ObjectiveTo investigate and explore the characteristics and influencing factors of glucose metabolism in children with β-thalassemia major （β-TM） after allogeneic hematopoietic stem cell transplantation （allo-HSCT）. MethodsThe follow-up data of 41 patients with β-TM who underwent HSCT at Hematopoietic Stem Cell Transplantation Department of Children's Medical Center of Sun Yat-sen Memorial Hospital， Sun Yat-sen University were retrospectively analyzed. Their glucose metabolism characteristics were evaluated through laboratory tests and the related influencing factors were analyzed. ResultsIn the study， 41.46% （17/41） of patients developed abnormal glucose homeostasis after HSCT. Among them， 82.35% （14/17） characterized by insulin resistance， but no cases of diabetes mellitus were found. The results of insulin releasing test and oral glucose tolerance test（OGTT） showed that 45.00% （9/20） of patients had abnormal insulin releasing curve and 40.0% （8/20） had delayed serum glucose peak. The average age of HSCT in abnormal glucose homeostasis group was significantly older than that in the normal glucose homeostasis group ［（8.8±3.9） years old vs （6.0±3.1） years old， P=0.015］. ConclusionsPatients with β-TM after HSCT may develop abnormal glucose homeostasis， consists largely of insulin resistance. The elder age of HSCT （≥7 years old） is a risk factor for abnormal glucose homeostasis in β-TM patients after HSCT. It is recommended to regularly monitor glucose metabolism indicators in β-TM children after HSCT， especially in elderly transplant recipients.

Background::Copper and zinc are involved in the development of multiple malignancies; yet, epidemiological evidence on hepatocellular carcinoma (HCC) is limited. This study aimed to investigate the association between dietary intake and serum levels of copper and zinc with the risk of HCC.Methods::A total of 434 case-control pairs matched for sex and age (±1 year) were included in this study. Cases with newly diagnosed HCC were from the Guangdong Liver Cancer Cohort (GLCC) study, and healthy controls were from the Guangzhou Nutrition and Health Study (GNHS). A semi-quantitative 79-item food frequency questionnaire (FFQ) was used to assess habitual dietary intakes of copper and zinc. Serum levels of copper and zinc were measured by using inductively coupled plasma mass spectrometry. The copper (Cu)/ zinc (Zn) ratio was computed by dividing copper levels by zinc levels. Conditional logistic regression models were performed to calculate the odds ratio (OR) and 95% confidence intervals (CI) for per 1 standard deviation increase (per-SD increase) in copper and zinc levels.Results::Higher dietary intake (OR per-SD increase = 0.65, 95% CI: 0.44, 0.96, Ptrend = 0.029) and serum levels of zinc (OR per-SD increase = 0.11, 95% CI: 0.04, 0.30, Ptrend <0.001) were both associated with a lower risk of HCC. Subgroup analyses showed that the inverse association was only pronounced in men but not in women ( Pinteraction = 0.041 for dietary zinc intake and 0.010 for serum zinc levels). Serum copper levels (OR per-SD increase = 2.05, 95% CI: 1.39, 3.03, Ptrend = 0.020) and serum Cu/Zn ratio (OR per-SD increase = 6.53, 95% CI: 2.52, 16.92, Ptrend <0.001) were positively associated with HCC risk, while dietary copper intake and dietary Cu/Zn ratio were not associated with HCC risk. Conclusion::Zinc may be a protective factor for HCC, especially among men, but the effects of copper on HCC risk are not clear.

Objective:To explore the association between the intake and changes in various types of food and the changes in blood pressure in patients with mild to moderate hypertension.Methods:Mild to moderate hypertension participants with complete baseline and outcome data were included from DECIDE-Diet study, a multicenter, randomized controlled trial. Dietary records and blood pressure measurements at both 7-day run-in (baseline) and 28-day intervention phases were collected for enrolled participants. Blood pressure change was defined as the difference between blood pressure at the end of trial and the baseline blood pressure. Baseline intake of food was the average daily intake during the run-in period, and the intake increment was defined as the difference between the average intake during the trial period and the average intake during the run-in period. After adjusting for age, sex, study center, intervention groups, baseline body mass index (kg/m 2), antihypertension medication use, and baseline total calorie intake, a linear regression model was used to analyze the associations of the before-after-intervention change in blood pressure with baseline intake and intake increment of foods. Results:A total of 258 patients with mild to moderate hypertension were included, including 133 males, aged (56.5±9.9) years. (1) After adjusting for confounding factors, there was no significant association between baseline intake of food and baseline blood pressure (all P>0.05). The blood pressure change was negatively associated with baseline intakes of tubers, vegetables, and vegetable oils but positively with baseline intake of meats; and was negatively associated with intake increment of whole grains and fish (all P<0.05). (2) The multiple linear regression analysis showed that baseline intake of vegetables ( β=-0.021, P=0.004), vegetable oils ( β=-0.260, P=0.002), and increment in intake of fish ( β=-0.128, P=0.026) were all significantly associated with changes in systolic blood pressure; baseline intake of vegetables ( β=-0.017, P=0.002), vegetable oils ( β=-0.182, P=0.001), dairy products ( β=0.021, P=0.022), and increment in intake of fish ( β=-0.092, P=0.010) were all significantly associated with changes in diastolic blood pressure. Conclusion:Increasing the intake of whole grains, vegetables, vegetable oils, and fish and decreasing the intake of meat may be beneficial for blood pressure control in patients with mild to moderate hypertension.

Hepatic stellate cells (HSCs) represent a significant component of hepatocellular carcinoma (HCC) microenvironments which play a critical role in tumor progression and drug resistance. Tumor-on-a-chip technology has provided a powerful in vitro platform to investigate the crosstalk between activated HSCs and HCC cells by mimicking physiological architecture with precise spatiotemporal control. Here we developed a tri-cell culture microfluidic chip to evaluate the impact of HSCs on HCC progression. On-chip analysis revealed activated HSCs contributed to endothelial invasion, HCC drug resistance and natural killer (NK) cell exhaustion. Cytokine array and RNA sequencing analysis were combined to indicate the iron-binding protein LIPOCALIN-2 (LCN-2) as a key factor in remodeling tumor microenvironments in the HCC-on-a-chip. LCN-2 targeted therapy demonstrated robust anti-tumor effects both in vitro 3D biomimetic chip and in vivo mouse model, including angiogenesis inhibition, sorafenib sensitivity promotion and NK-cell cytotoxicity enhancement. Taken together, the microfluidic platform exhibited obvious advantages in mimicking functional characteristics of tumor microenvironments and developing targeted therapies.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

PURPOSE: Hepatocellular carcinoma (HCC) is the most common malignant tumor of liver cells. Researchers have reported that cancer susceptibility candidate 2 (CASC2), a long non-coding RNA, is down-regulated in various cancers, including HCC. Our study aimed to investigate the molecular mechanism(s) of CASC2 in HCC. MATERIALS AND METHODS: Real-time quantitative PCR (RT-qPCR) was used to analyze the expression of CASC2 and miR-183 in HCC tissues and cells. The viability of HCC SMMC-7721 and Huh-7 cells was detected through MTT assay. Colony formation assay was performed to assess the colony formation ability of HCC cells. The migration and invasion abilities of HCC cells were evaluated by Transwell assay. Western blot was conducted to examine levels of key Wnt/β-catenin signaling pathway factors, C-myc, cyclinD, survivin, and β-catenin. The interaction between CASC2 and miR-183 was affirmed by bioinformatics analysis and luciferase reporter assay. RESULTS: CASC2 was down-regulated in HCC tissues and cell lines, while miR-183 was up-regulated. The expression of miR-183 was negatively correlated with CASC2 expression in HCC tissues. Overexpression of CASC2 inhibited cell viability, colony formation, migration, and invasion in HCC cells, as well as Wnt/β-catenin signaling pathway activity. miR-183 was a downstream target of CASC2 and negatively regulated by CASC2. Introduction of miR-183 rescued CASC2-induced suppressive effects on HCC cell viability, colony formation, migration, and invasion and Wnt/β-catenin signaling. CONCLUSION: CASC2 inhibited cell viability and the colony formation, migration, and invasion abilities of HCC cells by directly downregulating miR-183 through inactivation of the Wnt/β-catenin signaling pathway.
Blotting, Western ; Carcinoma, Hepatocellular ; Cell Line ; Cell Survival ; Computational Biology ; Liver ; Luciferases ; Polymerase Chain Reaction ; RNA, Long Noncoding

Objective To understand the present situation of occupational low back pain of clinical nurses, and analyze its influence factors.Methods A questionnaire survey was conducted among 1300 clinical nurses from 7 Class Ⅲ Grade A general hospitals in 5 provincial capital cities, in the region of north China, central China, southern China, southwest and northwest, from April to December 2016. The survey tools included general demographic characteristics questionnaire, Visual Analogue Scale (VAS) and Chinese version of Fear-Avoidance Belief Questionnaire (FABQ-CHI). A total of 1300 questionnaires were distributed, and 1279 valid were collected. SPSS 21.0 was applied for statistical analysis.Results In the 1279 nurses, 115 (8.99％) had no low back pain, and 1164 (91.01％) was positive. The majority of nurses suffered with mild pain, account for 64.69％. The average score of FABQ-CHI in negative nurses was (50.11±17.5), and that in positive nurses was (55.24±8.2), the difference was statistically significant (t=14.56,P< 0.001). Univariate analysis showed that there were significant differences in VAS scores among nurses of different ages, marital status, fertility status, professional titles, working years, and whether or not they participated in training (P<0.01). Multivariate analysis showed that age (OR=1.40) and professional title (OR=1.84) were the influencing factors of low back pain.Conclusions The incidence of occupational low back pain in nurses is high, and it is related to individual factors, work related factors and psychological factors. It is suggested that great attention should be paid to the popularization of knowledge on prevention and treatment of low back pain and the training of occupational protection skills for clinical nurses. Especially, we should pay attention to the correlation between psychological factors and nurses' occupational low back pain, gradually improve the working environment and bad living habits of nurses, reduce the occurrence of low back pain, and improve the job satisfaction of clinical nurses.

Objective To evaluate the effect of dexmedetomidine on the expression of Semaphorin 7A during lung ischemia-reperfusion (I/R) in rats.Methods Thirty healthy clean-grade adult male Sprague-Dawley rats,aged 8-12 weeks,weighing 200-240 g,were divided into 3 groups (n=10 each) using a random number table method:sham operation group (S group),I/R group and dexmedetomidine group (D group).Only sternotomy was performed,and the left hilum of lung was not clamped in S group.The model of lung I/R injury was established by clamping the left hilum of lung for 45 min followed by 120 min of reperfusion in I/R group.Dexmedetomidine 50 μg/kg was intraperitoneally injected at 30 min before ischemia,and then the model was established in D group.The rats were sacrificed at the end of reperfusion,and the lungs were removed for examination of the pathological changes (using haematoxylin and eosin staining) which were scored and for determination of the wet to dry weight ratio (W/D ratio),expression of Semaphorin 7A protein and mRNA (by Western blot or real-time polymerase chain reaction),and contents of tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) in lung tissues (by enzyme-linked immunosorbent assay).Results Compared with S group,W/D ratio and pathological scores were significantly increased,the expression of Semaphorin 7A protein and mRNA was up-regulated,and the contents of TNF-α and IL-1β were increased in I/R and D groups (P＜0.05).Compared with I/R group,W/D ratio and pathological scores were significantly decreased,the expression of Semaphorin 7A protein and mRNA was down-regulated,and the contents of TNF-α and IL-1 β were decreased in D group (P＜0.05).Conclusion The mechanism by which dexmedetomidine reduces lung I/R injury may be related to down-regulating Semaphorin 7A expression,thus inhibiting inflammatory responses of rats.

Objective To investigate the transitional care needs of ischemic stroke patients when they were discharged and analyze the influencing factors.Methods Transitional care needs of stroke patients questionnaires were conducted in 136 ischemic stroke patients in the department of neurology from April 2014 to December 2014.Results Telephone follow-up was the easiest way of transitional care to be accepted by patients. The transitional care needs included five aspects:safe medication(86.0%),blood pressure self monitoring(83.1%),diet guiding(83.1%),rehabilitating exercise(80.1%) and stroke knowledge(75.7%). The influencing factors of transitional care needs were:the patients with previous medical history demanded much more on the safe medication intervention than the patients without history disease. The demand of the patients with previous medical history was 7.17 times as much as that of the patients without previous medical history (OR=7.15,95%CI:1.83-27.94).The demand of the patients with previous medical history on "rehabilitation exercise" was 4.68 times as much as that of the patients without previous medical history (OR=4.68,95%CI:1.40-15.63). The demand of the patients over 60 years old on "diet guiding" was 11.41 times as much as patients under 50 years old (OR=11.41,95%CI:1.75-74.46).Conclusions For ischemic stroke patients,telephone follow-up can be used as the method of transitional care. Older patients and patients with previous medical history are the main patients who need transitional care.

Objective To detect the changes of G protein-coupled inwardly rectifying potassium channels (GIRK)expression in allergic asthma model and identify the regulatory factors.Methods The E3 rat asthma models were induced by challenge with ovalbumin 14 days after immunization with ovalbumin and aluminium adjuvant.The asthma models were evaluated based on changes in lung pathomorphology and total IgE levels.The levels of GIRK1-4 mRNA and protein were detected using real time-PCR and Western blot.The anatomic sites where GIRK was expressed dominantly in the lung were identified using immunohistological staining.To identify the effects of IL-4 on the expressions of GIRK channels,GIRK 1 -4 mRNA and protein in IL-4 stimulated bronchial epithelial cell line A549 were detected by RT-PCR and Western blot.Results The levels of GIRK1-4 mRNA and protein decreased significantly in the lung in asthmatic E3 rats.The results of immunohistological staining showed that GIRK channels were dominantly expressed in airway epithelia in the lung.The levels of GIRK 1-4 mRNA and protein were down-regulated in time-and dose-dependent manners in IL-4 treated A549.Conclusion IL-4 down-regulates the expression levels of GIRK subunits in bronchial epithelia during allergic asthma.