【Objective】 To investigate the correlation between heart rate variability (HRV) and the degree of nervousness before blood donation. 【Methods】 The psychological state of 253 blood donors before blood donation was assessed by the self-rating anxiety scale (SAS) and the degree of nervousness and their HRV were measured. The correlation between the SAS score, the degree of nervousness and the HRV parameters was analyzed, and the differences were compared among different types of donors by multivariate linear regression. 【Results】 A total of 247 blood donors were included in the study. Five HRV parameters in blood donors aged 18-24 were higher than in those aged 25 years and above(all P<0.05), and the anxiety level was higher in female donors(SAS score 41-46) than in males(SAS score 35-43)(P<0.001); the pre-donation SAS score was consistent with the assessment of the tension level (r=0.970, P<0.001); the pre-donation tension level and the SAS score were all significantly negatively correlated with VLF in HRV parameters(r=0.179, P=0.005), and the associations were independent of confounders such as age, body mass index and gender (P<0.05). 【Conclusion】 Compared with SAS and tension assessment, HRV is more objective, and can be used as one of the tests for assessing the tension level of blood donors. The inclusion of HRV in the routine screening of blood donors deserves further study for its application in assessing the anxiety level of blood donors before blood donation, identifying people prone to blood donation-related vasovagal reaction (DRVR), preventing and reducing the risk of DRVR, and improving the safety of blood donation.

OBJECTIVE To explore the specific application and evaluation effect of objective structured clinical examination(OSCE)-guided scenario-based practical teaching mode in training clinical pharmacists. METHODS Fifty-six trainees who participated in the clinical pharmacist training program in the Second Xiangya Hospital of Central South University from October 2020 to September 2022 were selected as the research objects. OSCE-guided teaching was conducted, and the application effect of OSCE-guided teaching mode in clinical pharmacist training was explored and analyzed by using theoretical examination results and OSCE assessment results as evaluation indicators. RESULTS Through comparative analysis, it was found that the OSCE-guided teaching mode not only enabled students to better grasp the theoretical knowledge points required by the training outline, but also improved their clinical thinking ability, problem-solving ability, and communication and coordination skills to varying degrees. CONCLUSION For clinical pharmacist trainees, the OSCE teaching mode is conducive to the comprehensive improvement of clinical pharmacist skills and is suitable for cultivating clinical pharmacists who are capable of independently carrying out clinical pharmacy services in the new situation.

Objective To study placental microcirculation and microstructure of pregnant women with pregnancy-induced hyper-tension by using MRI intravoxel incoherent motion(IVIM)at plateau area.Methods A retrospective analysis was performed on 22 healthy pregnant women at third trimester with single birth and 20 pregnant women with pregnancy-induced hypertension.All subjects underwent ultrasound,routine MRI and IVIM examination.The D,D*,f values of the whole placental and various parts of the placental,estimated fetal weight(EFW)and postnatal weight were measured and recorded.The differences of two groups data were analyzed by independent sample t test or one-way analysis of variance,and then multiple comparisons of placental quantitative parameters between the two groups were analyzed by Bonferroni method.Results The fetal side and whole placental f values in healthy pregnant women at third trimester were higher than pregnancy-induced hypertension(P＜0.05),the maternal side and whole placental D values in healthy pregnant women at third trimester were higher than pregnancy-induced hypertension(P＜0.05),the EFW and fetal birth weight in healthy pregnant women at third trimester were higher than pregnancy-induced hypertension(P＜0.05).Conclusion IVIM can effectively evaluate placental blood flow microcirculation and microstructure with pregnancy-induced hypertension at plateau area,and provide a new proof for clinical evaluation of placental structure and function changes.

Objective:To investigate the current state of missed nursing care during labor, explore the reasons why nursing care was missed, and examine the influencing factors of missed nursing care.Methods:Data were collected from 14 medical institutions of different levels in southwest China using a convenience sampling from February to April, 2023. A total of 491 midwives were included. A cross-sectional survey was conducted using a general information questionnaire and the Chinese version of the Perinatal Missed Care. Multiple linear regression analysis was conducted to identify the influencing factors on missed nursing care.Results:Among 491 midwives, there are 6 males and 485 females. 194 midwives aged ≤ 30, 205 midwives aged 31-40 years, and 92 midwives aged ≥41 years. 80.45%(395/491) of midwives reported missing at least one item of nursing care during labor in the past week, and the missing rate of single item ranged from 13.24% (65/491) to 53.36% (262/491). The average score across 23 items of missed nursing care during labor was 1.49 ± 0.58. The average scores of items spanning the three dimensions of basic care, necessary care and postnatal care were 1.67 ± 0.68, 1.36 ± 0.56, and 1.51 ± 0.70, respectively. The average score of 13 items representing reasons for missed nursing care was 1.82 ± 0.71. The average scores of items in three dimensions of communication, labor resources, and material resources were 1.75 ± 0.73, 1.97 ± 0.87, and 1.74 ± 0.83, respectively. The multiple linear regression analyses showed that gender, monthly average income level, and whether overtime hours were included in total working hours were independently associated with missed nursing care (all P<0.05). Conclusions:The current state of missed nursing care during labor needs to be improved. Missed basic care is common, and labor resources are the significant reasons, and is influenced by factors such as demographic and sociological factors. Human resource factors are an important reason for nursing deficiency, and targeted measures should be taken to reduce the occurrence of nursing deficiency.

Glioblastoma (GBM) is the most common and aggressive malignant brain tumor in adults and is poorly controlled. Previous studies have shown that both macrophages and angiogenesis play significant roles in GBM progression, and co-targeting of CSF1R and VEGFR is likely to be an effective strategy for GBM treatment. Therefore, this study developed a novel and selective inhibitor of CSF1R and VEGFR, SYHA1813, possessing potent antitumor activity against GBM. SYHA1813 inhibited VEGFR and CSF1R kinase activities with high potency and selectivity and thus blocked the cell viability of HUVECs and macrophages and exhibited anti-angiogenetic effects both in vitro and in vivo. SYHA1813 also displayed potent in vivo antitumor activity against GBM in immune-competent and immune-deficient mouse models, including temozolomide (TMZ) insensitive tumors. Notably, SYHA1813 could penetrate the blood-brain barrier (BBB) and prolong the survival time of mice bearing intracranial GBM xenografts. Moreover, SYHA1813 treatment resulted in a synergistic antitumor efficacy in combination with the PD-1 antibody. As a clinical proof of concept, SYHA1813 achieved confirmed responses in patients with recurrent GBM in an ongoing first-in-human phase I trial. The data of this study support the rationale for an ongoing phase I clinical study (ChiCTR2100045380).

Objective:To investigate the intention to participate in health care in transitional children and adolescents with diabetes and analyze its influencing factors.Methods:This was a cross-sectional survey study. From March to October 2021, 185 children and adolescents with diabetes were selected as research subjects by convenience sampling method from People′s Hospital Affiliated to Jiangsu University. General data questionnaire, Participation in Health Care Intention Questionnaire, Health Literacy Scale and Diabetes Self-management Scale were used to investigate, and multiple linear regression was used to analyze the influencing factors of the population′s intention to participate in health care.Results:The transitional children and adolescents with diabetes participation in health care intention total score was (124.87 ± 16.31) points, the health literacy total score was (33.70 ± 4.38) points, diabetes self-management total score was (35.11 ± 5.19) points. The regression analysis found that age, course of the disease, diabetes type, family structure modes, health literacy, and self-management ability were the main factors influencing adolescents involved in health care intention ( t values were -1.99-2.66, all P<0.05), including health literacy ability and disease management ability was positively correlated with the disease ( r = 0.250, 0.232, both P<0.01). Conclusions:The transitional children and adolenscents with diabetes have a medium level of intention to participate in health care. The transitional children and adolenscents with older age, longer disease course and nuclear family structure had higher levels of health care intention. The higher the level of health literacy and self-management, the higher the level of intention to participate in health care, medical staff should take targeted measures to improve the intention to participate in health care, promote this group to improve disease management ability and quality of life.

Melatonin receptor 1B (MT2, encoded by the MTNR1B gene), a high-affinity receptor for melatonin, is associated with glucose homeostasis including glucose uptake and transport. The rs10830963 variant in the MTNR1B gene is linked to glucose metabolism disorders including gestational diabetes mellitus (GDM); however, the relationship between MT2-mediated melatonin signaling and a high birth weight of GDM infants from maternal glucose abnormality remains poorly understood. This article aims to investigate the relationship between rs10830963 variants and GDM development, as well as the effects of MT2 receptor on glucose uptake and transport in trophoblasts. TaqMan-MGB (minor groove binder) probe quantitative real-time polymerase chain reaction (qPCR) assays were used for rs10930963 genotyping. MT2 expression in the placenta of GDM and normal pregnant women was detected by immunofluorescence, western blot, and qPCR. The relationship between MT2 and glucose transporters (GLUTs) or peroxisome proliferator-activated receptor γ (PPARγ) was established by western blot, and glucose consumption of trophoblasts was measured by a glucose assay kit. The results showed that the genotype and allele frequencies of rs10830963 were significantly different between GDM and normal pregnant women (P<0.05). The fasting, 1-h and 2-h plasma glucose levels of G-allele carriers were significantly higher than those of C-allele carriers (P<0.05). Besides, the protein and messenger RNA (mRNA) expression of MT2 in the placenta of GDM was significantly higher than that of normal pregnant women (P<0.05). Melatonin could stimulate glucose uptake and GLUT4 and PPARγ protein expression in trophoblasts, which could be attenuated by MT2 receptor knockdown. In conclusion, the rs10830963 variant was associated with an increased risk of GDM. The MT2 receptor is essential for melatonin to raise glucose uptake and transport, which may be mediated by PPARγ.
Female ; Humans ; Pregnancy ; Blood Glucose/metabolism* ; Diabetes, Gestational/metabolism* ; Glucose/metabolism* ; Melatonin/metabolism* ; Polymorphism, Genetic ; PPAR gamma ; Receptor, Melatonin, MT2/genetics*

Super-enhancers (SEs) are large clusters of enhancers located near the promoter and are necessary to determine the identity of cancer cells. The alterations of super-enhancers can cause dysregulation of the transcriptional program, which resulted in tumor cells being addicted to certain transcriptional programs. Tumor metastasis is the leading cause of death in cancer. Recently, SEs have been demonstrated to facilitate tumor metastasis by regulating lncRNA generation, tumor microenvironment, epithelial-mesenchymal transition, and cancer stem cells. In this review, the characteristics of SEs, the relationship between SEs and tumor metastasis, and inhibitors against SEs are summarized to provide a reference for the relevant mechanism of SEs regulating tumor metastasis and provide new perspectives for the diagnosis and treatment of patients with cancer metastasis.

Objective:To analyze the duration of each phase of Unity MR-linac in clinical application, aiming to provide reference for clinical optimization of the process time.Methods:Clinical data of 55 patients treated with Unity MR-linac were retrospectively analyzed. All patients were divided into the adapt to position (ATP) and adapt to shape (ATS) groups according to the planning method. The duration of each phase in the treatment process, the name and the time of each sequence, the number of beams, segments and total monitor units (MUs) were recorded and compared between two groups. In addition, the set-up time was counted according to different treatment sites. The time of each sequence and set-up time were expressed as the median M (Q 1, Q 3), and the number of beams, segments and total MUs of each plan were described as the mean±SD. Results:42 patients underwent ATP with a total of 305 treatment sessions: setup time was 3(2, 5) min, MR scanning time was 5(4, 7) min, registration time was 3(3, 4) min, adaptive planning time was 8(4, 12) min, beam on time was 8(6, 11) min, and the total time was 30(25, 36) min. 13 patients received ATS with a total of 65 treatment sessions: setup time was 2(2, 3) min, MR scanning time was 7(5, 8) min, registration time was 4(3, 5) min, time of delineation of target and organs at risk was 12(9, 16) min, adaptive planning time was 11(10, 14) min, beam on time was 10(9, 11) min and the total time was 55(49, 61) min. The set-up time according to treatment sites was 4(2, 4) min in the head and neck, 2(2, 4) min in the chest, and 3(2, 5) min in the abdomen. The number of fields, segments and total MUs during ATP were 8.1±1.7, 49.9±31.2, 846.75±363.44 in the head and neck, 8.0±2.0, 60.7±13.3, 790.21±279.00 in the chest, and 9.7±2.0, 81.2±22.3, 2007.32±1053.81 in the abdomen, respectively. The number of fields, segments and total MUs during ATS in head and neck of one case were 13, 39, 993.07, and 9.5±1.5, 65.5±6.3, 2763.26±835.41 in the abdomen.Conclusions:MR-guided radiotherapy yields huge potential in clinical application. However, there is still much room for the improvement of shortening the process duration.

Synechocystis sp.PCC 6803(hereafter:Synechocystis)is a model organism for studying photosynthesis,energy metabolism,and environmental stress.Although known as the first fully sequenced phototrophic organism,Synechocystis still has almost half of its proteome without func-tional annotations.In this study,by using co-fractionation coupled with liquid chromatography-tandem mass spectrometry(LC-MS/MS),we define 291 multi-protein complexes,encompassing 24,092 protein-protein interactions(PPIs)among 2062 distinct gene products.This information not only reveals the roles of photosynthesis in metabolism,cell motility,DNA repair,cell division,and other physiological processes,but also shows how protein functions vary from bacteria to higher plants due to changes in interaction partners.It also allows us to uncover the functions of hypothetical proteins,such as S110445,S110446,and S110447 involved in photosynthesis and cell motility,and Sill 334 involved in regulation of fatty acid biogenesis.Here we present the most exten-sive PPI data for Synechocystis so far,which provide critical insights into fundamental molecular mechanisms in cyanobacteria.