Objective:To analyze the current status of physical composition in medical workers and the evaluation effects of each indicator on nutritional status.Methods:It was a cross-sectional study. A total of 313 medical workers from one hospital in Beijing were recruited from May 21st to June 22nd in 2021 for body composition measurement. Variance analysis was used to compare the age and gender distribution differences in total body fat, fat-free body weight, body fat percentage, skeletal muscle, protein, water, mineral, and basal metabolic rate indicators among the medical workers. Protein content, body fat percentage, and body mass index (BMI) were used to evaluate the nutritional status of medical workers, and the evaluation effects were analyzed too.Results:Of the 313 medical workers included in this study, there were 221 females and 92 males. In females, total body fat, fat-free body weight, skeletal muscle mass, and basal metabolic rate were all positively correlated with age ( F=19.823, 6.745, 6.561, 6.707) (all P<0.001). There was no significant differences in body composition indicators among male participants of different age groups (all P>0.05). The total body fat in female medical workers was significantly higher than that in males (17.58 kg vs 17.08 kg). Total water, protein, minerals, fat-free body weight, skeletal muscle mass, and basal metabolic rate were all significantly lower in female medical workers when compared with those in males [30.40 kg vs 41.78 kg, 8.07 kg vs 11.26 kg, 2.96 kg vs 3.88 kg, 41.43 kg vs 56.92 kg, 22.37 kg vs 31.98 kg, 1 264.86 kcal (1 kcal=4.184 kJ) vs 1 599.39 kcal] (all P<0.05). Among the medical workers, 190 cases (60.7%) had normal protein levels, 103 cases (32.9%) had protein deficiencies, and 20 cases (6.3%) had protein levels exceeding the standard. Additionally, 110 cases (35.1%) had normal body fat ratios, 193 cases (61.6%) had excessive body fat ratios, and 10 cases (3.2%) had insufficient body fat ratios. Concerning body mass index (BMI), 198 cases (63.2%) had normal BMI. Among them, 145 cases (73.2%) had normal body fat ratios, 53 cases (26.7%) had excessive body fat ratios, 108 cases (54.5%) had normal protein levels, 89 cases (44.9%) had insufficient protein levels, and 1 case (0.5%) had excessive protein levels. Furthermore, 103 cases (32.9%) had excessive BMI, with 20 cases (19.4%) having normal body fat ratios indicating the muscle/bone strength type, and 83 cases (80.6%) having normal protein levels indicating the muscular type. Lastly, 12 cases (3.8%) had insufficient BMI, including 6 cases (50.0%) with normal body fat ratios. Conclusion:There are significant gender differences in body composition distribution among healthcare workers. In females, total body fat, lean body mass, skeletal muscle, and basal metabolic rate are all correlated with age. Evaluating individual nutrition status based solely on BMI would underestimate the obesity rate. Individuals with low or high protein/muscle content should not be assessed using BMI.

Objective:To investigate the value of 18F-FDG PET/CT combined with conventional imaging modalities in the evaluation of the depth of tumor invasion, regional lymph node metastasis, distant organ and lymph node metastasis (TNM staging), and the adjacent structure invasion of rectal cancer. Methods:Fifty-four patients (28 males, 26 females, age (65.8±11.0) years) with pathologically confirmed rectal cancer admitted to the Affiliated Qingdao Central Hospital of Qingdao University between September 2019 and June 2021 were retrospectively analyzed. 18F-FDG PET/CT examination, conventional imaging modalities including high-resolution MRI (HR-MRI), chest CT plain scan, upper abdominal MRI or CT plain scan+ enhanced examination were performed within 2 weeks before or after the rectal cancer being confirmed. The TNM staging and adjacent structural invasions including circumferential resection margin (CRM), extramural vascular invasion (EMVI), anal sphincter complex involvement were evaluated by 18F-FDG PET/CT and conventional imaging modalities separately or in combination, and those results based on imaging were compared with the pathological results or clinical follow-up results. χ2 test was used to compare the differences of diagnostic sensitivity, specificity and accuracy between the 18F-FDG PET/CT or conventional imaging modalities and combined examination. Results:The accuracy for T staging and the sensitivity and accuracy for N staging of the combined examination were 96.30%(52/54), 98.65%(73/74) and 93.91%(185/197), respectively, which were significantly higher than those of 18F-FDG PET/CT (85.19%(46/54), 66.22%(49/74), 81.73%(161/197); χ2 values: 3.97, 26.88, 13.66, all P<0.05). The specificity (91.06%, 112/123) and accuracy of the combined examination for N staging were higher than those of the conventional imaging modalities (77.24%(95/123), 83.76%(165/197); χ2 values: 8.81, 10.23, both P<0.05). The sensitivity and accuracy of the combined examination for M staging were higher than those of the conventional imaging modalities (97.01%(65/67) vs 73.13%(49/67), 95.95%(71/74) vs 68.92%(51/74); χ2 values: 15.05, 18.66, both P<0.001). The sensitivities of the combined examination in evaluating CRM and EMVI were 100%(22/22) and 95.00%(19/20), and the accuracies were 98.15%(53/54) and 96.30%(52/54), all of which were higher than those of 18F-FDG PET/CT (CRM: 54.55%(12/22), 74.07%(40/54); EVMI: 30.00%(6/20), 74.07%(40/54); χ2 values: 12.94, 13.08, 18.03, 10.56, all P<0.01). The accuracy of the combined examination in evaluating EMVI was higher than that of the conventional imaging modalities (85.19%(46/54); χ2=3.97, P=0.046). Conclusion:18F-FDG PET/CT combined with conventional imaging modalities can improve the diagnostic efficacy for TNM staging and assessment of adjacent structural invasion in rectal cancer.

Objective:To investigate the effect of exogenous recombinant human Annexin A6(rhANX A6)intervention on early plasma membrane damage and its metabolic characteristics in skeletal muscle in mice with eccentric exercise injury models. Method:Fifty-six C57 male mice,aged 8 weeks,were randomly divided into the quiet control group(group C),exercise group injected with phosphate-buffer saline(group EP)and exercise group injected with rhANX A6(group ER).The exercise groups were further subdivided based on different post-exercise sampling times:EP2,EP6,EP12,and ER2,ER6,ER 12,with 8 mice in each subgroup.Two hours before exercise,the group EP and group ER received intraperitoneal injections with l*PBS buffer(1 x concentration)and rhANX A6(0.8 mg/kg),respectively.ELISA was used to detect the content of ANX A6 in serum creatine kinase(CK),Annexin A6(ANX A6)and skeletal muscle in each group of mice,and Evans Blue dye(EBD)was used to observe the damage of the skeletal muscle plasma membrane of each group of mice. Result:The serum CK activity in all EP subgroups and ER12h were significantly higher than those in the C group(P＜0.01).At the same time point,CK levels in all EP subgroups were significantly higher than in the ER group(P＜0.05).The average fluorescence intensity of EBD-positive regions in all EP and ER subgroup was significantly higher than that in group C(P＜0.01).All EP subgroups had significantly higher intensities than the ER group(P＜0.01).The serum ANX A6 levels in all ER subgroups and EP6h,EP12h were signifi-cantly higher than that in group C(P＜0.01).At 12h time point,ANX 46 levels in the ER group were signifi-cantly higher than in the EP group(P＜0.05).ANX A6 levels in skeletal muscle of all EP and ER subgroups were significantly higher than that in group C(P＜0.05);All ER subgroups had significantly higher than those in the EP group(P＜0.05). Conclusion:Exogenous rhANX A6 injection 2 hours before eccentric exercise in mice can significantly improve the early plasma membrane injury in skeletal muscle after exercise.It is speculated that rhANX A6 directly in-volved in the repair of early plasma membrane damage in skeletal muscle induced by eccentric exercise.

Objective To explore the interventional effect of repetitive transcranial magnetic stimulation (rTMS) on tardive dyskinesia (TD) in schizophrenic patients. Methods A total of 105 schizophrenic patients were selected as subjects and randomly divided into 1 Hz treatment group, 10 Hz treatment group and control group, with 35 patients in each group. All three groups received rTMS treatment for 12 weeks. The Abnormal Involuntary Movement Scale (AIMS), Scale for the Assessment of Negative Symptoms (SANS), Positive and Negative Syndrome Scale (PANSS) and Treatment Emergent Symptom Scale (TESS) scores were compared among the three groups. Physiological indicators such as electrocardiogram, blood routine, blood biochemistry and hormone levels were monitored. Results After treatment, the total AIMS scores in the 1 Hz and 10 Hz treatment groups were significantly lower than before treatment, and those in the 1 Hz and 10 Hz treatment groups were significantly lower than those in the control group (P < 0.05). The reduction rates of AIMS scores in the 1 Hz and 10 Hz treatment groups were 68.6% and 65.7%, respectively, which were significantly higher than the 22.9% in the control group (P < 0.05). After treatment, the total SANS and PANSS scores in the 1 Hz and 10 Hz treatment groups were significantly lower than before treatment, and those in the 1 Hz and 10 Hz treatment groups were significantly lower than those in the control group (P < 0.05). There was no statistically significant difference in the total AIMS score, efficacy and total PANSS score between the 1 Hz and 10 Hz treatment groups (P>0.05). There were no significant differences in the total TESS scores and physiological indicators among the three groups before and after treatment (P>0.05). Conclusion Both 1 Hz and 10 Hz rTMS can effectively improve TD in schizophrenic patients with good safety and have no significant side effects or physiological damage.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.

MicroRNA (miRNA) plays an important role in the development of diffuse large B-cell lymphoma (DLBCL) by binding to the 3′ non-coding region of the target gene mRNA to regulate gene expression after transcription. The expression level of miRNA is closely related to the clinical staging, typing, prognosis assessment, and therapeutic effect of DLBCL. miRNA has a great potential as that of DLBCL-related biomarkers, and because of the close link between the two, miRNA-based therapies are expected to lead to new treatment options for DLBCL patients.

BACKGROUND: Although newly formed constructs of feasible pressure-preadjusted bone marrow mesenchymal stem cells (BMSCs) and platelet-rich fibrin (PRF) showed biomechanical flexibility and superior capacity for cartilage regeneration, it is still not very clear how BMSCs and seed cells feel mechanical stimuli and convert them into biological signals, and the difference in signal transduction underlying mechanical and chemical cues is also unclear. METHODS: To determine whether mechanical stimulation (hydrostatic pressure) and chemical cues (platelet-rich fibrin, PRF) activate canonical or noncanonical Wnt signaling in BMSCs, BMSCs cocultured with PRF were subjected to hydrostatic pressure loading, and the activation of the Wnt signaling molecules and expression of cartilage-associated proteins and genes were determined by western blotting and polymerase chain reaction (PCR). Inhibitors of canonical or noncanonical Wnt signaling, XVX-939 or L690,330, were adopted to investigate the role of Wnt signaling molecules in mechanically promoted chondrogenic differentiation of BMSCs. RESULTS: Hydrostatic pressure of 120 kPa activated both Wnt/b-catenin signaling and Wnt/Ca2+ signaling, with the the maximum promotion effect at 60 min. PRF exerted no synergistic effect on Wnt/b-catenin signaling activation. However, the growth factors released by PRF might reverse the promotion effects of pressure on Wnt/Ca2+ signaling. Real-time PCR and Western blotting results showed that pressure could activate the expression of Col-II, Sox9, and aggrecan in BMSCs cocultured with PRF. Blocking experiment found a positive role of Wnt/b-catenin signaling, and a negative role of Wnt/ Ca2+ signaling in chondrogenic differentiation of the BMSCs. Mutual inhibition exists between canonical and noncanonical Wnt signaling in BMSCs under pressure. CONCLUSION Wnt signaling participates in the pressure-promoted chondrogenesis of the BMSCs co-cultured with PRF, with canonical and noncanonical pathways playing distinct roles during the process.

Objective:To compare the efficacy of haplotype hematopoietic stem cell transplantation (HIDT) and sibling matched hematopoietic stem cell transplantation (MSDT) in the treatment of complete remission (CR) acute T-lymphoblastic leukemia (T-ALL) .Methods:We retrospectively analyzed the clinical characteristics and outcomes of 98 patients who underwent HSCT in Hebei Yanda Ludaopei hospital with HID ( n=81) or ISD ( n=17) between May 2012 and May 2016. Results:The incidence of grades 2-4 and 3-4 acute-versus-host disease 100 days after HSCT were 51.9% (95% Confidence interval [ CI] 42.0%-64.0%) vs 29.4% (95% CI 14.1%-61.4%) ( P=0.072) and 9.8% (95% CI 5.1%-19.1%) vs 11.8% (95% CI 3.2%-43.3%) ( P=1.000) for HIDT and MSDT. The 100-day cumulative incidences of CMV and EBV viremia were 53.1% (95% CI 43.3%-65.2%) vs 29.4% (95% CI 14.1%-61.4%) ( P=0.115) and 35.8% (95% CI 26.8%-47.9%) vs11.8% (95% CI 3.2%-43.3%) ( P=0.048) . The 5-year overall survival, leukemia-free survival, cumulative incidences of relapse, and no-relapse mortality were 60.5% (95% CI 5.4%-49.0%) vs 68.8% (95% CI 11.8%-40.0%) ( P=0.315) , 58.0% (95% CI 5.5%-46.5%) vs 68.8% (95% CI 11.8%-40.0%) ( P=0.258) , 16.1% (95% CI 9.8%-26.4%) vs 11.8% (95% CI 3.2%-43.3%) ( P=0.643) , 25.9% (95% CI 17.9%-37.5%) vs 19.4% (95% CI 6.9%-54.4%) ( P=0.386) for HIDT and MSDT, respectively. Conclusion:HID could be a valid alternative donor for patients with T-ALL in CR lacking an identical donor.

Objective:To study the clinical efficacy of chimeric antigen receptor T-cell (CART) treatment followed by a second allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with B-cell acute lymphoblastic leukemia (ALL) who relapsed following the first HSCT.Methods:Retrospective analysis of the clinical characteristics and prognosis of 41 patients with B-cell ALL who received a second allo-HSCT from October 2015 to June 2020 in Hebei Yanda Lu Daopei Hospital. After the first HSCT, all patients received CD19-CART, or CD22-CART treatment following a relapse of bone marrow morphology or extramedullary leukemia.Results:A total of 41 patients (male, 21; female, 20) were included in this study. The median age at the second HSCT was 16 (3-46) years. There were 31 cases of bone marrow recurrence (75.6%) , 5 cases of extramedullary recurrence (12.2%) , and 5 cases of bone marrow and extramedullary recurrences (12.2%) . After relapse, 35 patients (85.4%) received CD19-CART treatment, 2 patients received CD22-CART treatment (4.9%) , and 4 patients received CD19-CART and CD22-CART treatments (9.8%) . The expected 3-year overall survival (OS) , leukemia-free survival, cumulative relapse incidence, and non-relapse mortality (NRM) of patients after the second HSCT were 48.9% (95% CI 23.0%-70.6%) , 41.8% (95% CI 17.3%-64.9%) , 8.8% (95% CI 2.9%-26.4%) , and 51.1% (95% CI 31.2%-83.6%) , respectively. The 1-year OS of patients who relapsed ≤6 months and >6 months after the first HSCT were 45.0% (95% CI 12.7%-73.5%) and 75.0% (95% CI 51.4% -88.8%) ( P=0.017) , respectively. Conclusion:CART bridging in the second HSCT enables some B-cell ALL patients who relapsed after the first HSCT to achieve long-term survival. However, because of the high NRM, further modifications could help improve the outcome.

Objective:To retrieve and analyze the relevant guidelines for the second and third stages of normal delivery, and summarize the evidence of high-quality guidelines so as to provide references for the formulation of clinical practice programs.Methods:We took Johns Hopkins evidence-based nursing practice model as theoretical guidance and set up an evidence-based team.We systematically searched major guideline publication websites, electronic resource databases, related academic groups and guideline networks at home and abroad, evaluated guidelines and summarized the best evidence, and the search time limit was up to June 1, 2019. The literature quality evaluation and evidence extraction were carried out independently by four researchers with evidence-based training.Results:This study included two guidelines, summarizing the 20 best evidences in 9 aspects of humanistic support, delivery companion, delivery position, fetal monitoring, delayed exertion, perineal protection, fundus compression, prevention of postpartum hemorrhage, and delayed umbilical cord clamping.Conclusions:Based on the existing evidence, it integrates the best evidence of nursing measures for the second and third stages of normal delivery. It is recommended that maternal and child institutions promote the transformation of the best evidence based on their actual conditions.