Objective To observe the effect of X-ray radiation on NF-κB-HIF-1α pathway activation in three malignant lymphoma and to explore the mechanism of radioresistance mediated by this pathway.Methods Expression levels of p-P65,IKK and HIF-1α in Namalwa,Ramos and Raji cells were determined by Western blot 1,4,10 and 20 h after 5 Gy X-ray irradiation.The effect of QNZ on HIF-1α expression was also observed.Results Expression level of IKK protein was up-regulated 4 h after irradiation in the 3 lymphoma cell strains( t = 8.01,5.14,5.42,P ＜ 0.01 ),followed by up-regulation of p-P65 protein expression level at 10 h and HIF-1α at 10-20 h after X-ray irradiation (t = 11.25,17.43,22.09,P ＜ 0.01 ).Pretreatment of QNZ 24 h before X-ray irradiation significantly reduced the upregulation of HIF-1α protein expression induced by simple ion radiation ( t = 18.69,19.35,12.26,P ＜0.01 ).Conclusion NF-κB - HIF-1α pathway was activated in human lymphoma cells after ion radiation and may be involved in the mechanism of radioresistance.

Objective To Investigation the quality of marrow smear purchased by CDUTCM.Methods The quality and the typ-icality of marrow smears purchased during 2015 -2016 were collectively examined,and then decided whether these smears fit the blood cell morphology experimental teaching requirement.Results Of all the 960 marrow smears purchased these two years, 49.7% failed in smear made or stained,and 16.0% failed to meet the teaching requirements in the typicality of marrow cells.Con-clusion Teaching marrow smears,being different from clinic ones in their preparation and morphological diagnosis,must be of great quality in sustaining and of better typicality in their cell features.

Objective To analyze the imaging characteristics of hepatic involvement in Langerhans cell histiocytosis(LCH) in children on MRCP, MRI and CT. Methods Twenty-nine children from three children hospitals in China, who were diagnosed as hepatic involvement by disseminated LCH during Aug 2008 and Jan 2015 were included in this study. Their MRCP (n=16), MRI (n=22), contrast?enhanced CT (n=15) data were retrospectively analyzed. The stenoses and dilatation of the intrahepatic bile ducts, the common hepatic bile duct and its first order branches and the common bile duct were evaluated on the MRCP image. The size and shape of the liver, the imaging characteristics of the periportal lesions in the Glisson sheath and hepatic parenchymal lesions were also evaluated on the cross?sectional images. Results MRCP indicated alternative stenoses/dilatation of the bile duct tree (n=16), stenoses of the common hepatic duct and its first?order branches (n=15), partialindistinctness of the common bile duct (n=2) and multiple cystic lesions along the biliary tree (n=5). On the cross?sectional images, the periportal lesions in the Glisson sheath were observed in 28 children. On MRI, the periportal lesions were shown in all the 22 children with MRI, presented as hypo-signal intensity on T1WI, hyper?signal intensity on T2WI (n=11) or mixed?signal intensity on T1WI and T2WI (n=11); On CT, the periportal lesions were found in 14 of the 15 children with CT, presenting as low density (n=13) and mixed density (n=1). Multiple nodular or cyst?like parenchymal lesions were observed in 21 patients including 18 patients on MRI and 5 patients on enhanced CT. Sixteen patients presented as hypo?intensity on T1WI, hyper?intensity on T2WI and low density on plain CT, and 5 patients with iso? or hypo?intensity on T1WI, hypo?intensity on T2WI,and milder enhancement relative to the adjacent parenchyma on contrast?enhanced CT. Conclusions The imaging characteristics of hepatic involvement by LCH include alternative stenoses and dilatation of the intrahepatic ducts, stenoses of the common hepatic bile duct and its first?order branches on MRCP, the periportal lesions in the Glisson sheath and hepatic parenchymal nodular or cyst?like lesions on cross?sectional images.

Objective:To investigate the effects of normal iodized salt diet on urinary iodine concentration and iodine uptake rate in patients with differentiated thyroid cancer (DTC) before 131I treatment. Methods:A prospective study was conducted on patients with DTC (59 male patients and 130 female patients, age (43.7±12.2) years) who received 131I treatment for the first time after total thyroidectomy in the First Affiliated Hospital of Zhengzhou University between January 2021 and April 2022. Patients were divided into normal iodized salt diet group and limited iodized salt diet group according to whether iodized salt diet was administered 4 weeks before 131I treatment. The age, gender, urinary iodine concentration, iodine uptake rate and tumor risk stratification of the two groups were compared by independent-sample t test or χ2 test. In addition, according to the concentration of urinary iodine, patients were divided into group a1 (urinary iodine <200 μg/L) and group a2 (urinary iodine ≥200 μg/L). Logistic regression analysis was used to analyze the factors affecting urinary iodine concentration. Results:The urinary iodine concentration of normal iodized salt diet group was not significantly different from that of non-iodized salt diet group ((140.53±76.66) vs (121.74±74.64) μg/L; t=1.67, P=0.489). The iodine uptake rates at 2 h, 4 h and 24 h in the 2 groups were (3.77±1.06)% vs (3.42±0.97)%, (3.33±1.07)% vs (3.21±1.15)%, (2.90±2.60)% vs (3.23±2.94)%, respectively ( t values: 2.33, 0.68, -0.81, all P>0.05). There were no significant differences in age ( t=0.56, P=0.889), gender ( χ2=1.33, P=0.250) and tumor risk stratification ( χ2=0.14, P=0.709) between the two groups. Logistic regression analysis showed that tumor risk stratification was associated with urinary iodine concentration (odds ratio ( OR)=3.914, 95% CI: 1.505-10.176; P=0.005). Conclusion:Normal iodized salt diet may have no effect on urinary iodine concentration and iodine uptake rate of patients with DTC before 131I treatment.

Objective:To investigate the status quo of a mobile nursing application acceptance of nurses, and analyze the influencing factors, so as to promote the application of a mobile nursing APP in clinic.Methods:On the principle of convenience sampling, 1207 participants from Shandong province were recruited to complete the self-designed questionnaire, including demographic data, smartphone use behavior and acceptance evaluation of the mobile nursing APP.Results:Average score of nurses' acceptance of a mobile nursing APP was 4.16±0.69. Multiple regression results showed that duty, use experience, recognition, smartphone self-efficacy and daily use time were the main factors affecting the acceptance of a mobile nursing APP for nurses ( t value was -7.132-22.678, P<0.05 or 0.01) and explained 39.1% of the total variation of the acceptance of mobile nursing app ( P<0.01). Conclusions:The acceptability of mobile nursing APP of clinical nurses is at a medium and high level, and it is influenced by the use experience, smartphone self-efficacy and other aspects, suggesting that nursing managers attach importance to the behavioral differences of nurses in using a mobile nursing APP.

Objective By analyzing the practical management of daytime surgery in a large public hospital in Xinjiang Uygur Autonomous Region,this paper aims to provide a reference for optimizing the management of daytime surgery.Methods Based on hospital management,the management experiences of daytime surgery from 2017 to 2022 were analyzed from the per-spectives of building the management system of daytime surgery and optimizing the management model.Results Since 2017,the hospital has initiated the pattern of pilot daytime surgery,from opening a green channel for daytime surgery,setting up daytime wards,to conducting daytime chemotherapy,continuously increasing the disease types for daytime surgery and procedures.This has led to the full development of 708 procedures in the national recommended daytime surgery catalogue,with the proportion of daytime surgery in elective surgeries gradually rising to 23.83 percent.The management of daytime surgery has achieved achieve-ments.Conclusion The current regulatory scope of daytime surgery depends on its definition.Therefore,hospitals should pur-sue innovative initiatives for daytime diagnosis and treatment in line with the hospital actualities and the development of medical disciplines.This will further enhance the regulatory and incentive mechanisms for daytime surgery pattern,aiding public hospitals to develop in a high-quality manner.

Objective? To understand the work experience of PICC nurse specialists in using intracavitary electrocardiogram for PICC placement, so as to provide a reference for further promoting and standardizing of the intracavitary electrocardiogram method. Methods? From October 2018 to February 2019, the PICC nurse specialists from 5 Class Two and 16 Class Three hospitals which developed intracavitary electrocardiogram guided PICC in Shandong Province were selected by purposive sampling method as interveiwees. A qualitative phenomenological study was used to conduct semi-structured interviews with 21 PICC specialist nurses. Colaizzi's seven-step analysis method was used to analyze the data. Results? Three themes were identified:a method that "makes your mind at rest", difficulties met in work, growth and learn. The intracavitary electrocardiogram method effectively promoted PICC placement and released pressure of nurse specialists. Nurse practitioners will experience hardship at the beginning of using the intracavitary electrocardiogram method. As they gradually became skilled and came across difficulties, they would experience development personally and professionally. Conclusions? The intracavitary electrocardiogram method can benefit PICC nurse specialists both in their profession and career identity. However, the PICC nurse will face difficulties from different aspects while using this method. It is necessary to support better training courses and standardized management for the extension of intracavitary electrocardiogram method, promoting the promotion and application of new technologies.

Objective:This study aimed to evaluate the diagnostic value of serum Golgi protein 73(GP73) alone and GP73 combined with liver stiffness measurement (LSM), aspartate aminotransferase/platelet ratio index (APRI), and 4-factor-based fibrosis index (FIB4) in diagnosing liver fibrosis in patients with chronic liver disease of different etiologies.Methods:A diagnostic test. A total of 68 patients who underwent liver biopsy in the Department of Traditional and Western Medical Hepatology of the Third Hospital of Hebei Medical University from October 2019 to December 2020 were selected to detect serum GP73 levels. iLivTouch was used to assess liver stiffness measurement (LSM). In addition, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), total bilirubin (TBil), direct bilirubin (DBil), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL) levels, and peripheral platelet (PLT) counts were assayed. The correlation between GP73 and the above indexes was assessed, and APRI and FIB-4 were calculated. SPSS 21.0 statistical software was used for statistical analysis. The area under the receiver operating characteristic curve was calculated to evaluate diagnostic efficacy of GP73 in identifying hepatic fibrosis stages. Furthermore, the difference between GP73 and liver stiffness, as well as APRI and FIB4 in diagnosing significant fibrosis was assessed.Results:Based on liver biopsy, 13, 18, 17, and 20 cases were diagnosed as stages S0-1, S2, S3, and S4, respectively. The AUC of GP73 diagnosing hepatic fibrosis stage S≥3 and S=4 were 0.806 and 0.844 at cut-off points of 2.06 and 3.27 μg/L, and the sensitivity and specificity were 93.5%, 61.5%, 90.0%, 70.3%, respectively. In addition, GP73 levels were positively correlated with the degree of liver fibrosis ( r=0.547, P<0.001). Conclusions:The efficacy of serum GP73 level in diagnosing the degree of liver fibrosis in patients with chronic liver disease from different causes was significantly higher than that of APRI, FIB4, and LSM. The combination of GP73 and FIB4 can further improve the accuracy of diagnosis of liver fibrosis staging S≥3 and S=4, which is a reliable serological marker for the diagnosis of fibrosis in patients with chronic liver disease.

Objective:To analyze the prevalence of influenza B virus and its HA and NA genes characteristics during 2017—2020 in Songjiang district, Shanghai.Methods:Samples from suspected cases of influenza were detected using real-time fluorescence reverse transcription-polymerase chain reaction. Influenza B virus positive specimens were cultured by MDCK cells and embryonated chicken eggs. The hamagglutinin (HA) and neuraminidase (NA) genes of influenza virus B strains were sequenced and analyzed for gene evolution and amino acid variation. The sensitivity of the strains to oseltamivir and zanamivir was studied by neuraminidase inhibition assay.Results:The positive rate of influenza B virus in Songjiang district from 2017 to 2020 was 14.24% (506/3554). Influenza B virus circulated mainly in winter-spring season and alternated between B/Victoria and B/Yamagata subtypes. Subclade 1A (△3) B was the predominant Victoria lineage circulating in Songjiang district. Otherwise, the remaining strains belonged to subclade 1A(△2)and clade 1A. Compared with vaccine strain B/Brisbane/60/2008, the nucleotide homology of circulating strains HA (NA) was 97.62%~98.19% (98.11%~98.78%). The mutations of HA in 1A (△3) B subclade mainly were in 120 loop and 160 loop. All the Yamagata strains circulating in Songjiang district belonged to clade 3. Compared with vaccine strain B/Phuket/3073/2013, the nucleotide homology of HA and NA were 98.71%~99.04% and 98.69%~99.27%, respectively. No amino acid change was found in the antigenic clusters. Neuraminidase inhibition assay showed that the influenza B virus strains were sensitive to both oseltamivir and zanamivir.Conclusions:Inconsistence of the antigenicity between the vaccine strains and the circulating strains during 2017—2020, influenza B virus should be persistently monitored, including the epidemic situation and the etiological characteristics, which might be helpful in vaccine screening and drug development.

Objective:To explore the relationship between the psychological stress response of clinical nurses and hospital violence and ability empathy.Methods:Using the convenient sampling method, a total of 300 clinical nurses in Beijing Anzhen Hospital were selected as the research objects from March to June 2021. Nurses were surveyed using the Hospital Violence Incidents Inventory, Impact of Event Scale-Revised (IES-R) and Interpersonal Reactivity Index (IRI) . Pearson correlation analysis was used to explore the relationship between psychological stress response of clinical nurses and hospital violence and empathy ability. Stepwise regression analysis was used to explore the effect of hospital violence and empathy ability on predicting nurses' psychological stress response. A total of 300 questionnaires were distributed, 291 were recovered and 279 were valid.Results:The overall incidence of hospital violence among clinical nurses within 1 year was 58.1% (162/279) . There were statistically significant differences in scores of each dimension of psychological stress response of clinical nurses with different gender and education levels ( P<0.05) . The total score of psychological stress response was correlated with the total number of violent incidents, the number of verbal injuries and the number of threats in the past year ( P<0.05) . The severity of physical conflict, imagination, number of threats were positively correlated with psychological stress response ( P<0.01) , and females had more stress response ( P<0.01) . Opinion-taking was negatively correlated with psychological stress response ( P<0.05) . Conclusions:Clinical nurses may have a certain degree of psychological stress response after being subjected to hospital violence, which is more likely to occur in women, and empathy is a protective factor against this response.