There were some samples collected from the Antarctic soil and South Ocean water for isolation of microorganisms and screening of their antitumor bioactivity by lethality bioassay using brine shrimp and a flow cytometric bioassay.There were 259 stains were isolated from the samples,11% of the Antarctic microorganisms showed strong antitumor activity.This result showed that the Antarctic microorganisms have a good potential in bioactive metabolites researching.

Objective To investigate the clinical characteristics and treatment strategies of arachnoid cyst combined with chronic subdural hematoma.Methods Seventeen patients with arachnoid cyst combined with chronic subdural hematoma,who received treatment in our hospital from February 2008 to March 2016,were chosen in our study;13 of them were performed burr hole irrigation and drainage,2 received craniotomy for removing hematoma and cystectomy,and 2 received endoscopic cyst excision and hematoma removal surgery.A retrospectively analysis of clinical characteristics and treatment strategies of these patients was performed.Results Follow up for 0.5-2 years was performed in the 13 patients performed burr hole irrigation and drainage,and no hematoma relapse was noted;one was found rebleeding in the cyst associated with a small amount of subdural hematoma on the 5th d of surgery,and the subdural hematoma was absorbed during the follow-up observation;one was found that the cyst and subdural hematoma both disappeared in the postoperative check,while the cyst reappeared 40 days after surgery,and during the follow-up observation,the cyst was not enlarged and the chronic subdural hematoma was not relapsed.Two patients recovered after receiving the craniotomy for removing hematoma and cystectomy;two patients recovered after receiving the endoscopic cyst excision andhematoma removal surgery.Conclusion For patients with arachnoid cyst associated with chronic subdural haematoma,burr-hole irrigation and drainage are generally selected;for patients with reappeared cyst or hematoma,there is no need to burr hole again or perform the surgery aiming at the cyst in a haste,and follow-up observation is suggested;for patients whose symptoms in the cyst have appeared before hemorrhage or whose hemorrhage appeared recurrently in the cyst,surgery of hematoma removal and cyst excision can be chosen at the same time.

Objective To explore the expression of peripheral blood miRNA-134 in the patients with breast cancer and chemotherapy drug resistance mechanism.Methods A total of 98 cases of newly diagnosed breast cancer were divided into the chemotherapy sensitive group(n=68) and chemotherapy drug resistant group(n=30).The expression of miRNA-134 in peripheral blood was measured by adopting RT-PCR.miRNA-mimics and miRNA-inhibitor were transfected into epirubicin and docetaxel resistant cell lines,the cell apoptosis and expression levels of Bax and Caspase-3 protein were detected.Results The level of serum miRNA134 expression in the chemotherapy sensitive group was significantly higher than that in the chemotherapy drug resistant group (P＜0.05);the proliferation capacity of epirubicin and docetaxel resistant cell lines was significantly lower than that in the MCF-7 cells(P＜0.05).Compared with normal MCF-7 cell line,the expression level of miRNA-134 in the epirubicin and docetaxel resistant cell lines was significantly decreased(P＜0.05).The apoptosis rate in the miRNA-mimics group was significantly higher than that in the control group and miRNA-inhibitor group(P＜0.05).The expression of Bax and Caspase-3 protein in the miRNA-mimics group was significantly higher than that in the control group and miRNA-inhibitor group(P＜0.05).Conclusion MiRNA-134 may enhance the sensitivity of breast cancer ceils to chemotherapy by promoting the expression of Bax and Caspase-3.

Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.

Objective:To investigate the clinical significance of cytokine levels and routine cytology in bronchoalveolar lavage fluid (BALF) in children with severe Mycoplasma pneumoniae pneumonia (SMPP).Methods:A total of 207 children with Mycoplasma pneumoniae pneumonia who underwent parallel bronchoalveolar lavage in the Department of Respiratory, Shanghai Children′s Hospital, Shanghai Jiaotong University from July 2018 to February 2019 were enrolled in this study.There were 121 patients in the SMPP group and 86 patients in the non-SMPP group.Flow cytometry was used to determine the level of cytokines in BALF.Meanwhile, the cells in BALF were stained and cytokines levels and routine cytology were compared between the 2 groups.Receive operating characteristic(ROC) curves were used to analyze the predictive value of cytokine levels and routine cytology for SMPP.Results:The levels of interleukin(IL)-8, IL-1βand IL-6 and white blood cell count in BALF of SMPP group were significantly higher than those of non-SMPP group [1 717.77 (784.31, 3 304.03) ng/L vs.1 013.03 (469.27, 2 040.52) ng/L, 373.18 (70.08, 941.56) ng/L vs.107.50 (0.10, 489.88) ng/L, 200.74 (41.09, 570.61) ng/L vs.95.47 (0.10, 337.68) ng/L, 1 890.00 (955.00, 3 600.00)×10 6/L vs.1 430.00 (467.50, 2 724.00)×10 6/L]( Z=3.27, 3.45, 2.47, 2.57, all P<0.05). The percentage of macrophages in the non-SMPP group was significantly higher than that in the SMPP group [0.04 (0, 0.12) vs. 0 (0, 0.06)] ( Z=-2.67, P=0.01). The optimal critical value and the area under curve (AUC) of IL-8 were 722.69 ng/L and 0.63 (95% CI: 0.56-0.71, P<0.01), respectively. The optimal critical value and AUC of IL-1β were 166.33 ng/L and 0.64, respectively (95% CI: 0.56-0.72, P<0.01). The optimal critical value and AUC of IL-6 were 142.95 ng/L and 0.60, respectively (95% CI: 0.52-0.68, P<0.05). The optimal critical value and AUC of the total white blood cells were 970×10 6/L and 0.61, respectively (95% CI: 0.53-0.69, P<0.05). The optimal critical value and AUC of the percentage of macrophages were 0.19 and 0.60, respectively (95% CI: 0.32-0.48, P<0.05). Conclusions:Children with SMPP have higher levels of cytokines IL-8, IL-1β and IL-6, a higher white blood cell count, and a lower percentage of macrophages in BALF than children with no SMPP. However, cytokine levels and cytology are inadequate to predict SMPP since they are not effective in the clinical diagnosis of SMPP.

Objective:To investigate the current status of literature reading report and clinical research ability among professional postgraduate students in pediatrics, and to provide a reference for cultivating high-quality pediatric talents.Methods:A total of 91 professional postgraduate students majoring in pediatrics were selected as research subjects from five affiliated hospitals of Zhengzhou University, and according to whether they participated in literature reading report, they were divided into participating group with 38 students and non-participating group with 53 students. The method of questionnaire combined with interview was used to investigate the implementation of literature reading report, the willingness to participate in literature reading report, and the current status of clinical research ability. SPSS 25.0 was used to perform the chi-square test and the Wilcoxon rank-sum test.Results:In the participating group, 60.53% (23/38) of the students thought that there was a significant improvement in clinical research ability after literature reading report, and in the non-participating group, 94.12% (48/51) of the students wanted to carry out literature reading report. Compared with the non-participating group, the participating group had significantly higher publication rate, project participation rate, academic exchange rate, and literature reading quantity ( P<0.05) and significantly better abilities of literature search and reading, professional English, and PPT presentation ( P<0.05), while there were no significant differences between the two groups in the scores of statistical analysis ability, project design ability, clinical thinking ability, and evidence-based medicine ability ( P>0.05). Conclusions:Literature reading report can promote the improvement in clinical research ability among professional postgraduate students in pediatrics, and it should be carried out regularly for a long time with adherence to the principle of clinical orientation and emphasis on the reading of methodology and statistics in literature.

To summarize the continued nursing management of a patient with combined liver-lung transplantation.Nursing points:regular review and joint remote guidance;dynamic optimization of the rehabilitation program;strict control of blood concentration of Tacrolimus;the strengthening of infection prevention and control;standardized management of post-transplant diabetes mellitus;active interventions in osteoporosis;helping patients to self-empower and achieve all-round rehabilitation.In 2 years and 8 months after surgery,the follow-up showed that the patient had normal transplant organ function and good quality of life.

The nursing experience of a patient with right-to-left inverted lung transplantation was summarized.The key points of nursing care:closely monitoring frequent arrhythmiac;developing excessive pulmonary rehabilitation strategies based on heart rate;being alert to carbon dioxide retention caused by pulmonary insufficiency;performing non-invasive ventilation combined with nitric oxide inhalation for pulmonary hypertension care;early identification and management of gastrointestinal dysfunction;and strengthening the prevention and management of complications.After fine care,the patient recovered well,and the transplanted lung function was normal,and he was discharged smoothly.

Objective To retrieve,evaluate and summarize the best evidence of early mobilization in awake patients on extracorporeal membrane oxygenation,and to provide a reference for clinical practice.Methods UpToDate,BMJ Best Practice,Registered Nurses'Association of Ontario,National Guideline Clearinghouse,National Institute for Health and Care Excellence,Yimaitong,Joanna Briggs Institute Library,Cochrane Library,CINAHL,PubMed,SinoMed,CNKI,Wanfang Database,Vip Database and Extracorporeal Life Support Organization Website were researched to collect the literature,including clinical guidelines,expert consensuses,evidence summaries,systematic reviews,and well-designed original studies.The time limit for retrieval was until June 2023.The quality of literature and the level of evidence were evaluated by the evaluation criteria and evidence grading system of J BI Evidence-Based Health Care Center.Results 14 pieces of the literature were included,including 2 clinical guidelines,4 expert consensuses,5 systematic reviews,2 cohort studies and 1 case series.Totally 33 pieces of evidence were summarized,covering 7 aspects:adaptation conditions for the implementation of awake ECMO,team composition,comprehensive assessment,pre-mobilization preparation,mobilization content,prevention and control of adverse events,and effect evaluation.Conclusion The study summarizes the best evidence of early mobilization in awake patients on extracorporeal membrane oxygenation.It is suggested that medical institutions establish a professional team for the early mobilization of awake ECMO patients,apply the best evidence to standardize the early mobilization process,and formulate an individualized mobilization program.