The core competencies of Operating Room specialist nurses are the key to being competent in Operating Room nursing work. However, the core competencies that Operating Room specialist nurses should possess in China are not yet clear, and there is no unified and standardized training model. This paper summarizes the concepts, core competency standards, and training models of Operating Room specialist nurses, explores the existing problems in admission conditions, curriculum arrangement, training content, training methods, and assessment of Operating Room specialist nurses, and puts forward suggestions for the training of Operating Room specialist nurses in China, in order to promote the improvement of core competency of Operating Room specialist nurses and the homogenization and standardization of training models.

The global COVID-19 coronavirus pandemic has infected over 109 million people, leading to over 2 million deaths up to date and still lacking of effective drugs for patient treatment. Here, we screened about 1.8 million small molecules against the main protease (M^pro) and papain like protease (PL^pro), two major proteases in severe acute respiratory syndrome-coronavirus 2 genome, and identified 1851M^pro inhibitors and 205 PL^pro inhibitors with low nmol/l activity of the best hits. Among these inhibitors, eight small molecules showed dual inhibition effects on both M^pro and PL^pro, exhibiting potential as better candidates for COVID-19 treatment. The best inhibitors of each protease were tested in antiviral assay, with over 40% of M^pro inhibitors and over 20% of PL^pro inhibitors showing high potency in viral inhibition with low cytotoxicity. The X-ray crystal structure of SARS-CoV-2 M^pro in complex with its potent inhibitor 4a was determined at 1.8 Å resolution. Together with docking assays, our results provide a comprehensive resource for future research on anti-SARS-CoV-2 drug development.
Humans ; Antiviral Agents/chemistry* ; COVID-19 ; COVID-19 Drug Treatment ; High-Throughput Screening Assays ; Molecular Docking Simulation ; Protease Inhibitors/chemistry* ; SARS-CoV-2/enzymology* ; Viral Nonstructural Proteins

The 2030 Immunization Agenda of the World Health Organization （WHO） states that everyone in the world should fully benefit from vaccines to achieve good health and well-being. With the ever-changing disease spectrum and the improvement of residents' health literacy， relying solely on vaccines included in the National Immunization Program （NIP） is insufficient to meet the current requirements for disease prevention and control. Non-NIP vaccines play an important role in meeting people's diverse needs. Vaccine hesitancy is a global issue and an important factor affecting vaccine uptake. By reviewing relevant studies on vaccine hesitancy in recent years， this paper summarized different vaccination situations， current situation of vaccine hesitancy， measuring tools of vaccine hesitancy， and major influencing factors. It aims to provide references for the development of scientific and effective vaccine education strategies， which can increase public knowledge and understanding of vaccines， enhance healthcare professional's willingness and behavior in recommending vaccines， improve public vaccine literacy， and reduce vaccine hesitancy. At the same time， the supervision and guidance of media discourse should be strengthened to enhance the protective role of non-NIP vaccines in immunization barriers.

Purpose: Neoadjuvant therapy modality can increase the operability rate and mitigate pathological risks in locally advanced cervical cancer, but treatment response varies widely. It remains unclear whether genetic alterations correlate with the response to neoadjuvant therapy and disease-free survival (DFS) in locally advanced cervical cancer. Materials and Methods: A total of 62 locally advanced cervical cancer (stage IB-IIA) patients who received neoadjuvant chemoradiation plus radical hysterectomy were retrospectively analyzed. Patients’ tumor biopsy samples were comprehensively profiled using targeted next generation sequencing. Pathologic response to neoadjuvant treatment and DFS were evaluated against the association with genomic traits. Results: Genetic alterations of PIK3CA were most frequent (37%), comparable to that of Caucasian populations from The Cancer Genome Atlas. The mutation frequency of genes including TERT, POLD1, NOS2, and FGFR3 was significantly higher in Chinese patients whereas RPTOR, EGFR, and TP53 were underrepresented in comparison to Caucasians. Germline mutations were identified in 21% (13/62) of the cohort and more than half (57%) had mutations in DNA damage repair genes, including BRCA1/2, TP53 and PALB2. Importantly, high tumor mutation burden, TP53 polymorphism (rs1042522), and KEAP1 mutations were found to be associated with poor pathologic response to neoadjuvant chemoradiation treatment. KEAP1 mutations, PIK3CA-SOX2 co-amplification, TERC copy number gain, and TYMS polymorphism correlated with an increased risk of disease relapse. Conclusion We report the genomic profile of locally advanced cervical cancer patients and the distinction between Asian and Caucasian cohorts. Our findings highlight genomic traits associated with unfavorable neoadjuvant chemoradiation response and a higher risk of early disease recurrence.

Objective:To survey bone age, vitamin A, vitamin D and IGF-1 levels among stunted children, and to explore the clinical values.Methods:The experimental group was composed of 200 stunted children who visited the growth retardation clinic of Jiangning Hospital Affiliated to Nanjing Medical University between October 2017 and October 2019.The control group consisted of 200 children of normal height during the same period.The differences of developmental level, the qualified rates of serum vitamin A and vitamin D, and the number of the children whose serum IGF-1 at or above the median and their corresponding measurements were compared between the two groups.Results:Totally, 26% of the experimental group fell behind normal children by two years in their bone ages, as compared with 12% of control group.The differences in developmental levels of bone ages between the two groups were statistically significant( χ2=12.74, t=5.42、7.92, P<0.01). Compared with the control group, the experimental group had obviously lower rates of vitamin A and vitamin D levels( χ2=26.85、13.65, t=8.45、12.47, P<0.01). A total of 88 children (44%) of the experimental group had serum IGF-1 levels at or above the median, as compared with 138 children (69%) of the control group( χ2=25.43, t=32.31, P<0.01). Conclusion:This finding supports the potential use of the bone age, vitamin A and D status and IGF-1 levels in growth retardation screening among children.

Objective To analyze the monitoring results of iodine deficiency disorders (IDD) of Dehong State in 2017,to find out the present situation of prevention and control of IDD,and to provide scientific basis for guiding the comprehensive prevention and control of IDD in our state in the future.Methods According to "Yunnan Iodine Deficiency Disorders Monitoring Program",a sampling survey was conducted in 5 counties (cities) of Dehong State,Yunnan Province.Urine and household salt samples were collected from children aged 8 to 10 years old and pregnant women in Mangshi,Lianghe County and Yingjiang County.Iodine content was detected.In addition,household salt samples of Ruili City and Longchuan County were collected to detect iodine content.Results There were 1 609 salt samples from local inhabitants,the coverage rate of iodized salt was 99.19％ (1 596/1 609),the edible rate of qualified iodized salt was 95.03％ (1 529/1 609) and the median of iodized salt was 23.76 mg/kg.The median of urinary iodine in 623 children aged 8 to 10 years old was 221.34 μg/L and the thyroid enlargement rate was 0.48％ (3/623).The median of urinary iodine in 346 pregnant women was 159.52 μg/L.Conclusion The iodine nutrition of children aged 8 to 10 years old and pregnant women of Dehong State is appropriate in 2017.

Objective To investigate the influence of systematic nursing intervention on family cohesion, adaptability, internet addiction rehabilitation degree and psychological status of patients with internet addiction disorder ( IAD ) . Methods IAD patients were randomly divided into control group ( n=50 ) and experimental group ( n=50) according to random number table. Patients in the control group were intervened by conventional nursing treatment. On the base of that, patients in the experimental group were intervened by systematic nursing intervention mode, such as inspirational education, comment classroom of nursing, systematic health education, regular follow-up, etc. Changes in family cohesion, adaptability, internet addiction rehabilitation degree and psychological status of the IAD patients were evaluated before and three months after the intervention.Results After the intervention, of patients in the experimental group, scores of ideal family cohesion improved from ( 67. 54 ± 4. 58 ) points to ( 74. 63 ± 3. 20 ) points; scores of actual family cohesion improved from (53.14±4.29) to (76.29±3.93); scores of ideal adaptability improved from (46.43±7.98) to (57.50±6.05);scores of actual adaptability improved from (44.90±5.78) to (50.78±5.43);scores of internet addiction rehabilitation degree declined from (83.37±3.46) to (56.01±5.02);various indexes of psychological health status had all improved significantly than before the treatment ( P<0. 05 ) . Indexes of patients in the control group showed no significant improvement (P>0.05).Conclusions Systematic nursing intervention mode can obviously improve physiological and psychological conditions of IAD patients, and increase the rate of internet addiction rehabilitation.

Objective To explore the regional homogeneity (ReHo) feature of the spontaneous neural activity within young male depressed patients,and conduct correlation analysis of the abnormal regions with the severity of depressive symptoms.Methods 19 male depressed patients and 19 educated age-matched male healthy controls were undergone resting-state functional magnetic resonance imaging scanning at 3.0 Tesla.The whole brain' s regional homogeneity was calculated.The ReHo values of abnormal brain regions after alphasim correction were conducted correlation analysis with the total score of Hamilton Rating Scale for Depression.Results As compared with the controls,the depressed patients exhibited significantly increased ReHo in the bilateral parahippocampal (-30,-42,-9:K=43:27,-33,-12:K=18) and the right posterior cingulate gyrus(3,15,33:K=54),while decreased ReHo in the right postcentral gyms (27,-36,54,K =21) (P＜0.05,Alphasim).The correlation analysis showed that the ReHo of the right parahippocampal gyrus was positively correlated with the HAMD17 total scores (r=0.535,P=0.018).Conclusions The male depressed patients exhibit abnormities in the limbicrelated brain regions during rest,and the extent of damage is correlated with the severity of depression.

Objective To explore the characteristic differences of the fractional amplitude of low-frequency fluctuation (fALFF) feature of the spoutaneous neural activity between young male unipolar depression and bipolar depression patients,and determine the biological markers to distinguish the two disorders.Methods Twelve male unipolar depression,12 bipolar depression patients and 11 age and educated-matched healthy males underwent resting-state functional magnetic resonance imaging scanning at 3.0 Tesla.The whole brain' s fALFF were calculated and analyzed.Results The differences of the fALFF of the three groups had significant differences (P＜0.01,Alphasim) in the right orbital medial frontal gyrus (6,33,-9;K =29),the left medial frontal gyrus (-6,60,3;K =44) and the left paracentral lobule (-3,-27,5 1;K =20).The unipolar depression subjects had significantly higher fALFF compared with heahhy controls in the left anterior cingulate gyrus.The bipolar depression subjects had significantly higher fALFF compared with healthy controls in the bilateral medial frontal gyrus and the left middle cingulate gyrus.And the unipolar depression subjects had significantly lower fALFF compared with bipolar depression ones in the right orbital medial frontal gyrus,the right anterior cingulate gyrus and the bilateral medial frontal ~rus(all P＜0.05).Conclusions Abnormalities exist in the brain regions in male with unipolar or bipolar depression patients in the resting state,and the abnormal regions are different.

BACKGROUND:Previous studies have shown that calcitonin gene-related peptide can be released from cardiac sensory afferent terminals fol owing coronary artery occlusion in rats, indicating the involvement of calcitonin gene-related peptide during pathological process of acute myocardial ischemia.
OBJECTIVE:To investigate the effect of calcitonin gene-related peptide on neonatal rat cardiomyocytes apoptosis induced by oxidized low-density lipoprotein and hypoxia/reoxygenation.
METHODS:Twenty wel s of primary cultured neonatal rat myocardial cel s were randomly divided into five groups:normal control group, oxidized low-density lipoprotein group, oxidized low-density lipoprotein hypoxia/reoxygenation group, calcitonin gene-related peptide group and calcitonin gene-related peptide 8-37 group. The cel s in the last four groups were incubated with oxidized low-density lipoprotein for 24 hours before establishing the myocardial hypoxia/reoxygenation model. At 30 minutes prior to hypoxia/reoxygenation, 10-8 mol/L calcitonin gene-related peptide were added into the culture fluid in calcitonin gene-related peptide group;10-7 mol/L competitive antagonist calcitonin gene-related peptide 8-37 of calcitonin gene-related peptide-1 receptor were added at 30 minutes before calcitonin gene-related peptide administration in calcitonin gene-related peptide 8-37 group. Myocardial apoptotic rate and caspase-3 activity were detected respectively.
RESULTS AND CONCLUSION:Calcitonin gene-related peptide could significantly attenuate apoptosis of neonatal rat myocardial cel s through inhibiting the caspase-3 activation induced by oxidized low-density lipoprotein and hypoxia/reoxygenation. And this effect could be partial y reversed by competitive antagonist calcitonin gene-related peptide 8-37 of calcitonin gene-related peptide 1 receptor, indicating that calcitonin gene-related peptide has anti-apoptotic effect in combination with the calcitonin gene-related peptide 1 receptor to inhibit cardiomyocyte apoptosis in neonatal rats induced by oxidized low-density lipoprotein and hypoxia/reoxygenation.