Objective:To explore the current situation of emotion labor among emergency nurses and to analyze its influence on job engagement.Methods:From May to August 2018, this study selected 448 emergency nurses from 6 ClassⅢ general hospitals in Beijing as subjects by convenience sampling. All nurses were investigated with the General Information Scale, Emotional Labor Scale (ELS) and Utrecht Work Engagement Scale (UWES) . SPSS 22.0 was used to data entry and analysis. T test, variance analysis, Pearson correlation was used to single factor analysis, and multiple hierarchical regression was used to influencing factor analysis. Results:Among 448 emergency nurses, the total average scores of ELS and UWES were (3.94±0.75) and (3.43±0.69) respectively. There were statistical differences in the scores of UWES among emergency nurses with different genders and posts ( t=-2.048, -4.553; P<0.05) . Pearson correlation analysis showed that surface acting and expression of emotions in ELS had negative correlations with dimensions in UWES among nurses with statistical differences ( r=-0.108--0.330, P<0.05) ; deep acting in ELS had positive correlations with dimensions in UWES with statistical differences ( r=0.220-0.256, P<0.01) . Hierarchical regression analysis showed that deep acting positively predicted job engagement, and surface acting negatively predicted job engagement which explained 17.9% of the variance of job engagement. Conclusions:Emergency nurses of Class Ⅲ general hospitals have middle level of emotion labor and upper middle level of job engagement. Nursing managers should pay more attention to emotion labor of nurses and improve the job engagement by emotion labor so as to improve the nursing service quality.

This article summarizes the current situation of transport risk in critical patients, and analyzes the related risk factors such as patient condition, transporters, communication and so on. This paper also summarizes the measures of risk prevention from transport risk intervention, standardized transport system, process and personnel protection, which provides a reference for improving the safety of hospital transport in critical patients.

Objective To observe the value of radiomics models based on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced hepatobiliary phase(HBP)MRI for assessing clinical pathological stage of hepatic fibrosis(HF).Methods Data of 240 patients with pathologically/clinically diagnosed and clinical pathological staged HF who underwent Gd-EOB-DTPA enhanced MR examination were retrospectively analyzed.The liver-to-muscle signal intensity ratio(SIR1)and liver-to-spleen signal intensity ratio(SIR2)were measured based on HBP images.Radiomics features of HBP images were extracted and screened to construct radiomics models.The signal intensity ratio(SIR)-radiomics combined models were constructed based on SIR and radiomics signatures.Receiver operating characteristic(ROC)curves were drawn to evaluate the efficacy of each model for assessing clinical pathological stage of HF.Results The area under the curve(AUC)of SIR1 and SIR2 models for assessing clinical pathological stage of HF were 0.63-0.70 and 0.65-0.71,respectively.The most effective radiomics model for assessing HF,significant HF,advanced HF and early cirrhosis was support vector machine(SVM),SVM,light gradient boosting machine and K-nearest neighbor model,respectively,with the AUC in validation set of 0.87,0.82,0.81 and 0.80,respectively,while the AUC of SIR-radiomics combined models in validation set of 0.88,0.82,0.82 and 0.81,respectively.Conclusion The radiomics models based on Gd-EOB-DTPA enhanced HBP MRI were helpful for assessing clinical pathological stage of HF.Combining with HBP SIR could improve their efficacy.

Fungal infections gradually attract global public health attention. Candida, Aspergillus, and Cryptococcus are the most common pathogens of fungal infections.With the widespread use of antifungal drugs, fungal resistance is gradually increasing.Clarifying the current status of antifungal drug resistance and the mechanism is helpful for rational treatment of fungal infections.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.

As known, the benefits of photothermal therapy (PTT) are greatly limited by the heat tolerance of cancer cells resulting from overexpressed heat shock proteins (HSPs). Then HSPs further trigger the formation of stress granules (SGs) that regulate protein expression and cell viability under various stress conditions. Inhibition of SG formation can sensitize tumor cells to PTT. Herein, we developed PEGylated pH (low) insertion peptide (PEG-pHLIP)-modified hollow copper sulfide nanoparticles (HCuS NPs) encapsulating the SG inhibitor ISRIB, with the phase-change material lauric acid (LA) as a gate-keeper, to construct a pH-driven and NIR photo-responsive controlled smart drug delivery system (IL@H-PP). The nanomedicine could specifically target slightly acidic tumor sites. Upon irradiation, IL@H-PP realized PTT, and the light-controlled release of ISRIB could effectively inhibit the formation of PTT-induced SG to sensitize tumor cells to PTT, thereby increasing the antitumor effect and inducing potent immunogenic cell death (ICD). Moreover, IL@H-PP could promote the production of reactive oxygen species (ROS) by tumor-associated macrophages (TAMs), repolarizing them towards the M1 phenotype and remodeling the immunosuppressive microenvironment. In vitro/vivo results revealed the potential of PTT combined with SG inhibitors, which provides a new paradigm for antitumor and anti-metastases.

Multi-modal therapeutics are emerging for simultaneous diagnosis and treatment of cancer. Polymeric carriers are often employed for loading multiple drugs due to their versatility and controlled release of these drugs in response to a tumor specific microenvironment. A theranostic nanomedicine was designed and prepared by complexing a small gadolinium chelate, conjugating a chemotherapeutic drug PTX through a cathepsin B-responsive linker and covalently bonding a fluorescent probe pheophorbide a (Ppa) with a branched glycopolymer. The branched prodrug-based nanosystem was degradable in the tumor microenvironment with overexpressed cathepsin B, and PTX was simultaneously released to exert its therapeutic effect. The theranostic nanomedicine, branched glycopolymer-PTX-DOTA-Gd, had an extended circulation time, enhanced accumulation in tumors, and excellent biocompatibility with significantly reduced gadolinium ion (Gd