Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Objective:To explore the relationships among workplace bullying,resilience and work perform-ance in nurses,employing a moderation and matching analysis perspective.Methods:A total of 3 026 nurses from 4 tertiary hospitals in Shandong Province were recruited.The Negative Acts Questionnaire Revised,Connor-Davidson Resilience Scale-10item,and Work Performance Scale were used to evaluate workplace bullying,psychological re-silience and work performance.Moderation analysis and response surface analysis were used to investigate the rela-tionships among workplace bullying,psychological resilience and work performance in nurses.Results:The results of the moderation effect analysis indicated that psychological resilience could moderate the negative relationship be-tween workplace bullying and work performance(β=0.07,95％CI:0.03-0.10).Response surface analysis re-vealed that compared to nurses with low bullying-low resilience,nurses with high bullying-high resilience showed higher work performance(Z-hat difference=2.06;95％CI=0.48-3.58).Nurses with high bullying-low resili-ence exhibited lower work performance compared to those with low bullying-high resilience(Z-hat difference=-8.31;95％CI=-12.06--5.68).Conclusion:Psychological resilience plays a moderating role in the negative effects of workplace bullying on job performance of nurses,and there are relative differences in work performance between individuals with different levels of workplace bullying and psychological resilience.

Objective To investigate the association between baseline IgM level and treatment response to ursodeoxycholic acid (UDCA) in patients with primary biliary cholangitis (PBC). Methods A retrospective analysis was performed for the clinical data of 637 PBC patients who were diagnosed and treated with UDCA for the first time in The Fifth Medical Center of Chinese PLA General Hospital from January 2010 to January 2020. The PBC patients were divided into UDCA complete response group with 436 patients and UDCA poor response group with 201 patients, and baseline clinical data were compared between the two groups. According to the optimal cut-off value of IgM determined by the area under the ROC curve (AUC) of baseline indices in predicting the risk of poor treatment response, the patients were divided into IgM ≥1.5×ULN group and IgM < 1.5×ULN group, and baseline parameters, treatment response, and prognostic model score were compared between groups. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Cochran-Mantel-Haenszel test was used for subgroup analysis, and forest plots were plotted for related risk values. Results Compared with the UDCA complete response group, the UDCA poor response group had significantly higher proportion of patients with liver cirrhosis, levels of total bilirubin, aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bile acid, total cholesterol (TC), IgA, and IgM, and positive rate of anti-Gp210 antibody at baseline ( χ 2 =4.596, Z =-9.932, -8.931, -8.361, -7.836, -4.694, -3.242, and -2.115, χ 2 =15.931, all P < 0.05). The UDCA poor response group had significantly higher Mayo Risk Score, Globe score, and UK-PBC risk score than the UDCA complete response group ( t =4.092, Z =-10.910 and -11.646, all P < 0.001). Compared with the normal IgM group, the elevated IgM group had significantly higher levels of AST, ALP, TC, IgA, and IgG and a significantly higher positive rate of anti-Gp210 antibody ( Z =-3.774, -5.063, -4.344, -2.051, and -6.144, χ 2 =25.180, all P < 0.05). IgM had an AUC of 0.552 in predicting poor treatment response. Compared with the IgM < 1.5×ULN group, the IgM ≥1.5×ULN group had significantly higher levels of AST, ALP, TC, and IgG, a significantly higher positive rate of anti-Gp210 antibody, and a significantly higher poor UDCA response rate ( Z =-4.193, -5.044, -3.250, and -5.465, χ 2 =25.204 and 8.948, all P < 0.05). IgM ≥1.5×ULN had an odds ratio of 1.416 (95% confidence interval [ CI ]: 1.129-1.776, P =0.003) in predicting poor response. The subgroup analysis showed that for patients without liver cirrhosis, IgM ≥1.5×ULN had an odds ratio of 1.821 (95% CI : 1.224-2.711, P =0.003) in predicting poor response. Conclusion Baseline IgM level has an important value in predicting UDCA response. IgM level should be closely monitored during treatment in PBC patients with a high baseline IgM level, and second-line drugs should be given in time if the abnormality persists.

Primary biliary cholangitis (PBC) is an autoimmune liver disease, mainly characterized by chronic progressive cholestasis. The root cause of PBC is the loss of immune tolerance to autoantigen E2 subunit of pyruvate dehydrogenase (PDC-E2). The unique immunobiological characteristics of intrahepatic bile duct epithelial cells make it an active participant in the pathogenesis of PBC. In recent years, the detection rate of PBC has been increasing year by year, but the clinical situation of ursodeoxycholic acid monotherapy has not changed. Therefore, an in-depth understanding of the immune pathogenesis of PBC will help clinicians better prevent and treat diseases.

Objective This study aims to investigate the frequency and characteristics of vascular involvement in Beh(c)et's disease (BD).Methods We enrolled patients who were hospitalized at Changhai Hospital affiliated Naval Medical University and who had been diagnosed with BD at discharge from January 1999 to July 2017.Patientswere divided into two groups,Vascular Beh(c)et's disease (VBD) group and non-VBD group,according to vascular involvement or not.We recorded and compared the demographicinformation,disease activity scores Beh(c)et’s Disease Current Activity Form (BDCAF),other systemic involvement and laboratory test results between the two groups.The clinical features of vascular involvement were analyzed.The measureddata were statistically analyzed with Student's t/t’ test or Mann-Whitney U test.The numerical data were statistically analyzed with x2 test or continuity correction x2 test.Results The total numbers of BD patients were 224,including 120 males and 104 females.Vascular involvements were found in 41 (18.3％) cases,including 34 males and 7 females.VBD was more common in males (28.3％ vs 6.7％,x2=17.388,P＜0.01).Of 41 VBD patients,11 cases (26.8％) had single vascular lesions,and 30 cases (73.2％) had multiple vascular lesions.Moreover,24 cases (58.5％) had arterial lesions,and 25 cases (61.0％) had venous lesions.Eight (19.5％) patients had both arterial and venous lesions.Compared to the non-VBD group,the VBD group had a higher frequency of cardiac involvement (22.0％ vs 3.8％,x2=16.592,P＜0.01),a higher disease activity index score (BDCAF) [3.0(2.0,4.0) score vs 2.0(2.0,3.0) score,U=2 609.5,P=0.001],higher levels of C-reactiveprotein (CRP) (14.45(4.97,64.08) mg/L vs 9.02(3.16,26.53) mg/L,U=2 809,P=0.046) and plasma homocysteine (Hcy) [(17.6±7.7) μmol/L vs (7.1±2.1) μmol/L,t'=7.894,P＜0.01].Conclusion VBD mainly affectsmales.It mainly presentsas multiple lesions.Moreover,patients in the VBD group havehigher frequency of cardiac complications,higher disease activity index scores (BDCAF),higher levels of CRP and Hcy than the non-VBD group.These results may have great valueto predict and diagnoseof VBD.

BACKGROUND: Tissue engineering provides a new way for the repair of urinary tissue and organ defects.Urinary tissue engineering has shown a bright prospect.OBJECTIVE: To review the latest research on urinary tissue engineering at national and international level.METHODS: With the keywords of tissue engineering, urology, scaffold, vascularization in Chinese and in English,respectively, a computer-based search for articles published from January 2000 to January 2016 was performed in CNKI and PubMed databases. The articles addressing urology tissue engineering, scaffolds and vascularization were collected,summarized and analyzed.RESULTS AND CONCLUSION: The selection and cultivation of seed cells, scaffold material performance, tissue construction in vitro, and degree of vascularization all make an important influence on the repair of urinary injuries. As different seed cells hold different biological characteristics, we should make full consideration prior to choosing an appropriate seed cell, so as to pave a good foundation for urinary tissue engineering. Scaffolds with good three-dimensional structure can promote the cell growth and proliferation, tissue in-growth and vascularization.Tissue-engineered materials are superior to traditional repair materials, but still on initial stage, and further large scale trials will be necessary. Moreover, some problems needed to be solved, such as the regenerated tissue with incomplete function different from natural tissues, and regeneration failure caused by biological stent rejection.

Objective: To investigate the effect of Δ40p53, an alternative spliced isoform of p53 lacking the N-ter minus, on the pro-apoptotic function of p53. Methods: The wild-type p53 was ectopically expressed in HCT116-p53^-/- (endogenous Δ40p53 expression), HCT116-p53^{+ /+} (wild-type p53) and H1299 (p53-null) cells by adenoviral delivery, while Δ40p53 plasmid were transfected into these cells to overexpress Δ40p53. The levels of Δ40p53 and p53 mRNA were detected by reverse transcription-polymerase chain reaction (RT-PCR) and quantitative PCR. The expression of related proteins was deter mined by Western blotting. The interaction of p53 and Δ40p53 was observed by co-immunoprecipitation assay. Calcein-AM/propidium iodide (PI) staining and flow cytometry were used to detect the apoptotic rate of tested cells in each group. Results: HCT116-p53^-/- cells expressed endogenous Δ40p53 isoform. Neither transcription nor protein expression of wild-type p53 was interfered by the increased expression of Δ40p53. Full length p53 and Δ40p53 could bind to each other. Calcein-AM/PI staining showed that the apoptotic rates of H1299-Control, HCT116-p53^-/- -Control, H1299+ p53, HCT116-p53^-/-+ p53, H1299+ oxaliplatin (Oxa), HCT116-p53^-/-+ Oxa, H1299+ p53+ Oxa and HCT116-p53^-/-+ p53+ Oxa groups were (2.50±0.47)%, (2.40±0.32)%, (5.20±0.58)%, (4.10±0.18)%, (22.40±1.73)%, (19.30±1.11)%, (29.90±1.15)% and (39.30±2.26)%, respectively. It was statistically significant between H1299+ p53+ Oxa and HCT116-p53^-/-+ p53+ Oxa groups (t=3.721, P=0.0205). Moreover, the apoptotic rates of H1299-Control, H1299+ Δ40p53, H1299+ p53, H1299+ p53+ Δ40p53, H1299+ Oxa, H1299+ Δ40p53+ Oxa, H1299+ p53+ Oxa and H1299+ p53+ Δ40p53+ Oxa groups were (2.60±0.35)%, (2.20±0.17)%, (4.80±0.49)%, (4.90±1.10)%, (20.30±1.10)%, (19.60±1.45)%, (27.90±1.39)%, (35.20±1.43)%, respectively. Furthermore, flow cytometry assay showed that the apoptotic rates of above cells were (2.70±0.32)%, (2.20±0.24)%, (4.60±0.48)%, (3.90±0.67)%, (19.30±1.11)%, (17.70±0.66)%, (28.30±2.76)% and (37.50±1.51)%, respectively. H1299+ p53+ Δ40p53+ Oxa cells showed higher cell apoptosis than H1299+ p53+ Oxa cells (t=2.930, P=0.042). Conclusion Δ40p53 isoform can bind to full-length p53, and enhance its pro-apoptotic function in tumor cells.

BACKGROUND:MicroRNAs (miRNAs) are widely involved in regulation of physiological processes, such as human development, cel proliferation, differentiation, and apoptosis, angiogenesis and lipid metabolism. MiRNAs also play an important regulating role in the pathological process of femoral head necrosis. At present, the research about the effect of icarin on miRNA expression in glucocorticoid- induced avascular necrosis is stil in the exploratory stage, and the specific targets, possible regulation mechanism and signaling pathway remain unclear.
OBJECTIVE:To explore the effect of icarin on miRNA expression of bone microvascular endothelial cels in steroids-induced human femoral head lesionsin vitro.
METHODS: Bone microvascular endothelial cels in cancelous bone of the femoral head were isolated and harvested in vitro. Icarin preconditioning preceded establishment of models of glucocorticoid-induced bone microvascular endothelial cel injury. Differential expression profiles and transcriptomes in glucocorticoid and normal groups were tested by miRNA microarrays. The most differentialy expressed miR-23b and miR-339 in microarray analysis were further confirmed by real-time quantitative PCR, Meanwhile the effects of icarin on the expression of miR-23b-5p and miR-339-5p were detected.
RESULTS AND CONCLUSION:According to the microarray analysis, one miRNA was up-regulated and four mi RNAs were down-regulated in the glucocorticoid group (fold > 2,P < 0.05). Results of RT-qPCR revealed that miR-23b was down-regulated and miR-339 up-regulated in the glucocorticoid group, which were in agreement with the microarray analysis (P < 0.05). Icarin pretreatment effectively prevented the imbalances of miR-23b expression induced by glucocorticoid (P < 0.01). These findings indicate that Icarin may participate in the pathological process of steroid-induced femoral head necrosis through regulating the expression of miR-23b.

OBJECTIVETo investigate the role of apoptosis stimulating protein 2 of p53 (ASPP2) phosphorylation status in the regulation of ASPP2-p53 apoptotic pathway activity.

METHODSCells were individually transfected with green fluorescent protein (GFP)-encoding vector, constitutively non-phosphorylatable ASPP2 mutant-ASPP2 (Am)-encoding vector, and wild type ASPP2 (Aw)-encoding vector) plasmids, respectively, to make them overexpressing phosphorylated and non-phosphorylated ASPP2 proteins, respectively. Cell apoptosis was induced by oxaliplatin. The apoptosis rate of cells was determined by flow cytometry after staining with FITC-conjugated annexin V and PI. ASPP2 protein level and its phosphorylation status were observed by Western blot. The interaction between ASPP2 and p53 was observed by immunoprecipitation assay.

RESULTSOxaliplatin induced cell apoptosis and caused phosphorylation of ASPP2 at ser92/ser361 in the HCT116 cells. The apoptosis rate of Aw and Am plasmids-transfected cells were (3.8 ± 1.0)% and (3.9 ± 1.2)% respectively, statistically with a non-significant difference (P > 0.05) in comparison with that of the GFP plasmid-transfected cells [(4.0 ± 0.8)%]. After oxaliplatin treatment, the apoptosis rate of Aw plasmid-transfected cells was (46.7 ± 3.9)%, significantly higher than that of the Am and GFP plasmid-transfected cells [(40.1 ± 10.2)% and (37.1 ± 6.9)%, respectively, P < 0.05], however, there was no statistically significant difference (P > 0.05) between Am and GFP plasmid-transfected cells. These results indicate that phosphorylated ASPP2 promoted the oxaliplatin-induced apoptosis of HCT116 cells through a p53-dependent pathway. Phosphorylation status of ASPP2 influenced its binding activity to p53.

CONCLUSIONPhosphorylation status of ASPP2 modulates p53 apoptotic function in oxaliplatin-induced apoptosis of colorectal cancer HCT116 cells.

Apoptosis ; Apoptosis Regulatory Proteins ; metabolism ; Colorectal Neoplasms ; metabolism ; HCT116 Cells ; Humans ; Organoplatinum Compounds ; Phosphorylation ; Tumor Suppressor Protein p53 ; genetics ; metabolism

Objective To evaluate the clinical results of femoral-deep femoral crossover bypass in the treatment of long-segment unilateral iliac artery occlusive disease.Methods From July 1995 to December 2010,40 patients (28 males,12 females,aged from 66 to 90,with mean age of 73) with comprehensive unilateral iliac-superficial femoral arteriosclerosis obliterans were enrolled in this procedure.All patients suffered from unilateral common iliac,external iliac,common femoral,and superficial femoral arteriosclerosis obliterans.These patients were treated with femoral-deep femoral crossover bypass.Postoperative ankle-brachial index,blood flow velocity and patency rates in 5,7 and 10 years and limb salvage rates in 5,7 and 10 years were evaluated.Results There was no perioperative mortality nor extremity amputation.35 (87.5％ ) patients were followed-up from 1 to 13 years (mean 5.7 y).Anklebrachial index rose from preoperative 0.23 ± 0.10 to postoperative 0.55 ± 0.11 (t =15.91,P =0.000 ).Popliteal arterial velocity rose from preoperative ( 14 ±6) cm/s to postoperative (34 ± 10) cm/s (t =15.63,P =0.000) ; Tibial arterial velocity rose from ( 10 ±4) cm/s to (22 ±7) cm/s (t =15.71,P =0.000).The primary and secondary patency rates were 60.1％,44.3％,25.3％,and 93.5％,86.8％,57.9％ at 5,7 and 10 years,respectively.Limb salvage rates were 97.5％,95％,and 90％,at 5,7 and 10 years,respectively.Conclusions Femoral-deep femoral crossover bypass is safe and reliable in treating certain unilateral iliofemoral occlusive disease,especially for high-risk old patients or those who are not indicated for endovascular therapies or direct aortic approaches.