Objective To analyze the main characteristics of air pollution in Nanchang City, and discuss the correlation between air pollution exposure (especially PM2.5) and the development of pneumonia related intensive care unit (ICU) patients and their lag effect.Methods 2454 patients who lived in Nanchang City admitted to ICU of Jiangxi Provincial People's Hospital from January 1st, 2014 to December 31st, 2016 were enrolled. According to the diagnosis, the patients were divided into pneumonia group (156 cases) and non-pneumonia group (2298 cases). The general clinical characteristics of patients and air pollution concentration in Nanchang in the year between 2014-2016 were collected. Multiple regression model was used to analyze the influence of meteorological factors on the condition of ICU patients associated with pneumonia. Using odds ratio (OR), the correlation intensity of air pollution exposure and pneumonia related ICU patients' development was reflected, and the confidence level of association intensity was reflected by the 95％ confidence interval (95％CI). The distribution lag nonlinear model (DLNM) was established to evaluate the effect of air mass parameters on the time lag effect.Results The results of air pollution analysis in Nanchang City in the year between 2014-2016 showed that the annual average concentration of carbon monoxide (CO), sulfur dioxide (SO2) and nitrogen dioxide (NO2) was low and maintained at the same level in the year between 2014-2016. The annual average concentration of CO and NO2 increased in the year between 2014-2016, but the average annual concentration of SO2 decreased rapidly in the year between 2014-2016, and the average annual concentration of PM2.5 tended to slow down after the year between 2014-2016. The annual average concentration of PM10 decreased in the year between 2014-2016, but continued to rise in the year between 2014-2016. The annual mean concentration of O3 showed a trend of continuous increase from the year between 2014-2016. The age of pneumonia group was generally higher than that of non-pneumonia group, most of them were male, and had higher expected mortality and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score. The average air temperature in the pneumonia group was lower than that in the non-pneumonia group on the day of entering the group, and the air pollutants such as PM2.5 and PM10 were significantly higher than those in the non-pneumonia group. The analysis of multiple regression models showed that PM2.5 and air temperature were significantly related to patients with ICU pneumonia on the day of entry (PM2.5:OR = 1.02, 95％CI =1.00-1.03,P < 0.05; air temperature:OR = 0.96, 95％CI = 0.92-0.98,P < 0.05), and the effect of PM2.5 on patients with ICU pneumonia could last for at least 5 days (OR = 1.04, 95％CI = 1.00-1.09,P < 0.05), and the effect disappeared until the 7th day. According to the analysis of the influence of different concentrations of PM2.5 on ICU pneumonia patients, when the PM2.5 concentration reached 200μg/m3, its effect on ICU pneumonia patients would last for 5 days (OR = 1.45, 95％CI = 1.07-1.76,P < 0.01).Conclusion PM2.5 and air temperature are significantly related to the condition of ICU patients with pneumonia, and the influence of high concentration of PM2.5 on ICU patients with pneumonia has a lag effect.

Objective:To explore the academic procrastination (AP) status and related factors in college students. Methods: Totally 828 undergraduates (277 male, 551 female, age 18-25 years) from Sun Yat-Sen University were investigated with a self-made questionnaire for basic information and Undergraduate Academic Procrastination Questionnaire (UAPQ) for AP status. UAPQ included overall learning procrastination (OLP), homework procrastination (HP), exam preparing procrastination (EPP) and self-learning procrastination (SLP). Students who scored more than 3 in OLP, HP, EPP, SLP were regarded as procrastinator. Result: The procrastination rates of OLP, HP, EPP, SLP were 40.7％, 29.7％, 41.5％, and 47.6％. Multiple linear regression analysis results showed that bigger (β = 0.32) and normal (β =0.15) influence for academic by mobile-phone, higher level of computer dependence (β =0.15) were positively related with academic procrastination. Higher (β =-0.27) and normal (β =-0.17) levels of grade satisfaction were negatively correlated with academic procrastination. The seniors' academic procrastination levels were lower than those in other grade (β =-0.12). Conclusion: It suggests that undergraduates procrastinate widely in many academic activities. Bigger and normal influence for academic by mobile-phone, higher level of computer dependence may be risk factors of procrastination, while being satisfied with grades and seniors may be protective factors.

OBJECTIVE:To prepare Dexzopiclone orally disintegrating tablets (DODT),and to optimize its formulation.METHODS:Direct powder compression method was used to prepare DODT.Using repose angle of material,disintegration time and taste evaluation as indexes,single factor test was used to screen the types or amount of bulking agent,disintegrating agent,glidant and flavoring agent;using disintegration time as index,orthogonal experiment was applied to optimize the proportion of bulking agent,the amount of disintegrating agent,glidant and flavoring agent.Then the hardness and main component contents of DODT prepared by optimal formulation were determined.RESULTS:The optimal formulation was as follows as the ratio of mannitol-MCC 1 ∶ 4,the amount of disintegrating agent PVPP was 15％,the amount of glidant magnesium stearate was 1.0％,the amount of flavoring agent stevia was 3.0％.Three batches of prepared DODT were smooth in surface and good in taste;their disintegration time were(26.7 ± 1.2),(26.7 ± 0.6),(27.6 ± 0.9)s,hardness were (3.59 ± 0.19),(3.49 ± 0.18),(3.27 ± 0.16) kg,and contents were (99.47 ± 0.15) ％,(99.53 ± 0.05)％,(99.46 ± 0.20) ％,respectively (all RSDs≤0.87％,n=3).CONCLUSIONS:Prepared DODT are all in line with the quality requirements of orally disintegrating tablets.

Objective To observe Hedgehog signaling pathways of liver cancer cell growth and the influence of the metastatic potential targeted inhibit Hedgehog.Methods Construction of Smo shRNA plasmid,The stable and low-expressed Smo-expressing HCC QGY-7701 cell line was screened after lipofection.The stable and low-expressed Smo-expressing HCC QGY-7701 cell line was screened,The cell cycle,apoptosis,invasion and metastasis of QGY-7701 cells were detected by Western blot,flow cytometry,CCK8 and transwell assay.Subcutaneous implantation of hepatocarcinoma cells in nude mice.Study on the growth and metastasis of hepatocarcinoma cells with low expression of Smo in.The ultrastructural changes of hepatoma cells with low expression of Smo were observed under electron microscope.Results RT-PCR and Western blot showed stable shR-Smo cell line was successfully constructed.Cell cycle test showed that compared with the control group,G0/G1 cells increased in shR-Smo,cells in S phase decreased;apoptosis,CCK8 and Transwell tests showed that Smo-gene silencing could significantly increase the apoptosis percentage of the hepatic cancer cells to (5.46％ ± 1.46％),proliferation activity decreasedand and the migration rates reduced to (7.82％ ±2.14)％;nude mice model showed that Smo-gene silencing could inhibit the growth of hepatocellular carcinoma cells in vivo,electron microscopy revealed that lysosomes increased significantly in Smo-gene silence cells.Conclusions Blocking Hh signaling pathways,liver cancer cells in vitro malignant degree of decline.Hedgehog in treating liver cancer have hidden meaning.

Objective To analyze the distribution characteristics and risk factors of extended stay over 30 days at tertiary comprehensive hospitals, and explore methods of shortening average length of stay(LOS).Methods Homepage of all inpatients discharged from October 2014 to October 2015 of 31 tertiary comprehensive hospitals in Shanxi province were collected.39 234 cases of these inpatients stayed over 30 days and their case information was complete.A generalized linear model was used for risk factors analysis.Results With the extension of LOS, most of the inpatients with extended stay were found during their 30th-40th days, accounting for 50.21% of all and constituting the highest daily costs as well.The ratio of inpatients decreases with their LOS, and its distribution presents a positive skew in entirety.Distribution of inpatients over 30 days identified urban employees under medical insurance accounting for the highest ratio among all payment categories,and those from the department of orthopedics for the highest ratio among all departments, while those of diseases from injury and poisoning accounting for the highest ratio among all disease categories.The findings indicated ten important factors for extended stay, namely gender, medical payment category, ICD, inter-department transfer, nosocomial infection, and clinical pathway.Conclusions To strengthen management of specific departments and inpatients, focus on key process of medical quality, and accelerate medical insurance payment reform can effectively control extended stay.

By bioinformatics analysis, a putative keratinase gene gm2886 (Accession number: KY368946) was discovered in the genome of a feather-degrading strain, Streptomyces albidoflavus Fea-10. gm2886 was ligated into integrative Escherichia coli-Streptomyces shuttle vector pSET152 under the promoter PermE and added with C-terminal His-tag. The expression vector was transformed into Streptomyces pactum ACT12 by conjugal transfer and the recombinant protein GM2886-His6 was detected in fermentation broth. GM2886-His6 was purified and characterized. Its size was nearly 36 kDa. GM2886-His6 showed proteolytic activity towards a variety of substrates and could even degrade insoluble substrates, such as azure keratin and chicken feathers. The optimal pH and temperature of GM2886-His6 for proteolysis of casein was pH 10.0 and 50 ℃, respectively. The enzyme activity was inhibited by PMSF, but not EDTA, indicating that GM2886-His6 was a serine proteinase. Our results laid the foundation for the research of the molecular biological mechanism on feather-degrading and for the further utilization of Fea-10.

Objective To study the effect of lincRNA-p21 on the proliferation of renal cell carcinoma.Methods The expression levels of lincRNA-p21in renal cell carcinoma tissues and their corresponding para-cancerous tissues from 17 patients in department of nephrology,Hua Xi hospital,was detected by RT-PCR.In addition,the expression of lincRNA-p21 was analyzed in human clear cell RCC cell line 786-O and human embryonic kidney cell line HEK-293.The cell proliferation,apoptosis and the expression of Bax、Noxa、Puma that participated in p53 signaling pathway were detected after lincRNA-p21 was downregulated with siRNA.Results The expression levels of lincRNA-p21was higher in renal cell carcinoma tissues and 786-O cells than para-cancerous tissues and HEK-293 cells respectively(P ＜ 0.05).The ability of proliferation was significantly increased after lincRNA-p21 siRNA treatment in 786-O cells,whereas the cell apoptosis was decreased (P ＜ 0.05).The mRNA expressions of Bax,Noxa,Puma were also dramatically decreased after lincRNA-p21 was downregulated(P ＜0.05).Conclusion LincRNA-p21 inhibits the cell proliferation of 786-O cells through participation in p53 signal transduction pathways.These data suggested that lincRNA-p21 maybe could be used as molecular targets for human RCC treatment.

Objective To identify the critical indicators of nursing practice environment in China, as a reference for related studies. Methods Descriptive systematic review was used to retrieve literature of nursing practice environment, collect all potential indicators and design questionnaires based on those indicators. In the end, 39 potential indicators were identified, for a questionnaire survey of nurses from cooperating medical institutions in 30 provinces in China, with the data subject to statistical analysis in multiple linear regression model. Results Questionnaire items of higher mean score were usually found with a smaller 95% confidence interval, while coefficient of variation tended to be lower. Seventeen indicators were recommended as key indicators for nursing practice environment in China, including proper working hours and intensity, opportunities for nurses to participate in hospital management, good working relationship with doctors within a department,nursing managers′support for nurses′right decisions. The remaining components turned out to be insignificant in the analysis. Conclusions The influencing factors for the nursing practice environment in China are different from other countries. In this consideration, nursing managers should further explore and focus on such special indicators, and proactively improve the quality of nursing practice environment for better nursing service.

Objective To summarize the hot spots and cutting-edges by exploring Multidisciplinary Team (MDT) research in cancer.Methods CiteSpace is used to analyze MDT in cancer visually.Results 2 160 related literatures,10 key literatures,15 main clusters and 29 burst terms are detected.Conclusion MDT research on cancer mainly focuses on operation process,implemention and evaluation of effects.Improving efficiency,cost-effectiveness analysis and randomized controlled trial is the cutting-edge topics.This provides a new perspective for China.

Objective To analyze the spatial distribution of the incidence of tuberculosis (TB)in China from 2012 to 2014 and provide evidence for the prevention and control of TB.Methods The database of TB in China from 2012 to 2014 was established by using geographical information system,the spatial distribution map was drawn,trend analysis and spatial autocorrelation analysis were conducted to explore the spatial distribution pattern of TB and identify hot areas.Results The trend surface analysis showed that the incidence of TB decreased gradually from the west to the east in China,and the U type curve could reflect the TB distribution from the south to the north;Global spatial autocorrelation analysis showed the 2012-2014 global Moran's I were 0.366,0.364 and 0.358(P＜0.01),suggesting that the incidence of TB had a spatial clustering in China;Local Getis-OrdGi spatial autocorrelation analysis by ArcGIS software showed that there was 11 cluster areas,3 high incidence areas (Xinjiang,Tibet,Qinghai) and 8 low incidence areas (Beijing,Tianjin,Shanghai,Hebei,Inner Mongolia,Shanxi,Shandong,Jiangsu).Conclusion The incidence of TB had obviously spatial clustering characteristic,the areas at high risk were mainly in the northwestern and plateau area in China.