Objective : To study the effect of ubiquinol⁃cytochrome C reductase subunit 2 (QCR2) on cell cycle arrest of cervical cancer SiHa cell line , and to explore related mechanisms. Methods : The log⁃phase SiHa cells were taken , and QCR2 siRNA and control siRNA were transfected into SiHa cells by liposome transfection , which were set as QCR2 siRNA group and control siRNA group , and untreated cells were set as a blank group. qRT⁃PCR and Western blot were used to determine the relative expression of QCR2 , p53 mRNA and protein. Propidium iodide(PI) staining was used to determine cell cycle. The cells in the QCR2 siRNA group were taken , and were intervened with a final concentration of 50 nmol/L ubiquitin⁃proteasome inhibitor PS341 as the QCR2 siRNA + PS341 group. In addition , the cells in the QCR2 siRNA group were intervened with the same amount of normal saline (NS) and set as the QCR2 siRNA + NS group. Western blot was used to determine the relative expression of p53 protein. The immunoprecipitation test was used to determine the level of p53 ubiquitination. Results : Observed under a fluorescence microscope , the transfection efficiency of QCR2 siRNA group and control siRNA group were both > 80% . Compared with the blank group and control siRNA group , the relative expression of QCR2 mRNA and protein in the QCR2 siRNA group decreased (P < 0. 05) , the proportion of G0/G1 increased (P < 0. 05) , and the proportion of S , G2/M decreased (P < 0. 05) . There was no significant difference in the relative expression of p53 mRNA between the groups. Compared with the blank group and control siRNA group , the relative expression of p53 protein in the QCR2 siRNA group increased (P < 0. 05) . Compared with the blank group and QCR2 siRNA + PS341 group , the relative expression of p53 protein in the QCR2 siRNA group and QCR2 siRNA + NS group increased (P < 0. 05) . Compared with the blank group and control siRNA group , the degree of p53 ubiquitination in the QCR2 siRNA group was reduced ( P < 0. 05 ) . Conclusion Silencing QCR2 can block SiHa cells in G0/G1 phase. Its mechanism may be related to the inhibition of p53 ubiquitination and the increase of its protein expression.

Objective:To investigate the regulatory effect of targeted siRNA on β-globin in erythroid cells cultured by targeted differentiation in vitro and provide new theoretical support for gene therapy for hemoglobin H (HbH) disease.Methods:Based on the β-globin gene expression results, the optimal siRNA sequence and its effective action dose were screened in erythroid cells, and the effect of the effective dose of the optimal siRNA on the regulation of β-globin expression and apoptosis in erythroid cells was examined. The effective dose of the optimal siRNA was applied to erythroid cells with HbH disease. The effects of transfected siRNAs on red line cells with HbH disease were comprehensively evaluated by measuring the expression of β-globin, reactive oxygen species (ROS) , and apoptosis rates.Results:Within 96 hours after transfection, siRNA2 significantly downregulated β-globin expression in in vitro cultured erythroid cells, but not α-globin. siRNA silencing effect and duration of effect were dose-dependent. siRNA2 downregulated β-globin expression, reduced intracellular ROS production, and decreased apoptosis rate in erythroid cells with HbH disease.Conclusion:Targeted siRNAs can downregulate β-globin expression, reduce intracellular ROS production, and downregulate apoptosis rate in erythroid cells with HbH disease.

Objective:To explore the chain mediating effect of intrusive thinking and psychological distress on the fear of disease progression and quality of life of kidney transplant recipients, with a view to providing scientific theoretical guidance for effective psychological interventions for kidney transplant recipients.Methods:This study is a cross-sectional study. Convenience sampling was used to select 312 kidney transplant recipients who were followed up in the Outpatient Clinic of the First Affiliated Hospital of University of Science and Technology of China from January to May 2019. Patients were investigated with the General Information Questionnaire, the Fear of Progression Questionnaire, the Impact of Events Scale-Revised Intrusion Subscale, Distress Thermometer and 12-Item Short-Form Health Survey Questionnaire. Mplus 8.3 was used to construct and verify multiple intermediary models.Results:A total of 296 kidney transplant recipients were included in this study. In quality of life, the mental health score was (49.58±8.97) , and the physical health score was (49.90±9.17) . Fear of disease progression, intrusive thinking and psychological distress were all negatively correlated with mental health and physical health of quality of life (the r values were -0.453 to -0.401, P<0.01) . The mediating effect of fear of disease progression on the quality of life was established. The total mediating effect value was -0.273, and the specific mediating effect of intrusive thinking accounted for 46.52%, and the specific mediating effect of psychological distress accounted for 41.76%. The chain mediating effect of intrusive thinking and psychological distress between fear of disease progression and quality of life accounted for 11.72%. Conclusions:The intrusive thinking and psychological distress of kidney transplant recipients are established as a chain mediation between the fear of disease progression and the quality of life. While paying attention to patients' fear of disease, clinical staff should pay attention to assessing patients' intrusive thinking and psychological distress, and take targeted measures to reduce the impact of fear of disease progression on the quality of life.

Objective:To explore the clinical value of "hydration therapy" in the treatment of severe acute paraquat poisoning (APP).Methods:A prospective historical control observation was conducted. Fifty-eight patients with severe APP admitted to Shouguang People's Hospital Affiliated to Weifang Medical College from February 2014 to June 2019 were enrolled. Twenty-six patients admitted before May 10th, 2016 were enrolled in the standard treatment group. After being admitted to intensive care unit (ICU) from the department of emergency, patients in the standard treatment group were immediately given standard treatment such as repeated gastric lavage, catharsis, adsorption of poison by activated carbon or montmorillonite powder, drug treatment and blood purification. From May 10th, 2016, 32 patients were enrolled in the intensive treatment group. On the basis of standard treatment, "hydration therapy" was carried out, that was, 0.9% NaCl and/or 5% glucose injection were used for continuous intravenous infusion throughout the day, so as to ensure that the total amount of fluid infusion per day reached 200 mL/kg within 48-72 hours after ICU admission. At the same time, furosemide was used to strengthen diuresis to ensure the balance of water and electrolyte. If heart failure or acute pulmonary interstitial edema occurred during the treatment, "hydration therapy" should be stopped immediately. Six months after treatment, all patients were followed up. The patients with normal activity, no complaints of discomfort and no damage of heart, lung, liver, kidney and other organs were regarded as cured. The therapeutic effect of "hydration therapy" was evaluated.Results:There was no significant difference in gender, age, dosage or time from taking poison to ICU between the two groups. In the intensive treatment group, 32 patients did not appear heart failure during continuous rehydration treatment. Follow-up after 6 months showed that the overall cure rate in the intensive treatment group was significantly higher than that in the standard treatment group [59.4% (19/32) vs. 19.2% (5/26), P < 0.05]. In the 6-month follow-up, there was no significant difference in age or time from taking poison to ICU between the two groups, but the dosage in the intensive treatment group was significantly higher than that in the standard treatment group (mL: 54.06±26.03 vs. 23.00±4.47, P < 0.05). After 6 months of follow-up, chest CT showed that the lesions of pulmonary fibrosis of cured patients in both group gradually reduced with time, not completely progressive and irreversible. Conclusion:"Hydration therapy" with intensive diuresis can significantly improve the rescue success rate of patients with severe APP.

Paraquat (PQ) poisoning has become one of the common pesticide poisoning in China. PQ is extremely toxic to human beings. The fatality rate of oral PQ poisoning is more than 90%. So far, there is no specific antidote. Seek effective treatment measures for PQ poisoning has become the focus of clinical medical research. In November 2017, a patient with acute severe PQ poisoning was treated in the intensive care unit (ICU) of Shouguang People's Hospital Affiliated to Weifang Medical College. The patient refused blood purification therapy and was rescued successfully only by continuous fluid therapy, diuresis, catharsis and routine treatment. By reviewing the treatment process of this case, new treatment ideas for the clinical treatment of PQ poisoning in primary hospitals were provided. Patients with acute PQ poisoning should be rescued by immediate administration of emetic, gastric lavage, catharsis and oral montmorillonite powder. For those without dysfunction of heart, lung and and kidney, a large amount of fluid treatment and diuresis should be given immediately to promote the excretion of poison. The key to improve the success rate of rescue of acute PQ poisoning is to eliminate PQ from the body as soon as possible.

Objective To make bibliometrics analysis on case management literature in China so as to understand the research hotspots of case management and provide a basis for development of case management. Methods Journal articles related to case management were retrieved based on the theme "Case Management"in Chinese National Knowledge Infrastructure (CNKI) from 1st January 2009 to 31st December 2018 and the bibliography was collected. Excel and self-design computer program were used to frequency statistics and to construct co-word analysis and co-occurrence matrix of high-frequency keywords. SPSS 22.0 was used to hierarchical cluster analysis. Results A total of 1 102 articles were included and 53 high-frequency keywords were extracted. From 2009 to 2018, case management applied research showed growth trend in China. A total of 988 authors published 1 102 articles in 531 journals. Hierarchical cluster analysis showed that research hotspots of case management in China focused on 8 aspects including community-based rehabilitation, Aids, chronic heart failure, diabetes, peritoneal dialysis, chronic obstructive pulmonary disease, human resources and social work. Conclusions Nearly 10 years, case management is widely used in nursing field and social work, but research depth and width is insufficient. Achievable case management scheme should be built and informative case management system should be constructed to improve prognosis and quality of life of patients. There is still large room for development in the future.

How to effectively using the electronic health records (EHR) in contracted family doctors service was studied according to the new model of HER-based community medical service with community health service station as a center in combination with large hospitals,and suggestions were put forward for the solution of problems in contracted family doctor service,namely establishing and perfecting the community health service system,enlarging the scale of HER,strengthening the construction of general doctors team,and training the technically competent community health service staff.

ObjectiveTo investigate the influence of the number of T-junctions between central venous catheter and pressure transducer on measurement of central venous pressure (CVP) in patients.Methods A prospective controlled study was conducted. The patients with CVP monitoring in Department of Critical Care Medicine of the Fifth Center Hospital in Tianjin from February to October in 2014 were enrolled. The patients were divided into three groups according to the number of T-junction between central venous catheter and pressure transducer: without T-junction control group and 1, 2, 3 T-junctions groups. In each patient, corresponding CVP values with different number of T-junctions placed between the central venous catheter and pressure sensors were determined within a certain period, and a square-wave graphic was obtained and preserved on the monitor. The own frequency (fn) and the attenuation coefficient (D) of the system of pressure measurement were calculated after measurement of the shock wave following a square-wave to obtain the distance between two vibrations and the amplitude of the shock wave. The difference in CVP, fn and D were compared among the groups.Results A total of 20 cases were enrolled, and 150 groups of data were collected.① With the increase in the number of T-junction, CVP showed a tendency of gradual reduction. The CVP of the groups of control and 1, 2, 3 T-junctions was (7.00±1.60), (7.00±3.00), (5.00±2.00), and (4.00±1.00) mmHg (1 mmHg = 0.133 kPa), respectively. The CVP of 3 T-junctions group was significantly lower than that of the control group (F = 9.333,P = 0.015).② With an increase in the number of T-junction, fn showed a tendency of gradual increase. The fn of groups control and 1, 2, 3 T-junctions was (12.30±0.79), (16.00±0.91),(18.10±1.75), (20.90±2.69) Hz, respectively. The fn of 1, 2, 3 T-junctions group was significantly higher than that of the control group (F1 = 45.962,F2 = 45.414,F3 = 46.830, allP = 0.000); the fn of groups 2 and 3 T-junctions was significantly higher than that of 1 T-junction group (F1 = 5.827,P1 = 0.042;F2 = 15.038,P2 = 0.004), but there was no significant difference between the groups of 2 T-junctions and 3 T-junctions (F = 3.800,P = 0.087).③ With an increase of the number of T-junction, D also showed a tendency of gradual increase. The D of 1, 2, 3 T-junction group was 1.62±0.27, 1.60±0.22, 1.82±0.25, and 2.15±0.58, respectively. There were no differences among four groups.ConclusionAfter the application of T-junctions between central venous catheter and pressure transducer, CVP values will be underestimated, the reason of which is considered to be the increase in length and thinner lumen of the T-junctions.

OBJECTIVETo study the different expressions of glypican-3 in lung squamous cell carcinoma and adenocarcinoma and explore the association of glypican-3 with the prognosis of the patients.

METHODSGlypican-3 expression was detected immunohistochemically in the tumor tissues and adjacent tissues from 48 cases of lung squamous cell carcinoma and adenocarcinoma. Kaplan-Meier method and log-rank test were used for survival analysis of the patients.

RESULTSGlypican-3 expression was detected in the tumor tissues in 29.2% (14/48) of the cases, but not in the adjacent tissues. Of the 22 patients with lung squamous cell carcinoma, 12 (54.5%) showed positive glypican-3 expression in the tumor tissue, a rate significantly higher than that in patients with lung adenocarcinoma [7.7% (2/26), P<0.01]. In all the glypican-3-positive cases, the tumor tissues showed stronger glypican-3 expression in cases with lymph node metastasis or poor tumor differentiation. Kaplan-Meier survival analysis did not indicate a significant correlation of glypican-3 expression with the prognosis of the lung cancer patients.

CONCLUSIONPatients with lung squamous cell carcinoma have higher glypican-3 expressions in the tumor tissues than those with lung adenocarcinoma, suggesting the value of glypican-3 protein as a potential marker to detect lung squamous cell carcinoma.

Adenocarcinoma ; metabolism ; pathology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Gene Expression Regulation, Neoplastic ; Glypicans ; metabolism ; Humans ; Kaplan-Meier Estimate ; Lung Neoplasms ; metabolism ; pathology ; Paraffin Embedding ; Prognosis