Objective To discuss the construction of training model for cooperation between doctors and nurses and evaluate its teaching effect.Methods 101 nursing students and 80 clinical medicine students were involved in an overall training for the purpose of cooperation between doctors and nurses by using of Sim-man and then test and questionnaire were conducted to evaluate the effect of the training.Results Statistics showed that training for cooperation between doctors and nurses had improved in such factors as attitude to the cooperation,communication skills,team work,and adaptability (operant skill was note included).In addition,88％ of the subjects supported the views that this kind of training should be offered before their internship.Conclusions Training for cooperation between doctors and nurses by using Sim-man can cultivate awareness of cooperation between doctors and nurses and improve team work,and set a better foundation for good collaboration between doctors and nurses.

Objective: To evaluate the risk factors for contrast-induced nephropathy (CIN) in patients of acute coronary syndrome (ACS) with normal or slightly impaired renal function after percutaneous coronary intervention (PCI).
Methods: A total of 254 consecutive ACS patients with normal or slightly impaired renal function received PCI in the Second Artillery General Hospital from 2013-06 to 2015-06 were retrospectively studied. All patients had eGRF≥60 ml (min?1.73 m2) and they were divided into 2 groups:CIN group, the patients with serum creatinine increased by 0.5mg/dl (44.2μmol/L) or elevated to 25%higher than the baseline, n=23;Non-CIN group, n=231. The basic condition with laboratory tests, operative indexes were recorded and eGRF value were calculated in all patients.
Results: There were 9%(23/254) patients suffered from CIN after PCI. Multivariate regression analysis indicated that emergent PCI (OR=0.370, 95%CI 0.060-2.297), increased plasma level of NT-proBNP (OR=4.209, 95%CI 1.202-14.742) and without pre-operative aspirin administration (OR=7.950, 95%CI 1.108-57.034) were the clinical risk factors for post-operative CIN occurrence.
Conclusion: Emergent PCI, higher plasma level of NT-proBNP and no pre-operative aspirin administration were the risk factors for CIN occurrence in ACS patients with normal or slightly impaired renal function after PCI.

Objective To evaluate the effects of sevoflurane on hippocampal neurogenesis in den-tate gyrus (DG) of mice of different ages. Methods Ninety-six SPF healthy male C57BL∕6 mice, aged 2 weeks, 6 weeks, 9 months and 20 months (24 mice for each age, 12 mice for each group), were divided into 2 groups (n＝48 each) using a random number table method: control group (group C) and sevoflurane group (group S). Group S inhaled 3. 0% sevoflurane for 2 h once a day for 3 consecutive days, while group C inhaled the mixture of air and O2. Six mice of each age were selected, and 5′-bromo-2′-deoxyuridine (BrdU) 50 mg∕kg was intraperitoneally injected immediately before and after inhalation once a day for 3 consecutive days in two groups. Mice were sacrificed at 24 h after the last inhalation (T1), brains were re-moved and hippocampi isolated for determination of the number of nestin and doublecortin ( DCX) positive cells in DG by immunohistochemistry. Mice were sacrificed at 4 weeks after the last inhalation ( T2), brains were removed and hippocampi isolated for determination of the number of neuronal nuclei antigen (NeuN)∕BrdU and glial fibrillary acid protein ( GFAP )∕BrdU positive cells by immunofluorescence. Re-sults Compared with group C, the number of nestin and DCX positive cells was significantly reduced at T1, and the number of NeuN∕BrdU and GFAP∕BrdU positive cells was reduced at T2in mice of 2 weeks and 20 months old (P＜0. 05), and no significant change was found in the indices mentioned above in mice of 6 weeks and 9 months old in group S ( P＞0. 05). Conclusion Three percent sevoflurane can inhibit hipp-ocampal neurogenesis in DG of immature and old mice and exerts no influence on hippocampal neurogenesis in DG of juvenile and adult mice.

Objective To evaluate the effect of sevoflurane on activities of Na+-K+-ATPase and Ca2+-ATPase in the hippocampus of diabetic rats.Methods SPF healthy male Wistar rats,aged 8 weeks,weighing 180-200 g,were fed a high-fat diet for 3 consecutive weeks and streptozotocin was intraperitoneal-ly injected to induce type 2 diabetes mellitus.Forty-four rats with diabetes mellitus were divided into 2 groups (n=22 each) using a random number table:diabetic group (D group) and sevoflurane group (S group).Another 22 healthy Wistar rats,aged 8 weeks,weighing 180-200 g,served as control group (C group).Oxygen was inhaled for 2 h in C and D groups,and 2.4％ sevoflurane was inhaled for 2 h in S group.Eight rats were sacrificed at 30 min after treatment,brains were removed and hippocampi were isolated for measurement of Na+-K+-ATPase and Ca2+-ATPase activities in hippocampal tissues by spectrophotometry.Ten rats were randomly selected at 1 day after treatment,and Morris water maze test was performed to assess the cognitive function.Four rats were randomly sacrificed,brains were removed and hippocampi were isolated for examination of the mitochondrial ultrastructure with a transmission electron microscope.Results Compared with group C,the escape latency was significantly prolonged,the number of crossing the original platform was reduced,the percentage of time of staying at the original platform quadrant was decreased,the activities of Na+-K+-ATPase and Ca2+-ATPase in hippocampi were decreased (P＜ 0.05),and mitochondrial swelling and decreased mitochondrial cristae were observed under the electron microscope in group D.Compared with group D,the escape latency was significantly prolonged,the number of crossing the original platform was reduced,the percentage of time of staying at the original platform quadrant was decreased,the activities of Na+-K+-ATPase and Ca2+-ATPase in hippocampi were decreased (P＜ 0.05),and mitochondrial swelling and vacuolization were found under the electron microscope in group S.Conclusion The mechanism by which sevoflurane aggravates cognitive dysfunction is related to deceasing activities of Na+-K+-ATPase and Ca2+-ATPase in the hippocampus of diabetic rats.

Objective:To evaluate the effect of nicotinamide mononucleotide (NMN) on neurogenesis decline in sleep-deprived infancy rats.Methods:Seventy-eight clean-grade healthy male Sprague-Dawley rats, aged 7 days, weighing 10-15 g, were divided into 3 groups ( n=26 each) using a random number table method: control group (group Con), sleep deprivation group (group SD) and sleep deprivation plus NMN group (group SD+ NMN). Sleep deprivation model was established by gentle stimulation method with a brush (10 h per day) for 14 consecutive days.NMN 500 mg/kg was intraperitoneally injected in group SD+ NMN, while the equal volume of aqua pura was given instead in Con and SD groups.5′-bromo-2′-deoxyuridine (BrdU) 100 mg/kg was intraperitoneally injected immediately after the end of sleep deprivation to label the new-born cells.At 24 h after completion of sleep deprivation, the stem cell pluripotency transcription factor (SOX2) and doublecortin (DCX) positive cells in the hippocampal DG region were counted using immunofluorescence and immunohistochemical methods, and positron emission tomography-computed tomography was used to observe the metabolism of 18F-fluorodeoxyglucose in the hippocampus.At 4 weeks after completion of sleep deprivation, the number of neuronal nuclei antigen (NeuN)/BrdU and glial fibrillary acid protein (GFAP)/BrdU positive cells in hippocampal DG region was recorded using immunofluorescence, and novel object recognition test was performed to evaluate the cognitive function. Results:Compared with group Con, the number of SOX2 and DCX positive cells was significantly reduced, the standard uptake value of glucose in the hippocampus was decreased, the number of NeuN/BrdU and GFAP/BrdU positive cells was reduced, and discrimination index in novel object recognition test was decreased in group SD ( P<0.05). Compared with group SD, the number of SOX2, DCX NeuN/BrdU and GFAP/BrdU positive cells was increased, the standard uptake value of glucose in the hippocampus was increased, and discrimination index in novel object recognition test was increased in group SD+ NMN ( P<0.05). Conclusion:Nicotinamide mononucleotide can promote neurogenesis, thus improving cognitive function, and the mechanism is related to increasing the metabolism of hippocampal glucose in sleep-deprived infancy rats.

Objective·In view of the low funding rate of the Young Scientists Fund of National Natural Science Foundation of China in the medical field,this research conducted an in-depth investigation of the applicants in a medical school and quantitatively analyzed the influencing factors of project establishment,so as to provide reference for further improving the quality of project application and strengthening the training of young medical talents.Methods·A cross-sectional survey was used to select applicants from secondary schools of Shanghai Jiao Tong University School of Medicine and its 13 affiliated hospitals who had experience in applying for the fund from 2020 to 2022.Logistic stepwise regression model was applied to modeling and analysis by using the project application result as the dependent variable and the applicants'basic information and application status as independent variables.Results·The analysis results of 921 applicants showed that educational background(OR=1.86,95%CI 1.14?3.04),graduate university(OR=2.45,95%CI 1.47?4.08),sufficient preliminary work foundation(OR=4.22,95%CI 2.44?7.29),average impact factor of representative works(OR=1.10,95%CI 1.04?1.17),and total self-evaluation score of application documents(OR=1.06,95%CI 1.04?1.08)were the main influencing factors for project approval.The average impact factor and the highest impact factor of the approved representative works showed an increasing trend year by year.In addition,the influencing factors for the approval of young doctors and full-time researchers were different.The longer the graduation time of young doctors,the lower the approval rate.Conclusion·The funding rate of Young Scientists Fund is low,and the requirements for scientific research achievements are increasing year by year.Attention should be paid to early accumulation and improving the quality of application writing.Further measures should be taken to strengthen the early training of young medical talents,improve cultivation measures and consolidate research foundations.

Objective To evaluate the effects of sevoflurane on neurogenesis in hippocampal den-tate gyrus(DG)of mice with Alzheimer′s disease. Methods Thirty-six SPF male APP∕PS1 mice, aged 8 months, weighing 30-35 g, were divided into 3 groups(n=12 each)using a random number table:Alzheimer′s disease group(group AD), oxygen group(group O2)and sevoflurane group(group Sev). Another 12 wild-type mice served as control group(group C). In group Sev, 30% sevoflurane was in-haled for 2 h once a day for 3 consecutive days. The mixture of air and oxygen was inhaled in group O2. Morris water maze test was performed on 22 to 28 days after the last sevoflurane inhalation. Then the mice were sacrificed and hippocampi were isolated for determination of doublecortin(DCX)positive cell count (by immunohistochemistry)and neuronal nuclei(NeuN)∕5-bromo-2′-deoxyuridine(BrdU)and glial fi-brillary acidic protein(GFAP)∕BrdU positive cell count in hippocampal DG(by immunofluorescence). Results Compared with group C, the escape latency was significantly prolonged, the percentage of time spent in the target quadrant was decreased, and DCX, NeuN∕BrdU and GFAP∕BrdU positive cell counts were reduced in AD, O2and Sev groups(P<005). There was no significant difference in each parameter between group O2and group AD(P>005). Compared with group O2, the escape latency was significantly prolonged, the percentage of time spent in the target quadrant was decreased, and DCX, NeuN∕BrdU and GFAP∕BrdU positive cell counts were reduced in group Sev(P<005). Conclusion Sevoflurane leads to cognitive decline through depressing neurogenesis in hippocampal DG of mice with Alzheimer′s disease.

Objective To summarize the experience of perioperative treatment of lung transplantation for end-stage lung disease. Methods Perioperative clinical data of 7 recipients undergoing lung transplantation were retrospectively analyzed, including 3 cases with bilateral lung transplantation and 4 cases with unilateral lung transplantation. The perioperative status and clinical prognosis of lung transplantation recipients were observed. Results The operation time of 7 lung transplantation recipients was (344±133) min. Cold ischemia time was (236±74) min in 4 cases of single-lung transplantation and (480±120) min in 3 cases of bilateral-lung transplantation. The length of Intensive care unit(ICU) stay was 21 (13-25) d and the length of hospital stay was 101 (64-117) d. In the first 3 d after surgery, the daily fluid output was significantly larger than the fluid input (all P < 0.05). The arterial oxygen partial pressure (PaO₂) of lung transplantation recipients in the first 3 d after surgery was significantly elevated than preoperative level (all P < 0.05), whereas the arterial carbon dioxide pressure (PaCO₂) did not significantly change (all P > 0.05). All recipients had pulmonary bacterial infection after lung transplantation, including 3 cases complicated with fungal infection. One recipient underwent exploratory thoracotomy for hemostasis due to active thoracic bleeding after operation, 1 recipient suffered from primary graft dysfunction (PGD) and 4 recipients received secondary endotracheal intubation. Two cases died after operation, 1 case died of septicemia caused by multidrug-resistant acinetobacter baumannii, the other case died of rejection reaction after self-terminating use of immunosuppressive agents. The remaining 5 cases were successfully discharged and recovered well. The longest survival period was 3.1 years. Conclusions In the perioperative management of lung transplantation, it has great significance to hold the surgical indications, monitor and manage postoperative refined fluid and hemodynamics, implement the strategy of protective pulmonary ventilation, and early diagnose and treat severe postoperative complications for the recipients of lung transplantation to safety through the perioperative period.

Objective:To investigate the expression of Macrophage migration-inhibitory factors (MIF) in hepatocellular carcinoma (HCC) tissues and its interaction with ERK1/2 signaling pathway, so as to establish a theoretical basis for further studying the molecular mechanism of MIF promoting HCC.Methods:From February 2020 to August 2021, 52 cases of hepatocellular carcinoma (HCC) tissues based on hepatitis B cirrhosis (HBV-LC) and 52 cases of adjacent tissues in Tianjin Medical University Cancer Hospital and 940th Hospital of Joint Logistic Support Force of PLA were collected as the experimental group, including 39 males and 13 females, aged 35-65 years. And 20 cases of normal liver tissue were selected as the control group. Immunohistochemistry was used to detect the expression of MIF, ERK1/2 and p-ERK1/2 proteins in liver tissues of the two groups, and in situ hybridization was used to detect the expression of ERK1/2 nucleic acid in liver tissues of the two groups.HepG2 HCC cells and L-02 normal hepatocytes were co-cultured with different concentrations of rMIF, the expression and phosphorylation levels of ERK1/2 and JNK1 proteins in the two kinds of liver cells were detected by Western-blot, and the expression levels of ERK1/2 nucleic acids in the two kinds of liver cells were detected by RT-PCR. One-way ANOVA was used for measurement data and χ 2 test was used for counting data. Results:The expressions of MIF, ERK1/2, p-ERK1/2 and ERK1/2 mRNA were significantly increased in HCC and para-cancer tissues (the expression of MIF in HCC group was 78.8%, and that in adjacent group was 75.0%; ERK1/2 80.8% in HCC group and ERK1/2 71.8% in paracancerous group. The expression of p-ERK1/2 75.0 % in HCC group and 46.2% in paracancerous group were respectively detected. ERK1/2 mRNA was expressed in HCC group 76.9%, ERK1/2 mRNA expression in paracancerous group 78.8%), and the differences were statistically significant compared with normal liver tissues ( P<0.05), but there was no significant difference between HCC and para-cancer tissues ( P>0.05). The expressions of ERK1/2, p-ERK1/2 and ERK1/2 mRNA in HepG2 HCC cells were significantly increased with the increase of rMIF concentration, and the increase was most obvious when rMIF concentration was 200 ng/ml, and the difference was statistically significant compared with L-02 normal hepatocytes ( P<0.05). Conclusion:MIF, ERK1/2 and p-ERK1/2 are highly expressed in HCC tissues and HepG2 HCC cells, suggesting that MIF promotes the occurrence and development of hepatocellular carcinoma through ERK1/2 signaling pathway.