ATP-sensitive potassium channel(KATP) consists of a 4.4 complex of an inwardly rectifying Kir6.x pore plus a sulfonylurea receptor,which is an ATP-binding cassette transporter.KATP has been indentified in a variety of tissues and recognized as an important drug target.It connects cell metabolism with cell electric activity.KATP has been proposed to play protective roles during heart failure,arrhythmia,myocardial infarction,stress,myocardial ischemia and hypertension.In this review,a summary of KATP is presented with molecular structure,localization,regulation,cardiovascular protective effect and its mechanisms.

Objective To evaluated the role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of thoracic tuberculosis.Methods The study was retrospective,from September 2009 to September 2012,38 patients who underwent EBUS-TBNA were finally diagnosed of thoracic tuberculosis,with enlarged hilar or mediastinal Iymph nodes on chest enhanced computed tomography(≥ 1.0 cm).Patients in whom EBUS TBNA was nondiagnostic subsequently underwent surgical biopsy.All the patients had a minimum of 6 months clinical and radiologic follow-up.Results EBUS-TBNA was performed on a total of 88 lymph node stations in 38 patients.Of the enlarged lymph nodes,60(68.18％) were located in the mediastinal region and the remaining 28 (31.82 ％) around the hilum or interlobar area.Of the 38 patients,EBUS-TBNA achieved definitive diagnosis in 34 patients(89.47％).EBUS was well tolerated by all of the patients with no complications.Conclusion EBUS-TBNA is a safe procedure with a high yield for the diagnoses of thoracic tuberculosis.

Objective To investigate the radiation dose levels to the adults examined from diagnostic exposure in Beijing. Methods The radiation doses to the examined individuals were measured by using individual diagnostic radiology equipments in 30 random hospitals from a total of 10 districts and suburban areas, including 1 182 samples of X-ray photography,542 samples of mammography and 410 samples of CT examination. Results 2 134 samples were measured in this study. The dose ranges of X-ray photography, CR, and DR were 0?4 -24?1, 0?3 -13?9 and 0?1 -15?9 mGy, respectively. The average dose range of glandular breast was 0?3-5?4 mGy. In 410 CT samples the value of CTDIw , CTDIvol and DLP were 28?1 - 96?3 mGy, 7?0 - 23?4 mGy, and 162?2 - 898?1 mGy·cm, respectively. Conclusions Several dose levels from diagnostic examination were higher than guidance level for medical exposure in GB 18871-2002,which should be noted.

ObjectiveTo analyze the main types of the leadership in the charge nurses in ClassⅢ general hospitals by the potential category model, so as to explore the management training needs for the different types of charge nurses. MethodsBy cluster random sampling, charge nurses from 11 ClassⅢgeneral hospitals in Zhejiang province were selected from October to December of 2017 and studied by General Information Questionnaire, Leadership Questionnaire, and Training Needs Questionnaire. By Mplus 7.0 software, the potential category model of charge nurses＇ leadership was analyzed and all categories of charge nurses＇ training needs were analyzed by SPSS 19.0 software. Totally 782 questionnaires were collected with 736 valid ones left after omitting the invalid ones, yielding an effective recovery rate of 94.12%. ResultsPotential category model analysis showed that in the 736 charge nurses, 3 leadership categories of high level of leadership, medium level of leadership and low level of leadership accounted for 12.64%,55.84% and 31.52% respectively. The charge nurses had high demands on management position training, with each clauses exceeding 3.50 points, there were statistical differences in the 3 potential leadership categories of charge nurses＇training demands as well as scores from each clauses(P＜ 0.05). There were no statistical difference between each categories in terms of the training needs of "nursing quality management","hospital infection management""occupational protection" "computer application skills" "human resource management" and "scheduling as well as basic qualify and abilities" (P＞0.05). ConclusionsThere are 3 types of leadership in the charge nurses of the Class Ⅲ general hospitals. The clauses with high demands among the nurses with low level of leadership include "nursing quality management" "nursing safety management"; the clauses with high demands among the nurses with medium level of leadership include "staff stimulation and talent cultivation" "nursing safety management"; the clauses with high demands among the nurses with high level of leadership include "strategic management setup" "leadership improvement", etc.

Objective? To explore the effect of staged group positive psychological intervention on resilience and professional identity of "post-90s"nursing students during internship. Methods? A convenience sampling method was adopted. Nursing students of 2017 were selected as a control group (n=151) and nursing students of 2018 were selected as an intervention group (n=137). Nursing students in control group were given a conventional teaching method, while the psychological counseling team used staged group positive psychological interventions on nursing students in intervention group. Connor-Davidson Resilience Scale(CD-RISC) and Professional Identify Scale were used to evaluate the effect of intervention. Results? The CD-RISC score and Professional Identify Scale score of intervention group were (89.58±21.37)and (5.48±0.29), both higher than those of control group(t=2.253,5.725;P＜ 0.05). Conclusions? The staged group positive psychological intervention has positive effect on the psychological resilience and professional identity of the "post-90s" nursing students during internship, which provides a reference for further maintenance of the mental health of nursing students and stabilization of the nursing team.

The existing doctor-patient communication pattern often falls prey to insufficient informed consent and even medical disputes. In the patient centered perspective, Zhejiang Provincial People′s Hospital explored a new communication mode centering on patients. Based on diagnosis-related groups catalogues and high-frequency surgeries catalogues of the departments, multimedia technology was called into play to produce dubbed PPTs and videos that were easy to understand, standardized and homogeneous, which were embedded into medical records system. Following observation of the PPT or video, patients could directly sign an informed consent on the computer. This practice not only deepens patient′s understanding and achieves homogeneous level of the communication, but also elevates doctor′s work efficiency, contributing to building a harmonious doctor-patient relationship.

The construction of safe hospital is the foundation of high-quality development of the hospital, and innovation provides power for the construction of safe hospital from the perspective of high-quality development. Taking Zhejiang Provincial People′s Hospital as an example, the authors introduced the innovation construction path of safe hospital in detail, and put forward the construction strategy of safe hospital with " two hearts" (patient-centered, employee-centered)and " four wings" (multimedia doctor-patient communication, Wulin aunt medical studio, integrated operation safety inspection, third-party medical liability insurance). Through the combination of basic safety management and innovative practice, the hospital vigorously promoted the culture of " two hearts" , and established an efficient collaborative information management system, so as to form replicable and promotable practical experience and promote the development of safe hospital.

Objective:To monitor and analyze the activity concentrations of 7Be and 210Pb in atmospheric aerosol in Beijing from 2017 to 2020. Methods:Totally 1 074 atmospheric aerosol samples were collected by high flow air sampler (SnowWhite) including 275 in spring, 266 in summer, 262 in autumn and 271 in winter and subjected to analysis by low background high-purity germanium gamma-ray spectrometery (ORTEC) to determine the activity concentrations of 7Be and 210Pb. Results:The activity concentrations of 7Be in atmospheric aerosol were from 0.56 to 14.84 mBq/m 3, with an avearage of 6.84 mBq/m 3, and from 0.01 to 9.37 mBq/m 3 for 210Pb, with an avearage 3.19 mBq/m 3. The differences in activity concentrations of 7Be and 210Pb in atmospheric aerosol among differernt seasons were statistically significant ( F=32.66, 93.93, P<0.05). Activity concentration of 7Be was highest in spring, followed by autumn, and lowest in summer and winter. Activity concentration of 210Pb ranged from winter, autumn, spring to summer in descending order. Conclusions:The activity concentrations of 7Be and 210Pb in atmospheric aerosol in Beijing from 2017 to 2020 fluctated within the range of normal level.

The 8th Japan-China Hepato-Pancreato-Biliary Symposium was held in Tokyo,Japan from 22nd to 23rd November 2018.The meeting was convened coincidently with the 80th Annual Congress of Japanese Surgical Association,which attracted the participation of Chinese and Japanese hepatobiliary and pancreatic surgeons.The symposium aimed to explore the latest achievements and clinical issues of diagnosis and treatment for hepato-pancreato-biliary diseases.In this article,authors reviewed the up-to-date research information in order to share the experience,achievements and new information in the field of hepatobiliary and pancreatic diseases with colleagues.

Background ¹³⁷Cs in atmospheric aerosol is the product of past nuclear weapon tests and nuclear accidents. When ¹³⁷Cs is released into the atmosphere, it will deposit in dry land and marine environment, causing pollution of soil surface, water, agricultural products, and animal byproducts, and affecting public health. Objective To identify the variation pattern of ¹³⁷Cs activity concentration in aerosol and its correlation with dust concentration in Beijing area from 2017 to 2020. Methods A total of 958 aerosol samples were collected from November 1, 2017 to June 30, 2020 in Beijing with a high volume air sampler at a sampling flow rate about 600 m³·h⁻¹ and a collection time for each sample about 24 h. The activity concentration of ¹³⁷Cs in the aerosol samples was determined with a low-background high-purity germanium γ spectrometer. The dust concentration was calculated using the difference in the mass of the aerosol filter before and after sampling. The detection rate of ¹³⁷Cs and dust concentration in different seasons were compared. Spearman rank correlation test was used to analyze the correlation between ¹³⁷Cs activity concentration and dust concentration. Results From 2017 to 2020, the ¹³⁷Cs activity concentrations of 33 from 958 aerosol samples in Beijing were above the minimum detectable activityconcentration, the overall detection rate of ¹³⁷Cs was 3.4%, and the activity concentration ranged from 1.86 to 45.53 μBq·m⁻³, with a median value of 4.85 μBq·m⁻³. The detection rate of ¹³⁷Cs was highest in spring, followed by autumn, and lowest in winter and summer (8.4%, 3.0%, 1.1%, and 0.5%, respectively). The dust concentration ranged from 0.03 to 1.55 mg·m⁻³, with an average value of 0.18 mg·m⁻³. There was a statistically significant difference in the dust concentrations in spring, summer, autumn, and winter (F=45.51, P<0.05), and the highest value was 0.24 mg·m⁻³ in spring (P<0.05). The ¹³⁷Cs activity concentration was positively correlated with the dust concentration (P<0.05). Conclusion The ¹³⁷Cs activity concentration in aerosol in Beijing from 2017 to 2020 fluctuates within the range of background level, and its activity concentration is highest in spring, followed autumn, and lowest in summer and winter.