Objective:To investigate the effects of brief mindfulness-based stress reduction(MBSR)on preoperative anxiety in pa-tients undergoing painless gastrointestinal endoscopy.Methods:We enrolled 100 patients scheduled to undergo elective painless gas-trointestinal endoscopy at The First Affiliated Hospital of Zhengzhou University from September 2024 to April 2025.The inclusion cri-teria were:age,18-60 years;body mass index,18.0-28.0 kg/m2;American Society of Anesthesiologists physical status,class Ⅰ orⅡ;and no gender restriction.The patients were assigned to experimental group(n=50)or control group(n=50)using a random num-ber table.A dedicated nursing team implemented the brief MBSR protocol.At 30 minutes before endoscopy,both groups underwent anxiety assessment using the Amsterdam Preoperative Anxiety and Information Scale(APAIS).All the patients received routine preop-erative education.Guided by the nurses,the experimental group received the brief MBSR intervention consisting of mindful body scan-ning,mindful breathing,and mindful music listening,for 12 minutes each at 30 and 15 minutes before the procedure.We recorded the APAIS score,bispectral index(BIS),heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),and mean arterial pressure(MAP)at 30 minutes before the procedure(T0),after brief MBSR(T1),and immediately before anesthesia induction(T2);the length of stay in the post-anesthesia care unit(PACU)and postoperative adverse reactions;and the APAIS score and degree of sat-isfaction of patients at discharge from the PACU(T3).Results:Com-(all P<0.05).However,no significant differences were observed be-pared with the control group,the experimental group exhibited sig-nificantly lower APAIS scores,significantly reduced BIS values,and significantly lower HR values at T1 and T2 and a significantly lower APAIS score and a significantly higher degree of satisfaction at T3 tween the groups in SBP,DBP,MAP,postoperative adverse events,or PACU length of stay at any time point(all P>0.05).Conclusion:Brief MBSR is an effective non-pharmacological intervention to cope with perioperative negative emotions in patients undergoing pain-less gastrointestinal endoscopy,which can alleviate preoperative anxiety,reduce electroencephalographic arousal,and improve patient satisfaction.

Objective To explore the impact of antimicrobial volume-based procurement(VBP)and classification management policy on the clinical use of carbapenem antibiotics.Methods Changing trend in defined daily doses(DDDs),procurement cost(Cost),defined daily dose cost(DDDc),and DDDs per 1 000 inhabitants daily(DID)of carbapenem antibiotics in all levels of medical institutions were analyzed by Mann-Kendall trend test.May 1,2020 was taken as the intervention cut-off point of VBP policy,September 2021 was as intervention cut-off point of cla-ssification management list.The impact of VBP and classification management policy on the clinical use of carbape-nem antibiotics were studied by interrupted time series analysis.Results After implementing VBP policy,the DDDs and DID of carbapenem antibiotics increased obviously,but the long-term trend didn't change significantly.Compared with before the implementation of the policy,the cost and DDDc of carbapenem antibiotics decreased im-mediately,the long-term trend of DDDc changed significantly,but the long-term trend of cost didn't change signifi-cantly.The DDDs and Cost of carbapenem antibiotics decreased immediately after the update of classification ma-nagement list,but the long-term downward trend was not significant,and DDDc presented a long-term upward trend.Conclusion VBP policy reduces the DDDc and short-term cost of carbapenem antibiotics,but its long-term impact on DDDs,cost and DID is limited.Classification management has limited impact on the use of carbapenem antibiotics in medical institutions.

Objective To explore the impact of antimicrobial volume-based procurement(VBP)and classification management policy on the clinical use of carbapenem antibiotics.Methods Changing trend in defined daily doses(DDDs),procurement cost(Cost),defined daily dose cost(DDDc),and DDDs per 1 000 inhabitants daily(DID)of carbapenem antibiotics in all levels of medical institutions were analyzed by Mann-Kendall trend test.May 1,2020 was taken as the intervention cut-off point of VBP policy,September 2021 was as intervention cut-off point of cla-ssification management list.The impact of VBP and classification management policy on the clinical use of carbape-nem antibiotics were studied by interrupted time series analysis.Results After implementing VBP policy,the DDDs and DID of carbapenem antibiotics increased obviously,but the long-term trend didn't change significantly.Compared with before the implementation of the policy,the cost and DDDc of carbapenem antibiotics decreased im-mediately,the long-term trend of DDDc changed significantly,but the long-term trend of cost didn't change signifi-cantly.The DDDs and Cost of carbapenem antibiotics decreased immediately after the update of classification ma-nagement list,but the long-term downward trend was not significant,and DDDc presented a long-term upward trend.Conclusion VBP policy reduces the DDDc and short-term cost of carbapenem antibiotics,but its long-term impact on DDDs,cost and DID is limited.Classification management has limited impact on the use of carbapenem antibiotics in medical institutions.

Objective:To investigate the effects of echinatin(Ech)on the malignant biological behavior and immune escape of lung cancer A549 cells and its underlying mechanisms.Methods:Normal lung epithelial cells(BEAS-2B)and A549 cells were routinely cultured and treated with different concentrations of Ech for 24h.Cell viability was assessed using the MTT assay,and concentrations of 20,30,and 40 μmol/L were selected for subsequent experiments.A549 cells were divided into the following groups:control group(0 μmol/L Ech),low-(20 μmol/L),medium-(30 μmol/L),and high-concentration(40 μmol/L)Ech groups(Ech-L,Ech-M,Ech-H),and high-dose Ech combined with the pathway inhibitor H-151(1.0 μmol/L)group(Ech-H+H-151).Cell proliferation,migration,and invasion were evaluated using the EdU assay,wound-healing assay,and Transwell assay,respectively.Western blotting(WB)assay was applied to detect the expression of proteins related to proliferation,migration,invasion,and the STING/TBK1/IRF3 signaling pathway.Subsequently,A549 cells were co-cultured with CD8+T cells,and trypan blue staining was used to detect CD8+T cell viability.The levels of type Ⅰ interferon(IFN-Ⅰ)in the co-culture supernatants were detected by WB,while the levels of programmed death ligand 1(PD-L1),interleukin-10(IL-10),interleukin-4(IL-4),and transforming growth factor-β(TGF-β)were determined using ELISA.Results:Ech inhibited the viability of A549 cells in a dose-dependent manner(all P<0.05)but had no significant effect on the viability of BEAS-2B cells.Ech dose-dependently inhibited the proliferation,migration and invasion of A549 cells(all P<0.05),as well as the protein expression of cyclinD1,Ki67,MMP2,MMP9,STING,p-TBK1 and p-IRF3(all P<0.05).These effects were partially reversed by H-151.Ech dose-dependently promoted the survival of CD8+T cells co-cultured with A549 cells(all P<0.05),enhanced IFN-Ⅰexpression(all P<0.05),and inhibited the secretion of PD-L1,IL-10,IL-4,and TGF-β(all P<0.05),with H-151 partially reversing these effects(all P<0.05).Conclusion:Ech inhibits malignant biological behavior and immune escape of lung cancer A549 cells by activating the STING/TBK1/IRF3 signaling pathway.

ObjectiveTo analyze and construct a curriculum framework and content system of the vocational college rehabilitation therapy technology exercise therapy technology course, based on World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) and rehabilitation competency framework (RCF). MethodsUsing educational psychology and curriculum theory, and applying the ICF and RCF, the curriculum system for rehabilitation therapy technology curriculum system was constructed. A systematic analysis of the existing exercise therapy technology course content was conducted to identify the core elements related to ICF and RCF. Through the design of course modules, these core elements were integrated into theoretical courses, skills training and practical courses to form a comprehensive curriculum structure. ResultsCombining the ICF and RCF, a curriculum system for rehabilitation therapy technology curriculum system was constructed, covering theoretical courses, skills training and practical courses. This system enabled students to systematically master rehabilitation assessment and treatment techniques and develop clinical decision-making abilities and interdisciplinary collaboration skills. The introduction of the ICF framework allowed students to acquire knowledge, skills and abilities in the field of exercise therapy technology through the course. Developing competency-oriented courses based on RCF framework helped students develop comprehensive professional competencies through learning. ConclusionBy integrating the ICF and RCF, a curriculum for exercise therapy technology course in vocational colleges has been constructed. Based on the ICF framework, the content of the course has been aligned with the bio-psycho-social theory of functioning and health, covering three levels: body function, activity and participation, and environmental factors. The curriculum content should include the analysis, assessment and intervention of these functioning. RCF provides a theoretical structure and methodology for developing competency-oriented courses. When designing the course modules, teaching objectives have been established based on the core competency framework, aiming to develop students' comprehensive professional competence and professionalism through theoretical courses, practical training and clinical internships.

BACKGROUND: Insufficient angiogenesis and the lack of skin appendages are critical challenges in cutaneous wound healing. Stem cell-fabricated cell sheets have become a promising strategy, but cell sheets constructed by a single cell type are inadequate to provide a comprehensive proregenerative microenvironment for wound tissue. METHODS: Based on the communication between cells, in this study, bone marrow mesenchymal stem cells (BMSCs) and hair follicle stem cells (HFSCs) were cocultured to fabricate a composite cell sheet (H/M–CS) for the treatment of fullthickness skin wounds in mice. RESULTS: Experiments confirmed that there is cell–cell communication between BMSCs and HFSCs, which enhances the cell proliferation and migration abilities of both cell types. Cell–cell talk also upregulates the gene expression of proangiogenic-related cytokines in BMSCs and pro-hair follicle-related cytokines in HFSCs, as well as causing changes in the properties of secreted extracellular matrix components. CONCLUSIONS Therefore, the composite cell sheet is more conducive for cutaneous wound healing and promoting the regeneration of blood vessels and hair follicles.

Objective:To explore the effects of applying a four-step training method based on an attitude-skill-knowledge (ASK) model combined with workshops in training on the prevention and control of nosocomial infection among medical students, and to provide a reference for reforming nosocomial infection prevention and control training for medical students and establishing a nosocomial infection prevention and control training system.Methods:Medical students from five medical schools entering clerkships during 2018 to 2020 were selected. They were divided into control group (218 medical students in 2018-2019 receiving conventional nosocomial infection control training) and experimental group (216 medical students in 2019-2020 receiving nosocomial infection control training based on the ASK model-based four-step method combined with workshops). The two groups were compared in terms of the compliance rate of hand hygiene, the pass rates of nosocomial infection control theory and skill examinations, the correct rate of medical waste disposal, the incidence of occupational exposure, and the degree of satisfaction with teaching.Results:All the indices of the experimental group were significantly better than those of the control group: the compliance rate of hand hygiene ( χ2=4.92, P=0.027), the correct rate of medical waste disposal ( χ2=5.13, P=0.023), the pass rate of nosocomial infection control theory examination ( χ2=4.03, P=0.038), the pass rate of nosocomial infection control skill examination ( χ2=6.71, P=0.010), and the degree of satisfaction with teaching [(98.03±2.16) vs. (92.53±2.01), P<0.001]. No one had occupational exposure in the experimental group, while there were three cases in the control group. Conclusion:The ASK model-based four-step method combined with workshops is effective in nosocomial infection prevention and control training for medical students. This innovative training method improves students' satisfaction with clinical teaching, providing a basis for the establishment of a training system for the prevention and control of nosocomial infection.

AIM: To introduce the entry point of clinical pharmacists on developing pharmaceutical care in the department of nephrology to further explore more pharmaceutical care entry point and to better promote rational drug use. METHODS: To summarize the work of the clinical pharmacists participate in the formulation and optimization of anti-infection therapy; participate in the formulation of parenteral nutrition program; conduct medication and adherence education; conduct pharmaceutical monitoring; provide evidence-based medical analysis for the off-label drug use in the department of nephrology by case sharing. RESULTS: Clinical pharmacists provide pharmaceutical care in the department of nephrology. This improves the medication compliance, avoids adverse reactions, optimize therapeutic regimen. CONCLUSION: Developing various pharmaceutical care in the department of nephrology will be safe, effective and economic for drug application.

OBJECTIVES: Our previous study has verified that high level of SET and MYND domain-containing protein 2 (SMYD2) plays an important role in acquiring aggressive ability for liver cancer cells in hepatocellular carcinoma. MiR-200b as a tumor suppressor gene involves in a variety of cancers. This study aims to investigate the correlation between miR-200b and SMYD2 in hepatocellular carcinoma and the underlying mechanism. METHODS: Firstly, the levels of SMYD2 and miR-200b in hepatocellular carcinoma tissues and matched adjacent non-tumor liver tissues were tested with real-time reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting. Secondly, we evaluated the interaction between miR-200b and SMYD2 using dual-luciferase reporter assay. Thirdly, we elucidated the effect of miR-200b on SMYD2 and its downstream targets p53/CyclinE1. Finally, we silenced SMYD2 in hepatocellular carcinoma cell lines to investigate its effect on tumor proliferation and cell cycle progression, and further confirmed the correlation among SMYD2 and p53/CyclinE1. RESULTS: Compared with the matched adjacent non-tumor liver tissues, miR-200b was obviously decreased, and SMYD2 was significantly increased in hepatocellular carcinoma (both P<0.05). Spearman's rank correlation revealed that miR-200b expression was negatively correlated with SMYD2 (P<0.01). Computer algorithm and dual-luciferase reporter assay revealed that miR-200b directly targeted and suppressed SMYD2 in HEK 293T cells. The down-regulated miR-200b expression promoted hepatoma cell proliferation (P<0.05) and increased SMYD2 expression(P<0.01), while the up-regulated expression of miR-200b had an opposite effect. The knockdown of SMYD2 suppressed the proliferation of MHCC-97L cells (P<0.01), down-regulated CyclinE1, and up-regulated p53 expression (both P<0.05). CONCLUSIONS MiR-200b is involved in hepatocellular carcinoma progression via targeting SMYD2 and regulating SMYD2/p53/CyclinE1 signaling pathway and may be used as a potential target for hepatocellular carcinoma treatment.
Humans ; Carcinoma, Hepatocellular/pathology* ; Tumor Suppressor Protein p53/metabolism* ; MicroRNAs/metabolism* ; Cell Line, Tumor ; Signal Transduction ; Liver Neoplasms/pathology* ; Cell Proliferation/genetics* ; Histone-Lysine N-Methyltransferase/metabolism*

Objective:To understand the clinical characteristics of risperidone-induced rhabdomyolysis (RM).Methods:Risperidone-related RM case reports were collected by searching relevant databases at home and abroad as of February 2021, and the patients′ general conditions, disease conditions, medication use, RM occurrence [time of occurrence, clinical symptoms, and serum creatine kinase (CK) level, etc.], and treatment and outcome were recorded and descriptively analyzed.Results:A total of 16 patients were collected, including 14 males and 2 females, with age of 13-76 years. The primary diseases were schizophrenia in 11 patients, psychomotor agitation, obsessive-compulsive disorder, depressive syndrome with psychotic symptoms, depressive symptom cluster, and suspected psychotic symptoms in 1 case each. Among the 16 patients, 2 were treated with risperidone alone, and 14 were treated with risperidone combined with other drugs (6, 6, 5, 4, 3, and 1 with other antipsychotics, sedatives, antidepressants, statins, anticholinergics, and cyclosporine, respectively, and 3, 7, 1, and 3 cases with 1, 2, 3, and 4 combination drugs, respectively). Except that the medication method was not described in 2 cases, risperidone was orally administered in 13 cases and injected in 1 case. Thirteen patients with oral risperidone had dosage descriptions, of which 12 cases′ dose met the requirements of the drug labels, and 1 case took risperidone 96 mg due to severe hallucinations induced by drug withdrawal after taking the drug with routine dose for 5 years. In addition to the patient with overdose of risperidone, the occurrence time of RM was described in 14 cases, which was 4 days to 2 years after risperidone, and 10 cases occurred within 4 to 15 days after risperidone use. The main clinical symptoms were muscle pain (10 cases), acute liver injury (8 cases), acute kidney injury (5 cases), muscle weakness (4 cases), fever (3 cases), tachycardia (3 cases), and acute tendon intermembrane space syndrome (3 cases). The CK level was 4 587 to 928 961 U/L with a median level of 27 355 U/L in the 16 patients with RM, and it was>15 000 U/L in 10 cases (62.5%). After RM occurred, risperidone was discontinued in 13 patients, continued in 2 patients, and used at reduced dose in 1 patient; 8 patients received hydration therapy, 3 received hemodialysis, 1 received organ support therapy, and 3 with acute compartment syndrome (ACS) were treated with fasciotomy. All 16 patients′ symptoms disappeared and CK levels returned to normal. Among them, the specific time of recovery were described in 12 patients. The time of symptom disappearance was 2-12 months and the time of CK level recovery was 7-56 days.Conclusions:Risperidone-related RM mostly occurs within 4-15 days after exposure to risperidone, which is mostly related to the combination with other drugs. The elevation of CK level is usually severe, which can be complicated by ACS. Symptoms could return to normal after risperidone was discontinued and/or symptomatic treatments are given.