Objective To investigate the pressures from night shifts among nurses from pediatrics department and find the countermeasures.Methods A self-designed questionnaire was used to investigate the pressures from night shifts among 112 nurses from pediatrics department as well as the reasons.Results 110 of the nurses(98.2%) assumed that the pressures from night shifts was intensive.The main reasons for the pressures came out of heavy workload,shortage of staff and stuff and the unsettled balance between job and family.Conclusion Such measures as reasonable distributions of nurses,abound supply of stuff and reduced working links may be effective for the alleviation of the pressures on nurses at night shifts,motivated activeness in them and then the enhancement of nursing quality.

Objective To investigate the effect of stellate ganglion block on the pain and quality of life in patients with lung cancer.Methods 90 patients with lung cancer were divided into observation group and control group according to random number table method.The control group was treated with morphine 10mg,orally,1 time/ 12h.The observation group was treated with stellate ganglion block and morphine.For the patients with poor analgesic effect,50％ doses were added gradually.The analgesic effect,quality of life and changes of immune function were compared between the two groups.Results After treatment,the VAS scores of the two groups were significantly decreased.And the VAS score reduction in the observation group was significantly better than that in the control group [(2.5 ± 0.7) points vs.(3.7 ± 0.9) points],the difference was statistically significant (t =7.060,P ＜ 0.05).The analgesic efficacy of the observation group was significantly higher than that of the control group(91.1％ vs.75.6％,x2 =3.920,P ＜ 0.05),the duration of analgesia of the observation group was longer than that of the control group (t =20.681,P ＜ 0.05).For the total morphine dosage method,the observation group was significantly lower than the control group[(143.5 ± 21.3) mg vs.(238.7 ± 38.3) mg] (t =14.572,P ＜ 0.05).After treatment,the scores of quality of life of the two groups were significantly improved,and the improvement degree of the observation group was significantly better than that of the control group [(86.5 ± 14.3) vs.(79.6 ± 15.7),t =2.179,P ＜ 0.05].After treatment,the TGF-beta level of the observation group was significantly reduced,which was significantly lower than that of the control group[(215.4 ± 38.7)pg/mL vs.(240.5 ± 41.2)pg/mL],the difference was statistically signifi cant (t =2.979,P ＜ 0.05).Conclusion Stellate ganglion block has good therapeutic effect in the treatment of lung cancer patients with pain.

Objective:To systematically review the teaching effects of flipped classroom (FC) in undergraduate medical education in China.Methods:Such databases as CNKI, VIP Data, and WanFang, were electronically searched for literature of randomized controlled trials (RCTs) on FC versus lecture-based learning (LBL) applied in medical education in China up to March, 2018. The included literature were evaluated for the quality, and RevMan5.3 software was used for Meta-analysis.Results:A total of 26 RCTs were included in the study, including 4 249 students, of whom the FC group had 2 135 cases, while LBL group had 2 114 cases. The students in FC group got significantly higher scores than those of the students in LBL group in the theoretical scores (WMD = 7.81, 95%CI = 5.18 -10.43, P < 0.05), skills tests (WMD = 4.69, 95%CI = 0.65 -8.73, P < 0.05). Conclusion:The FC can significantly improve the teaching results in undergraduate medical education.

This study is to investigate the inhibitory effect and mechanism of prosapogenin A (PSA) on MCF7. MTT assay was performed to determine the inhibitory effect of PSA on MCF7 cells. PI/Hoechst 33342 double staining was used to detect cell apoptosis. RT-PCR was used to test the mRNA levels of STAT3, GLUT1, HK and PFKL. Western blotting was performed to determine the expression of STAT3 and pSTAT3 protein in MCF7 cells. The results showed that PSA could dose-dependently inhibit cell growth of MCF7 followed by IC50 of 9.65 micrmol x L(-1) and promote cell apoptosis of MCF7. Reduced mRNA levels of STAT3, HK and PFKL were observed in MCF7 cells treated with 5 micromol x L(-1) of PSA. PSA also decreased the level of pSTAT3 protein. STAT3 siRNA caused decrease of mRNA of GLUT1, HK and PFKL which indicated STAT3 could regulate the expressions of GLUT1, HK and PFKL. The results suggested that PSA could inhibit cell growth and promote cell apoptosis of MCF7 via inhibition of STAT3 and glycometabolism-related gene.

To explore an effective method with few operative complications for treating circumferential mixed hemorrhoids (CMH).Sixty three cases of CMH (Group A) were treated with limited external incision and internal ligation combined with restoration of intervenient skin and 34 cases (Group B) were treated with traditional external incision and internal ligation as control. Anal canal diameter (ACD), anal canal quiescent pressure (ACQP) and anal canal systolic pressure (ACSP) were determined before and after operation. Short term and long term therapeutic effects were also observed and compared in the two groups.Short term and long term therapeutic effects in Group A were better than those in Group B (P

Objective To observe the effect of Chaihushugansan combined with fluoxetine on interleukin -6 ( IL-6 ) , interleukin -1β( IL-1β) , tumor necrosis factor ( TNF-α) in the treatment of patients with postpartum depression.Methods 83 patients from November 2013 to July 2015 in Jiaxing Maternity and Child Health Care Hospital were randomly divided into 41 patients of observation group and 42 patients of control group.The control group were treated with fluoxetine treatment, the obsercation group received Chaihushugansan on the basis of control group.The Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA),IL-6, IL-1β, TNF-α, high-sensitivity C-reactive protein (hs-CRP) and adverse reactions were followed up and recorded.Results The HAMD and HAMA score in observation group post-treatment were (8.31 ±2.05,9.03 ±2.08)points, which were lower than (13.96 ±2.16, 13.61 ±2.14) points in control group (P<0.05).The serum IL-6 and IL-1βlevels in observation group post-treatment were (6.59 ±3.20,5.01 ±2.83)pg/mL, which were lower than (10.64 ±3.86,9.31 ±3.42)pg/mL in control group (P<0.05).The serum TNF-αand hs-CRP levels in observation group post-treatment were ( 9.16 ±2.01 ) pg/mL, ( 3.62 ±1.06 ) mg/L, which were lower than ( 12.30 ±2.37 ) pg/mL, (5.29 ±1.14)mg/L in control group (P<0.05).The total adverse reaction rate in observation group was 7.32%, significantly lower than 23.81% in control group ( P <0.05 ) .Conclusion Chaihushugansan combined with fluoxetine has a good therapeutic effect in the treatment of postpartum depression, could significantly reduce the IL-6, IL-1β, TNF-α levels, with fewer side effects, it is better than fluoxetine alone.

Cationic lipid nanoparticles possessing favorable biocompatibility and controllable particle size has at-tracted increasing attention in the field of non-viral vectors for delivering nucleic acids in vitro and in vivo.1,2-Dilinoleyloxy-3-dimethylaminopropane(DLinDMA)and its derivatives,one of the most important cationic lipid materials,have been widely studied as the mainly composition of cationic lipid nanoparticels.This paper summa-rized the structure,characteristics and clinical application of DLinDMA nanoparticles.

Abstract: Objective　To genotype and analyze whole genomic features of Coxsackievirus B3 (CVB3) isolated in Tianjin, to improve evolution information of CVB3 virus in Tianjin, and to provide basis for surveillance and early warning of related diseases. Methods　Viral RNA was extracted from five CVB3 strains isolated in Tianjin, whole genome sequence of the virus was amplified by RT-PCR and sequenced by next-generation sequencing method, and phylogenetic and recombinant analysis were carried out. Results　The open reading frame 1(ORF) of the five CVB3 strains contained 6 555 nucleotides and encoded 2 185 amino acids, and ORF2 was composed of sequences encoding 68 amino acids. The nucleotide sequence similarity ranged from 78.3%-100%, and the amino acid sequence similarity ranged from 95.7%-100%. Compared with the CVB3 prototype strain, the nucleotide sequence similarity of the five viruses was between 78.2%-79.1%, and the similarity of amino acid sequences was 94.9%-95.3%. All five viruses exhibited a T151A mutation on the VP2 protein. Additionally, the encephalitis isolate showed a K158E mutation on the VP2 protein, while one of the sewage isolates had a C234T mutation in 5' noncoding region. The five strains belonged to two different genotypes, among which the encephalitis isolate in 2016 belonged to the D genotype, while the sewage isolates in 2021 belonged to the E genotype. This is also the first report of E genotype CVB3 in northern China. The CVB3 strain may have recombinant events in non-structural protein regions, in which encephalitis isolate may recombine with a Coxsackievirus B5 (CVB5) strain, while sewage isolates may have recombinant events with a strain of ECHO virus 18 (E18). Conclusions　The CVB3 isolates in Tianjin belong to D and E genotypes, and recombination events may exist in non-structural protein region of the viral genome. The results of CVB3 virus genome analysis in sewage suggests presence of CVB3 infection in the population of Tianjin, and its epidemic dominant genotype may have changed.

Objective:To preliminarily compile the words list of personality in southern China, and structurally analyse the words with natural personality traits.Methods:A semi-structured questionnaire was used to obtain 603 valid questionnaires in six provinces in southern China, and the lexical collation, consolidation, deletion, lexicographic analysis and structural analysis were conducted.Results:(1)After three rounds of collation and merging of 8 022 natural words describing personality traits, a personality trait word list containing 136 words was obtained.(2)Econometric analysis of words according to positivity, neutrality and negativity, showed that all negative words involving moral evaluations (ruthless, vicious, evil, cunning, narrow-minded and so on) were used to describe others, while negative words describing oneself were mainly non-virtuous words (capricious, stubborn, impatient, impetuous, pessimistic and so on). (3) The proportion of desirability and virtue dimensions in the words list was highest(23.20%, 16.80%); and the proportion of desirability and extroversion in total words frequency was highest(24.39%, 19.96%).Conclusion:A personality word list containing 136 personality traits in southern China is compiled from primary sources; and a 7-factor personality structure was latent in the word list.Subjects are richer in describing the content of the vocabulary of agreeable, virtuous, pioneering, and persevering personality traits, while agreeable and extroverted personality traits are most easily perceived in interpersonal interactions.

Objective:Summarize and analyze the clinical features of immune checkpoint inhibitor (ICI)-related colitis.Methods:From January 2019 to September 2020, the clinical data of 8 patients with ICI-related colitis from Peking Union Medical College Hospital were retrospectively collected and including the onset of ICI-related colitis, clinical symptoms, endoscopic and pathological findings, treatment, comorbidities and resuming of ICI. Independent sample t test was used for statistical analysis. Results:Eight patients were all male, and the median age (range) was 66 years old (55 to 74 years old), 7 cases were diagnosed with stage Ⅳ lung cancer and 1 case was diagnosed with stage Ⅲc pyelo-carcinoma. Among 8 patients, 4 cases of ICI-related colitis occurred during combination of anti-programmed death-1 (PD-1) treatment and chemotherapy, 2 cases occurred during anti-PD-1 monotherapy after combination of anti-PD-1 treatment and chemotherapy, and 2 cases occurred after anti-PD-1 monotherapy. The median time (range) was 44 d (27 to 128 d) from initial anti-PD-1 treatment to the onset of ICI-related colitis and the median time (range) was 8 d (6 to 35 d) from last anti-PD-1 treatment to onset of ICI-related colitis. The ICI efficacy of 4 patients had partial response, 2 patients had stable disease, 1 patient had disease progression, and 1 patient′s condition was not assessed. All 8 patients had moderate to severe extensive colitis. The main clinical manifestation was diarrhea (5/8), 3 patients accompanied by abdominal pain. The endoscopic findings were diffuse mucosal erosion, accompanied by ulcer in 2 patients. The main pathologic findings were cryptitis or crypt abscess, accompanied by apoptosis in 2 patients. Eight patients were all treated with glucocorticoids, among them 2 patients were further treated with biologics, due to the insufficient efficacy of glucocorticoid treatment, 4 patients had opportunistic infections. The initial prednisone dose for patients with opportunistic infections and patients without opportunistic infections was (85.00±52.60) and (60.00±23.09) mg, respectively. The prednisone treatment course was (8.75±4.03) and (7.50±3.11) weeks, respectively, and the differences were not statistically significant (both P>0.05). The colitis relapsed in all 3 patients after resuming of ICI. Conclusions:ICI-related colitis had corresponding ICI treatment history and clinical, endoscopic, and histopathological features. Glucocorticoid is the main treatment, and it is prone to relapse after resuming of ICI.