Objective To discuss the clinicd effect of using nebulised budesonide to treat neonatal laryneal edema caused by mechanical ventilation.Methods 43 newborns with mechanical ventilation were included in this study and divided into two groups:The Observational group(23 newborns)were treated with nebulised budesonide right before excubation once and three times after that,and the control group(20 newborns)were treated with dexamethasone once right before excubation and nebulised adrenine after that for three times.Comparisons were made between two groups about dismissing time of wheeze or hoarseness,tachypnea,PaO2 and PaCO2.Results Observational group:dismissing time of wheeze or hoarseness was(10.26±4.01)hours,dismissing time of tachypnea was(1.63±0.55)days,which was shorter than that of control group[(14.20±5.58)hours/(2.05±0.58)days],P＜0.05).PaO2 and PaCO2 of two groups had no statistical difference(P＞0.05).Conclusion Nebulised budesonide was effective in treatment neonatal laryneal edema caused by mechanical ventilation,using.

Objective To investigate the correlation between ICRU reference point dose and dosevolume parameters of organs at risk (OARs) under different bladder and rectal filling status in threedimensional conformal brachytherapy for locally advanced cervical cancer.Methods A total of 31 patients who received magnetic resonance imaging-guided three-dimensional conformal brachytherapy for cervical cancer in 96 fractions were enrolled.The ICRU rectal and bladder reference points were determined in the treatment planning system,and the doses at these points were recorded and compared with the dose-volume parameters of the rectum and bladder.The paired t-test was used to analyze the differences between them.Results Bladder DICRU was lower than bladder D0.1cm3 and D1 cm3 (P=0.000 and 0.000),higher than bladder D5 cm3 and D10cm3 (P=0.000 and 0.000),and similar to bladder D2 cm3 (P=0.345).Under the bladder filling status,bladder DICRU was lower than D2cm3.Rectal DICRU was lower than rectal D0.1 cm3 and D1cm3 (P =0.000 and 0.002),higher than rectal D5 cm3 and D 10 cm3 (P =0.000 and 0.000),and similar to rectal D2cm3 (P=0.058).The ICRU bladder and rectal reference point doses were positively correlated with corresponding D2 cm3.In the case of bladder volume ≥ 200 cm3,the ICRU bladder reference point dose underestimated bladder D2 cm3.In the case of rectal volume ≥ 37 cm3,the ICRU rectal reference point dose overestimated rectal D2 cm3.Conclusions In three-dimensional conformal brachytherapy,it is generally safe to use D2 cm3 as an index to evaluate OARs,but when the bladder or rectum is in an empty status,the ICRU bladder or rectal reference point doses should be considered.

Objective To summarize the experiences in the diagnosis and treatment of the hepatic hereditary hemorrhagic telangiectasia (HHHT).Methods The clinical data of 15 HHHT patients who were admitted to the Qilu Hospital,People's Hospital of Mengyin,People's Hospital of Liaocheng,Henan Provincial People's Hospital,the Second Hospital of Hebei Medical University,First Affiliated Hospital of Zhejiang University were retrospectively analyzed.The clinical manifestation,features of imaging and laboratory examination were summarized,and the diagnosis,treatment and prognosis of the disease were investigated.Results HHHT patients had nonspecific symptoms in the early stage,and some patients presented with right upper quadrant discomfort,shortness of breath,anemia and liver bruit.The condition of HHHT patients could be worsened by liver cirrhosis or portal hypertension rapidly.The results of color doppler ultrasound and computed tomography showed intrahepatic telangiectasia,arteriovenous fistula and hepatic artery aneurysm in the 15 patients.Digital subtraction angiography was not clear enough for 2 HHHT patients with more than 1 enlarged hepatic arteries,but computed tomographic angiography was feasible.According to the degree and stages of the HHHT,all the 15 patients were divided into asymptomatic HHHT,simple HHHT and complex HHHT.Among the 6 patients who underwent surgical treatment,5 received ligation or banding of the enlarged hepatic arteries with subsequent disappearance of symptoms.Three patients received interventional treatment,and the treatment for 1 patient with complex HHHT was failed,and the patient died 30 months after medical treatment.Six patients were treated by conservative treatment,2 patients of them had no symptoms at the beginning,then they suffered from hepatic dysfunction and ascites at 21 and 35 months,respectively,and 1 of them died 6 months later.Four patients received medical treatment,and the results of color doppler ultrasound and computed tomography showed the pathological changes were aggravated gradually.Conclusions Telangiectasia,intrahepatic arteriovenous fistula and hepatic artery aneurysm are the main imaging characteristics of HHHT,and imaging diagnosis has significant value in the diagnosis of HHHT.HHHT is a progressive disease,early,active and individualized treatment is beneficial to the patients.The outcome of ligation or banding of the hepatic arteries is satisfactory.

Objective To explore the relationship between posttraumatic stress disorder and nurses′ psychological capital. Methods By convenient sampling, totally 550 nurses in 5 first-class upper level general hospitals in Zhejiang province were investigated by the posttraumatic stress disorder (PTSD)Cheeklist-Civilan Version (PCL-C) and Nurses Psychological Capital Questionnaire Revision (NPCQR), and the results were analyzed. Results 18.35%investigated nurses showed a certain degree of PTSD symptoms and 13.71% showed obvious PTSD symptoms. The positive rate was 32.06%.The overall score of nurses′psychological capital was 78.81 ± 16.54, which was in the middle level, and the dimension scores from high to low were self-efficacy (23.80±5.35), hope (23.36±5.24), resilience (19.66 ±4.29), and optimism (11.99 ± 3.21). The nurses′psychological capital had a negative effect on posttraumatic stress disorder (P<0.01). Conclusions Psychological capital of nurses is a negative predictor of PTSD symptoms, which suggested that managers should pay more attention to the development of nurses′psychological capital to reduce and prevent the occurrence of posttraumatic stress disorder,then to improve nursing service quality.

Objective To investigate the effect of proteasome inhibitor MG132 on the proliferation of human lens epithelial cells SRA01/04. Methods The SRA01/04 cells were treated with MG132 by different concentrations (0, 0. 1, 0. 5, 1. 0, 2. 5, 5.0, 10. 0μmol/L) for 36 hours. The cell viability in all groups was determined using methylthiazoltetrazolium (MTT) test. The effect of MG132 on the apoptosis and regulation of cell cycle about SRA01/04 cells were detected by flow cytometry (FCM). The SRA01/04 cells treated with MG132 were observed after Annexin V/FITC-PI staining by fluorescence microscope. Results The inhibitory effect of MG132 on SRA01/04 cells proliferation was enhanced with the increase of MG132 concentration. The 50% inhibiting concentration ( IC50 ) of MG132 was 2. 50μmol/L after SRA01/04 cells were treated with MG132 for 36 hours. The apoptosis index of the cells treated by MG132 at 2. 5μmol/L and 5 μmol/L for 36 hours was 6. 55 ± 0. 35% and 13.75 ± 3.18%, and 0. 75 ± 0. 21% for 5.0μmol/L for 36 hours in control group. After cells were treated with MG132 for 48h, the percentages of cells at G0/G1 phase were (42. 57 ± 0. 64) %, (73.42 ± 3.10) %, ( 80. 95 ± 3.83 ) % 0, 2. 5,5.0 μmol/Lgroups respectively, and those at S phase were (49. 44±1.36)%, ( 17. 40 ± 1.50)%, ( 19. 57 ± 1.29)%.Annexin V/FITC-PI staining was used, and MG132 was found to result to apoptosis. Conclusions MG132 could inhibit the proliferation of SRA01/04 cells by the effect of inducing apoptosis and regulation of cell cycle. The proteasome inhibitor-might play a key role in the prevention of posterior capsular opacification.

Objective To investigate the relation between intrauterine growth and the development of carotid atherosclerosis in later life. Methods The intima-media thickness of carotid was measured with ultrasonography in 2036 people aged above fifty who had complete birth records, and divided into normal and abnormal group. They were asked to fill in the cardio-cerebrovascular questionnaire, and venous blood samples were taken and analysed for various biochemical parameters. The relation between carotid atherosclerosis and various parameters at birth and in adult life was assessed. Results The birthweight and head circumference in abnormal group were less than those in normal. The prevalence of carotid atherosclerosis was greatest in those weighed 2500g or less, whose risk of carotid atherosclerosis was greater than those weighed between 3000g and 3500g, after adjustment for cardiovascular risk factors. Conclusions Increased atherogenesis may be one independent mechanism mediating the epidemiological link between impaired fetal growth and vascular disease.

Objective: To investigate the relationship between workplace bullying and posttraumatic stress disorder (PTSD) in nursing staff, and to analyze the role of psychological capital between workplace bullying and PTSD. Methods: From December 2014 to June 2015, convenience sampling was used to collect 496 nurses from 5 grade A tertiary hospitals in a province of China. Their workplace bullying, psychological capital, and PTSD status were assessed using the Negative Acts Questionnaire, Psychological Capital Questionnaire, and Posttraumatic Stress Disorder Self-Rating Scale, respectively. The correlation between variables was analyzed using a structural equation model. Results: Among these nurses, the scores of negative acts, psychological capital, and PTSD were 37.15±12.83, 78.81±16.54, and 34.56±12.52, respectively. The score on each dimension of negative acts was positively correlated with that on each dimension of PTSD (P<0.01) ; the score on each dimension of psychological capital was negatively correlated with that on each dimension of PTSD and negative acts (P<0.01). Negative acts had a positive predictive effect on PTSD (β=0.539, P<0.01) , which was reduced after inclusion of psychological capital (β=0.513, P<0.01). The path coefficient was 0.62 for the effect of negative acts on PTSD, -0.18 for the effect of negative acts on psychological capital, and -0.11 for the effect of psychological capital on PTSD (P<0.05) . Conclusion Workplace bullying is a predictive factor for PTSD, and psychological capital plays a mediating role between workplace bullying and PTSD. The manager should reduce workplace bullying to improve the psychological capital in nursing staff and to prevent and reduce PTSD.

Objective:To explore the status and influencing factors of workplace bullying in Operating Room nurses.Methods:This study is a cross-sectional study. From April to May, 2022, a total of 158 Operating Room nurses from 4 ClassⅢ Grade A hospitals in Hangzhou were selected as research objects by the convenient cluster sampling method. The general information questionnaire, Negative Acts Questionnaire-Revised (NAQ-R) and PTSD Checklist-Civilian Version (PCL-C) were used to investigate Operating Room nurses. Binomial Logistic regression analysis was used to investigate the influencing factors of workplace bullying in Operating Room nurses. Pearson correlation analysis was used to investigate the association between workplace bullying and post-traumatic stress disorder. A total of 158 questionnaires were distributed in this study, and 154 valid questionnaires were received, with an effective recovery rate of 97.47%.Results:A total of 78.57% (121/154) of Operating Room nurses had experienced workplace bullying, 33.12% (51/154) had experienced moderate to severe workplace bullying, and 44.81% (69/154) had post-traumatic stress disorder. The NAQ-R score and PCL-C score of Operating Room nurses were (31.34±10.06) and (37.71±15.47) , respectively. Binomial Logistic regression analysis results showed that age and position were the influencing factors of workplace bullying in Operating Room nurses ( P<0.05) . Pearson correlation analysis results showed that workplace bullying was positively correlated with post-traumatic stress disorder ( r=0.657, P<0.01) . Conclusions:Workplace bullying is common in Operating Room nurses in ClassⅢ Grade A hospitals in Hangzhou. Younger nurses and nurses with position are more likely to suffer from workplace bullying, and workplace bullying is positively correlated with post-traumatic stress disorder. Operating Room managers should pay more attention to workplace bullying and develop targeted intervention measures to avoid workplace bullying.

Objective:To summarize the progress in research of economic evaluation of HIV vaccination strategies in the world, and provide reference for future decision-making and research on HIV vaccination.Methods:The key words used for literature retrieval were "HIV/AIDS", and "vaccine/vaccination" and "economic evaluation/cost-effectiveness analysis/cost-utility analysis/cost-benefit analysis/HTA". Literatures about the economic evaluation of HIV vaccination strategies published as of July 31, 2022, were retrieved from Wanfang Data (Wanfang), China Hospital Knowledge Database (CHKD), and PubMed databases. The quality of the articles was evaluated and analyzed comprehensively.Results:A total of 17 study articles with good quality were included. Results from the comprehensive analysis showed that HIV vaccination is a cost-saving or cost-effective strategy for key populations or the whole population. HIV vaccination could effectively reduce new infections and improve the quality of life of population. Factors, such as vaccine efficiency, coverage rate, price, and risk behavior change after vaccination, would affect the vaccination effect in different targeted populations.Conclusions:There were limited high-quality research data about the economic evaluation of HIV vaccination strategies. It is necessary to conduct in-depth research based on real-world evidence.

Objective:To investigate the feasibility of conducting active surveillance (AS) for low risk papillary thyroid microcarcinoma (PTMC) in China and to examine the factors in association with disease progression during AS.Methods:This study was a prospective observational research conducted from Jun. 2018 to Aug. 2022 at Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine. Seventy-three patients with cytologically confirmed low-risk PTMC were enrolled in this study. They were followed up by ultrasonography, and the observed nodules were re-assessed whether or not to have disease progression. Disease progression was defined as having nodule enlarged more than 3 mm in any of diameters measured on ultrasound, or/and presence of suspicious lymph node metastasis.Results:The median follow-up time was 33 months. At the time of last follow-up, 16 cases (21.9%) exhibited disease progression, including 9 cases (12.3%) with suspicious lymph nodes detected by ultrasound, and 8 cases (11.0%) with lesion enlargement; one case (1.3%) exhibited both situations. The univariate chi-square analysis revealed that young patients (≤45 years old, P=0.041), presence of microcalcifications ( P=0.032), initial larger nodule (diameter greater than 7 mm, P=0.003), and elevated thyroid autoantibody levels ( P=0.008) were associated with disease progression. Multiple regression analysis showed elevated thyroid autoantibodies ( OR=4.311, P=0.030) and initial larger nodule ( OR=6.196, P=0.034) were independent risk factors for PTMC progression,respectively. Conclusions:AS for low-risk PTMC is a feasible and effective. During the observation, ultrasound can reveal suspicious lymph nodes and nodule enlargement, which are crucial indicators for assessing disease progression. Patients with initially larger nodule size and elevated thyroid autoantibody level are more likely to exhibit disease progression and should receive closer attention.