OBJECTIVE:To improve the safety management level of high-risk drug Insulin injection in our hospital. METH-ODS:The standard management of Insulin injection(400 u/injection)was conducted by using PDCA(plan-do-check-action). The application of Insulin injection in wards was compared before and after six months of management. RESULTS:By strengthening training,improving ward baseline insulin management register system,adjusting the specification of insulin in information system, etc.,the application and storage of insulin became more standard;no expired drugs occurred;the rate of waste drug decreased from 95.06% before management to 22.00% after management,decreasing by 73.06%. CONCLUSIONS:PDCA cycle can im-prove the safety management of Insulin injection in wards effectively.

OBJECTIVE: To screen and analyze items of the second-generation sub-health questionnaire through various item analysis methods, so as to provide basic data for the further study of sub-health measuring scale. METHODS: The investigation and analysis was completed in Southem Medical University between November 2006 and May 2008. A total of 6 000 college students were selected as the investigation targets with cluster sampling method from a medical university in Guangzhou. 6 000 questionnaires were assigned to them in which the answerer was asked about their somatic symptoms, psychological symptoms and social symptoms, with 5 599 valid ones obtained. Eighty three items were analyzed through five methods based on dispersion, correlation coefficient, factor analysis, t-test and Cronbach's g. RESULTS: At last, 63 items were selected to constitute the item pool of the sub-health scale, which were nominated over 4 times according to the nomination summary of the 5 methods.CONCLUSION: All the 63 items kept in the second-generation sub-health questionnaire feature satisfactory sensibility, representation, independence, significance and intemal consistency, which can accordingly lay a good foundation for the further study of the sub-health measuring scale.

Objective To investigate the clinical features, phenotypes and genotypes of Pseudomonas aeruginosa (PA) strains isolated from patients with diabetic foot infection (DFI) resisting to aminoglycosides antibiotics (AmAn). Methods The clinical profiles of 209 DFI patients hospitalized in the Tianjin Metabolic Diseases Hospital were collected and ana?lyzed. Forty-one PA strains were identified, and their antibiotic resistance profiles were obtained. The DNAs of PA isolates were extracted and applied to amplifications for several aminoglycosides modifying enzyme genes, including aac(3′)-Ⅰ, aac (3′)-Ⅱ, aac(6′)-Ⅰb, aac(6′)-Ⅱ, ant(2′′)-Ⅰand ant(3′′)-Ⅰby PCR method. Combining with the clinical features and the antibiotic resistance profiles, the relationship between genotypes and phenotypes of the PA strains was analyzed. Results Gram positive bacteria (G+) were the majority of the pathogen with 51.67%detection rate. The total detection rate of PA was 19.62%, listed as the top one pathogenic bacterium among gram negative bacteria (47.67%). There was significant difference in the ratio of ulcer area≥4 cm2 between PA group and non-PA group and G+group. There were significantly higher inci?dence rate of ischemic ulcer and osteomyelitis in PA group than those of G+group. There were higher clinical characteristics and ulcer depth (SAD) score, and increased hypersensitive C-reactive protein in PA group than those of G+ group. There were 30 strains of PA being resistant to AmAn (73.17%). The predominant drug resistance gene to AmAn was ant(3′′)-Ⅰ(65.85%), and aac(3′)-Ⅰgene was not found from all PA isolates. Conclusion The detection rate of PA isolated from DFI patients was higher, and patients were with the characteristics of larger, deeper and severe ischemia of ulcer area. The phe?nomenon of PA resistant to AmAn was more serious, and ant(3′′)-Ⅰgene identified from PA isolates was the most common resistance gene identified to AmAn.

Objective:To investigate the incidence trends and clinicopathologic characteristics of papillary thyroid cancer (PTC). Methods:A retrospective analysis was conducting using the following data:3,766 cases with thyroid disease in the People's Hospital of Wuhan University between January 2001 and July 2013;and 977 cases with thyroid cancer in the Hubei Cancer Hospital between Janu-ary 2006 and July 2013. Results:The incidence of thyroid cancer increased significantly since 2008, ranging from 14.94%to 18.10%(P<0.05). In particular, the PTC cases ranged from 85.33%to 90.89%(P<0.05). A total of 1,416 cases were diagnosed as PTC with a male to female ratio of 1:3.75. The positive rate of neck lymph node metastasis (NLNM) was significantly different in terms of gender and age (P<0.05). Significant differences were also found between the unifocal group and the multifocal group;the positive rate of NL-NM was 77.94%in the latter group. The rate of NLNM in PTC was 72.29%, which had higher significance compared with Hashimoto's thyroiditis or with nodular goiter. Conclusion: The incidence of thyroid cancer is increasing. Cases involving males aged below 45 years old and with>1 cm tumor diameter and multifocal PTC are more likely to be complicated with NLNM.

Objective To construct the conditionally replicative adenovirus vector pAd-Egr1-TRAIL-hTERT-E1A-E1Bp-E1B55K carrying early growth response gene-1 (Egr1)promoter and tumor necrosis factor related apoptosis inducing ligand (TRAIL)gene, and to observe the effects of the vector combined with 2 Gy irradiation on the TRAIL expression in MDA-MB-231 cells.Methods Egr-1 promotor sequence was cloned from pMD18 T-Egr1, TRAIL was constructed the downstream of Egr1 promoter, pShuttle-Egr1-TRAIL-hTERT-E1A-E1Bp-E1B55K (CRAd.pEgr1-TRAIL)was constructed,after the adenovirus vector was packaged successfully,MDA-MB-231 cells were infected with them and irradiated with X-rays.Real time PCR method and ELISA were used to detect the expression levels of TRAIL mRNA and protein, respectively. Six groups in the experiment were set up:control, 2 Gy,CRAd.p,CRAd.pEgr1-TRAIL,CRAd.p + 2 Gy and CRAd.pEgr1-TRAIL + 2 Gy. Results The recombinant adenovirus vector pAd-Egr1-TRAIL-hTERT-E1A-E1Bp-E1B55K was constructed and packaged successfully.The expression level of TRAIL mRNA in MDA-MB-231 cells transfected with the vector of 5 MOI for 24 h following 2.0 Gy X-rays irradiation began to increase and arrived to the top 8 h later in various groups,then declined.The expression level of TRAIL protein in MDA-MB-231 cells began to increase 6 h after irradiation and reached to the peak 24 h later,then declined 48 h later.There were significant differences in the expression levels of TRAIL protein between CRAd.pEgr1-TRAIL + 2.0 Gy and other groups at the same time point (P<0.01). Conclusion The recombinant adenovirus vector is obtained successfully, and the TRAIL mRNA and protein expression levels in MDA-MB-231 cells can be increased significantly by the vector combined with 2.0 Gy X-rays irradiation.

Objective To investigate the prevalence of healthcare-associated infection(HAI)in a tumor hospital,and provide evidence for prevention and control of HAI.Methods According to requirement of cross sectional survey of nationwide HAI monitoring network,prevalence rates of HAI in hospitalized patients at a tumor hospital in 2013-2015 were surveyed,surveyed results were statistically analyzed.Results A total of 3 515 hospitalized patients were investigated from 2013 to 2015,24(0.68%)had HAI.The prevalence rates of HAI from 2013 to 2015 were 0.79%,0.54%,and 0.76%respectively,difference was not statistically significant(x2=0.65,P>0.05).The main infection site was lower respiratory tract,accounting for 45.83%.The main pathogens causing HAI were gram-negative bacilli,accounting for 47.37%,followed by fungi(26.32%).Conclusion The prevalence rate of HAI in tumor patients is low,targeted monitoring should be carried out according to the current situation,the prevention and control of lower respiratory tract infection should be focused on,fungal infection should be paid attention.

Aim To observe the intervention effects of sodium aescinate on acute lung injury model of rats induced by oleate. Methods Fifty four male SD rats were randomly divided into five groups: normal control group, sodium aescinate control group (without oleate) , oleate model control group,medrol interventional group and sodium aescinate interventional group. Acute lung injury models of rats were made by injecting oleate (OA, 0. 1 ml · kg~(-1) ) through caudal veins, and then rats were observed and killed to detect correlated in-dice. The observation indice were the histomorphology of lung, the wet and dry weights of lung ( W/D), score of injury of lung under light microscope (IQA ) , partial pressure of oxygen in artery ( PaO_2) , the levels of SOD and MDA in blood plasma and lung tissue. Results ① Histomorphology of lung: Lung surface hyperemia relieved obviously and pink secretion from trachea of rats in sodium aescinate interventional group and medrol interventioal group decreased significantly compared with oleate model control group. Under light microscope , compared with oleate model control group, effusion of inflammatory cells in alveolar space of rats in sodium aescinate interventional group and medrol interventional group decreased. ② The wet and dry weights of lung ( W/D ) ; W/D of rats in oleate control model group increased obviously compared with those in normal control group, W/D of rats in sodium aescinate interventional group and medrol interventional group decreased obviously compared with those in oleate model control group. ③ Score of injury of lungs under light microscope (IQA) ; IQA of rats in oleate model control group advanced obviously compared with that in normal control group. IQA of rats in sodium aescinate interventional group and medrol interventional group lowered significantly compared with that in oleate model control group.④ Partial pressure of oxygen in artery (PaO_2) : PaO_2 of rats in oleate model control group lowered significantly compared with that in normal control group. PaO_2 of rats in sodium aescinate interventional group and medrol interventional group improved significantly compared with that in oleate model control group. ⑤ The levels of SOD and MDA in blood plasma and lung tissue:The levels of SOD in plasma and lung tissue of rats in oleate model control group lowered significantly compared with those in normal control group. SOD in plasma and lung tissue of rats in sodium aescinate in-terventional group and medrol interventional group increased significantly compared with that in oleate model control group. The levels of MDA in plasma and lung tissue of rats in oleate model control group lowered significantly compared with those in normal control group. MDA in plasma and lung tissue of rats in sodium aescinate interventional group and medrol interventional group increased significantly compared with that in oleate model control group. Conclusion Sodium aescinate can improve W/D, IQA and PaO_2 by adjusting oxidization of the acute lung injury model of rats, which may provide a possible path for treating acute lung injury in clinical practice.

Objective To investigate the expression of Specific protein1(SP1)in esophageal squamous cell carci-noma(ESCC)and adjacent normal tissues and its effect on the proliferation and apoptosis of ESCC cells.Methods The expression of SP1 protein in 121 ESCC tissues and 74 adjacent normal tissues was detected by immunohisto-chemistry.Chi-square test and Cox regression analysis were used to analyze the relationship between SP1 and clini-copathological parameters and survival prognosis of ESCC patients.SP1 siRNA(small interfering RNA)was con-structed and transfected into esophageal squamous cell carcinoma Eca1 09 and EC9706 cell lines.Western blot was used to detect the expression of SP1 after transfection.The effects of SP1 on the proliferation and apoptosis of e-sophageal squamous cell carcinoma cells were detected by cloning assay,CCK-8 cell proliferation assay and flow cytometry.Results SP1 protein was expressed in the nucleus of esophageal squamous cell carcinoma tissues,and the expression rate of SP1 protein in esophageal squamous cell carcinoma tissues was significantly higher than that in adjacent normal tissues(x2=20.568,P＜0.01).Comparison between groups showed that the high expression rate of SP1 was higher in female(P=0.041),moderately or poorly differentiated(P=0.038)and T3-T4 inva-sion depth(P=0.041)ESCC(esophageal squamous cell carcinoma)patients.Log-rank test showed that the sur-vival time of patients with high expression of SP1 was shorter than that of patients with low expression of SP1(P=0.048).Multivariate Cox regression analysis showed that TNM(tumor node metastasis classification)stage(Ⅲ+Ⅳ)was a potential risk factor for shorter survival time in patients with esophageal squamous cell carcinoma(P＜0.001).Cell biological experiments showed that compared with the control group,the proliferation ability of esoph-ageal squamous cell carcinoma cell lines decreased(P＜0.05)and the apoptosis index increased(P＜0.05)after silencing SP1.Conclusion SP1 protein is highly expressed in human esophageal squamous cell carcinoma tissues and is associated with poor prognosis in patients.Silencing SP1 can inhibit the proliferation of esophageal squamous cell carcinoma cells and promote their apoptosis.

Objective To explore the effect of different concentrations of endothelin-1 (ET-1)on the en-dogenous nitric oxide (NO)and hydrogen sulfide (H2S)pathways of vascular smooth muscle cells (A7r5 cell lines)in rats.Methods A7r5 cell lines were divided into the control group and the experimental group.ET-1 at a concentra-tion of 10 -8-10 -6 mol/L was added into the experimental group,and as for the control group,the same volume of sterile phosphate buffered saline (PBS)buffer solution was added.The content of NO and H2S in A7r5 cell lines was detected by fluorescent NO probe and H2S probe after ET-1 stimulation for 48 h,respectively.The content of NO in the supernatant was measured by NO assay kit at 48 h of the incubation.The content of H2S in the supernatant was measured by polarographic H2S sensor at 48 h of the incubation. The expressions of inducible nitric oxide synthase (NOS2),endothelial nitric oxide synthase (NOS3),cystathionine -γ -lyase (CSE),cystathionine -β -synthase (CBS)and proliferating cell nuclear antigen (PCNA)were detected by the Western blot method.Results The rela-tive fluorescence intensity of the content of NO in the A7r5 cell lines of ET-1 10 -8,10 -7 and 10 -6mol/L groups (0. 078 ± 0. 080,0.075 ± 0.002,0.056 ± 0.009)was markedly lower than that in the control group(0.094 ± 0. 061), and the differences were statistically significant(F＝15.248,P＜0.05);Compared with the control group[(2. 131 ± 0. 484)μmol/L],the content of NO in the supernatant of the experimental groups [(1.391 ± 0.134 )μmol/L, (1.219 ± 0. 280)μmol/L,(1.116 ± 0.181)μmol/L]was significantly decreased,and the differences were statistically significant(F＝20.833,P＜0.01);NOS2 protein expression(0.457 ± 0.097,0.462 ± 0.116,0.438 ± 0.180)was decreased markedly compared with that of the control group(0.721 ± 0.222),and the differences were statistically sig-nificant(F＝6.196,P＜0.01),but the expression of NOS3 showed no significant differences(F＝2.669,P＞0.05). The relative fluorescence intensity of the content of H2S in the A7r5 cell lines of ET-1 10 -8,10 -7 and 10 -6mol/L groups (0.063 ± 0.002,0.056 ± 0.008,0.042 ± 0.009)was markedly lower than that in the control group (0.082 ± 0. 006),and the differences were statistically significant(F ＝16.297,P＜0.01);Compared with the control group [(29.439 ±4.236)μmol/L],the content of H2S in the supernatant of the experimental groups [(17.516 ±5.144) μmol/L,(14.481 ± 4.885)μmol/L]was significantly decreased,and the differences were statistically significant (F＝12.518,P ＜0.01).CBS protein expression(0.359 ± 0.096,0.270 ± 0.038,0.174 ± 0.051)was decreased markedly compared with that of the control group(0.707 ± 0.107),and the differences were statistically significant (F＝20.833,P＜0.01),and the expression of CSE showed no significant differences(F＝0.708,P＞0.05).The data showed that PCNA protein expression in the 10 -7mol/L ET-1 group(0.686 ± 0.180)significantly increased com-pared with that of the control group(0.437 ± 0.191),and the difference was statistically significant (t＝ -2.840,P＜0.01).Conclusion ET-1 stimulation can lead to the proliferation of vascular smooth muscle cells and down-regu-late its endogenous NO and H2S pathways.

BackgroundQuality of life， as a major criterion for judging the clinical outcome of ovarian cancer patients， can be affected by adverse psychological symptoms of patients. Meanwhile， fear of disease progression， as a frequent psychological symptom among cancer survivors， is significantly influenced by metacognition， while there is a paucity of research into the specific correlation among the three in patients with ovarian cancer. ObjectiveTo explore the correlation among fear of disease progression， metacognition and quality of life in patients with ovarian cancer， and to test the role of fear of disease progression in the relationship between metacognition and quality of life， so as to provide references for improving the quality of life in patients with ovarian cancer. MethodsA total of 135 patients with ovarian cancer hospitalized in Cangzhou People's Hospital of Hebei Province from January 2019 to December 2022 were selected. All subjects were requested to complete the Functional Assessment of Cancer Therapy-Ovarian Cancer （FACT-O）， Fear of Progression Questionnaire-Short Form （FoP-Q-SF） and Metacognition Questionnaire （MCQ） to assess their quality of life， fear of disease progression and metacognitive level. Pearson correlation analysis was adopted to examine the correlation among the above scales. Process v3.5 macro program was utilized to determine the mediating effect of fear of disease progression on the relationship between metacognition and quality of life， and nonparametric Bootstrap with bias-correction was used to test the mediating effect. ResultsA total of 122 patients （90.37%） with ovarian cancer completed the effective questionnaire survey. Patients scored （90.52±17.13） on FACT-O， （68.52±16.31） on MCQ， and （37.72±8.91） on FoP-Q-SF. Pearson correlation analysis denoted that FoP-Q-SF score was negatively correlated with FACT-O score （r=-0.412， P<0.05） and positively correlated with MCQ score （r=0.241， P<0.05）， and MCQ score was negatively correlated with FACT-O score （r=-0.453， P<0.05）. Analysis demonstrated that the total effect of metacognition on quality of life was -0.298 （95% CI： -0.402~-0.186）. The direct effect of metacognition on quality of life was -0.219 （95% CI： -0.504~-0.277）， accounting for 73.49% of the total effect， and the indirect effect of metacognition on quality of life via fear of disease progression was -0.079 （95% CI： -0.162~-0.037）， accounting for 26.51% of the total effect. ConclusionQuality of life is reduced in patients with ovarian cancer， and fear of disease progression plays a partial mediating role in the relationship between metacognition and quality of life.