Objective To analyze the cause of neonatal unplanned extubation( UEX)of gastric tube as well as explore the strategies. Methods Seven hundred and sixteen neonates with gastric tube were registered. Their intubation time,intubation aim,extubation time,extubation reasons of unplanned extubation of gastric tube were recorded and analyzed. Results The incidence of UEX of gastric tube was 13. 3%(95 cases) and 1. 54 per 100 tube days in the neonates. The incidences of UEX in channel orally and body unrestraint were 33. 6%(46/137)and 24. 3%(42/173),higher than that of nasopharyngeal tube(18. 5%(49/579))and body restraint(9. 8%( 53/543 )),and the difference was significant( P = 0. 046,0. 004 ). Incidence of UEX in adhesive tape fixing group was 18. 1%( 23/127 ),higher than in bandage group( 11. 4%( 41/359 )) and transparent dressing group(9. 4%(31/330)),and the difference was significant(P=0. 034). Incidence of UEX caused by doctors or nurses was 24. 2%(23/95). There were more UEX from 12 to 14 O'clock and 22 to 1 O'clock. The channel of gastric tube( Oral cavity and nasopharynx,P = 0. 031,RR = 1. 563,95% CI 1. 205-2. 341),fixing method of tube( tape,bandage and transparent dressing,P=0. 004,RR=1. 492,95%CI 1. 320-3. 541)and body restraint(had/hadn't,P=0. 021,RR=1. 298,95%CI 1. 087-3. 271)were the influence factors of UEX. Conclusion The approaches including selecting nasal cavity as the tube channel,effective fixing of the tube,proper body restraint,perfect wandering round and standard nursing practicing are effective strategies to prevent UEX of gastric tube.

Aim To investigate the effect of preventive administration of icariin on learning and memory abili-ties and brain mitochondrial oxidative stress in senes-cence-accelerated mouse prone8 ( SAMP8 ) . Methods
The 6-month-old SAMP8 mice were randomly divid-ed into the SAMP8 model group, ICA groups (75, 150 mg · kg-1 ) , the positive Diethylstilbestrol ( DES ) group and estrogen receptor inhibitor ICI182780 com-bined with ICA (150 mg·kg-1 ) group, with 8 mice in each group. 8 same month old SAMR1 mice were selected as the normal control group. After oral admin-istration for 8 weeks, Morris water maze test and step-down passive test were used to investigate the effects of preventive administration of ICA on learning and mem-ory abilities in SAMP8 mice. Cerebral cortex mitochon-dria were isolated to determine the effect of preventive administration of ICA on the oxidative stress by detec-ting reactive oxygen species ( ROS) level, lipid perox-ides ( MDA ) content, glutathione GSH content and catalase ( CAT ) activity. Results Preventive treat-ment of ICA could significantly improve the abilities of place navigation and space exploration of SAMP8 mice, enhance their reflex ability in step-down passive test. ICA could also reduce the level of ROS and MDA content, increase GSH content in brain mitochondria of SAMP8 mice. CAT activity was not obviously changed. Compared with ICA high dose group, the learning and memory abilities of mice in ICA and estrogen receptor inhibitor ICI182780 co-administrated group were signif-icantly decreased. However,brain mitochondria oxida-tive stress was not changed obviously. Conclusion Preventive administration of icariin can significantly improve learning and memory abilities and brain mito-chondrial oxidative stress in SAMP8 mice. The mecha-nism of ICA improving learning and memory abilities may be related to its estrogen-like effect;while the ac-tion on brain mitochondrial oxidative stress may be in-dependent of estrogen receptor.

Objective To verify the relationship between personality traits and clinical nurse competence in five third-A level hospitals in Shenyang. Methods A total of 1559 clinical nurses from five tertiary-level hospitals in Shenyang were recruited into this study. Two self-report questionnaires, the Nurse Competence Scale (NCS) and the Tridimensional Personality Questionnaire (TPQ), were used to collect data. Results The average score of NCS was 71.97 ± 13.25.Nursing competence increased with the increase of working years (β=0.272, P<0.01) and RD (β=0.134, P<0.01). Practicing nurses with the lower HA appear to have a higher level of competence (β=-0.117, P<0.01). Conclusions The overall level of nurses' competencies good in third-A level hospitals in Shenyang. The predicting factors of nursing competence are work experience, HA and RD. More psychological courses should be provided in fundamental nursing education and continuing nursing education for helping nurses shape their good personality traits.

During the 13th Five-Year Plan period, China issued a series of policies for private hospitals, which made an important impact on the running of medical institutions by social forces. One hundred and sixty-one policy documents for private hospitals were sorted out from January 2016 to January 2020, national policies and measures in terms of access approval, comprehensive supervision, fiscal and taxation support, supporting policies, talent development, open innovation, and resource sharing were being reviewed. It found that the characteristics of China′s policies were consistent in content, comprehensive in coverage, and supported the development of traditional Chinese and Western medicine.From 2016 to 2020, the total number of private medical institutions in China maintained growth, however, there were some practical problems, such as insufficient professional and technical capacity, low coordination development with public healthcare, and incomplete supervision and evaluation system. Therefore, during the 14th Five-Year Plan period, we should realize the transformation from private hospital management to modern governance, integrate private hospital development policies, optimize the system of approval and access, standardize the supervision and evaluation system, enhance the sharing of development resources, strengthen the construction of professionals, adhere to the concept of fairness, openness, and innovation, so as to promote the sustainable development of private hospitals.

Objective To analyze the diagnostic value of serum procalcitonin (PCT), C-reactive protein (CRP) and interleukin-6 (IL-6) in the detection of incision infection after breast cancer surgery. Methods A total of 152 breast cancer patients admitted to our hospital from June 2016 to April 2018 were enrolled. All patients were given surgery.According to whether the wound infection occurred after operation, the patients were divided into control group (not infected, n=114) and observation group (infected, n=38). The serum levels of PCT, CRP and IL-6 were measured in the two groups on the 2 nd postoperative day. Results The average operation time and hospital stay in the observation group were longer than those in the control group (P<0.05). The serum levels of PCT, CRP and IL-6 in the observation group were higher than those in the control group (P<0.05). The positive rate of the observation group was higher than that of the control group (P<0.05). Conclusion In patients with breast cancer surgery, serum PCT, CRP and IL-6 detection can provide a good reference for the prediction of postoperative incision infection.

S-Nitros(yl)ation is a ubiquitous redox-based post-translational modification of protein cysteine thiols by nitric oxide or its derivatives, which transduces the bioactivity of nitric oxide (NO) by regulation of protein conformation, activity, stability, localization and protein-protein interactions. These years, more and more S-nitrosated proteins were identified in physiological and pathological processes and the number is still growing. Here we developed a database named SNObase ( http://www.nitrosation.org ), which collected S-nitrosation targets extracted from literatures up to June 1st, 2012. SNObase contained 2561 instances, and provided information about S-nitrosation targets, sites, biological model, related diseases, trends of S-nitrosation level and effects of S-nitrosation on protein function. With SNObase, we did functional analysis for all the SNO targets: In the gene ontology (GO) biological process category, some processes were discovered to be related to S-nitrosation ("response to drug", "regulation of cell motion") besides the previously reported related processes. In the GO cellular component category, cytosol and mitochondrion were both enriched. From the KEGG pathway enrichment results, we found SNO targets were enriched in different diseases, which suggests possible significant roles of S-nitrosation in the progress of these diseases. This SNObase means to be a database with precise, comprehensive and easily accessible information, an environment to help researchers integrate data with comparison and relevancy analysis between different groups or works, and also an SNO knowledgebase offering feasibility for systemic and global analysis of S-nitrosation in interdisciplinary studies.
Animals ; Binding Sites ; Databases, Protein ; Disease ; Humans ; Internet ; Mice ; Models, Molecular ; Nitrosation ; Protein Processing, Post-Translational ; Proteins ; chemistry ; metabolism ; Rats ; Software ; Sulfur ; metabolism

Objective:To evaluate the safety and effectiveness of Kangduo endoscopic surgical robot system for partial nephrectomy.Methods:Consecutive patients with stage T 1 renal tumor meeting the inclusion criteria from the Department of Urology, Peking University First Hospital from December 2020 to February 2021 were prospectively enrolled. All patients underwent partial nephrectomy with the Kangduo endoscopic surgical robot system after signing the informed consent. Clinical data including preoperative, perioperative and postoperative pathology and follow-up were collected. Results:Among the 26 patients, there were 16 males and 10 females, with a median age of 53(33-74) years, and a median body mass index of 25.99(20.90-32.91) kg/m 2. There were 12 cases of left kidney tumor and 14 cases of right kidney tumor. The median tumor diameter was 2.2(1.0-3.5) cm. The median time of warm ischemia was 17.7(7.1-29.2) minutes, and all of them were less than 30 minutes. The median docking time was 4.7(2.3-9.9) minutes, and the median time of robotic arm operation was 65.0 (37.0-155.0) minutes. The median National Aeronautics and Space Administration Task Load Index (NASA-TLX) score was 5.3 (2.0-28.0), and no instrument-related adverse events occurred intraoperatively. The median postoperative hospital stay was 4 (4-5) days. All tumor margins were negative on pathologic reports. No Clavien Ⅱ stage operative complications occurred in all patients during perioperative period and 1 month after the surgery. Conclusions:The partial nephrectomy using the kangduo endoscopic surgical robot system were completed successfully, and no instrument-related adverse events and complications occurred, showing that this surgical system used for partial nephrectomy is safe and effective.

Objective:To investigate the correlation of miRNA-181b (miR-181b) and prognostic factors of myelodysplastic syndrome (MDS), to predict target gene and main biological functions of miR-181b, and to evaluate the risk prediction ability of miR-181b in MDS.Methods:The samples of 131 bone marrow in MDS patients who followed the criteria of World Health Organization (WHO) classification (2016) from the Blood Diseases Hospital, Chinese Academy of Medical Sciences between January 2019 and September 2019 were collected, and the clinical data including routine blood test results, related gene test results of blood diseases were retrospectively analyzed. The expression levels of miR-181b in all bone marrow samples were detected by using quantitative real-time polymerase chain reaction (qRT-PCR). According to the international prognostic scoring system (IPSS), WHO classification-based prognostic scoring system (WPSS) and revised IPSS (IPSS-R), the patients were divided into different groups by the risk grade, and the expression differences of miR-181b in different risk groups were compared, and the correlation between the expressions of miR-181b and partial prognostic factors, including white blood cell (WBC), hemoglobin (Hb), platelet (Plt), absolute neutrophil count(ANC), myeloblast and gene mutations was analyzed. Bioinformatics online tool TargetScan was used to make target gene prediction and the potential function of miR-181b.Results:The expression levels of miR-181b was increased with the increasing risk of IPSS, WPSS and IPSS-R, and there were statistically significant differences in miR-181b expression levels of different risk groups in different scoring systems (all P < 0.01). There was a positive correlation between the expression level of miR-181b and the scores of the three prognostic scoring systems (r was 0.437, 0.368, 0.327; all P = 0.001); miR-181b expression was positively correlated with the proportion of bone marrow myeloblasts ( r = 0.450, P < 0.01) and was negatively correlated with Plt ( r = -0.199, P = 0.024). And miR-18b was not associated with WBC, Hb, ANC, and related gene mutations of blood diseases (all P > 0.05). A total of 1 363 potential target genes of miR-181b were predicted by using bioinformatics, and biological processes of these target genes were mainly enriched in transcription regulation, RNA metabolism regulation. Among them, 22 target genes were related to the hematological malignancies, including RUNX1, ASXL2, NRAS, ATM and KRAS, which have been previously confirmed to be related to MDS. The relative expression level [the median ( P25, P75)] of miR-181b in patients who had those hematological malignancies related to miR-181b target gene mutation (32 cases) was 1.33(0.63, 1.60), which was higher than that in patients without mutation (99 cases) [0.85 (0.49, 1.38)], and the difference was statistically significant ( Z = 2.285, P = 0.022). Conclusions:miR-181b has a correlation with the risk grade of prognostic scoring systems in MDS, and it may be involved in the molecular biology pathogenesis of MDS.

BACKGROUND:Acupotomy is an effective method for the clinical treatment of osteoarthritis,with affirmed clinical outcomes,but the specific mechanisms remain unclear OBJECTIVE:To investigate the role of acupotomy in modulating chondrocyte autophagy to promote chondrocyte homeostasis in osteoarthritis. METHODS:Twenty-eight New Zealand rabbits were randomly divided into control group,osteoarthritis group,acupotomy group,and hyaluronic acid group,with seven rabbits in each group.The knee osteoarthritis rabbit model was prepared using the Videman method in the latter three groups.After modeling,the control group and osteoarthritis group received no interventions.The acupotomy group received acupotomy treatment 15 minutes per time,once a week,while the hyaluronic acid group received intra-articular injection of hyaluronic acid once a week,with a continuous treatment duration of 5 weeks.The day after the final intervention,knee joint macrostructure was observed using DR imaging,chondrocyte ultrastructure was examined through transmission electron microscopy,apoptosis of chondrocytes was assessed using Tunel staining,and western blot analysis was used to detect the expression of proteins related to the PI3K/Akt/mTOR pathway. RESULTS AND CONCLUSION:The DR imaging results revealed that the osteoarthritis group exhibited narrowed knee joint spaces and the formation of periarticular osteophytes,while the hyaluronic acid group and acupotomy group showed widened knee joint spaces with a reduction in periarticular osteophytes.Transmission electron microscopy results demonstrated a decreased number of autophagosomes in chondrocytes in the osteoarthritis group,along with nuclear shrinkage,nuclear membrane rupture,incomplete organelle morphology,and a clear tendency towards cell death.In contrast,both the hyaluronic acid group and acupotomy group exhibited a significant increase in autophagosomes,intact nuclear membranes,and a well-preserved cellular state.Tunel staining results indicated a considerable decrease in the number of apoptotic cells in the hyaluronic acid group and acupotomy group compared with the osteoarthritis group.Western blot results revealed that,compared with the control group,the expression levels of Beclin1,Cath D,and LC3II/LC3I were significantly decreased in the osteoarthritis group(P<0.05),while the expression levels of p-Akt/Akt and p-mTOR/mTOR were significantly increased(P<0.05);compared with the osteoarthritis group,the expression levels of Beclin1,Cath D,and LC3II/LC3I were significantly increased in both the hyaluronic acid group and acupotomy group(P<0.05),while the expression levels of p-Akt/Akt and p-mTOR/mTOR were significantly decreased(P<0.05).To conclude,acupotomy intervention can modulate the PI3K/Akt/mTOR signaling pathway to enhance the autophagic level in chondrocytes,thereby maintaining chondrocyte homeostasis.This ultimately leads to a slowdown in cartilage degeneration.