Objective To retrospectively analyze of factors influencing early preterm birth(EPB)and late preterm birth(LPB)in pregnancy women with placenta previa complicated by placenta accreta spectrum disorders(PAS),and assess maternal and infant outcomes.Methods We included 590 cases of pregnancy women with placenta previa complicated by PAS who underwent cesarean sections at five hospitals in Wuhan and Xianning cities between January 2018 and June 2021.These patients were divided into three groups based on delivery gesta-tional age:EPB,LPB,and term birth(TB).A multiple logistic regression model was employed to analyze the risk factors associated with EPB and LPB.Additionally,differences in early maternal and infant outcomes among these groups were examined.Results Among 590 pregnancy women with placenta previa complicated by PAS,the proportions of EPB and LPB were 9.7%and 54.4%.The use of uterine contraction inhibitors prior to cesarean section,vaginal bleeding,and previous cesarean sections history were identified as risk factors for both EPB and LPB.The proportion of severe postpartum hemorrhage was comparable between the EPB group and the LPB group;however,the incidence of neonatal asphyxia,low birth weight infants,and the rate of newborns transferred to the Neonatal Intensive Care Unit(NICU)within 24 hours after cesarean delivery were significantly higher in the EPB group compared to the LPB group.Conclusions Placenta previa complicated by PAS predominantly leads to LPB.The history of prior cesarean sections,uterine contractions,and vaginal bleeding prior to cesarean section,are sig-nificantly associated with both EPB and LPB.During the perinatal period,efforts should be made to extend gesta-tional weeks under close monitoring to minimize the incidence of premature births and thereby improve early mater-nal and infant outcomes.

Objective To explore the differential expression of the key microfilament cytoskeleton-binding proteins in immature dendritic cells(imDCs)during antigen phagocytosis.Methods Monocytes(MOs)were isolated from peripheral blood of healthy individuals and cultured with recombinant human granulocyte-macrophage colony stimulating factor(rhGM-CSF)and recombinant human interleukin-4(rhIL-4)for 6 days to obtain imDCs.ImDCs were co-cultured with low molecular weight(40 kDa)and high molecular weight(150 kDa)dextrans for 1,3 and 6 hours,respectively.Flow cytometry was used to detect the percentage of imDCs phagocytosing dextran and the expression of immunophenotype molecules.The localization of filamentous actin(F-actin),PFN1,WASP,and α-actinin in cells were observed by immunofluorescence imaging.The differential expression of MCBPs at the mRNA and protein levels were respectively detected by q-PCR and Western blotting.Finally,the MCBPs with the highest component coefficients were identified based on the stepwise regression and principal component analysis method in systems biology algorithms.Results During the process of antigen phagocytosis,imDCs phagocytized low molecular weight antigens at a faster rate,with a phagocytic duration of approximately three hours.Their cell phenotypes and morphology gradually differentiated into mDCs,and F-actin remodeling was occurred significantly.The expression of MCBPs such as PFN1,CDM,WASP,CAPZB,Filamin A,α-actinin were downregulated,while the expression of WAVE1,Arp2/3 complex,and Fascin were upregulated.The mRNA expression of signaling protein Rac1 was upregulated,while the mRNA expressions of CDC42 and RhoA were downregulated.The immunofluorescence results showed that PFN1,WASP,and α-actinin were transposed during the antigen phagocytosis process of imDCs.The results of stepwise regression and principal component analysis showed that PFN1 had the highest component coefficient.Conclusions PFN1 may be a key MCBPs involved in the process of antigen phagocytosis of imDCs,which is of great significance for further understanding the relationship between changes in the cytoskeleton structure of imDCs and their immunological functions.

Abstract: Objective　To construct HepG2, Huh7 cell lines stably express hepatitis B virus X (HBx) mutant (C1653T, T1753C), and explore their effect on the biological behavior of hepatocellular carcinoma cells. Methods　The lentivirus plasmid of pLVX-HBxC1653T-IRES-tdTomato, pLVX-HBxT1753C-IRES-tdTomato were obtained by PCR site mutagenesis according to wild type ayr HBx. Double enzyme digestion and Sanger sequencing were performed for accuracy of plasmid. Blank HepG2 and Huh7 cells were used as the control group, HepG2, Huh7 cells were infected by pLVX-HBx-IRES-tdTomato, pLVX-HBxC1653T-IRES-tdTomato, and pLVX-HBxT1753C-IRES-tdTomato lentivirus solution, then monoclonal cell was selected by 0.6 μg/mL puromycin. Immunostaining and Western Blot were performed for the verification of stable strains. CCK8 assay was performed for the proliferation capacity of stable strains. Western Blot was performed for expression of EMT-related signal molecules in cells. The independent samples t-test was used for comparison between two groups. Results Double enzyme digestion and Sanger sequencing showed that that the size of the cut fragments of recombinant lentiviral plasmids was correct, and the point mutation location and base substitution were correct, suggesting that the plasmid of pLVX-HBx-IRES-tdTomato, pLVX-HBxC1653T-IRES-tdTomato, pLVX-HBxT1753C-IRES-tdTomato were constructed successfully. Immunostaining and Western blot showed that HBX were expressed in stable strains, while there was no HBX expression in the blank control group, indicating that the HepG2 and Huh7 cell lines stably expressing HBx, HBxC1653T, HBxT1753C were successfully constructed. CCK8 assay showed that the proliferation capacity of HBx and mutant were enhanced compared to the control group (P<0.01), HBx C1653T displayed further additive the effect compared to HBx (P<0.05). Moreover, HBxC1653T mutation also significantly upregulated N-cadherin expression and downregulated E-cadherin expression, thus promoting the occurrence of EMT. Conclusions　HepG2 and Huh7 cell lines stably expressing HBx, HBxC1653T, HBxT1753C were successfully constructed, HBxC1653T mutation significantly enhanced the proliferation of HCC cells and epithelial to mesenchymal transition occurrence.

Objective:To investigate the predictive value of KAI1 expression in colon cancer tissues for tumor recurrence.Methods:Ninety-two pathological tissue samples were collected from patients undergoing radical operation for colon cancer in Tangshan People's Hospital from August 2010 to November 2011. According to the results of follow-up, the patients were divided into recurrent group (33 cases) and non-recurrent group (59 cases). KAI1 expression in tumor tissues was detected by immunohistochemistry. χ2 test was used to analyze the relationship between KAI1 expression in colon cancer tissues and clinicopathological characteristics of patients with colon cancer. Spearman correlation test was used to analyze the relationship between KAI1 expression in colon cancer tissues and the recurrence time of patients. Cox proportional hazards model was used to analyze the related factors affecting postoperative recurrence of colon cancer. Results:KAI1 expression in tumor tissues in the recurrent group was lower than that in the non-recurrent group [39.39% (13/33) vs. 62.71% (37/59), χ2 = 4.638, P = 0.031]. KAI1 expression was not associated with patients' gender, age and tumor maximum diameter (all P > 0.05), but related to the tumor differentiation and lymphatic metastasis [high and medium differentiation vs. low differentiation: 70.3% (26/37) vs. 43.6% (24/55), χ2 = 6.324, P =0.012; lymph node metastasis vs. non-lymph node metastasis: 43.2% (19/44) vs. 64.6% (31/48), χ2 = 4.238, P = 0.039]. KAI1 expression in tumor tissues was positively correlated with tumor recurrence time ( r = 0.845, P < 0.05). Cox multivariate analysis showed that the low differentiation of the tumor, lymph node metastasis and negative expression of KAI1 in colon cancer tissues were independent risk factors for recurrence of colon cancer after surgery ( HR = 1.736, 95% CI 1.598-5.391, P = 0.019; HR =1.526, 95% CI 1.175-3.029, P = 0.037; HR = 1.799,95% CI 1.756-5.825, P = 0.013). Conclusion:Low KAI1 expression in colon cancer tissues is closely related to colon cancer recurrence, and the detection of KAI1 expression in colon cancer tissues has certain predictive value for tumor recurrence.

For effective resistance to virus attack and infection, reducing virus transmission chance, it is extremely important for the medical staff and related workers to have their own safe protection. This paper summarizes the development causes, common locations, and prevention ways about the device related pressure injuries on the face resulted from wearing medical-grade protective equipment for a long working time. The paper proposes the nursing strategy for device related pressure injuries and other nursing strategy is proposed to take care efficiently the device related pressure injuries. Meantime, a corresponding nursing strategy is also suggested to deal with the correlative skin diseases during the application of medical-grade protective equipment. These paper aims to provide reference for the prevention of device related pressure injuries and the care of skin-related diseases for clinical working staff, especially to the respectable personnel in front line of fighting against Corona virus disease 2019.

Objective To evaluate the clinical characteristics and pregnant outcomes of gravidae with COVID-19. Methods This study involved nine gravidae with COVID-19 admitted to the Renmin Hospital of Wuhan University from January 22 to February 1, 2020. Their clinical data, including epidemiological history, clinical symptoms, laboratory examinations, chest CT, treatment, delivery mode, and pregnancy outcomes, were analyzed retrospectively. Specimens of maternal vaginal swab were collected in six pregnant women, and the specimens of amniotic fluid, cord blood, neonatal throat swab and breast milk samples were collected in four pregnant women who had a delivery during our study. All samples were tested for the existence of COVID-19. Descriptive analysis was applied in this study. Results (1) Among the nine cases, five were admitted in the third trimester and four in the second trimester. The median incubation period of COVID-19 was 8 (1-14) d. Fever was presented in all cases on admission, and the other commonly seen symptoms were cough (seven cases) and diarrhea (five cases). Other signs and symptoms were also reported, including shortness of breath, myalgia and fatigue (four cases in each), nasal obstruction, pharyngalgia, chest pain, and headache/dizziness (three cases in each), rash (two cases), and chills and expectoration (one case in each). The most common laboratory abnormalities were a decreased number of lymphocytes (seven cases) and elevated C-reactive protein (six cases). Chest CT scans were performed in seven women, and all showed patchy areas or ground-glass opacity in both lungs. Oligohydramnios was detected in only one case at 37 +5 weeks, which was 7 d after the diagnosis of COVID-19. (2) All nine cases received empiric antibiotic and antiviral therapy with Chinese medicine as adjuvant treatment. Eight patients required oxygen inhalation, and eight were treated with glucocorticoid. Six cases received immunotherapy. (3) Four of the nine cases had delivered, including three cesarean sections and one spontaneous vaginal preterm birth after premature rupture of membranes, and the mother was transferred to the intensive care unit 2 d after delivery due to acute respiratory distress syndrome. One case was terminated at 26 gestational weeks. Of the four neonates, there were two term and two premature babies, and one preterm baby was small-for-gestational-age. No neonatal asphyxia was observed. Serial real-time quantitative reverse transcription-polymerase chain reaction showed negative results in the detection of 2019-novel coronavirus in all samples obtained from amniotic fluid, umbilical cord blood, neonatal nasopharynx, breast milk, and vagina. Maternal conditions were all stable in all cases, including the four continuing pregnancy, and the terminated ones, except the case mentioned above. Conclusions There is no distinguishable clinical feature between pregnant and non-pregnant COVID-19 patients. So far, there is no evidence for vertical transmission or worsening perinatal outcome in mothers and babies.

Objective:To explore the application effect of scenario infiltration joint interactive training mode for junior nurse training in the prevention and treatment of pressure sore.Methods:A total of 118 junior nurses starting to work in the First Affiliated Hospital of Air Force Medical University from July 2017 to July 2018 met the inclusion criteria and were divided into routine training (RT) group and scenario infiltration joint interactive training (SIJIT) group using the random number table for prospective randomized controlled trial. There were 2 males and 57 females, aged (23.9±1.2) years in RT group and 3 males and 56 females, aged (23.5±1.3) years in SIJIT group. Before the training, nurses in both groups received theory and practical tests for the prevention and treatment of pressure sore with a homemade theory test paper and operation requirements designed by the training group. The training content was drawn up in 3 themes according to the weak points shown in the test. Nurses in RT group were trained in a large classroom with the help of multimedia teaching technique, and one lesson of 2 h targeting one theme was given once a week.Nurses in SIJIT group were trained by using the SIJIT mode, with online self-study for 2 weeks and then multimedia theory and practical teaching, and interaction in scene. After the training, theoretical and practical tests were conducted again in nurses of two groups. Satisfaction scores of nurses for the training mode, training effect, and curriculum design and answers to open questions about the degree of training satisfaction were investigated through homemade questionnaire for satisfaction degree. Homemade training contents and requirements questionnaire designed by the training group was used to understand the demands of nurses for training contents and requirements in 2 groups. Data were statistically analyzed with chi-square test and independent sample t test. Results:(1) The theoretical and practical scores on the prevention and treatment of pressure sore before the training were (78±11) and (83±10) points respectively in RT group, similar to (79±11) and (84±10) points in SIJIT group ( t=0.522, 0.615, P>0.05). The theoretical and operational scores on prevention and treatment of pressure score of nurses after the training were (90±8) and (92±5) points in SIJIT group, significantly higher than (82±10) and (85±9) points in RT group ( t=4.581, 5.259, P<0.01). (2) The satisfaction degree scores for training mode, curriculum design, and training effect of nurses in SIJIT group were significantly higher than those in RT group ( t=5.169, 7.976, 4.463, P<0.01). Nurses in the 2 groups were satisfied with the curriculum content, and unsatisfied with the curriculum time and the ways of test. (3) The top demand of the training nurses for curriculum content was the treatment of phase Ⅱ-Ⅲ pressure sore, accounting for 81.36% (96/118). Conclusions:The SIJIT has flexible training mode, and reasonable curriculum design and content, which significantly improves the theoretical and operational levels on prevention and treatment of pressure sore of the training nurses and receives recognition of the training nurses.

For effective resistance to virus attack and infection and reducing virus transmission chance, it is extremely important for the medical staff and related workers to have their own safe protection. The paper summarizes the occurrence causes, common locations, and prevention ways about the device related pressure ulcers on the face resulted from wearing medical-grade protective equipment for a long working time. The paper proposes the prevention and nursing strategies for device related pressure ulcers and other related skin injuries during application of medical-grade protective equipment. The paper aims to provide reference for the prevention and nursing of device related pressure ulcers and related skin diseases for clinical medical staff, especially to the respectable personnel in front line of fighting against coronavirus disease 2019.

Objective:To explore the curative effect of ginger combined with tropisetron on preventing nausea and vomiting caused by chemotherapy in patients with breast cancer.Methods:80 patients with breast cancer who received first chemotherapy from Beijing Tiantan Hospital from April 2019 to December 2019 were selected by the convenient sampling method. According to the random number table method, they were divided into the control group and the intervention group, with 40 cases in each group. The control group received intravenous tropisetron before routine chemotherapy to prevent nausea and vomiting. On this basis, patients in the intervention group took slices of fresh ginger under the tongue 30 min before chemotherapy and applied the slices of fresh ginger to Shenque acupoint and Neiguan acupoint. The degree of nausea and vomiting after chemotherapy and compliance with chemotherapy were compared between the two groups.Results:On 0 to 5 d after chemotherapy, there were 7 patients with nausea of grade Ⅱ and Ⅲ in the intervention group and 18 patients with nausea of grade Ⅱ and Ⅲ in the control group. There were 4 patients with vomiting of grade Ⅱ and Ⅲ in the intervention group and 18 patients with vomiting of gradeⅡ and Ⅲ in the control group. There were statistically significant differences in the degrees of nausea and vomiting between the two groups ( Z=-2.980, -4.151; P<0.05) . There was no statistically significant difference in chemotherapy compliance between the two groups ( P>0.05) . Conclusions:Ginger in mouth and ginger point application combined with tropisetron can effectively alleviate chemotherapy-induced nausea and vomiting symptoms.

Objective: To explore the relationship between gap junction and glucose uptake of astrocytes under oxygen-glucose deprivation(OGD) and reperfusion. Methods: Cerebral cortical astrocyte from 1 day newborn SD rats were undergone the primary culture. The ischemia cell model was established by OGD. This experiment were divided into control group, OGD group and OGD+ CBX group.After different reperfusion time (0 h, 12 h 24 h and 48 h), the glucose uptake of astrocyte was measured by 2-NBDG through flow cytometry analysis and connexin 43(Cx43) gap junction plaques was detected using immunofluorescene. Results: Compared with the control group, the glucose uptake of astrocyte was up-regulated induced by OGD following different reperfusion time.The glucose uptake of OGD group was (2.32±0.43)nmol/μgDNA in 24 hours reperfusion time and was (0.95±0.28)nmol/μgDNA in control group. The up-regulation was up to 2.63-fold increase (t=13.99, P=0.0024) in 24 hours after reperfusion.Compared with the control group, the Cx43 gap junction number was up to 2.5- fold increase(t=11.34, P=0.003) and the size was 1.85-fold increase (t=10.27, P=0.004) in 24 h reperfusion. The glucose uptake of astrocyte after OGD was reduced by CBX and the decrease was 42% in 48 h after reperfusion. Conclusion Those results urges us consider the clinical treatment for interfering with Cx43 gap junction.