Objective To investigate the incidence of needle stick injuries of nursing students in different stages of clinical practice and occupational protective education to provide evidence for developing education strategies. Methods One hundred and forty-one nursing students were surveyed retrospectively by a self-designed questionnaire. Results A total of 75.9%(107/141) nursing students had been injured in clinical practice. The incidence of needle stick injuries varied in different stages of clinical practice. Compared with the middle and late stage of clinical practice, the incidence of needle stick injuries was highest in the early stage of clinical practice:53.9%(76/141) vs. 38.3%(54/141),7.8%(11/141),and there was significant difference, χ2=216.14, P<0.05.About 64.2%(88/141)-78.0%(110/141) nursing students had not received protective education on the needle stick injuries. Only 48.9%(69/141)-55.3%(78/141) of nursing students were given protective training on needle stick injuries in their practice hospitals. Before clinical practice, 63.1%(89/141) nursing students had not been vaccinated to prevent infective diseases. Conclusions To reduce the incidence of needle stick injuries and related potential risks of infection caused by injuries, it is necessary to strengthen pre-practice education on occupational protection among nursing students. Perfect supervision system should also be established in practice hospitals and clinic wards.

Objective To investigate the expression of CXCR4 and CXCL12 in the labial gland of patients with primary Sj?gren's syndrome (pSS), and to explore their role in the pathogenesis of pSS. Methods The expression of CXCR4 and CXCL12 in labial gland tissues was detected by immunohistochemistry in 32 cases of newly diagnosed pSS and 30 cases of oral mucosa cysts or trauma patients. The expression level, intensity and location were analyzed and compared statistically. χ2 test and Spearman correlation analysis were used for statistical analysis. Results The positive rate of CXCR4 in the test group was 91%(n=29), which was significantly higher than that in the control group (33%, n=10, χ2=21.77, P=0.001). The positive rate of CXCL12 in the test group was 97%(n=31), which was significantly higher than that in the control group 40%(n=12), and the difference was statistically significant ( χ2=23.57, P=0.001). Conclusion CXCR4 and CXCL12 are highly expressed in labial gland of pSS patients, this suggests that they participate in the pathological process of pSS local inflammatory response and play an important role in pSS pathogenesis.

BACKGROUND: High-intensity exercise can induce the depolymerization and/or degradation of tubulin in the skeletal muscle. According to the close relation with the mitochondria, tubulin may influence mitochondrial movement track and molecular motor, thereby varying the movement and distribution of mitochondria. OBJECTIVE: To observe the effect of high-intensity exercise on α-tubulin, MAP4, Miro1 and mitochondrial ultrastructures, analyze their sequential changes and further explore whether tubular depolymerization regulates the movement and distribution of mitochondria via Miro1. METHODS: Fifty-six Sprague-Dawley rats were divided into control (n=8) and exercise (n=48) groups. The rats in the exercise group ran on the treadmill ( -16°, 20 m/minute) for 90 minutes, and the soleus samples were removed immediately, 6, 12, 24, 48 and 72 hours after exercise (n=8 each time point). The expression levels of α-tubulin, MAP4 and Miro1 were detected by western blot assay, and the ultrastructural changes of mitochondria were observed under transmission electron microscope. RESULTS AND CONCLUSION: The expression level of α-tubulin was decreased significantly at 6 and 12 hours after exercise. The expression level of MAP4 was increased significantly at 6, 12, 48 and 72 hours after exercise. The expression level of Miro1 was increased firstly at 6 and 12 hours after exercise, and decreased at 72 hours after exercise. In the control group, the paired mitochondria were arranged on the both sides of Z line, and few appeared in the myolemma. Mitochondria began to accumulate in the myolemma immediately and 6 hours after exercise; the number achieved the peak at 12 hours, reduced at 24 and 48 hours, and returned to normal at 72 hours. These results suggest that high-intensity exercise can induce the depolymerization of microtubules in the skeletal muscle, thus regulating the movement and distribution of mitochondria via Miro1.

Objective To measure the tear film lipid layer thickness (LLT) in dry eye patients and investigate the correlations of LLT with ocular surface signs.Methods One hundred and thirty dry eye patients (130 eyes),including 64 meibomian gland dysfunction (MGD) patients and 66 non-MGD patients,were included in this study.LLT,break-up time (BUT),fluorescein staining (FL),Marx's line (ML) score and Schirmer I test were performed and examined.The distribution of LLT in different age groups and the correlations between LLT and other examinations were analyzed.Results There was significant difference in LLT among different age groups (P =0.007),while LLT was not significantly different between male and female in each age group (P ＞ 0.05).LLT was positively correlated with age (r =0.334,P ＜ 0.001) and was not correlated with sex (r =0.107,P =0.226).LLT was positively correlated with upper eyelid ML score (r =0.295,P =0.001) and lower eyelid ML score (r =0.233,P =0.008).There was no significant correlation of LLT with BUT,FL or Schirmer Ⅰ test (all P ＞0.05).In the MGD group,there were positive correlations of LLT with upper eyelid ML score and lower eyelid ML score (all r =0.306,P =0.014),and no correlation of LLT with other examinations (all P ＞ 0.05).In the non-MGD group,there was no correlation of LLT with other examinations (all P ＞ 0.05).In a multivariate linear regression analysis,age and upper eyelid ML score were significantly related to LLT (β =0.254,P =0.005 for age and β =0.207,P =0.022 for upper eyelid ML score) in all dry eye patients.Age was the only factor related to LLT (β =0.382,P =0.002) in the MGD group.Upper eyelid ML score and lower eyelid ML score were higher in the MGD group than the non-MGD subgroup (all P ＜ 0.001).Conclusion LLT is positively correlated with age and ML score in dry eye patients.The measurement of tear film LLT,as an auxiliary examination in the diagnosis of dry eye disease,should be analyzed with the influential factors including age.

To investigate a new teaching model so as to improve the teaching and learning efficiency of pharmaceutical analysis, a total of 61 undergraduates who majored in chemistry (pharmacy) were chosen as the trainees. The teaching reform based on Aalborg PBL model was conducted from such three aspects as teaching contents, teaching manners and assessment methods. Under the new teaching model, students' learning interest could be improved significantly, and their knowledge understanding, mastery and application were enhanced. Besides, the students' abilities of team work and communication were also cultivated.

Objective To investigate the nutrition status, sleep quality, anxiety and depression in patients with chronic heart failure (CHF), and to analyze the relationships between them. Method Hospital anxiety and depression scale (HADS), mini nutritional assessment (MNA) and Pittsburgh sleep quality index (PSQI) were used to assess anxiety and depression, nutrition status and sleep quality in 118 CHF patients who were selected by convenience sanpling respectively. Results The score of anxiety of the patients was with a median of 5 (3, 8) and the score of depression was with a median of 5 (2, 8). Anxiety was present in 47 cases (39.8％). Depression was present in 48 cases (40.7％).MNA score was with an average of 21.5 ±3.5, 19 patients (16.1％) were malnourished, 59 patients (50.0％) were at risk of malnutrition and 40 (33.9％)well nourished. The MNA scores of patients with anxiety or depression were significantly lower than those with no anxiety or depression (P<0.001). The PSQI score in 118 patients was 6(4, 10), where 42(35.6％) were with sleep disorder and patients with depression and anxiety were higher than those without (P<0.01). The MNA score was negatively correlated with anxiety and depression (all P<0.001). The PSQI score was positively related with anxiety and depression (all P<0.01). Conclusions The prevalence of anxiety and depression was high in CHF patients. Both nutrition status and sleep quality were related to them. In the clinic work, medical workers should pay attention to the treatment of heart failure and the assessment of psychological status in heart failure patients with malnutrition or sleep disorders.

ObjectiveTo observe the effect of 99Tc-methylene diphosphate (99Tc-MDP, Yunke) combined with rehabilitation on ankylosing spondylitis (AS).Methods118 AS patients were randomly divided into the treatment group (n=58) and control group (n=60). The treatment group was treated with meloxicam, sulfasalazine and vein injecting Yunke combined rehabilitation. The control group was treated only with meloxicam and sulfasalazine. The changes of both clinical and experimental indexes of two groups before and after treatment were analyzed.ResultsAfter two therapeutic courses, a much better result was obtained in the treatment group compared with the control group at the respects of releasing arthralgia, shortening morning stiffness, improving range of spinal motion, and decreasing the levels of ESR, CRP, PLT and IgM, ect (P<0.05～0.01) without obvious side effects.ConclusionThe effect of Yunke combined with rehabilitation on AS is evident.

Purpose: This study aims to evaluate the efficacy and safety of trastuzumab biosimilar (HLX02) in combination with pertuzumab and chemotherapy in patients with human epidermal growth factor receptor 2 (HER2)–positive metastatic breast cancer (MBC) after progression of trastuzumab. Materials and Methods: In this prospective, single-arm, phase II study, patients with HER2-positive MBC after progression of trastuzumab received pertuzuamb, HLX02, and chemotherapy in Beijing Cancer Hospital from March 2020 to December 2022. The primary endpoint was progression-free survival (PFS), and secondary endpoints included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety. The study was registered with ClinicalTrials.gov (NCT05188495). Results: A total of 45 patients were included in this study. Twelve patients (26.7%) were treated in second-line and 33 patients (73.3%) were in third-line and later setting. Eighty percent and 15.5% patients had previously received pyrotinib/lapatinib and T-DM1, respectively. With a median follow-up of 24.4 months (range, 1.2 to 43.9 months), the median PFS was 7.6 months (95% confidence interval, 4.3 to 10.9), OS was not reached, the ORR was 31.1%, and DCR was 91.1%. The treatment was well tolerated. Conclusion The combination of trastuzumab biosimilar HLX02, pertuzumab, and chemotherapy exhibited promising efficacy and a favorable safety profile as second- and beyond-line treatment in HER2-positive MBC.

Objective To evaluate the clinical efficacy of deoxynucleotide combined with pegylated interferon α-2a in the treatment of chronic hepatitis B (CHB﹚ with liver injury. Methods All 92 cases of CHB with liver injury patients were selected in our clinical study. All patients were randomly divided into treatment group(n=46, treated with PEG-IFNα-2a and deoxynucleotide acid injection, 200 mg/d, intravenous drip﹚and control group (n=46, treated with PEG-IFNα-2a﹚.Then assessment of CHB serum markers and liver function after 48 weeks continuous treatment. Results There were significant differences between the two groups in the HBV-DNA negative rate (60.7% v s 39.2%﹚, the HBeAg se roconversion rate (34.8%vs 15.2%﹚, the HBsAg negative rate (28.3% vs 10.8%﹚, the ALT levels(51.6±12.4 vs 72.3± 15.3﹚U/L, the AST levels(51.8±12.8 vs 70.8±13.4﹚U/L, the TBiL levels(23.5±7.6 vs 33.4±6.8﹚μmol/L, the ALP lev-els(87.2±24.2 vs 158.4±28.7﹚U/L, the serum levels of total protein (76.2±9.2 vs 65.2±8.2﹚g/L, albumin (37.5±8.3 vs 32.3±7.9﹚g/L, and the A/G levels (1.8±0.3 vs 1.4±0.3﹚(P<0.05﹚. What’s more, during the course of treatment, the neutropenia rate(6.5%vs 26.1%﹚,thrombocytopenia incidence rate (4.3% vs 23.9%﹚also had significant difference be-tween the treatment group and control group (P<0.05﹚. Conclusion There is synergistic clinical efficacy of deoxynu-cleotide combined pegylated interferonα-2a, and less adverse events during treatment.

Objective:This study mainly discussed the clinical characteristics, autoimmune status and lymphocyte subsets of patients with Takayasu arteritis (TA) without hormone and immunosuppressive therapy, in order to provide guidance for immunotherapy.Methods:Using cross-sectional study, twenty-nine patients with TA admitted to the Department of Rheumatology and the Department of Vasculitis of Beijing Anzhen Hospital from January 2018 to November 2019 were selected, including 28 females and 1 male, with the middle age of 39 year. These patients met the diagnostic criteria of American Society of Rheumatology for TA, and were not treated with hormone and immunosuppressant. Clinical data of these patients were collected, and the immunological indexes and lymphocyte subsets of peripheral blood were detected simultaneously. At the same time, the immunological indexes and peripheral blood lymphocyte subsets of 21 healthy normal people were detected as control. Chi square test, independent sample t test and nonparametric test were used for analysis. Results:Among the 29 patients with TA, 28 were female, 26 were in the active stage of disease; the main manifestations of systemic symptoms were malaise (62.07%) and headache (41.38%), the main manifestations of vascular symptoms were bruits and pulse weakening (68.97%), and the most of Numano type was V type (79.31%). The absolute value of total T (CD3) lymphocytes [(1 337.14±312.46)μl vs (1 139.95±340.96)μl, t=2.120, P=0.039], the percentage [46.29%±6.55% vs 36.55%±7.42%, t=4.903, P<0.000 1] and the absolute value [(815.52±194.11)μl vs (571.44±187.55)μl, t=4.450, P<0.000 1] of helper T (CD4) lymphocytes, the ratio of CD4/CD8 [1.83 (1.41-2.30) vs 1.32 (1.03-1.39), Z=3.401, P=0.001] were higher compared with those of healthy controls, while the percentage of natural killer (NK) cells (CD56) [10.71%(6.45%-14.30%) vs 14.57%(10.87%-18.47%), Z=2.408, P=0.016] decreased. The complement C3 [1.16 (1.02-1.31) g/L vs 1.05 (0.93-1.15) g/L, Z=2.383, P=0.021] in patients with TA was higher than those in healthy controls and immunoglobulin (Ig) G [11.97 (8.74-14.43) g/L vs 14.37 (13.11-15.47) g/L, Z=3.017, P=0.003] in patients with TA was lower than those in healthy controls. Compared with the control group, the ESR [19.31 (9.50-28.50) mm/h vs 3.71 (2.00-5.00) mm/h, Z=5.338, P<0.000 1], hs-CRP [6.52 (0.32-8.62) mg/L vs 0.73 (0.35-1.07) mg/L, Z=2.983, P=0.003] and Q-CRP [8.73 (1.03-7.72) mg/L vs 0.57 (0.08-0.98) mg/L, Z=4.263, P<0.000 1] of patients with TA were all increased. Conclusions:The autoimmunity of patients with TA without hormone or immunosuppressant treatment is in active state, and the total T-lymphocytes and helper T-lymphocytes in peripheral blood are significantly increased in order to cope with the inflammatory response of the systemic artery vessels.