Objective To investigate the effect of hyperoxia on the expression and transport function of epithelial sodium channel (ENaC) in neonatal rat alveolar epithelial type Ⅱ(AT Ⅱ) cells.Methods AT Ⅱ cells were isolated from neonatal rats,and primarily cultured under hyperoxic or normoxic conditions.Western blot was applied to examine the ENaC expression,and the amiloride-sensitive Na + currents were recorded using the whole-cell patch clamp technique.Results Hyperoxia upregulate the expression of β-ENaC and γ-ENaC subunits in the neonatal rat ATⅡ cells(β-ENaC:1 d:0.43 ±0.06 vs0.32 ±0.04,P =0.047;2 d:0.73±0.06 vs 0.50±0.08,P =0.019;3 d:0.72 ±0.08 vs 0.52 ±0.06,P =0.027;γ-ENaC:1 d:0.64±0.05 vs0.53 ±0.05,P =0.044;2 d:0.76 ±0.03 vs 0.52 ±0.04,P =0.001 ;3 d:0.77 ±0.06 vs 0.61 ±0.05,P =0.025).In addition,the amiloride-sensitive Na+ currents in hyperoxia-exposed AT Ⅱ cells were also increased (1d:13.71 ±2.77 vs8.92±1.38,P＜0.001;2d:29.12±11.03 vs 10.41 ±1.80,P＜0.001),which was consistent with the upregulated expression of β-ENaC and γ-ENaC.However,the expression of α-ENaC was inhibited by hyperoxia to some extent (1 d:0.31 ± 0.05 vs 0.46 ± 0.05,P =0.025 ; 2 d:0.30 ±0.01 vs0.38±0.02,P=0.002;3d:0.37±0.06 vs 0.37 ± 0.08,P =0.983).Conclusion Hyperoxia enhanced the transport function of ENaC in neonatal rat AT Ⅱ cells.Dysfunctional transport of Na + may not be a key factor involving in pulmonary edema at the early stage of bronchopulmonary dysplasia.

Objective To observe the difference of retinal vessel oxygen saturation in glaucoma and normal eyes.Methods A cross sectional study design was performed.Fifty eyes of 30 glaucoma patients (glaucoma group) and 41 eyes of 27 age-and sex-matched healthy subjects (control group) were included.Retinal vessel oxygen saturation was measured with a spectrophotometric retinal oximeter in darkness and visual fields were obtained by Humphrey filed analyzer.The glaucoma eyes were divided into two groups:mean defect (MD) ＜6 dB (28 eyes) and MD≥6 dB (22 eyes) according to mean defect of visual field.Results Retinal arteriolar oxygen saturation values in glaucoma group and control group were (94.52 ±6.51) ％ and (93.47±6.30) ％ respectively.No statistical difference was found in retinal oxygen saturation in arterioles (H =-0.949,P =0.343).Retinal venous oxygen saturation values in glaucoma group and control group were (57.57 ± 7.96)％ and (52.60 ± 7.70) ％ respectively.The retinal venous oxygen saturation values in glaucoma group was higher than that in control group (H=-3.318,P=0.001).The retinal arteriovenous difference in glaucoma group and control group were (36.59± 4.69)％ and (42.41 ±6.73) ％ respectively.The retinal arteriovenous difference in glaucoma group was lower than that in control group (H=-4.148,P＜0.01).The retinal arteriolar oxygen saturation values in glaucoma eyes with MD＜6 dB and MD≥6 dB were (93.38 ± 6.33)％ and (95.71 ± 6.54)％ respectively,with no statistical difference (H=-1.857,P=0.063).Retinal venous oxygen saturation values in glaucoma eyes with MD＜6 dB and MD≥6 dB were (54.83 ± 6.10) ％ and (6 1.07 ± 8.79) ％ respectively.The retinal venous oxygen saturation values in MD≥ 6 dB glaucoma eyes was higher than that in MD＜ 6 dB glaucoma eyes (H =-2.599,P=0.009).The retinal arteriovenous difference in glaucoma eyes with MD＜6 dB and MD≥6 dB were (38.12± 4.34) ％ and (34.64 ± 4.49) ％ respectively.The retinal arteriovenous difference in MD≥6 dB glaucoma eyes was lower than that in MD＜6 dB glaucoma eyes (H=-2.463,P＜0.05).Conclusions Compared with healthy eyes,there is no change in the retinal arteriolar oxygen saturation,but the retinal venous oxygen saturation is higher and the retinal arteriovenous difference is lower.This feature is more obvious in MD≥6 dB glaucoma eyes.

Objective To investigate the efficacy and safety of electronic flexible ureteroscope Holmium laser lithotripsy in the treatment of kidney stones larger than 2. 0 cm. Methods From October 2012 to December 2013,43 cases of kidney stones larger than 2. 0 cm in diam-eter were treated with holmium laser lithotripsy under electronic flexible ureteroscope. A double-J stent was indwelled in ureter for 1~2 weeks before operation in each patient. Ureteral catheter guide wire was firstly put into the ureter with F8. 0/9. 8 semi-rigid ureteroscope,and the ac-cess sheath was put along the wire. Then,the electronic flexible ureteroscope(Olympus V5) was introduced into the pelvis. Stones were frag-mented with holmium laser,and greater than 3 mm crushed stones were removed with a set of stone basket. Results The diameter of the stones of the 43 patients ranged from 2~3. 2 cm,with an average of 2. 4 cm. The operation time ranged from 35~120 min,with an average of 68 min. Three patients complicated with chills,fever and other symptoms of infection,who were improved by active anti-infective treatment. No serious complications occurred. Postoperative hospital stay was 2~4 d,with an average of 3. 2 d. After 12 weeks of follow-up,stone clearance rate was 86% (37/43). Conclusion It is safe and efficacy to treat kidney stones larger than 2. 0 cm with electronic flexible ureteroscope, especially for the elderly,solitary kidney,and patients with a previous incision or percutaneous nephrolithotomy.

Objective To compare the safety and efficacy of flexible ureteroscopic lithotripsy (F-URS) and mini-percutaneous nephrolithotomy(MPCNL) for treating upper ureteral calculi by the randomized controlled clinical trial .Methods 120 cases of up-per ureteral calculi treated in this hospital from May to September 2013 were randomized into the F-URS group and the MPCNL group with 60 cases in each group .The postoperative clinical curative effects were compared between the two groups .Results The initial stone clearance rates of the F-URS group and the MPCNL group were 68 .33% and 95 .00% respectively ,and the difference was statistically significant (P< 0 .05) .The clearance rate of the two groups after postoperative 3 months were 96 .67% and 98 .33% respectively ,and the difference between the two groups had no statistical significance (P>0 .05) .The operating time of the F-URS group and the MPCNL group was (35 .33 ± 11 .57)min and (53 .75 ± 17 .31)min respectively ,the average hospital stay after operation was(3 .05 ± 0 .62)d and (5 .43 ± 1 .84)d respectively ,and the average visual analogue scale(VAS) score on first postoper-ative day was 1 .70 ± 1 .37 and 3 .68 ± 1 .57 respectively .These indicators had statistically significant differences between the two groups(P<0 .05) .The average dropped amount of hemoglobin and the occurrence rate of complications after operation had no sta-tistically significant differences between the F-URS group and the MPCNL group(P>0 .05) .Conclusion For upper ureteral calculi with surgical indication ,the effect of F-URS is equivalence to MPCNL in the aspect of the stone clearance rate ,but F-URS has high-er security and shorter postoperative hospital stay .In the department with the condition to conduct F-URS ,F-URS should be ranked as the preferred treatment method for upper ureteral calculi .

Objective To explore the current status of physician-nurse collaboration in public Class Ⅲ general hospitals and analyze its related factors so as to provide a basis and data support for pushing forward physician-nurse collaboration and improving negatively related factors. Methods From April to June 2018, totals of 465 nurses and 249 physicians form 6 public ClassⅢ general hospitals in Beijing were selected as subjects by convenience sampling and cross-sectional study. The questionnaire survey was carried out with the Chinese version of Nurse-Physician Collaboration Scale(NPCS). The related factors of physician-nurse collaboration were analyzed with the simple correlation and multiple linear regression. Results The scores of NPCS of 465 nurses and 249 physicians were(78.81±17.68)and(84.86±15.22)respectively. Simple correlation showed that there were statistical differences in the scores of NPCS among physicians and nurses with the different personnel categories,physician-nurse working relationships,physician-nurse working mode, whether to carry out clinical pathways or not and income satisfaction(P< 0.05). Multiple linear regression revealed that the related factors of physician-nurse collaboration included the physician-nurse working mode, personnel categories,income satisfaction and clinical pathways with statistical differences(P < 0.05). Conclusions Public Class Ⅲ general hospitals have good physician-nurse collaboration. However,physicians and nurses lack communication in participating the treatment and nursing decision making for patients. Managers should further deepen the reform of personnel system,implement position management and performance incentive systems,carry out the physician and nurse responsibility system and physician-nurse working mode and positively develop clinical pathways so as to promote physician-nurse collaboration.

Objective To investigate the clinical efficacy and safety of flexible ureteroscopic lithotripsy ( FURL) using holmium laser for medullary sponge kidney stones. Methods A flexible ureteroscope was placed into renal calyx via a ureteral access sheath ( UAS) . The stones underlying the mucosa were found,and then broken by holmium laser following incision of renal papillary mucosa. The stone fragments were washed or clamped out. The remission of clinical symptoms and incidence of perioperative complications were observed,and a KUB plain film was rechecked postoperatively. Results Stones underlying mucosa were found and broken successfully in all 14 patients and there was no serious bleeding. Back pain symptoms of patients were relieved in 3 to 7 days postoperatively or after the removal of double J stent. The stone fragments were mainly discharged spontaneously. The rechecking KUB showed the amount of stones of most patients was significantly re-duced three months after operation. Conclusion FURL using holmium laser is effective for the treatment of medullary sponge kidney stones as it can significantly reduce the loads of stones without serious complications. It’ s a minimally invasive,effective,safe and suitable way which is suitable for further spread of clinical application.

Objective:To analyze the time of recovery to the respiratory baseline after treatment of retinopathy of prematurity (ROP) and the possible influencing factors.Methods:The preterm infants with ROP who received ophthalmic treatment from January 2016 to December 2020 in the Department of Neonatology, Guangdong Women and Children′s Hospital were enrolled retrospectively.The baby who received vitreous injection were included in the injection group, and who received laser photocoagulation were included in the photocoagulation group.The patients were divided into two groups according to whether they returned to the respiratory baseline within 48 hours after ROP surgery.Relevant data were collected, including respiratory baseline, the respiratory status 24 hours, 48 hours, 72 hours, 96 hours, 5 days and 7 days after treatment, gestational age, birth weight, gender, corrected gestational age at surgery, weight at surgery, laser points, and treatment location.Wilcoxon signed-rank test was used for continuous variables. Data were expressed as the number and percentage of patients for categorical variables, using Chi-square test or Fisher′ s exact test. Binary Logistic regression analysis was used to analyze the influencing factors.The time taken by preterm infants to return to the preoperative respiratory baseline after treatment and its influencing factors were analyzed. Results:A total of 386 ROP infants were included in this study.There were 157 infants who did not return to the respiratory baseline within 48 hours after treatment.No significant difference in the source, gender, gestational age, birth weight, corrected gestational age at surgery, weight at surgery, and respiratory pressure support required before surgery were found between the group who returned to the respiratory baseline within 48 hours and the group who did not (all P>0.05). However, there were significant differences in treatment methods and location between two groups (all P<0.01). The ratio of returning to the respiratory baseline in the group receiving intravitreal injection was significantly different from that in the group treated with laser therapy at 24 h, 48 h, 72 h, and 96 h after treatment (77% vs.14%, 82% vs.33%, 86% vs.58%, 89% vs.76%; all P<0.01). There was no difference in that ratio between two groups at 5 d and 7 d after treatment (91% vs.86%, 95% vs.92%; P>0.05). Of the 157 infants who did not return to the respiratory baseline within 48 hours after treatment, 108 cases (68.8%) required additional supplemental oxygen, whereas 153 cases (98.5%) required more intensive respiratory support ( P<0.001). According to the multivariate Logistic regression analysis results, the preterm infants who received laser therapy were less likely to return to the respiratory baseline within 48 hours than those who received intravitreal injection ( OR=0.099, 95% CI: 0.060-0.164). A small corrected gestational age at surgery was an independent risk factor for infants not returning to the respiratory baseline within 48 hours ( OR=1.147, 95% CI: 1.009-1.302). Conclusions:Infants with ROP who receive intravitreal injection can return to the respiratory baseline more quickly than those who underwent laser photo-coagulation under. The difference persisted up to 4 days. The smaller the corrected gestational age at treatment, the less likely return to the respiratory baseline within 48 hours in photocoagulation group..

OBJECTIVE To analyze the status quo ，influential factors of medication compliance and adverse drug reactions of home-based patients with severe mental disorders . METHODS Patients with severe mental disorders at home who were enrolled in the Shanghai mental health information management system in Jinshan district of Shanghai in Jan . 2022 were selected as the research objects . In combination with the relevant basic data registered in the information system and through face -to-face or telephone surveys by mental health doctors ，basic information ，medication compliance ，mental symptoms ，social function defects ， drug use information and adverse drug reactions of patients were understood . Univariate and multivariate Logistic regression analysis of medication compliance were performed . RESULTS Totally 2 684 questionnaires were distributed and 2 606 valid questionnaires were recovered ，with an effective recovery rate of 97.10%. The overall medication compliance of patients with severe mental disorders at home was 68.11%. The results of multivariate Logistic regression analysis showed that 51-60 years old ，unmarried， divorced or widowed ，partial social function defects ，no social function defects ， and use of third -generation antipsychotic drugs were the promotion factors of medication compliance ， （P＜0.05）；medical insurance ，non participation in work ，total number of hospitalizations of 1-4 times，total number of hospitalizations ≥ 5 times，general mental symptoms ，and use of second -generation antipsychotic drugs were the obstacles to medication compliance （P＜0.05）. The incidence of adverse drug reactions in patients with severe mental disorders a t home was 10.59%，mainly caused by second -generation antipsychotic drugs，and no new and serious adverse reactions were reported . CONCLUSIONS The medication compliance of patients with severe mental disorders at home is affected by many factors . It is urgent to need pharmacists ’participation to promote the standardization and rationality of patients ’medication.

Postoperative pain, a common problem in perioperative management, has negative impact on patients' experience and functional recovery. The development of postoperative pain is not only related to direct surgical trauma, but also a series of preventable perioperative risk factors, among which perioperative sleep quality should not be neglected. In recent years, more and more researches have indicated that poor perioperative sleep quality is a risk factor for both acute and chronic postoperative pain, and some researches have even pointed out that sleep quality can directly influence patients' pain threshold. Therefore, this review aims to summarize current research progress on the influence of perioperative sleep quality on postoperative pain, hoping to provide reference for improving the perioperative pain management for patients.

  Objective  To identify the risk factors for postoperative nausea and vomiting (PONV) in surgical patients undergoing patient controlled intravenous analgesia (PCIA).  Methods  Our study was a retrospective cohort study, including patients who underwent surgery at Peking Union Medical College Hospital from July 1 to October 31, 2023 and received PCIA after surgery. Patient characteristics, medical history, surgical information, intraoperative medication information, postoperative analgesia follow-up information were obtained through the electronic medical record system. The patients were divided into PCIA-PONV group and non-PCIA-PONV group, depending on the occurrence of PONV during PCIA, and all patients were also divided into PCIA-POV group and non-PCIA-POV according to whether postoperative vomiting (POV) occurred. Multivariate Logistic regression analysis was used to identify the risk factors for PCIA-PONV and PCIA-POV.  Results  A total of 1373 patients were included in this study, with 676 cases in PCIA-PONV group. The incidence of PCIA-PONV was 49.2%. There were 285 patients in PCIA-POV group, and the incidence of PCIA-POV was 20.8%. The results of multivariate Logistic regression analysis showed that female (OR=2.134, 95% CI: 1.590-2.865, P < 0.001) and abdominal surgery (OR=1.655, 95% CI: 1.253-2.186, P < 0.001) were risk factors for PCIA-PONV, whereas the increase of age (OR=0.990, 95% CI: 0.982-0.998, P=0.019) and the increase of BMI (OR=0.961, 95% CI: 0.932-0.991, P=0.012) were protective factors for PCIA-PONV. Female (OR=2.646, 95% CI: 1.754-3.992, P < 0.001), history of general anesthesia (OR=1.372, 95% CI: 1.042-1.806, P=0.024), and intraoperative use of high-dose opioids (OR=1.607, 95% CI: 1.206-2.142, P=0.001) were risk factors for PCIA-POV, whereas no intraoperative use of neuromuscular blocking antagonists (OR=0.393, 95% CI: 0.237-0.651, P < 0.001) was protective factor for PCIA-POV.  Conclusions  Our study reveals the risk factors for PONV in surgical patients undergoing PCIA, and shows that comprehensive preoperative assessment and reasonable perioperative management strategies are significant in the prevention of PCIA-PONV.