Objective To investigate the clinical features of bilateral native pelvic and ureteral transitional cell carcinoma (TCC) in renal transplant patients. Methods A retrospective analysis was carried out on 16 patients with bilateral native pelvic and ureteral TCC after kidney transplantation.The mean time between transplantation and diagnosis of upper urinary TCC was 56. 2 ± 33. 0 months.Two patients were suffered from bilateral upper urinary TCC at the same time. The mean interval between 2 upper urinary tract operations of the remaining 14 cases was 8. 6 ± 6. 7 months. Hematuria and hydronephrosis of native kidneys were the main symptoms and targets in checkup. Intravesical chemotherapy was postoperatively given. Results All operations were performed successfully. All specimens obtained from the operations were pathologically diagnosed as TCC. The TCC location involved pure native pelvis (n = 4), pure native ureter (n = 9), and pelvis combined with ureter (n = 19). Pelvic TCC pathological grades included grade 1 in 8 cases, grade 2 in 11 cases, and grade 3 in 4 cases; Ureteral TCC grades included grade 1 in 6 cases, grade 2 in 10 cases, and grade 3 in 12 cases.Patients were followed up for 26. 8 ± 25. 1 months. One patient died of lung metastasis. (One case of lumbar soft tissue transfer was given local excision. The remaining patients had no recurrence and metastasis. Conclusion Renal transplant patients with hematuria and native renal hydronephrosis should be highly vigilant of the occurrence of upper urinary tract TCC. TCC after renal transplantation is invasive. Prophylactic contralateral nephroureterectomy should be performed on the recipients having TCC at the bladder and one side of native upper urinary tract.

Objective:The incidence of occupational burnout among emergency department healthcare workers is high,and their occupational health deserves attention.Establishing a comprehensive occupational health system in medical institutions is crucial.This study aims to understand the current status of occupational burnout among emergency department healthcare workers,analyze its influencing factors,and provide references for preventing burnout in this population. Methods:A cross-sectional survey was conducted using convenience sampling through the Questionnaire Star platform from December 2022 to January 2023 among emergency department healthcare workers.The Maslach Burnout Inventory-General Survey(MBI-GS)scale was used to assess the level of occupational burnout,and univariate analysis and binary Logistic regression analysis were employed to explore the influencing factors of burnout. Results:A total of 1 173 valid questionnaires were collected,with 946(80.65％)respondents experiencing occupational burnout.The proportions of mild-to-moderate and severe burnout were 73.57％and 7.08％,respectively.The scores for the three dimensions of burnout among emergency department healthcare workers were as follows:emotional exhaustion(EE)2.33±0.31;depersonalization(DP)1.88±0.28;low personal accomplishment(LPA)3.20±0.39.The overall score was 2.46±0.22.Factors associated with occupational burnout included being an only child(OR=1.362,95％CI-0.707 to-0.058),the average number of night shifts per month(OR=1.167,95％CI 0.091 to 0.272),and personal experience of workplace violence(OR=1.094,95％CI 0.027 to 0.195)(all P＜0.05). Conclusion:The incidence of occupational burnout is high among emergency department healthcare workers.Effective measures should be taken by management to promptly intervene,reduce burnout,and ensure the smooth functioning of emergency medical services.

Objective: To explore the effect of nursing scheduling software combined with mobile phone APP in the nursing manpower arrangement in intensive care unit. Methods: The nursing scheduling software and mobile phone APP were applied to management resources of 82 nurses in ICU, substituted for traditional manual way. The work efficiency, nursing quality and nurse satisfaction were compared before and after implementing in intensive care unit. Results: After implementation of nursing scheduling software combined with mobile phone APP, the average time of scheduling was reduced from (6.49±0.62) h to (4.29±0.44) h, the difference was statistically significant (t=19.97, P<0.01). The nursing quality score was improved from (97.54±1.19) points to (95.16±1.29) points, the difference was statistically significant (t=-4.70, P<0.01). The nurses′ satisfaction about scheduling was improved from 73.2%(60/82) to 96.3%(79/82), the difference was statistically significant (χ²=17.04, P<0.01). Conclusions The mode of nursing scheduling software combined with mobile phone APP in intensive care unit has a good effect, which can improve the scheduling efficiency, the job satisfaction of nursing staff and the quality of nursing,and promote the nursing information management.

Effective expression of pIFN-α in recombinant Pichia pastoris was conducted in a 5 L fermentor. Ethanol accumulation during the late glycerol feeding period inhibited heterologous protein expression. Comparative transcriptome analysis was thus performed to compare the gene transcription profiles of Pichia pastoris KM71H in high and low ethanol concentration environments. The results showed that during the glycerol cultivation stage, 545 genes (265 up-regulated and 280 down-regulated) were differentially expressed with ethanol stress. These genes were mainly involved in protein synthesis, energy metabolism, cell cycle and peroxisome metabolism. During the methanol induction stage, 294 genes (171 up-regulated and 123 down-regulated) were differentially expressed, which were mainly related to methanol metabolism, amino acid metabolism and protein synthesis. Ethanol stress increased protein misfolding and reduced structural integrity of ribosome and mitochondria during cultivation stage, and led to the failure of endoplasmic reticulum stress removal and damaged amino acid metabolism during induction stage in Pichia pastoris.
Amino Acids ; metabolism ; Bioreactors ; Endoplasmic Reticulum Stress ; Energy Metabolism ; Ethanol ; chemistry ; Gene Expression Profiling ; Gene Expression Regulation, Fungal ; Glycerol ; Methanol ; Pichia ; metabolism ; Protein Biosynthesis ; drug effects ; Protein Folding ; Recombinant Proteins ; biosynthesis ; Transcriptome