Objective To investigate the current status of cognitive level of patient safety culture in intensive care unit (ICU) nurses and analyze the influencing factors.Methods Totally 373 ICU nurses were investigated with the general information questionnaire,the Hospital Survey on Patient Safety Culture instrument (HSOPSC),the Report Barriers Questionnaire and the Condition of Work Effectiveness Questionnaire (CWEQ-Ⅱ).Results The mean rate of positive response on safety culture dimensions was 68.08％ in ICU nurses,Organizational learning-continuous improvement was the safety culture dimension with the highest positive response(89.95％),the lowest positive response was staffing(35.53％).Multiple regression analysis showed that the meaning of report,punitive culture,resources,opportunity,formal empowerment and ICU department were influencing factors of patient safety culture (P ＜ 0.05).Conclusions The level of patient safety culture in ICU nurses was medium,it remains a further improvement.Nursing managers should take targeted measures according to the influencing factors to enhance the cognitive level of patient safety culture in ICU nurses,strengthen the consciousness of safety culture,and improve the quality of intensive care.

Purpose To detect the HER2 gene amplification by fluorescence in-situ hybridization(FISH) and to explore its clinicopathologic relationship with the breast cancer.Methods A prospective study was conducted in 50 cases of breast invasive ductal carcinoma from Beijing Toren Hospital. Clinicopathologic data were summarized and FISH was performed in the paraffin-embedded sections for HER2 gene amplificayion using DNA probe, and immunohistochemical stain for ER, PR and HER2.Results The average age of the patients was 55.5 years. The pathologic grading showed that 11 cases were in grade Ⅰ, 30 cases in grade Ⅱ, and 9 cases in grade Ⅲ. The TNM staging showed that 13 cases were in stage Ⅰ,15 cases in ⅡA,13 cases in ⅡB,6 cases in ⅢA,2 cases in ⅢB,and 1 case in ⅢC.The median metastasis rate of lymph node was 6.91%.33 cases were positive for ER,and 32 cases positive for PR.For HER2 detection, 40 cases were positive by IHC and 33 positive by FISH. HER2 gene amplification by FISH was closely related with the expression of HER2 protein by immunohistochemistry, but not significantly related with pathologic grading, The TNM staging, median lymph node metastasis rate, ER and PR status (P>0.05). FISH test was positive in 3 cases of tumor embolus and 3 cases of multiple primary tumors. Conclusions FISH and immunohistochemistry for detecting HER2 have a good conformance, HER2 gene amplification may be related with tumor embolus and multiple primary tumors, but it can not be used as an indirect marker to predict the prognosis.

Objective To construct a Luciferace reporter vector containing the 3'untranslated region (3'UTR) of NFAT5 and measure the correlation between NFAT5 and miR-155.Methods The miR-155 targeting NFAT5 3'UTR was predicted by Target Scan,Mir Base and Pic Tar.NFAT5 and mutant NFAT5 sequence(NFAT5-mu) were then designed and synthesized,and they were cloned into pMIR-REPORTTM Luciferace reporter vector.Human embryonic kidney-293AD (HEK-293AD) cells of the 4th passage were divided into 4 groups according to the random number table.cells in plasimd +miR-155 mimics groups were transfected with pMIR-NFAT5 recombinant plasimid,pRL-Tk plasmid and miR-155 mimics;cells in plasimd + miR-155 mutated groups were transfected with pMIR-NFAT5-mu recombinant plasimid,pRL-Tk plasmid and miR-155 mimics;cells in plasimd + miR-155 control groups were transfected with pMIR-NFAT5 recombinant plasimid,pRL-Tk plasmid and miR-155 Negative control;cells in plasimd +miR-155 inhibitor were transfected with pMIR-NFAT5 recombinant plasimid,pRL-Tk plasmid and miR-155 inhibitor;and were respectively transfected into together by liposome.After culture for 24 h,the luciferase activity was detected by dual luciferase reporter assay system.Results TargetScan,Miranda and PicTar shared the results that NFAT5 has the complementary binding sites with 3'UTR of miR-155.And luciferase reporter vectorwas constructed.Therefore the result of sequencing and double digesting of recombined plasmid were completely correct.Dual-luciferase reporter assay showed that miR-155 possesses a target effect on 3'UTR of NFAT5.Compared to the pMIR-NFAT5 + miR-control group,the luciferase activity of the pMIR-NFAT5 + miR-1 5 5 mimics group was decreased,with statistically significant difference(P＜0.01),while there was no significant difference at other time points(P＞0.05).Conclusion The pMIR-NFAT5 recombinant plasmid and pMIR-NFAT5 recombinant mutated plasmid were confirmed with successful construction.and it was found that miR-155 can target NFAT5 mRNA 3'-UTR.The results provide the experiment data for further disclosing the mechanism of inhalation injury on the level of gene expression.

OBJECTIVEUnder the premise of smoke inhalation injury, to explore the effects of microRNA-146a on Fas-associated factor 2 (FAF-2) and inflammatory factors in human lung adenocarcinoma A549 cells under the stimulation of cigarette smoke extract (CSE).

METHODS(1) The pMIR-FAF-2 recombinant plasmid and the pMIR-FAF-2 recombinant mutated plasmid were constructed. Human embryonic kidney 293 (HEK-293) cells of the third passage were divided into 3 groups according to the random number table, with 5 wells in each group. Cells in plasmid+ microRNA control group were transfected with pMIR-FAF-2 recombinant plasmid, pRL-TK plasmid, and microRNA control; cells in plasmid+ microRNA-146a group were transfected with pMIR-FAF-2 recombinant plasmid, pRL-TK plasmid, and microRNA-146a mimics; cells in mutated plasmid+ microRNA-146a group were transfected with pMIR-FAF-2 recombinant mutated plasmid, pRL-TK plasmid, and microRNA-146a inhibitor. After culture for 24 h, the relative luciferase activity in cells was assessed by dual-luciferase reporter gene assay. (2) Human lung adenocarcinoma A549 cells of the third passage were divided into 3 groups according to the random number table, with 4 wells in each group. Cells in microRNA control group were transfected with microRNA control; cells in microRNA-146a enhancement group were transfected with microRNA-146a mimics; cells in microRNA-146a inhibition group were transfected with microRNA-146a inhibitor. After culture for 24 h, the mRNA expression levels of microRNA-146a and FAF-2 in cells were determined with real-time fluorescent quantitative reverse transcription-PCR. (3) A549 cells of the third passage were stimulated by 0.8% CSE for 24 h after being divided and treated with the same method used in experiment (2). The mRNA expression levels of FAF-2, IL-8, monocyte chemotactic protein-1 (MCP-1), and growth-regulated oncogene-α (GRO-α) in cells were determined with real-time fluorescent quantitative reverse transcription-PCR. The protein expression levels of IL-8, MCP-1, and GRO-α in A549 cell culture supernatant were determined by enzyme-linked immunosorbent assay. The protein expression level of cyclooxygenase 2 (COX-2) of cells was assessed by Western blotting. Data were processed with one-way analysis of variance and LSD test.

RESULTS(1) The pMIR-FAF-2 recombinant plasmid and pMIR-FAF-2 recombinant mutated plasmid were confirmed with successful construction. The relative luciferase activity in HEK-23 cells of plasmid+ microRNA control group was close to that of mutated plasmid+ microRNA-146a group (P>0.05). The relative luciferase activity in HEK-23 cells of plasmid+ microRNA-146a group was significantly lower than that of plasmid+ microRNA control group and mutated plasmid+ microRNA-146a group (with P values below 0.01). (2) The expression level of microRNA-146a in A549 cells of microRNA control group was close to that of microRNA-146a inhibition group (P>0.05), and they were both significantly lower than the expression level of microRNA-146a in A549 cells of microRNA-146a enhancement group (with P values below 0.01). The mRNA expression level of FAF-2 in A549 cells of microRNA control group was close to that of microRNA-146a inhibition group (P>0.05), and they were both significantly higher than the mRNA expression level of FAF-2 in A549 cells of microRNA-146a enhancement group (with P values below 0.05). (3) After stimulation of CSE, the mRNA expression level of FAF-2 in A549 cells of microRNA control group (1.46±0.21) was close to that of microRNA-146a inhibition group (1.43±0.34, P>0.05), which were both significantly higher than the mRNA expression level of FAF-2 in A549 cells of microRNA-146a enhancement group (0.57±0.11, with P values below 0.05). The mRNA expression levels of IL-8, MCP-1, and GRO-α in A549 cells of microRNA-146a enhancement group were significantly lower than those of microRNA control group and microRNA-146a inhibition group (with P values below 0.01). The mRNA expression levels of IL-8, MCP-1, and GRO-α in A549 cells of microRNA-146a inhibition group were significantly higher than those of microRNA control group (with P values below 0.05). The protein expression levels of IL-8, MCP-1, and GRO-α in A549 cell culture supernatant of microRNA-146a enhancement group were significantly lower than those of microRNA control group and microRNA-146a inhibition group (with P values below 0.05). The protein expression level of IL-8 in A549 cell culture supernatant of microRNA-146a inhibition group was close to that of microRNA control group (P>0.05), while the protein expression levels of MCP-1 and GRO-α in A549 cell culture supernatant of microRNA-146a inhibition group were significantly lower than those of microRNA control group (with P values below 0.05). The protein expression level of COX-2 in A549 cells of microRNA-146a enhancement group was significantly lower than the levels of microRNA control group and microRNA-146a inhibition group (with P values below 0.05). The protein expression level of COX-2 in A549 cells of microRNA control group was close to that of microRNA-146a inhibition group (P>0.05).

CONCLUSIONSIn A549 cells, after being transfected with microRNA-146a and stimulated by CSE, microRNA-146a can decrease the expression of FAF-2 through integrating with the 3'-untranslated region of target gene FAF-2, thereby decrease the expression of inflammatory factors.

Adenocarcinoma ; chemically induced ; Blotting, Western ; Chemokine CCL2 ; metabolism ; Enzyme-Linked Immunosorbent Assay ; HEK293 Cells ; Humans ; Interleukin-8 ; Lung ; drug effects ; metabolism ; Lung Neoplasms ; chemically induced ; MicroRNAs ; analysis ; Plasmids ; RNA, Messenger ; Smoke ; adverse effects ; Smoking ; Transfection

Objective To investigate the causes,the prevention and the treatment of the complications of blepharoplasty for double eyelids.Methods The clinical data,the surgery methods and the causes were analyzed in 100 cases of blepharoplasty from July 2011 to December 2017.Results All of these patients underwent these perfect procedures with satisfied anesthesia.Incisions were all healed in one stage with no infection.Double eyelid width was (7.0± 1.2) mm with natural and smooth lines after 3 months operation,86 patients (86％) had double eyelid with natural and smooth lines,slight scars and good bilateral symmetry.14 patients (14％) required surgical revision for complications,as asymmetry of supratarsal folds (7 ％),over narrow of supratarsal folds (4 ％),over width of supratarsal folds (2 ％),disappearance of supratarsal folds (2 ％),multiple eyelid (3 ％) and ptosis (1％),and the effects were satisfactory.Conclusions In order to achieve the natural and smooth double eyelids,it is important for plastic surgeons to have the comprehensive grasp of overall outline and operational details in blepharoplasty for double eyelids.Preoperative design should be accurate,intraoperative procedures should be careful,and postoperative care should be standardized.

Objective:To characterize the clinical and epidemiological changes, treatments, and prognoses of primary esophageal small cell carcinoma (PESC). Methods:A retrospective analysis was conducted using the clinical epidemiology data of 529 PESC patients se-lected from the clinical databases of 500,000 esophageal and gastric cardiac carcinomas of the Henan Key Laboratory for Esophageal Cancer Research (1992-2015). Among these patients, 241 cases were included in the survival analysis. The five-year survival rate was calculated using Kaplan-Meier analysis, and the differences in survival rates were compared using the Log-rank analysis model. Re-sults:All 529 PESC cases were analyzed, which accounted for 0.2%of esophageal cancers diagnosed in the same period. The incidence of PESC increased annually (R2=0.574). The survival rates for 1-, 2-, 3-, and 5-year of 241 PESC patients were 55%, 40%, 29%, and 9%, respectively, and the median survival time was 21.9 months. On the basis of the VALSG criteria of lung small cell carcinoma, a statisti-cal difference was observed in the overall survival rates for limited and extensive diseases (P=0.003), with the median survival time of 24.3 and 17.5 months, respectively. Furthermore, significant differences were observed on survival with various treatment modalities (P=0.004). The median survival time of PESC patients treated with combined surgery and radiochemotherapies (28.8 months) was lon-ger than those with either chemotherapy (17.8 months, P=0.015) or chemoradiotherapy (14.5 months, P=0.004). In limited disease pa-tients, the median survival time was longer in patients treated with surgery (27.7 months) than in those without surgery (16.2 months, P=0.007). Notably, the biopsy diagnosis before surgery for PESC was only 40.8%. Conclusion:PESC is a rare malignant carcinoma with increasing incidence. PESC presents poor prognosis, and the survival rate can be improved through combined therapies based on sur-gery. A high misdiagnosis rate for PESC is observed before surgery with biopsy.

OBJECTIVE: To analyze ultrasonographic finding in fetuses with Wolf-Hirschhorn syndrome (WHS) and refine the critical region on chromosome 4p16.3 for WHS-associated fetal growth retardation (FGR). METHODS: In total 2262 fetuses with abnormal ultrasonographic findings who underwent prenatal karyotyping and chromosomal microarray analysis were reviewed. WHS-associated 4p deletions detected in these fetuses were compared, and prenatal ultrasound findings in such fetuses were summarized. Meanwhile, WHS cases with prenatal ultrasound findings and isolated 4p deletions in previous studies were included for further analysis. An analysis of smallest region of overlap (SRO) among discrepant 4p deletions in these cases above was performed to define a critical region for FGR. RESULTS: 4p deletions were detected in 10 of the 2262 fetuses and 5.0% of the 202 fetuses with FGR. Combined with 80 WHS cases from previous studies, the most common prenatal ultrasound finding was FGR, which yielded a frequency of 76.7%. In addition, a SRO spanning approximately 419 kb (genomic position: 1.32-1.74 Mb) on chromosome 4p16.3 was discovered by comparing the unusual 4p deletions among the 10 fetuses. The region contained seven protein-coding genes, including TACC3, SLBP, TMEM129, FAM53A, MAEA, UVSSA and CRIPAK. CONCLUSION For fetuses with WHS, the most common prenatal ultrasound phenotype was FGR. A region between 1.32 Mb to 1.74 Mb from the telomere on chromosome 4p16.3 is critical for WHS-associated FGR, for which TACC3 and SLBP are the candidate genes.

Objective To explore the clinical efficacy and prognosis of spironolactone in patients with heart failure and type 2 diabetes with slightly reduced ejection fraction.Methods A total of 409 patients with heart failure and type 2 diabetes with slightly reduced ejection fraction who were treated in Beijing Chaoyang Hospital from February 2019 to December 2022 were in-cluded.All patients had not taken spironolactone before the trial and had received treatment with other standard heart failure drugs and hypoglycemic drugs for at least six months.Patients will be randomly divided into an experimental group and a con-trol group.The experimental group will receive 10-20 mg/d of spironolactone in addition to the treatment in the control group.The changes in glycated hemoglobin(HbA1c),body mass index,plasma N-terminal B-type natriuretic peptide(NT proB-NP),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),ratio of diastolic peak mitral valve velocity to early mitral annulary(E/e'),serum creatinine(Scr),serum uric acid(SUA),creatinine clearance rate(Ccr),and blood potassium levels between two groups of patients before and after treatment were compared.The incidence of treatment-re-lated adverse reactions,cardiovascular death,or worsening heart failure readmission composite endpoint events were ob-served.Evaluate Clinical treatment efficacy were evaluated.Results There was no statistically significant difference in general information between the two groups of patients before treatment(P＞).05).After treatment,the HbA1c level in the experimen-tal group decreased when compared to the control group[(7.2±0.5)vs.(7.9±0.7),P＜0.05],and the NT proBNP level de-creased when compared to the control group[(423±155)vs.(640±157),P＜0.05].The improvement of various indicators of cardiac and renal function in the experimental group after treatment was better than that in the control group(all P＞0.05).Pa-tients in the experimental group with heart function grades Ⅱ-Ⅳ had relatively stable blood potassium levels during treatment(all P＞0.05).The clinical efficacy and total effective rate of the experimental group after treatment were higher than those of the control group(both P＞0.05),and there was no statistically significant difference in the incidence of composite endpoint e-vents and drug-related adverse reactions between the two groups(P＞0.05).Conclusion Spironolactone is helpful to the blood sugar management of heart failure patients with type 2 diabetes and slightly reduced ejection fraction,and can further improve the heart function and renal function,with satisfying drug safety.

Objective:To compare the four nucleic acid detection method of hepatitis A virus.Methods:Using method A, B, and C real-time fluorescent quantitative RT-PCR(RT-qPCR)and method D droplet chip digital PCR(RT-dPCR)to detect the sensitivity of HAV plasmid and gradient dilution HAV vaccine respectively. Specific detection of related viral nucleic acid was performed. Methods A, B, and C were used to detect 40 artificially contaminated HAV oysters, commercially available oysters and serum samples, and HAV vaccine samples, and compare the detection rates. The recovery rates of method A and D on artificially contaminated oysters were compared with low concentration of HAV.Results:Both method A and B could detect HAV plasmids up to 10 copies/μL. In the detection of HAV vaccine with gradient dilution, the slope, R 2 value and amplification efficiency of method A, B, and C were all within the acceptable range (-3.446~-3.297, 0.991-0.998, -95.07%-101.051%). For 40 specimens from different sources, the positive detection rates of method A, B, and C were 50% (20/40), 47.5% (19/40), 55% (22/40), and the difference was not statistically significant ( χ2=0.467, P=0.792). Methods A and D have no significant difference in the detection sensitivity of gradient dilution vaccines. For the detection of artificially contaminated oysters with low concentration of HAV, the recovery rate of method D was higher than that of method A, but the difference was not statistically significant (F=0.294, P=0.642). Conclusions:There is no significant difference between method A, B, and C, which is more convenient and fast. When detecting low concentrations of HAV in food, Methods D had a slight advantage, but the detection cost is slightly higher. The detection method can be selected according to the actual situation.

Objective:To explore the association between salivary galectin-3(Gal-3)and periodontitis stage.Methods:For this cross-sectional study,35 patients for each periodontitis Stage Ⅰ,Ⅱ and Ⅲ group were recruited,and 35 periodontally healthy subjects were included in the control group.Salivary level of Gal-3 was examined by ELISA.The association between Gal-3 and periodontitis stage was analyzed.Results:The median levels(M(Q1,Q3),ng/mL]of salivary Gal-3 in the healthy control group and the peri-odontitis Stage Ⅰ,Ⅱ and Ⅲ groups were 89.40(84.56,96.58),98.26(89.15,112.29),136.22(116.21,144.33)and 183.27(161.45,196.92),respectively.Jonckheere-Terpstra trend test showed that there was a sequential effect between salivary Gal-3 level and the stage of periodontitis(Z=10.178,Ptrend＜0.001).Spearman's rank correlation analysis showed that the level of Gal-3 was posi-tively correlated with PD,CAL,BI,BOP and PLI respectively(P＜0.001).Multinomial logistic regression analysis showed that Gal-3 level was significantly associated with periodontitis Stage Ⅰ,Ⅱ and Ⅲ,the adjusted odds ratio(aOR)were 1.061(95％CI:1.016-1.108,P=0.008),1.181(95％CI:1.105-1.202,P＜0.001)and 1.267(95％CI:1.177-1.365,P＜0.001),respectively.ROC curves showed that the AUCs of Gal-3 in the predicting stage Ⅰ,Ⅱ and Ⅲ periodontitis were 0.685(95％CI:0.167-0.524,P=0.005),0.958(95％CI:0.167-0.524,P＜0.001)and 0.997(95％CI:0.942-1.000,P＜0.001),respectively.Conclusion:Salivary Gal-3 level is significantly correlated with periodontitis stage,and it might be a potential biological marker for predicting peri-odontitis severity.