Objective To systematically analyze the spatiotemporal distribution characteristics and epidemiological trends of tracheal, bronchus, and lung cancer (TBL) disease burden attributed to air pollution globally and in China and the United States from 1990 to 2021, and to assess the patterns of disease burden changes from 2022 to 2031 based on predictive models, providing a scientific basis for formulating targeted TBL prevention and control strategies. Methods Based on the Global Burden of Disease (GBD) 2021 database, we analyzed the disease burden data of TBL attributed to air pollution globally and in China and the United States from 1990 to 2021. R Studio 4.3.2 software was used to analyze the corresponding trends and the Bayesian age-period-cohort (BAPC) prediction model was used to predict the status of the disease burden of TBL attributed to air pollution in the world and in China and the United States from 2022 to 2031. Results In 2021, China had the highest number of deaths and disability-adjusted life years attributed to air pollution (211 400 patients and 4.8947 million person-years), followed by the United States (6 000 patients and 124 300 person-years). The age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate (ASDR) of TBL due to air pollution in the world and in China and the United States showed a decreasing trend. From 1990 to 2021, the ASMR and ASDR of TBL in China due to air pollution were much higher than those in the United States and the global average. In terms of gender, from 1990 to 2021, the disease burden of male patients with TBL attributed to air pollution was much higher than that of female patients. The BAPC prediction model showed that from 2022 to 2031, the ASMR and ASDR of TBL attributed to air pollution showed an upward trend globally, while they showed a downward trend in China and the United States. Conclusion Over the past 30 years, the air pollution-related TBL disease burden in the world and in China and the United States has continued to decline, but China's disease burden is still significantly higher than the global average. The disease burden in men far exceeds that in women, with men and the population aged ≥50 years being high-risk groups. In the future, the global disease trend may reverse and rise, while China and the United States are expected to continuously decline. However, precise prevention and control for high-risk groups remains a key challenge.

Objective:To integrate and analyze the trend of the disease burden of tracheal,bronchus,and lung cancer(TBL)attributable to secondhand smoke in China from 1990 to 2021 and to analyze future projections,aiming to provide data support for the prevention and treatment of TBL in China.Methods:Based on the global burden of disease(GBD)2021 database,TBL with ICD-10 disease classification C33,C34-C34.92 was studied.Using secondhand smoke as a risk factor,the data on TBL mortality and disability-adjusted life year(DALY)due to secondhand smoke in China from 1990 to 2021 were further age-standardized.Using Joinpoint 4.7.1 regression analysis model to calculate annual percentage change(APC)and average annual percentage change(AAPC),Hiplot software was used to plot disease burden data for different ages and genders,and R 4.3.1 software was used to construct a grey model GM(1,1)to predict the predicted value and trend of TBL disease burden attributed to secondhand smoke in China from 2022 to 2031.Results:From 1990 to 2021,the TBL mortality rate,age-standardized mortality rate,and DALY rate attributed to secondhand smoke in China increased from 1.76/100 000,2.63/100 000,and 49.43/100 000 to 4.08/100 000,2.80/100 000,and 95.57/100 000,respectively;the growth was 131.18%,6.45%,and 93.34%;the age-standardized DALY rate decreased from 65.04/100 000 to 63.32/100 000 with the reduction of 2.65%.The results of the Joinpoint regres-sion showed that the AAPC(95%CI)of mortality,age-standardized mortality rate,and DALY rate for TBL were 2.75(2.58-2.93)%,0.16(0.11-0.21)%,and 2.15(2.11-2.18)%,respectively,with an overall increasing trend;the AAPC(95%CI)of age-standardized DALY rate was-0.14(-0.40-0.12)%,with an overall fluctuating and unchanged trend and it was higher in males than in females.In both 1990 and 2021,the TBL mortality rate attributable to secondhand smoke in China gradually increased with age,and the DALY rate first increased and then slowed down with age.The main groups of the burden of disease were the elderly and males.The grey prediction model GM(1,1)showed that the age-standardized mortality rate of TBL attributable to secondhand smoke from 2022 to 2031 showed a slow increasing trend,and the predicted value in 2031 would increase to 2.95/100 000.The age-standardized DALY showed a slow decreasing trend,and the predicted value in 2031 would decrease to 63.83/100 000.Conclusions:From 1990 to 2021,the TBL mortality,age-standardized mortality,and DALY rates attributable to secondhand smoke in China increased,and the age-standardized DALY rate decreased.Men and the elderly are the main groups affected by TBL.Appropriate measures should be formulated to reduce exposure to and contact with secondhand smoke,tak-ing into account gender and age differences.Additionally,efforts should be made to strengthen secondhand smoke prevention and public health education.

Objective:To integrate and analyze the trend of the disease burden of tracheal,bronchus,and lung cancer(TBL)attributable to secondhand smoke in China from 1990 to 2021 and to analyze future projections,aiming to provide data support for the prevention and treatment of TBL in China.Methods:Based on the global burden of disease(GBD)2021 database,TBL with ICD-10 disease classification C33,C34-C34.92 was studied.Using secondhand smoke as a risk factor,the data on TBL mortality and disability-adjusted life year(DALY)due to secondhand smoke in China from 1990 to 2021 were further age-standardized.Using Joinpoint 4.7.1 regression analysis model to calculate annual percentage change(APC)and average annual percentage change(AAPC),Hiplot software was used to plot disease burden data for different ages and genders,and R 4.3.1 software was used to construct a grey model GM(1,1)to predict the predicted value and trend of TBL disease burden attributed to secondhand smoke in China from 2022 to 2031.Results:From 1990 to 2021,the TBL mortality rate,age-standardized mortality rate,and DALY rate attributed to secondhand smoke in China increased from 1.76/100 000,2.63/100 000,and 49.43/100 000 to 4.08/100 000,2.80/100 000,and 95.57/100 000,respectively;the growth was 131.18%,6.45%,and 93.34%;the age-standardized DALY rate decreased from 65.04/100 000 to 63.32/100 000 with the reduction of 2.65%.The results of the Joinpoint regres-sion showed that the AAPC(95%CI)of mortality,age-standardized mortality rate,and DALY rate for TBL were 2.75(2.58-2.93)%,0.16(0.11-0.21)%,and 2.15(2.11-2.18)%,respectively,with an overall increasing trend;the AAPC(95%CI)of age-standardized DALY rate was-0.14(-0.40-0.12)%,with an overall fluctuating and unchanged trend and it was higher in males than in females.In both 1990 and 2021,the TBL mortality rate attributable to secondhand smoke in China gradually increased with age,and the DALY rate first increased and then slowed down with age.The main groups of the burden of disease were the elderly and males.The grey prediction model GM(1,1)showed that the age-standardized mortality rate of TBL attributable to secondhand smoke from 2022 to 2031 showed a slow increasing trend,and the predicted value in 2031 would increase to 2.95/100 000.The age-standardized DALY showed a slow decreasing trend,and the predicted value in 2031 would decrease to 63.83/100 000.Conclusions:From 1990 to 2021,the TBL mortality,age-standardized mortality,and DALY rates attributable to secondhand smoke in China increased,and the age-standardized DALY rate decreased.Men and the elderly are the main groups affected by TBL.Appropriate measures should be formulated to reduce exposure to and contact with secondhand smoke,tak-ing into account gender and age differences.Additionally,efforts should be made to strengthen secondhand smoke prevention and public health education.

Metabolic-associated fatty liver disease (MAFLD), which is previously known as non-alcoholic fatty liver disease (NAFLD), represents a major health concern worldwide with limited therapy. Here, we provide evidence that ferroptosis, a novel form of regulated cell death characterized by iron-driven lipid peroxidation, was comprehensively activated in liver tissues from MAFLD patients. The canonical-GPX4 (cGPX4), which is the most important negative controller of ferroptosis, is downregulated at protein but not mRNA level. Interestingly, a non-canonical GPX4 transcript-variant is induced (inducible-GPX4, iGPX4) in MAFLD condition. The high fat-fructose/sucrose diet (HFFD) and methionine/choline-deficient diet (MCD)-induced MAFLD pathologies, including hepatocellular ballooning, steatohepatitis and fibrosis, were attenuated and aggravated, respectively, in cGPX4-and iGPX4-knockin mice. cGPX4 and iGPX4 isoforms also displayed opposing effects on oxidative stress and ferroptosis in hepatocytes. Knockdown of iGPX4 by siRNA alleviated lipid stress, ferroptosis and cell injury. Mechanistically, the triggered iGPX4 interacts with cGPX4 to facilitate the transformation of cGPX4 from enzymatic-active monomer to enzymatic-inactive oligomers upon lipid stress, and thus promotes ferroptosis. Co-immunoprecipitation and nano LC-MS/MS analyses confirmed the interaction between iGPX4 and cGPX4. Our results reveal a detrimental role of non-canonical GPX4 isoform in ferroptosis, and indicate selectively targeting iGPX4 may be a promising therapeutic strategy for MAFLD.

Objective? To develop the Operating Room Professional Nurses Core Competency Evaluation Scale so as to provide an evaluation criterion for career planning and promotion evaluation of operating room nurses. Methods? From January 2017 to March 2017, we built item pool of the scale by literature study and consulted 5 experts to form the questionnaire. From April 2017 to October 2017, we selected 443 operating room nurses attending 2017 National Operating Room Nursing Annual Meeting by convenient cluster sampling. The reliability and validity test were carried out for the original questionnaire. Items of the questionnaire were adjusted based on results to the final edition of operating room professional nurses core competency evaluation scale. Results? The final edition of the scale included 5 dimensions and 45 items involving professional development ability (12 items), professional cooperation ability (12 items), professional management ability (10 items), perioperative assessment ability (6 items) and basic professional ability (5 items). The KMO of the questionnaire was 0.975. The Cronbach's α of the scale was 0.983 and Cronbach's α of the dimensions was 0.848-0.973. Conclusions? The scale has good reliability and validity. Its content can provide a reference object for career planning of operating room nurses and an evaluation criterion for promotion evaluation of operating room nurses. The quantization of evaluation results can be a basis for operating room personnel training.

Objective To investigate the effects of hyperbaric oxygen (HBO) on the osteogenic differentiation of adipose-derived stem cells.Methods Adipose-derived stem cells were isolated,cultured and passed to next generations.The fourth adipose-derived stem cells were collected and seeded to the 96-well plates (2 × 105 cells/well) for culture in osteogenic induction medium,and were randomly divided into the control group and the hyperbaric oxygen (HBO) group.In the entire experiment,the control group was only kept in the 5％ CO2 incubator at a temperature of 37 ℃,while the HBO group was treated with HBO for 24 hours a day at the same culture conditions as the control group.(The HBO treatment cells were placed in the HBO chamber,which was washed with pure oxygen at a ventilation rate of 10 L/min for 15min.When oxygen flow rate was down-regulated to 2-3 L/min,the chamber was compressed for 20-25 min to a pressure of 2.5 ATA,which was maintained for 60 minutes.Then,uniform decompression was implemented for 20-25 minutes.At days 7,14 and 21,alkaline phosphatase activity of the cells was detected by alkaline phosphatase kit.At days14 and 21,osteocalcin concentration was detected by using the osteocalcin quantitative test kit,and at day 21,the calcified nodules were stained with Alizarin red.The data obtained were analyzed by 2 independent samples t test,paired sample t test and repeated test ANOVA.Results The cultured cells could express such mesenchymal stem cell markers as CD90 and CD105,but could not express hematopoietic markers such as CD34.After 7,14 and 21 days of culture,the activity of alkaline phosphatase in the HBO group was significantly increased,as compared with that of the control group A (P ＜ 0.01).Following culture for 14 and 21 days,the expression level of osteocalcin in the HBO group was significantly elevated,as compared with that of the control group (P ＜ 0.05).At day 21,the detection results by alizarin red staining showed that the number of calcified nodules for the HBO group was increased markedly as compared with that of the control group,and the calcified size became larger.Conclusions Treatment of HBO could increase osteogenic differentiation of adipose-derived stem cells.

Objective To investigate the effects of hyperbaric oxygen (HBO) on the osteogenic differentiation of adipose-derived stem cells.Methods Adipose-derived stem cells were isolated,cultured and passed to next generations.The fourth adipose-derived stem cells were collected and seeded to the 96-well plates (2 × 105 cells/well) for culture in osteogenic induction medium,and were randomly divided into the control group and the hyperbaric oxygen (HBO) group.In the entire experiment,the control group was only kept in the 5％ CO2 incubator at a temperature of 37 ℃,while the HBO group was treated with HBO for 24 hours a day at the same culture conditions as the control group.(The HBO treatment cells were placed in the HBO chamber,which was washed with pure oxygen at a ventilation rate of 10 L/min for 15min.When oxygen flow rate was down-regulated to 2-3 L/min,the chamber was compressed for 20-25 min to a pressure of 2.5 ATA,which was maintained for 60 minutes.Then,uniform decompression was implemented for 20-25 minutes.At days 7,14 and 21,alkaline phosphatase activity of the cells was detected by alkaline phosphatase kit.At days14 and 21,osteocalcin concentration was detected by using the osteocalcin quantitative test kit,and at day 21,the calcified nodules were stained with Alizarin red.The data obtained were analyzed by 2 independent samples t test,paired sample t test and repeated test ANOVA.Results The cultured cells could express such mesenchymal stem cell markers as CD90 and CD105,but could not express hematopoietic markers such as CD34.After 7,14 and 21 days of culture,the activity of alkaline phosphatase in the HBO group was significantly increased,as compared with that of the control group A (P ＜ 0.01).Following culture for 14 and 21 days,the expression level of osteocalcin in the HBO group was significantly elevated,as compared with that of the control group (P ＜ 0.05).At day 21,the detection results by alizarin red staining showed that the number of calcified nodules for the HBO group was increased markedly as compared with that of the control group,and the calcified size became larger.Conclusions Treatment of HBO could increase osteogenic differentiation of adipose-derived stem cells.

Objective To observe clinical efficacy of laparoscopy combined with gonadotropin-releasing hormone agonist (GnRH-a ) in the treatment of endometriosis (EMs).Methods 158 patients who underwent laparoscopic surgery and were diagnosed endometriosis in our hospital during Sep.2010 to Dec.2010 were chosen and divided into three groups:control group were treated with pure laparoscopic surgery,group A were treated with laparoscopic surgery and follow-up GnRH-a medication,and group B were treated with laparoscopic surgery,follow-up GnTH-a medication and add-back therapy.The total effective rates,recurrence rates,the changes of hormone levels before and after the treatment and adverse reaction rates after treatment were compared and analyzed to evaluate the efficacy of different treatments.Results The total effective rates of group A and group B (84.6%,86.2%) were significantly higher than that of control group (58.3%),and the difference was statistically significant (P=0.032,P=0.032).The recurrence rates of group A and group B (15.4%,13.8%)were significantly reduced compared with that of control group (41.6%)(P=0.012,P=0.012).The hormone levels decreased dramatically after treatment in three groups.The adverse reaction rate of group B was apparently reduced compared with that of group A,and the difference was statistically significant (P=0.001 ).Conclusion Laparoscopy combined with GnRH-a medication was a safe and effective treatment for endometriosis.The application of GnRH-a after laparoscopy can significantly increase the total effective rate of the operation and reduce the postoperative recurrence rate.For the patients who need to take long-term GnRH-a treatment,add-back therapy need to be given to decrease its adverse reaction and recurrence rate,or to delay its recurrence,thus could improve patients' living qualities significantly.

Objective To explore the influence of core competence evaluation on continuing education of training nurses in operation room.Methods Questionnaires were administered to 42 training nurses by using the registered nurse core competence scale (CIRN) in operation room.Results The level of core competence of training nurses in operation room was medium (3.25 ± 0.45).Legal and ethical practice dimension of scores was the highest (3.55 ± 0.63).The single average of clinical nursing dimension was the advanced lowest (3.11 ± 0.54).The nurses self identity was the core influencing factors by multiple stepwise regression analysis in regression.Conclusions The core competence of training nurses in operation room is on the middle level,The focus is to improve the ability of clinical nursing in continuing education.To give more attention and support in self identity of the operation room training nurses,and to provide the scientific basis for the training plan and specialist training for them,in order to promote the continuing education projects of training nurses.

Objective To analyze the misdiagnosis reasons in renal tumors with contrast-enhanced ultrasound (CEUS) and to improve cognition on CEUS. Methods Two-hundred and eighty-five cases were compared with pathology, the images in 22 cases misdiagnosed on CEUS were reviewed retrospectively and the reasons were analyzed. Results The diagnosis accuracy and misdiagnosis rate of CEUS were 92. 28 % (263/285) and 7. 72%(22/285), respectively. In these 22 cases, 9 cases misdiagnosed as renal cell carcinoma (RCC) were conformed by pathology as renal angiomyolipoma(RAMD), showed 5 cases "fast wash-in and fast wash-out", 4 cases "fast wash-in and slowly wash-out". Seven cases were conformed as RCC, in which 5 were misdiagnosed as RAML, showed 4 cases "fast wash-in and slowly wash-out", 1 cases "simultaneously wash-in and simultaneously wash-out", and 2 were misdiagnosed as renal cyst with no enhancement founded. Four cases misdiagnosed as hematoma were conformed as pyelo-carcinoma, with no enhancement founded in renal pelvis. The remaining 2 cases misdiagnosed as inflammatory pseudotumor were conformed as RCC, showed "fast wash-in and slowly wash-out". Conclusions With the high diagnosis accuracy,CEUS is an important method in diagnosis of renal tumors. Analyzing the misdiagnosed reasons may improve the cognition on CEUS and decrease the misdiagnosis.