Objective To develop a scale of the executive functional status for adolescents.Methods Regarding to the structure and the conception of executive function and the results of interviews to several adolescents,a preliminary inventory including 37 items was developed.The investigation sample consisted of 1722 students from 2 provinces in China by stratified sampling,and the the internal consistency,conduct validity and criterion validity were assessed by exploratory factor analysis.Results The revised scale including 21 items was consisted of three factors:inhibition control,cognitive flexibility,working memory,which explained 45.39％ of the total variance.The factor loading ranged from 0.499 to 0.727.The Cronbach alpha ranged from 0.786-0.897 for the scale and its three factors.Factor structure fitted actual data and its fit indices were x2=530.44,df=186,RESMA =0.053,GFI =0.93,AGFI =0.91,NFI =0.96,CFI =0.97.Conclusion It shows that the reliability and validity of the scale meet the standard of the psychometrics,and it can be suitable for evaluating the functional status of execution of Chinese adolescent.

Objective To observe the incidence of severe acute pancreatitis (SAP) in obese acute pancreatitis (AP) patients with medical treatment, and evaluate the impact of obesity in AP progression.Methods A multicenter prospective controlled study was conducted. APACHE Ⅱ scoring system was used to evaluate the severity of AP. Results 161 patients with mild AP(MAP) were enrolled, according to the cut-off point of 25 kg/m2, these patient were divided into obese group (79 patients) and non-obese group (82patients). The levels of CRP, hypertriacylglycerolemia, complication rate, incidence of SAP and mortality were observed under the circumstance of identical medical treatment. The levels of CRP in obese group and non-obese group were (117±109 ) mg/L and (35±36 ) mg/L(P<0.01). The number of obese patients with hypertriacylglycerolemia was two times as many as that in non-obese patients, but there was no significantly difference. There was no local complication in both groups, but the incidence of systematic complication in obese patients (20.3%) was significantly higher than that in non-obese group (6.1%, P<0.01). 16patients (20.3%) in obese group progressed into SAP, which was significantly higher than that in non-obese group (5 patients, 6.1%, P<0.01). One patient(1.3%) died in obese group, but no one died in non-obese group. In MAP patients with APACHE Ⅱ 4～7 points, the incidence of SAP (43.3%) in obese group was significantly higher than that in non-obese group (18.5%, P<0.05). Conclusions Obese MAP patients with APACHE Ⅱ 4～7 points were prone to develop into SAP. More aggressive interventions are needed.

PURPOSE: Studies have found that long noncoding RNA HEIH (lncRNA-HEIH) is upregulated and facilitates hepatocellular carcinoma tumor growth. However, its clinical significances, roles, and action mechanism in colorectal cancer (CRC) remains unidentified. MATERIALS AND METHODS: lncRNA-HEIH expression in CRC tissues and cell lines was measured by quantitative real-time polymerase chain reaction. Cell CountingKit-8, ethynyl deoxyuridine incorporation assay, terminal deoxynucleotidyl transferase dUTP nick end labeling staining, and nude mice xenografts assays were performed to investigate the roles of lncRNA-HEIH. RNA pull-down, RNA immunoprecipitation, chromatin immunoprecipitation, and luciferase reporter assays were performed to investigate the action mechanisms of lncRNA-HEIH. RESULTS: In this study, we found that lncRNA-HEIH is significantly increased in CRC tissues and cell lines. lncRNA-HEIH expression is positively associated with tumor size, invasion depth, and poor prognosis of CRC patients. Enhanced expression of lncRNA-HEIH promotes CRC cell proliferation and decreases apoptosis in vitro, and promotes CRC tumor growth in vivo. Whereas knockdown of lncRNA-HEIH inhibits CRC cell proliferation and induces apoptosis in vitro, and suppresses CRC tumor growth in vivo. Mechanistically, lncRNA-HEIH physically binds to miR-939. The interaction between lncRNA-HEIH and miR-939 damages the binding between miR-939 and nuclear factor κB (NF-κB), increases the binding of NF-κB to Bcl-xL promoter, and promotes the transcription and expression of Bcl-xL. Moreover, Bcl-xL expression is positively associatedwith lncRNA-HEIH in CRC tissues. Blocking the interaction between lncRNA-HEIH and miR-939 abolishes the effects of lncRNA-HEIH on CRC tumorigenesis. CONCLUSION: This study demonstrated that lncRNA-HEIH promotes CRC tumorigenesis through counteracting miR-939-mediated transcriptional repression of Bcl-xL, and suggested that lncRNA-HEIH may serve as a prognostic biomarker and therapeutic target for CRC.
Animals ; Apoptosis ; Carcinogenesis* ; Carcinoma, Hepatocellular ; Cell Line ; Cell Proliferation ; Chromatin Immunoprecipitation ; Colorectal Neoplasms* ; Deoxyuridine ; DNA Nucleotidylexotransferase ; Heterografts ; Humans ; Immunoprecipitation ; In Vitro Techniques ; Luciferases ; Mice ; Mice, Nude ; Prognosis ; Real-Time Polymerase Chain Reaction ; Repression, Psychology* ; RNA ; RNA, Long Noncoding*

Objective To validate the efficacy of Pediatric Early Warning Score (PEWS) in severity evaluation of respiratory inpatients.Methods Four hundred and thirteen children with respiratory disease were hospitalized in Pneumology Department of Guangzhou Women and Children's Medical Centre from October 2012 to October 2013,of which 36 cases required Intensive Care Unit (ICU) treatment while the rest 377 controls did not.According to the disease severity,cases and controls were further categorized into 3 groups:no-monitor-required group (n =302,controls),monitor-required group (n =75,controls),ICU group (n =36).PEWS was assessed at admission in controls and 12 hours before ICU transfer,respectively.PEWS were compared among all groups and receiver operator characteristic curve(ROC) was performed.Results The median [interquartile rang(IQR)] age in ICU group was 10 months(4-13 months),monitor-required group was 10 months (6-16 months),and no-monitor-required group was 14months(6-24 months),and the difference was significant (H =13.59,P ＜ 0.01).The median (IQR) of PEWS in ICU group was 6 scores (6-7 scores),monitor-required groups was 5 scores (4-5 scores),on-monitor-required group was 2 scores (1-2 scores),and the difference was significant (x2 =255.641,P ＜ 0.01).PEWS in monitor required group and ICU group was 3.5 score with area under ROC (AUC) as 0.898 (95％ CI:0.867-0.929,sensitivity0.907,specificity 0.893) and 4.5 with AUC as 0.978 (95％ CI:0.964-0.992,sensitivity 1.000,specificity 0.862),respectively.Conclusions PEWS can be indicative for severity classification in hospitalized respiratory pediatric patients,and can serve as a potentially excellent screening tool for prediction of ICU admission.

In order to enhance the level of public health practical skills among undergraduates majoring in preventive medicine and improve the professional skills of disease prevention and control staff in case of public health emergencies,Nanjing Medical University School of Public Health performed an individual protection training for senior undergraduates majoring in preventive medicine in 2017.After related experience was summarized and students' feedback was collected,comprehensive training of public health practical skills was pedormed for senior undergraduates majoring in preventive medicine in 2018,with the inclusion of virtual experiments for public health.The results showed that the students were interested in practical skill training,mastered the contents of the training,and took pride in their major.This training has an excellent teaching effect and can enhance the ability to deal with public health emergencies among students majoring preventive medicine.

Objective:To establish the risk prediction models for postoperative delirium (POD) in elderly patients undergoing non-cardiac surgery and to evaluate the predictive efficacy.Methods:A total of 685 patients of both sexes, aged 65-90 yr, of American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅳ, who underwent non-cardiac elective surgery requiring tracheal intubation during general anesthesia in general surgery, orthopedics, urology, hepatobiliary and pancreatic surgery in our hospital from January 2020 to December 2020, were selected.Patients were assigned to the training set and validation set at a ratio of 7∶3 using a simple random sampling method.The clinical data of patients in the perioperative period were collected, and the patients were followed up within 1-7 days after operation (or before discharge), and the occurrence of POD was recorded.Univariate and multivariate logistic regression analysis was used to identify the independent risk factors for POD.The risk prediction model for POD was established based on the results of multivariate logistic regression analysis of the training set, a nomogram and receiver operating characteristic (ROC) curve were drawn, and the area under the curve (AUC) was calculated.The validation set was used to verify the prediction model and assess the efficacy of the risk prediction model for POD.Results:A total of 653 patients were enrolled in this study, 139 patients developed POD, and the incidence was 21.3%.The results of multivariate logistic regression analysis showed that advanced age, high ASA physical status classification, low preoperative Mini-Mental State Examination score, complication with diabetes mellitus, low years of education, high preoperative Pittsburgh Sleep Quality Index scale score, long anesthesia time and high numerical rating scale score after operation were independent risk factors for POD in elderly patients undergoing non-cardiac surgery.The risk prediction model for POD was established based on the independent risk factors mentioned above.The AUC of the training set was 0.981, the Youden index was 0.881, the sensitivity was 95.95%, and the specificity was 92.92%; the AUC of the validation set was 0.939, the Youden index was 0.795, the sensitivity was 94.44%, and the specificity was 85.09%.Conclusion:The risk prediction model for POD established based on age, ASA physical status classification, history of diabetes melittus, years of education, preoperative Mini-Mental State Examination score, preoperative Pittsburgh sleep quality index scale score, anesthesia time and postoperative numerical rating scale score has good predictive efficacy in elderly patients undergoing non-cardiac surgery.

Purpose: RIOK1 has been proved to play an important role in cancer cell proliferation and migration in various types of cancers—such as colorectal and gastric cancers. However, the expression of RIOK1 in breast cancer (BC) and the relationship between RIOK1 expression and the development of BC are not well characterized. In this study, we assessed the expression of RIOK1 in BC and evaluated the mechanisms underlying its biological function in this disease context. Materials and Methods: We used immunohistochemistry, western blot and quantitative real-time polymerase chain reaction to evaluate the expression of RIOK1 in BC patients. Then, knockdown or overexpression of RIOK1 were used to evaluate the effect on BC cells in vitro and in vivo. Finally, we predicted miR-204-5p could be a potential regulator of RIOK1. Results: We found that the expression levels of RIOK1 were significantly higher in hormone receptor (HR)–negative BC patients and was associated with tumor grades (p=0.010) and p53 expression (p=0.008) and survival duration (p=0.011). Kaplan-Meier analysis suggested a tendency for the poor prognosis. In vitro, knockdown of RIOK1 could inhibit proliferation, invasion, and induced apoptosis in HR-negative BC cells and inhibited tumorigenesis in vivo, while overexpression of RIOK1 promoted HR-positive tumor progression. MiR-204-5p could regulate RIOK1 expression and be involved in BC progression. Conclusion These findings indicate that RIOK1 expression could be a biomarker of HR-negative BC, and it may serve as an effective prognostic indicator and promote BC progression.

Objective To understand the development of healthcare-associated infection(HAI)management organ-izations in China in the past 30 years.Methods Development of HAI management organizations in 12 provinces (municipalities,autonomous regions)in China was surveyed.Results A total of 166 hospitals were surveyed,96 (57.83%)were tertiary hospitals.Among 164 hospitals which had a history of development of HAI management department,46(28.05%)before 1995,63(38.14%)in 1995-2005,and 55(33.54%)in 2005-2015 set up HAI management departments.HAI management professionals per 1 000 beds in 165 hospitals decreased from 4.80 in 1995 to 4.09 in 2015,occupational categories in HAI management departments in 1995 -2015 were significantly different (χ2 =26.22,P <0.01).The constituent ratios of education background and profession of HAI manage-ment professionals in each province in 1995-2015 were significantly different(χ2 =242.91,47.10,respectively,all P <0.01).In 1995 and 2005,70.81%,53.30% of professionals were with college degree or below;in 2015,the percentage of professionals with bachelor’s degree,doctoral degree,and master’s degree were 53.79%,2.45%, and 22.86% respectively.Most professionals were nursing staff,but the percentage decreased from 58.38% in 1995 to 45.96% in 2015.Conclusion Although HAI management organizations have developed for 30 years and made some achievements,there still remain some problems,the proportion of professionals needs to be enhanced,and personnel structure should be optimized.

Objective To understand the development situation of healthcare-associated infection (HAI)manage-ment departments in the rational antimicrobial application and management in hospitals in China.Methods A total of 166 hospitals from 12 provinces,municipalities,autonomous regions,and military hospitals were selected for survey,the participation of HAI management departments in the rational clinical antimicrobial application and man-agement in different years was compared.Results Of 166 hospitals,68(40.96%)in 2005,119(71.69%)in 2010, and 160(96.39%)in 2015 participated in the establishment of management organizations for rational antimicrobial application (χ2 =121.143,P <0.001).The percentage of HAI management departments participating in antimicro-bial management increased from 10.24%(n=17)in 2005 to 22.29%(n=37)in 2010,and 31.33%(n=52)in 2015 (χ2 =22.172,P < 0.001 ).The percentages of HAI management departments participating in formulating cata-logues for antimicrobial varieties and classification,stipulating permission for antimicrobial use,joining antimicrobi-al management teams,monitoring bacterial resistance,managing antimicrobial prophylaxis in clean incision,super-vising clinical antimicrobial use,conducting clinical consultation,and evaluating prescription were 10.87% -30.72% in 2005,25.90%-65.06% in 2010,and 36.14%-95.18% in 2015 (all P <0.01).Intensity of antimicro-bial use (defined daily dose/100 bed-days,DDD/ 100 bed-days)decreased from 69.16 in 2005 to 41.40 in 2015, antimicrobial usage rate decreased from 46.98% in 2005 to 36.90% in 2015,among patients receiving therapeutic antimicrobial use,specimens sending for pathogenic detection increased from 20.58% in 2005 to 49.39% in 2015. Conclusion Departments of HAI management in China play important role in management of rational antimicrobial application.

Objective:To investigate the value of α-synuclein (α-syn) concentration in cerebrospinal fluid (CSF) in predicting postoperative delirium (POD).Methods:One thousand patients underwent elective surgery with combined epidural-spinal anesthesia in our hospital from January 2018 to September 2020 were selected.The epidural puncture was performed at L 3, 4 interspace, and 2 ml of CSF was collected after the needle reaching the subarachnoid space.The concentrations of α-syn, β-amyloid (Aβ)40, Aβ42, total tau protein (T-tau), and phosphorylated tau protein (P-tau) in CSF were determined by enzyme-linked immunosorbent assay.The concentrations of α-syn in CSF and occurrence of POD in patients of different ages were recorded.Patients were divided into POD group and non-POD group according to whether POD occurred, and frequency matching (1∶1) was performed based on five matching variables of age, ASA physical status, education level, duration of operation, and intraoperative blood loss. Results:Eight hundred and forty-one patients were finally included in the study, and the incidence of POD was 15.0%. There were 126 cases in POD group and 126 cases in non-POD group after matching. The concentrations of α-syn in CSF and incidence of POD were gradually increased with age ( P<0.05). Compared with non-POD group, the concentrations of α-syn, T-tau and P-tau in CSF were significantly increased, the concentrations of Aβ40 and Aβ42 were decreased, Aβ40/P-tau, Aβ42/P-tau, Aβ42/Aβ40 and P-tau/T-tau were decreased in POD group ( P<0.05). After confounding factors were corrected by logistic regression analysis, increased concentrations of α-syn, p-tau, and T-tau in CSF were risk factors for POD ( P<0.05). Increased concentrations of Aβ40 and Aβ42 in CSF and increased Aβ40/P-tau and Aβ42/P-tau were protective factors for POD ( P<0.05). Multiple linear regression analysis showed that the concentration of α-syn in CSF was negatively correlated with Aβ40 and Aβ42 concentrations and positively correlated with P-tau and T-tau concentrations ( P<0.05). The area under the receiver operating characteristic curve of concentrations of α-syn in CSF predicting POD was 0.895, Youden index was 0.664, sensitivity was 80.00%, and specificity was 86.36% ( P<0.001). Conclusion:The concentration of α-syn in CSF is related to the occurrence of POD, and it provides higher accuracy in predicting POD.