Purpose/Significance To analyze the network security risk events monitored by the situational awareness platform of large hospitals,to find out the causes,and to put forward solutions and suggestions for improvement.Method/Process Taking the First Affiliated Hospital of Zhengzhou University as an example,the paper analyzes risk events on the situational awareness platform,screens the risky ter-minals on the hospital intranet,carries out rectification and reinforcement,analyzes the department distribution and causes of risky termi-nals,and puts forward suggestions for improvement.Result/Conclusion The number of risky terminals in medical and technical depart-ments is large,mainly due to the lack of management and the lack of full coverage of antivirus software.Through the rectification and rein-forcement of risky terminals,the number of network security risk events has been significantly reduced.Strengthening the hospital terminal security management,enhancing staff awareness of network security,and strengthening network security protection in different areas can ef-fectively reduce the incidence of hospital network security risk events and improve the hospital network security protection capability.

OBJECTIVE: The present study aimed to evaluate the therapeutic effect and explore the underlying mechanisms of Longxue Tongluo Capsule (LTC) on ischemic stroke rats. METHODS: Twenty-six rats were randomly divided into four groups, including sham group, sham + LTC group, MCAO group, and MCAO + LTC group. Ischemic stroke rats were simulated by middle cerebral artery occlusion (MCAO), and LTC treatment group were orally administrated with 300 mg/kg of LTC once daily for seven consecutive days. LTC therapy was validated in terms of neurobehavioral abnormality evaluation, cerebral infarct area, and histological assessments. The plasma metabolome comparisons amongst different groups were conducted by UHPLC-Q Exactive MS in combination with subsequent multivariate statistical analysis, aiming to finding the molecules in respond to the surgery or LTC treatment. RESULTS: Intragastric administration of LTC significantly decreased not only the neurobehavioral abnormality scores but also the cerebral infarct area of MCAO rats. The interstitial edema, atrophy, and pyknosis of glial and neuronal cells occurred in the infarcted area, core area, and marginal area of cerebral cortex were improved after LTC treatment. A total of 13 potential biomarkers were observed, and Youden index of 11 biomarkers such as LysoPC, SM, and PE were more than 0.7, which were involved in neuroprotective process. The correlation and pathway analysis showed that LTC was beneficial to ischemic stroke rats via regulating glycerophospholipid and sphingolipid metabolism, together with nicotinate and nicotinamide metabolism. Heatmap and ternary analysis indicated the synergistic effect of carbohydrates and lipids may be induced by flavonoid intake from LTC. CONCLUSION The present study could provide evidence that metabolomics, as systematic approach, revealed its capacity to evaluate the holistic efficacy of TCM, and investigate the molecular mechanism underlying the clinical treatment of LTC on ischemic stroke.

Objective:To investigate the clinical practice level and influencing factors of geriatric nursing specialist nurses.Methods:This study was a cross-sectional survey. Using the convenient sampling method, a total of 332 specialist nurses from 5 phases trained by Beijing Nursing Association from January to February 2021 were selected as the research objects. The general data questionnaire, Questionnaire on Clinical Practice Level of Geriatric Nursing Specialist Nurses, Questionnaire on Unit Support for Geriatric Nurses and Core Competence Self-Assessment Scale of Geriatric Nursing Specialist Nurses were used to investigate the nurses. Pearson correlation was used to analyze the relationship between unit support, self-assessment of core competence and practice level. Multiple linear regression was used to analyze the factors influencing the clinical practice level of geriatric nurses. A total of 332 questionnaires were distributed, 306 questionnaires were returned and 298 were valid questionnaires.Results:The total mean score of clinical practice of geriatric nursing specialist nurses was (3.42±0.83) . The results of multiple linear regression analysis showed that the work department, unit support and core competence were the influencing factors of the clinical practice level of geriatric nursing specialist nurses ( P<0.05) . Conclusions:Specialist nurses who work in the geriatric ward, have a high degree of unit support and have a high level of core competence have a higher clinical practice level.

Objective:To investigate the effect of sevoflurane anesthesia on electroencephalographic (EEG) seizures and long-term behavior and possible mechanism in neonatal rats.Methods:A total of 141 postnatal days 4-6 Sprague-Dawley rats (66 male, 75 female) were divided into 3 groups ( n=47 in each group) according to random number table method: control group, sevoflurane group, and NKCC1 inhibitor group, with 22 males and 25 females in each group. Rats in the control group were fed in normal cage without anesthesia; rats in the sevoflurane group were anesthetized with 2.1% sevoflurane for 6 hours; rats in the NKCC1 blocker group received intraperitoneal injection of 1.82 mg / kg bumetanide 30 minutes before anesthesia with 2.1% sevoflurane. The rats in the control group and sevoflurane group were injected subcutaneously with the same dose of DMSO at the same time when the NKCC1 blocker group received the drug intervention, so as to eliminate the influence caused by the solvent. The rats were observed for 30 minutes after recovery from anesthesia and then continued to breastfeed normally. Some of the new born rats received EEG monitoring from 9 to 11 days after being raised; the other rats received EPM and PPI respectively at 60 and 70 days after being raised. Results:The results of EEG showed that, compared with the control group, the number of epileptic waves((0.429±0.787), (1.571±0.787), t=2.753, P<0.01), the average duration of single epileptic wave ((1.575±2.349), (6.392±3.374), t=3.880, P< 0.01), the total duration increased significantly ((1.800±3.617), (10.957±6.028), t= 3.929, P<0.01) were all increased, the differences were statistically significant. Compared with sevoflurane group, the number of epileptic waves in EEG of male rats in NKCC1 blocker group decreased, the average duration of single epileptic wave decreased, and the total duration of epileptic wave shortened significantly, with statistical significance ((0.286±0.756), (0.925±1.733), (1.043±2.759), t=3.097, 4.404, 4.254, all P<0.01). There were no significant differences in female rat among the three groups (all P>0.05). Compared with male rats, the average duration of female rats in sevoflurane group decreased ((6.392±3.374), (2.515±2.992), t=3.044, P<0.01), the total duration shortened ((10.957±6.028), (3.270±5.883), t=2.626, P<0.01), the difference was statistically significant.The behavioral results showed that, compared with the control group, the open arm dwell time of male rats in sevoflurane group was significantly shorter ( P<0.05), and the panic response in PPI group was significantly lower ( P<0.05), the difference was statistically significant.Compared with the sevoflurane group, the open arm dwell time in NKCC1 blocker group was significantly longer ( P<0.05), and the panic response in PPI group was significantly increased.The difference was statistically significant ( P<0.05). The change trend in female rats of each group was similar to that of male rats, but there was no significant difference (all P>0.05). Comparison between male and female rats: compared with male rats in sevoflurane group, the female rats in sevoflurane group had a longer open arm stay time in EPM experiment ( P<0.05), the difference was statistically significant. Conclusion:Sevoflurane anesthesia for 6 hours can significantly increase the generation of epileptic waves in EEG of male newborn rats, and cause behavioral abnormalities in adult male rats, which may be related to NKCC1.And male rats are more vulnerable to the negative effects of sevoflurane anesthesia on brain nerve development.

Objective The amyloid β-protein precursor contains a domain highly homologous to Kunitz-type serine protease inhibitors. We have successfully established and characterized the recombinant human rhKD/APP in vitro. The aim of this study is to investigate the potential neuroprotective role of rhKD/APP on cerebral ischemia/reperfusion injury in rats. Methods Rats pretreated with rhKD/APP (4, 8, 16 mg/kg) were subjected to prepare models of cerebral ischemia/reperfusion (I/R) injury and those rats treated with Nimodipine were used as positive control. Comparison of the scores of neurological deficits, TTC-stained infarct volume and cerebral water content between the groups was performed. The activities of SOD, Na+-K+-ATPase and the content of MDA in the cortex tissues were measured and the activities of serum myeloperoxidase ( MPO) enzyme were also compared. The expressions of adhesion molecules ( ICAM-1 and E-selectin) were compared by immunohistochemistry. End-labeling of nuclear DNA fragmentation (TUNEL) and qualification of caspase-3, Bcl-2 and Bax were also employed to evaluate the local apoptosis in cortex tissues. Results By pretreatment with the rhKD/APP at three doses, cerebral infarct volume, water content and neurological deficits were all reduced. The activities of SOD, and Na+-K+-ATPase were increased, the contents of MDA were decreased in the cortex tissues, and the serum MPO activity was reduced. The expressions of adhesion molecules were downregulated and the apoptotic signaling of neurons were inhibited. All the changes induced by rhKD/APP treatment in the ischemia/reperfusion injury models showed statistical significance compared with the control rats. However, no significant difference was shown between the rhKD/APP group and Nimodipine group excepted for the reduced MPO in sera. Conclusions The result of this study suggest that rhKD/APP has neuroprotective effect on the cerebral ischemia/reperfusion injury through inhibiting multiple signaling pathways and is promising to be a potential neuroprotective drug.

Objective To summarize the diagnosis and treatment of congenital pulmonary airway malformation in children.Methods The clinical data of 68 children with congenital pulmonary airway malformations from June 2014 to June 2017 were analyzed retrospectively,including 39 males and 29 females with mean age(1.1 ±:0.5) years old(from 2 months 12 days to 15 years),7 cases of pulmonary cyst resection in 68 cases,3 cases with lung segment resection,1 cases with lingulectomy,57 cases with lobectomy.Results 68 cases were cured and discharged without death.Postoperative short-term complications included subcutaneous emphysema in 5 cases,pleural effusion in 2 cases,pneumothorax in 2 cases.All cases were followed up well between 3 months and 1 year.Conclusion The diagnosis of congenital pulmonary airway malformation in children mainly depends on imaging examination.Because it is easy to repeat infection,and can not rule out malignant transformation,early diagnosis and early treatment should be done.Surgical resection is the only way to treat the disease.

Objective Comprehensive evaluated the characteristics and differences of prevalence of hypertension in cold and non-cold areas,to provide evidence-based prevention strategies for establishment and perfection hypertension prevention and control suitable for China's national conditions in cold area.Methods Northeast China (Heilongjiang,Jilin,Liaoning),Inner Mongolia,Ningxia,Gansu,Qinghai,Tibet and Xinjiang were classified as cold area,and the rest were non-cold area.Use hypertension as a search term,literatures on the prevalence of hypertension were retrieved in WanFang Data,CqVip,CNKI,SinoMed and Pubmed database from January 1 1995 to May 1 2017,then the relevant data were screened and extracted.Heterogeneity was estimated and corresponding effect model was selected.Publication bias was evaluated by funnel plot,Egger test and Begg test.Comprehensive meta-analysis V2 was used for Meta analysis,stratified analysis of age,gender,province and region was did.Results In China,the pooled prevalence of hypertension was 27.00％.The pooled awareness rate of hypertension was 50.80％,the pooled treatment rate of hypertension was 40.40％,and the pooled control rate was 6.80％.The pooled prevalence in cold area was 29.70％ and 26.30％ in non-cold area,respectively,the difference of prevalence between cold and non-cold areas was significant (P ＜ 0.05).After the stratified analysis of age and gender,the pooled prevalence in men and women in cold area had a increased trend than that in non-cold area;the pooled prevalence in ＜ 30,40-,50-,and 60-＜ 70 years old groups in cold area was higher than that in non-cold area.The pooled prevalence was the highest in Tibet (40.70％) and north and northeast China area (30.40％,29.20％),and the lowest in Hainan (16.70％) and southern China area (20.70％).Conclusions In China,the pooled prevalence of hypertension is 27.00％,which is higher in cold area than non-cold area.The pooled prevalence is the highest in Tibet and north and northeast China,and the lowest in Hainan and Southern China.

Objective To explore the relationship between angiogenin-1/2 (Ang-1/2) and clinical parameters of idiopathic pulmonary fibrosis (IPF), and to assess the value of Ang-1/2 in predicting the prognosis of patients with IPF.Methods A retrospective analysis was conducted. Ninety-one patients diagnosed as IPF by high resolution CT (HRCT) and lung biopsy admitted to Daqing Oil Field General Hospitalfrom March 2014 to January 2015 were enrolled. The general data, serum parameters and pulmonary function parameters of all patients were collected. After treatment, all of the 91 patients were followed-up to 2 years. The patients were divided into favorable prognosis group and unfavorable prognosis group according to follow-up results. The differences in all parameters between the two groups werecompared. The relationship between Ang-1, Ang-2 and lung function parameters was analyzed by Pearson correlation analysis. Cox proportional hazard regression model was used to evaluate the effect of clinical parameters on the prognosis of patients with IPF. The effect of Ang-2 in predicting prognosis of patients with IPF was analyzed by receiver operating characteristic (ROC) curve.Results During the 2-year follow-up period, 30 of 91 patients showed a favorable prognosis, and 55 showed an unfavorable prognosis with a poor prognosis rate of 64.71%, and 6 patients withdrew from the study due to loss of follow-up and death. Compared with the favorable prognosis group, Ang-2 level in the unfavorable prognosis group was significantly increased (μg/L: 2.88±1.63 vs. 1.89±1.22,t = 2.909,P= 0.005), but Ang-1 only showed a slight increase (μg/L: 28.70±14.26 vs. 25.62±11.95,t = 1.005,P = 0.318). The results of Pearson correlation analysis showed that Ang-2 level was negatively correlated with forced expiratory volume in 1 second (FVC1) and the percentage of carbon monoxide diffusing capacity accounting for the expected value (DLCO%;r value was -0.227 and -0.206, andP value was 0.147 and 0.253, respectively), but no significant correlation between the level of Ang-1 and FVC1 as well as DLCO% was found (r value was -0.153 and -0.121, andP value was 0.147 and 0.253, respectively). Cox proportional hazard regression model analysis showed that the prognosis of patients with IPF was significantly affected by smoking time and Ang-2 (bothP< 0.05), and the influence of Ang-2 was greater [relative risk (RR): 1.236 vs. 1.006, P= 0.037]. Age, gender, smoking and the levels of FVC1, DLCO% and Ang-1 had no significant effect on the prognosis of IPF patients (allP> 0.05). Prognostic analysis showed that the area under ROC curve (AUC) of Ang-2 for predicting prognosis of patients with IPF was 0.692, and the best diagnostic point was 0.35μg/L, the sensitivity was 61.8%, the specificity was 73.3%, the positive predictive value was 69.8%, and the negative predictive value was 65.7% which indicated that Ang-2 could predict the prognosis of patients with IPF.Conclusion Ang-2 could assess the prognosis of patients with IPF, which is expected to be used as an indicator of predicting the prognosis of patients with IPF.

OBJECTIVE:To provide reference for imipenem-resistant Pseudomonas aeruginosa infection control. METHODS:114 patients infected with imipenem-resistant P. aeruginosa were selected from 3 tertiary hospitals in Zhoushan during Feb. 2013 to Feb. 2014. 114 strains of P. aeruginosa were isolated from clinical specimens,and drug resistance characteristics and carbapene-mase-producing gene diversity were analyzed. 101 inpatients with imipenem-resistant P. aeruginosa infection were included in con-trol group;univariate and multivariate Logistic regression analysis were adopted to explore the risk factors of imipenem-resistant P. aeruginosa infection. RESULTS:114 strains were sensitive to polymyxin B,and had different levels of resistance to other 9 kinds of antibiotics. Carbapenemase-producing gene were mainly IMP and VIM type gene. Long-term hospitalization,mechanical ventila-tion,used imipenem and early combined use of antibiotics were risk factors of imipenem-resistant P. aeruginosa infection. CON-CLUSIONS:In Zhoushan area,imipenem-resistant P. aeruginosa shows serious drug resistance. To avoid long-term hospitalization and early combined use of antibiotics can reduce imipenem-resistant P. aeruginosa infection.

The effects of RNAi-mediated gene silencing of LRIG1 on proliferation and invasion of the human glioma cell line U251-MG and the possible mechanisms were explored in this study.The plasmids pGenesi12-LRIG1-shRNA1 and pGenesi12-LRIGl-shRNA2 were transfected into U251-MG glioma cells respectively by using Lipofectamine 2000 and the transfected cells in which the LRIGI expression was stably suppressed were selected by G418.The cells transfected with negative shRNA served as control.The expression levels of LRIG1 mRNA and protein were measured by qRT-PCR and Western blotting,respectively.The cell cycle was analyzed by flow cytometry.The results showed that LRIG1 mRNA expression was reduced by 70％ and 58％ and LRIG1 protein expression by 58％ and 26％ in U251-MG cells transfected with pGenesil2-LRIGl-shRNAl and pGenesil2-LRIG1-shRNA2 relative to the negative shRNA-transfected U251-MG cells.The proliferative capacity of the LRIG1 specific siRNA-transfected cells was stronger than that of control cells.Cell cycle analysis showed that silencing LRIG 1 significantly increased the percentage of S phase cells and the proliferation index (P＜0.01).Moreover,silencing LRIG1 could promote the invasion of U251-MG cells (P＜0.05).These findings suggested that LRIG1-targeting siRNA can exert a dramatically inhibitory effect on RNA transcription and protein expression of LRIG1,and LRIG1down-regulation could promote the proliferation of U251-MG cells,arrest U251-MG cells in S phase,and enhance the invasion of U251-MG cells.