As one of the main members of the Rho GDI dissociation inhibitory factors,D4-GDI inhibits the dissociation of Rho protein and GDP,which is also involved in a wide range of celluar functions,such as cell contraction,adhesion,migration,proliferation and apoptosis.Recently,accumulating evidence has been suggested that D4-GDI is involved in the pathogenesis of several pulmonary diseases,such as lung cancer.Intervention of D4-GDI expression may improve the pathological changes and prognosis of these diseases.

Objective To investigate the incidence, risk factors and outcome of acute kidney injury (AKI) following cardiac surgeries. Methods Clinical data of 1056 patients undergoing open heart surgery in Renji Hospital from January 2004 to June 2007 were retrospectively analyzed. Univariate and multivariate analyses were used to evaluate possible pre-,intra-, and post-operative parameters associated with AKI according to AKI Network (AKIN). Results Of the 1056 patients, 328 (31.06%) developed AKI. In-hospital mortality was 4.07% in all discharges while 11.59% in AKI patients (P<0.01). Multivariate logistic regression analysis revealed that increased age (OR=1.40), pre-operative hyperurieemia (OR=1.97), pre-operative left ventricular insufficiency (OR=2.53), combined surgery (OR=2.79), prolonged operation time (OR=1.43), post-operative circulation volume insufficiency (OR=11.08) were risk factors of AKI. Conclusions AKI is a common complication and associated with increased mortality following cardiac surgery. Increased age, pre-operative hyperuricemia, pre-operative left ventricular insufficiency, combined surgery, prolonged operation time, post-operative circulation volume insufficiency are useful in stratifying risk factors for the development of AKI.

OBJECTIVE Gestational rhinitis(GR) is a relatively common condition in women during pregnancy.Patients with GR often complain of nasal obstruction and rhinorrhea.The exact mechanism of GR are not clear.Safe and effective treatments for this disease have not been found to date.The aim of this study is to find an appropriate treatment method for GR.METHODS Thirty patients with GR were randomly divided into two groups.There were 15 patients in hypertonic saline group with a mean age of 28.73 years (range 24-31 years),and 15 patients in normal saline group with a mean age of 25.93 years (range 24-31 years).Hypertonic saline group was treated using 3.0％ saline with a temperature of 40℃ nasal irrigation,and normal saline group was treated with 0.9％ saline with a temperature of 40℃ nasal irrigation.The duration of the intervention period was 4 weeks.Visual Analog Scale(VAS) was used to evaluate the nasal symptoms including nasal obstruction and rhinorrhea,and the health-related quality of life was assessed with the 12-item Short Form Health Survey version 2.0(SF-12v2).Contents of histamine(HIS) and acetylcholinesterase(ACHE) in nasal lavage fluid(NLF) was assessed before and after 4-week treatment in the two groups in the study.RESULTS There were 28 patients completed the study.The total VAS scores of nasal symptoms including nasal obstruction and rhinorrhea decreased,and SF-12v2 score increased in the hypertonic saline group after 2-week,3-week and 4-week interventions.Furthermore,ACHE in NLF was also increased after 4-week treatment,but HIS showed no statistical changes.The VAS scores of nasal obstruction and rhinorrhea and SF-12v2 score after 2-week,3-week and 4-week interventions,and the contents of HIS and ACHE in NLF after 4-week treatment showed no statistical differences in the normal saline nasal irrigation group.There were statistical differences in the VAS scores of nasal obstruction and rhinorrhea,SF-12v2 score and ACHE in NLF after 4-week treatment,and no significant differences in the content of HIS in NLF between the 2 groups.CONCLUSION Hypertonic saline nasal irrigation is a safe and effective treatment for GR.

Objective: A longitudinal mediating model was designed to explore the relationship between sleep chronotype and depressive mood with stressful life events as the mediating variable, so as to provide reference basis for preventing depression in adolescents. Methods: From March (T1) to October (T2) 2022, the Munich Chronotype Questionnaire, and Adolescent Self-rating Life Events Checklist and Center for Epidemiologic Studies Depression Scale were administered in 1 251 middle school students in the first and second grades of a middle school in Meishan, Sichuan Province for a follow up study. Two wave of date on sleep time type, stressful life events, and depressive moods were collected. Results: At T1, the detection rate of depressive mood was 22.5% in adolescents but 27.0% at T2.At the same time point, there were significant positive correlations between chronotype, stressful life events and depressive mood ( r=0.06-0.69, P <0.05). Cross lagged model results showed that early sleep chronotype could significantly predict later depressive mood ( β=0.53, P <0.05), and early depressive mood could significantly predict later sleep chronotype ( β=0.01, P <0.01). Longitudinal mediation model analysis showed that T1 sleep chronotype not only directly affected T2 depressive mood (direct effect value=1.421, 95% CI =0.985- 1.858 , P <0.01), but also affect T2 depressive mood through the partial mediating effects of T2 stressful life events (indirect effect value=1.268, 95% CI =0.810-1.726, P <0.05). Although T1 depressive mood was a direct predictor of T2 sleep chronotype (direct effect value=0.025, 95% CI =0.017-0.032), it was not a direct predictor of T2 sleep chronotype by partial intermediate action of T2 stressful life events (indirect effect value=-0.001, 95% CI = -0.006- 0.004, P >0.05). Conclusions Sleep chronotype can not only directly predict depressive mood of adolescents, but also indirectly affect depressive mood of adolescents through the longitudinal mediating effect of stressful life events. To prevent depression and improve mental health in this population, adolescents should develop the habit of early sleep schedule, and improve their ability to cope with stressful life events.

Objective:To design and develop a digital auricle reconstruction simulation training system and to evaluate the application effect of the system.Methods:Based on 3D reconstruction and 3D printing technology, a new auricle reconstruction simulation training system was designed and developed from September 2019 to December 2021. Thirty-six basic volunteers (including 15 males and 21 females, aged from 22 to 27 years, with mean 23.1 years) without auricle reconstruction (surgical clinical standardized training students) were selected and divided into two groups (experimental group and control group) for clinical teaching experiment, and the teaching effect of simulation system was preliminarily evaluated.Results:Theoretical test scores before and after the intervention in the experimental group were 8.00 (4.75, 11.25) compared to 16.50 (13.00, 19.25) , P<0.001; design test scores were 2.00 (0, 4.25) compared to 7.00 (6.00, 10.00), P<0.001. In the control group, theoretical test scores before and after the intervention were 5.50 (3.75, 12.25) compared to 11.00 (9.50, 16.25), P<0.001; design test scores were 1.00 (1.00, 2.25) compared to 5.00 (3.75, 6.00), P<0.001. The improvement in the experimental group compared to the control group was significantly more pronounced with a statistically significant difference ( P<0.001). Conclusions:This system can assist teachers in teaching more systematically in auricle reconstruction training with autologous costal cartilage, and the teaching effect is better.

Objective To explore the effect of tea polyphenols on the growth of human papillomavirus 16 (HPV16) subgenes-immortalized human cervical epithelial cells (H8 cells).Methods Cultured H8 cells were divided into 5 groups to be treated with 0 (control group),6.25,12.5,25 and 50 mg/L tea polyphenols respectively for 24,36,and 48 hours,and then cell counting kit-8 (CCK8)assay was performed to detect cell proliferation.After 24 hours of incubation,flow cytometry was conducted to detect cell apoptosis and cell cycle,and fluorescence microscopy to observe the morphology of apoptotic cells.Results After incubation with tea polyphenols at different concentrations for 24,36 and 48 hours,the proliferation of H8 cells was inhibited,and 12.5 mg/L tea polyphenols could inhibit the relative growth rate of H8 cells in a time-dependent manner.Flow cytometry showed that there was a significant difference in cell apoptosis rate among the 6.25-,12.5-,25-,50-mg/L tea polyphenols groups and the control group (52.62％ ± 0.62％,52.22％ ± 0.72％,42.52％ ± 0.90％,45.96％ ± 2.11％,29.96％ ± 0.70％ respectively,F =272.0,P ＜ 0.05).Moreover,all the tea polyphenol groups showed significantly increased cell apoptosis rate compared with the control group (all P ＜ 0.05).Fluorescence microscopy showed karyopyknosis,nuclear fragmentation and other typical apoptotic morphological changes in H8 cells in tea polyphenols groups.There were significant differences in the percentage of cells in G1,G2 phase and cell proliferation index among the 5 groups (all P ＜ 0.05).Compared with the control group,the 6.25-,12.5-,25-mg/L tea polyphenols groups showed significantly increased percentage of cells in G1 phase (55.96％ ± 0.72％,54.12％ ± 3.20％,65.30％ ± 1.51％ respectively,all P ＜ 0.05),but significantly decreased percentage of cells in G2 phase (3.17 ± 1.82％,4.94 ± 1.46％,4.65 ± 4.26％ respectively,all P ＜ 0.05) and lower cell proliferation index(0.44 ± 0.01,0.46 ± 0.02,0.36 ± 0.01 respectively,all P ＜ 0.05).Conclusion Tea polyphenols can inhibit the proliferation of H8 cells,induce cell apoptosis,and block cell cycle progression.

OBJECTIVES: During the coronavirus disease 2019 (COVID-19) pandemic, a growing prevalence of racial and ethnic discrimination occurred when many Americans struggled to maintain healthy lifestyles. This study investigated the associations of racial and ethnic discrimination with changes in exercise and screen time during the pandemic in the United States. METHODS: We included 2,613 adults who self-identified as non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, or Hispanic from the Health, Ethnicity, and Pandemic study, a cross-sectional survey conducted among a nationally representative sample of United States adults between October and November 2020. We assessed self-reported racial and ethnic discrimination by measuring COVID-19-related racial and ethnic bias and examined its associations with changes in exercise and screen time using multivariable logistic regression models. We analyzed data between September 2021 and March 2022. RESULTS: COVID-19-related racial and ethnic bias was associated with decreased exercise time among non-Hispanic Asian (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.13 to 1.89) and Hispanic people (OR, 1.91; 95% CI, 1.32 to 2.77), and with increased screen time among non-Hispanic Black people (OR, 1.94; 95% CI, 1.33 to 2.85), adjusting for age, sex, education, marital status, annual household income, insurance, and employment status. CONCLUSIONS Racial and ethnic discrimination may have adversely influenced exercise and screen time changes among racial and ethnic minorities during the COVID-19 pandemic in the United States. Further studies are needed to investigate the mechanisms through which racial and ethnic discrimination can impact lifestyles and to develop potential strategies to address racial and ethnic discrimination as a barrier to healthy lifestyles.

Objective: To observe the therapeutic effect of simple 3.0% saline nasal irrigation and combined treatment of 3.0% saline nasal irrigation and budesonide nasal spray for vasomotor rhinitis (VMR), and explore the long-term effect for VMR. Through examination of levels of substance P (SP) and mucin (MUC)5B in nasal lavage fluid, the mechanisms of nasal irrigation treatment for VMR was discussed. Methods: One hundred and one patients from Department of Otorhinolaryngology Head and Neck Surgery, Huashan Hospital of Fudan University with VMR were randomly divided into 4 groups. The number of patients was 24 in control group, 25 in budesonide nasal spray treatment group (budesonide group), 25 in nasal irrigation treatment group (nasal irrigation group) and 27 in budesonide nasal spray + nasal irrigation group (combined treatment group). Control patients were left untreated. Budesonide group was under budesonide nasal spray treatment, nasal irrigation group was treated using 3.0% saline with a temperature of 40℃ and combined treatment group was given both treatments. The duration of the intervention period was 3 months (90 days). Visual Analog Scale (VAS) was used to evaluate nasal symptoms, and the health-related quality of life was assessed using the 12-item Short Form Health Survey version 2.0 (SF-12v2). Enzyme-linked immunosorbent assay (ELISA) was used to assess the contents of SP and MUC5B in nasal lavage fluid before and after 3-month treatments in budesonide and nasal irrigation group in the study. MUC5B in nasal lavage fluid after the SP challenge and anticholinergic drug intervention in control group were also evaluated with ELISA. Results: Nighty out of 101 patients completed the study. In the budesonide and combined treatment group after relevant interventions, the total VAS score of nasal symptoms decreased (5.91±0.21 vs 3.82±0.15, 6.18±0.17 vs 3.92±0.15, t value was 8.193, 10.060, respectively, all P<0.05) and SF-12v2 score increased (146.00±1.23 vs 152.30±0.97, 146.00±1.08 vs 155.40±0.90, t value was 3.982, 6.697, respectively, all P<0.05), with both scores showed no significant differences in the nasal irrigation group (5.96±0.17 vs 5.72±0.15, 146.10±1.17 vs 147.00±0.94, t value was 1.038, 0.607, respectively, all P>0.05) after the first month. In the budesonide and combined treatment group after relevant interventions, the total VAS score of nasal symptoms decreased (5.91±0.21 vs 5.05±0.15, 6.18±0.17 vs 5.10±0.12, t value was 3.374, 5.351, respectively, all P<0.05) and SF-12v2 score increased (146.00±1.23 vs 150.90±0.76, 146.00±1.08 vs 153.60±0.94, t value was 3.373, 5.343, respectively, all P<0.05), with both scores showed no significant differences in the nasal irrigation group (5.96±0.17 vs 5.78±0.17, 146.10±1.17 vs 148.10±0.80, t value was 0.716, 1.438, respectively, all P>0.05) after the second month. By the end of the third month, in nasal irrigation and combined treatment group, the VAS score was diminished (5.96±0.17 vs 4.80±0.12, 6.18±0.17 vs 4.44±0.13, t value was 5.485, 8.264, respectively, all P<0.05) and SF-12v2 score was elevated (146.10±1.17 vs 150.80±0.96, 146.00±1.08 vs 152.90±0.85, t value was 3.163, 5.008, respectively, all P<0.05), but there were no significant differences in budesonide group (5.91±0.21 vs 5.68±0.18, 146.00±1.23 vs 148.40±0.85, t value was 0.819, 1.587, respectively, all P>0.05). Additionally, SP in nasal lavage fluid decreased and MUC5B showed no statistical changes in budesonide group after three months, however, SP showed no any changes and MUC5B reduced significantly in nasal lavage fluid in nasal irrigation group. Furthermore, the anticholinergic drug could not decrease the concentration of MUC5B after the SP challenge in nasal cavity in control group. Conclusions The therapeutic effect of simple nasal irrigation with 3.0% saline or combined treatment of 3.0% saline nasal irrigation and nasal corticosteroids is superior to simple nasal corticosteroids. Nasal corticosteroids plays a role in the inhibition of sensory nerve endings in nasal mucosa, but neurotransmitter plays a limited role in the pathogenesis of VMR.

Objective: To investigate and compare the attitudes of clinical nurses and nursing managers towards float nurse, and to provide references for the implementation of nurse mobile practice mode in China. Methods: By stratified sampling, the survey was conducted on clinical nurses and nursing managers of 15 tertiary hospitals in 9 prefecture-level cities in Fujian. Results: A total of 9 389 valid questionnaires were recovered, including 525 for nursing managers and 8 864 for clinical nurses. By comparing the attitudes between two groups, it was found that nursing managers who knew more about mobile practice were more willing to practice floating practice, including 50.86% (267/525) heard and inquired, 49.14% (258/525) willing to float, than clinical nurses who paid less attention, including 32.41% (2 873/8 864) heard and inquired, 38.87% (3 445/8 864) willing to float. Multi-factor analysis showed that among nursing managers, those with a bachelor’s degree or above was more willing to float. While among clinical nurses, young, unmarried, side, bachelor degree or above were more willing to float. On the choice of flow mode, nursing managers were inclined to float between hospitals (46.54%, 215/525), but clinical nurses were prone to community float (42.45%, 3 142/8 864). Furthermore, nursing managers had higher requirements on the professional title and seniority of float nurse, and 39.43% (207/525) believe that the professional title should be supervisor, while 81.71% (429/525) thought that length of service as a nurse should be 5 years or more. Conclusion There are differences between clinical nurses and nursing managers in such aspects as the intention of floating practice, obstacles and guarantee factors, cognition and selection of demanders, and acceptance of practice threshold. The above differences should be fully considered in the trial of the "Internet + Nursing" floating practice mode for nurses.

Hemophilia is a congenital hemorrhagic disease caused by genetic abnormalities in coagulation factor Ⅷ or factor Ⅸ. Current conventional therapy to prevent bleeding requires frequent intravenous injections of coagulation factor concentrates from early childhood. Hemophilia provides an attractive target for gene therapy studies, due to the monogenic nature of these disorders and easily measurable endpoints (factor levels and bleed rates). All successful, pre-clinical and clinical studies to date have utilized recombinant adeno-associated virus(AAV) vectors for factor Ⅷ or Ⅸ hepatocyte transduction. Although this is likely to alter the paradigm of hemophilia care in the near future, it will be important to overcome immune responses against AAV. This review focuses on current successes of clinical trials, and the future direction of hemophilia gene therapy.