Objective To investigate the role of HK2 and VDAC1 in diacetylmorphine-induced cardiomyocyte apoptosis.Methods A dose-escalation method was used to establish a rat model of diacetylmorphine addiction.Forty SD rats were randomly divided into three groups,the normal group(n=10)was injected with an equal amount of saline subcutaneously,the model group(n=15)was injected with 5 mg/kg of diacetylmorphine for the first time,and then the dose was increased by 2.5 mg/(kg·d)day by day for 20 days,and the group of model +10 D(n=15)continued to increase the dose based on the model group up to the 10th day.Lactate dehydrogenase(LDH)and glutamic oxaloacetic transaminase(GOT)were detected by ELISA;HE staining was used to observe the pathological changes of myocardial tissues in each group;TUNEL staining was used to detect apoptosis in myocardial tissues in each group;and immunohistochemistry,RT-q-analysis,and immunochemistry were used to detect apoptosis in myocardial tissues in each group.Immunohistochemistry,RT-qPCR and Western bl-ot were used to detect the mRNA and protein expression of HK2,VDAC1 and apoptosis-related factors.Results HE staining revealed that myocardial tissues exhibited different degrees of damage with the prolongation of diacetylmorphine intervention.Compared with the normal group,serum LDH,GOT content and myocardial apoptosis rate increased in the model group,mRNA and protein levels of HK2 and anti-apoptotic factor Bcl-2 decreased,mRNA and protein levels of VDAC1 and pro-apoptotic factors Bax and Caspase-3 increased,and the protein level of Clevead Caspase-3 increased;in the model +10 D group the above indexes,there was a statistically significant difference(P<0.05).Conclusion Diacetylmorphine can cause cardiomyocyte apoptosis,and VDAC1 may be involved in the process of cardiomyocyte apoptosis caused by diacetylmorphine.

Objective To analyze the literature on urinary incontinence after radical prostatectomy by bibliometric method, and to understand the research status and development trend in this field. Methods The Web of Science core collection database was searched for articles on urinary incontinence after radical prostatectomy from January, 1 2013 to March, 25 2023, and the visual analysis of the annual number of publications, countries, institutions, authors, source journals and keywords was performed by VOS viewer and CiteSpace software. Results A total of 1 212 relevant literatures were retrieved, and the annual number of publications was on the rise. The United States ranked the first in the number of publications, followed by Germany and Italy, among which the United States cooperated more with other countries. The institutions ranking top 10 were mostly concentrated in the United States, and the high-contribution institutions were mainly Memorial Sloan-Kettering Cancer Center and University of California, San Francisco. The author with the largest number of articles was MATTHEW R, and many stable cooperation teams had been formed among the authors. The main journals in this field included Journal of Urology, European Urology, etc. The research hotspots in this field mostly focused on the relationship between influencing factors, evaluation diagnosis, treatment methods and outcome indicators of urinary incontinence after radical prostatectomy. Urinary incontinence rehabilitation, biofeedback, local therapy, robot-assisted radical prostatectomy, and patient reported outcomes have been active topics in recent years. Conclusion Urinary incontinence after radical prostatectomy has attracted more and more attention from scholars. However, compared with the developed countries such as the United States, the total number of papers published in China is less, and the academic influence and exchanges between scholars are weak. In the future, it is advisable to learn from relevant research results of foreign countries, strengthen international scientific research exchange and cooperation, and promote the development of related research on urinary incontinenceafter radical prostatectomy in China.

Objective To explore the objective indicators of tongue and pulse manifestations in patients with endometriosis diseases by collecting the data of tongue and pulse manifestations of patients with endometriosis diseases by digital tongue and pulse diagnostic instrument. Methods The endometriosis disease group included 72 patients with endometriosis diseases who were treated in Department of Gynecology (Professor ZHANG Tingting),Yueyang Hospital of Integrated Traditional Chinese and Western Medicine from Jun. 1,2021 to Sep. 15,2022. The normal group included 35 healthy adult women recruited by the Physical Examination Center of Shuguang Hospital,Shanghai University of Traditional Chinese Medicine. Results In terms of age,there was no significant difference between the endometriotic disease group and normal group (P>0.05). In terms of tongue color,the values of zhiCon,zhiASM,zhiENT,zhiMEAN,zhiClrB,zhiClrI,zhiClrLa,zhiClrCb,and zhiClrLb in the endometriosis disease group were significantly different from those in the normal group (all P<0.05),while there were no significant differences in the values of zhiClrR,zhiClrG,zhiClrS,zhiClrL,zhiClrY,or zhiClrCr between the 2 groups (all P>0.05). In terms of tongue coating color,the values of taiClrR,taiClrB,taiClrI,taiClrS,taiClrLa,taiClrLb,taiClrCr,and taiClrCb in the endometriosis disease group were significantly different from those in the normal group (all P<0.05),while there were no significant differences in the values of taiClrG,taiClrL,or taiClrY (all P>0.05). In terms of texture and thickness of tongue coating,there were no significant differences in the values of perAll,perPart,taiCon,taiASM,taiENT,or taiMEAN between the 2 groups (all P>0.05). In terms of pulse manifestation,the values of h3,h4,h5,t4,h3/h1,and h4/h1 in the endometriosis disease group were significantly different from those in the normal group (all P<0.05),while there were no significant differences in the values of h1,t,t1,or t5 (all P>0.05). Conclusion There are significant differences in tongue and pulse indicators between patients with endometriosis diseases and healthy individuals. It can provide objective indicators for further research on the pathogenesis changes and clinical differentiation of endometriosis diseases.

Objective: To understand the working experience of responsible nurses after the day surgery in the ward under the concept of accelerated rehabilitation surgery, in order to provide reference for the development of targeted interventions. Methods: In this study, 10 primary nurses in 4 departments of day surgery in Shanghai Tenth People′s Hospital were interviewed by using the method of objective sampling in April-May, 2018. The semi-structured interview was conducted using the phenomenological research method in the qualitative study, and the Colaizzi phenomenological data was used. The analysis method analyzes the interview data. Results: Through the repeated refinement, analysis and extraction of the interview data, the following two themes reflecting the work experience of the daytime surgical department responsible nurses: own growth and harvest, difficulties and challenges. Conclusion Based on the concept of accelerated rehabilitation surgery, daytime surgery is carried out to encourage responsible nurses to continuously improve their knowledge level and interpersonal communication skills. The nurses' professional identity is continuously improved. At the same time, due to the increase in nursing workload, the increase in nurse training needs and the incomplete workflow make nursing management Facing new problems and challenges.

0bjective To translate and revise the Assessment of Interprofessional Team Collaboration Scale (AITCS) into Chinese, then to evaluate the reliability and validity of the Chinese version of AITCS. Methods The Chinese version of AITCS was translated from the original one, back-translated and adjusted for cultural adaptation. The reliability and validity were tested among 288 nurses, 81 physicians, 25 respiratory therapists, 10 physical therapists and 3 nutritionists from a tertiary hospital in Hangzhou using convenience sampling. Results The average of scale-level content validity index was 0.98, unanimity of scale-level content validity index was 0.84 and item-level content validity index was 0.89-1.00. Exploratory factor analysis extracted three common factors,which explained 61.427% of the total variance,and each item had high factor loading quality (>0.4). The correlations coefficients between each dimension score and the total score ranged from 0.801 to 0.898 (P<0.05),and the correlations coefficients between each dimension score ranged from 0.607 to 0.698 (P<0.05). The Cronbach α of AITCS was 0.909, split-half reliability was 0.835 and test-retest reliability was 0.763. Conclusion The Chinese version of the AITCS has been proved to be reliable and valid. It is a valuable tool for evaluating interprofessional team collaboration among the health professional providers in mainland China.

Objective To investigate the effect of berberine on endoplasmic reticulum stress PERK apoptosis pathway in HK-2 cells by high fructose.Methods HK-2 cells were grown in DMEM/F12, containing 10% fetal bovine serum (FBS) and divided randomly into four groups: normal control group (Group C); Fructose group (Group F): it contains 25mmol/L fructose culture; Berberine group (Group B): 25mmol/L fructose + 10μmol/L berberine treatment group; TUDCA group (Group T):25mmol/L fructose +2μmol/L TUDCA culture group; Cells were collected after culturing 24h. The expression of glucose-regulated protein 78 (GRP78), CHOP protein and the phosphorylation levels of PERK, eIF2α were tested by Western blotting. The cell cycles were detected by flow cytometry and the apoptosis of cells were detected by TUNEL staining.ResultsWestern blotting showed that the expression of GRP78 and CHOP protein in group F was significantly higher than that in group C, and the levels of p-PERK and p-eIF2α in group F were significantly higher than those in group F. Compared with group F, GRP78, CHOP, p-PERK and p-eIF2α in group B and T were significantly lower (P<0.05). The expression of GRP78, CHOP, p-PERK and p-eIF2α in group B had no significant difference. Flow cytometry and TUNEL staining showed that the cell viability of fructose group was significantly lower than that of C group, and the apoptotic index was significantly higher than that of group C (P<0.05). Compared with group F, the activity of HK-2 cells in group B and T significantly increased, otherwise the apoptosis index significantly decreased, and the difference was statistically significant (P<0.05). Compared with group T, the viability index and apoptosis rate of group B had no significant difference (P>0.05).Conclusion Persistent high fructose can activate the intracellular PERK pathway in HK-2 cells, causing endoplasmic reticulum stress. Berberine can inhibit the fructose-induced PERK and eIF2α phosphorylation, down-regulated the expression of GRP78, CHOP protein, thus by regulating PERK Pathways to alleviate cell cycle arrest and reduce cell apoptosis.

Objective To investigate the quality of concentrated platelet with less WBC by improved white membrane method,so as to provide the basis for preparation of the concentrated platelet in the future.Methods Testing the quality indicators of 56 cases of concentrated platelet with less white blood cells by improved white membrane method,and comparing the quality indicators of 56 cases of collected platelet at random by machine.Testing the expression rate of platelet membrane surface glycoprotein molecules CD62P and PAC-1 before and after filtering in different storage time,and comparing the expression rate of 37 cases of collected platelets at random by machine.Results The differences of quality indicators between concentrated platelet with less white blood cells by improved white membrane methods and collected platelet at random by machine were not statistically significant (P＞0.05),such as volume,platelet content,Ph,amount of RBC mixed within.But The differences of amount of WBC mixed with were statistically significant (P＜ 0.01),both of sterility tests were negative.The differences of the expression rate of platelet membrane surface glycoprotein molecules CD62P and PAC-1 during storage period within 3 days were not statistically significant (P＞0.05).Conclusion The various quality indicators of concentrated platelet with less white blood cells by improved white membrane methods attain mixed concentrated platelet and platelet national standards,and in vitro platelet activity kept well.Platelet special leucocyte filter does not cause obvious platelet activation and damage within three days of storage period of concentrated platelet in filter processing.Collected platelet by machine is being activated and damaged continuously when kept in platelet oscillation device 22±2℃ for 3 days,but activation and damage does not significantly change the platelet activity in vitro.

Objective To study the status of anxiety and depression on clinical decision-making participation of laryngeal cancer patients.Methods A total of 82 laryngeal cancer patients participated in the investigation by questionnaire to study the clinical decision-making participation by control preferences scale.The degree of anxiety and depression was investigated by self-rating anxiety scale and self-rating depression scale.Results During the clinical decision-making process,40.24％ of the patients were passive,29.27％ had their families as absolute representatives,20.73％ took part collaborating with their families and only 9.76％ were active.47.56％ had anxiety and 64.63％ depression,and the anxiety and depression influenced their participation in clinical decision-making postively and passively relatively.Conclusions Patients with laryngeal cancer are passive in clinical decision-making and most of them have anxiety and depression.Doctors should enhance the communication with patients,which can help to eliminate adverse psychological emotions and make satisfying clinical decision-making.

Objective To develop and apply an ICU orientation program based on the Miller pyramid competency model. Methods 45 new ICU nurses in 2013 and 2014 were selected as the experimental group. The experimental group was oriented by the new program,including the orientation of preceptors, workshop-centered orientation courses, checklists-precepting and comprehensive competency evaluation methods. 39 new ICU nurses in 2011 and 2012 were selected as the control group. The control group was oriented by the conventional program,including focused theory classes and traditional precepting.New nurses′ satisfaction with the orientation and the competency were analyzed before and after intervention in two groups. Results Satisfaction with the orientation, self-evaluated competency and peer-evaluated competency in the experimental group were(16.71±1.19) scores, (126.52±3.31) scores and (90.00±2.68) scores respectively,which were much better than the control group and had statistically significant difference in two groups. Conclusions The ICU new nurse orientation program based on the Miller pyramid competency model can improve the new nurses′ satisfaction with the orientation and the competency after the orientation.

Background and purpose:Hepatic epithelioid hemangioendothelioma (HEHE) is an extremely rare, vascularly original tumor, and would be misdiagnosed easily in the clinical and imaging characteristics. This study aimed to investigate the imaging features of HEHE and our experience in clinical diagnosis and treatment, and to provide important reference for the diagnosis and treatment of HEHE in the future.Methods:This study retrospectively analyzed clinical manifestations, imaging features, pathological characteristics and treatment effects of 5 HEHE cases confirmed by pathology at Department of Integrative Cancer, Fudan University Shanghai Cancer Center.Results:The ratio of male to female patients was 2 to 3. HEHE predominantly occurred in middle-aged female patients whose ages range from 26 to 65 (mean=45.6). Imaging features of HEHE included multifocal hepatic disease (n=2), systemic multi-center multi-tissue occurrence (n=3). The ultrasound images showed isoechoic or hypoechoic lesions with no obvious blood lfow signal in the lesions. CT plain scan showed isointensity or hypointensity, while MR unenhanced with hypointense T1 signal and hyperintense T2 signal. The density or signal was uneven. Contrast-enhanced CT and MR images showed “slow in slow out”, obvious and variable degrees of peripheral rim enhancement. High FDG uptake showed delayed imaging characteristics (PET/CT). DSA angiography showed the tumor blood vessels were slim. After transcatheter arterial chemoembolization (TACE) surgery, lipiodol deposition within the lesion was not ideal. Under the microscope, tumor cells showed epithelial differentiation; angiogenesis was also visible. Immunohistochemistry staining showed CD31 and CD34 positive in all the 5 cases. Two cases treated with TACE combined with high intensity focused ultrasound (HIFU) and/or radiofrequency ablation (RFA) had good result.Conclusion:The clinical and radio-logical characteristics of HEHE are distinctive. Currently, for patients with systemic multi-organizational multi-center lesions, TACE combined with HIFU and/or RFA might be the most effective treatment method.