Ursodeoxycholic acid (UDCA) is a naturally occurring, low-toxicity, and hydrophilic bile acid (BA) in the human body that is converted by intestinal flora using primary BA. Solute carrier family 7 member 11 (SLC7A11) functions to uptake extracellular cystine in exchange for glutamate, and is highly expressed in a variety of human cancers. Retroperitoneal liposarcoma (RLPS) refers to liposarcoma originating from the retroperitoneal area. Lipidomics analysis revealed that UDCA was one of the most significantly downregulated metabolites in sera of RLPS patients compared with healthy subjects. The augmentation of UDCA concentration (≥25 μg/mL) demonstrated a suppressive effect on the proliferation of liposarcoma cells. [¹⁵N₂]-cystine and [¹³C₅]-glutamine isotope tracing revealed that UDCA impairs cystine uptake and glutathione (GSH) synthesis. Mechanistically, UDCA binds to the cystine transporter SLC7A11 to inhibit cystine uptake and impair GSH de novo synthesis, leading to reactive oxygen species (ROS) accumulation and mitochondrial oxidative damage. Furthermore, UDCA can promote the anti-cancer effects of ferroptosis inducers (Erastin, RSL3), the murine double minute 2 (MDM2) inhibitors (Nutlin 3a, RG7112), cyclin dependent kinase 4 (CDK4) inhibitor (Abemaciclib), and glutaminase inhibitor (CB839). Together, UDCA functions as a cystine exchange factor that binds to SLC7A11 for antitumor activity, and SLC7A11 is not only a new transporter for BA but also a clinically applicable target for UDCA. More importantly, in combination with other antitumor chemotherapy or physiotherapy treatments, UDCA may provide effective and promising treatment strategies for RLPS or other types of tumors in a ROS-dependent manner.

Alzheimer's disease(AD)is the most common cognitive disorder in the elderly and manifests primarily as progressive cognitive function decline, neuropsychiatric symptoms and multiple functional impairments.Obstructive sleep apnea(OSA)is a common type of respiratory disorder.Studies have found that AD and OSA are connected in many ways, including the risk of developing these diseases, biomarkers and neuroimaging features.These connections may result from a variety of mechanisms, such as neuropathological protein deposition, exacerbated immune-mediated inflammation, oxidative stress abnormalities, impaired mitochondrial function, and disturbed neurotransmitter systems, among others.This article reviewed the relationship between AD and OSA, the mechanisms linking them and their treatment.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Objective:To understand the change trend and influencing factors of fecal calprotectin(FC) in very low birth weight(VLBW) infants, and to explore the application value of FC detection in the diagnosis of necrotizing enterocolitis(NEC) in VLBW infants.Methods:VLBW infants hospitalized in the neonatal department at Quanzhou Children′s Hospital from June 2018 to May 2019 were selected as research object for a prospective study.Fecal samples from the 1st, 7th, 14th, 21st, 28th and 35th days after birth and fecal samples from the acute and recovery stages of NEC were collected continuously.The content of FC was determined quantitatively by immunofluorescence assay.Results:(1) The FC level of non NEC VLBW infants from 1 to 35 days after birth was 143.5(47.8, 391.2) μg/g.Univariate analysis showed that the level of FC fluctuated with the postnatal age, the level of FC was the highest at 21 days, and then decreased.The level of FC increased significantly in formula feeding, premature rupture of membranes, neonatal sepsis, feeding intolerance and pregnant mothers without glucocorticoid before delivery( P< 0.05). (2) Multivariate covariance analysis showed that prenatal application of glucocorticoid( F=10.550, P=0.001), premature rupture of membranes( F=13.311, P<0.001), neonatal sepsis( F=8.001, P=0.005), feeding intolerance( F=4.751, P=0.030) and NEC( F=54.566, P<0.001) had significant effects on FC level.After controlling the effects of prenatal corticosteroid, premature rupture of membranes, neonatal sepsis and feeding intolerance, the levels of FC in NEC group and non-NEC group were 3 162.3(1 412.5-7 244.4)μg/g and 141.3(125.9-162.2)μg/g, respectively.In NEC group, the levels of FC in acute stage and recovery stage were 3 166.9(1 745.1, 6 806.4)μg/g and 130.9(97.4, 273.9)μg/g, respectively, with significant difference( t=10.304, P<0.001). While the levels of FC were 2 347.9(1 404.4, 5 893.4)μg/g in the mild NEC and 4 114.7(2 764.5, 9 208.4)μg/g in the moderate or severe NEC, respectively, with no significant difference( t=1.131, P=0.280). Conclusion:The levels of FC fluctuate with postnatal age and it is affected by multiple factors.FC maybe a useful marker for the diagnosis and evaluation of efficacy of NEC in VLBW infants.

In recent years, the oral feeding readiness for preterm infants has been paid more and more attention, and there are various assessment tools for the oral feeding readiness. The professionals in various countries have been constantly improved and adjusted according to the national and clinical conditions, but up to now, no unified standard has been formed. This paper reviews the assessment tools of preterm infant′s oral feeding readiness at home and abroad, and provides reference for the unified evaluation standard of preterm infant's oral feeding readiness, so as to establish more standardized and effective intervention strategies and enhance the effect of preterm infant′s oral feeding nursing.

Objective To evaluate the effectiveness of family-centered educational intervention on disease-related knowledge, health behavior and subsequent visit compliance among children with systemic lupus erythematosus (SLE). Methods From October 2014 to June 2015, a total of 62 children with SLE from a class Ⅲ grade A hospital of Beijing were selected as the research object by convenient sampling method. They were divided into control group with 32 cases and observation group with 30 cases in chronological sequence. No children were withdrawn from the observation group, and 2 cases in the control group had not been followed up for 3 months after discharge. A total of 60 children had completed the study for 6 months. Children in the intervention group were given family-centered educational intervention, while children in the control group were given conventional treatment and nursing in ward. We assessed their disease-related knowledge and health behaviors before the intervention, 3 months after discharge, and 6 months after discharge, and evaluated their subsequent visit compliance before the intervention and 6 months after discharge. Results The disease-related knowledge level of children in intervention group was significantly higher than that of children in control group at 3 and 6 months after discharge (F=4.513, 5.412;P<0.001);For the health behavior, there was no significant difference between two groups of children at 3 months after discharge (F=1.948,P=0.057), but at 6 months after discharge, the intervention group was higher than the control group (F=3.399,P=0.001); There was a significant difference in the compliance of the two groups of children in the 6 months after discharge (χ2=6.667,P=0.021). Conclusions Family-centered educational intervention can rapidly improve the level of disease-related knowledge in children with systemic lupus erythematosus. It can improve children's health behavior and improve their subsequent visit compliance.

Objective To explore the current situation of stressor,job burnout and anxiety of pediatric nurses of Class Ⅲ Grade A hospitals and to analyze the correlation between stressor and job burnout as well as stressor and anxiety.Methods From January to February 2017,a total of 233 pediatric nurses of 5 Class Ⅲ Grade A hospitals of Beijing were selected by convenience sampling as subjects.All of the pediatric nurses were investigated with the Nurse Job Stressor Scale (NJSS),Maslach Burnout Inventory-Human Services Survey (MBI-HSS),Self-Rating Anxiety Scale (SAS).Results Among 233 pediatric nurses,two dimensions of NJSS with high scores included time allocation and workload (2.69 ± 0.87) as well as patient care(2.54 ± 0.70).Two items of NJSS with high scores contained that the wages and other welfare treatment was low (3.04 ± 0.93) as well as worrying about mistakes and accidents in work (2.97 ± 0.97).The emotion exhaustion dimension of MBI-HSS was with 22.7％ for the severe level.Patients with low scores of sense of personal achievement accounted for 41.2％.The score of SAS was (38.38 ± 7.47) significantly higher than Chinese model (t=17.57,P ＜ 0.01).There were 10.7％ of nurses with the moderate-severe level of anxiety.The correlation analysis among stressor,job burnout and anxiety of pediatric nurses showed that except for time allocation and workload as well as sense of personal achievement,other dimensions of NJSS had positive correlations with dimensions of MBI-HSS and SAS (r=0.169-0.527,P ＜ 0.05).Conclusions Pediatric nurses are with high working pressure.Policy makers and managers should consider characteristics in pediatric nursing,reduce nurses' stressors as well as the level of nurses' job burnout and improve their mental health,so as to ensure the quality of pediatric nursing.

Objective To explore the medical compliance behavior among systemic lupus erythematosus (SLE) children so as to provide a basis for implementing targeted nursing intervention. Methods From November 2015 to October 2017, we selected 124 SLE children of Department of Pediatrics of Peking Union Medical College Hospital as subjects in by convenience sampling. The self-designed SLE Children Medical Compliance Behavior Questionnaire was used to the investigation. A total of 124 questionnaires were sent out and 116 valid questionnaires were collected. Results Among 116 children, the mean of total score of medical compliance behavior was (105.91±10.62) along with the highest score (4.91±0.43) in the term of"I will not presume to reduce the dose" belong to the dimension of medication and review. Conclusions SLE children have the high level of compliance in medication and review. Health care providers should continue to carry out sunscreen, choose appropriate diet, pay attention to the details of infection prevention and develop a regular exercise habit for children along with their patients so as to improve long-term prognosis and quality of life of SLE children.

Objective The article aimed to investigate the effect of application of phase learning teaching method in teaching of clinical nursing skills.Methods A total of 97 undergraduate nursing students in grade 2008 were grouped as the experimental group,these students adopted phase learning teaching method,which divided clinical nursing skills course into three stages.A total of 103 undergraduate nursing students in grade 2008 were set as the control group,the students were given traditional teaching method.The teaching effect was compared between two groups.Results Compared with the control group,theoretical knowledge,practical skills,professional emotion and critical thinking were better in the experimental group,the difference was significant,t value was-4.566,-6.332,-2.371 and-4.308.Conclusions The phase learning teaching method is an effective and practical method to improve the teaching effect of clinical nursing skills.

Objective To explore the effects of hemodialysis on patients' coagulation function and to analyze its rea-sons. Methods Blood samples of 68 patients before and after hemodialysis who took maintenance hemodialysis in our hospital from January 2012 to April 2014 were selected. Flow cytometry was applied to test P-selectin on platelet sur-face. Indirect enzyme linked immunosorbent assay was applied to test ultra-sensitive C-reactive protein, endothelial von Willebrand factor and D-dimer. Through the observation on patients, arrangement of patient data, and measurement of dialyzer blood volume after hemodialysis, reasons and analysis for changes of coagulation function for patients taking hemodialysis were retrospectively analyzed. Results All patients were discharged from hospitals after the treatment, and PT and FIB values after the treatment were significantly lower than those before the treatment (P<0.05). APTT and TT values were not statistically different from those before the treatment (P>0.05). Positive rate of D-dimer was 50%before the treatment and 0.0% after the treatment, and the difference compared before and after the treatment was statistically significant (P<0.05). Results of P-selectin on platelet surface, ultra-sensitive C-reactive protein, endothelial von Wille-brand factor and D-dimer after hemodialysis were significantly higher than those before hemodialysis, and the differ-ences were statistically significant. Factors affecting changes of patients' coagulation function included individual health quality, doctors' inaccurate assessment, inappropriate anti-coagulation, insufficient usage of heparin and inappropriate operation techniques by nurses. Conclusion Medical staff should enhance their knowledge of anti-coagulation, improve the assessment and testing of coagulation status for patients taking hemodialysis, provide anti-coagulation protocol timely and properly, and practice operation techniques. Meanwhile, although heparin is used during treatment, patients may still be highly coagulated. Therefore, regular monitoring of coagulation indicators is able to effectively reduce co-agulation during hemodialysis.