Objective To explore the influence of PUMA on radiosensitivity of pancreatic cancer AsPC-1 cells after Slug gene inhibition by transfected short interferencing RNA(siRNA). Methods The AsPC-1 cells were infected with MOI 10,50,100 for 72 h, respectively. The expression of Slug and PUMA was analyzed by Western blotting and immunohistochemistry methods. The transfected and control cells were exposed to 4 Gy γ-rays. The cells inhibition rate was examined by MTT, Hoechst 33342 and IP double staining. DNA ladder and Giemsa staning was used to observe apoptosis. Results The relative value of Slug expression was 0.831 ±0.14,0. 546 ±0.12 and 0.178 ±0.08 after AsPC-1 was infected with Slug-siRNA ( MOI 10,50,100) for 72 h, significantly lower than that of control group ( F = 4. 992,P ＜ 0.05 ).The relative value of PUMA was 0. 325 ±0. 07,0. 593 ±0. 11 and 0. 978 ±0. 12, after AsPC-1 was infected with Slug-siRNA ( MOI 10,50,100) for 72 h, significantly higher than that of control group ( F = 4. 324,P ＜ 0. 05 ). The cell proliferation rate was ( 78.76 ± 9. 36 ) % in transfection combined with radiosensitivity group, significantly higher than that of transfection group [ ( 43.68 ± 6.71 ) % ] and radiosensitivity group alone [( 19.25 ± 3.72)% ] (F = 5.056, P ＜ 0.05). The apoptosis of transfection combined with radiosensitivity group was significantly higher than that of others. Conclusions Slug gene targeting siRNA could inhibit the expression of Slug, and consequently increase the activation of PUMA expression, and so enhance the radiosensitivity to γ-rays.

Objective Explore the expression of intercellular adhesion molecule-1(ICAM-1) and Pselectin in the healing process for possible application in timing of incised wounds. Method An immunohistochemical study on the expression of ICAM-1 and P-selectin was performed on rats vital skin incised wounds (5min～7d)using postmortem incisions(5～30min)as control.Results In the vital skin incisions,positive stain of ICAM-1 was observed on epidermis began from 1h and lasted till 3d, while the P-selectin stain was observed on vascular endothelium as early as 10min after incision and lasted 5h; in addition, the expression of ICAM-1 was also found in the inflammatory cells and fibroblasts,the lasting period varied from group to group (groupⅠ 5min～1h,groupⅡ 3～7h,group Ⅲ 9～12h,groupⅣ 1d,groupⅤ 3d,groupⅥ 5～7d.).The positive ratios of ICAM-1 among the cells were very low in group Ⅰ(0.41?0.73%),and increased considerably in group Ⅱ(9.79?3.74%) and group Ⅲ(23.33?1.10%),maximized in group Ⅳ(30.58?2.65%),then decreased in group Ⅴ and Ⅵ.There were no changes of ICAM-1 and P-selectin in the postmortem incision group. Conclusion ICAM-1 and P-selectin are considered potentially useful markers for wound age determination in forensic practice.

Physical restraint is a complex and dynamic process in which nurses are the main decision makers and implementer. This article is to review the factors influencing the implementation of physical restraint in ICU nurses, and summarize from 4 aspects: nurses' own factors, environmental factors, promotion measures of rational use of physical restraint and ethical factors, so as to provide a basis for the effective clinical intervention measures in the future.

Objective? To investigate the incidence of post-stroke depression(PSD) and its risk factors, so as to provide the theoretical reference for the prevention of community PSD. Methods? A total of 300 stroke patients hospitalized in the department of neurology in the First Bethune Hospital of Jilin University from July 2016 to May 2017 were selected and assessed by Self-rating Depression Scale(SDS) and Hamilton Depression Scale(HAMD) on their depression. The incidence of PSD was analyzed and after controlling the confounding factors, the relation between PSD and relevant influencing factors were indicated by the Odds Ratio(OR) and 95% Confidence Interval (CI). Results? The incidence of PSD was 31.6% (95/300) in the 300 stroke patients. After controlling the confounding factors, it was found that marital status, occupational status, decreased activity ability, muscle strength, neurological impairment and diabetes were closely related to PSD (P＜0.05). Conclusions? The prevalence of PSD is high and closely related to marital status, occupational status, decreased activity ability, muscle strength, neurological impairment and diabetes. Understanding the risk factors of PSD is necessary to provide intervention for the prevention and treatment of PSD, which has a certain effects in reducing PSD and improving the PSD patients' physical function.

China has entered an aging society,fall in the elderly often causes their physical and mental damage and even be life-threatening.Literature reviews studying on fall prevention in the elderly discovered that the improvement of the lower-extremity muscle strength can reduce the fall incidence in the elderly.This paper summarized the current researches on the methods for elderly people's lower-extremity muscle strength improvement.In addition,this paper also gave an analysis of both advantages and disadvantages of these methods,in order to provide a theoretical evidence and reference for the future study in improving the lower-extremity muscle strength.

Objective? To analyze hot research areas of nutrition support for cancer patients from 2008 to 2017, so as to provide guidance for the development of researchin nutrition support for the cancer patients in our country. Methods? Databases including CNKI, Wanfang, and VIP were searched with the subject or key words of "tumor""cancer""nutrition support/nutritional support", and databases including PubMed, Web of Science were searched with the subject or keywords of "cancer""tumor""malignant tumor"and"nutrition support/nutritional support" to review the relevant literature published from 2008 to 2017. Softwares including BICOMB 2.0 and SPSS 23.0 were used to generate high-frequency keywords, and construct cluster analysis. Results A total of 889 articles were retrieved and the number of articles showed an increasing trend on the whole. There were 69 core authors with≥3 published articles, and 62 high frequency subject words with word frequency ≥21 times. Cluster analysis showed that the research mainly focused on four fields: perioperative nursing of gastrointestinal cancer patients; nutritional risk screening and prognostic factors in gastrointestinal cancer patients; nutritional status and quality of life of patients treated with chemotherapy/radiotherapy;nutritional assessment and intervention for malignant oncology patients. Conclusions? The concept of tumor nutrition has been gradually developed, but there is still great room for development in the future in terms of the depth and breadth of research, early identification of patients with nutritional risk, nutritional assessment, formulation of feasible nutritional intervention programs and measures to improve the prognosis of patients and their quality of life.

The rapid development of point-of-care testing (POCT) in clinical laboratories has brought challenges to the unified management in the hospital. There are many problems, such as how to ensure the ability and qualification of POCT operators, how to improve the quality management awareness of human, machines, materials, methods and environment in the process of POCT in clinical laboratories, how to help the clinical laboratories in the hospital to carry out POCT comparison, and how to strengthen the information construction of POCT in the hospital. Thus, this article reviews the practice and experience of POCT management in our hospital on POCT quality assurance and the problems existing in POCT in clinical departments, proposes suggestions and solutions to strengthen the unified management of POCT in clinical laboratories and establish POCT quality management documents and to improve quality awareness. We hope to provide references for hospital administrators, medical departments, nursing departments, quality control departments and other functional departments on the quality management of POCT in the hospital, and find helpful answers to the puzzles of clinical laboratory in POCT, so as to make joint efforts to standardize the quality management of POCT in the hospital to ensure the accuracy of testing results.

Objective:To investigate the clinical characteristics, gene mutation, treatment and prognosis of familial aggregation myelodysplastic syndromes/acute myeloid leukemia (MDS/AML).Methods:The 3 familial aggregation MDS/AML admitted to Shanghai Yangpu District Hospital from August 2012 to March 2019 were collected. The bone marrow examination, gene mutation detection, therapeutic effect and prognosis of the patients were retrospectively analyzed, and the relevant literature was reviewed.Results:In pedigree 1, the survival time of 2 AML patients was 8 months and 1 month, respectively. In pedigree 2, the transformation time of 2 patients diagnosed MDS to AML/high-risk MDS was 4 and 3 months, the survival time was 5 and 8 months, respectively. TP53 and RUNX1 mutations were detected in the older brother. In pedigree 3, the survival time of the AML patient was 13 months, and the MDS patient was stable.Conclusions:Familial aggregation MDS/AML has rapid progression and short survival time, and its diagnosis needs to be combined with family history, cytogenetics, and molecular biology.

Objective:To explore the training needs for clinical core competence of master of nursing specialist (MNS) from the perspective of supervisors, providing reference for the development of future MNS clinical practice training programs.Methods:Using phenomenological research methods from qualitative research, purposive sampling was used to select 10 MNS supervisors from Jilin Province, Heilongjiang Province, Sichuan Province, and Zhejiang Province as research subjects for semi-structured interviews from May to July 2023. Colaizzi 7-step analysis method was used to extract themes.Results:Six themes were extracted, including the need to strengthen MNS ideological and political education, differences in clinical training needs and ability goals between fresh and non-fresh students, the need to enhance MNS clinical practice ability, clinical research should be a key training content, thinking ability training should be integrated throughout the entire clinical training process, and achievement transformation.Conclusions:Relevant training institutions should attach importance to the cultivation of MNS ideological and political education, specialized practical abilities, thinking abilities, clinical research, and achievement transformation abilities, distinguish the tendency of cultivating fresh and non-fresh students, and actively set up relevant courses to improve students' core competence and job competitiveness, and cultivate nursing expert talents that truly meet the needs of clinical development.

Objective:To develop a joint clinical practice teaching and assessment program tailored to the clinical training needs of master of nursing specialist (MNS) postgraduates which focuses on core competency requirements.Methods:Totally 10 MNS postgraduate supervisors were selected by convenience sampling for semi-structured interviews between May and July 2023. Subsequently, a Delphi method was employed with 22 MNS postgraduate supervisors over two rounds of consultations from October to December 2023.Results:A total of 22 experts participated in the Delphi consultations, with an effective response rate of 100.00% (22/22) in both rounds. The expert authority coefficients were 0.822 and 0.833, respectively, for the two rounds. The Kendall's W for various levels of indicators ranged from 0.097 to 0.243 and 0.159 to 0.256, respectively ( P<0.01). The final training program included five primary indicators, 10 secondary indicators, and 26 tertiary indicators. Conclusions:The development process for the joint clinical practice teaching and assessment program for MNS postgraduates is scientific and reliable. The program can serve as a reference for the clinical practice training of MNS postgraduates.