Objective To investigate the clinical diagnostic value of extra-spindle pole-like protein 1(ESPL1)in the progression of hepatitis B virus(HBV)-related liver fibrosis.Methods A total of 228 patients with HBV infection who were admitted to The First Affiliated Hospital of Guangxi Medical University from June 2017 to August 2023 were enrolled.The transient elastography system FibroScan was used to determine liver stiffness measurement(LSM)for all patients,and according to the LSM value,they were divided into non-liver fibrosis group with 80 patients,mild liver fibrosis group with 83 patients,advanced liver fibrosis group with 30 patients,and liver cirrhosis group with 35 patients.ELISA was used to measure the serum level of ESPL1.The Kruskal-Wallis H test was used for comparison of the serum level of ESPL1 between the four groups;the Spearman correlation analysis was used to investigate the correlation between ESPL1 and LSM;the receiver operating characteristic(ROC)curve was used to analyze the value of serum ESPL1 in predicting the progression of liver fibrosis.Results The liver cirrhosis group had a significantly higher serum level of ESPL1 than the non-liver fibrosis group and the mild liver fibrosis group(both P<0.05),and the advanced liver fibrosis group and the mild liver fibrosis group had a significantly higher serum level of ESPL1 than the non-liver fibrosis group(both P<0.05).The correlation analysis showed that there was a positive correlation between serum ESPL1 and LSM in the patients with HBV infection and varying degrees of liver fibrosis(r=0.515,P<0.001).Serum ESPL1 had an area under the ROC curve(AUC)of 0.809 in predicting liver cirrhosis and an AUC of 0.638 in predicting advanced liver fibrosis,with a sensitivity of 87.5%and 100%,respectively,and a specificity of 59.7%and 31.3%,respectively.Conclusion There is a certain correlation between serum ESPL1 and HBV-related liver fibrosis,and higher serum ESPL1 may indicate a higher degree of liver fibrosis.Serum ESPL1 is expected to become one of the serum markers for assisting in the diagnosis of liver cirrhosis and an important clinical method for dynamically monitoring the progression of liver fibrosis in patients with HBV infection.

Objective:To investigate the correlation between circulating tumor cell (CTC) detection, RAS/RAF gene mutation and clinicopathological characteristics in patients with colorectal cancer (CRC).Methods:The Amplification Refractory Mutation System (ARMS)-polymerase chain reaction (PCR) were used to detect the gene mutation in the tumor tissues of 138 CRC patients in the Third Affiliated Hospital of Sun Yat-sen University from May 2017 to May 2020. At the same time, the venous blood of 138 patients was collected and enriched for CTC genotyping by mRNA in situ hybridization. The correlation between CTC, RAS/RAF gene mutation and clinicopathological features of CRC patients was analyzed.Results:The mutation rates of KRAS, NRAS and BRAF genes were 48.6%(67/138), 5.1%(7/138) and 1.4%(2/138), respectively; The overall positive rate of CTC was 84.1%(116/138). The positive rates of different CTC types were: 23.1%(32/138) in epithelial type, 71.7%(99/138) in mixed type and 12.3%(17/138) in interstitial type respectively. The positive rate of CTC in CRC patients with clinical stage Ⅲ-Ⅳ, lymph node metastasis (N1-N3) and distant metastasis (M1) was significantly higher than that in CRC patients with stage Ⅰ-Ⅱ, no lymph node metastasis (N0) and no distant metastasis (M0) (all P<0.05). The total number of CTC, mixed CTC and interstitial CTC were positively correlated with clinical stage, lymph node metastasis and distant metastasis (all P<0.05). RAS/RAF gene mutation, gender, age, tumor location and tumor differentiation did not affect the positive rate of CTC (all P>0.05). Conclusions:The results of CTC typing are of great research significance for comprehensive treatment, prognosis assessment and stratified management of CRC, among which the interstitial type of CTC may be a high risk factor for the recurrence and metastasis of CRC.

Objective To investigate the epidemiological features and antiviral response of patients with genotype 6 chronic hepatitis C (CHC) in Guangxi, China. Methods A total of 97 patients with genotype 6 CHC who were admitted to The First Affiliated Hospital of Guangxi Medical University from December 2012 to December 2020 were enrolled, among whom 62 patients were given antiviral therapy. The 62 patients receiving antiviral therapy were divided into interferon group with 22 patients and direct-acting antiviral agent (DAA) group with 40 patients. Related data were collected, including general demographic data, HCV RNA, liver function, routine blood test results, and renal function. The chi-square test was used for comparison of categorical data between groups. Results Among the 97 patients, there were 69 male patients (71.1%) and 28 female patients (28.9%), with a mean age of 41.97±10.12 years, and the patients aged 30-40 years accounted for 47.4% (46/97). Of all 97 patients, 95 (97.9%) had genotype 6a, 1 had genotype 6e, and 1 had genotype 6xa. Among the 65 patients with a definite route of infection, 41 (63.1%) had intravenous drug use, 14 had medical-related operations, 9 had blood transfusion, and 4 had sexual contact as the route of infection. For the interferon group, the rapid virologic response (RVR) rate at week 4 was 81.8% (18/22), the rate of undetectable virus at the time of drug withdrawal (Epoint) was 86.4% (19/22), the rate of sustained virologic response at 12 weeks after drug withdrawal (SVR12) was 81.8%, and the rate of sustained virological response at 24 weeks after drug withdrawal (SVR24) was 81.8%; 1 patient in this group experienced recurrence. All 40 patients in the DAA group were previously untreated patients (33 patients without liver cirrhosis and 7 patients with compensated liver cirrhosis), with an overall RVR rate of 87.5%(35/40), an Epoint rate of 100%, and an SVR12 rate of 100%, and there was no treatment failure or recurrence. Although different DAA regimens had different RVR rates, they all had a SVR12 rate of 100%. The patients with compensated liver cirrhosis and other diseases had a SVR12 rate of 100%. Conclusion Intravenous drug addiction is the main route of infection for patients with genotype 6 CHC in Guangxi, and CHC is more common in men, with genotype 6a as the main subtype. DAA treatment has a higher virologic response rate than interferon treatment, with an SVR12 rate of 100%. There is no significant difference in SVR12 rate between the patients with compensated liver cirrhosis and those without liver cirrhosis.

Objective:To evaluate the safety and efficacy of dual stent-assisted coil embolization in intracranial ruptured vertebral artery dissecting aneurysms (VADAs).Methods:Seventeen patients with intracranial ruptured VADAs (17 aneurysms), treated with dual stent-assisted coil embolization in our hospital from September 2015 to March 2020, were recruited. DSA was performed immediately after surgery to evaluate the embolization degrees of VADAs. At the end of follow-up, modified Rankin scale (mRS) was used to evaluate the prognoses of these patients, and DSA was used to determine the healing status of aneurysms.Results:The postoperative immediate DSA showed that total occlusion was achieved in 6 patients (35.3%), subtotal occlusion in 8 (47.1%) and partial occlusion in 3 (17.6%). Two patients died during the perioperative period and 2 patients presented symptoms of cranial nerve palsy after surgery. Fifteen patients were followed up for 5-24 months, 14 were with good prognosis, and one was with poor prognosis. Eleven patients underwent DSA follow-up, which showed that 8 aneurysms healed completely, 2 aneurysms were stable, and 1 aneurysm recurred.Conclusion:Dual stent-assisted coil embolization may be an effective and safe treatment method for intracranial ruptured VADAs.

Objective:To compare the similarities and differences of clinical characteristics of human immunodeficiency virus (HIV)-negative and HIV-positive patients with talaromycosis marneffei (TSM).Methods:The clinical data of 175 inpatients diagnosed with TSM in First Affiliated Hospital of Guangxi Medical University from May 2012 to April 2019 were retrospectively analyzed. The patients were divided into HIV-positive group and HIV-negative group according to the results of HIV confirmation test. The clinical manifestations, laboratory examination indicators (white blood cell count, hemoglobin, albumin, CD4 + T lymphocyte count and C-reactive protein (CRP)) between the two groups were compared. Mann-Whitney U test and chi-square test were used for statistical analysis. Results:Among 175 TSM patients, 85 were HIV-positive and 90 were HIV-negative patients. The main clinical manifestations of fever and lymphadenopathy in the HIV-positive group and HIV-negative group were 71 (83.53%) cases and 73 (81.11%) cases, 50 (58.82%) cases and 47 (52.22%) cases, respectively, and there were both no statistical differences ( χ2=0.175 and 0.771, respectively, both P>0.05), while respiratory symptoms, weight loss and subcutaneous masses were 62 (72.94%) cases and 81 (90.00%) cases, 73 (85.88%) cases and 56 (62.22%) cases, one (1.18%) case and 16 (17.78%) cases, respectively, the differences were all statistically significant ( χ2=8.514, 12.630 and 13.737, respectively, all P<0.01). Hemoglobin in HIV-positive group and HIV-negative group were 90.50 (77.00, 113.95) g/L and 88.65 (72.85, 99.93) g/L, respectively. The difference was statistically significant ( Z=2.023, P=0.043). The ratios of albumin<30 g/L, CRP>10 mg/L in the two groups were 69.41%(59/85) and 60.00%(54/90), 94.37%(67/71) and 94.19%(81/86), respectively, and the differences were both not statistically significant ( χ2=1.693 and 0, respectively, both P>0.05). The ratios of cases with white blood cell counts >10×10 9/L and CD4 + T lymphocyte count<50/μL in the positive and negative groups were 3.53%(3/85) and 81.11%(73/90), 80.77%(63/78) and 1.75%(1/57), respectively, the differences were both statistically significant ( χ2=107.095 and 82.467, respectively, both P<0.01). Conclusions:In TSM patients, HIV-negative with subcutaneous masses, and increased white blood cell counts are common. Decreased body weight and CD4 + T lymphocyte count<50/μL in HIV-positive patients are more common than HIV-negative patients.

Objective:To investigate the current status of emotional labor of nurses in standardized training period, and to analyze the relationship between emotional labor and emotional intelligence.Methods:From May to June 2020, 312 nurses in the standardized training period were selected as the research objects, which were investigated with general information questionnaire, Emotional Labor Scale and Emotional Intelligence Scale.Results:The total score of standardized training nurses' emotional labor was (52.27±10.18) points, and the total average score of items was (3.73±0.73) points. The average scores of the three dimensions from high to low: deep acting (4.62±0.86) points, expression of genuine emotion (3.62±0.99) points and surface acting (3.42±0.95) points. There was a correlation between emotional intelligence and emotional labor. Multiple linear regression analysis showed that the emotional evaluation of others ( β value was -0.189, P<0.05) ( β value was -0.255, P<0.01). Self emotional assessment ( β value was 0.297, P<0.01) ( β value was 0.177, P<0.05). Self emotional assessment ( β value was 0.269, P<0.05), which had a positive predictive effect on emotional expression requirements. Conclusions:The emotional labor of nurses in standardized training period is at the medium level, and the deep acting score is the highest between three dimensions. Hospital managers could promote nurses to use appropriate emotional labor strategies by strengthening the cultivation of emotional intelligence during standardized training period.

Objective:To explore the mediating role of occupational benefit in the emotional intelligence and emotional labor of nurses during the standardized training period, so as to provide references for enhancing the professional adaptation potential of nurses during the standardized training period.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 318 standardized training nurses from the Fifth Affiliated Hospital of Sun Yat-sen University and the First Affiliated Hospital of Nanchang University were selected as research objects from May to June 2020. They were investigated by general data questionnaire, Emotional Intelligence Scale, Occupational Benefit Scale and Emotional Labor Scale. Structural equation model (SEM) was used to explore the mediating effect of occupational benefit on emotional intelligence and emotional labor.Results:A total of 318 questionnaires were collected in this study, among which 312 were valid. The mean scores of items of emotional intelligence and occupational benefits of 312 nurses were (3.69±0.52) and (3.97±0.54) , respectively. The average scores of the three dimensions of emotional labor were surface acting (3.42±0.95) , emotional expression requirements (3.62±0.99) and deep acting (4.62±0.86) . There were correlations between emotional intelligence, occupational benefit and emotional labor (all P<0.05) . The structural equation model showed that the emotional intelligence and occupational benefit of nurses in the standardized training period had direct predictive effects on emotional labor, and emotional intelligence also indirectly affected emotional labor with occupational benefit as an intermediary variable. The structural equation fitting index χ 2/ df was 1.731, the goodness of fit index was 0.949, the adjusted goodness of fit index was 0.912 and the root mean square error of approximation was 0.058. Conclusions:Occupational benefit has a partial mediating effect between the emotional intelligence and emotional labor of nurses during the standardized training period. Nursing managers can take effective measures to improve the emotional intelligence level of nurses during the standardized training period, enhance the sense of occupational benefit and optimize their emotional labor performance from individual factors.

OBJECTIVE: To explore the relationship between adversity quotient and professional values in standardized-trained nurses. METHODS: OBJECTIVE: sampling method was adopted, 502 nurses who received standardized training from third class A hospitals were selected as research subjects. Questionnaire survey was carried out by Adversity Quotient Scale and Weis Nurses Professional Values Scale-Revised to calculate standardized scores of adversity quotient and professional values. RESULTS: The standardized scores of adversity quotient and professional values in the standardized-trained nurses were(3.2±0.4) and(3.8±0.6). The standardized scores of professional values, care provision, activism, responsibility, freedom and safety, and trust in standardized-trained nurses were positively correlated with the standardized score of adversity quotient(correlation coefficients were 0.192, 0.160, 0.179, 0.227, 0.166, P<0.01). Multiple linear regression analysis results showed that the higher the score of freedom and safety in standardized-trained nurses, the higher the level of adversity quotient(P<0.01). The level of adversity quotient of those who are satisfied with their position was higher than those who are indifferent to their position(P<0.01). CONCLUSION: The adversity quotient of standardized-trained nurses is positively correlated with their professional values. The level of adversity quotient of standardized-trained nurses can be improved by cultivating good professional values to stabilize the clinical nursing team.

Objective To investigate the expression and clinical significance of CD28 and CD160 in patients with chronic HIV infection.Methods 50 patients with HIV from January 2016 to January 2017 were selected as the observation group, and 50 healthy volunteers were recruited as control group.Observe and record general information of all participants, the expression of CD28, CD160 in CD4+and CD8+T cells, initial T cells (TN), the expression of CD160 in central memory T cells (TCM), effector memory T cells (TEM), end effector memory T cells (TEMRA), mean fluorescence intensity (MFI), viral load of two kinds of the cells, analyze the correlation between the expression level of CD28 and CD160 and CD4+T cell count and viral load.Results With the increase of CD160 expression of CD4+T cells, CD4+T cells showed a downward trend, there is a negative correlation between them (r=-0.561, P＜0.05), CD8+T cell number is on the rise, there is a positive correlation between them (r=0.619, P＜0.05), and HIV-RNA copy number increased with the increase of CD160 expression on CD4+T cells and CD8+T cells, both positive (r=0.684, P＜0.05, r=0.459, P＜0.05);with the increase of CD28 cells on the expression of CD4+T, CD4+, CD8+T cells showed a rising trend, there is a positive correlation between them (r=0.621, P＜0.05, r=0.527, P＜0.05, HIV-RNA) and the copy number decreased with the increase of the expression of CD28 and CD4+T on CD8+T cells, there is a negative correlation between them (r=-0.634, P＜0.05, r=-0.582, P＜0.05).There was no significant difference in the positive rate of expression in TEMRA subgroup and MFI of CD160 in CD8+T cell in two groups (P＞0.05).The positive rate and MFI of CD8+T cell CD160 in TN, TCM and TEM subgroups in observation group were significantly higher than those in control group (Tcm), with statistical significance.Conclusion The expression of CD28 in patients with chronic HIV infection is decreased, and the expression of CD160 is increased, which may be related to the decrease of HIV CD4+T and CD8+T cells, in which CD160 mainly affects the memory CD8+T.

Objective? To explore the risk factors of incontinence-associated dermatitis(IAD) in intensive care uni(t ICU) patients, so as to provide evidence for early clinical prevention of IAD. Methods? The relevant literature about IAD in ICU patients were retrieved from multiple electronic databases including Cochrane library, PubMed, Ovid Medline, Web of Science, CBM, CNKI, Wanfang Data and VIP from buiding database to November 2018. The Meta-analysis was performed after searching databases, extracting data and assessing quality of included studies using the software of RevMan 5.3. Results? Finally, 14 articles were included with totally 691 case groups, and 1 377 cases in the control group with 2 068 subjects, the incidence of IAD was 20.00%-50.00%. The results of Meta-analysis indicated that feve[r OR=1.79, 95%CI (1.43-2.26), P＜0.05], diabetes[OR=2.73, 95%C(I 1.77-4.21), P＜0.05], the use of antibiotics[OR=2.45, 95%C(I 1.71-3.53), P＜ 0.05], level of albumin[OR=-3.81, 95%C(I -4.61- -3.00), P＜ 0.05], Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ) score[OR=1.70, 95%C(I 0.06-3.33), P＜0.05], fecal incontinence[OR=1.80, 95%C(I 1.07-3.03), P＜ 0.05], incontinence frequency (＞ 3 times/day) [OR=1.86, 95%CI(1.56-2.22), P＜ 0.05]and watery stoo[l OR=2.22, 95%CI(1.81-2.73), P＜0.05]significantly associated with the onset of IAD. Through the sensitivity analysis of the combined effect of the fixed effect model and the random effect model, it was found that the combined effect values were close, indicating that the analysis results were robust and credible. Conclusions? According to the present evidence, the risk factors of IAD in ICU patients are fever, diabetes, antibiotics, low albumin level, high APACHE score, fecal incontinence, incontinence frequency (＞ 3 times/day) and watery stool. Medical staff should pay attention to these risk factors in clinical practice, and actively implement targeted preventive measures to reduce the incidence of IAD in ICU patients and improve the quality of nursing practice.