Objective This study focuses on the construction and cultivation of young administrative management per-sonnel in Shanghai's public hospitals,aiming to provide scientific support for the development of high-quality young administra-tive management professionals in public hospitals.Methods Utilizing an anonymous online survey,this research collected data on the current state of subjective well-being and its influencing factors among the targeted groups from hospitals.Analysis of vari-ance and multivariate analysis were conducted to analyze potential factors affecting their sense of well-being.Results A total of 171 cases were included in the survey,with an average score of 80.37.This group of respondents exhibited a higher level of sub-jective well-being compared to the national norm.Notably,young administrative staff who had obtained Shanghai residency,had a surplus income,spent time with family after work,had career advancement opportunities,felt a strong connection to their work's value,and received affirmation from family members,demonstrated higher subjective well-being scores,with significant statisti-cal differences(P＜0.05).Conversely,those with an income ranging from 0 to 100 000,and those who felt overwhelmed by their current roles,scored lower on well-being,with significant statistical differences(P＜0.05).Conclusion This study sug-gests that by bolstering professional security and job stability,fostering a set of correct values and a sense of work identity,and improving job satisfaction and competence,the subjective well-being of this group can be further elevated.This,in turn,can in-ject new momentum into the high-quality development of public hospitals.

Objective:To investigate the status quo of stress response, self-care and job performance among nurses in emergency department, and to analyze whether self-care has a mediating effect between stress response and job performance.Methods:This was a cross-sectional survey. From February to April 2022, 467 emergency department nurses from 11 tertiary hospitals in Changsha were investigated and analyzed by using random cluster sampling method, general data questionnaire, Stress Response Questionnaire, Self-Compassion Scale and Nursing Performance Scale.Results:The total score of nurses′ Stress Response Questionnaire was (78.02 ± 26.78) points, the total score of Self-Compassion Scale was (81.75 ± 22.23) points, and the total score of Nursing Performance Scale was (74.05 ± 21.57) points. Stress response was negatively correlated with self-care and work performance ( r=-0.452, -0.572, both P<0.01), and self-care was positively correlated with work performance ( r=0.515, P<0.01). Self-care played a partial mediating role between stress response and job performance, accounting for 26.98% of the total effect. Conclusions:Self-care is an intermediary variable between emergency department nurses′ stress response and work performance. Nursing managers should pay attention to emergency department nurses′self-care and stress response levels, and evaluate them regularly in order to take timely intervention measures to improve their self care ability, reduce stress response, and improve work performance of emergency department nurses.

Objective:To summarize the clinical and genetic characteristics in patients with transthyretin familial amyloid polyneuropathy (TTR-FAP).Methods:Fourteen unrelated TTR-FAP patients diagnosed at Xuanwu Hospital, Capital Medical University from September 2014 to February 2022 were retrospectively reviewed. The clinical manifestation, electrophysiology, cardiac function, biopsy and gene mutation were analyzed.Results:In the 14 patients (13 males, 1 female) diagnosed as TTR-FAP, the mean age at onset was 53.9 years (range: 33.0-71.0 years), with a mean course from symptom-onset to diagnosis of 4.1 years. The late-onset type occurred in 9 cases. Seven patients had a family history of TTR-FAP. Distal paresthesia of lower limbs was the commonest initial symptom (8 cases), with sensorimotor neuropathy and autonomic dysfunction seen initially in 4 and 2 cases, respectively. Cardiac involvement occurred in 6/8 of the patients. Nerve conduction studies indicated extremely axonal impairment with demyelinating features. Sural nerve biopsies showed moderate to severe axonal loss of myelinated fibers and the positive rate of Congo red staining was 8/14. Of 8 different TTR mutations detected, V50M was the most common (appearing in 5 cases). No obvious neuropathy progression was seen in the 5 patients who received tafamidis and 2 patients died of dyscrasia. Conclusions:TTR-FAP is more common in males, with sensorimotor axonal polyneuropathy, autonomic dysfunction and cardiac subclinical damage as the predominant symptoms. V50M is the commonest mutation. Tafamidis can delay the progression of disability.

Objective: To investigate the prevalence and influencing factors of chronic diseases among adult residents in Hunan Province, so as to provide insights into management of chronic diseases. Methods: Permanent residents at ages of 18 years and older were sampled using a multi-stage random sampling method in Hunan Province from April to June, 2021, and participants' demographics, smoking, alcohol consumption, sleep quality and development of chronic diseases were collected using questionnaire surveys. The prevalence of chronic diseases was estimated and standardized by the seventh national population census data. In addition, the factors affecting the prevalence of chronic diseases were identified using a multivariable logistic regression model. Results: A total of qualified 9 469 adult residents were enrolled, including 4 678 men (49.40%) and 4 791 women (50.60%), with a mean age of (59.37±14.14) years. The overall prevalence and standardized prevalence rates of chronic diseases were 50.84% and 38.44%, respectively, and the prevalence and standardized prevalence rates of hypertension, protrusion of intervertebral disc and diabetes were 18.66% and 15.06%, 6.31% and 5.28%, and 4.44% and 4.18%, respectively. Multivariable logistic regression analysis revealed that women (OR=1.252, 95%CI: 1.131-1.386), age (45 years-, OR=3.699, 95%CI: 3.104-4.407; 60 years and older, OR=9.255, 95%CI: 7.743-11.064), unmarried/divorced/widowed (OR=1.170, 95%CI: 1.036-1.321), educational level (junior high school, OR=0.730, 95%CI: 0.653-0.816; high school/technical secondary school, OR=0.710, 95%CI: 0.609-0.827; diploma and above, OR=0.586, 95%CI: 0.454-0.758), monthly household income (3 000 yuan-, OR=0.846, 95%CI: 0.759-0.943; 6 000 yuan-, OR=0.819, 95%CI: 0.710-0.943; 10 000 yuan and higher, OR=0.790, 95%CI: 0.657-0.950), smoking (OR=1.528, 95%CI: 1.363-1.713), insomnia (OR=2.637, 95%CI: 2.271-3.063) statistically correlated with the development of chronic diseases. Conclusion The prevalence of chronic diseases was 50.84% among adult residents in Hunan Province in 2021, and hypertension was the predominant chronic disease. Women, the middle-aged and elderly residents, residents with a low educational level and residents with low incomes are at a high risk of developing chronic diseases.

Objective:To explore the value of Krüppel-like factor 5 (KLF5), a family member of the zinc finger protein transcription factor, in the diagnosis and prognostic evaluation of hepatocellular carcinoma (HCC).Methods:Cancerous and non-cancerous tissues were collected from 126 cases after HCC surgery by self-matching method with microarray fabrication. Immunohistochemistry was used to analyze the expression of KLF5, clinicopathological characteristics and prognostic value. The sera of 222 cases with chronic liver disease were collected and their KLF5 levels were quantitatively determined by enzyme-linked immunosorbent assay (ELISA). Simultaneously, 40 normal human sera were used as controls to evaluate the value of abnormal KLF5 in the diagnosis and differentiation of benign and malignant liver diseases. T-test, Z-test and χ 2 test were performed on the data. Results:The positive expression rate of KLF5 in the HCC group was 95.2% (120/126), which was significantly higher than the non-cancerous group 38.9% (49/126; χ 2 = 14.385, P < 0.001). KLF5 expression was significantly correlated with TNM stage (stage I 35%, stage II 40%, stage III 74.4%, stage IV 78.1%), tumor size, alpha fetoprotein (AFP) concentration, portal vein embolism, HBV infection and 5-year survival rate. Univariate/multivariate analysis showed that KLF5 high expression was an independent predictor of HCC prognosis. The serum KLF5 level was significantly higher in HCC patients than liver cirrhosis, chronic hepatitis and normal control group ( P < 0.001). With the serum KLF5 > 800 ng/ml and AFP > 25 μg/L as limit, the positive rates for HCC diagnosis were 90.48% and 73.81%, respectively, which were lower than the AFP specificity and false positive rate, and was helpful for the differential diagnosis of benign and malignant liver diseases. Conclusion:The overexpression of KLF5 in liver cancer tissues and blood is closely related to the HCC clinical stage and prognosis. Moreover, KLF5 analysis is helpful for HCC diagnosis and differential diagnosis.

The early diagnosis and effective treatment of hepatocellular carcinoma (HCC) still remains a difficult problem that plagues the medical community. Exosomes are microvesicles with a diameter of 40~100 nm, and contains proteins, lipids and nucleic acids (mRNAs, lncRNAs, circRNAs, and microRNAs). They serve as an information exchange carrier, and play an important role in regulating and controlling the biomolecular function to maintain the stability of the intracellular environment. The function of exosomes in HCC includes intercellular communication, neoangiogenesis, cancer cell metastasis and multidrug resistance, which mediates the transformation of microRNAs (miRNA) and regulate the microenvironment of tumor progression, and then affect the pathophysiological behavior of cancer cells. Exosome-derived miRNA can be used for HCC monitoring or potential specific markers of early diagnosis. In addition, with the development and application prospects it could be a therapeutic goal for HCC. This paper summarizes the recent progress in the study of HCC-derived exosomal miRNA.

Objective:To investigate the expression of hypoxia-inducible factor (HIF)-1α, vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2) during the progression of liver diseases and the molecular mechanism of HIF-1α in regulating the expression of angiogenic factors in hepatocellular carcinoma (HCC).Methods:Serum samples from hospitalized patients with liver cancer, liver cirrhosis, and chronic hepatitis were collected, and healthy people were used as controls. Mouse models of hepatocarcinogenesis were used to detect the dynamic expression of HIF-1α, VEGF and Ang-2. Enzyme-linked immunosorbent assay was used to quantitatively analyze the serum levels of HIF-1α, VEGF and Ang-2 in patients with liver disease and mice. HIF-1α-specific miRNA expression plasmids was constructed to transfect HepG2 human HCC cells. HIF-1α mRNA transcriptional interference effects were analyzed on biological behavior, VEGF and Ang-2 expression, and epithelial mesenchymal transformation (EMT) in human HCC cell line. The sample means of multiple groups were compared by analysis of variance and q test and the sample rate was compared by χ2 test. Results:In patients with chronic liver disease, the serum expression of HIF-1α, VEGF and Ang-2 in the liver cancer group (145.6 ± 32.6) μg/L, (458.9 ± 125.3) μg/L and (42.9 ± 5.1) μg/L was significantly higher than the liver cirrhosis ( P < 0.001) (79.5 ± 28.4) μg/L, (206.8 ± 56.8) μg/L and (26.2 ± 6.1) μg/L and chronic hepatitis group (60.1 ± 18.8) μg/L, (178.1 ± 85.4) μg/L and (21.8 ± 6.9) μg/L. In addition, HIF-1α was positively correlated with VEGF ( r = 0.937, P < 0.001), HIF-1α and Ang-2 ( r = 0.933, P < 0.001), and VEGF and Ang-2 ( r = 0.910, P < 0.001). Mouse models of hepatocarcinogenesis confirmed that HIF-1α, VEGF and Ang-2 had progressively increased during the process of malignant transformation from normal hepatocytes, hepatocyte degeneration, and precancerous lesions to canceration. HIF-1α miRNA intervention plasmid had transformed HepG2 cells. Compared with the blank group, HIF-1α mRNA, HIF-1α, VEGF and Ang-2 were decreased by 88.1%, 59.8%, 54.0% and 36.0% at 72h, respectively. The expression level of EMT-related protein Snail (0.26 ± 0.02 and 0.67 ± 0.09, q = 6.75, P < 0.003), VIM (0.27±0.08 and 0.73±0.04, t = 10.35, P < 0.001) and Twist (0.24 ± 0.07 and 0.73 ± 0.02, q = 12.08, P < 0.001) was significantly reduced, but the expression level of E-cadherin (0.76 ± 0.08 and 0.27 ± 0.09, q = 7.05, P < 0.002) was significantly increased. Conclusion:HIF-1α mediates and regulates angiogenesis-related factors such as VEGF and Ang-2 expression in hepatocellular carcinoma. Furthermore, HIF-1α transcriptional interference can significantly affect the biological characteristics and EMT transformation of hepatocellular carcinoma cells.

Objective: To investigate the risk factors of left ventricular hypertrophy (LVH) in non-dialysis dependent end-stage renal disease (ESRD) patients. Methods: ESRD patients in the First Affiliated Hospital of Sun Yat-sen University from Jan to July 2019 were enrolled. Demographic data of patients were collected and biochemical parameters were measured. Hydration status index (extracellular water/total body water, ECW/TBW) was measured by bioelectrical impedance analysis (BIA), and LVH was diagnosed by echocardiography. Patients were divided into LVH group and non-LVH group according to LVH diagnostic criteria, and the incidence of LVH in ESRD non-dialysis patients was calculated. Logistic regression was used to analyze the risk factors of LVH. Results: A total of 105 non-dialysis dependent ESRD patients aged (47.03±12.56) years (21-78 years) were enrolled in present study, among whom 74 patients (70.5%) had LVH. Compared to non-LVH group, patients in LVH group had higher proportion of diabetes and calcium antagonist used, higher value of ECW/TBW and ECW/Height, higher level of night systolic pressure, and were older (all P<0.05). Spearman correlation analysis showed LVH was positively correlated to diabetes (r=0.345, P<0.001), night systolic pressure (r=0.286, P<0.001), night diastolic pressure (r=0.251, P=0.012), calcium antagonist used (r=0.381, P=0.013), ECW/TBW (r=0.383, P=0.005), ECW/Height (r=0.298, P=0.003), 24 h sodium urinary excretion (r=0.257, P=0.025), brain natriuretic peptide (r=0.315, P=0.005) and hemoglobin (r=0.307, P=0.018), and negatively correlated to 24 h potassium urinary excretion (r=-0.248, P=0.023). Logistic regression showed that increased night diastolic pressure (OR=2.036, 95%CI 1.144-3.623, P=0.016) and ECW/TBW (OR=1.232, 95%CI 1.025-1.523, P=0.014) were the independent risk factors of LVH after adjusting for gender, age, diabetes, nocturnal blood pressure, antihypertensive drugs used, ECW/TBW, urinary sodium excretion and hemoglobin. Conclusions LVH is common in non-dialysis dependent ESRD patients. Over hydration and high night diastolic blood pressure are the independent risk factors of LVH in non-dialysis dependent ESRD patients.

Objective: To quantitatively detect CD44 expression in patients with nonalcoholic fatty liver disease (NAFLD) for comparative analysis. Methods: Patients with chronic liver diseases accompanied with or without NAFLD, including chronic hepatitis B, cirrhosis and hepatocellular carcinoma after chronic hepatitis B, and healthy blood donors as normal controls who admitted to the Affiliated Hospital of Nantong University from May to October 2018 were selected. The proportion of CD44 positive cells was analyzed by flow cytometry. CD44 level was quantified by an enzyme-linked immunosorbent assay, and the biochemical indicators such as serum aspartate aminotransferase, alanine aminotransferase activity, total cholesterol and triglyceride were routinely analyzed. The cancerous and adjacent cancerous tissues of patients accompanied with or without NAFLD were collected by self-matching method and analyzed by immunoblotting and histochemistry and compared by CD44 integrated optical density. Image-Pro Plus version 6.0, Image J, GraphPad Prism 5.0, Photoshop, Microsoft Excel and IBM SPSS statistics 23 were used to analyze and draw pictures. An independent sample t-test was used to compare the differences between groups. Results: Patients accompanied with NAFLD had hepatocyte injury and dyslipidemia. NAFLD and chronic liver disease patients had significantly elevated serum CD44 levels than normal control group (P < 0.01). CD44 positive lymphocyte ratio was 78.19 % ± 16.33 % in NAFLD patients and 68.47% ± 20.91% in chronic hepatitis B group, which was higher than the control group (46.51% ± 20.52%). Chronic hepatitis B group with steatosis had significantly higher CD44 concentration (181.42 ± 49.36) ng/ml than chronic hepatitis B group (142.52 ± 53.87) ng/ml and normal control group (99.47 ± 15.23) ng/ml. CD44/GAPDH ratio in the liver cancer group (1.306 ± 0.614) was significantly higher than paracancerous group (0.477 ± 0.291) and the difference between the two groups was statistically significant (t = 3.451, P = 0.004). The integrated optical density of CD44 in the NAFLD-related liver cancer and paracancerous group were 25.721 ± 5.881 and 14.155 ± 4.001 and the difference between the groups was statistically significant (t = 14.544, P < 0.001). The pathological features of high expression of CD44 in patients with hepatocellular carcinoma were significantly correlated with HBV infection, tumor size, single/multi-center, and lymph node metastasis, degree of differentiation, TNM grade, Child-Pugh score, portal vein tumor thrombus and extrahepatic metastasis. HCC patients with NAFLD had significantly higher serum CD44 (234.62 ± 69.40) ng/ml than patients without NAFLD (186.49 ± 58.89) ng/ml (t = -3.191, P = 0.002), but there was no statistically significant difference in the clinicopathological characteristics between the high/low CD44 groups of HCC patients with NAFLD. Conclusion The results suggest that CD44 is abnormally activated and its mechanism may play an important role in the progression of NAFLD.

Objective: To investigate the Wnt3a expression in tissues of HCC and its gene knockout on effects of HepG2 cell proliferation or xenograft tumor growth. Methods: Hepatic Wnt3a expressions in 87 HCC and their matched surrounding tissues were observed by tissue microarray and immunohistochemistry for analyzing its clinicopathological characteristics; Wnt3a-knockout HepG2 cell lines were established by Crispr/cas9-sgRNA system and genomic cleavage efficiency was verified at gene level by surveyor assay. The relative proteins were confirmed by Western blotting; Cell Counting Kit-8 assay was used to examine cell proliferation after knocking-out Wnt3a successfully, and the nude mice HepG2 cell xenograft tumors delete that the relationship between Wnt3a and HCC growth. Results: The positive Wnt3a with brown staining particles was mainly distributed in cytosol and membrane of hepatocytes. The incidence of hepatic Wnt3a expression in cancerous tissues (95.4%) was significantly higher (χ ² = 47.754, P < 0.001) than that in their surrounding tissues (49.4%). The high Wnt3a expression was 70.1% in the HCC and only 14.9% in the surrounding tissues. High Wnt3a expression was associated with poorly-differentiated grade, liver cirrhosis, HBV infection, portal vein invasion, TNM stage and 5-year survival rate. After knocked-out by Crispr/cas9-sgRNA system successfully, Wnt3a expression was down-regulated significantly at gene or protein level. Key molecule β-catenin in cytoplasma was obviously inhibited. HepG2 cell lines proliferation was suppressed in time-dependent manner. The nude mice HepG2 cell xenograft tumors confirmed that the knock-out of Wnt3a could significantly supressed HCC growth with slower speed (t = 6.418, P < 0.001), smaller volume(869.4 ± 222.5 mm³ vs 355.0 ± 99.9 mm³, t = 5.168, P < 0.001), and lighter weight (0.88 ± 0.20 g vs 0.35 ± 0.11 g, t = 5.628, P < 0.001)compared with the control group. Conclusion Abnormal expression of Wnt3a could be expected as a promising target for HCC gene therapy.