Objective:To investigate the current status and influencing factors of ICU nurses' perception of risks and benefits of family presence during resuscitation, and to provide scientific evidence for the formulation of relevant policies in medical institutions.Methods:A convenience sampling method was used to recruit 370 ICU nurses from four Class Ⅲ Grade A hospitals in Taizhou between October and December 2024. A general information questionnaire, the Chinese version of the Family Presence Risk-Benefit Scale (FPR-BS), and the Chinese version of the Family Presence Self-Confidence Scale (FPS-CS) were used. Hierarchical multiple linear regression was applied to explore the influencing factors of ICU nurses' perception of risks and benefits of family presence during resuscitation.Results:A total of 370 questionnaires were distributed, and 357 valid questionnaires were collected, with a valid response rate of 96.49%. The total score of the Chinese version of FPR-BS among 357 ICU nurses was (50.25±10.54), and the total score of the Chinese version of FPS-CS was (40.36±8.19). Hierarchical multiple linear regression analysis showed that gender, age, years of work experience, educational level, number of times participating in resuscitation, and self-confidence regarding family presence during resuscitation were influencing factors of risk-benefit perception ( P<0.05) . Conclusions:ICU nurses' perception of the risks and benefits of family presence during resuscitation was at a relatively low to moderate level. Self-confidence regarding family presence during resuscitation was correlated with risk-benefit perception. When implementing policies on family presence during resuscitation, medical institutions should first improve nurses' self-confidence in this regard and provide targeted support.

Objective:To observe the effect of high-intensity interval training (HIIT) on diabetic rats with non-alcoholic fatty liver disease (NAFLD), and to explore the role of miR-122 in it.Methods:Forty Wistar rats were randomly divided into a healthy control group, a sedentary group, a high-intensity interval training (HIIT) group and a moderate-intensity continuous training (MICT) group using a random number table. All except the healthy control group had type 2 diabetes with NAFLD induced using a high-fat and high-fructose diet. The healthy control and sedentary groups were kept quiet in their cages, while the HIIT and MICT groups performed treadmill exercise of the corresponding intensity for 8 consecutive weeks. At 48h after the last training, plasma was collected to measure biochemical markers, and the livers were resected for histological observation using hematoxylin and eosin staining. miR-122 expression was measured using real-time fluorescent quantitative polymerase chain reactions, while the protein expressions of fatty acid synthase (FAS), acetyl-CoA carboxylase (ACC), sterol regulatory element binding protein-1c (SREBP1c) and peroxisome proliferator-activated receptor γ (PPARγ) were detected using western blotting.Results:Compared with the healthy control group, the average fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), insulin and insulin resistance index (HOMA-IR) had increased significantly in the sedentary group. Compared with the sedentary group, the average FBG, TG, TC, insulin and HOMA-IR had decreased significantly in both the HIIT and MICT groups, and the average ALT and AST in the HIIT group had also decreased significantly. The average TG, TC, ALT and AST levels in the HIIT group were then significantly lower than in the MICT group. Compared with the sedentary group, the average liver steatosis score had decreased significantly in both the HIIT and MICT groups, with that of the HIIT group significantly lower than in the MICT group, on average. Compared with the healthy control group, the expression of miR-122 had decreased significantly, but that of SREBP1c, PPARγ, FAS and ACC had increased significantly in the sedentary group. And compared with the sedentary group, the expression of miR-122 had increased significantly in both the HIIT and MICT groups, on average, but that of SREBP1c, PPARγ, FAS and ACC had decreased significantly. Average miR-122 levels in the HIIT group were then significantly higher, and those of SREBP1c, PPARγ, FAS and ACC were significantly lower than in the MICT group.Conclusions:Either MICT or HIIT training can relieve NAFLD in rats modeling diabetes, but HIIT has a better therapeutic effect. Its therapeutic mechanism may be related to the upregulation of miR-122 in the liver.

Objective:To detect pathogenic gene mutations in a patient with CARD14-associated papulosquamous eruption (CAPE) and his family, and to evaluate the short-term and long-term efficacy and safety of ustekinumab treatment.Methods:Clinical data were collected from a 6-year-old child presenting with erythroderma secondary to pityriasis rubra pilaris and from his family members. Peripheral blood samples were collected from the patient, his parents and younger brother, and DNA was extracted from these peripheral blood samples. A next-generation skin-targeted sequencing panel was used to detect gene mutations, and Sanger sequencing was performed for verification. Genomic DNA was also extracted from 100 unrelated healthy controls using the same method.Results:A heterozygous mutation c.349+1G>A in intron 6 of the CARD14 gene was identified in the proband and his mother, but was not identified in his father, younger brother or 100 healthy controls, leading to a diagnosis of CAPE in the proband. The patient received subcutaneous injections of ustekinumab at a dose of 45 mg at weeks 0 and 4, and every 12 weeks thereafter. After 1-week treatment, the skin lesions and symptoms improved markedly. No adverse events were reported during the 18-month treatment and follow-up.Conclusion:The heterozygous mutation c.349+1G>A in the CARD14 gene may be the cause of the disease in this family, and ustekinumab was effective and safe for the treatment of CAPE.

Objective:To detect pathogenic gene mutations in a patient with CARD14-associated papulosquamous eruption (CAPE) and his family, and to evaluate the short-term and long-term efficacy and safety of ustekinumab treatment.Methods:Clinical data were collected from a 6-year-old child presenting with erythroderma secondary to pityriasis rubra pilaris and from his family members. Peripheral blood samples were collected from the patient, his parents and younger brother, and DNA was extracted from these peripheral blood samples. A next-generation skin-targeted sequencing panel was used to detect gene mutations, and Sanger sequencing was performed for verification. Genomic DNA was also extracted from 100 unrelated healthy controls using the same method.Results:A heterozygous mutation c.349+1G>A in intron 6 of the CARD14 gene was identified in the proband and his mother, but was not identified in his father, younger brother or 100 healthy controls, leading to a diagnosis of CAPE in the proband. The patient received subcutaneous injections of ustekinumab at a dose of 45 mg at weeks 0 and 4, and every 12 weeks thereafter. After 1-week treatment, the skin lesions and symptoms improved markedly. No adverse events were reported during the 18-month treatment and follow-up.Conclusion:The heterozygous mutation c.349+1G>A in the CARD14 gene may be the cause of the disease in this family, and ustekinumab was effective and safe for the treatment of CAPE.

Objective:To observe the effect of high-intensity interval training (HIIT) on diabetic rats with non-alcoholic fatty liver disease (NAFLD), and to explore the role of miR-122 in it.Methods:Forty Wistar rats were randomly divided into a healthy control group, a sedentary group, a high-intensity interval training (HIIT) group and a moderate-intensity continuous training (MICT) group using a random number table. All except the healthy control group had type 2 diabetes with NAFLD induced using a high-fat and high-fructose diet. The healthy control and sedentary groups were kept quiet in their cages, while the HIIT and MICT groups performed treadmill exercise of the corresponding intensity for 8 consecutive weeks. At 48h after the last training, plasma was collected to measure biochemical markers, and the livers were resected for histological observation using hematoxylin and eosin staining. miR-122 expression was measured using real-time fluorescent quantitative polymerase chain reactions, while the protein expressions of fatty acid synthase (FAS), acetyl-CoA carboxylase (ACC), sterol regulatory element binding protein-1c (SREBP1c) and peroxisome proliferator-activated receptor γ (PPARγ) were detected using western blotting.Results:Compared with the healthy control group, the average fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), insulin and insulin resistance index (HOMA-IR) had increased significantly in the sedentary group. Compared with the sedentary group, the average FBG, TG, TC, insulin and HOMA-IR had decreased significantly in both the HIIT and MICT groups, and the average ALT and AST in the HIIT group had also decreased significantly. The average TG, TC, ALT and AST levels in the HIIT group were then significantly lower than in the MICT group. Compared with the sedentary group, the average liver steatosis score had decreased significantly in both the HIIT and MICT groups, with that of the HIIT group significantly lower than in the MICT group, on average. Compared with the healthy control group, the expression of miR-122 had decreased significantly, but that of SREBP1c, PPARγ, FAS and ACC had increased significantly in the sedentary group. And compared with the sedentary group, the expression of miR-122 had increased significantly in both the HIIT and MICT groups, on average, but that of SREBP1c, PPARγ, FAS and ACC had decreased significantly. Average miR-122 levels in the HIIT group were then significantly higher, and those of SREBP1c, PPARγ, FAS and ACC were significantly lower than in the MICT group.Conclusions:Either MICT or HIIT training can relieve NAFLD in rats modeling diabetes, but HIIT has a better therapeutic effect. Its therapeutic mechanism may be related to the upregulation of miR-122 in the liver.

Objective:To investigate the current status and influencing factors of ICU nurses' perception of risks and benefits of family presence during resuscitation, and to provide scientific evidence for the formulation of relevant policies in medical institutions.Methods:A convenience sampling method was used to recruit 370 ICU nurses from four Class Ⅲ Grade A hospitals in Taizhou between October and December 2024. A general information questionnaire, the Chinese version of the Family Presence Risk-Benefit Scale (FPR-BS), and the Chinese version of the Family Presence Self-Confidence Scale (FPS-CS) were used. Hierarchical multiple linear regression was applied to explore the influencing factors of ICU nurses' perception of risks and benefits of family presence during resuscitation.Results:A total of 370 questionnaires were distributed, and 357 valid questionnaires were collected, with a valid response rate of 96.49%. The total score of the Chinese version of FPR-BS among 357 ICU nurses was (50.25±10.54), and the total score of the Chinese version of FPS-CS was (40.36±8.19). Hierarchical multiple linear regression analysis showed that gender, age, years of work experience, educational level, number of times participating in resuscitation, and self-confidence regarding family presence during resuscitation were influencing factors of risk-benefit perception ( P<0.05) . Conclusions:ICU nurses' perception of the risks and benefits of family presence during resuscitation was at a relatively low to moderate level. Self-confidence regarding family presence during resuscitation was correlated with risk-benefit perception. When implementing policies on family presence during resuscitation, medical institutions should first improve nurses' self-confidence in this regard and provide targeted support.

OBJECTIVE To synthesize a polymer PEI-ss-PEG2000-DSPE containing disulfide bond and to prepare as cationic micelle(P-ss-PD) based on branched polyethyleneimine(PEI). To investigate the ability of P-ss-PD micelle to reduce cytotoxicity and improve the transfection efficiency of antisense oligonucleotide(ASO) in human breast cancer cell lines, and to study the anti-tumor effect of P-ss-PD micelle in nude mice. METHODS PEI-ss-PEG2000-DSPE was synthesized by grafting PEG2000-DSPE onto branched PEI with disulfide bond as a connecting arm. P-ss-PD micelle was prepared by ethanol injection method and P-ss-PD/ASO nanocomplex was obtained by combining P-ss-PD micelle with ASO. The particle size and zeta potential of P-ss-PD/ASO nanocomplex at various mass ratios were determined by laser particle size analyzer. Agarose gel retardation assay was used to investigate the binding degree of P-ss-PD/ASO nanocomplex and determine the optimal mass ratio. At the same time, the reduction responsive ability of P-ss-PD micelle was investigated. The cytotoxicity of P-ss-PD micelle was detected by CCK8 kit. The transfection efficiency of P-ss-PD micelle was investigated by flow cytometry and high content cell imaging analysis system in MDA-MB-231 cells. The anti-tumor effect of P-ss-PD micelle was investigated by tumor-bearing nude mice models. RESULTS When the mass ratio was 300∶1, the particle size of P-ss-PD/ASO nanocomplex was the smallest and had a good stability. The average particle size was (58.90 ± 4.08)nm, the average zeta potential was (16.80 ± 1.23)mV, and the morphology was uniform spherical. P-ss-PD/ASO nanocomplex had the reduction responsive ability and could release ASO under highly reductive conditions.In vitro, compared with unmodified branched PEI, the cytotoxicity of P-ss-PD micelle was significantly reduced and the transfection efficiency was significantly increased.In vivo, the tumor growth inhibition rate of P-ss-PD/ASO nanocomplex in tumor-bearing nude mice was more than 50%. CONCLUSION The P-ss-PD micelle prepared in this study is a kind of low toxicity and high transfection efficiency non-viral vector, which has the characteristics of reduction responsive releasing, and shows a promising application in ASO drug delivery.

Medical education is the cornerstone of the development of health care.In the context of advance-ments in New Medical Science,the Second Hospital of Jilin University took the reform of the school's clinical medi-cal education system as an opportunity to strengthen the teaching quality assurance capabilities,focus on improving teachers'teaching capabilities,and pay attention to the quality of student training,thus comprehensively building a new pattern of innovative development of medical education.It was also proposed that university-affiliated hospitals should focus on the overall national strategic plan for medical education development and deepen medical education reform,use artificial intelligence to lead the innovative development of medical education,and use the construction of new-era textbooks as the carrier of medical education innovation to promote deeper reforms in medical education.

Objective:To clarify the medical security plan and its practical effects at the main venue of the 19th Hangzhou Asian Games.Methods:The plan described the medical security implementation plan of the main venue of the 19th Asian Games in Hangzhou (organizational management and operation mechanism, medical security operation system, standardized training and support processes, application of Asian Games intelligent first aid security system, and so on). And through high-facticity simulation verify the operation effect of the main venue's medical support (team mode and response time). Finally, the feasibility and effectiveness of the medical security program verified through the effect of medical services (quantity, disease types, transfers, etc.) during the Asian Games and Asian Paralympic Games.Results:The medical security team of the main venue of the 19th Hangzhou Asian Games included the management team and the operation team, of which consisted of 44 medical staffs (22 doctors and 22 nurses); and were deployed to 16 different security positions. It was also accompanied with 16 volunteers to assist medical staff to transport patients. In addition, a total of 300 medical observers were enrolled in audience area to assist rapid identification, intervention, and collaborative diagnosis and treatment with the medical team. Medical security teams were arranged to cover all the audience areas who can arrive at the patient's area within 2 minutes after receiving orders, transfer the patient to the ambulance’s site in 8 minutes, and transport the patient to a designated hospital within 10-20 minutes. During the Asian Games and Asian Paralympic Games, the medical-care team treated a total of 3 742 patients, including 9 patients transported from medical service sites of the audience area to the stadium infirmary, as well as 83 patients referred to the designated hospital.Conclusions:The medical security implementation plan for the main venues of the Asian Games provides good medical security for the Asian Games and Asian Paralympic Games. It also provides theoretical and practical experience for the development of the medical security system for international events in future.

Medical education is the cornerstone of the development of health care.In the context of advance-ments in New Medical Science,the Second Hospital of Jilin University took the reform of the school's clinical medi-cal education system as an opportunity to strengthen the teaching quality assurance capabilities,focus on improving teachers'teaching capabilities,and pay attention to the quality of student training,thus comprehensively building a new pattern of innovative development of medical education.It was also proposed that university-affiliated hospitals should focus on the overall national strategic plan for medical education development and deepen medical education reform,use artificial intelligence to lead the innovative development of medical education,and use the construction of new-era textbooks as the carrier of medical education innovation to promote deeper reforms in medical education.