ABSTRACT:Objective To evaluate the expressions of cell adhesion molecules CD146 and transferrin receptor 1 (TfR1)in ovarian epithelial cancer and investigate their relationship with clinical pathological features of patients with ovarian epithelial cancer (OEC ) so as to further explore the pathogenesis of OEC. Methods Immunohistochemistry was employed to determine the expressions of CD146 and TfR1 in normal,benign and ovarian cancer tissues.Results The immunohistochemical results showed that the positive expressions of CD146 and TfR1 gradually increased with the changes of normal,benign and malignant tissues in OEC.There were significant differences between all the groups (P<0.05).The advanced the clinical stage,the higher the expression rate (P<0 .0 5 ).The lower the histopathological differentiation,the higher the expression rate (P<0 .0 5 ).The expressions of CD146 and TfR1 were not correlated with age or pathological patterns (P>0.05).There was a significant correlation between expressions of CD146 and TfR1 in OEC (P<0.05,rs=0.532).Combined detection sensitivity and specificity were 82.4% and 75.0%.Conclusion The high expressions of CD146 and TfR1 may play a key role in the occurrance,progression and metastasis of OEC.They may be used as potential markers for diagnosis,postoperative follow-up and targeted therapy.

Objective: To investigate the hepatitis C prevention and control knowledge among clinicians in Jiaxing City, Zhejiang Province, so as to provide the evidence for intensified training and improved diagnosis and treatment of hepatitis C among clinicians. Methods: In November, 2021, clinicians were sampled using a stratified random sampling method from a city-level and a county (district)-level hepatitis C designated hospital in Jiaxing City. A questionnaire survey was performed using the Questionnaire for Hepatitis C Prevention and Control Knowledge among Clinicians, and the awareness of basic knowledge, professional knowledge and related knowledge about hepatitis C prevention and control among clinicians were descriptively analyzed. Results: A total of 186 questionnaires were allocated and 179 valid questionnaires were recovered, with an effective recovery rate was 96.24%. The respondents included 107 men (59.78%) and 72 women (40.22%) and had a mean age of (37.06±9.46) years. There were 107 respondents with a bachelor degree (59.78%), 56 with junior professional titles (31.28%), and 170 from non-infectious disease departments (94.97%). The awareness of basic hepatitis C prevention and control knowledge was 96.09%, and the awareness of “Transfusion of blood containing hepatitis C virus may acquire hepatitis C” was high (98.88%), and the awareness of “Hepatitis C can be cured” was low (77.09%). The awareness of professional hepatitis C prevention and control knowledge was 3.91% to 100.00%, and the awareness of “Pathogens of hepatitis C” (100.00%) and “Recommended screening populations for hepatitis C” (86.59%) was high, while the awareness of “There are two categories of hepatitis C cases: clinically diagnosed cases and confirmed cases” (3.91%) and “Clinical diagnosis of hepatitis C: positive anti-HCV antibody + any one of abnormal liver function or epidemiological history or clinical symptoms” (3.91%) was low. The awareness rates of “The state has included antiviral agents against hepatitis C into medical insurance” was and “Antiviral agents against hepatitis C are reimbursed in outpatient and inpatient departments of our hospital” were 81.56% and 59.78%, respectively. There were 69 clinicians participating hepatitis C-related training within one year (38.55%), and the awareness of clinicians that had participated in hepatitis C-related training had a higher awareness rate of basic hepatitis C prevention and control knowledge than those without participation (100.00% vs. 93.64%, P<0.05). Conclusion The awareness of basic hepatitis C prevention and control knowledge is high among clinicians in Jiaxing City; however, the training on diagnosis and classification criteria of hepatitis C and related medical insurance policy require to be improved.

Objective:To investigate the resuscitation effect of sodium bicarbonate Ringer's solution on traumatic hemorrhagic shock in patients.Methods:A randomized controlled trial was conducted on 70 patients with traumatic hemorrhagic shock who were admitted to Yiwu Central Hospital between February 2021 and February 2022. The patients were randomly assigned to a control group ( n = 35) and an observation group ( n = 35) using the random number table method. Both groups received routine treatment. The control group was given adequate resuscitation by intravenous injection of a compound sodium chloride injection, while the observation group received restricted resuscitation with sodium bicarbonate Ringer's solution. Related clinical indicators, coagulation function, lactate levels, hemorheological indicators, and incidence of complications were compared between the two groups. Results:The blood oxygen saturation, shock index, pulse pressure difference, and urine output in the observation group were (76.53 ± 2.56)%, (0.43 ± 0.07), (38.56 ± 6.52) mmHg (1 mmHg = 0.133 kPa), and (35.62 ± 4.21) mL/h, respectively. These values were all superior to those in the control group [(65.32 ± 3.21)%, (1.21 ± 0.13), (23.56 ± 4.23) mmHg, (23.65 ± 5.68) mL/h, t = 16.15, 31.25, 11.42, 10.06, all P < 0.001]. The prothrombin time, fibrinogen, activated partial thromboplastin time, and thrombin time in the observation group were (17.65 ± 0.83) seconds, (1.69 ± 0.89) g/L, (39.68 ± 0.52) seconds, and (17.86 ± 0.74) seconds, respectively. These values were significantly superior to those in the control group [(14.56 ± 0.86) seconds, (1.32 ± 0.23) g/L, (35.26 ± 0.16) seconds, and (16.02 ± 0.05) seconds, t = 15.30, 2.38, 48.06, 14.68, all P < 0.05]. The lactate level in the observation group was significantly lower than that in the control group [(2.24 ± 0.53) mmol/L vs. (2.94 ± 0.78) mmol/L, t = 4.39, P < 0.05]. The platelet cohesion, red blood cell deformability, and blood viscosity in each group were significantly reduced, and these indices in the observation group were superior to those in the control group ( t = 13.71, 5.64, 5.67, all P < 0.001). The incidence of complications in the observation group was significantly lower than that in the control group (8.6% (3/35) vs. 60.0% (21/35), χ2 = 10.08, P < 0.05). Conclusion:Restricted resuscitation with sodium bicarbonate Ringer's solution can improve clinical indicators, coagulation function, and lactate levels in patients with traumatic hemorrhagic shock. It can effectively improve hemodynamic indicators and reduce the incidence of complications. It is worthy of clinical promotion.

Long non-coding RNAs (lncRNAs) are a class of non-coding transcripts which are greater than 200 nucleotides in length and have a variety of biological functions. Studies have found that lncRNAs play an important role in the development of gastrointestinal cancers and can affect tumor cell growth, angiogenesis, metastasis and drug resistance. This paper has reviewed lncRNAs associated with gastrointestinal cancers and explored their roles in the occurrence, diagnosis and treatment of gastrointestinal cancers.
Animals ; Gastrointestinal Neoplasms ; genetics ; metabolism ; Gene Expression Regulation, Neoplastic ; Humans ; RNA, Long Noncoding ; genetics ; metabolism

Objective: To understand the epidemiological characteristics and differences of HIV-positive cases among 15-24 years old in Jiaxing city and provide evidence for the development of targeted prevention and control measures. Methods: A descriptive epidemiological method was used to analyze the data of HIV cases aged 15-24 reported in Jiaxing from 1999 to 2018. Results: A total of 375 cases of young HIV were reported in 1999-2018, with an average age of 21.29±1.90 years, of which 42 were students. The ratio of male to female was 2.47∶1. The proportion of foreign household registration was higher (76%, 285 cases). The proportion of off-campus youth cases in total cases showed a downward trend(χ2=8.26, P=0.00), but the proportion of student cases showed an upward trend(χ2=15.73, P<0.01). Off-campus youth cases were mainly heterosexual transmission(59.16%, 197 cases), and the students’ cases were mainly homosexual transmission(88.10%, 37 cases). There were significant differences in gender, age, household registration, education level, route of transmission, late detection, CD4 level and source of detection among students and off-campus adolescents(P<0.05). Conclusion The prevalence of AIDS in adolescents and students is worthy of attention. The characteristics of adolescents inside and outside the school are different. Targeted prevention measures should be taken to reduce the harm of AIDS to young people.

Objective:To provide a reference for the hierarchical management of clinical nurses in top three hospitals, the hierarchical management evaluation system was conducted and evaluated in the present study.Methods:On the context of three-dimensional structure theory of medical quality, the Delphi method was applied to conduct two rounds of correspondence consultation among 23 nursing experts, and then related indexes were established based on the evaluation results and recommendations.Results:An evaluation system for hierarchical management of clinical nurse in top three hospitals was finally constructed, which included 3 first-grade and 19 second-grade indexes. The effective recovery rate of the two rounds of expert questionnaires and authority Cr of two rounds of expert consultation were 100% and 0.915, respectively. The Kendall coefficients of concordance for significance and operability of the first-grade and second-grade indexes were 0.353/0.515 and 0.344/0.469, respectively ( P<0.01). Conclusions:The hierarchical management of clinical nurses in top three hospitals constructed based on three-dimensional structure theory has reliability and feasibility.

Objective:To investigate the factors affecting postoperative short-term improvement of consciousness level in patients with prolonged disorders of consciousness after severe traumatic brain injury (sTBI).Methods:A case-control study was conducted to analyze the clinical data of 55 patients with prolonged disorders of consciousness after sTBI admitted to Beijing Tiantan Hospital Affiliated to Capital Medical University and Seventh Medical Center of PLA General Hospital from September 2021 to September 2022. There were 33 males and 22 females, with the age range of 13-68 years [(43.0±15.5)years]. All patients were assessed for the consciousness level using the coma recovery scale-revision (CRS-R) preoperatively and within 48 hours postoperatively. A total of 33 patients were observed in vegetative state and 22 in minimally conscious state preoperatively. The consciousness level was found to be improved in 26 patients (consciousness- improved group), but not improved in the remaining 29 patients (consciousness-unimproved group). Indicators were documented including gender, age, cause of injury, Glasgow coma score (GCS) on admission, course of injury, preoperative consciousness level, operation mode, operation time, intraoperative fluid replenishment, intraoperative urine volume, intraoperative bleeding volume, American Society of Anesthesiologists grade, analgesic regimen and sedation maintenance drugs. A univariate analysis was conducted first to assess those indicators′ correlation with postoperative short-term improvement of consciousness level in patients with prolonged disorders of consciousness after sTBI. Multivariate Logistic regression analysis was then used to determine the independent risk factors for their postoperative short-term improvement of consciousness level.Results:Univariate analysis showed that GCS on admission, course of injury, preoperative consciousness level and analgesic regimen were correlated with short-term improvement of postoperative consciousness level in patients with prolonged disorders of consciousness after sTBI (all P<0.05), whereas gender, age, cause of injury, operation mode, operation time, intraoperative fluid replenishment, intraoperative urine volume, intraoperative bleeding volume, American Society of Anesthesiologists grade and sedation maintenance drugs showed no relation to the improvement of postoperative consciousness level (all P>0.05). Multivariate Logistic regression analysis showed that the GCS &ge;7 points on admission ( OR=0.06, 95% CI 0.01, 0.36, P<0.01), preoperative minimally conscious state ( OR=0.09, 95% CI 0.02, 0.40, P<0.01) and intraoperative use of Sufentanil combined with Remifentanil ( OR=0.07, 95% CI 0.01, 0.43, P<0.01) were significantly correlated with postoperative improvement of consciousness level. Conclusion:The GCS on admission (&ge;7 points), preoperative minimally conscious state and intraoperative use of Sufentanil combined with Remifentanil are independent risk factors affecting short-term postoperative improvement of consciousness level in patients with prolonged disorders of consciousness after sTBI.

With the aggravation of aging and the increasing demand of the elderly for pension and medical services,the old-age model of medical care combined with nursing emerges as the times required.Traditional Chinese medicine medical institutions have the advantages and opportunities in the process of developing integrated medical and nursing services,such as the treatment and prevention of chronic diseases,the increasing demand of the elderly for integrated medical and nursing institutions,and the strong support of the state for integrated medical and nursing institutions.However,they are also facing challenges and difficulties such as imperfect team,weak market competition and low payment ability.Through the analysis of opportunities and challenges for TCM medical institutions,this paper provides corresponding counter measures and suggestions for their development.

Objective To analyze the characteristics on demographical,spatial distribution and transmission mode of HIV infections among 50-year-old population.Methods Related information on demography,spatial distribution,high risk behavioral and history of HIV infections among 50-year-old population were collected and analyzed.Possible time of infection based on their first CD4 testing results right after the HIV diagnoses,was estimated.Results Since 2008,the number of new HIV/AIDS cases among the over-50-year-olds was reported increasing annually.The number of aged 50 and above in 2014 was 4.2 times than the number in 2008.50-year-old or older population were infected mainly through heterosexual behavior (88.0％).Among these cases,83.9％ self-reported as having histories on extramarital sex intercourse and the number was increasing yearly.Among male cases who admitted as having heterosexual experience,95.1％ of them reported as having histories of extramarital sex intercourse while 53.4％ of the female cases reported as having the same experiences.46.6％ of spouses of the females or with fixed partners were HIV positive.Through estimating the time of infection and the time interval between infection and diagnosis,we found that the proportion was 15.5％,from infection to diagnosis as 3 years among the 50 and older age groups,but the proportion of 8 years from infection to diagnosis was 43.6％.We estimated that 66.5％ of the new HIV cases who were at age 50 and over,were infected when they were at that age span.The average time from infection and being tested was (6.8 ± 2.7) years.Conclusion The increasing number of being diagnosed on HIV among the 50-year-olds population might be related to both high risk exposure and belated diagnoses among this population,calling for the necessity of deriving the sources of HIV infection and tailoring the HIV prevention strategies in this population.

Objective:To investigate the effects of intelligent hand hygiene monitoring system on hand washing compliance and the incidence of catheter-related bloodstream infections.Methods:A retrospective analysis was conducted on the hand hygiene compliance of medical staff and works at different seasons in 2018. The daily doses of hand sanitizer patients in each quarter of 2017 and 2018, the microbial contamination of the hands before the medical staff contacted the patients, the overall hospital infection rate and the incidence of catheter-related bloodstream infections were calculated and compared.Results:The hand-washing compliance rate of medical staff and workers were increased in 2018. Compared with daily doses of hand sanitizer patients in 2017 and 2018, there was significant difference ( F value was 4.99, P<0.05). In 2018, the qualified rate of microbial contamination in the hands of medical staff before contacting patients was higher than in 2017: 91.5%(43/47) vs. 51.1%(23/45), there was significant difference ( χ2 value was 92, P<0.05) . The rate of hospital infection and catheter-related bloodstream infections were 1.57%(30/1 907), 0.5%(6/1 158) in 2018 and 3.11%(57/1 843), 1.6%(17/1 095) in 2017, there was significant difference ( χ2 values were 9.551, 5.959, P<0.05). Conclusions:The intelligent control hand hygiene monitoring system can improve the hand-washing compliance of medical staff and workers, reduce microbial contamination in the hands of medical staff, thereby reducing the incidence of catheter-related bloodstream infections.