Wound incidence and outcomes in atrial fibrillation: Comparing catheter ablation and anti-arrhythmic drug therapy.

The most prevalent form of cardiac arrhythmia is atrial fibrillation (AF), which is typically managed through catheter ablation or anti-arrhythmic drug therapy. We compared the incidence and outcomes of wound complications in patients with atrial fibrillation who were treated with catheter ablation as opposed to anti-arrhythmic drug therapy. From May to November 2023, 240 adult AF patients who were treated with catheter ablation or anti-arrhythmic medications participated in a 6-month retrospective cohort study at Sir Run Run Shaw Hospital in Hangzhou, China. An observation was made regarding 29 wound complications out of 240 patients. In comparison to drug therapy group, incidence of minor (8 vs. 11) and total complications (18 vs. 11) was greater in catheter ablation group. Significant adverse events occurred at higher rate in the catheter ablation group (6 versus 1) (p < 0.05). However, despite these patterns, there was no statistically significant difference in the rates of complications (total: p = 0.245; minor: p = 0.217; major: p = 0.128). Comparable treatment efficacy was observed across groups. In contrast to drug therapy, catheter ablation was associated with decreased probability of complications (odds ratio: 0.86), as determined by logistic regression; cardiac failure was a significant predictor of adverse outcomes. The study concluded that the risks of wound complications associated with catheter ablation and anti-arrhythmic drug therapy in patients with atrial fibrillation are comparable. Notwithstanding an elevated propensity for complications in ablation group, the statistical analysis indicated comparable safety profiles.

Andrographolide protects against atrial fibrillation by alleviating oxidative stress injury and promoting impaired mitochondrial bioenergetics / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia seen in clinical settings, which has been associated with substantial rates of mortality and morbidity. However, clinically available drugs have limited efficacy and adverse effects. We aimed to investigate the mechanisms of action of andrographolide (Andr) with respect to AF. We used network pharmacology approaches to investigate the possible therapeutic effect of Andr. To define the role of Andr in AF, HL-1 cells were pro-treated with Andr for 1 h before rapid electronic stimulation (RES) and rabbits were pro-treated for 1 d before rapid atrial pacing (RAP). Apoptosis, myofibril degradation, oxidative stress, and inflammation were determined. RNA sequencing (RNA-seq) was performed to investigate the relevant mechanism. Andr treatment attenuated RAP-induced atrial electrophysiological changes, inflammation, oxidative damage, and apoptosis both in vivo and in vitro. RNA-seq indicated that oxidative phosphorylation played an important role. Transmission electron microscopy and adenosine triphosphate (ATP) content assay respectively validated the morphological and functional changes in mitochondria. The translocation of nuclear factor erythroid 2-related factor 2 (Nrf2) to the nucleus and the molecular docking suggested that Andr might exert a therapeutic effect by influencing the Keap1-Nrf2 complex. In conclusions, this study revealed that Andr is a potential preventive therapeutic drug toward AF via activating the translocation of Nrf2 to the nucleus and the upregulation of heme oxygenase-1 (HO-1) to promote mitochondrial bioenergetics.

Global spatiotemporal trends and determinants of COVID-19 vaccine acceptance on Twitter: a multilingual deep learning study in 135 countries and territories

BackgroundCOVID-19 vaccination has faced a range of challenges from supply-side barriers such as insufficient vaccine supply and negative information environment and demand-side barriers centring on public acceptance and confidence in vaccines. This study assessed global spatiotemporal trends in demand- and supply-side barriers to vaccine uptake using COVID-19-related social media data and explored the country-level determinants of vaccine acceptance. MethodsWe accessed a total of 13,093,406 tweets sent between November 2020 and March 2022 about the COVID-19 vaccine in 90 languages from 135 countries using Meltwater(R) (a social listening platform). Based on 8,125 manually-annotated tweets, we fine-tuned multilingual deep learning models to automatically annotate all 13,093,406 tweets. We present spatial and temporal trends in four key spheres: (1) COVID-19 vaccine acceptance; (2) confidence in COVID-19 vaccines; (3) the online information environment regarding the COVID-19 vaccine; and (4) perceived supply-side barriers to COVID-19 vaccination. Using univariate and multilevel regressions, we evaluated the association between COVID-19 vaccine acceptance on Twitter(R) and (1) country-level characteristics regarding governance, pandemic preparedness, trust, culture, social development, and population demographics; (2) country-level COVID-19 vaccine coverage; and (3) Google(R) search trends on adverse vaccine events. FindingsCOVID-19 vaccine acceptance was high among Twitter(R) users in Southeast Asian, Eastern Mediterranean, and Western Pacific countries, including India, Indonesia, and Pakistan. In contrast, acceptance was relatively low in high-income nations like South Korea, Japan, and the Netherlands. Spatial variations were correlated with country-level governance, pandemic preparedness, public trust, culture, social development, and demographic determinants. At the country level, vaccine acceptance sentiments expressed on Twitter(R) predicted higher vaccine coverage. We noted the declining trend of COVID-19 vaccine acceptance among global Twitter(R) users since March 2021, which was associated with increased searches for adverse vaccine events. Interpretation In future pandemics, new vaccines may face the potential low-level and declining trend in acceptance, like COVID-19 vaccines, and early responses are needed. Social media mining represents a promising surveillance approach to monitor vaccine acceptance and can be validated against real-world vaccine uptake data. FundingNational Natural Science Foundation of China.

Research progress of ferroptosis in the treatment of leukemia / 国际肿瘤学杂志

Leukemia is a group of hematologic malignancie. Ferroptosis is a novel of cell death caused by iron-dependent lipid peroxidation accumulation, which participates in the occurrence and development of leukemia. Activation of different regulatory sites in the ferroptosis pathway can promote the death of leukemia cells. Therefore, it can provide a new direction for the treatment of leukemia by inducing ferroptosis of cells.

Pure drug nano-assemblies: A facile carrier-free nanoplatform for efficient cancer therapy

Nanoparticulate drug delivery systems (Nano-DDSs) have emerged as possible solution to the obstacles of anticancer drug delivery. However, the clinical outcomes and translation are restricted by several drawbacks, such as low drug loading, premature drug leakage and carrier-related toxicity. Recently, pure drug nano-assemblies (PDNAs), fabricated by the self-assembly or co-assembly of pure drug molecules, have attracted considerable attention. Their facile and reproducible preparation technique helps to remove the bottleneck of nanomedicines including quality control, scale-up production and clinical translation. Acting as both carriers and cargos, the carrier-free PDNAs have an ultra-high or even 100% drug loading. In addition, combination therapies based on PDNAs could possibly address the most intractable problems in cancer treatment, such as tumor metastasis and drug resistance. In the present review, the latest development of PDNAs for cancer treatment is overviewed. First, PDNAs are classified according to the composition of drug molecules, and the assembly mechanisms are discussed. Furthermore, the co-delivery of PDNAs for combination therapies is summarized, with special focus on the improvement of therapeutic outcomes. Finally, future prospects and challenges of PDNAs for efficient cancer therapy are spotlighted.

Screening strategy on precision prevention strategies for three types of malignant tumors / 上海预防医学

Malignant tumors can be classified into three categories， rapidly progressing tumors， slowly progressing tumors， and "indolent" tumors. Rapidly progressing tumors （such as liver cancer， pancreatic cancer， and cholangiocarcinoma） have acute onset， shorter time duration from onset to death， and poorer treatment effects， which warrants primary prevention. Slowly progressing tumors （such as lung cancer， colorectal cancer， breast cancer， and gastric cancer） have slow onset， clear precancerous lesions， longer time duration from onset to death， and better therapeutic effects， which is accordingly suitable for secondary prevention. “Indolent” tumors （such as prostate and thyroid cancer） do not affect the life expectancy and are suitable for tertiary prevention. Early screening of “indolent” tumors may lead to overtreatment. Furthermore， early screening of rapidly progressing tumors is difficult to identify early cancers， which results in low cost-effectiveness. In contrast， for slowly progressing tumors suitable for secondary prevention， early screening may have cost-effectiveness， though there might be over-diagnosis. It is crucial to adopt appropriate prevention and treatment strategies for diverse types of tumors. Currently， large-scale cohort studies and randomized controlled clinical trials with complete follow-up may accurately evaluate the effect of cancer prevention strategies. This review discusses the significance of screening in precision prevention of tumors based on the characteristics of tumor progression and patients’ prognosis.

Posterior circulation ischemic stroke: emergency diagnosis errors and improvement strategies / 国际脑血管病杂志

Posterior circulation ischemic stroke (PCIS) is caused by the infarction of the blood supply area of vertebrobasilar artery system, accounting for about 20% of all ischemic strokes. The clinical manifestations of PCIS are different and usually lack specificity. The commonly used pre-hospital stroke scale can not fully reflect signs and symptoms of PCIS, and even imaging examination is not easy to detect PCIS. As a result, it is difficult to correctly identify PCIS in the early stage in emergency settings, and the rates of misdiagnosis and missed diagnosis are significantly higher than those of the anterior circulation ischemic stroke. Early and correct identification of PCIS is of great significance to improve the prognosis of patients. By summarizing the relevant literature at home and abroad, this article discusses the diagnostic error factors of PCIS in emergency room from different angles, and summarizes the strategies and methods to improve the speed and accuracy of PCIS recognition and early management.

Monitoring global trends in Covid-19 vaccination intention and confidence: a social media-based deep learning study

BackgroundThis study developed deep learning models to monitor global intention and confidence of Covid-19 vaccination in real time. MethodsWe collected 6.73 million English tweets regarding Covid-19 vaccination globally from January 2020 to February 2021. Fine-tuned Transformer-based deep learning models were used to classify tweets in real time as they relate to Covid-19 vaccination intention and confidence. Temporal and spatial trends were performed to map the global prevalence of Covid-19 vaccination intention and confidence, and public engagement on social media was analyzed. FindingsGlobally, the proportion of tweets indicating intent to accept Covid-19 vaccination declined from 64.49% on March to 39.54% on September 2020, and then began to recover, reaching 52.56% in early 2021. This recovery in vaccine acceptance was largely driven by the US and European region, whereas other regions experienced the declining trends in 2020. Intent to accept and confidence of Covid-19 vaccination were relatively high in South-East Asia, Eastern Mediterranean, and Western Pacific regions, but low in American, European, and African regions. 12.71% tweets expressed misinformation or rumors in South Korea, 14.04% expressed distrust in government in the US, and 16.16% expressed Covid-19 vaccine being unsafe in Greece, ranking first globally. Negative tweets, especially misinformation or rumors, were more engaged by twitters with fewer followers than positive tweets. InterpretationThis global real-time surveillance study highlights the importance of deep learning based social media monitoring to detect emerging trends of Covid-19 vaccination intention and confidence to inform timely interventions. FundingNational Natural Science Foundation of China. Research in contextO_ST_ABSEvidence before this studyC_ST_ABSWith COVID-19 vaccine rollout, each country should investigate its vaccination intention in local contexts to ensure massive vaccination. We searched PubMed for all articles/preprints until April 9, 2021 with the keywords "("Covid-19 vaccines"[Mesh] OR Covid-19 vaccin*[TI]) AND (confidence[TI] OR hesitancy[TI] OR acceptance[TI] OR intention[TI])". We identified more than 100 studies, most of which are country-level cross-sectional surveys, and the largest global survey of Covid-19 vaccine acceptance only covered 32 countries to date. However, how Covid-19 vaccination intention changes over time remain unknown, and many countries are not covered in previous surveys yet. A few studies assessed public sentiments towards Covid-19 vaccination using social media data, but only targeting limited geographical areas. There is a lack of real-time surveillance, and no study to date has globally monitored Covid-19 vaccination intention in real time. Added value of this studyTo our knowledge, this is the largest global monitoring study of Covid-19 vaccination intention and confidence with social media data in over 100 countries from the beginning of the pandemic to February 2021. This study developed deep learning models by fine-tuning a Bidirectional Encoder Representation from Transformer (BERT)-based model with 8000 manually-classified tweets, which can be used to monitor Covid-19 vaccination beliefs using social media data in real time. It achieves temporal and spatial analyses of the evolving beliefs to Covid-19 vaccines across the world, and also an insight for many countries not yet covered in previous surveys. This study highlights that the intention to accept Covid-19 vaccination have experienced a declining trend since the beginning of the pandemic in all world regions, with some regions recovering recently, though not to their original levels. This recovery was largely driven by the US and European region (EUR), whereas other regions experienced the declining trends in 2020. Intention to accept and confidence of Covid-19 vaccination were relatively high in South-East Asia region (SEAR), Eastern Mediterranean region (EMR), and Western Pacific region (WPR), but low in American region (AMR), EUR, and African region (AFR). Many AFR countries worried more about vaccine effectiveness, while EUR, AMR, and WPR concerned more about vaccine safety (the most concerns with 16.16% in Greece). Online misinformation or rumors were widespread in AMR, EUR, and South Korea (12.71%, ranks first globally), and distrust in government was more prevalent in AMR (14.04% in the US, ranks first globally). Our findings can be used as a reference point for survey data on a single country in the future, and inform timely and specific interventions for each country to address Covid-19 vaccine hesitancy. Implications of all the available evidenceThis global real-time surveillance study highlights the importance of deep learning based social media monitoring as a quick and effective method for detecting emerging trends of Covid-19 vaccination intention and confidence to inform timely interventions, especially in settings with limited sources and urgent timelines. Future research should build multilingual deep learning models and monitor Covid-19 vaccination intention and confidence in real time with data from multiple social media platforms.

The psychological status of 8817 hospital workers during COVID-19 Epidemic: A cross-sectional study in Chongqing.

BACKGROUND: There was an outbreak of COVID-19 towards the end of 2019 in China, which spread all over the world rapidly. The Chinese healthcare system is facing a big challenge where hospital workers are experiencing enormous psychological pressure. This study aimed to (1) investigate the psychological status of hospital workers and (2) provide references for psychological crisis intervention in the future. METHOD: An online survey was conducted to collect sociodemographic features, epidemic-related factors, results of PHQ-9, GAD-7, PHQ-15, suicidal and self-harm ideation (SSI), and the score of stress and support scales. Chi-square test, t-test, non-parametric, and logistic regression analysis were used to detect the risk factors to psychological effect and SSI. RESULTS: 8817 hospital workers participated in this online survey. The prevalence of depression, anxiety, somatic symptoms, and SSI were 30.2%, 20.7%, 46.2%, and 6.5%, respectively. Logistic regression analysis showed that female, single, Tujia minority, educational background of junior or below, designated or county hospital, need for psychological assistance before or during the epidemic, unconfident about defeating COVID-19, ignorance about the epidemic, willingness of attending parties, and poor self-rated health condition were independent factors associated with high-level depression, somatic symptom, and SSI among hospital workers (P<0.05). LIMITATIONS: This cross-sectional study cannot reveal the causality, and voluntary participation could be prone to selection bias. A modified epidemic-related stress and support scale without standardization was used. The number of hospital workers in each hospital was unavailable. CONCLUSION: There were a high level of psychological impact and SSI among hospital workers, which needed to be addressed. County hospital workers were more severe and easier to be neglected. More studies on cognitive and behavioral subsequence after a public health disaster among hospital workers are needed.

Assessment of public attention, risk perception, emotional and behavioural responses to the COVID-19 outbreak: social media surveillance in China

BackgroundUsing social media surveillance data, this study aimed to assess public attention, risk perception, emotion, and behavioural response to the COVID-19 outbreak in real time. MethodsWe collected data from most popular social medias: Sina Weibo, Baidu search engine, and Ali e-commerce marketplace, from 1 Dec 2019 to 15 Feb 2020. Weibo post counts and Baidu searches were used to generate indices assessing public attention. Public intention and actual adoption of recommended protection measures or panic buying triggered by rumours and misinformation were measured by Baidu and Ali indices. Qualitative Weibo posts were analysed by the Linguistic Inquiry and Word Count text analysis programme to assess public emotion responses to epidemiological events, governments announcements, and control measures. FindingsWe identified two missed windows of opportunity for early epidemic control of the COVID-19 outbreak, one in Dec 2019 and the other between 31 Dec and 19 Jan, when public attention was very low despite the emerging outbreak. Delayed release of information ignited negative public emotions. The public responded quickly to government announcements and adopted recommended behaviours according to issued guidelines. We found rumours and misinformation regarding remedies and cures led to panic buying during the outbreak, and timely clarification of rumours effectively reduced irrational behaviour. InterpretationSocial media surveillance can enable timely assessments of public reaction to risk communication and epidemic control measures, and the immediate clarification of rumours. This should be fully incorporated into epidemic preparedness and response systems. FundingNational Natural Science Foundation of China.

The real experience of postoperative functional exercise in PICC patients: a qualitative research / 中国实用护理杂志

Objective@#To explore the real experience of functional exercise after PICC operation.@*Methods@#Phenomenological methods were used to conduct semi-structured interviews with 15 patients who had different functional exercises after PICC. Colaizzi phenomenological analysis was used to analyze the data.@*Results@#Through interviews, four themes were drawn: the exercise characteristics of different postoperative functional exercise, the benefits of postoperative functional exercise, the obstacles to postoperative functional exercise and the suggestions for education related to postoperative functional exercise.@*Conclusion@#The patients with PICC think that the postoperative functional exercise is safe and practical, but the recognition and compliance of the postoperative functional exercise are still limited. It is suggested that appropriate training should be carried out among medical staff, so as to rationally select the way of postoperative functional exercise, further promote the application of postoperative functional exercise, and improve the compliance and experience of patients.

Investigation on the acceptance of a mobile nursing application of clinical nurses and analysis of influencing factors / 中国实用护理杂志

Objective:To investigate the status quo of a mobile nursing application acceptance of nurses, and analyze the influencing factors, so as to promote the application of a mobile nursing APP in clinic.Methods:On the principle of convenience sampling, 1207 participants from Shandong province were recruited to complete the self-designed questionnaire, including demographic data, smartphone use behavior and acceptance evaluation of the mobile nursing APP.Results:Average score of nurses' acceptance of a mobile nursing APP was 4.16±0.69. Multiple regression results showed that duty, use experience, recognition, smartphone self-efficacy and daily use time were the main factors affecting the acceptance of a mobile nursing APP for nurses ( t value was -7.132-22.678, P<0.05 or 0.01) and explained 39.1% of the total variation of the acceptance of mobile nursing app ( P<0.01). Conclusions:The acceptability of mobile nursing APP of clinical nurses is at a medium and high level, and it is influenced by the use experience, smartphone self-efficacy and other aspects, suggesting that nursing managers attach importance to the behavioral differences of nurses in using a mobile nursing APP.

The real experience of postoperative functional exercise in PICC patients: a qualitative research / 中国实用护理杂志

Objective:To explore the real experience of functional exercise after PICC operation.Methods:Phenomenological methods were used to conduct semi-structured interviews with 15 patients who had different functional exercises after PICC. Colaizzi phenomenological analysis was used to analyze the data.Results:Through interviews, four themes were drawn: the exercise characteristics of different postoperative functional exercise, the benefits of postoperative functional exercise, the obstacles to postoperative functional exercise and the suggestions for education related to postoperative functional exercise.Conclusion:The patients with PICC think that the postoperative functional exercise is safe and practical, but the recognition and compliance of the postoperative functional exercise are still limited. It is suggested that appropriate training should be carried out among medical staff, so as to rationally select the way of postoperative functional exercise, further promote the application of postoperative functional exercise, and improve the compliance and experience of patients.

Impact of socioeconomic status on healthy sports behaviors among minority college students / 中国学校卫生

Objective@#To explore the impact of socioeconomic status on minority college students’ healthy sports behaviors, and to provide guidance for improving physical fitness among minority college students.@*Methods@#Binary Logistic regression and path analysis were used to analyze the path and effect of socioeconomic status on minority college students’ healthy sports behaviors, controlled for health status, academic pressure, sports attitude, sports venues, sports skills and health knowledge.@*Results@#Socioeconomic status was positively associated with students’ healthy sports behaviors (OR>1). With the potential variables controlled, the odds of participating in healthy sports activity among urban students, sophomores and female students was 2.10, 2.60 and 0.59 times higher than that of rural students, freshman and male students. Path analysis showed that the direct effect of socio-economic status on minority college students’ healthy sports behavior was 0.07, the indirect effect was 0.16, and the total effect was 0.23.@*Conclusion@#Socioeconomic status shows direct and indirect effect on healthy sports behaviors among college students, with the indirect effect being larger than direct effect. Apart from socioeconomic status, physical fitness education, as well as creating and maintaining a good physical exercise environment by schools and society should be encouraged to facilitate college students establishing healthy sports behaviors.

A survey of the status of care quality evaluation in the institution that integrating pension and health care service:a qualitative research / 中国实用护理杂志

Objective@#To explore the status of care quality evaluation in the built-in type institution that integrating pension and health care service and analyze the focus on nursing service and management,it aims to provide theoretical basis for nurse managers to implement scientific nursing management.@*Methods@#Descriptive phenomenological methodology was adopted in this study,a semi-structured interview was conducted with 8 nurse managers from 7 built-in type institutions that integrating pension and health care service.Data were analyzed based on Colaizzi′ s phenomenological research method.@*Results@#Two themes were extracted, including the status of care quality evaluation in the built-in type institution that integrating pension and health care service; key indicators of nursing quality in the built-in type institution that integrating pension and health care service.@*Conclusions@#Through in-depth interviews with 8 nurse managers, we suggest that state should attach importance to the quality inspection of nursing care in the built-in type institution that integrating pension and health care service, and explore the evaluation criteria for nursing quality,in order to ensure the safety of elderly care, and it also can provide a basis for the comparison between inter-agency nursing quality and promote healthy competition among institutions.

The user experience of patients with PICC catheter for PICC maintenance network: a qualitative research / 中国实用护理杂志

Objective To explore the real user experiences of patients with PICC catheter for PICC maintenance network in Shandong province.Methods Descriptive phenomenological methodology was adopted in this study.A semi-structured interview was conducted with 18 patients of PICC-line maintained in different hospitals from PICC maintenance network in Shandong province.We analysed the data by Colaizzi's phenomenological research method.Results The experiences of patients with PICC catheter for PICC maintenance network in Shandong province contain positive and negative aspects.The positive aspects were convenient medical treatment,cooperation in various level hospitals,progress of basic hospitals,and enthusiastic services;the negative aspects were personnel shortage,different levels of nurses and imperfect supporting system.Conclusions Patients with PICC maintenance network possessed positive experience,but the accessibility of PICC maintenance network should be further enhanced,specialized development should be promoted.Meanwhile,for the questions proposed by patients,some measures should be taken to improve the overall PICC maintenance service from various level hospitals in Shandong province and make the experience of patients better.These measures include strengthening the standardized training and quality control of PICC,improving the supporting system,and promoting the implementation of continuous nursing mode in the primary hospitals.

The work experiences in nursing homes among nurses:a qualitative research / 中国实用护理杂志

Objective To explore the work experiences in nursing homes among nurses and to provide the referenced basis for managers to understand the needs of nurses and develop humanistic nursing management measures. Methods Descriptive phenomenological methodology was adopted in this study,a semi-structured interview was conducted with 9 nurses working in nursing homes.Data were analyzed based on Colaizzi′s phenomenological research method. Results Four themes were extracted including:heavy work tasks;high psychological pressure;strong demand in training;emotional experience of work. Conclusions Through in-depth interviews with 9 nurses working in nursing homes,we suggest that in order to promote the professional development of geriatric nursing, managers should change and update the concept of geriatric nursing and attach importance on professional study of nurse, and take appropriate intervention measures to lighten nurses' work pressure and adjust their bad mood, so as to arouse the enthusiasm of nurses.Finally,we can achieve the goal of stabilizing the nursing personnel and improving the quality of care in the nursing homes.

Survey of construction of PICC nurses of Shandong province / 中国实用护理杂志

Objective To investigate the construction of PICC catheterization nurses in Shandong province. Methods A total of 235 hospitals were investigated from PICC maintenance network in Shandong province with self-designed questionnaire through internet survey. Results 179 hospitals established intravenous (IV) nurse team(76.17%). 86.92%(93/107) of the tertiary hospitals established Ⅳ nurse team, which was higher than 67.19% (86/128) of the secondary hospitals, the difference was statistically significant(χ2=12.50,P<0.01). There were 1335 trained and certificated nurses while 1382 nurses engaging in PICC catheterization, and there were more PICC catheterization nurses in tertiary hospitals than secondary hospitals, the difference was statistically significant(t=7.23,P<0.01). 22.98%(54/235) of the hospitals had more PICC catheterization nurses than trained and certificated nurses, 11.49%(27/235) of the hospitals had more trained and certificated nurses than PICC catheterization nurses. 7.81%(108/1382) of the PICC catheterization nurses worked full-time and 31.91%(441/1382) had a manager position. 51.06% (120/235) of the hospitals had set up clear selection criteria for PICC catheterization nurses, mainly focusing on education background, professional tittle and (or) work experience. Organization in PICC training was diversified, giving priority to nursing association in provinceand nursing association in city. PICC catheterization nurses in only 20.43% (48/235) of the hospitals would accept training annually, 31.49%(74/235) of the hospitals would re-certificate PICC nurses. Conclusion PICC nurse team has been preliminarily established in Shandong province, but nursing staff deployment was unevenness, and primary hospitals should be further reinforced. The position role of PICC nurses should be further clarified. The selection criteria of PICC nurses should be further standardized. And the training space of PICC nurses should be further promoted.

Clinical Study on TanshinoneⅡA Sodium Sulfonate Injection in the Treatment of Acute Cerebral Infarction / 中国药房

OBJECTIVE:To investigate the effects of TanshinoneⅡA sodium sulfonate injection on levels of P-selectin,glial fi-brillary acidic protein (GFAP),vascular endothelial growth factor (VEGF) and neurological function in patients with acute cere-bral infarction. METHODS:A total of 114 patients with acute cerebral infarction selected from Lianyungang First People's Hospi-tal during Apr. 2013-Apr. 2016 were divided into control group and observation group according to random number table,with 57 cases in each group. Control group was given routine treatment. Observation group was additionally given Tanshinone ⅡA sodium sulfonate injection 40 mg 0.9％ sodium chlonride injection 250 mL,ivgtt,qd. A treatment course lasted for 7 d,and both received 2 courses of treatment. NIHSS scores,the levels of serum P-selectin,GFAP and VEGF were compared between 2 groups before treatment and after 7,14 d of treatment. The occurrence of ADR was also compared. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). Compared to before treatment,NIHSS score,the levels of se-rum P-selectin and GFAP in 2 groups were decreased significantly after 7,14 d of treatment,while the serum level of VEGF was increased significantly. These indexes of 2 groups after 14 d of treatment were significantly better than 7 d of treatment,except for NIHSS score. Above indexes of observation group was significantly better than those of control group during corresponding period, with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:For acute cerebral infarction, Tanshinone ⅡA sodium sulfonate injection can significantly reduce the levels of serum P-selectin and GFAP,improve VEGF level and promote the recovery of neurological damage with good safety.

Effects and mechanisms of hepatitis B virus X protein on invasion and migration of hepatocellular carcinoma cells / 中华消化外科杂志

Objective To explore the effects and mechanisms of hepatitis B virus-X protein (HBx) on invasion and migration of hepatocellular carcinoma (HCC) cells.Methods The retrospective cohort study was conducted.The clinicopathological data of 30 patients with liver tumor (20 with HCC and 10 with benign tumor of liver) who were admitted to the Affiliated Hospital of Xuzhou Medical College between July 2014 and July 2015 were collected.HCC tissues of 20 patients with HCC (with history of HBV infection) were collected by surgical resection and peritumoral normal tissues (outside of tumor capsule) of 10 patients with benign tumor of liver (without history of HBV infection) were collected.The expressions of epidermal growth factor receptor 3 (ErbB3)in HCC tissues and peritumoral normal tissues were detected by immunohistochemistry (IHC).The relative expressions of ErbB3 and HBx in HCC tissues and peritumoral normal tissues were detected by Western blot,and relative expressions of ErbB3 in HepG2 of which green fluorescent protein (GFP) and GFP-HBx were respectively transfected were detected.The relative expressions of ErbB3 mRNA in HepG2 transfected by GFP and GFP-HBx were detected by real-time polymerase chain reaction (RT-PCR).The migration and invasion of HepG2 were respectively detected by Transwell assay with and without matrix.The measurement data with normal distribution were represented as $± s.The comparisons between groups were evaluated with the independent-sample t test.Correlation analysis was done by the Pearson test.Results (1) The expressions of ErbB3 were detected by IHC:relative value of mean optical density (MOD) of ErbB3 in HCC tissues of 20 patients with HCC and peritumoral normal tissues of 10 patients with benign tumor of liver were 2.54± 1.33 and O.99±0.29,respectively,with a statistically significant difference (t =6.542,P ＜ 0.05).(2) The relative expressions of ErbB3 and HBx were detected by Western blot:relative expressions of ErbB3 and HBx were respectively 0.79±0.13,1.10±0.28 in HCC tissues of 10 patients with HCC and 1.07±0.17,0 in peritumoral normal tissues of 10 patients with benign tumor of liver,with statistically significant differences (t =3.229,19.486,P＜0.05).The results of Pearson test showed that there was a positive correlation of expression between ErbB3 and HBx in HCC tissues (r=O.637,P＜ 0.05).(3) The relative expressions and transcriptional levels of ErbB3 were detected by Western blot and RT-PCR:relative expressions of ErbB3 in HepG2 of which GFP and GFP-HBx were respectively transfected were O.75±0.11 and 1.10±0.10,respectively,with a statistically significant difference (t=4.291,P＜0.05).The relative expressions of ErbB3 mRNA in HepG2 of which GFP and GFP-HBx were respectively transfected were O.38±0.03 and O.94±0.07,respectively,with a statistically significant difference (t=11.703,P＜O.05).(4) The effects of ErbB3 on migration and invasion of HepG2:numbers of transmenbrane cell in HepG2 of which His and His-ErbB3 were respectively transfected by Transwell assay with matrix were respectively 271± 18 and 463± 31,respectively,with a statistically significant difference (t =8.202,P＜0.05).Numbers of transmenbrane cell in HepG2 of which His and His-ErbB3 were respectively transfected by Transwell assay without matrix were respectively 315±38 and 549±34,respectively,with a statistically significant difference (t =8.310,P＜0.05).Conclusion HBx protein can promote the invasion and migration of hepatocellular carcinoma cells through up-regulating expressions of ErbB3 protein.