OBJECTIVE To establish a interview outline design process and quality control evaluation method based on grounded theory， providing ideas for qualitative research interview outline design in medical fields. METHODS A literature review was conducted to understand the current research status； a preliminary interview outline was developed around the research content. The triangulation method， group evaluation， expert review and pre-interview were adopted to execute the interview outline and conduct quality control. The evaluation indicators and target values were formulated （an average score for the overall quality evaluation of all indicators ≥4.5， and an average score for individual indicators ≥4.00） to evaluate the effect of the interview outline. Taking the research on the mechanism of physicians’ prescribing behavior under the background of Diagnosis Related Groups （DRGs） payment as an example， the methodological contents of above interview outline were applied in practical research. RESULTS The interview outline included basic information and interview questions. The interview questions were divided into three parts：influencing factors survey， promoting and hindering factors of standardizing physician prescription behavior， and communication， with a total of 12 questions. After being reviewed by members of the research group， experts review and pre- interview， a total of 9 people participated in the quality control evaluation of the interview outline. The overall evaluation score was 4.94 （＞4.50）， and the average score of each indicator was greater than 4.00， indicating that the quality of the outline met the requirements for the interview and could be used for the formal interview. CONCLUSIONS The established interview outline design and quality control method based on grounded theory provides ideas for the qualitative research interview outline design in the medical field， and lays the foundation for further using grounded theory to study the influencing factors and mechanisms of physician prescription behavior under the DRG background.

Objective:To analyze the implementation of early essential newborn care (EENC) in baby-friendly hospitals in China.Methods:This is an investigation carried out using convenience sampling method. People in charge of labor ward, obstetric wards or neonatology department of the selected hospitals, such as baby-friendly hospitals with birth facilities, primary or higher level of hospitals, or general hospitals or those specialized in obstetrics and gynecology or materal and child health care centers, were selected as the subjects of the survey. Information about EENC practices in these hospitals was collected using a self-designed questionnaire sent through WeChat from April 1 to 30, 2021. Chi-square test was used for statistical analysis. Results:A total of 126 questionnaires were distributed and 124 (124 baby-friendly hospitals) were withdrawn. There were 74 hospitals in the eastern, 18 in the central and 32 in the western region. Among the 124 hospitals, tertiary hospitals, general hospitals, and maternity and child care hospitals accounted for 72.6% ( n=90), 64.5% ( n=80) and 35.5% ( n=44), respectively. There were no significant differences in the hospital type, levels, EENC coverage and training, or implementation of mainly recommended EENC practices among the hospitals in the eastern, central and western regions (all P>0.05). The implementation rate of at least one mainly recommended EENC practice was 79.0% (98/124) and there was no significant difference in the implementation rates among eastern, central and western regions [86.4% (64/74), 13/18 and 65.6% (21/32), χ2=6.60, P=0.159]. A total of 80 (64.5%) hospitals implemented 10 or more recommended EENC practices, and the implementation rates in eastern, central and western regions were 71.6% (53/74), 10/18 and 53.1% (17/32), respectively ( χ2=4.08, P=0.130). Among the 17 mainly recommended measures of EENC, in eastern, central and western hospitals, the implementation rates were 10.8% (8/74), 2/18 and 18.8% (6/32) for mother-infant skin-to-skin contact for 90 min after birth; 66.2% (49/74), 11/18 and 68.8% (22/32) for delayed umbilical cord clamping; and 25.7% (19/74), 7/18 and 21.9% (7/32) for delayed routine care following skin-to-skin contact, respectively ( χ2=6.57, 0.34 and 4.53, all P>0.05). Conclusions:There is a big gap between the implementation of EENC in most baby-friendly hospitals in eastern, central and western China and the recommendation of the World Health Organization. It is necessary to further strengthen and standardize the implementation of EENC practices in baby-friendly hospitals in our country to continuously improve the health of newborns.

【Objective】 To identify low-risk donor population and optimize blood screening, recruitment and consultation strategies via retrospectively analyzing the unqualified results of Hb, ALT, HBsAg, TP before whole blood donation from 2015 to 2018. 【Methods】 Pre-donation examinations of Hb, ALT, HBsAg and TP were conducted by copper sulfate method, dry chemical method, and TPPA etc. 【Results】 A total of 70 146 out of 685 469 blood donors in Zhengzhou city from 2015 to 2018 were deferred due to unqualified pre-donation. The unqualified rates of Hb, ALT, HBsAg and TP were 1.75%(11 996/685 469), 7.78%(53 329/685 469), 0.60%(4 113/685 469) and 0.10%(685/685 469), respectively. For Hb deferral, 2.5%(17 137/685 469) were male and 97.5%(668 332/685 469)female; for ALT deferral, 85.9%(588 818/685 469) male and 14.1%(96 651/685 469) female. 【Conclusion】 The causes of pre-donation deferral in whole blood donors were mainly ALT, then Hb. Hb deferral showed an increasing trend and dominated by female donors, while ALT deferral was dominated by male donors. The overall unqualified rate of ALT, HBsAg and TP, however, are decreasing year by year through taking targeted measures, strengthening the publicity and education of blood donation, standardizing the blood collection and supply process.

Objective To analyze the characteristics of alcohol-related brain damage according to 18F-fluorodeoxy-glucose (18F-FDG) position emission tomography-computer tomography (PET-CT).Methods Excessive alcohol consumption patients accepted 18F-FDG PET-CT in our hospital from August 2016 to November 2018 were chosen as excessive alcohol consumption group and non-drinking patients accepted 18F-FDG PET-CT in our hospital at the same time were chosen as non-drinking group according to 1:4 ratio.The 18F-FDG PET-CT imaging data were analyzed;the characteristics of abnormal changed rate of CT sequences after stratification by age and the relations of alcohol consumption with abnormal CT sequences and PET sequences were compared between the two groups.Results A total of 52 patients with excessive alcohol consumption and 200 non-drinking patients were chosen.Among patients aged 45-59 years,the abnormal changed rate of CT sequences in the excessive alcohol consumption group was significantly higher than that in the non-drinking group (P＜0.05).In the CT sequences,33 patients in the 2 groups presented abnormalities,mainly including cerebral atrophy and lacunar infarction.In the PET sequences,62 patients in the two groups presented abnormalities,mainly manifesting as reduced metabolism level of bilateral frontal and parietal lobes.Among the 52 patients from excessive alcohol consumption group,those with abnormal CT sequences were older,had longer drinking history and had higher total drinking amount than those with normal CT sequences,and the differences were statistically significant (P＜0.05).As compared with those in patients with normal PET sequences,those with abnormal PET sequences had higher weekly and total alcohol consumption,and longer drinking history,and the differences were statistically significant (P＜0.05).Conclusion Excessive alcohol consumption is an important risk factor for structural damages in middle-aged men,which can cause a decrease of glucose metabolism level in the frontal and parietal lobes.

Oncogenic microRNAs are essential components in regulating the gene expression of cancer cells. Especially miR21, which is a major player involved of tumor initiation, progression, invasion and metastasis in several cancers. The delivery of anti-miR21 sequences has significant potential for cancer treatment. Nevertheless, since anti-miR21 sequences are extremely unstable and they need to obtain certain concentration to function, it is intensely difficult to build an effective delivery system for them. The purpose of this work is to construct a self-assembled glutathione (GSH)-responsive system with tumor accumulation capacity for effective anti-miR21 delivery and cancer therapy. A novel drug delivery nanosphere carrying millions of anti-miR21 sequences was developed through the rolling circle transcription (RCT) method. GSH-responsive cationic polymer polyethyleneimine (pOEI) was synthesized to protect the nanosphere from degradation by Dicer or other RNase in normal cells and optimize the pompon-like nanoparticle to suitable size. Dehydroascorbic acid (DHA), a targeting molecule, which is a substrate of glucose transporter 1 (GLUT 1) and highly expressed on malignant tumor cells, was connected to pOEI through PEG, and then the polymer was used for contracting a RNA nanospheres into nanopompons. The anti-miR21 nanopompons showed its potential for effective cancer therapy.

The blood-brain barrier (BBB) and the poor ability of many drugs to cross that barrier greatly limits the efficacy of chemotherapies for glioblastoma multiforme (GBM). The present study exploits albumin as drug delivery vehicle to promote the chemotherapeutic efficacy of paclitaxel (PTX) by improving the stability and targeting efficiency of PTX/albumin nanoparticles (NPs). Here we characterize PTX-loaded human serum albumin (HSA) NPs stabilized with intramolecular disulfide bonds and modified with substance P (SP) peptide as the targeting ligand. The fabricated SP-HSA-PTX NPs exhibited satisfactory drug-loading content (7.89%) and entrapment efficiency (85.7%) with a spherical structure (about 150 nm) and zeta potential of -12.0 mV. The drug release from SP-HSA-PTX NPs occurred in a redox-responsive manner. Due to the targeting effect of the SP peptide, cellular uptake of SP-HSA-PTX NPs into brain capillary endothelial cells (BCECs) and U87 cells was greatly improved. The low IC, prolonged survival period and the obvious pro-apoptotic effect shown by TUNEL analysis all demonstrated that the fabricated SP-HSA-PTX NPs showed a satisfactory anti-tumor effect and could serve as a novel strategy for GBM treatment.

Objective To investigate serum lipid profiles in newly diagnosed patients with polycystic ovary syndrome (PCOS) using lipidomics and correlate these features with hyperinsulinemia and hyperandrogenism associated with PCOS and obesity. Methods 32 newly-diagnosed PCOS women and 34 controls were enrolled and divided into obese and lean subgroups according to the body mass index (BMI). Anthropometric, biochemical, and hormonal parameters were collected. Serum lipid profiles including phospholipids, free fatty acids (FFAs), and bioactive lipids were analyzed using GC-MS and LC-MS. Results PCOS patients, in particular, the obese ones with fatty liver, have abnormal phosphatidylcholine (PC)/lysophospholipid (LPC) metabolism. PC was increased (16∶0, 18∶0, 18∶1, 18∶2, and 20∶4), while LPC was decreased (16∶0, 18∶0, and 18∶1; all P<0.05). Serum polyunsaturated fatty acids (PUFAs), were decreased significantly, and the long chain saturated fatty acid was increased. We also found that insulin stimulated the metabolism of PUFAs, but the androgen inhibits the metabolism of PUFAs by measuring their metabolites. Conclusion PCOS patients have metabolic disorders of phospholipids and PUFAs. Insulin stimulated while androgen inhibited PUFAs metabolism.

Objective To investigate the expression of UHRF1 protein in breast cancer and adjacent normal tissues, and its relationship with local recurrence. Methods Immunohistochemistry (IHC) was applied to detect the expression of UHRF1 protein in 69 specimens of breast cancer and 33 specimens of corresponding adjacent normal tissues; Chi-square test was used to analyze the relationship between UHRF1 protein expression and clinical factors. Results The positive rate expression of UHRF1 protein in breast cancer was 55.1 % (38/69), and UHRF1 protein expression was not found in adjacent normal tissues. The positive expression rate of UHRF1 protein in stage III was higher than that in stageⅠ-Ⅱ[68.4%(26/38) vs. 38.7 % (12/31), P< 0.05]. The positive expression rate of cancer tissue in breast cancer patients with chest wall recurrence after radiotherapy within 1 year was higher than that in patients without recurrence [83.3 %(10/12) vs. 49.1 % (28/57), P< 0.05], and UHRF1 protein expression of patients in different age and Herb-2 had no statistical significance (P> 0.05). Conclusions The positive expression rate of UHRF1 protein is obviously higher than that in adjacent normal tissue. Besides, UHRF1 protein is related to the stage and chest wall of local recurrence after radiotherapy.

Objective To evaluate the training effects of obstetric nurses in training center of Shanghai. Methods Totally 63 trainees of Obstetrics & Gynecology Hospital of Fudan University(Shanghai obstetric nurse training center) who received training from December 2012 to September 2015,were investigated by questionnaires,focus group interviews,written and practice examinations,etc. Kirkpatrick's four-level model of training evaluation was used to assess the training effects.Results Five themes were extracted from fifteen focus group discussions,and they were normative,characteristic,frontier,practical and humanistic. Satisfaction rate of trainees towards training schedules was 100.0%;satisfaction rate towards clinical teachers was 96.8%;satisfaction towards practical training environment was 95.2%;satisfaction towards instructional mode and content was 98.4%;and the satisfaction towards examination and evaluation was 100.0%. The total score of obstetric knowledge and skills was (50.83±11.37) before training and was (62.52±8.61) after training (t=-6.508, P<0.05). Within six months after practical training,89.7% of trainees thought that they could apply the learned professional knowledge into clinical practice,and 93.1% of trainees thought that they could apply the learned obstetric skills into nursing practice. Within 12 months after practical training,25 trainees worked as clinical teachers,nine trainees became head nurses,and six trainees implemented the learned new model of obstetric care and techniques into their clinical settings.Conclusions Shanghai obstetric nurse training center provides a resource platform for professional nurses' continuing education. The training improves trainees' obstetric knowledge and skills,and has a positive impact on nurses' actual job performance.

Objective To investigate the effect of lipoxin A4 LXA4) on radicular pain caused by intervertebral disc herniation.Methods Non-compressive intervertebral disc herniation was induced into forty-eight adult male Sprague-Dawley rats,and they were divided into a sham group (sham operation + 10 μl normal saline),a control group (modeled + 10 μl normal saline),an LXA4 10 ng group (modeled + 10 ng LXA4) and an LXA4 100 ng group (modeled + 100 ng LXA4),with 12 rats in each group.The normal saline (10 μl) or LXA4 (10 μl) was administered intrathecally right after the operation and on each of the three succeeding days.General behavior was observed and the 50％ paw withdrawal threshold (50％ PWT) was measured.On postoperative day 7 all the rats were killed and the ipsilateral lumbar (L4~) segments of their spinal dorsal horns were removed for determination of the expression of p-JNK,t-JNK,p-ERK and t-ERK proteins using western blotting.TNF-α,IL-1β and TGF-β1 expression were determined using ELISA.Results There was no significant difference in the 50％PWT of the sham group before and after surgery,but the 50％ PWTs of the control group and the LXA4 10 ng group were significantly decreased after the operation compared with their values beforehand and significantly lower than the value of the sham group at all time points.Moreover,the 50％ PWT of the LXA4 10 ng group on postoperative days 3 and 5 was significantly higher than the control group;as was the value of the LXA4 100 ng group on postoperative days 2,3,4,5,6 and 7.The p-JNK and p-ERK expression in the control group,the LXA4 10 ng group and the LXA4 100 ng group were all increased significantly more than in the sham group,but their expression in the LXA4 10 ng group and LXA4 100 ng group were decreased significantly more in a dose-dependent manner compared with the control group,with the LXA4 100 ng group showing the greatest decrease.There were no significant differences in t-JNK or t-ERK expression within each group.Conclusion LXA4 can alleviate radicular pain caused by non-compressive lumbar intervertebral disc herniation.The underlying mechanism involves inhibiting the activation of the ERK and JNK pathways,reducing the expression of pro-inflammatory cytokines and increasing the expression of anti-inflammatory cytokines.