Objective:To understand the current status of human resources in Operating Room nursing in China, so as to provide reference for nursing management, human resource allocation, nursing education and training in Operating Rooms.Methods:Using the stratified sampling method, a self-made Operating Room nursing human resource survey questionnaire of Chinese Nursing Society was used as a research tool in July 2021 to investigate the general situation, surgical workload, human resource allocation, Operating Room management, Operating Room information construction, nursing education and training of 2 201 hospitals in 31 provinces, autonomous regions and municipalities of China.Results:Among the 2 201 hospitals, there were 1 021 tertiary hospitals (46.39%), 1 177 secondary hospitals (50.75%), and 63 primary and below hospitals (2.86%). There were 2 056 hospitals with less than 30 Operating Rooms, accounting for 93.41%. There were 1 991 hospitals with an annual number of surgical cases less than 20 000, accounting for 90.46%, the educational background of Operating Room nurses was mainly undergraduate (66.93%, 43 359/64 780), with a total of 67.99% (44 045/64 780) having a bachelor's degree or above. Nurses were the main professional titles (42.66%, 27 632/64 780). Number of Operating Rooms: the number of Operating Room nurses (median) was 1: 2.43 and 78.96% (1 738/2 201) of hospital operating theatres were managed by Nursing Departments or hospitals. A total of 1 479 hospitals (67.20%) established anesthesia recovery rooms in their Operating Rooms, which was higher than 59.34% (1 210 hospitals) surveyed in 2016, and the difference was statistically significant (χ 2=226.701, P<0.01). 74.69% (1 644/2 201) and 87.87% (1 934/2 201) of hospitals carried out post management and capacity classification management in Operating Rooms, respectively. Day surgery and robotic surgery were performed in 47.80% (1 052/201) and 7.68% (169/2 201) hospitals, respectively. 36.98% (814/2 201) of the hospitals passed the information evaluation system certification and 64.61% (1 422/2 201) of the hospitals used the Operating Room information management system. In the Operating Room information system of the hospital, 2.54% (56/2 201) had intelligent functions. And 77.24% (1 700/2 201) of hospitals participated in the qualification training of Operating Room specialist nurses. Conclusions:By July 2021, the number of Operating Rooms in most hospitals in China is less than 30, and the annual number of operating cases is less than 20 000. The educational background and professional title of Operating Room nurses are mainly undergraduate and nurse. More than 60% of hospitals have set up anesthesia recovery rooms and have information management systems for Operating Rooms. At the same time, Operating Rooms in Chinese hospitals have widely implemented diversified nursing management models such as post management and ability grading management.

Immune Checkpoint Inhibitors ; Transcriptome ; Immunotherapy ; Biomarkers, Tumor

Objective:To investigate the correlation between circulating tumor cell (CTC) detection, RAS/RAF gene mutation and clinicopathological characteristics in patients with colorectal cancer (CRC).Methods:The Amplification Refractory Mutation System (ARMS)-polymerase chain reaction (PCR) were used to detect the gene mutation in the tumor tissues of 138 CRC patients in the Third Affiliated Hospital of Sun Yat-sen University from May 2017 to May 2020. At the same time, the venous blood of 138 patients was collected and enriched for CTC genotyping by mRNA in situ hybridization. The correlation between CTC, RAS/RAF gene mutation and clinicopathological features of CRC patients was analyzed.Results:The mutation rates of KRAS, NRAS and BRAF genes were 48.6%(67/138), 5.1%(7/138) and 1.4%(2/138), respectively; The overall positive rate of CTC was 84.1%(116/138). The positive rates of different CTC types were: 23.1%(32/138) in epithelial type, 71.7%(99/138) in mixed type and 12.3%(17/138) in interstitial type respectively. The positive rate of CTC in CRC patients with clinical stage Ⅲ-Ⅳ, lymph node metastasis (N1-N3) and distant metastasis (M1) was significantly higher than that in CRC patients with stage Ⅰ-Ⅱ, no lymph node metastasis (N0) and no distant metastasis (M0) (all P<0.05). The total number of CTC, mixed CTC and interstitial CTC were positively correlated with clinical stage, lymph node metastasis and distant metastasis (all P<0.05). RAS/RAF gene mutation, gender, age, tumor location and tumor differentiation did not affect the positive rate of CTC (all P>0.05). Conclusions:The results of CTC typing are of great research significance for comprehensive treatment, prognosis assessment and stratified management of CRC, among which the interstitial type of CTC may be a high risk factor for the recurrence and metastasis of CRC.

The heterogeneity of exhausted T cells (Tex) is a critical determinant of immune checkpoint blockade therapy efficacy. However, few studies have explored exhausted T cell subpopulations in human cancers. In the present study, we examined samples from two cohorts of 175 patients with head and neck squamous cell cancer (HNSCC) by multiplex immunohistochemistry (mIHC) to investigate two subsets of Tex, CD8⁺PD1⁺TCF1⁺ progenitor exhausted T cells (TCF1⁺Tex^prog) and CD8⁺PD1⁺TCF1^- terminally exhausted T cells (TCF1^-Tex^term). Moreover, fresh tumor samples from 34 patients with HNSCC were examined by flow cytometry and immunohistochemistry to further investigate their properties and cytotoxic capabilities and their correlation with regulatory T cells (Tregs) in the tumor immune microenvironment (TIME). mIHC and flow cytometry analysis showed that TCF1^-Tex^term represented a greater proportion of CD8⁺PD1⁺Tex than TCF1⁺Tex^prog in most patients. TCF1⁺Tex^prog produced abundant TNFα, while TCF1^-Tex^term expressed higher levels of CD103, TIM-3, CTLA-4, and TIGIT. TCF1^-Tex^term exhibited a polyfunctional TNFα⁺GZMB⁺IFNγ⁺ phenotype; and were associated with better overall survival and recurrence-free survival. The results also indicated that larger proportions of TCF1^-Tex^term were accompanied by an increase in the proportion of Tregs. Therefore, it was concluded that TCF1^-Tex^term was the major CD8⁺PD1⁺Tex subset in the HNSCC TIME and that these cells favor patient survival. A high proportion of TCF1^-Tex^term was associated with greater Treg abundance.
CD8-Positive T-Lymphocytes ; Head and Neck Neoplasms/therapy* ; Humans ; Immunotherapy/methods* ; Prognosis ; Programmed Cell Death 1 Receptor ; Squamous Cell Carcinoma of Head and Neck/therapy* ; Tumor Microenvironment ; Tumor Necrosis Factor-alpha

Objective To evaluate the effect of aminolevulinic acid-based photodynamic therapy (ALA-PDT) on the expression of Toll-like receptor 2 (TLR2) and downstream signaling pathway molecules,and secretion of cytokines in murine RAW264.7 cells.Methods The RAW264.7 murine macrophages were induced by inactivated Propionibacterium acnes suspension for the establishment of a cell model of inflammation.The cultured RAW264.7 cells were divided into 5 groups:blank control group receiving normal culture followed by the treatment with phosphate buffer saline (PBS),model group treated with inactivated Propionibacterium acnes suspension followed by the treatment with PBS,and three ALA groups treated with inactivated Propionibacterium acnes suspension followed by the treatment with 0.03,0.06 and 0.12 mmol/L ALA,respectively,and infrared radiation at a dose of 16 J/cm2.Enzyme-linked immunosorbent assay (ELISA) was performed to detect levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the culture supematant of RAW264.7 cells,and Western blot analysis to determine the protein expression of TLR2 and myeloid differentiation factor 88 (MyD88),as well as p38,c-Jun N-terminal kinase (JNK),extracellular signal-regulated kinase (ERK),inhibitor of κB kinase α (IκBα) and their phosphorylated forms (p-p38,p-JNK,p-ERK and p-IκBα).Results Compared with the blank control group,the model group showed significantly higher levels of TNF-α ([0.34 ± 0.02] ng/L,P ＜ 0.01) and IL-6 ([0.21 ± 0.03] ng/L,P ＜ 0.05).Compared with the 0.03 mmol/L ALA group,the 0.12 mmol/L ALA group showed a similar level of TNF-α ([0.03 ± 0.01] ng/L,P ＞ 0.05),but a significantly lower level of IL-6 ([0.07 ± 0.01] ng/L,F =114.813,P ＜ 0.01).The protein expression of TLR2,MyD88,p-p38,p-IκBα,p-JNK and p-ERK was all significantly higher in the model group (0.90 ± 0.14,1.11 ± 0.13,0.84 ± 0.04,1.45 ± 0.20,2.56 ± 0.06,3.70 ± 0.40) than in the blank control group (all P ＜ 0.01),and gradually decreased along with the increase of ALA concentration in a dose-dependent manner.Conclusion Photodynamic therapy can suppress the expression of TLR2 in RAW264.7 murine macrophages,and decrease the secretion of cytokines likely by the TLR2 signaling pathway.

Objective To evaluate the efficacy and safety of radiotherapy combined with concurrent and then adjuvant temozolomide in the patient with glioblastoma.Methods The databases of PubMed,Cochrane library,Medline and OVID were retrieved according to the Cochrane systematical assessment method.The included literatures were performed the quality evaluation and the meta analysis was performed after extracting the data.Results The summary of comparison between temozolomide group and radiotherapy group in the included studies showed that the 12-month overall survival rate[RR 1.22,95 ％ CI(1.01,1.47),P=0.04]and 24-month overall survival rate[RR 2.65,95 ％ CI(1.53,4.40),P＜0.01]had statistically significant differences;the 12-month pregrossion free survival rate[RR 2.59,95 ％CI(1.53,4.40),P=0.000 4] and 24-month pregrossion free survival rate[RR 6.77,95 ％ CI (2.82,16.26),P＜ 0.01] also showed statistically significant difference.The results of adverse reaction events revealed that the hematological toxic reactions in the temozolomide group had statistical difference between the concurrent therapy period and radiotherapy period [RR 3.21,95％CI(1.89,5.46),P＜0.01];which in the temozolomide group had statistical difference between the concurrent period and adjuvant period [RR 0.48,95 ％ CI(0.36,0.65),P＜0.01);but the non-hematological toxic reaction had no statistical difference[RR 1.11,95％CI(0.72,1.70),P=0.64].Conclusion Radiotherapy combined with concurrent and then adjuvant temozolomide therapy improves the overall and progression free survival period in the patient with glioblastoma,the higher occurrence rate of hematologic toxic reactions is correlated with temozolomide treatment drugs.

Objective To analyze the intervention effect of the dose-dense schemes of temozolomide on the newly diagnosed glioblastoma compared with the standard schemes. Methods The Pubmed,Cochrane,Em-base,CNKI,CBM,Wanfang,VIP databases were used for the retrievals on the intervention effect.The quality of included papers was assessed to extract network meta-analysis data with using the statistical software Stata 13.0. Results The treatment plans were ranked according to the intervention effect from the best to the worst as follows:the dose-dense,the early,the metronomic,the standard,the RT and post-RT adjuvant temozolomide. The most common adverse effects in hematotoxicity were neutropenia,leucopenia,lymphopenia,thrombocytopenia and ane-mia. Between the different temozolomide therapeutic regimens,there was no significant difference. Conclusion The intervention effect of the dose-dense schemes with temozolomide is better than the standard therapy. It also revealed that,the hematoxicity in the different temozolomide schemes is not significantly different.

Objective To investigate the inhibitory effect of Xiaoaiping injection (XAP) combined with paclitaxel (PTX) on human ovarian cancer SK-OV-3 cells .Methods In vitro anti-proliferation activity study of XAP combined with PTX on hu-man ovarian cancer SK-OV-3 cells was performed using optical microscope and MTT assay .Human ovarian cancer SK-OV-3 cells were treated with PTX ,XAP ,PTX combined XAP or vehicle control .Each group of cells was treated with drugs for 24 h or 48 h .SK-OV-3 cell morphology was observed with optical microscope .MTT assay was used to detect the A value and cell vi-ability was calculated .In vivo effect of XAP combined with PTX on the growth of SK-OV-3 cells was determined in nude mice . In our study ,thirty-six mice were randomly divided into six groups :G1 (NS) ,G2 (PTX ,10 mg/kg) ,G3 (XAP ,20 ml/kg) , G4 (XAP ,50 ml/kg) ,G5 (PTX 10 mg/kg+XAP 20 ml/kg) and G6 (PTX 10 mg/kg+XAP 50 ml/kg) .Animals were trea-ted for 18 days .Body weight ,tumor volume and tumor inhibition rate were recorded and calculated .The results were analyzed by the SPSS 19 .0 software .Results In vitro study showed that SK-OV-3 cell viability decreased significantly in PTX com-bined XAP group compared to PTX group or XAP group ,in a time and dose-dependent manner .In vivo study showed that the combination of PTX and XAP resulted in decreased tumor weight significantly compared to the control or the PTX alone . Conclusion The combination of XAP and paclitaxel exhibited a synergistic effect both in vitro and in vivo in nude mouse tumor xenograft model .

Objective To evaluate the curative effect and safety of mild hypothermia on patients with traumatic brain injury. Methods According to the cochrane systematic review methods , the data bases such as Cochrane, Pubmed, Embase, CBM, CNKI, Wanfang and VIP database were searched. The quality of included documents were assessed to extract meta analysis data. Results Compared to the control group, there was no statistically significant difference in patients treated by hypothermia for 3 days or less in mortality , but the difference was statistically significant after the summary [RR=0.74, 95%CI 0.64~0.85,P<0.000 1]; And there was no statistically significant difference in improving neural function of patients treated by hypothermia for < 3 days , but hypothermia improves the prognosis after the summary [RR=1.40,95%CI 1.24~1.59,P<0.000 01]. The difference was statistically significant in the incidence of pneumonia (P=0.007), there was no statistically significant difference in the incidence of arrhythmia (P=0.06), but the difference was statistically significant after sensitivity analysis. Conclusions Patients treated by hypothermia for < 3 days is not valid for clinical outcomes , the duration of the treament up to 3 days may not reduce mortality rates, but can improve the prognosis, lasts longer than 3 days or until the pressure back to normal, reducing the mortality rate, improve the neurological prognosis;but increased incidence of pneumonia, whether to increase the rate of cardiac arrhythmias have yet to be determined.