Objective The purpose of this study is to define the pollution level of CO2 pneumoperitoneum in operation room and its influence on the health of medical personnel,and put forward certain countermeasures.Methods This research consisted of four groups of experiments,and gradually proved that the use of pneumoperitoneum machine would lead to air pollution in the operation room,and the health of medical staff were influenced too.The four experiments were:the maximum CO2 gas leakage experiment;laparotomy and pneumoperitoneum surgery in the operating room CO2 gas concentration control experiment;CO2 gas concentration increase on the influence of the medical staff experiment; long-time pneumoperitoneum surgery operating room CO2 gas concentration change experiment.Results The maximum CO2gas leakage situation could cause the operation room CO2 gas concentration to increase(＞ l 000× 104); pneumoperitoneum machine in actual use process,could cause the increase of CO2 gas concentration in operation room; increase of CO2 gas concentration had an impact on the vital signs of the medical staff,the heart rate and blood pressure were statistically different before and after the operation; during pneumoperitoneum surgery for a long time,indoor CO2 gas concentration increased (＞1000× 10-6)and reduced quickly postoperation.Conclusions The use of C02 pneumoperitoneum machine in operation room influence the health of medical personnel.Effective protective measures dealing with gas pollution should be taken to reduce the chronic injury to medical staff.

Objective:To study the application value of WeChat video teaching mode in clinical teaching of digestive endoscopy nurses.Methods:The study selected 126 nursing trainees taking an internship in the Department of Gastroenterology in our hospital from January 2018 to June 2020 as the teaching objects, and they were randomized into two groups, Control Group and Experimental group, with 63 cases in each group. The control group adopted traditional teaching and the experimental group took traditional teaching combined with WeChat video teaching. The internship time of both groups was 4 weeks. The scores of comprehensive ability assessment after practice were compared between the two groups, and the critical thinking ability scale and nursing students' clinical practice satisfaction scale were used to evaluate the critical thinking ability and satisfaction of practice nurses of the two groups before and after teaching. SPSS 19.0 was used for statistical analysis of the research data. Continuous variables were expressed as (mean ± standard deviation), t test was performed, categorical variables were expressed as percentage, four-grid test was conducted, and the test level was α=0.05. Results:The scores of comprehensive ability, theoretical knowledge and operation skills of the experimental group were significantly higher than those of the control group ( P<0.05). After teaching, the scores of seeking truth, opening mind, systematization ability, analytical ability, curiosity, cognitive maturity and total scale score of the two groups were significantly higher than those before teaching ( P<0.05), and there was no significant difference in the score of thinking self-confidence before and after the teaching ( P>0.05). The scores of seeking truth, opening mind, systematization ability, analytical ability, curiosity, cognitive maturity and total scale score of the experimental group were significantly higher than those of the control group ( P<0.05), and there was no significant difference in the score of thinking self-confidence between the two groups ( P>0.05). The experimental group's practice management, practice environment, teaching content, practice effect score and total scale score were significantly higher than those of the control group ( P<0.05), and compared with the control group, the score of teaching quality was poorer, without significant differences ( P>0.05). Conclusion:The application of WeChat video teaching mode in clinical teaching of digestive endoscopy nurses can improve the performance and satisfaction of comprehensive ability assessment of practice nurses, and enhance their ability of critical thinking.

Objective To investigate the medication safety and relevant influence factors among the elderly with chronic diseases,to improve the safety of the elderly medication,and provide the theory basis for the rational use of drugs.Methods Questionnaire survey was conducted on 452 elderly outpatients with chronic diseases using self-designed questionnaire.Results 21.7％ (98/452) of the elderly took seven or more drugs.The incidence of adverse drug reactions was 38.4％ (174/452).The prevalence in the top three were cardiovascular disease [61.3％ (277/452)],diabetes [53.5％ (242/452)],and lung disease [42.0％ (190/452)].Old people had unsafe medication behaviors including missing medication,stopping medication on their own,increased or reduced dosages of medicine and taking overdue medication,and so on.Logistic regression analysis showed that the main influence factors of medication safety were age,previous occupation,educational level,monthly household income per capita,medication time,the source of drugs and whether received medication safety health education (P＜0.05).Conclusions Relative lack of safety knowledge,wrong cognition and behaviors exist in the elderly.It is worthy of paying attention to adverse drug reactions and hidden dangers of the elderly.

ObjectivesTo detect the effects of P-selectin on deep venous thrombosis (DVT) in nephrotic syndrome (NS). and to evaluate the molecular magnetic resonance imaging (MRI) with a P-selectin targeted conlrost agent in diagnosis of thrombosis in the early phase. Methods(1) Forty-one patients with NS hospitalized in our department from 2005 to 2006 were enrolled in this study. They were assigned into DVT group and non-DVT group according to lower limbs radionuclide imaging (RNV) with 99mTc MAA. Blood P-selectin level was measured by ELISA method. (2) P-selectin was detected both in injured vein and blood immediately, 1 h and 3 h after the dog DVT model was established. (3) The P-selectin-targeted contrast agent was developed by conjugating anti-P-selectin lectin-EGF domain monoclonal antibody (PsL-EGFmAb) which was prepared by our lab. The potential of this contrast agent used in vitro molecular imaging experiment as well as in vivo experiment in dog DVT model was investigated. Results (1) Blood P-selectin level was elevated in patients with NS. It was much higher in DVT group than that in non-DVT group. (2) Blood P-selectin level was also elevated in DVT dogs and P-selectin expressed immediately in tunica intima of injured vein and subsequently in thrombus after the model established. (3) Mural thrombus showed higher signal visualization than surrounding muscle in 30 rain after contrast agent injection. These enhanced signals exhibited P-selectin specificity and persisted from the initiation of intima lesions to 3 h after development of thrombosis. There was signficant Differences in contrast-to-noise ratio (CNR) of the experiment group and the control group (11.50±2.32 vs 2.71±0.86, P＜0.01). The same results were derived from 30 rain to 1 hafter contrast agent being injected in distal to heart part of the injured vessel, and the signal decreased 24 h later. Differences in CNR of the experiment group and the control group were also statistically significant (10.40±2.15 vs 1.93±0.57, P＜0.01). Moreover, the contrast agent did not affect the vital signs of the dog. The function of the heart, lung, liver and kidney functions remained normal after contrast administration. Conclusions P-selectin*targeted new MR contrast can be used to early locate thrombus in vivo in an early stage, which does not compromise the function of the important organs. It may become a new method for early diagnosis of thrombosis.

Objective:To investigate the clinical efficacy of laparoscopic resection of retrorectal cystic lesions.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 58 patients undergoing laparoscopic resection of retrorectal cystic lesions in the Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from August 2012 to August 2019 were collected. There were 5 males and 53 females, aged from 15 to 70 years, with a median age of 38 years. All the 58 patients underwent laparoscopic resection of retrorectal cystic lesions and the combined operation through the transsacral approach was chosen according to the patient condition. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) postoperative histopathological examination; (4) follow-up. Patients were followed up regularly using outpatient examination once every 6 months during the first postoperative year and once every 12 months after the first postoperative year. The recurrence of cysts was evaluated by computed tomography or magnetic resonance imaging examinations during the follow-up up to August 2020. Measurement data with normal distribution were represented as Mean± SD and measurement data with skewed distribution were described as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations: of the 58 patients, 54 cases underwent laparoscopic resection of retrorectal cystic lesions and 4 cases underwent laparoscopic resection of retrorectal cystic lesions combined with the transsacral approach operation. One of the 58 patients who had a huge cyst surrounding the rectum underwent transverse colostomy after repairing the damage of separated posterior wall of rectum. Two cases underwent preventive transverse colostomy because the external rectal wall heat injury could not be excluded after separation of the tight adhesion between cyst and rectum. The operation time and volume of intraoperative blood loss were (123±56)minutes, 20 mL(range, 5?500 mL) of 54 cases who underwent laparoscopic resection of retrorectal cystic lesions and (232±38)minutes, 90 mL(range, 30?800 mL) of 4 cases who underwent laparoscopic resection of retrorectal cystic lesions combined with the transsacral approach operation, respectively. (2) Postoperative situations: 7 of the 58 patients had complica-tions. Of the 7 patients, 2 cases had postoperative rectal fistula and were cured after the treatment of transverse colostomy combined with pelvic drainage, 2 cases had postoperative urinary tract infection and were relieved after anti-infection treatment, 2 cases had urinary retention after removal of catheter and were recovered after 3 weeks of re-indwelling catheter, and 1 case had poor incision healing of transsacral and was healed after wound dressing change. The duration of postoperative hospital stay of the 58 patients was (7±4)days. (3) Postoperative histopathological examination: results of the postoperative histopathological examination showed that there were 26 of 58 patients with epidermoid cyst, 20 patients with teratoma (2 cases with mature teratoma accompanied by mucinous adenocarcinoma and 1 case with mature teratoma accompanied by neuroendocrine carcinoma), 10 patients with dermoid cyst, and 2 patients with tailgut cyst. (4) Follow-up: 57 of the 58 patients were followed up for 2-85 months, with a median follow-up time of 51 months. Of the 57 patients who were followed up, 1 patient was diagnosed with buttock subcutaneous cyst at postoperative 8 months and treated with local excision, 1 patient was diagnosed with a small presacral cyst recurrence by pelvic magnetic resonance imaging at postoperative 6 months and continued follow-up as the cyst without obvious enlargement, and the other 55 patients had no cyst recurrence.Conclusion:The laparoscopic resection of retrorectal cystic lesions is safe and feasible.

Objective To prepare the sunscreen lipstick in order to prevent UVA and UVB.Methods The ratio of bees-wax,castor oil and liquid paraffin were optimized with the orthogonal test based on viscosity and heat resistance.The spread-able ability,stability and the anti-ultraviolet effect of the optimized lipstick were investigated.Results The best ratio of bees-wax,castor oil and liquid paraffin was 8:5:4(w/w/w).The viscosity of the sunscreen lipstick was appropriate,easy to spread and stable,which was demonstrated the good prevention effect from UVA and UVB.Conclusion The advantages of the prepared sunscreen lipstick included simple preparation,low cost and stable quality.It could be a new type of sunscreen lipstick protecting from UVA and UVB.

Objective Ti explire the periiperative cimplicatiins and nursing ciuntermea-sures in elderly patients with hip replacement.Methods The periiperative cimplicatiins,han-dling methid and nursing ciuntermeasures if 150 senile patients with hip replacement were retri-spectively analyzed.Results In all patients,there were 12 patients with varying degrees if liwer bliid pressure because if bine cement reactiin,15 patients with delirium,13 patients with thrim-bisis if deep vein,2 patients with pulminary embilism,3 patients with dislicatiin if hip jiint. After timely and effective nursing,there were 1 patient with pulminary embilism and 1 dead pa-tient caused by dislicatiin if hip jiint,and the ithers were all healed.Conclusions Predictive preventiin frim the periiperative cimplicatiins with priper nursing ciuntermeasures can help se-nile patients ti get thriugh periiperative periid,prevent pistiperative cimplicatiin and ti imprive the clinical curative rate.

Objective Ti explire the periiperative cimplicatiins and nursing ciuntermea-sures in elderly patients with hip replacement.Methods The periiperative cimplicatiins,han-dling methid and nursing ciuntermeasures if 150 senile patients with hip replacement were retri-spectively analyzed.Results In all patients,there were 12 patients with varying degrees if liwer bliid pressure because if bine cement reactiin,15 patients with delirium,13 patients with thrim-bisis if deep vein,2 patients with pulminary embilism,3 patients with dislicatiin if hip jiint. After timely and effective nursing,there were 1 patient with pulminary embilism and 1 dead pa-tient caused by dislicatiin if hip jiint,and the ithers were all healed.Conclusions Predictive preventiin frim the periiperative cimplicatiins with priper nursing ciuntermeasures can help se-nile patients ti get thriugh periiperative periid,prevent pistiperative cimplicatiin and ti imprive the clinical curative rate.

PURPOSE: Elevation in serum alanine aminotransferase (ALT) levels is a biomarker for metabolic syndrome (MS); however, the relationship has not been fully investigated within the reference interval of ALT levels. Our objective was to explore the relationship between serum ALT levels within the reference interval and MS in Chinese adults. MATERIALS AND METHODS: This cross-sectional study included 16028 adults, who attended routine health check-ups at Shengli Oilfield Central Hospital from January 2006 to March 2012. The reference interval of serum ALT level was defined as less than 40 U/L. Logistic regression models and restricted cubic spline were used to evaluate the association of ALT with MS. RESULTS: The prevalence of MS in the total population was 13.7% (6.4% for females and 18.4% for males). Multiple logistic regression showed that ALT levels were positively associated with MS after adjustment for potential confounding factors. The odds ratio of MS in the top quartile was 4.830 [95% confidence interval (CI): 2.980–7.829] in females and 3.168 (95% CI: 2.649–3.790) in males, compared with the ALT levels in the bottom quartile. The restricted cubic spline models revealed a positive non-linear dose-response relationship between ALT levels and the risk of MS in women (p for nonlinearity was 0.0327), but a positive linear dose-response relationship in men (p for nonlinearity was 0.0659). CONCLUSION: Serum ALT levels within the reference interval are positively associated with MS in a dose-response manner. Elevated ALT levels, even within the reference interval, may reflect early dysmetabolic changes.
Adult ; Aged ; Alanine Transaminase/*blood ; Asian Continental Ancestry Group ; Biomarkers/blood ; Confidence Intervals ; Cross-Sectional Studies ; Dose-Response Relationship, Drug ; Female ; Humans ; Logistic Models ; Male ; Metabolic Syndrome X/*enzymology/epidemiology ; Middle Aged ; Odds Ratio ; Prevalence ; Reference Values

Objective:To investigate the effect of circRNA-102231 on the sensitivity of colon cancer HT-29 cells to cisplatin and its mechanism.Methods:The expression of circRNA-102231 and ABCB1 were detected by Western blot and RT-qPCR in cisplatin-resistant HT-29/DDP cell lines. Overexpress or knockdown circRNA-102231 in HT-29 cells were respectively followed by treatment with cisplatin, CCK-8 method was used to detect cell viability, Western blot and RT-qPCR were used to detect the protein and mRNA expression levels of circ-102231 and ABCB1; The circRNA-102231 combined microRNA was predicted by the database and verified with RT-qPCR; Activation or inhibition of ERK and overexpression of miR-145, Western blot and RT-qPCR were used to detect the protein and mRNA levels of ABCB1, and the luciferase reporter assay was used to detect the ABCB1 promoter activity.Results:Compared with HT-29 cells, the expression levels of circRNA-102231 and ABCB1 were significantly up-regulated in HT-29/DDP cells(all P<0.05). Overexpression of circRNA-102231 up-regulated the expression of ABCB1 and decreased the sensitivity of cells to cisplatin( P<0.05). Knockdown of circRNA-102231 down-regulated the expression of ABCB1, hence increased the sensitivity to cisplatin( P<0.05); circRNA-102231 can recruit miR-145 and promote its expression; miR-145 induce ERK phosphorylation, activation or inhibition of ERK activity can promote or up regulate the expression level and promote activity of ABCB1( P<0.05). Conclusion:circRNA-102231 may increase the resistance of HT-29 cells to cisplatin by promoting the up-regulation of ABCB1 through miRNA-145/ERK pathway.