Objective To observe the expression of Caspase-12 and GRP78 of endoplasmic reticulum stress (ERS) in cardiac arrest and beating heart mitral valve replacement Methods Thirty patients with rheumatic heart disease mitral stenosis were randomly divided into beating heart group (BH,n=15) and cardiac arrest group(CA, n = 15). Both groups accepted MVR by beating heart surgery and cardiac arrest surgery under cardiopulmonary bypass (CPB) respectively. Right atrial myocardial tissues were collected at prior the start of CPB (T0), after aortic cross-clamping 30 minutes (BH group 30 minutes after CPB, T1) and stitched right atrium (T2) respectively. The method of reverse transcriptase polymerase chain reaction (RT-PCR) was applied to detect the expression level of Caspase-12 and GRP78 in two groups and positive staining of Caspase-12 and GRP78 of myocardial tissue slices in both groups was observed by immunohistochemical method. Results The expression of Caspase-12 in CA group heightened at T1and significantly increased at T2 (P < 0.05) but the expression of Caspase-12 in BH group had increased in T2 only (P < 0.05). Caspase-12 in CA group expressed higher than that in BH group at T1 and T2. The expression of GRP78 had increased at T1 in two groups but it in CA group expressed higher than that inBH group at T2. The number of positive staining of Caspase-12 and GRP78 in CA group was higher than that in BH group at T2. Conclusion MVR of beating heart can reduce the reaction of ERS to enhance the myocardial protection under CPB.

Objective To investigate the effects of different delay time on examination results of patients with suspected cervical cancer after injection of contrast agents.Methods A total of 120 patients with suspected cervical cancer were selected and randomly divided into 20 s group,70 s group,90 s group and 120 s four groups.Patients in four groups were injected with non-ionic contrast agent iohexol(300 mgl/mL)90 mL,and the injection rate was 2 mL/s.Patients in four groups started the scanning at 20 s,70 s,90 s and 120 s after injection,and each group was scanned for 240 s.Arterial developing rate,venous developing rate,the positive rate of detection for cervical cancer,accuracy rate of stage for cervical cancer,and accuracy rate of tumor lymph node metastasis were compared between four groups.Results The results showed that the longer the delay time was,the higher the rate of venous developing was and the lower the rate of arterial developing was,and there were significant differences between the four groups(P<0.05).There was no significant difference in the positive rate of cervical cancer between the four groups(P>0.05).There was significant difference in accuracy rate of stage for cervical cancer between four groups(P<0.05),and there was no significant difference in accuracy rate of tumor lymph node metastasis between four groups(P>0.05).Conclusion Different delay time has affect the results of patients with suspected cervical cancer after injection of contrast agents.

Objective To investigate the effects of different delay time on examination results of patients with suspected cervical cancer after injection of contrast agents.Methods A total of 120 patients with suspected cervical cancer were selected and randomly divided into 20 s group,70 s group,90 s group and 120 s four groups.Patients in four groups were injected with non-ionic contrast agent iohexol(300 mgl/mL)90 mL,and the injection rate was 2 mL/s.Patients in four groups started the scanning at 20 s,70 s,90 s and 120 s after injection,and each group was scanned for 240 s.Arterial developing rate,venous developing rate,the positive rate of detection for cervical cancer,accuracy rate of stage for cervical cancer,and accuracy rate of tumor lymph node metastasis were compared between four groups.Results The results showed that the longer the delay time was,the higher the rate of venous developing was and the lower the rate of arterial developing was,and there were significant differences between the four groups(P<0.05).There was no significant difference in the positive rate of cervical cancer between the four groups(P>0.05).There was significant difference in accuracy rate of stage for cervical cancer between four groups(P<0.05),and there was no significant difference in accuracy rate of tumor lymph node metastasis between four groups(P>0.05).Conclusion Different delay time has affect the results of patients with suspected cervical cancer after injection of contrast agents.

Background and Objectives: Osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) plays a critical role in the success of lumbar spinal fusion with autogenous bone graft. This study aims to explore the role and specific mechanism of miR-34c-5p in osteogenic differentiation of BMSCs. Methods: and Results: Rabbit model of lumbar fusion was established by surgery. The osteogenic differentiation dataset of mesenchymal stem cells was obtained from the Gene Expression Omnibus (GEO) database, and differentially expressed miRNAs were analyzed using R language (limma package). The expressions of miR-34c-5p, miR-199a-5p, miR-324-5p, miR-361-5p, RUNX2, OCN and Bcl-2 were determined by qRT-PCR and Western blot. ELISA, Alizarin red staining and CCK-8 were used to detect the ALP content, calcium deposition and proliferation of BMSCs. The targeted binding sites between miR-34c-5p and Bcl-2 were predicted by the Target database and verified using dual-luciferase reporter assay. MiR-34c-5p expression was higher in rabbit lumbar fusion model and differentiated BMSCs than normal rabbit or BMSCs. The content of ALP and the deposition of calcium increased with the osteogenic differentiation of BMSCs. Upregulation of miR-34c-5p reduced cell proliferation and promoted ALP content, calcium deposition, RUNX2 and OCN expression compared with the control group. The effects of miR-34c-5p inhibitor were the opposite. In addition, miR-34c-5p negatively correlated with Bcl-2. Upregulation of Bcl-2 reversed the effects of miR-34c-5p on ALP content, calcium deposition, and the expressions of RUNX2 and OCN. Conclusions miR-34c-5p could promote osteogenic differentiation and suppress proliferation of BMSCs by inhibiting Bcl-2.

Background and Objectives: Osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) plays a critical role in the success of lumbar spinal fusion with autogenous bone graft. This study aims to explore the role and specific mechanism of miR-34c-5p in osteogenic differentiation of BMSCs. Methods: and Results: Rabbit model of lumbar fusion was established by surgery. The osteogenic differentiation dataset of mesenchymal stem cells was obtained from the Gene Expression Omnibus (GEO) database, and differentially expressed miRNAs were analyzed using R language (limma package). The expressions of miR-34c-5p, miR-199a-5p, miR-324-5p, miR-361-5p, RUNX2, OCN and Bcl-2 were determined by qRT-PCR and Western blot. ELISA, Alizarin red staining and CCK-8 were used to detect the ALP content, calcium deposition and proliferation of BMSCs. The targeted binding sites between miR-34c-5p and Bcl-2 were predicted by the Target database and verified using dual-luciferase reporter assay. MiR-34c-5p expression was higher in rabbit lumbar fusion model and differentiated BMSCs than normal rabbit or BMSCs. The content of ALP and the deposition of calcium increased with the osteogenic differentiation of BMSCs. Upregulation of miR-34c-5p reduced cell proliferation and promoted ALP content, calcium deposition, RUNX2 and OCN expression compared with the control group. The effects of miR-34c-5p inhibitor were the opposite. In addition, miR-34c-5p negatively correlated with Bcl-2. Upregulation of Bcl-2 reversed the effects of miR-34c-5p on ALP content, calcium deposition, and the expressions of RUNX2 and OCN. Conclusions miR-34c-5p could promote osteogenic differentiation and suppress proliferation of BMSCs by inhibiting Bcl-2.

OBJECTIVE: We hypothesize that the amplitude of low-frequency fluctuations (ALFF) is involved in the altered regional baseline brain function in social anxiety disorder (SAD). The aim of the study was to analyze the altered baseline brain activity in drug-naive adult patients with SAD. METHODS: We investigated spontaneous and baseline brain activities by obtaining the resting-state functional magnetic resonance imaging data of 20 drug-naive adult SAD patients and 19 healthy controls. Voxels were used to analyze the ALFF values using one- and two-sample t-tests. A post-hoc correlation of clinical symptoms was also performed. RESULTS: Our findings show decreased ALFF in the bilateral insula, left medial superior frontal gyrus, left precuneus, left middle temporal gyrus, right middle temporal pole, and left fusiform gyrus of the SAD group. The SAD patients exhibited significantly increased ALFF in the right inferior temporal gyrus, right middle temporal gyrus, bilateral middle occipital gyrus, orbital superior frontal gyrus, right fusiform gyrus, right medial superior frontal gyrus, and left parahippocampal gyrus. Moreover, the Liebowitz Social Anxiety Scale results for the SAD patients were positively correlated with the mean Z values of the right middle occipital and right inferior occipital but showed a negative correlation with the mean Z values of the right superior temporal gyrus and right medial superior frontal gyrus. CONCLUSION: These results of the altered regional baseline brain function in SAD suggest that the regions with abnormal spontaneous activities are involved in the underlying pathophysiology of SAD patients.
Adult* ; Anxiety ; Anxiety Disorders* ; Brain* ; Humans ; Magnetic Resonance Imaging* ; Orbit ; Parahippocampal Gyrus

Objective: To assess and analyze clinical nursing workload of tertiary general hospitals in Tianjin. Methods: 4 tertiary general hospitals in Tianjin were recruited by convenience sampling. 13 representative departments of the medical system and the surgical system were selected as the investigation departments. All the clinical duty nurses of every day work in selected departments were taken as the observation objects. Unified training investigators used work sampling method to observe and record the "operation" , "movement", "waiting" and "others" four types of activities of nurses, taking an observation point in a minute; SPSS17.0 was used for analysis. Results: Totally 172 800 sampling points were selected. Besides 2.62% (4 534/172 800) of other affairs, the total nursing workload in one day was 97.38% (168 264/272800), with 85.03% (146 923/172 800) operating time including direct nursing accounting for 33.64% (58 144/172 800), indirect nursing accounting for 8.92% (15 422/172 800), and 42.46% (73 363/172 800) of related nursing. Movement accounted for 11.71% (20 228/172 800), while waiting accounted for 0.65% (1 113/172 800). Conclusion Generally, nurses in tertiary general hospitals have long working time and heavy workload, but direct nursing which can reflects the value and connotation of nursing work is low. In nursing work, the "waiting" caused by the lack of personnel, material, equipment, environment problems made a waste of time and human resources to certain extent. Therefore, results of the present study can provide reference for tertiary hospitals to optimize the allocation of nursing human resources, improve the quality of nursing service, reduce the workload of nurses and construct lean management system.

Objective: To investigate the smartphone addiction among college students during the Coronavirus Disease 2019 (COVID-19) pandemic and its association with daily behaviors and mental health,and to provide reference for heath education and psychological counseling for college students. Methods: An observational study using online quyestionnaire was conducted among 10 357 college students of two provincial medical schools in Guangdong and Shanxi Province from February 24th to March 4th in 2020. Participants were investigated on demographic information, smartphone addiction, daily routine, physical activity, weight status, anxiety, and other health information. Logistic regression with inverse probability treatment weighting (IPTW) based on propensity score was used to analyze the association between smartphone addiction with daily behavior and mental health. Results: The prevalence of smartphone addiction was 59.42%. The prevalence of phone addiction was higher in postgraduates, senior undergraduates, students with non-medical major, students living in GuangDong and those without regular exercise habit before vacation(χ 2=47.91，17.78，42.75，138.58，P<0.05). With IPTW, there were significant associations between smartphone addiction and late bedtimes (OR=1.82, 95%CI=1.66-1.98) and wake-up times (OR=1.55, 95%CI=1.44-1.68), more sedentary behaviors (OR=1.21, 95%CI=1.12-1.31), less moderate to vigorous physical activity (OR=1.33, 95%CI=1.22-1.44), anxiety (OR=2.98, 95%CI=2.52-3.40), weight gain(OR=1.27，95%CI=1.17-1.37) and other detrimental daily behavior and feelings. Conclusion High prevalence of smartphone addiction has been observed during the COVID-19 pandemic, with impaired daily behavior and mental health.

The classification of nursing in clinical departments is the basis for deepening high-quality nursing service and implementing nursing post management, which is also the key point to improvethe level of nursing management. The objectivity of grading standard and rationality of the method would directly influence the scientificity and operability of human resources allocation and performance assessment scheme. Because of the diversity of departments in the tertiary hospitals and the requirement for departments classification under the trend of meticulous and scientific management of nursing posts, the present paper reviews quantity of literature on the development process, influencing factors, specific methods and applications effects of tertiary hospitals at home and abroad, to provide reference for the classification of clinical departments for tertiary hospitals, and to lay the foundation for the implementation of post management, the optimization of human resource allocation and the establishment of performance assessment mechanism in tertiary hospitals.

Objective: To explore the current status of nursing work process in Tianjin Third Grade A General Hospital, to interpret the available space of nursing human resources, and to find new ideas for configuration and optimization. Methods: According to the industrial engineering theory and program analysis method, combined with the characteristics of nursing professional, define the name of the activity, build the evaluation index and formula of the nursing process level, the workday practice method was used to investigate and analyze the nurses′ work processes in a total of 48 departments in four hospitals in Tianjin. Results: The overall nursing process level of Tianjin Third Grade A General Hospital was: β = 0.756. Among them, the process utility coefficient was: β₁=0.913, and the coherence coefficient is only: β₂=0.627. There were differences in the level of nursing processes between different hospitals and departments. Among them, the process coherence level was different and the overall level was low. Conclusions The level of nursing procedures in Tianjin Third Grade A General Hospital needs to be improved. It is necessary to improve the continuity of nursing work, appropriately increase the reserve talents, strengthen the standardized training of nursing procedures, and explore more flexible scheduling methods. Conditional hospitals and departments can explore the application of information technology in nursing work or implement an unaccompanied mode to reduce the workload of nurses and improve the continuity of the nursing process, thereby improving the level of nursing processes and improving the quality and efficiency of nursing work.