Objective To investigate the distribution difference of T lymphocyte subsets in common and refractory mycoplasma pneumonia and its impact on treatment.Methods Two hundred children with mycoplasma pneumonia hospitalized from October 2023 to January 2024 were retrospectively reviewed and divided into common mycoplasma pneumonia group and refractory mycoplasma pneumonia group(n=100 each)according to the severity of disease and treatment.The distribution of T cell immunophenotypes CD4+,CD8+and CD4+/CD8+were compared between common mycoplasma pneumonia and refractory mycoplasma pneumonia.The predictive value of CD4+,CD8+counting,CD4+/CD8+and combined detection on the occurrence of refractory mycoplasma pneumonia were ana-lyzed.Results Compared with the common mycoplasma pneumonia group,the refractory mycoplasma pneumonia group had more school-age children,longer fever duration and hospital stay(P＜0.05).Compared with the common mycoplasma pneumonia group,CD4+expression was slightly decreased in the refractory mycoplasma pneumonia group,but there was no statistical significance between the two groups;CD8+expression was significantly increased while CD4+/CD8+expression was significantly decreased(P＜0.05).Receiver operating characteristic curve(ROC)showed that CD4+(AUC=0.532,95%CI=0.455-0.608),CD8+(AUC=0.592,95%CI=0.515-0.666),CD4+/CD8+(AUC=0.579,95%CI=0.502-0.653)and combined detection(AUC=0.607,95%CI=0.531-0.680).Conclusions Compared with the common mycoplasma pneumonia group,CD4+expression is slightly decreased,CD8+expression is significantly increased,and CD4+/CD8+expression is significantly decreased in the refractory mycoplasma pneumonia group.All these indicators hold certain value in predicting the occurrence of refractory mycoplasma pneumonia,with combined detection demonstrating higher predictive value.

Objective To analyze the expression levels of RNA demethylase alkB homolog 5(ALKBH5)and p21 activated kinase 5(PAK5)in high-risk human papillomavirus(HR-HPV)positive cervical cancer tissue,and explore their clinical significance.Methods A total of 96 patients with HR-HPV positive cervical cancer were selected as the research object.The expressions of ALKBH5 and PAK5 mRNA and protein in cancer tissue and adjacent tissue were analyzed by real-time fluorescent quantitative PCR,immunohistochemistry and Western blot assay.The expression levels of ALKBH5 and PAK5 proteins in patients with HR-HPV positive cervical cancer with different clinicopathological characteristics were compared.Multivariate Cox regression analysis was used to analyze influencing factors of death in patients with HR-HPV positive cervical cancer.Kaplan-Meier curve was used to analyze the effects of ALKBH5 and PAK5 protein expression on the 5-year survival rate of patients.Results The results of real-time fluorescent quantitative PCR,immunohistochemistry and Western blot assay showed that expression levels of ALKBH5 and PAK5 mRNA and protein in HR-HPV positive cervical cancer tissue were higher than those in adjacent tissue(P<0.05).The positive rates of ALKBH5 and PAK5 in cancer tissue of HR-HPV positive cervical cancer patients with FIGO stage ⅡA and lymph node metastasis were increased(P<0.05).ALKBH5 positive(HR=1.467,95％CI:1.104-1.949),PAK5 positive(HR=1.435,95％CI:1.093-1.884),FIGO stage ⅡA(HR=1.435,95％CI=1.065-1.933)and lymph node metastasis(HR=1.652,95％CI:1.053-2.593)were risk factors affecting the prognosis of HR-HPV positive cervical cancer patients(P<0.05).The 5-year cumulative survival rate was lower in the ALKBH5 positive group[72.58％(45/62)vs.91.18％(31/34)]than that of the ALKBH5 negative group(log rank χ2=4.481,P=0.034).The 5-year overall survival rate of the PAK5 positive group[71.67％(43/60)vs.91.67％(33/36)]was lower than that of the PAK5 negative group(log rank χ2=4.153,P=0.043).Conclusion The expression levels of ALKBH5 and PAK5 are significantly up-regulated in HR-HPV positive cervical cancer,both of which are related to the poor clinicopathological features of patients,and are helpful to evaluate the prognosis.

Objective To analyze the expression levels of RNA demethylase alkB homolog 5(ALKBH5)and p21 activated kinase 5(PAK5)in high-risk human papillomavirus(HR-HPV)positive cervical cancer tissue,and explore their clinical significance.Methods A total of 96 patients with HR-HPV positive cervical cancer were selected as the research object.The expressions of ALKBH5 and PAK5 mRNA and protein in cancer tissue and adjacent tissue were analyzed by real-time fluorescent quantitative PCR,immunohistochemistry and Western blot assay.The expression levels of ALKBH5 and PAK5 proteins in patients with HR-HPV positive cervical cancer with different clinicopathological characteristics were compared.Multivariate Cox regression analysis was used to analyze influencing factors of death in patients with HR-HPV positive cervical cancer.Kaplan-Meier curve was used to analyze the effects of ALKBH5 and PAK5 protein expression on the 5-year survival rate of patients.Results The results of real-time fluorescent quantitative PCR,immunohistochemistry and Western blot assay showed that expression levels of ALKBH5 and PAK5 mRNA and protein in HR-HPV positive cervical cancer tissue were higher than those in adjacent tissue(P<0.05).The positive rates of ALKBH5 and PAK5 in cancer tissue of HR-HPV positive cervical cancer patients with FIGO stage ⅡA and lymph node metastasis were increased(P<0.05).ALKBH5 positive(HR=1.467,95％CI:1.104-1.949),PAK5 positive(HR=1.435,95％CI:1.093-1.884),FIGO stage ⅡA(HR=1.435,95％CI=1.065-1.933)and lymph node metastasis(HR=1.652,95％CI:1.053-2.593)were risk factors affecting the prognosis of HR-HPV positive cervical cancer patients(P<0.05).The 5-year cumulative survival rate was lower in the ALKBH5 positive group[72.58％(45/62)vs.91.18％(31/34)]than that of the ALKBH5 negative group(log rank χ2=4.481,P=0.034).The 5-year overall survival rate of the PAK5 positive group[71.67％(43/60)vs.91.67％(33/36)]was lower than that of the PAK5 negative group(log rank χ2=4.153,P=0.043).Conclusion The expression levels of ALKBH5 and PAK5 are significantly up-regulated in HR-HPV positive cervical cancer,both of which are related to the poor clinicopathological features of patients,and are helpful to evaluate the prognosis.

Despite decades of laboratory and clinical trials,breast cancer remains the main cause of cancer-related disease burden in women.Considering the metabolism destruction effect of metformin(Met)and cancer cell starvation induced by glucose oxidase(GOx),after their efficient delivery to tumor sites,GOx and Met may consume a large amount of glucose and produce sufficient hydrogen peroxide in situ.Herein,a pH-responsive epigallocatechin gallate(EGCG)-conjugated low-molecular-weight chitosan(LC-EGCG,LE)nanoparticle(Met-GOx/Fe@LE NPs)was constructed.The coordination between iron ions(Fe3+)and EGCG in this nanoplatform can enhance the efficacy of chemodynamic therapy via the Fenton reaction.Met-GOx/Fe@LE NPs allow GOx to retain its enzymatic activity while simultaneously improving its stability.Moreover,this pH-responsive nanoplatform presents controllable drug release behavior.An in vivo biodistribution study showed that the intracranial accumulation of GOx delivered by this nano-platform was 3.6-fold higher than that of the free drug.The in vivo anticancer results indicated that this metabolism destruction/starvation/chemodynamic triple-combination therapy could induce increased apoptosis/death of tumor cells and reduce their proliferation.This triple-combination therapy approach is promising for efficient and targeted cancer treatment.

Objective:To comprehensively search the relevant literature on prone position-cardiopulmonary resuscitation (PP-CPR) in adults at home and abroad, analyze the content, summarize the evidence, and provide reference for clinical health care professionals.Methods:Systematic search of CNKI, China Biomedical Literature Service System (SinoMed), Wanfang Data, VIP database, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochran Library, Web of Science, Scopus literature database and other Chinese and English databases was conducted. The search period was from inception to June 15 in 2024. The contents of PP-CPR from randomized controlled trial (RCT), non-RCT (prospective or retrospective), cohort studies and case reports were extracted and systematically analyzed. The search results were standardized by the method of scoping review.Results:A total of 523 articles were obtained through preliminary search, and 14 references and gray literature were retrieved, totaling 537 articles. After strict screening by two researchers, a total of 26 literatures were included, 3 were non-RCT and 23 were case reports, involving 12 countries, including 3 in Chinese, 19 in English, 2 in French, 1 in German, and 1 in Korean. Three non-RCT demonstrated that compared with standard cardiopulmonary resuscitation (CPR), PP-CPR could produce higher pressure, and provide good respiratory and circulatory support. A total of 25 adult patients were included in the 23 case reports, of which 17 reported total recovery time and 13 reported PP-CPR time ≤ 5 minutes, all of which recovered spontaneous circulation, indicating the effectiveness of PP-CPR technology. In terms of final outcome, 4 patients (16.0%) died and 21 patients (84.0%) survived, indicating that PP-CPR technology could provide timely blood circulation and improve clinical outcomes for prone cardiac arrest patients. Among the 11 patients who reported complications after resuscitation, no neurological damage was found in the short-term outcomes, indicating that PP-CPR technology had a certain level of safety.Conclusions:PP-CPR can provide timely blood circulation for patients with cardiac arrest who are unable to lie supine quickly, and win "golden time" for defibrillation and further treatment. In clinical practice, medical staff need to evaluate the emergency environment, the number of rescuers and the specific condition of the patient, and implement first aid as soon as possible, so as to reduce the time of no blood flow in the vital organs of patients with cardiac arrest in prone position, and improve the clinical prognosis.

Objective:To understand the effect of presenteeism behavior of nurses on patient satisfaction and to explore the correlation between them.Methods:This study was a cross-sectional study. In December 2019, the convenient sampling method was adopted to select 500 in-service responsible nurses and 500 inpatients under the charge of the responsible nurses in 5 Class Ⅲ Grade A hospitals in Henan Province as the research objects. The responsible nurses were surveyed by general information questionnaire and Presenteeism Behavior Scale and patients in charge were surveyed by Inpatient Satisfaction and Experience Monitoring Scale.Results:A total of 435 valid questionnaires were collected from responsible nurses and patients in charge. The score of Presenteeism Behavior Scale of 435 nurses was (2.62±0.93) and the score of Inpatient Satisfaction and Experience Monitoring Scale of 435 patients was (4.50±0.49) , showing negative correlation ( r=-0.19, P<0.01) . Conclusions:The level of nurses' presenteeism behavior is at a moderate level and patient satisfaction is at an upper-middle level. Nurses' presenteeism behavior affects patient satisfaction. The higher the incidence of nurses' presenteeism behavior, the lower the patient satisfaction. It is recommended to reduce nurses' presenteeism behavior and improve patient satisfaction.

Objective:To analyze the research status of the midwifery in China from 2012 to 2021, and to explore the research hotspots and research trends in the midwifery in China in the past 10 years.Methods:The CiteSpace software was used to analyze the time distribution, authors, institutions and keywords of related studies in the field of midwifery published in nursing core journals in China. The search period was from January 2012 to December 2021.Results:A total of 442 articles were included, with the largest number of papers published in 2014 and 2015, and no increase in the number of papers published after 2016. The core author group in the field of midwifery was basically formed, with close cooperation among authors and high output from the five cooperative groups, but little cooperation among teams. Cooperative research with regional institutions began to take shape, and inter-regional collaborative research was relatively scarce. The hotspot keywords in the field of midwifery were "midwife", "pregnant woman", "natural childbirth", "obstetric nursing" and "delivery outcome".Conclusions:The development of research in the field of midwifery in China is slow, and cooperation between teams, institutions and regions needs to be further strengthened in the future. Strengthening the capacity building of midwifery professionals is the key direction of future research, and obstetric nursing is the main trend of future research.

[Abstract] Objective: To explore the expression patterns of melanoma lineage antigens and nuclear antigen Ki-67 and their correlations with survival in melanoma patients. Methods: A retrospective analysis was conducted to analyze the pathological data of melanoma patients treated at the Department of Melanoma, Peking University Cancer Hospital from February 2008 to August 2020, mainly including the expression patterns of melanoma lineage antigens (S-100, HMB-45, Melan-A) and Ki-67, demographics, clinical features and survival. The correlation between expression patterns of melanoma lineage antigens, Ki-67 and melanoma-specific survival (MSS) was analyzed. Results: In total, 603 patients were included in this study. The median follow-up time was 47.4 months. The positive rates of S-100, HMB, and Melan-A were 92.8%, 92.1% and 90.0%, respectively. The percentages of patients with melanoma lineage antigen scores (S-100, HMB-45 and Melan-A was scored each, as 1 when positive and 0 when negative) of 0, 1, 2, and 3 were 0.5%, 5.0%, 15.6%, and 78.8%, respectively. The percentages of patients with Ki-67 scores of 0, 1, 2, and 3 were 43.0%, 36.3%, 16.3%, and 4.5%, respectively. Ki-67 was highly expressed in mucosal and progressive melanomas. In a multivariate analysis, Ki-67 expression was an independent prognostic factor for poorer MSS (HR=1.506, 95%CI: 1.248-1.818, P<0.001) as the incidence of MSS event increased by 50% per 25% increase in Ki-67 expression, whereas there was no statistical correlation between melanoma lineage antigen expression and MSS (HR=0.991, 95%CI: 0.759-1.293, P=0.94). Conclusion: High expressions melanoma lineage antigens are ubiquitous in melanoma tissues, and Ki-67 is an independent prognostic factor for MSS.

[摘 要] 目的：本研究旨在评估白蛋白紫杉醇+卡铂联合抗血管生成药物（nab-paclitaxel, carboplatin, antiangiogenic drug, NCA）方案用于既往治疗失败的晚期黑色素瘤患者的疗效和安全性。方法：收集2012年4月1日至2019年5月31日在北京大学肿瘤医院肾癌黑色素瘤科住院的黑色素瘤患者，回顾性分析NCA方案在既往治疗失败后的不可切除Ⅲ c期和Ⅳ期黑色素瘤患者中的疗效和安全性。主要终点指标为无进展生存期（PFS），次要指标为客观缓解率（ORR）、总生存期（OS）、疾病控制率（DCR）和不良反应。根据使用的抗血管药物分为恩度治疗组（n=73）和贝伐珠单抗治疗组（n=103），采用倾向性评分匹配以均衡不同抗血管生成药物组间基线变量的差异。结果：共计176例患者被纳入本项分析中。所有患者中位年龄51岁（范围为18~78岁）。Ⅳ期患者占97%，50%的患者LDH水平高于正常值，28%的患者存在肝转移。既往治疗线数占比分别为1线57%、2线33%、3~4线10%。所有患者的中位PFS为3.8个月（95%CI：3.0~4.6），中位OS为10.5个月（95%CI： 8.9~12.1）。2例患者获得完全缓解，9例患者获得部分缓解，全组的ORR为6%，DCR达70%。恩度治疗组和贝伐珠单抗治疗组的中位PFS分别为4.7个月（95%CI：3.5~5.9）和3.4个月（95%CI：3.0~4.6），两组中位OS分别为12.2个月（95% CI：11.1~13.2）和9.1个月（95%CI： 7.8~10.4）。对所有患者的年龄、性别、既往治疗线数和LDH水平进行倾向性评分匹配，贝伐珠单抗和恩度治疗组间PFS和OS差异无统计学意义。常见的不良反应包括脱发、周围神经病变、中性粒细胞减少、疲劳和恶心。26名（15%）患者由于不良反应停止了治疗。结论：白蛋白紫杉醇+卡铂联合抗血管生成药物对既往治疗失败的晚期黑色素瘤患者具有一定的疗效，不良反应可耐受。