Objective To retrieve the relevant evidence of ICU nurse ventilator alarm management and summarize the best evidence to provide a reference for ICU nurse ventilator alarm management decision.Methods The clinical decision,guideline,systematic evaluation,expert consensus and all kinds of original studies related to the alarm management of ICU nurses in PubMed,CINAHL,Embase,Web of Science,VIP,CNKI and Wanfang were searched from database construction until April 22,2023.The literature quality evaluation and result extraction were performed independently by 2 investigators.Results 14 articles were finally involved,including 4 guidelines,2 international standards,2 national standards,2 expert consensuses,3 systematic evaluations and 1 randomized controlled trial;combined with professional judgment,27 pieces of the evidence were summarized,including multidisciplinary teamwork,alarm monitoring and processing,alarm setting,alarm management requirements,alarm education and training and ventilator maintenance.Conclusion This study summarizes the best evidence of ventilator alarm management for ICU nurses,which can provide evidence-based bases for clinical decisions,solve clinical ventilator alarm problems in a scientific management way,and improve the quality of management.

Objective To study the protective effect of active peptide GRGDS on rat nerve cells (PC12 cells) in oxygen glucose deprivation (OGD) injury model and explore its mechanism of action. Methods PC12 cells were divided into control group, ODG group, and active peptide GRGDS treatment group. The injury model was established by simulating in vitro cerebral ischemia by oxygen and sugar deprivation. MTT and flow cytometry were used to detect apoptosis after oxygen-glucose deprivation. ELISA method was used to detect the changes of inflammatory factors TNF-α and IL-1β in PC12 cell supernatant after oxygen-glucose deprivation. Western blot was used to detect the expression of apoptosis pathway-related proteins. Results The results of MTT and flow cytometry showed that the active peptide GRGDS significantly reduced the apoptosis of PC12 cells after oxygen glucose deprivation (P<0.05). ELISA test results showed that the active peptide GRGDS significantly reduced the content of TNF-α and IL-1β in the supernatant of PC12 cells after oxygen-glucose deprivation. (P<0.05). Western blot results showed that the active peptide GRGDS significantly reduced the expression levels of p-JNK, Bax, and cleaved caspase 3 in PC12 cells mediated by oxygen-glucose deprivation injury (P <0.01). Conclusion The active peptide GRGDS has protective effect on PC12 cells damaged by oxygen and glucose deprivation. The mechanism may be related to anti-apoptotic and anti-inflammatory effects.

Objective Investigating alterations of axon microstructures in white matter lesions in a rat model of hypertension. Methods Eighteen male Sprague-Dawley rats were randomly divided into sham operation group (n=9) and operation group (n=9). Operation group received two kidneys two clips surgeries and bilateral common carotid arteries ligations. In the 12th week after common carotid arteries ligation, rats were evaluated by Morris Water Maze test and then sacrificed for evaluation of pathological features, including small arteries' pathologies, white matter lesions, glia changes and axon micro organizations. Results Morris Water Maze test showed that escape latencies was significantly higher in operation group than in sham operation group. The number of times of cross-over cite in the target quadrant was significantly lower in the operation group than in sham operation group (P＜0.05). Compared with sham operation group, operation group showed a series of pathological features, such as arteriosclerosis, leukoaraiosis, loss of oligodendrocyte and disorganized paranode. Conclusions White matter lesion is a chronic progressive disease which involves both demyelination and axon injuries.

Objective To evaluate the protective effect of epigallocatechin gallate (EGCG) on lipopolysaccharide (LPS) -induced acute kidney injury (AKI) in rats and its underlying mechanisms. Methods Sprague-Dawley rats were randomly divided into the Sham group, AKI group, EGCG group and TLR4 group (n = 10 each). To establish the rat model of endotoxemia, serum creatinine (Cr) and urea nitrogen (BUN) levels were detected by biochemical assays; serum interlukin (IL) -6, IL-1β, IL-10, and TNF-α levels were detected by ELISA; kidney histopathology was examined by hematoxylin and eosin (HE) staining method; and expression of TLR4, Myd88 and nuclear factor-kappa B (NF-κB) in rat kidneys at both protein and mRNA levels was detected by Western blotting and qRT-PCR, respectively.Results Kidney injury increased significantly in AKI group compared to the sham group. Serum Cr, BUN, IL-6, IL-1β, and TNF-α levels significantly increased whereas IL-10 levels significantly decreased in AKI group compared to the sham group. Expression levels of TLR4, Myd88, and NF-κB also significantly increased at both protein and mRNA levels in AKI group compared to the sham group. Treatment with EGCG prior to induction of LPS-mediated AKI conferred protection against AKI by significantly reducing the expression of inflammatory markers such as, TLR4, Myd88, and NF-κB. Given TLR4 inhibitor based on this, the protective effect of EGCG on AKI was via inhibition of the TLR4/Myd88/NF-κB pathway. Conclusion EGCG exhibited a protective effect against LPS-induced AKI by inhibiting the activation of TLR4/Myd88/NF-κB pathway.

Objective To prepare a mouse anti-human B7-2 monoclonal antibody ( McAb) and to study its effect on the induction of death-related molecules on the surface of tumor cells. -ethods Trans-genic cells, L929-B7-2, were used as the immunogen to immunize BALB/c mice. Through cell fusion, mul-tiple screening by immunofluorescence labeling and continuous subcloning, the hybridoma secreting B7-2 McAb was obtained. Biological characteristics of the McAb were analyzed using Ig subclass identification test strip, antigenic site competition inhibition assay and specific cell membrane molecules binding test. McAb was prepared through inducing ascites in vivo and then purified by protein G affinity chromatography. The purified McAb was co-cultured with 8266 cells, naturally expressing B7-2 molecules, to observe the expres-sion of Fas and FasL on cell surface by flow cytometry ( FCM) . Results The prepared B7-2 McAb labeled as 12G4 was successfully obtained with a titer of 0. 1 μg/5×105 cells. Its heavy and light chains were IgG2b and κ, respectively. The concentration of the purified ascites-derived antibody was 1. 61 mg/ml. FCM re-sults showed that the 12G4 McAb recognized cell membrane molecules well with a positive binding rate of 89. 6％ to 8266 cells. The mean value of the Fas molecule on the cell surface increased after incubating with 20 μg/ml of 12G4 McAb for 12 h and reached the peak of 62575. 8 at 48 h, which was significantly higher than the maximum value of 57135. 4 in the IgG control group (P<0. 05). After culturing the cells with 20μg/ml of 12G4 McAb for 12 h, the expression of FasL on the cell surface also increased and reached the maximum of 7. 98％ at 48 h, which was significantly higher than the 1. 10％ in the IgG control group ( P<0. 05). Conclusions B7-2 McAb was successfully prepared. It could be used to induce the expression of some death-related molecules on the surface of tumor cells.

Objective? To investigate the effect of high-intensity interval training on glucose homeostasis and cardiac function in patients with type 2 diabetes mellitus. Methods? A total of 56 inpatients in Endocrine Department of the Fourth Affiliated Hospital of Harbin Medical University from March 2017 to August 2018 were randomly divided by convenient sampling method into an intervention group and a control group, with 28 inpatients in each. The inpatients in the control group received the standardized care process while the intervention group would further received the high intensity interval training. The homeostasis model assessment insulin resistance(HOMA-IR),ejection fractions(EF) and cardiac outpu(t CO) were compared before and after the intervention. Results? After intervention, HOMA-IR in the intervention group was (6.32±1.65)%, lower than that in the control group (7.22±1.40)%, the difference between the two groups was statistically significant (t=2.20, P=0.03). After intervention, there was no significant difference in EF and CO between the two groups (P＞0.05). Conclusions? The high intensity interval training can improve the level of glucose homeostasis in patients with type 2 diabetes, but more evidence is needed for the effect on heart function in the future.

Objective: To investigate the therapeutic effects of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with FLAG sequential busulfan/cyclophosphamide(Bu/Cy) conditioning regimen for refractory/relapsed acute myeloid leukemia. Methods: From February 2012 to June 2017, 21 patients with refractory/relapsed acute myeloid leukemia underwent allo-HSCT with FLAG sequential Bu/Cy conditioning regimen. Transplantation-related complications and clinical outcome were retrospectively analyzed. Results: After conditioning, no hepatic veno-occlusive disease (VOD) and grade Ⅲ hemorrhagic cystitis occurred. 76.2% (16/21) patients had fever with 4 septicemia. One patient died of septic shock before engraftment. Twenty patients achieved neutrophil engraftment with a median time of 13 days (range, 10 to 21 days). Seventeen patients achieved platelet engraftment with a median time of 18 days (range, 9 to 25 days). The cumulative incidence of acute graft-versus-host disease (aGVHD) was 39.5%, and 3 patients developed grade Ⅲ-Ⅳ aGVHD. Of 19 patients who survived more than 100 days after transplantation, 4 had local chronic graft-versus-host disease (cGVHD). Of 21 patients, the median survival time was 15 months (range, 0.5 to 67 months) post-transplantation. Transplantation-related mortality rate was 28.7%. Leukemia relapse occurred in 4 patients with a median time of 4 months (range, 3 to 8 months) after transplantation. The cumulative relapse rate at 1 year was 21.4%. The 1-year and 3-year overall survival (OS) rates were 60.7% and 54.9% respectively. Log-rank analysis revealed that bone marrow blasts ≥ 20% or extramedullary leukemia before transplantation, poor platelet engraftment and grade Ⅲ-Ⅳ aGVHD were significantly related to shortened OS (P<0.05). Conclusions Allo-HSCT with FLAG sequential Bu/Cy conditioning regimen in patients with refractory/relapsed myeloid leukemia has acceptable transplantation-related risk and relapse rate. The 1-year and 3-year OS rates are comparable with those in remission patients.

Objective To explore the effects of structural health education on the self-management and uric acid value of gout patients. Methods From January 2016 to May 2017, a total of 126 cases of gout patients in the Fourth Affiliated Hospital of Harbin Medical University were included by convenience sampling method. According to the random number table method, all the research subjects were divided into the control group and the observation group with 63 patients in each. The patients of the control group received traditional health education intervention, including education manual and health seminars. In the observation group, the structural education programs were implemented, including analyzing the patients' self-management health needs, setting goals combining with propaganda manual, arranging staged health education courses and training health education nurses and patients to focus on individual health education. The uric acid value and self-management ability were compared between two groups before intervention and 3 months after. Results After 3 months' intervention, the uric acid value of the observation group [(394.2±13.1)μmol/L] was lower than that of the control group [(427.3±14.5)μmol/L], and the difference was statistically significant (P＜0.01). The total score of self-management of the observation group (111.2±17.3) was significantly higher than that of the control group (94.5±19.4). In addition, the scores of diet control, regular exercise, drug and adverse drug reactions, follow-up and monitoring and the prevention of complications of the observation group were all higher than those of the control group, with statistical differences (P＜ 0.01). Conclusions The application of structural health education for gout patients can improve the prognosis of the disease and improve gout patients' self-management.

Objective: To investigate the postoperative prognosis and the related factors of patients with stage pT2N0-1M0 of thoracic esophageal carcinoma(EC). Methods: From 2008 to 2011, clinical data of 275 cases with stage pT2N0-1M0 of thoracic EC treated by esophagectomy were enrolled. These cases includ 180 male and 95 female. Among them, 32 cases were upper thoracic EC, 186 cases were middle thoracic EC and 57 cases were lower thoracic EC. Alternatively, 205 cases were stage pN0, 70 cases were stage pN1. 155 cases received esophagectomy alone and 120 cases received esophagectomy and postoperative adjuvant therapy. Results: The end of follow-up time was on September 30th, 2014. The 1-, 3-, 5-year overall survival (OS) rates were 91.6%, 70.2% and 63.7%, respectively. The 1- 3-, 5-year progression-free survival (PFS) rates were 83.9%, 64.0% and 60.0%, respectively. The result of univariate analysis showed that the depth of tumor invasion, pathological type, pN stage and number of metastatic lymph nodes were significantly associated with OS (all of P<0.05). Moreover, the gender, the depth of tumor invasion, pathological type, pN stage and number of metastatic lymph nodes were significantly associated with PFS (all of P<0.05). Cox multivariate analysis showed that the location of primary tumor and pN stage were the independent factors of OS (both P<0.05). The gender, pN stage and postoperative adjuvant therapy were the independent factors of PFS (all of P<0.05). Conclusion Among the patients with pT2N0~1M0 stage of thoracic EC, patients with upper thoracic EC or pN1 stage have poorer postoperative prognosis compared with others, and postoperative adjuvant treatment is recommended for these patients.

Objective To study the therapeutic effect of anti-CD80 bivalent antibody on mouse lu-pus nephritis and to explore the possible molecular mechanism. Methods A mouse model of lupus nephritis was established through intraperitoneal injection of 0. 5 ml of pristine in female C57BL/6J mice. Appearance of urinary protein and significantly increased levels of peripheral antinuclear antibody ( ANA) and anti-doub-le-stranded DNA ( anti-dsDNA) antibody in the fourth month after injection indicated that the mouse model was established successfully. Then the mice were divided into two groups including anti-CD80 bivalent anti-body intervention group (injected with 200μg of anti-CD80 bivalent antibody at day 1, 3, 5, 8 and 15, fol-lowed by three times of injection with an interval of one month) and model group ( injected with the same protein using the same strategy). A normal control group was set up accordingly. Albustix test paper was used to monitor the dynamic changes in mouse urinary protein. Flow cytometry was used to analyze the acti-vation of immune-related cells in spleen. Levels of autoantibodies ( ANA and anti-dsDNA) and levels of IFN-γ and IL-4 in serum were detected by indirect immunofluorescence assay. Renal tissue samples were an-alyzed with hematoxylin and eosin ( HE) staining and immunocomplex ( IC) assay. Results Urinary pro-tein level of the anti-CD80 bivalent antibody intervention group was significantly lower than that of the model group (P<0. 05). Activated macrophages, dendritic cells, neutrophils and B cells in spleen tissues of the anti-CD80 bivalent antibody intervention group were significantly less than those of the model group ( P<0. 05), and the numbers of CD4+ and CD154+ T cells were significantly less than those of the model group (P<0. 05). Positive rates and titers of ANA and dsDNA in serum samples of the intervention group were lower than those of the model group (P<0. 05). Levels of IFN-γand IL-4 in serum samples of the interven-tion group were decreased as compared with those of the model group (P<0. 05). HE staining and immuno-fluorescence assay showed that glomerular inflammatory injury and necrosis were alleviated and kidney im-mune complex deposition was reduced after anti-CD80 bivalent antibody intervention. Conclusion Anti-CD80 bivalent antibody specifically binds to the CD80 molecule on antigen presenting cell surface, blocks the CD80/CD28 co-stimulatory signaling pathway and down-regulates the body′s immune response, which al-leviates and reverses the lupus-like nephritis-induced pathological damages in mice.