Objective To explore the applicability and optimal cut-off of the revised Cubbin & Jackson scale in the diagnosis of pressure injury in ICU patients in China.Methods From April 2021 to October 2022,6 203 ICU patients from 35 tertiary hospitals in Gansu Province were included in the study by convenience sampling method.The standardized trained ICU nurses examined the skin and collected relevant data,determined whether or not there was pressure injury and its stage,and simultaneously used the revised Cubbin & Jackson scale for pressure injury risk assessment.The software was used to statistically analyze the area under the receive operating characteristic curve(AUC),Yoden index,sensitivity,specificity and other indexes of the revised Cubbin & Jackson scale in the diagnosis of pressure injury in ICU patients.Results A total of 79 cases of pressure injury occurred during hospitalization in 6 203 ICU patients,with an incidence of 1.27％.Hierarchical analysis showed that the AUC of the revised Cubbin & Jackson scale in the prediction and diagnosis of pressure injury ranged from 0.74 to 0.92 in ICU patients with different sex,age,length of ICU stay,whether or not mechanically ventilated,and whether or not surgical.The Yoden index,sensitivity and specificity were 0.40-0.74,77.27％-94.44％and 62.44％-82.63％,respectively.When the total score was ≤28 points,the revised Cubbin & Jackson scale obtained the highest AUC(0.86),and the Yoden index,sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,and negative likelihood ratio were 0.60,92.41％,67.26％,3.50％,99.86％,2.82 and 0.11,respectively.Conclusion The revised Cubbin & Jackson scale can be used as a suitable tool to effectively predict and diagnose pressure injury in ICU patients in China,and the optimal cut-off of ≤28 points is appropriate.

Animals ; SARS-CoV-2 ; Antibodies, Neutralizing ; Macaca mulatta ; COVID-19/prevention & control* ; Antibodies, Viral ; Vaccines

ObjectiveTo investigate the mental health status of the front-line anti-epidemic medical staff during the COVID-19 outbreak， so as to provide references for the targeted psychological intervention and improvement of mental health status. MethodsA total of 162 front-line medical staff who worked in Lanzhou Heavy Particles Hospital of Gansu Province from October to December 2021 were were enrolled， and assessed using self-designed general information questionnaire， Self-rating Anxiety Scale （SAS） and Self-rating Depression Scale （SDS）. ResultsA total of 144 medical staff completed the valid questionnaire survey， and 17 （11.81%） and 19 （13.19%） cases were found to have anxiety and depression， respectively. The detection rate of anxiety yielded statistical difference among medical staff with different anti-epidemic working hours （χ²=10.602， P<0.01）， and the detection rate of depression demonstrated statistical differences among medical staff with different occupations， family history of depression and anti-epidemic working hours （χ²=5.486， 4.039， 7.526， P<0.05）. ConclusionDuring the COVID-19 outbreak， front-line medical staff develop varying degrees of anxiety and depression. Furthermore， the detection rate of anxiety is relatively high among the staff with long anti-epidemic working hours， and the detection rate of depression is relatively high among the doctors， the staff with family history of depression and long anti-epidemic working hours.

Objective: To investigate the characteristics and prognostic value of peripheral blood T lymphocyte subsets in patients with severe influenza. Methods: This was a single-center cross-sectional study in influenza patients admitted to Peking Union Medical College Hospital from August 2017 to April 2018. Peripheral blood lymphocyte subsets were detected by flow cytometry in both patients and 108 healthy controls. Influenza patients were divided into mild group and severe group. Severe patients were further classified into alive and fatal subgroups. Results: A total of 42 influenza patients were recruited in this study, including 24 severe cases (6 deaths). The remaining 18 cases were mild. The peripheral blood lymphocyte counts and lymphocyte subset counts (B, NK, CD4⁺T, CD8⁺T) in either mild patients[795 (571,1 007), 43 (23,144), 70 (47,135), 330 (256,457), 226 (148,366) cells/μl respectively] or severe patients[661 (474,1 151),92 (52,139), 54 (34,134), 373 (235,555), 180 (105,310) cells/μl respectively] were both significantly lower than those of healthy controls [1 963 (1 603,2 394),179 (119,239), 356 (231,496), 663 (531,824), 481 (341,693) cells/μl respectively]. Meanwhile, the T cells and CD8⁺T counts in fatal patients [370 (260,537) cells/μl and 87 (74,105) cells/μl] were significantly lower than those in severe and alive patients [722 (390,990) cells/μl and 222 (154,404) cells/μl]. CD8⁺HLA-DR/CD8⁺and CD8⁺CD38⁺/CD8⁺T cell activating subgroups in mild cases[(53.7±19.2)% and 74.8% (64.1%,83.7%) respectively] were significantly higher than those in severe cases[(38.5±21.7)% and 53.3% (45.3%,67.2%) respectively].Moreover,CD8⁺HLA-DR/CD8⁺count in severe and alive group was higher than that in fatal group [(46.1±19.1)% vs. (18.2±14.6)%, P<0.01]. Logistic regression analysis showed that CD8⁺T cell count (OR=0.952, 95%CI 0.910-0.997, P=0.035) and CD8⁺HLA-DR/CD8⁺T (OR=0.916, 95%CI 0.850-0.987, P=0.022) were both negatively correlated with mortality.Peripheral blood lymphocyte counts in mild cases rapidly decreased within 1 day after diagnosis, and returned to the basic level one week later. Conclusions All peripheral blood lymphocyte subsets (T,B,NK) in patients with influenza are significantly reduced. These findings are consistent with the immunological characteristics of respiratory viral infections, in which peripheral lymphocytes (especially T cells) migrate to respiratory tract in the early stage and circulate to the peripheral blood after recovery. The activated CD8⁺T cell counts in peripheral blood are negatively correlated with the severity of disease, which could be considered as a prognostic indicator of severe influenza.

Objective:To explore the expression of miR-125 in nasopharyngeal carcinoma tissues and the possible regulatory mechanism of biological characteristics of tumor cells.Methods:Thirty cases of carcinoma and paracancerous tissues from patients with nasopharyngeal carcinoma admitted to Southern Hospital of Sixth People′s Hospital Affiliated to Shanghai Jiaotong University from June 2018 to June 2019 were collected. The expressions of miR-125 and fibroblast growth factor 2 (FGF-2) mRNA were detected by fluorescent quantitative PCR. Nasopharyngeal carcinoma CNE-2 cells were transfected by miR-125 mimic (miR-125 mimic group), and negative control group was set (NC group). Transwell chamber assay was used to determine cell invasion ability, scratch healing assay was used to determine cell migration ability, WST-1 assay was used to assess cell viability, flow cytometry and electron microscopy were used respectively to detect apoptosis and autophagy, dual luciferase reporter assay was used to analyze the target of miR-125, and Western blotting was used to detect the expressions of related proteins.Results:The relative expression of miR-125 mRNA in nasopharyngeal carcinoma tissues was 0.692±0.316, which was significantly lower than 1.501±0.748 in the adjacent tissues ( t=5.242, P<0.001). The relative expression of FGF-2 mRNA in nasopharyngeal carcinoma tissues was 1.317±0.552, which was significantly higher than 0.783±0.241 in the adjacent tissues ( t=7.360, P<0.001). The miR-125 mRNA expression of CNE-2 cells in the miR-125 mimic group was 4.091±0.145, which was significantly higher than 0.993±0.137 in the NC group ( t=85.062, P<0.001). The proliferative activities of CNE-2 cells in the miR-125 mimic group at 48 and 96 h after transfection were significantly lower than those in the NC group (0.891±0.214 vs. 1.295±0.245, t=6.802, P<0.001; 0.934±0.208 vs. 1.488±0.269, t=8.924, P<0.001). The number of transmembrane cells and cell migration rate of the miR-125 mimic group were 36 000±3 820 and (39.4±6.5)%, which were significantly lower than 74 000±7 500 and (102.7±10.6)% of the NC group ( t=24.728, P<0.001; t=27.883, P<0.001). The apoptosis rate of CNE-2 cells in the miR-125 mimic group was (22.5±1.4)%, which was significantly higher than that in the NC group (1.4±0.5)% ( t=77.740, P<0.001). The relative expression of the apoptotic protein Bax in the miR-125 mimic group was 0.983±0.158, which was significantly higher than that in the NC group (0.418±0.122; t=15.503, P<0.001), and the relative expression of Bcl-2 was 0.688±0.174, which was significantly lower than that of the NC group (1.013±0.109; t=8.670, P<0.001). Autophagy was observed in miR-125 overexpressing CNE-2 cells by electron microscopy, and the relative expression ratio of autophagy protein LC3Ⅱ/LC3Ⅰ in the miR-125 mimic group was 2.517±0.209, which was significantly higher than 1.238±0.135 in the NC group ( t=28.156, P<0.001). The expression of FGF-2 protein in the miR-125 mimic group was 0.504±0.118, which was significantly lower than 1.228±0.134 in the NC group ( t=22.210, P<0.001). The double luciferase report confirmed FGF-2 as the target gene of miR-125. At 12, 24, 48 and 96 h after the transfection, the cell proliferative activities of CNE-2 cells co-transfected by FGF-2 gene plasmid and miR-125 mimic were significantly higher than those of CNE-2 cells transfected by miR-125 mimic (all P<0.05), and the apoptosis rate was significantly lower than that of CNE-2 cells transfected by miR-125 mimic [(6.2±1.5)% vs. (17.6±2.4)%, t=22.062, P<0.001]. Conclusion:The expression of miR-125 is down-regulated in nasopharyngeal carcinoma tissues. Overexpression of miR-125 may inhibit the proliferation, migration and invasion of nasopharyngeal carcinoma CNE-2 cells and promote the apoptosis and autophagy of CNE-2 cells by down-regulating FGF-2 expression.

Objective To analyze the correlation between urinary albumin/creatinine ratio (ACR) and 24-hour urinary microalbumin (UMA) and evaluate the predictive value of ARC for early diabetic nephropathy.Methods A total of 368 patients with type 2 diabetes mellitus were retrospectively collected.Early diabetic nephropathy was defined as 24h UMA 30～＜300 mg/24h.The correlation between ACR and 24hUMA,and the area under the receiver operating characteristic (ROC) curve of ACR in diagnosis of early diabetic nephropathy were calculated.Gender,age,course of disease,fasting venous blood glucose,glycosylated hemoglobin,blood pressure,triglyceride and total cholesterol were used as adjusting variables to establish univariate and multivariate logistic models of ACR for early diabetic nephropathy,respectively.A regression model was used to evaluate the diagnostic value of ACR for early diabetic nephropathy.Results The correlation between ACR and 24h UMA was 0.658.The area under ROC curve of ACR for early diabetic nephropathy was 0.907 before and 0.933 after adjustments of gender,age,course of disease,fasting venous blood glucose,glycosylated hemoglobin,blood pressure,triglyceride and total cholesterol,respectively.The OR value of ACR of diabetic nephropathy was 2.016 before and 2.762 after same adjustments.The calibration of Hosmer-Lemeshow chi-square test evaluation model was 19.362 before (P=0.13) and 14.928 after adjustments (P=0.061).Conclusion ACR is a better predictor for early diabetic nephropathy although its value is influenced by gender,age,course of disease,blood sugar,lipid,and blood pressure.

Objective Type 2 diabetes increases the risk of colorectal cancer and reduces the survival rate of the patients. Therefore, analyzing the characteristics of colorectal cancer in patients with type 2 diabetes may help to develop precise medical measures and to improve the prognosis of patients. Methods The pathological characteristics of 123 colorectal cancer cases with or without type 2 diabetes were analyzed. In addition, PCR and pyrosequencing method were used to test the common gene mutation status of colorectal cancer, including KRAS( codons 12, 13, 61, and 146) , BRAF( codon 600) , and PIK3CA ( exons 9 and 20) , in order to investigate the molecular characteristics of colorectal cancer in diabetic patients which may provide some clues to clinical decision. Results The mean age and body mass index of patients with diabetes were higher than those of patients without diabetes, but there was no difference in the location, the degree of cell differentiation and the grade of colorectal cancer between these 2 groups. The rate of PIK3CA mutation in patients with type 2 diabetes mellitus, especially in patients with long term type 2 diabetes was significantly higher than that in patients without diabetes (28.6％vs 10.3％, P<0.05). There was no significant difference between the two groups in common BRAF and KRAS mutation sites. Conclusion Diabetes does not alter the clinical pathological characteristics of colorectal cancer, but long course type 2 diabetes increases PIK3CA mutation rate. Therefore, using medicine targeting PIK3CA gene mutation may help to improve the prognosis of patients.

Objective To observe the changes of serum and fecal taurine-conjugated bile acid levels and its association with glucose metabolism during the spontaneous development of type 2 diabetes in OLETO rats.Methods Twenty male OLETF rats(4 weeks old)were included and 10 male LETO rats of the same age were used as the normal control group.OLETF rats were fed with high fat diet whereas LETO rats were fed with normal diet.Serum and fecal taurine-conjugated bile acid levels of OLETF rats were tested at different stage of diabetes including baseline, normal glucose tolerance, impaired glucose tolerance and diabetes periods, and the association of taurine-conjugated bile acid level with body weight, blood glucose, and glucose-regulating hormones were also investigated.Results Compared with LETO rats, the baseline serum levels of taurine-conjugated bile acid in OLETF rats did not change, but the levels of fecal taurine-conjugated bile acid including taurine-conjugated chenodeoxycholic acid(TCDCA), taurocholic acid(TCA)and taurine-conjugated deoxycholic acid(TDCA)were significantly decreased [(14.25±7.18 vs 0.90±0.31)mg/kg,(7.12±4.14 vs 1.30±0.35)mg/kg,(4.30±1.78 vs 1.02±0.14)mg/kg, all P<0.01].During the development of diabetes, the fecal levels of TCDCA, TCA and TDCA were still lower than those in the control rats.TDCA was negatively associated with the level of fasting blood glucose(r=-0.470, P=0.032),but positively associated with the serum level of glucagon-like peptide(GLP)-l(r=0.406, P=0.044).Conclusion The decrease of intestinal taurine-conjugated bile acid level is involved in the development of diabetes in OLETF rats.Intestinal TDCA may regulate the secretion of GLP-1 by paracrine pathway.

Purpose To explore the preliminary application of spectral CT in the diagnosis of breast cancer,in order to provide more imaging supplemental information for clinical studies.Materials and Methods Twelve patients with pathologically confirmed breast cancer underwent preoperative spectral CT dual-phase contrast-enhanced scans in General Hospital of Lanzhou from May 2016 to February 2017 were retrospectively analyzed,including 6 patients with lymph node metastasis.With contralateral normal breast as the control group,the CT values at 40-140 keV,spectral curve slopes,iodine contents and relative iodine contents of breast cancer were measured in dual phase.The spectral curve,histogram,scatter plot of primary lesions and metastatic lymph nodes were drawn.In order to compare the radiation doses,12female patients undergoing dual-phase contrast-enhanced scans with traditional CT were included randomly as the control group,and the radiation dose evaluation parameters included volume CT dose index,dose-length product,effective dose.Results All the spectral parameters of breast cancer in arterial phase and venous phase were higher than those of normal breast,and the differences were statistically significant (P＜0.05).The average effective dose of spectral CT dual-phase contrast-enhanced scans was lower than that of regular CT,and the difference was statistically significant (P＜0.05).For the 6 patients with lymph node metastasis,the spectral curve,histogram and scatter plot of primary lesions and metastatic lymph nodes were in higher consistency in venous phase.Conclusion The special spectral parameters of breast cancer contribute to the further diagnosis of lesions.The consistence of spectral curve,histogram and scatter plot of primary lesions and metastatic lymph nodes is helpful for the identification of lymph nodes.Spectral CT breast dual-phase contrast-enhanced scans use lower radiation dose,which makes up for the deficiency of traditional CT in the qualitative diagnosis of breast diseases due to higher radiation dose.Therefore,spectral CT is of certain clinical application value in the diagnosis of breast cancer.

[ ABSTRACT] AIM:To investigate the effect of HOX transcript antisense RNA ( HOTAIR) on the migration and invasion abilities of liver carcinoma HepG 2 cells.METHODS:The expression of phosphoinositide-3-kinase regulatory sub-unit 3 (PIK3R3) in the liver cancer and normal liver tissues was detected by immunohistochemistry .The efficiency of gene silencing of HOTAIR or PIK3R3 by LV3-shHOTAIR or LV3-shPIK3R3 was determined by qPCR and Western blot .The mi-gration and invasion abilities of HepG 2 cells after silencing of HOTAIR and PIK3R3 were measured by wound healing assay and Transwell Matrigel invasion assay .The expression of miR-214 after silencing of HOTAIR and PIK3R3 was analyzed by qPCR.The expression of HOTAIR and PIK3R3 in the HepG2 cells was also evaluated by qPCR after transfected with miR-214 mimics or miR-214 inhibitor .Dual-luciferase reporter assay system was used to determine the regulatory effect of miR-214 on HOTAIR and PIK3R3 expression.RESULTS:PIK3R3 expression increased significantly in the liver cancer tissues compared with normal liver tissues .The abilities of invasion and metastasis of hepatocellular carcinoma were reduced after silencing of HOTAIR and PIK3R3.miR-214 expression was increased when silencing of HOTAIR and PIK3R3 was per-formed.HOTAIR and PIK3R3 expression was reduced after transfection with miR-214 mimics.HOTAIR and PIK3R3 ex-pression was increased after transfection with miR-214 inhibitor.The results of dual-luciferase reporter assay test showed that miR-214 directly regulated HOTAIR and PIK3R3 transcription activity .CONCLUSION: HOTAIR regulates the ex-pression of PIK3R3 through miR-214, thus promoting the migration and invasion abilities in the liver cancer cells .