Ursodeoxycholic acid (UDCA) is a naturally occurring, low-toxicity, and hydrophilic bile acid (BA) in the human body that is converted by intestinal flora using primary BA. Solute carrier family 7 member 11 (SLC7A11) functions to uptake extracellular cystine in exchange for glutamate, and is highly expressed in a variety of human cancers. Retroperitoneal liposarcoma (RLPS) refers to liposarcoma originating from the retroperitoneal area. Lipidomics analysis revealed that UDCA was one of the most significantly downregulated metabolites in sera of RLPS patients compared with healthy subjects. The augmentation of UDCA concentration (≥25 μg/mL) demonstrated a suppressive effect on the proliferation of liposarcoma cells. [¹⁵N₂]-cystine and [¹³C₅]-glutamine isotope tracing revealed that UDCA impairs cystine uptake and glutathione (GSH) synthesis. Mechanistically, UDCA binds to the cystine transporter SLC7A11 to inhibit cystine uptake and impair GSH de novo synthesis, leading to reactive oxygen species (ROS) accumulation and mitochondrial oxidative damage. Furthermore, UDCA can promote the anti-cancer effects of ferroptosis inducers (Erastin, RSL3), the murine double minute 2 (MDM2) inhibitors (Nutlin 3a, RG7112), cyclin dependent kinase 4 (CDK4) inhibitor (Abemaciclib), and glutaminase inhibitor (CB839). Together, UDCA functions as a cystine exchange factor that binds to SLC7A11 for antitumor activity, and SLC7A11 is not only a new transporter for BA but also a clinically applicable target for UDCA. More importantly, in combination with other antitumor chemotherapy or physiotherapy treatments, UDCA may provide effective and promising treatment strategies for RLPS or other types of tumors in a ROS-dependent manner.

Objective:To investigate the effects of Bruner's constructivist theory on the critical thinking and practice performance of nursing students interning in internal medicine.Methods:One hundred and fifty-three undergraduate nursing students practicing in the department of internal medicine of a Beijing grade A tertiary hospital were selected by convenience sampling and divided into control group ( n=76) and experimental group ( n=77) according to the order of rotation time. The experimental group received teaching based on Bruner's constructivist theory, while the control group was given traditional teaching. SPSS 24.0 was used to perform the t test. Results:Compared with the control group, the experimental group showed a significantly higher critical thinking score [(306.13±33.00) vs. (325.03±32.09)], a significantly higher exit theory assessment score [(94.74±3.24) vs. (96.94±1.79)], a significantly higher exit skills assessment score [(86.68±11.95) vs. (90.23±9.17)], and a significantly higher degree of satisfaction with teaching [(180.08±13.35) vs. (187.91±14.50); all P<0.05]. Conclusions:Bruner's constructivist theory can help nurse students improve their critical thinking, theoretical and practical performance, and satisfaction with teaching, which enhances the effects of internal medicine nursing teaching.

BACKGROUND: Feeding intolerance (FI) among intensive care unit (ICU) patients undergoing early continuous enteral nutrition (EN) is related to poor outcomes. This study aimed to explore the prevalence and risk factors of FI in ICU patients. METHODS: We retrospectively enrolled 1057 patients who received early continuous EN via a nasogastric tube between January 2014 and August 2019. The prevalence of FI during the first 7 days of ICU stay was calculated, and the risk factors were investigated using multivariate logistic regression analysis. RESULTS: The prevalence of FI during the first 7 days of ICU stay was 10.95%. FI occurred in 159 of 1057 (15.04%) patients on ICU day 2, 114 of 977 (11.67%) patients on ICU day 3, and 86 of 715 (12.03%) patients on ICU day 7. Mechanical ventilation (MV) (odds ratio [OR]: 1.928, 95% confidence interval [CI]: 1.064-3.493, P  = 0.03) was an independent risk factor for FI defined by a gastric residual volume (GRV) of 200 mL and/or vomiting, and acute renal failure (OR: 3.445, 95% CI: 1.115-10.707, P  = 0.032) was an independent risk factor of FI defined by a GRV of 500 mL and/or vomiting. Continuous renal replacement therapy (CRRT) was an independent predictor regardless of the FI defined by a GRV of 200 mL (OR: 2.064, 95% CI: 1.233-3.456, P  = 0.006) or 500 mL (OR: 6.199, 95% CI: 2.108-18.228, P  = 0.001) in the ICU patients. CONCLUSIONS FI occurs frequently in early ICU days, especially in patients receiving MV and CRRT. However, further investigation of a consensus definition of FI and risk factors is still warranted in future studies.
Critical Illness ; Enteral Nutrition/adverse effects* ; Humans ; Infant, Newborn ; Intensive Care Units ; Prevalence ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Vomiting/etiology*

Multidrug-resistant organism infection seriously affects the treatment and prognosis of ICU patients. The prevention and control of multidrug-resistant organism infection in hospital has become a common focus of clinical care and nursing. The effectiveness of chlorhexidine bathing for the prevention of multidrug-resistant organism infection in ICU patients were reviewed, and outcomes of the review would be expected to offer references to nursing practice and play a guiding role in reducing the incidence of multidrug-resistant organism infection, decreasing the cost of infection control, ensuring the safety of patient care.

Objective: To evaluate the feeding effect of not monitoring gastric residual volume in ICU patients receiving continuous enteral feeding,including complications and calorie intake. Methods: We searched for relevant studies in China national knowledge internet(CNKI), Wanfang Data, PubMed, Embase, Cochrane library. We included all Randomized controlled trials (RCTs) and pre-post studies related to the feeding effect of not monitoring gastric residual volume in ICU patients receiving continuous enteral feeding. Two researchers independently screened, appraised and extracted data, and meta-analysis was conducted via RevMan 5.3 software. Results: 3 RCTs and 2 pre-post studies with 1 000 patients were included. Not monitoring gastric residual volume increase the rate of vomiting [OR=1.35, 95%CI(1.02, 1.80), Z=2.08, P=0.04], decrease the proportion of intolerance to enteral nutrition [OR=0.35, 95%CI(0.26, 0.46), Z=7.29, P<0.01], there were no significant differences in diarrhea [OR=1.14, 95%CI(0.78, 1.67), Z=0.67, P=0.51] and distention[OR=1.24, 95%CI(0.76, 2.03), Z=0.87, P=0.38]. The cumulative calorie deficit between targeted volume and provided volume in not monitoring gastric residual volume group was significantly lower than the control group[MD=-0.29, 95%CI(-0.47, -0.11), Z=3.23, P=0.001], daily provided calorie amount was also significantly higher than the control group [MD=0.35, 95%CI(0.10, 0.59), Z=2.75, P=0.006]. Conclusions Not monitoring gastric residual volume in ICU patients increase calorie intake and have better enteral nutrition provision, decrease the proportion of intolerance to enteral nutrition. Monitoring gastric residual volume should not be taken as a routine task in critical care nursing.