptoms ( r =0.29, 0.71, P <0.01). Mobile phone addiction and anxiety symptoms were positively correlated ( r =0.30, P <0.01). Childhood psychological abuse could effectively predict depressiove symptoms, mobile phone addiction and anxiety symptoms ( β =0.08, 0.06, 0.66, P <0.01). Mobile phone addiction and anxiety symptoms had a chain mediating effect between childhood psychological abuse and depression symptoms, with a total indirect mediating effect (effect=25.27%, P <0.05), accounting for 72.44% of the total effect.@*Conclusions@#Mobile phone addiction and anxiety symptoms play a chain mediating role between childhood psychological abuse and depressive symptoms. Focusing on childhood psychological abuse, mobile phone addiction and anxiety among college students are beneficial for depression symptoms prevention.

Influencing factors for acute necrotizing pancreatitis in Eastern and Western countries: A meta-analysis / 临床肝胆病杂志

Objective To investigate the differences in the influencing factors for acute necrotizing pancreatitis (ANP) and infectious pancreatic necrosis (IPN) between Eastern and Western countries, and to provide a theoretical basis for the prediction and prevention of ANP. Methods Databases including PubMed, Embase, the Cochrane Library, and Web of Science were searched for articles on the influencing factors for ANP and IPN published up to January 21, 2021, and a Meta-analysis was performed. Results A total of 59 studies were included, with 22 studies from Eastern countries and 37 studies from Western countries.The Meta-analysis showed that in Eastern countries, male sex (odds ratio[ OR ]=1.51, 95% confidence interval[ CI ]: 1.18-1.91, P < 0.01), C-reactive protein (CRP)(standardized mean difference[ SMD ]=1.39, 95% CI : 1.06-1.71, P < 0.01), D-dimer ( SMD =0.44, 95% CI : 0.07-0.81, P =0.02), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE-Ⅱ) score (mean difference[ MD ]=3.51, 95% CI : 1.38-5.64, P < 0.01), alcoholic etiology ( OR =3.57, 95% CI : 2.68-4.75, P < 0.01), and biliary etiology ( OR =0.60, 95% CI : 0.46-0.77, P < 0.01) were the influencing factors for ANP, and in Western countries, male sex ( OR =1.63, 95% CI : 1.30-2.05, P < 0.01), CRP ( SMD =2.09, 95% CI : 1.12-3.05, P < 0.01), APACHE-Ⅱ score ( MD =4.28, 95% CI : 2.73-5.83, P < 0.01), Ranson score ( MD =2.99, 95% CI : 2.50-3.47, P < 0.01), and organ failure ( OR =10.87, 95% CI : 2.62-45.04, P < 0.01) were the influencing factors for ANP.In Eastern countries, age ( MD =2.16, 95% CI : 0.43-3.89, P =0.01), body mass index (BMI)( MD =1.74, 95% CI : 1.23-2.25, P < 0.01), albumin level ( SMD =-0.43, 95% CI : -0.75 to-0.12, P < 0.01), CRP ( SMD =0.58, 95% CI : 0.04-1.11, P =0.03), procalcitonin ( SMD =0.80, 95% CI : 0.56-1.04, P < 0.01), D-dimer ( MD =0.23, 95% CI : 0.15-0.31, P < 0.01), APACHE-Ⅱ score ( MD =2.47, 95% CI : 0.73-4.22, P < 0.01), Ranson score ( MD =1.60, 95% CI : 1.46-1.73, P < 0.01), and extent of necrosis ≥30%( OR =2.52, 95% CI : 1.26-5.06, P < 0.01) were the influencing factors for IPN, while in Western countries, age ( MD =4.07, 95% CI : 1.82-6.31, P < 0.01), APACHE-Ⅱ score ( MD =3.28, 95% CI : 1.39-5.17, P < 0.01), Ranson score ( MD =2.18, 95% CI : 1.75-2.62, P < 0.01), SIRS score ( OR =3.88, 95% CI : 1.58-9.51, P < 0.01), alcoholic etiology ( OR =0.61, 95% CI : 0.42-0.87, P < 0.01), and organ failure ( OR =3.63, 95% CI : 1.11-11.92, P =0.03) were the influencing factors for IPN. Conclusion Current evidence shows that biliary etiology and alcoholic etiology are unique influencing factors for ANP in the Eastern population, while Ranson score is a unique influencing factor in the Western population.BMI and extent of necrosis ≥30% are unique influencing factors for IPN in the Eastern population, while alcoholic etiology is a unique influencing factor in the Western population.

Study on Influencing Factors of Nurses’ Willingness to Participate in Humanistic Nursing Training / 中国医学伦理学

In order to understand nurses’ willingness to participate in humanistic nursing training and its influencing factors, and provide reference for managers to understand the current situation and improve nurses’ enthusiasm for humanistic nursing training. The convenience sampling method was used to investigate 23 707 nurses in 28 provinces (autonomous regions and municipalities directly under the central government) through a self-designed questionnaire distributed on the Internet. The results showed that 98.1% of nurses thought that participating in humanistic nursing related training was helpful to clinical work, but only 88.6% of the respondents were willing to participate in humanistic nursing training. Thirty factors were analyzed from four aspects of basic characteristics of individuals, cognitive relevant experience and organizational atmosphere. Fifteen factors had significant significance in binary Logistic regression analysis (P<0.05). Among them, the factors that had a positive impact on training willingness were: marriage, education, professional title, post establishment, agree with humanistic care is the basic duty of a nurse praised, experience of being praised at work, family support, rapport with patients, passion of colleagues to participate in training, sustained high-quality care demonstration activities, join the humanistic care related organization, hospital reimbursement of training expenses (OR value of 6.559~1.113, P<0.001). The OR value of humanistic nursing as a nurse’s responsibility was 6.559 and the 95%CI was 5.585~7.702. The factors that hindered nurses from participating in training were: work occupied most of time and energy, think humanistic nursing is abstract and difficult to understand, think the mastered humanistic knowledge and skills meet the needs of work (OR value of 0.657~0.722, P<0.001). Through the analysis, it is considered that nurses have a extremely consistent high recognition of the significance of humanistic nursing training, but their willingness to receive training is affected by many factors such as individual experience, cognitive attitude and organizational atmosphere. In order to realize nurses’ high recognition of humanistic nursing training to high enthusiasm of behavior, the aspects of individual cognition and organizational atmosphere must be discussed.

Advances on machine learning applications in sepsis associated-acute kidney injury / 中华危重病急救医学

Sepsis associated-acute kidney injury (SA-AKI) is a common complication of sepsis, which has a high incidence and is closely related to a poor prognosis. However, delayed diagnosis and non-specific treatments make it difficult to systematically manage SA-AKI. Based on massive clinical data, machine learning could build prediction models, which provide alarms and suggestions for the clinical decision support system. Although there are still many challenges such as poor interpretability, it has shown clinical application value in SA-SKI risk prediction, imaging diagnosis, subtype identification, prognosis assessment, and so on. Based on a brief introduction of machine learning, this article reviews the application, limitations, and future directions of machine learning in the diagnosis and treatment of SA-AKI, and explores the possibility of machine learning in the medical field, in order to promote the development of precision medicine and intelligent medicine.

Optimization of molding process of Jinpuju Qingrelishi Granules by Response Surface Methodology / 国际中医中药杂志

Objective:To optimize the best molding process of Jinpuju Qingrelishi Granules.Methods:Based on the single factor test, the relative density of clear ointment and the amount of diluent (dextrin∶lactose=2∶1) are used as investigating factors, and the overall evaluation of the molding rate and angle of repose overall desirability (OD) is used as the evaluation index. The effect surface method is used to optimize the best molding process of Jinpuju Qingrelishi Granules.Results:The best molding process conditions: the relative density of the clear paste is 1.20 (60 ℃) and the amount of diluent is 3 times that of the clear paste. After mixing the clear paste and diluent, make soft material, pass through a 14-mesh sieve to granulate, dry in an oven (55 ℃) for 1 hour, and sizing to obtain. The molding rates of the three batches of verification test granules were 93.73%, 93.03%, 95.59%, respectively, the predicted OD value was 0.928, the verification value was 0.936, and the deviation from the predicted value was -0.86%.Conclusion:The molding process of this experiment is stable and reliable, with good repeatability, which can provide a reference for the follow-up research of Jinpuju Qingrelishi Granules.

Application effect of silica gel stent loading technology in precision microscopic instrument management / 中国实用护理杂志

Objective:To improve the loading technology of precision micro instruments, so as to ensure not only the quality of cleaning and sterilization, but also the safe use of instruments.Methods:From January to March, 2021, 80 sets of precision micro instruments from Sterilization Supply Center, Shanghai Jiao Tong University School of Medicine Affiliated Ruijin Hospital were randomly divided into silica gel pad loading group (group A) and silica gel stent loading group (group B), 40 sets in each group. The cleaning effect, drying effect, loading effectiveness and sterilization wet bag of the instruments in the two groups were compared, and the staff of the disinfection supply center were satisfied with the operation of the loading technology of the instruments in the two groups.Results:The qualified cleaning numbers of the instruments in group A and B were 37 and 39 respectively, and there was no significant difference between the two groups ( χ2 = 1.05, P>0.05). The qualified drying numbers in the group A and B were 29 and 38 respectively, the difference between the two groups was significant ( χ2 = 7.44, P<0.05). The effective number of loading in the group A and B were 30 cases and 39 cases respectively, the difference was significant between the two groups ( χ2 = 8.54, P<0.05). The number of sterilized wet bags in the group A and B were 6 cases and 0 cases respectively, the difference was significant between the two groups ( χ2 = 6.49, P<0.05). The satisfaction of 44 personnel in the disinfection supply center with the operation of loading technology were 36 and 43 respectively, the difference was statistically significant between the two groups ( χ2 = 6.07, P<0.05). Conclusion:Loading precision micro instruments with silica gel stent can not only ensure the cleaning and sterilization quality of instruments, but also make the loading of instruments more safe and stable, greatly improve the working efficiency of instrument treatment and accelerate the turnover efficiency of instruments.

Research progress of humanistic nursing training for nurses / 中国实用护理杂志

This paper expounds the concept of humanistic nursing and humanistic nursing training, and summarizes the current situation of humanistic nursing training. Mainly includes training courses based on humanistic care nursing theory, training courses based on humanistic medical practice skill training, training courses based on training mode, training courses guided by promoting hospital development, humanistic training aimed at developing humanistic nursing discipline, etc. Through summarizing the existing research results, to provide reference for the construction of systematic training courses of humanistic nursing practice ability.