Objective:To investigate the effect of dexmedetomidine(DEX)on the polarization of alveolar macrophages in-duced by lipopolysaccharide(LPS)and to explore the related mechanisms.Methods:Rat alveolar macrophages NR8383 were cul-tured in vitro.Experiment one was divided into control group,model group(1 μg/ml LPS),DEX low,medium and high dose groups(1,5,10 mg/kg DEX+10 mg/kg LPS).Experiment two was divided into DEX high dose group(10 mg/kg)and DEX high dose+Colive-lin(JAK2/STAT3 signaling pathway activator)group(10 mg/kg DEX+0.5 μmol/L Colivelin).The morphological changes of rat alveo-lar macrophages NR8383 were observed by inverted microscope;RT-PCR method was used to detect the expression levels of iNOS and Arg1 mRNA in NR8383 cells,and flow cytometry was used to detect the expression levels of CD86 and CD163 proteins in NR8383 cells;Western blot was used to detect the expression levels of surface marker proteins TNF-α,iNOS,SOCS,Arg1,TGF-β and JAK2/STAT3 signaling pathway related proteins in NR8383 cells.Results:Compared with control group,there were a lot of cell debris in the intercellular space of NR8383 in the model group,the proportions of iNOS mRNA,CD86 positive cells,and the expression levels of TNF-α,p-JAK2/JAK2,p-STAT3/STAT3 were significantly increased,the proportions of Arg1 mRNA,CD163 positive cells,and the expression levels of SOCS and TGF-β were significantly reduced(P<0.05);compared with the model group,the NR8383 intercellular cell debris in the DEX low,medium,and high dose groups were decreased,the proportions of iNOS mRNA,CD86 positive cells,and the expression levels of TNF-α,p-JAK2/JAK2,p-STAT3/STAT3 were significantly reduced,the proportions of Arg1 mRNA,CD163 positive cells,and the expression levels of SOCS and TGF-β were significantly increased(P<0.05).The reactivation of the JAK2/STAT3 signal pathway by Colivelin could weaken the role of DEX in LPS induced NR8383 cell polarization.Conclusion:DEX can inhibit the M1 polarization of NR8383 cells induced by LPS,which may be achieved by inhibiting the JAK2/STAT3 signaling pathway.

Objective:To investigate the status of disaster preparedness of pediatric nurses and its influencing factors, as well as the impact path of psychological capital and perceived organizational support on disaster preparedness.Methods:This was a cross-sectional study. A total of 361 pediatric nurses from Henan Provincial People ′s Hospital, the Third Affiliated Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital were sampled from August to October 2021. They were investigated by the general information questionnaire, psychological capital questionnaire, perceived organizational support questionnaire and disaster preparedness questionnaire. SPSS25.0 was used to analyze the questionnaire and scale data, and AMOS23.0 was used to construct a structural equation model about the disaster preparedness of pediatric nurses. Results:The scores of disaster preparedness from pediatric nurses was 4.65 ± 0.92. The level of disaster preparedness was significantly positively correlated with psychological capital and perceived organizational support ( r=0.690, 0.525, both P<0.05). Disaster training and emergency drill 2 dimensions of psychological capital questionnaire (hope, resilience), perceived organizational support were independent contributing factors ( P<0.05). Psychological capital had direct effect on disaster preparedness. And the direct effect was 0.77, the indirect effect was 0.11, the total effect was 0.88, and the direct effect of perceived organizational support on disaster preparedness was 0.21. Conclusions:The score of disaster preparedness of pediatric nurses was in the middle level. Hospital managers should strengthen the training of pediatric nurses in disaster knowledge, operational and simulation exercise, pay attention to the level of nurses' psychological capital and perceived organizational support, so as to provide reference for the follow-up clinical pediatric disaster nursing education and management.

Objective:To analyze the current research status, hotspots, and trends in the field of cancer symptom management in recent 10 years, and to provide a reference for further research.Methods:Articles published from January 2010 to December 2019 were retrieved with "cancer OR tumor OR neoplasm" and "symptom management" as the subject terms from the core collection of Web of Science database. CiteSpace 5.7.R1 was used for analysis and visualization of researchers, countries, institutions, journals, documents, keywords and other content.Results:The number of papers published in the field of cancer symptom management was basically on the rise, but the number of co-authored papers by multiple authors and institutions was insufficient. The United States, the United Kingdom, Canada, and Australia were the main countries in the field of cancer symptom management. They occupied a key position in this field and cooperated closely with each other. China's number of publications ranked the fifth, but it did not take a central place, and it had less international cooperation. Journal of Clinical Oncology, Journal of Pain and Symptom Management, and Supportive Care in Cancer were the core journals in this field. The related articles published on them reflected the foundation of this field, and provided important reference for this field. Cancer, symptoms, intervention measures, self-care, remote management, etc. have been research hotspots in recent years. Conclusions:This study provides a perspective for understanding the related research in cancer symptom management, and supplies valuable information for researchers to identify potential collaborators and cooperative institutions, core journals, hot topics, and research frontiers. In the future, researchers may focus on such hotspots and frontiers as symptoms, interventions, self-care, and remote management.

The association between serum uric acid and the risk of incident diabetes in Chinese adults remains unknown. This study aimed to investigate this association in a community-dwelling population aged ≥ 40 years in Shanghai, China. Oral glucose tole3rance test was conducted during baseline and follow-up visits. Relative risk regression was utilized to examine the associations between baseline gender-specific serum uric acid levels and incident diabetes risk. A total of 613 (10.3%) incident diabetes cases were identified during the follow-up visit after 4.5 years. Fasting plasma glucose, postload glucose, and glycated hemoglobin A1c during the follow-up visit progressively increased across the sex-specific quartiles of serum uric acid (all Ps < 0.05). The incidence rate of diabetes increased across the quartiles of serum uric acid (7.43%, 8.77%, 11.47%, and 13.43%). Multivariate adjusted regression analysis revealed that individuals in the highest quartile had 1.36-fold increased risk of diabetes compared with those in the lowest quartile of serum uric acid (odds ratio (95% confidence interval) = 1.36 (1.06-1.73)). Stratified analysis indicated that the association was only observed in women. Accordingly, serum uric acid was associated with the increased risk of incident diabetes among middle-aged and elderly Chinese women.
Adult ; Aged ; China/epidemiology* ; Diabetes Mellitus/epidemiology* ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Uric Acid

Objective:To explore the nursing distance education model under the epidemic situation of COVID-19, and challenges of teachers and students so as to bring forth a proposal for future nursing education model reform.Methods:The mixed research was used with methods of questionnaire survey and interview. In February 2020, we investigated the distance learning conditions and needs among 922 nursing undergraduates in School of Nursing, Beijing University of Chinese Medicine. Qualitative research of phenomenology was used to carry out semi-structured and in-depth interview among 14 nursing teachers. Data analysis was implemented with the method of Colaizzi phenomenological analysis.Results:Among 922 nursing undergraduates, 95.99% (885/922) of them could learn on line normally on the public platform, but there were still some students in mountain area limited by network conditions; 97.18% (896/922) of them accepted the nursing distance education model proposed by our school. Qualitative interview of teachers extracted two themes, the key element to implement nursing distance education and challenges, inspiration of epidemic situation to nursing education reform.Conclusions:In distance education model, teachers face challenges of idea, technology and resource; students are influenced by study habits, online learning ability and objective environment. In future, we can make a reform in the aspects of teachers, educational content and form, educational resources and platforms, education management.

Objective To evaluate the relationship betweenα2 adrenergic receptors and expression of Nav1. 8 in dorsal root ganglion (DRG) neurons, and to illuminate the mechanism of dexmedetomidine-induced reduction of acute visceral pain in rats. Methods Thirty-two clean-grade healthy adult male Spra-gue-Dawley rats, aged 6-8 weeks, weighing 180-220 g, were divided into 4 groups ( n=8 each) using a random number table method: control group ( group C ) , acute visceral pain group ( group VP ) , dexmedetomidine group (group D), and dexmedetomidine plus atipamezole group (group DA). In VP, D and DA groups, 10-3 mmol∕L capsaicin 1. 3 ml was injected into the rectum at a dose of 10-3 mmol∕L to establish the acute visceral pain model, while the equal volume of normal saline was given instead in group C. Atipamezole 1 mg∕kg was subcutaneously injected through the back of the neck at 20 min before establishing the model in group DA. Dexmedetomidine 10μg∕kg was injected through the tail vein at 15 min before establishing the model in D and DA groups, while the equal volume of normal saline was given instead at the correspording time points in C and VP groups. The visceral pain behavior score was recorded at 1 h after establishing the model. The animals were then sacrificed, and DRGs of the lumbar segment (L3-6) were removed for determination of the number of Nav1. 8 positive DRG neurons (by immunohisto-chemistry) and expression of Nav1. 8 mRNA (by quantitative real-time polymerase chain reaction). Results Compared with group C, the visceral behavior scores and the number of Nav 1. 8 positive DRG neurons were significantly increased, and the expression of Nav 1. 8 mRNA was up-regulated in VP, D and DA groups (P<0. 05). Compared with group VP, the visceral behavior score and the number of Nav1. 8 positive DRG neurons were significantly decreased, and the expression of Nav 1. 8 mRNA was down-regulated in D and DA groups (P<0. 05). Compared with group D, the visceral behavior scores and the number of Nav1. 8 positive DRG neurons were significantly increased, and the expression of Nav1. 8 mRNA was up-regulated in group DA ( P<0. 05) . Conclusion The mechanism by which dexmedetomidine reduces acute visceral pain is related to activatingα2 adrenergic receptors and to down-regulating the expression of Nav1. 8 in DRG neu-rons of rats.

Objective To evaluate the effect of intrathecal dexmedetomidine on expression of sub-stance P (SP) and c-fos in the spinal dorsal horns of rats with visceral pain. Methods Thirty-two clean-grade healthy adult male Sprague-Dawley rats, weighing 250-300 g, were divided into 4 groups ( n=8 each) using a random number table method: control group (C group), visceral pain group (VP group), dexmedetomidine group (D group) and dexmedetomidine plus atipamezole group (DA group). VP, D and DA groups received intraperitoneal injection of 0. 9％ acetic acid 10 ml∕kg to establish the model of visceral pain, while group C received the equal volume of normal saline instead. At 10 min before the model was es-tablished, dexmedetomidine 20 μl (1μg∕kg) and dexmedetomidine 1μg∕kg plus atipamezole 1μg∕kg (20μl) were intrathecally injected in D and DA groups, respectively, and the equal volume of normal saline 20μl was given instead in C and VP groups. Visceral pain index ( VPI) was recorded at 1 h after intraperito-neal injection, and then rats were sacrificed, and the dorsal horns of the spinal cord ( L4-6 ) were removed for determination of the expression of SP and c-fos by immunohistochemistry. Results Compared with group C, VPI was significantly increased, and the expression of SP and c-fos was up-regulated in VP, D and DA groups (P<0. 05). Compared with group VP, VPI was significantly decreased, and the expression of SP and c-fos was down-regulated in D and DA groups (P<0. 05). Compared with group D, VPI was signifi-cantly increased, and the expression of SP and c-fos was up-regulated in group DA ( P<0. 05) . Conclusion Intrathecal dexmedetomidine reduces the visceral pain through inhibiting the expression of SP and c-fos in the spinal dorsal horns, which is related to the α2-adrenergic receptor in spinal dorsal horns of rats.

Objective To evaluate the effect of dexmedetomidine on visceral pain in rats and the role of α2 adrenergic receptors in locus coeruleus (LC).Methods Thirty-two healthy adult male SpragueDawley rats,weighing 250-300 g,were divided into 4 groups (n=8 each) using a random number table method:control group (group C),visceral pain group (group VP),dexmedetomidine group (group DEX) and α2-adrenergic receptor antagonist atipamezole group (group AP).α2-adrenergic receptor antagonist atipamezole 522 μg/kg was intramuscularly injected in group AP,and the equal volume of normal saline was given instead in C,VP and DEX groups.At 10 min after intramuscular injection,dexmedetomidine 10 μg/kg was injected via the tail vein in DEX and AP groups,and the equal volume of normal saline was given instead in C and VP groups.VP,DEX and AP groups received intraperitoneal injection of 0.9％ acetic acid 10 ml/kg to make the visceral pain model at 15 min after injection via the tail vein.The cumulative visceral pain score was recorded within 60 min after acetic acid injection.The number of c-fos positive cells in LC was detected by immunohistochemistry,and the content of norepinephrine (NA) in the spinal cord were detected by enzyme-linked immunosorbent assay at 2 h after acetic acid injection.Results Compared with group C,the cumulative visceral pain scores,the number of c-fos positive cells in LC and content of NA in the spinal cord were significantly increased in VP,DEX and AP groups (P＜0.05).Compared with group VP,the cumulative visceral pain scores,the number of c-fos positive cells in LC and content of NA in the spinal cord were significantly decreased in DEX and AP groups (P＜0.05).Compared with group DEX,the cumulative visceral pain scores,the number of c-fos positive cells in LC and content of NA in the spinal cord were significantly increased in group AP (P＜0.05).Conclusion Dexmedetomidine can alleviate visceral pain in rats,and the mechanism is partially related to activating α2 adrenergic receptors in LC.

Objective: Hepatitis B surface antigen (HBsAg) loss is seldom achieved with nucleos(t)ide analog (NA) therapy in chronic hepatitis B patients but may be enhanced by switching to finite pegylated-interferon (Peg-IFN) alfa-2a. We assessed HBsAg loss with 48- and 96-week Peg-IFN alfa-2a in chronic hepatitis B patients with partial response to a previous NA. Methods: Hepatitis B e antigen (HBeAg)-positive patients who achieved HBeAg loss and hepatitis B virus DNA < 200 IU/mL with previous adefovir, lamivudine or entecavir treatment were randomized 1:1 to receive Peg-IFN alfa-2a for 48 (n = 153) or 96 weeks (n = 150). The primary endpoint of this study was HBsAg loss at end of treatment. The ClinicalTrials.gov identifier is NCT01464281. Results: At the end of 48 and 96 weeks' treatment, 14.4% (22/153) and 20.7% (31/150) of patients, respectively, who switched from NA to Peg-IFN alfa-2a cleared HBsAg. Rates were similar irrespective of prior NA or baseline HBeAg seroconversion. Among those who cleared HBsAg by the end of 48 and 96 weeks' treatment, 77.8% (14/18) and 71.4% (20/28), respectively, sustained HBsAg loss for a further 48 weeks. Baseline HBsAg < 1 500 IU/mL and week 24 HBsAg < 200 IU/mL were associated with the highest rates of HBsAg loss at the end of both 48- and 96-week treatment (51.4% and 58.7%, respectively). Importantly, extending treatment from 48 to 96 weeks enabled 48.3% (14/29) more patients to achieve HBsAg loss. Conclusion Patients on long-term NA who are unlikely to meet therapeutic goals can achieve high rates of HBsAg loss by switching to Peg-IFN alfa-2a. HBsAg loss rates may be improved for some patients by extending treatment from 48 to 96 weeks, although the differences in our study cohort were not statistically significant. Baseline and on-treatment HBsAg may predict HBsAg loss with Peg-IFN alfa-2a.

Objective· To investigate the association between neck circumference (NC) and cardiovascular risk factors among middle-aged and elderly people without diabetes in Jiading District in Shanghai.Methods· A cross-sectional study was conducted among 4 657 nondiabetic inhabitants aged 40 and above in Jiading District,Shanghai from August 2014 to July 2015.Clinical information collection,anthropometric measurements,and biochemical analyses were performed.The objects were divided into 4 groups according to the quartiles of NC in order to analyze association between NC and cardiovascular risk factors.Results· With increase of NC,the prevalences of abdominal obesity,insulin resistance,hypertension,and dyslipidemia all increased as well as waist circumference,body mass index (BMI),blood pressure,lipid profile,fast blood glucose,and HOMA-IR level (all Ptrend ＜0.01).Multiple Logistic regression analysis showed that individuals in Q2,Q3 and Q4 group had significantly higher risk of abdominal obesity,insulin resistance,hypertension,and dyslipidemia compared with those in Q1 group after age,sex,smoking,drinking,physical activity,BMI,waist circumference,systolic blood pressure,C-reactive protein,fast blood glucose,and lipid profile were corrected (all Ptrend ＜0.01).Conclusion· NC is positively and independently correlated with cardiovascular risk factors in middle-aged and elderly nondiabetic people in Jiading District in Shanghai.