Investigation on Nurses' Willingness to "Internet + Nursing Service" and Analysis of Influencing Factors.

Objective: To investigate the willingness of nurses in Yichang to participate in "Internet plus nursing services" and analyze the influencing factors in order to provide reference for the implementation of "Internet plus nursing services". Methods: Using the "Internet plus Nursing Service" questionnaire, a cross-sectional survey was conducted among 1447 nurses in Yichang by convenience sampling from July to September in 2022, and the related influencing factors were analyzed. The questionnaire was composed of two parts: the demographic characteristics and the questionnaire of nurses' willingness to participate in "Internet plus nursing service", including 4 dimensions: awareness, promoting factors, concern factors and training needs. Likert 5-point scoring method was used for scoring. Binary logistic regression was used to screen the variables, and the ROC curve and Nomogram risk prediction model were drawn. Results: A total of 1233 valid questionnaires were collected. It shows that 76.07% of nurses in Yichang are willing to participate in "Internet plus nursing services". Among them, education background, specialist nurses, awareness, promotion factors, concerns and training needs are the independent influencing factors (all P < 0.05). The area under the ROC curve (AUC) of the prediction model is 0.802, and the consistency index (c-index) of nomogram is 0.800. The average absolute error of internal calibration is 0.014, and the model has good accuracy and discrimination. Conclusion: Nurses in Yichang have a high willingness to participate in "Internet plus nursing services", a low awareness of the program and a high demand for relevant professional training. It is suggested that the government and hospitals should strengthen the publicity of "Internet plus nursing services", improve relevant laws and regulations and strengthen the construction of specialist nurses' team, so as to provide a good practice environment for nurses' door-to-door service.

Investigation of the Psychological disorders in the healthcare nurses during a coronavirus disease 2019 outbreak in China.

The first case of atypical pneumonia caused by coronavirus disease 2019 (COVID-19) was reported in Wuhan, China in December 2019. Since then, cases of novel coronavirus-infected pneumonia (NCIP) have been reported throughout China as well as in 25 other countries. With the rapid growth of this global outbreak, psychological disorders or impact among the healthcare nurses caused by the COVID-19 pandemic is of great importance and worth to be evaluated. Here, we aimed to determine the levels of stress and psychological disorders of nurses who provided nursing care during the COVID-19 outbreak. A total of 159 nurses who provided healthcare work for COVID-19 patients were enrolled in our study. The psychological disorders and stress level were assessed via a questionnaire implemented by the mobile app. The results showed that the nurses who worked in the non-critical care ward (general ward in which the invasive medical procedure such as mechanical ventilation is absent) scored significantly higher on the traumatization condition (P < .05) and stress level (P < .01) as well as the impact of event scale -revised level (P < .01) compared with those worked in the critical care ward. In contrast to the previous report, our findings revealed that the future intervention for preventing the mental crisis among the healthcare nurses needs to be focusing on the individuals in the non-critical care ward instead of those in the critical care ward under the spreading of COVID-19.

Transdifferentiation of type II alveolar epithelial cells induces reactivation of dormant tumor cells by enhancing TGF-ß1/SNAI2 signaling.

Dormant tumor cells (DTCs) serve a crucial role in the pathogenesis of metastasis and may compromise the efficacy of existing therapeutic modalities aimed at fully eradicating cancer. However, the mechanisms underlying the dormant-to-proliferating switch of DTCs remain largely unknown. The lung is one of the most common sites of metastatic recurrence. The transdifferentiation of alveolar epithelial cells II (AEC IIs) to AEC Is is a hallmark of alveolar epithelial stimulation. However, the role of AEC II transdifferentiation during the reactivation of DTCs has not been fully elucidated. In the present study, we found that tumor cells promoted the transdifferentiation of AEC IIs. Furthermore, the supernatant of the transdifferentiation of AEC IIs to AEC Is (Super-TDA) promoted the dormant-to-proliferating switch of DTCs via the autocrine effect of TGF-ß1 on the 3D BME culture system in vitro. Monensin and LY2109761 blocked the dormant-to-proliferating switch of DTCs induced by Super-TDA. Although lipopolysaccharide did not directly stimulate the reactivation of DTCs, it promoted DTC reactivation by increasing the secretion of TGF-ß1 in the Super-TDA. We further demonstrated that the upregulation of SNAI2 expression was required for Super-TDA facilitating the DTC dormant-to­proliferating switch. Taken together, our findings demonstrated that tumor cells may promote AEC II transdifferentiation. Furthermore, the transdifferentiation of AEC IIs may, in turn, induce the reactivation of 3D-established DTCs by promoting TGF-ß1/SNAI2 signaling. Targeting this process may provide novel therapeutic strategies for the inhibition of the dormant­to-proliferating switch.

[Myocardial toll like receptor 4 expression in a rat model of myocardial ischemia reperfusion injury].

OBJECTIVE: To explore the role of TLR4 in myocardial ischemia reperfusion injury (MI/RI) by observing the dynamic TLR4 expression changes at mRNA and protein levels early after myocardial ischemia reperfusion. METHODS: Male SD rats were randomly divided into Sham and IR group and the rats were killed according to different reperfusion time (0, 0.5, 1, 2, 4 and 8 hours). Myocardial changes under light microscope and transmission electronic microscope were observed. TLR4 expressions at protein and mRNA levels were detected by immunohistochemistry and realtime RT-PCR respectively. Myocardial TNF-alpha was determined by ELISA. RESULTS: (1) Myocardial injury was observed in IR but not in Sham group and histopathological and ultrastructural changes in IR group remained unchanged up to 8 hours after reperfusion. (2) Positive TLR4 protein staining was visualized in both Sham and IR groups and significantly increased and peaked at 1 hour of reperfusion in IR group. (3) Compared to Sham group, TLR4 mRNA level was upregulated in myocardium in IR group and peaked at 1 hour of reperfusion. (4) Concentration of TNF-alpha in IR group was significantly higher than that of Sham group at corresponding time points (all P < 0.05), and myocardial TLR4 mRNA level correlated positively with myocardial TNF-alpha (r = 0.728, P < 0.01). CONCLUSION: Expression of TLR4 in myocardium during early after myocardial ischemia reperfusion was upregulated and actived TLR4 might play an important role in MI/RI through promoting myocardial TNF-alpha excretion.