Objective To investigate the current status of nurses'knowledge,attitude and practice regarding sleep management of critically ill children in pediatric ICU,and to analyze its impact factors.Methods A self-designed questionnaire on general information and a questionnaire on knowledge and practical behaviors of pediatric ICU nurses on child's sleep management were used.In March 2023,902 pediatric ICU nurses from 24 hospitals in China were surveyed using a convenient sampling method,and the impact factors were analyzed using multiple stepwise linear regression.Results 893 valid questionnaires were collected and the recovery rate of valid questionnaires was 99.00％.Nurses in pediatric ICU scored(33.71±7.76)in knowledge dimension,(37.38±4.86)in attitude dimension and(80.60±16.78)in practice dimension,with a total score of(151.78±24.27).The scores of knowledge and attitude,knowledge and practice,attitude and practice are all positively correlated(r=0.393,P＜0.001;r=0.495,P＜0.001;r=0.320,P＜0.001).The results of multiple stepwise linear regression analysis showed that gender,region,whether they had received sleep management training were the influencing factors of pediatric ICU nurses'total score of knowledge,attitude and practice towards children's sleep management(P＜0.05).Conclusion Nurses in pediatric ICU are positive about sleep management for critically ill children,but their knowledge and practice levels need to improve.Nursing managers should strengthen the theoretical knowledge and practical behavioral training of pediatric ICU nurses on child sleep management,develop scientific sleep management plans,and guide nurses to make reasonable evaluation and interventions to improve children's sleep quality.

Over-expression of glutathione S-transferase(GST)can promote Cisplatin resistance in hepatocellular carcinoma(HCC)treatment.Hence,inhibiting GST is an attractive strategy to improve Cisplatin sensi-tivity in HCC therapy.Although several synthesized GST inhibitors have been developed,the side effects and narrow spectrum for anticancer seriously limit their clinical application.Considering the abundance of natural compounds with anticancer activity,this study developed a rapid fluorescence technique to screen"green"natural GST inhibitors with high specificity.The fluorescence assay demonstrated that schisanlactone B(hereafter abbreviated as C1)isolated from Xue tong significantly down-regulated GST levels in Cisplatin-resistant HCC cells in vitro and in vivo.Importantly,C1 can selectively kill HCC cells from normal liver cells,effectively improving the therapeutic effect of Cisplatin on HCC mice by down-regulating GST expression.Considering the high GST levels in HCC patients,this compound demon-strated the high potential for sensitizing HCC therapy in clinical practice by down-regulating GST levels.

Objective:Based on a cross-sectional survey about the status of analgesia and sedation nursing behavior of PICU nurses in Northeast China and Inner Mongolia, to analyze the influencing factors and to provide reference for further constructing standardized training programs and developing standardized for analgesia and sedation nursing process.Methods:The self-designed questionnaire was made for investigation from 435 PICU nurses in 18 hospitals in Northeast China and Inner Mongolia.Results:The average questionnaire score of the analgesia and sedation nursing behavior of PICU nurses was(70.54±13.63)in Northeast China and Inner Mongolia.The behavioral scores were different in each group between different age, nursing age, PICU nursing age, educational background, professional title, and whether was the intensive care unit nurse, whether trained in analgesia and sedation, whether have experience in caring children with analgesia and sedation, and the differences were all statistically significant( P<0.05). The main factors influencing the analgesia and sedation behavior of PICU nurses were whether have received training in analgesia and sedation, whether have experience in caring children with analgesia and sedation treatment and their attitude score to analgesia and sedation. Conclusion:There is still much space for development in analgesia and sedation nursing behavior of PICU nurses in Northeast China and Inner Mongolia.The more analgesia and sedation training PICU nurses take participate in, the more experience and positive attitudes they have in nursing children with analgesia and sedation, their clinical nursing practice ability could become more stronger.

Objective To study the effects of different color light stimulus, duration of stimulus and day/night training on the incentive conditioned reflex of rats,and to provide a data basis for the methodology of incentive conditional reflection experiments. Methods Three experiments were included in this study. During the experiment 1, a total of 30 male 8-week-old Wistar rats were divided into three groups:red light stimulation group,yellow light stimulation group and blue light stimulation group. During the experiment 2, a total of 32 male 8-week-old Wistar rats were divided into three groups:the group I(with a light stimulation duration of 10 s), the group II(with a light stimulation duration of 30 s), and the group III(with a light stimulation duration of 60 s). During the experiment 3,a total of 16 male 8-week-old Wistar rats were randomly divided into two groups,of which the first group was trained at 9:00 a.m. every day, and the second group was trained at 21:00 every day. All the laboratory animals were given reward conditioned reflex training, and indicators such as the number of correct nose pokes,the number of incorrect nose pokes,the ratio of correct nose pokes and so on were counted and calculated. Results During the experiment 1,there was no significant difference in the numbers of correct nose pokes and incorrect nose pokes,movement distances and average speeds of the rats among the three groups. During the experiment 2,compared with the group with a light duration of 10 s,the rats in the groups with a light duration of 30 s or 60 s had a higher number of correct nose pokes(P< 0.05). Moreover,on the 13th and 14th days,the ratio of correct nose pokes of the group with a light duration of 30 s was significantly higher than that of the group with a light duration of 10 s(P< 0.001). During the experiment 3,there were no significant differences in the number of correct nose pokes and the nose poke accuracy of the rats between the two groups. Conclusions In the reward conditioned reflex test, red,yellow and blue light stimuli have similar reward prediction effect. When stimulated with the same light, the time of stimulation has an impact on the learning ability of the rats,and an appropriate extension of stimulation is beneficial to the formation of conditioned reflex in them. The day/night training has no effect on the learning and memory ability of the rats.

Objective To Study the depression-like behavior and impairment of learning and memory induced by chronic injection of corticosterone in mice. Methods Forty male C57BL/6J mice were divided into four groups, the control group, and the corticosterone groups(20,40,80 mg/kg). The mice received subcutaneous injection of corticosterone once a day for 21 days. The depression-like behaviors were detected by open field test(OFT), tail suspension test(TST)and forced swimming test(FST). To select the most effective dose of corticosterone, TST, FST, object location recognition test, and Morris water maze(MWM)test were used to study the corticosterone-induced depression-like behaviors and impairment of learning and memory in the mice. Results Compared with the control group, the movement distance and duration were significantly decreased in the corticosterone injection groups(40,80 mg/kg)(P< 0.01 or P< 0.05). In the TST group,the immobilization time was significantly increased in the corticosterone injection group(40,80 mg/kg)(P< 0.05). The TST and FST showed that the immobilization time of the corticosterone injection group(40 mg/kg)was significantly increased(P < 0.05). The object recognition test showed that the discrimination indexes of the object location recognition were decreased in the corticosterone injection group(40 mg/kg). The MWM test showed that the escape latency was increased(P< 0.05),and the number of crossing in target quadrant and the velocity in target quadrant were decreased(P< 0.05)in the corticosterone injection group(40 mg/kg). Conclusions Chronic injection of corticosterone can induce depression accompanied with learning and memory impairment in mice.

Objective To investigate the development and application of blood purification in PICU. Methods The demographic data,diagnosis,length of stay,prognosis,patterns and frequency of blood purifi-cation and complications of PICU patients treated with blood purification in our hospital from 2010 to 2017 were retrospectively analyzed. Results The patients with blood purification accounted for 3. 1％ of hospital-ized children in the same period. From 2010 to 2017,the patients and times with blood purification increased by 370. 6％ and 398. 3％ respectively. The times of continuous veno-venous hemodiafiltration(CVVHDF), plasma exchange and hemoperfusion increased by 135. 2％,6300％ and 1600％ respectively. The frequency of CVVHDF,plasma exchange and hemoperfusion accounted for 42. 8％(492/1151),33. 5％(386/1151), and 23. 7％ (273/1151) respectively. Drug and toxic poision accounted for the highest proportion of 28. 6％(81/284),neurological diseases accounted for 20. 8％(59/284),sepsis with multiple organ dysfunction syn-drome accounted for 18. 0％( 51/284 ) , digestive system diseases, autoimmune diseases, renal diseases and metabolic diseases accounted for 14. 4％( 41/284 ) ,4. 9％( 14/284 ) ,4. 9％ ( 14/284 ) and 4. 2％( 12/284 ) respectively. The cure rate was 63. 8％. Complication included thrombus. Conclusion Blood purification has become the preferred modality for the management of critically ill children. Pediatric blood purification tech-niques have developed rapidly in our PICU and domestic pediatric. Further specification is required,so that it may represent the adequate choice for critical ill children.

Objective : To investigate the morphology and proliferation viability in oxidative stress induced damage in human MG63 cells. Methods: The MG63 cells were treated with superoxide anion (O2.') produced by different concentrations of xanthine/xanthine oxidase enzymatic reactions to establish the model of oxidative stress in MG63 cells, using the xanthine oxidase inhibitor oxypurinol to observe the reverse effect of oxypurinol on xanthine/xanthine oxidase induced damage in human MG63 cells. Using the flow cytometry, the production of intracellular reactive oxygen species (ROS) induced by xanthine/xanthine oxidase induced cellular oxidative stress damage was evaluated by the oxidation⁃sensitive fluorescent probe, the 2’7' dichlorofluorescin diacetate. Cellular viability and morphology was evaluated by the MTT assay and the phase contrast microscope. Results : Xanthine/xanthine oxidase induced intracellular ROS production in a dose and time dependent manner (P < 0.05). The cellular viability was reduced and cellular morphology was damaged, too (P < 0.05). Xanthine/xanthine oxidase induced the damage of the cellular morphology. At the same processing time, the higher the xanthine/xanthine oxidase concentration, the higher intracellular ROS fluorescence intensity value, and the lower OD value, the difference was statistically significant (P < 0.05). The intracellular mean ROS fluorescence intensity in xanthine/xanthine oxidase + oxypurinol combined treatment group was significantly lower compared with the same concentration of xanthine/xanthine oxidase (P < 0.05). At the same concentration of xanthine/xanthine oxidase, with the extension of treatment time, the intracellular mean ROS fluorescence intensity gradually increased, the OD value decreased, compared with the control group, the intracellular mean ROS fluorescence intensity of 120 min increased to 345% of the control, was the highest among the xanthine/xanthine oxidase groups. The OD value of 24 h was the 22.9% of the control group, was the lowest among the xanthine/xanthine oxidase groups, cell proliferation activity decreased more obvious. Conclusions Xanthine/xanthine oxidase could induce oxidative stress damaged the cellular morphology and reduced the cellular viability in MG63 cell lines. The oxypurinol (the inhibitor of xanthine oxidas) could reverse the oxidative stress injury induced by xanthine/xanthine oxidase in human osteoblastic cells.

Objective To investigate the antidepressant effect of DS-1226, a hydrolysate of ginsenosides, on a mouse model of depression induced by chronic sleep interruption, and provide scientific evidence for the research and de?velopment of antidepressant drugs. Methods 72 male ICR mice were divided into control group, model group, positive control group (paroxetine hydrochloride, 10 mg/kg) and 3 treatment groups (20 mg/kg, 40 mg/kg, 80 mg/kg of DS?1226). Except the control group, the other mice were put into a rotary roller (parameter settings:1 min/rev;rest 2 min af?ter 1 rev) for 3 days of drum adaptation, 3 h/d. Then making model for 14 days in the roller( parameter settings:1 min/rev;rest 2 min after 1 rev) . The antidepressant effects of DS?1226 were evaluated by weight monitoring, open?field test, tail suspension test, and forced swimming test. Results After 14 d sleep disturbance, compared with the control group,the body weight, immobility time in tail suspension test and forced swimming test were significantly decreased in the model group. Compared with the model group, DS?1226(40 mg/kg)significantly reversed the weight loss caused by sleep disturb?ance. Paroxetine significantly reduced the immobility time of tail suspension test. DS?1226 (40 mg/kg, 80 mg/kg)signifi?cantly decreased the immobility time of tail suspension test, and DS?1226 (80 mg/kg) significantly decreased the immobil?ity time of forced swimming test. Conclusion The hydrolysate of ginsenosides DS?1226 shows antidepressant effect on mouse model of depression induced by chronic sleep interruption.

Objective To analyze the correlative factors that affect the main complications caused by peripherally inserted central catheter puncture (PICC) on low birth weight infant with different puncture sites,in order to reduce the incidence of complications and achieve the purpose of indwelling safely.Methods A total of 431 infants with different PICC puncture sites were recruited in this study from January 2008 to January 2013,261 cases of them were punctured in the elbow upper extremity veins, 147 cases were in the elbows downward veins,5 cases were in the superficial temporal veins, 12 cases were in the axillary veins,and 6 cases were in the femoral veins.The complications occurring in the period of indwelling catheter were analyzed, and the effective treatments or preventive nursing measures were taken.Results 431 cases were punctured successfully.The sites of puncture were mainly in the veins of the upper arm,and the main complications were phlebitis,extremities swelling,jamming pipe and infection.The incidence of phlebitis, extremities swelling in the elbows downward veins were lower than those in the elbow upper extremity veins: 10.89％(16/147) vs.3.83％(10/261), 17.69％(26/147) vs.4.98％(13/261), and the differences were significant, x2=7.840, 17.561, P＜0.05.Conehusions The veins in the elbow and elbow downward are mainly selected.It is necessary to assess the complications promptly that may occur and to take effecdve measures,and good catheter maintenance consciousness also has important significance to the reduction of complications.

Objective To explore the clinical effect of application of hospital information system in bedsore nursing process analysis.Methods To combine process management and continuous quality improvement organically,establish a complete set of the pressure ulcer management monitoring process,which was completed,networking,continuous for improvement and this process was used for the implementation of high-risk bedsore warning screening and bedsore informing,hospitalized patients with pressure ulcers online report system and level 3 monitoring system,bedsore nursing consultation system and pressure ulcer nursing intervention.Results The application of informatization in the pressure ulcer management process could effectively reduce the incidence of pressure ulcers,prompt bedsore nursing management level to be more standardized,scientific,and modernization.At the same time,it improved the patients' satisfaction degree with nursing work,meanwhile it let managers found that carrying out of pressure sores extended nursing service was imperative.Conclusions Application of hospital information system in bedsore nursing process analysis is satisfying,which is worthy of further development.