Objective:To construct a competency evaluation indicator system for infection prevention and control nurses in Operating Rooms (hereinafter referred to as "IPC") and provide an objective basis for the management of IPC nurses.Methods:From June to November 2022, an initial competency evaluation indicator system for IPC nurses was developed through literature review and semi-structured interviews. The Delphi method was employed to consult 20 experts from 11 provinces and municipalities across the country. Analytical Hierarchy Process (AHP) and mean distribution method were applied to quantify and determine the weight of each level of indicators within the system.Results:Nineteen experts were finally included, with two rounds of questionnaire recovery rates of 95.00% (19/20) and 100.00% (19/19), respectively. The authority coefficients of the experts were 0.858 and 0.861, familiarity coefficients were 0.850 and 0.853, and coefficients of judgment basis were 0.865 and 0.868, respectively. The Kendall's W coefficient of concordance for the two rounds of inquiries were 0.139 and 0.202 ( P<0.05), respectively. The final IPC nurse competency evaluation indicator system included six primary indicators, 22 secondary indicators, and 66 tertiary indicators. Conclusions:The constructed IPC nurse competency evaluation indicator system is scientific, reasonable, objective, and comprehensive, providing a valuable reference for the capability training, assessment, entry standards, and qualification certification of IPC nurses.

Objective:To understand the real feelings and needs of postgraduate nursing students during standardized training, and provide a reference for managers to formulate more complete standardized training programs in the future.Methods:Using the phenomenological research method, totally 12 postgraduate nursing students of the First Affiliated Hospital of Zhengzhou University who had completed the two-year standardized training were selected by purposive sampling and received semi-structured interviews from August to October 2018, and the Colaizzi 7-step method was used to organize and analyze the data.Results:A total of 5 themes were extracted, namely, increased self-efficacy and improved core competence, negative psychological experience, demand for policy guarantees for scientific research, demand for personalized training programs and high-standard teaching staff, and demand for the promotion system and salary.Conclusions:The recognition of various aspects is dominant in postgraduate nursing students, but they have also many negative emotions and unmet needs. Managers should pay attention to their feelings and needs, and properly formulate suitable training programs, thereby giving full play to the advantages of standardized training.

Objective To summarize the clinical data of macrophage activation syndrome (MAS) in adult-onset Still's disease (AOSD) patients and provide evidence for clinical diagnosis and treatment. Methods We retrospectively reviewed the clinical data of AOSD with MAS patients in the First Affiliated Hospital of Zhengzhou University from January 2012 to August 2018, and compared with patients with AOSD alone. Data were analyzed by t-test, Mann-Whitney U test, x2 test or Fisher exact test. Results A total of 14 AOSD with MAS patients were enrolled, accounting for 7.6％(14/185) of AOSD patients at the same period, including 2 males and 12 females. The median duration of AOSD in MAS was 1.3 (0.25, 4) months. Compared with the AOSD group, the age of onset was younger in the MAS group (t=-2.038, P=0.037), and the proportion of splenomegaly (t=9.020, P=0.003), pericardial effusion (t=8.663, P=0.003), pleural effusion (t=4.754, P=0.029) was higher. The white blood cell count (t=-4.171, P<0.01), hemoglobin level (t=-2.661, P=0.008), platelet count (t=-5.672, P<0.01), neutrophil count (t=-5.082, P<0.01), albumin (t=-3.426, P<0.01), fibrinogen (t=-5.986, P<0.01), ESR (t=-2.941, P=0.003), CRP (t=-2.014, P=0.044) was significantly decreased, ALT (t=-3.227, P<0.01), AST (t=-3.105, P=0.002), triglyceride (t=-5.612, P<0.01), ferritin>2000 μg/L (t=7.833, P=0.005) was significantly increased. Fourteen patients with AOSD complicated with MAS were treated with glucocorticosteroids, 5 with methylprednisolone, 8 with cyclosporine A, 8 with intravenous immunoglobulin (IVIG), 2 with etoposide, and 1 with tocilizumab. After treatment, 11 cases recovered and 3 cases died. Conclusion Younger AOSD patients tend to complicated with MAS, especially at the early course of the disease, and splenomegaly occur more frequently clinically compared to patients without MAS. When blood cell count, fibrinogen and ESR decreases, triglyceride and ferritin levels increases in AOSD patients, the occurrence of MAS is indicated. Timely treatment can improve the prognosis of patients.

Objective: To study the effect of LncRNA CRNDE on radiosensitivity of colorectal cells and underlying mechanism. Methods: Colorectal cancer HT-29 cells were transfected with CRNDE shRNA and the interference efficiency was determined by Real time PCR. HT-29 cells transfected with CRNDE shRNA or co-transfected with CRNDE shRNA and miR-384 inhibitor were irradiated at 8 Gy dose, then cell proliferation and apoptosis were detected by MTT and flow cytometry assay, respectively, and cell radiosensitivity was evaluated by cloning assay. It was predicted by a bioinformatics software that CRNDE and miR-384 have complementary binding sites, and this was identified by a luciferase reporting system. Results: CRNDE shRNA reduced the expression of CRNDE in HT-29 cells(1.00±0.08 vs. 0.42±0.06, t=10.051, P<0.05). Both CRNDE shRNA and radiation inhibited the proliferation and induced apoptosis of HT-29 cells, and their combination treatment had synergistic effect in apoptosis induction [Apoptosis rates: (2.27±0.13)%, (23.58±2.35)%, (26.91±2.81)%, (36.84±3.24)%, F=24.660, P<0.05; A values: 0.45±0.06, 0.30±0.02, 0.28±0.03, 0.20±0.02, F=106.207, P<0.05]. Transfection of CRNDE shRNA increased the radiosensitivity of HT-29 cells with a radiosensitization ratio of 1.374. CRNDE negatively regulated the expression of its target miR-384. The miR-384 inhibitor antagonized the effect of CRNDE shRNA on proliferation inhibition and apoptosis promotion of radiation-treated colorectal cancer cells. Conclusions Down-regulation of LncRNA expression enhances the radiosensitivity of colorectal cancer cells by regulating miR-384 expression.

Objective? To explore the effects of health failure mode and effect analysis(HFMEA) in the safety management of intraoperative radiotherapy(IORT). Methods? The HFMEA group was set up to analyze the potential risks of breast cancer patients undergoing intraoperative radiotherapy from January 2014 to April 2018. The group listed the failed modes that need to be improved, identified the invalid steps that need intervention, determined the causes of the failure and calculated the risk priority number (RPN), created the safety management plans and put them into action. Finally, the outcomes were observed and analyzed. Results? After the improvement of the HFMEA, the patients' healing rate of stage-Ⅰ incision increased from 85.42% to 98.18% with statistical significance (χ2=4.184,P＜0.05). The patients' satisfaction degree scored (98.21±3.98)from the patients and (99.02±5.89)from the surgeons, both higher than those before improvement with statistical significance (t=5.24, 3.07;P＜0.05). After the improvement, the absorbed and scattered dose of the affected and contralateral skin of thyroid gland, and the absorbed and scattered dose of the affected and contralateral skin of lens were lower than those before improvement. Conclusions? Through prospectively controlling non-standard operation behaviors and optimizing the process, the application of HFMEA in the intraoperative irradiation after conservative surgery for breast cancer can ensure patients' safety and improve the quality of surgeries.

Aim DPF2 has been reported to be involved in pathogenesis of leukaemia and oncogenic activity.However,the role of DPF2 in oncogenesis and pathogenesis of pancreatic cancer remains unclear.Therefore,the present research aims to investigate the effects of DPF2-RNAi on proliferation,apoptosis and cell cycle regulation of a pancreatic cell line,PANC-1 cells.Methods The lentivirus-mediated DPF2-RNAi was employed to knockdown DPF2 expression in PANC-1 cells,and the role of DPF2-RNAi in proliferation,apoptosis and cell cycle regulation of the PANC-1 cells was examined through MTT assay,colony formation assay and flowcytometry assay.Results The lentivirus-mediated DPF2-RNAi middle and high doses(2 μL and 4 μL)significantly decreased the expression of DPF2 in the PANC-1 cells.DPF2-RNAi decreased cell viability and colony formation,and increased apoptosis of the PANC-1 cells.Besides,DPF2-RNAi induced the S-phase arrest and decreased G2/M phase population of the PANC-1 cells.Conclusions DPF2 may play a crucial role in proliferation,apoptosis and cell cycle regulation of PANC-1 cells.Knockdown of DPF2 through lentivirus-mediated DPF2-RNAi may provide experimental basis for finding a new method for therapy of pancreatic cancer.

Objective To explore the effects of modified herringbone-Trendelenburg position during gynecological laparoscopic operation of the elderly. Methods A total of 60 elderly patients undergoing gynecological laparoscopic operation under general anesthesia were recruited and assigned to the observation group (30 cases) and control group (30 cases) by random digits table method with 30 cases each according to admitting time;Patients in the control group were placed in conventional Trendelenburg position, while the patients in the observation group were positioned in modified herringbone-Trendelenburg position .Intraocular pressure (IOP) were measured in the patients at anesthesia induction (T1),5 minutes after general anesthesia in supine position (T2) , and 5 minutes after pneumoperitoneum while in the operation position (T3) , every 30 minutes (times 4 to 11), while supine at the end of pneumoperitoneum (time 12) and before awakening (time 13);Patients were followed up at 24 h and 48 h after surgery, researcher investigate and record the scores of the Operation Position Comfort Questionnaire, the situation of the pain in the shoulder and postoperative complications of the lower limbs. Results There was no statistically significant difference (t=-1.098,-0.772,-0.656, P>0.05) of the IOP at T1, T2, T13. The IOP in the observation group had statistically significant difference compared with the control group at T3 to T12 (t=6.523-19.866, P<0.01). The incidence rate of the postoperative complications of the lower limbs in the observation group was 6.7%(2/30) lower than 26.7%(8/30) of the control group (χ2=4.320, P<0.05) and the VAS scores of the patients in the two groups was statistically significant (t=2.471, P<0.05). The incidence rate of the postoperative shoulder pain in the observation group was 10.0%(3/30) lower than 43.3%(13/30) of the control group (χ2=8.523, P<0.01), and the Visual Analogue Scale scores of the patients in the two groups was statistically significant (t=3.575, P<0.05).The scores of the Operation Position Comfort Questionnaire in the observation group was higher than the control group (t=-2.319, P<0.05). Conclusions Modified herringbone- Trendelenburg position can reduce the elevation of intraocular pressure in elderly patients without affecting the operation ,and effectively improve the comfort of the operation position of the patients, reduce the incidence rate of the shoulder pain and postoperative complications of the lower limbs, is conducive to the operation safety of elderly patients.

OBJECTIVEThis study investigated the expression of BNIP3 in salivary adenoid cystic carcinoma (SACC) and its correlations to the clinicopathological features and prognosis of patients with SACC. The role of BNIP3 in the progress of hypoxia-induced autophagy was elucidated.

METHODSThe expression levels of BNIP3, hypoxia inducible factor (HIF)-1α, and LC3 in 65 SACC cases were detected by immunohistochemical staining method, and the correlation between the expression of BNIP3 and the clinicopathological features in SACC was analyzed. In addition, the correlations of BNIP3 gene expression with HIF-1α and LC3 gene expression were analyzed. The survival rate of patients with SACC was evaluated by univa-riate survival analysis.

RESULTSBNIP3 was considerably expressed in SACC in all three histological patterns, and was positive in 41 cases (63.1%). BNIP3 gene expression was significantly correlated with histological grade (P=0.001) and HIF-1α gene expression (P=0.011). By contrast, BNIP3 gene expression was not significantly correlated with LC3 gene expression (P=
0.167). The overall survival rate of patients with negative BNIP3 expression was better than that of patients with positive BNIP3 expression (P<0.05).

CONCLUSIONSBNIP3 might play a vital role in the tumorigenesis of SACC and may be a new target for gene therapy.
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Objective To evaluate the effects of peer-assisted learning (PAL) combined with peer feedback in the teaching of operating room nursing. Methods 80 undergraduate nursing students in grade 2012 were assigned to the experimental group (n=40) and control group (n=40) by random number table method. The content of this training is operating room nursing skills. Nursing students in the experimental group received peer-assisted learning combined with peer feedback teaching,while nursing students in the control group received conventional teaching. Results The students′examination scores of the experimental group was (92.25 ± 3.43) obviously higher than that of the control group (89.20 ± 3.55) U=609.500, (P < 0.05), the students' evaluation of the new teaching method was higher than that of the control group (t=-2.76--2.27, P<0.05 or 0.01). Conclusions Peer-assisted learning combined with peer feedback can improve the operational capability of the students in operating room, is helpful to stimulate students′subjective initiative and improve the teaching quality of nursing.

Objective To explore the effect of training course based on the model of practical performance which was designed to improve the humanistic caring ability of nursing postgraduates. Methods After conceived, designed and trained the nursing postgraduates, we combined quantitative research method and qualitative research method to understand the effect and the true feelings of the students after taking the training. Results “Humanistic Caring Ability of Nursing Undergraduates Assessment scale (HCANU)“was used before and after 22 nursing postgraduates accepted the training. After training, their total score (86.06±5.16) was higher than before (67.70±5.00) (t=2.665, P<0.01) and 8 dimensions scores were respectively higher than before(P<0.01 or 0.05). The course has improved the humanistic caring ability of nursing postgraduates, enhanced their empathy of nursing objects and promote self-reflection. Conclusions This training course based on the model of practical performance helps to improve the humanistic caring ability of nursing postgraduates and cultivate their humantistic quality.