Long-term hypertension causes excessive vascular remodeling and leads to adverse cardiovascular events. Balance of ubiquitination and deubiquitination has been linked to several chronic conditions, including pathological vascular remodeling. In this study, we discovered that the expression of ubiquitin-specific protease 25 (USP25) is significantly up-regulated in angiotensin II (Ang II)-challenged mouse aorta. Knockout of Usp25 augments Ang II-induced vascular injury such as fibrosis and endothelial to mesenchymal transition (EndMT). Mechanistically, we found that USP25 interacts directly with Forkhead box O3 (FOXO3) and removes the K63-linked ubiquitin chain on the K258 site of FOXO3. We also showed that this USP25-mediated deubiquitination of FOXO3 increases its binding to light chain 3 beta isoform and autophagosomic-lysosomal degradation of FOXO3. In addition, we further validated the biological function of USP25 by overexpressing USP25 in the mouse aorta with AAV9 vectors. Our studies identified FOXO3 as a new substrate of USP25 and showed that USP25 may be a potential therapeutic target for excessive vascular remodeling-associated diseases.

Doxorubicin (Dox) is an anthracycline drug widely applied in various malignancies. However, the fatal cardiotoxicity induced by Dox limits its clinical application. Post-transcriptional protein modification via ubiquitination/deubiquitination in cardiomyocytes mediates the pathophysiological process in Dox-induced cardiotoxicity (DIC). In this study, we aimed to clarify the regulatory role and mechanism of a deubiquitinating enzyme, ubiquitin-specific peptidase 13 (USP13), in DIC. RNA-seq analysis and experimental examinations identified that cardiomyocyte-derived USP13 positively correlated with DIC. Mice with cardiac-specific deletion of USP13 were subjected to Dox modeling. Adeno-associated virus serotype 9 (AAV9) carrying cTNT promoter was constructed to overexpress USP13 in mouse heart tissues. Cardiomyocyte-specific knockout of USP13 exacerbated DIC, while its overexpression mitigated DIC in mice. Mechanistically, USP13 deubiquitinates the stimulator of interferon genes (STING) and promotes the autolysosome-related degradation of STING, subsequently alleviating cardiomyocyte inflammation and death. Our study suggests that USP13 serves a cardioprotective role in DIC and indicates USP13 as a potential therapeutic target for DIC treatment.

We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Female ; Humans ; Uterine Cervical Neoplasms/drug therapy* ; Prospective Studies ; Quality of Life ; Neoplasm Staging ; Chemoradiotherapy ; Chemotherapy, Adjuvant/adverse effects* ; Adjuvants, Immunologic ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Retrospective Studies

Nursing intervention classification (NIC) is an effective system in documenting nursing work, which can improve nursing quality, strengthen the standard of nursing charging, and promote nursing education and research. In addition, it can be used as a standardized nursing language to satisfy the needs of electronic computerized nursing record. The authors introduced the content of NIC, as well as the advantages found in overseas application and the status of application and research at home. Also presented are the application prospect, research approaches and advices on how to apply the NIC system in clinical practice at home.

Objective To assess the effect of parent-child individual management in children with mycoplasma pneumonia and to provide guidance for improve the quality.Methods 482 children with mycoplasma pneumonia were divided into parent-child individual management group and conventional intervention group according to the time including the study.The parent-child individual management group used specially formulated for the mother and child management intervention + conventional measures.The conventional intervention group used conventional nursing neasures.The duration of hospitalization,hospitalization expense,depression,family members of patients satisfaction,curative effect,clinical index were compared between the two groups.Results Mter intervention,compared with the conventional intervention group,the duration of hospitalization,hospitalization expense decreased lower [length of stay:(12.08 ± 1.26) d vs.(15.82 ± 3.07) d,t =16.398,P =0.000;hospitalization expense:(641.57 ± 124.28) RM B vs.(896.72 ± 179.15) RM B,t =17.012,P =0.000],the maternal anxiety of the parent child individual management group reduced obviously [anxiety scores (34.21 ± 4.51) points vs.(43.29 ± 6.17) points,t =17.245,P =0.000] and the satisfaction of children of the parent-child individual management group improved obviously(most satisfaction rate:65.71％ vs.49.52％,x2 =10.663,P =0.001;satisfaction rate:27.14％ vs.29.25％,x2 =0.928,P =0.710;general satisfaction rate:5.71％ vs.16.04％,x2 =10.538,P =0.000;dissatisfaction:1.43％ vs.5.19％,x2 =3.552,P =0.060;total rate:92.86％ vs.78.77％,x2 =16.021,P =0.000).The efficacy of the parent-child individual management group improved obviously (inefficiency:7.14％ vs.21.22％,x2 =16.021,P =0.000;efficiency:17.19％ vs.21.21％,x2 =1.812,P =0.178;cure rate:73.33％ vs.53.30％,x2 =17.364,P =0.000;total effective rate:92.85％ vs.78.77％,x2 =16.021,P =0.000).The clinical indicators of the parent-child individual management group were improved obviously[pyretolysis days:(3.42 ± 1.46) d vs.(4.56 ±1.67) d,t =7.463,P =0.000;cough disappeared days:(8.72 ± 2.04) d vs.(10.29 ± 1.95) d,t =8.030,P =0.000;rales disappeared days:(3.96 ± 1.45) d vs.(5.87 ± 1.7 1) d,t =12.370,P =0.000].Conclusion The parent-child individual management in children with mycoplasma pneumonia has good effect on the hospitalization days,hospitalization expense,the satisfaction of children,the curative effect and the clinical indicators,it is worthy of clinical promotion.

Objective The aim of this study was to investigate the value of ultrasound in diagnosis of benign and malignant thyroid nodules with rim calcification. Methods Sixty thyroid nodules with rim calcifications from Sun Yat-sen University Cancer center which were detected on ultrasound from January 2008 to December 2015 were included in this study, and all the thyroid nodules had pathological results. Ultrasonic features of thyroid nodules, including the size, border, internal echo, growth pattern, rear echo, interruption or inner sink of the rim calcification and hypoechoic soft tissue extrusion around rim calcification were analyzed. Results Thirty-seven nodules (61.7%) were confirmed to be benign, and twenty-three nodules (38.3%) were malignant. The ultrasonic features of interruption or inner sink of rim calcifications and hypoechoic soft tissue extrusion around rim calcification, were more often in malignant nodules than benign nodules. The sensitivity, specificity, the positive predictive values and the negative predictive values for interruption or inner sink of rim calcifications were 85.7%, 89.4%, 85.7% and 89.4%, respectively. The sensitivity, specificity, the positive predictive values and the negative predictive values for hypoechoic soft tissue extrusion around rim calcification were 81.3%, 94.4%, 92.9% and 85.0%, respectively. Internal hypoechogenicity was more frequently observed in the malignant nodules (82.6%) than in benign nodules (40.5%). The longitudinal growth pattern of thyroid was more frequently observed in malignant nodules (30.4%) than in benign nodules (2.7%). The differences of this two ultrasound features were statistically significant(χ2=9.958 and 9.440,both P<0.01).There were no significant differences in size,border and the rear echo between malignant and benign nodules (all P>0.05). Conclusion The interruption or inner sink of the rim calcification could be useful in differential diagnosis of thyroid nodules with rim calcification.

Objective To observe and evaluate the application effects of quality control circle ( QCC) intervention in the early parenteral nutrition nursing on extremely low birth weight ( ELBW) infants with electrolyte disorder.Methods Totals of 100 of ELBW infants admitted to the Neonatal Intensive Care Unit (NICU) between January 2014 and January 2015 were collected randomly and equally divided into intervention group and control group based on different care regimens .Intervention group were given early parenteral nutrition under the guidance of QCC intervention while control group were only with routine early parenteral nutrition .Plasma K+, Ca2+levels, hyperkalemia, hypocalcemia incidence and mortality were compared between two groups .Results The serum K+levels of intervention group were lower than the control group and the serum Ca 2+levels were higher than that of control group significantly ( P <0.05 ); The hyperkalemia and hypocalcemia incidence of intervention group were lower than that of control group greatly ( P<0 .05 ); No death occurred in intervention group, while 6 cases in the control group died of invalid correction of serum K +concentrations eventually , of which the mortality was 12.00%.Conclusions Early parenteral nutrition nursing care with the guidance of QCC on ELBW infants , can effectively correct infants′electrolyte disorder state , reduce the incidence of hyperkalemia and hypocalcemia and mortality of the infants .

Objective The current status of the quality of work life(QWL)among pediatric nurses was investigated and its influencing factors were analyzed,in order to supply references for improving work efficiency and quality.Methods Two hundred and eighty-two pediatric nurses from 2 children′s hospitals in Jiangsu province were selected by the simple random sampling method. Self-administered questionn aires were carried out by using the socio-demographic information questionnaire,the quality of work life questionnaire (QWL7-32),the occupation stress inventory-revised questionnaire and the psychological empowerment scale.The main influencing factors related with the quality of work life among pediatric nurses were statistically analyzed.Results The total QWL score of pediatric nurses was (1 01 .39 ±1 5.1 4)points.The percentage of pediatric nurses with a worse quality of work life was 29.8%.The percentage of pediatric nurses with a medium quality of work life was 52.8%.The percentage of pediatric nurses with a better quality of work life was 1 7.4%.The multiple regression analysis showed that the main factors,which were related to QWL in pediatric nurses,were working years of pediatric nursing,monthly night shift,work mode,workload,psychological strain,social support,the meaning of work.Conclusions The QWL of pediatric nurses is worse.Appropriate interventions related to different influencing factors should be carried out to increase the QWL of pediatric nurses,which is an effective method to improve work enthusiasm of nurses and ensure nursing of high quality.

Objective To set up a real-time quantitative PCR approach for detection and quantification for bcr-abl transcripts in CML patients,and detect minimal residual disease (MRD) in CML by real-time quantitative PCR (RQ-PCR)and evaluate the significance of MRD detection.Methods The ber-abl.fusion gene expression in 80 patients with CML was analyzed by RQ-PCR. The patients were divided into three groups according to the different treatment, allogeneic hematopoietic stem cell transplantation group,imatinib group and hydroxyurea group. The change of bcr-abl fusion gene was monitored in CML patients before and after treatment.Results The average of RQ-PCR detection on newly diagnosed patients with CML in chronic phase was 6847.67 copies / 104 cells,the accelerated phase was 306 176.08 copies / 104 cells,and the average results were 944.33, 2.37, 0.29, 0 copies / 104 cells after allogeneic hematopoietic stem cell transplantation one month,6 months,12 months or 24 months respectively.The average of RQ-PCR detection after use imatinib mesylate 3 months was 3720.23 copies / 104 cells and not be detected after one year. The average was 7290.11 and 3143.24 copies / 104 cells after hydroxyurea treatment 0 and 9 months respectively.The difference in first two groups was not significant (t=1.74,P=0.17), but the difference between the third group and the first two groups was significant (t=3.74,P=0.01.t=2.97,P=0.02). The upregulation of bcr-abl transcript levels could be detected when disease progression. The transcripts level in accelerated phase was significantly higher than that in chronic phase. Conclusion RQ-PCR can be used to detect the MRD,monitor the treatment outcome,predict disease recurrence and give early intervention.

Objective To analyze the treatment efficacy and safety of a modified GMALL protocol for adult acute lymphoblastic leukemia (ALL). Methods Data of 37 patients with newly diagnosed adult ALL treated with a modified GMALL protocol from January 2005 to December 2009 were retrospectively analyzed,and compared with that of 44 patients treated with an in-house conventional protocol at the same period.Results The complete remission (CR) rate was 89.2 %(33/37) treated with modified GMALL protocol. The cumulative overall survival (OS) rates at 1 year, 2 years, 3 years and 4 years were 77.5 %, 48.0 %, 40.0 %and 40.0 %, respectively. The main adverse events were grade 3 or grade 4 hematological toxicities and infections which were easily managed, and the treatment-related mortality rate was low. The OS of modified GMALL protocol was superior to that of the conventional protocol. Conclusion The modified GMALL protocol has a satisfying effect and the adverse events can be tolerated for adult ALL, so its clinical application can be encouraged.