Objective To study the effects of bundles of care on complications and unplanned extubation rate of neonatal in PICC .Methods 116 cases of neonatal which didn′t accept the bundles of care ware group A ,the other 93 cases of neonatal which accepted the bundles of care ware group B .Two groups were observed and compared on the incidence of complications and un-planned extubation rate and so on .Results The complications in A group treatment were 70 cases(60 .3% ) ,while there were 25 ca-ses in group B(26 .9% ) ,the group B was significantly lower than the group A (P<0 .05) .Mechanical phlebitis ,catheter occlusion , catheter ectopic and other aspects of ectopic group B were significantly lower than in group A (P<0 .05) .The rate of unplanned ex-tubation and catheter blockage in group B were significantly lower than A (P<0 .05) .The total rate of ectopic and right basilic vein ectopic rate in group B were all significantly lower in group A (P<0 .05) .Group B unplanned extubation rate and catheter blockage weresignificantlyloweringroupA(P<0.05).Gestationalagedidn′thaveimpactoncomplications(P>0.05),birthweightand catheter days had more impact on neonatal complications (P<0 .05) .Conclusion The cluster management can reduce the incidence of neonatal PICC complications ,reduce unplanned extubation rates ,better play the role of PICC ,try to arrange an experienced staff of medical operations for children of low birth weight newborns .

Objective To explore the features of coronary artery morphological changes and left ventricular function indicators of resident population in plateau .Methods 50 plateau healthy adults and 50 plain‐and Dalian‐healthy volunteers completed coronary CTA examination .We measured the pipe diameter of left main coronary atery and right coronary artery and their branches ,respec‐tively .Furthermore ,SV and EF value of left ventricular cardiac function indexes and the wall thickening of free ventricular wall at left ventricular end systolic were measured .Results The average diameter of proximal right coronary of plain‐and Dalian‐healthy volun‐teers thicker than plateau group ,with statistical difference ;Other coronary artery branch did not exhibit any significant between‐group differences ;The two groups did not show significant between‐group differences with heart function indexes .Conclusion The body circulation system have adaptability and compensatory changes of resident population in plateau ,and their coronary artery mor‐phology and left ventricular function are as similar as plain people .

Objective:To develop a questionnaire on perimenopausal cognition and behavior and verify its reliability and validity, in order to provide an effective tool for evaluating perimenopausal women's cognition, doctor-seeking and doctor-following behaviors.Methods:Baseline survey, literature analysis and brainstorming were formed in the initial items, and group discussion and expert interview were performed to identify items of the form. By convenience sampling method, A survey was conducted on perimenopausal women in the communities around Chongqing Health Center for Women and Children from July to August 2019. Project analysis, exploratory factor analysis, confirmatory factor analysis, Pearson correlation analysis and reliability test were used to evaluate the questionnaire.Results:Two rounds of questionnaires were distributed in this study. In the first round, 260 questionnaires were distributed, 249 valid questionnaires were recovered, and the effective recovery rate was 95.8% (249/260). In the second round, 249 questionnaires were distributed, and the effective recovery rate was 96.4% (240/249). The questionnaire on perimenopausal cognition and behavior included 4 dimensions and 24 items. The cumulative contribution of variance was 66.330%, the Cronbach α coefficient was 0.893 and the spearman-brown half-fold coefficient was 0.773. Regarding to the construct validity, the correlation coefficient between factors and total score of the questionnaire was 0.567-0.860 ( P < 0.01). Confirmatory factor analysis showed that the approximate error root mean square was 0.055, the normal fitting index was 0.801, and the goodness of fit index was 0.828. Conclusions:The questionnaire has been proved to be reliable and valid. It can be used to evaluate perimenopausal women′s cognition, doctor-seeking and doctor-following behaviors.

High mobility group protein B1 (HMGB1), a highly conversed non-histone nucleoproteins with strong pro-inflammatory property, is one of the inflammatory mediator of the acute respiratory distress syndrome (ARDS). Numerous studies have confirmed that HMGB1 regulates ARDS by binding to receptor for advanced glycation end product (RAGE), Toll-like receptor (TLR) and etc. And it can significantly increase the mortality of ARDS. But the mechanism of HMGB1 release is still unclear. This study focuses on the HMGB1 release progress, which connected with Janus kinases/signal transducer and activator of transcription (JAK/STAT), nuclear factor-κB (NF-κB), Notch, inflammasome, tumor necrosis factor (TNF), mitogen-activated protein kinase (MAPK), reactive oxygen species (ROS), peroxisome proliferator-activated receptor (PPAR) and other signaling or dependent pathways in ARDS.

Acute respiratory distress syndrome (ARDS) refers to acute diffuse lung injury caused by a variety of intrapulmonary and/or extrapulmonary factors such as infection and trauma. Uncontrolled inflammatory response is the main pathological feature. Different functional states of alveolar macrophages have different effects on inflammatory response. Transcription activating factor 3 (ATF3) is a fast response gene in the early stage of stress. In recent years, it has been found that ATF3 plays an important role in regulating the inflammatory response of ARDS by regulating the function of macrophages. This paper reviews the regulatory effects of ATF3 on alveolar macrophage polarization, autophagy and endoplasmic reticulum stress and its effects on the inflammatory process of ARDS, aiming to provide a new research direction for the prevention and treatment of ARDS.