Objective:To explore the application effect of scenario simulation training based on forgetting curve in urology robot surgery specialist nurses.Methods:Using the convenient sampling method, a total of 44 robot surgery specialized nurses from the Urology Department of the First Affiliated Hospital of Naval Medical University from December 2019 to December 2021 were selected for scenario simulation training based on forgetting curve. Before and after the intervention, the scores of specialized knowledge examination, scores of various nursing operations and the comprehensive quality and ability of nurses were compared.Results:After intervention, the scores of specialized knowledge examination, nursing operation scores and comprehensive quality scores of nurses were higher than those before intervention, and the differences were statistically significant ( P<0.05) . Conclusions:The application of scenario simulation training based on forgetting curve in urological robot nurses can improve the level of specialized knowledge of nurses, master nursing operations, and improve their comprehensive quality.

【Objective】 To establish a stable human megakaryocytic cell line with low expression of Le^y antigen to further study the role of Le^y on activation of platelets. 【Methods】 The expression level of the Le^y antigen in a human megakaryocytic cell line, DAMI, was determined using Western Blot and flow cytometry. The expression level of genes that encode fucosyltransferase (FUTs), which was involved in the biosynthesis of Le^y antigen, was also determined to identify the candidate genes to be knocked out. The candidate FUT gene was knocked out via a CRISPR/Cas 9 gene knockout system and cells with low Le^y antigen expression were sorted by flow cytometry. The sorted cell line was cultured and characterized. 【Results】 The Le^y was expressed intensively on DAMI cell. FUT1 and FUT4 mRNA was expressed relatively higher, both may be key enzymes for the biosynthesis of the Le^y antigen. In the DAMI cell line with the knockout of FUT1 gene, the expression of the Le^y adntigen was remarkedly reduced, while cell proliferation was not affected compared to the wildtype control cells. 【Conclusions】 Since various FUTs contributes to the biosynthesis of the Le^y antigen, the knockout of the primary one of them cannot totally block its biosynthesis, but only reduce its expression. In this study, a stable FUT gene knockout human megakaryocyticcell line is established using CRISPR/Cas 9 technology, which provides basis for the study of the impact of the Le^y antigen on platelet functions.

Objective:To explore the application effect of multidisciplinary teamwork mode in patients with laparoscopic partial nephrectomy of renal carcinoma.Methods:A total of 86 patients with renal cancer who received laparoscopic partial nephrectomy in Ningbo First Hospital of Zhejiang Province from February to December 2019 were selected by the convenient sampling method. According to admission time, the patients were divided into the control group and the observation group, with 43 cases in each group. The control group implemented urological nursing routines and various measures recommended in the accelerated rehabilitation surgery guidelines, while the observation group adopted a multidisciplinary team collaboration model based on evidence-based nursing on the basis of the control group. The Kolcaba General Comfort Questionnaire (GCQ) and Numerical Pain Rating Scale (NPRS) were used to evaluate the comfort and low back pain of the two groups at 1, 3, and 5 days after surgery. Hamilton Anxiety Scale was used to evaluate anxiety of patients in both groups 5 days after surgery, and postoperative rehabilitation indicators (postoperative supine position time, absolute bed time, anal exhaust time, drainage tube indwelling time, postoperative hospital stay) were collected in both groups.Results:The total score of GCQ of observation group was higher than that of control group on 1, 3, and 5 days after operation, and lower back pain score was lower than that of control group. The postoperative anxiety score, postoperative supine position time, absolute bed time, anal exhaust time, drainage tube indwelling time and postoperative hospitalization days in the observation group were lower than those in the control group. There were statistically significant differences between the two groups ( P< 0.05) . There was no postoperative bleeding or deep venous thrombosis (DVT) in the lower limbs of patients of the two groups. Conclusions:The multidisciplinary teamwork model can alleviate the postoperative anxiety of patients with partial nephrectomy, improve their overall comfort, shorten the postoperative hospital stay and promote postoperative recovery.

Objective: To study the intracellular location and autophagosome production of rhinovirus 16 2B protein using miniSOG labeling technique. Methods: 2B was fused with miniSOG and flag tags to construct pcDNA3.1-2B-miniSOG-flag plasmid, which was used to transfect HEK293 cells, LC3 protein was detected by western blot. The transfected cells were fixed, stained with DAB through the photooxidation activity of miniSOG, and used to prepare ultrathin sections. Localization of 2B-miniSOG protein in cells and ultrastructural changes of cells were observed under electron microscope. Results: 2B-miniSOG protein glows green under a fluorescence microscopy. Green flourescence coold be observed in the cells expressing 2B-miniSOG protein.LC-II protein increased in the cells transfected with pcDNA3.1-2B-miniSOG-flag. Under electron microscopy it was observed that 2B-miniSOG protein was located in the mitochondria, and a large number of vesicular structures appeared in the cytoplasm. Both autophagosomes and autophagic lysosomes can be observed. Conclusions Non-structural protein 2B of HRV16 can induce autophagy.

Objective: To explore the research status of rhinovirus (RV) through analysis of rhinovirus literature using GoPubMed. Methods: "Rhinovirus" was used as the major subject word and the rhinovirus literature was collected at PubMed database (from Jan 1, 1970 to April 16, 2018). The high frequency subject words of rhinovirus related literature and the distribution of countries, cities, and journals were analyzed through a bibliometrical analysis method . Results: A total of 5 367 reports were retrieved from PubMed. The quantity of rhinovirus papers increased overall year by year. The highest number of papers were mainly published in developed countries. The highest number of papers on RV were mainly published in J Virol among all journals related with rhinovirus and Tyrrell D published the highest number of papers in all authors contributed to articles on rhinovirus. The rhinovirus, human, virus, respiratory tract infection were the high frequency subject words in the rhinovirus research. Conclusions Rhinovirus research is becoming one of research hotspots according to the statistical analysis of the research literature on rhinoviruses by GoPubMed.

Objective To investigate the risk factors of ICU delirium in critically ill patients. Methods A total of 1 74 critically ill patients in ICU who were older than 18 yrs and stayed in ICU exceeding 24 hs from January 201 5 to June 201 5 were enrolled.Patients were divided into delirium group and non delirium group.Delirium was assessed twice daily with the Confusion Assessment Method for the ICU (CAM-ICU)during the first 7 days.The factors such as history of alcoholism and other 12 factors were analyzed by univariate and multivariate logistic regression analysis to identify those risk factors associated with delirium.Results With 22 cases of delirium in 1 74 patients,the in-cidence of delirium was 12.64% (delirium group).Variables associated with delirium were coronary heart history,operation,tracheal intubation,clinical use of mechanical ventilation,hypoxemia and Benzodiazepine.Multivariate logistic regression analysis showed that coronary heart disease (OR 3.932,95%CI 1.225-12.61 7),surgery(OR 9.691,95%CI 2.103-44.657),hypoxemia(OR 6.595, 95%CI 1.377-31.585),Benzodiazepine use (OR 7.620,95%CI 1.713-33.899)was independent risk factors of delirium in critically ill patients (P < 0.05 or P < 0.01 ).Conclusion Coronary heart disease,surgery,hypoxemia and Benzodiazepine are independent risk factors of ICU delirium in criti-cally ill patients.Early screening and prevention of delirium should be given to reduce the occurrence of delirium for patients in ICU.

Objective To determine the significance of the quantitative parameters obtained from intravoxel incoherent motion ( IVIM) diffusion weighted imaging ( DWI) in differentiating renal tumors from normal renal tissues.Methods Twenty-four patients with surgical pathology-proven renal tumors and 13 volunteers with healthy kidneys were included.DWI was performed with 9 b-values (0, 20, 50, 100, 200, 400, 600, 800 and 1 000 s/mm2).The slow component of diffusion (Dslow), fast component of diffusion ( Dfast ) and fraction of fast ADC ( f) of the biexponential DWI were calculated for the clear cell renal cell carcinoma (CCRCC), the normal renal parenchyma and the non CCRCC ( NCCRCC) .The ADC was calculated for all b-values using linear regression yielding standard ADC ( ADCtot ) .The parameters were compared among the groups, and the receiver operating characteristic ( ROC ) analysis was performed. Results CCRCC showed higher ADCtot (1.73 ±0.43) ×10 -3 mm2/s, Dfast (14.75 ±14.73) ×10 -3 mm2/s, Dslow(1.34 ±0.38) ×10 -3 mm2/s than NCCRCC (ADCtot(1.23 ±0.26) ×10 -3 mm2/s, Dfast(9.47 ± 5.27) ×10 -3 mm2/s, Dslow(0.58 ±0.15) ×10 -3 mm2/s), and the differences of ADCtot(P=0.037) and Dslow(P=0.001) were significant.The normal renal parenchyma showed higher ADCtot (2.25 ±0.11) × 10 -3 mm2/s, Dslow ( 1.74 ±0.17 ) ×10 -3 mm2/s, f ( 35.00% ±9.37%) than CCRCC ( f, 31.13% ± 10.75%) and NCCRCC(f, 33.76%±24.02%), and the differences between the normal renal parenchyma and CCRCC of ADCtot ( P =0.000 ) and Dslow ( P =0.001 ) were significant.There were no differences between the normal renal parenchyma and the tumor ipsilateral renal parenchyma of all parameters.Dslow had higher accuracy ( sensitivity 95%, specificity 100%) in distinguishing CCRCC and NCCRCC, with area under the curve of 0.988.Conclusions Multi-b-value DWI derived quantitative parameters including ADCtot and Dslow may differ significantly between the renal tumor and normal renal parenchyma.Dslow is the best parameter in distinguishing CCRCC and NCCRCC.

Abstract] Objective To study the roles of IL-12 and IL-23 in the development of protective im-munity and pathological changes during chlamydial urogenital infection.Methods C57BL/6J wild type (wt) mice and mice deficient in IL-12p35 (IL-12p35 KO) or IL-12p40 (IL-12p40 KO)were inoculated in-travaginally with 1×104 IFU of live Chlamydia muridarum ( C.muridarum) organisms.Half mice of each group were reinfected on day 114 after primary infection.Vaginal swabs were taken every 3 or 4 days to mo-nitor live organism shedding.The mice were sacrificed after 114 or 143 days of primary infection and the va-ginal tract and kidney samples were collected for pathological analysis.The numbers of chlamydial inclusion bodies and bacteria in kidney homogenates were titrated after 100 days of primary infection.Results The infection time courses of mice deficient in either IL-12p35 or IL-12p40 were similar after primary infection, but were prolonged as compared with the wild type mice.All mice regardless of genotypes developed severe pathological damages in upper genital tracts with no significant difference among different groups.Almost all IL-12p40 KO mice and some IL-12p35 KO mice showed pathological changes in kidney samples.No obvious abnormality was observed in any of the kidneys from wild type mice.Neither the age-matched IL-12p35 KO nor IL-12p40 KO mice developed any gross pathological changes in kidney in the absence of chlamydial in-fection.C.muridarum inclusions were detected in kidney samples with gross pathological damages from IL-12p35 KO mice and IL-12p40 KO mice.No inclusions were ever detected in kidneys from the wild type mice.The numbers of chlamydial inclusions in the IL-12p40 KO mice were much higher than those of the IL-12p35 KO mice.Live bacteria were detected in mice deficient in either IL-12p35 or IL-12p40, but not in the wild type mice.No significant difference with the number of live bacteria was found between IL-12p35 KO mice and IL-12p40 KO mice.Conclusion IL-12 and IL-23 could inhibit the spread of C.muridarum in-fection from genital tract to kidney.The deficiency of IL-12 or IL-23 might relate to the renal lesions induced by Chlamydia infection.

Objective To investigate the characteristics of minimal fat renal angiomyolipoma (MFAML)and clear cell renal cell carcinoma(CCRCC)in high resolution multi-slice spiral CT(MSCT)and to improve the diagnosis accuracy for the renal tumors.Methods A retrospective analysis was performed on 24 MFAML patients(16 females,8 males)with mean age of 43(19-74)years and 24 CCRCC patients(16 females,8 males)with mean age of 44(21-76)years.All patients had undergone MSCT and proved histopathologically after surgery.The characteristics included tumor location,tumor attenuation on unenhanced CT,enhancement characteristics(degree of tumor enhancement in the early corticomedullary phase,homogeneity of enhancement,amount of enhancement,enhancement pattern over time),tumor margin,intratumoral calcification,and perinephric changes.The predictive value of each CT characteristic was determined by using multivariate logistic regression analysis.Results The tumor location in the kidney (upper pole:MFAML,6 cases,CCRCC,6 cases;middle:MFAML,7 cases,CCRCC,9 cases;lower pole:MFAML,11 cases,CCRCC,9 cases)and smooth tumor margin(MFAML,n=21;CCRCC,n=19)were not significantly different between MFAML patients and those with CCRCC,P＞0.05.Twenty-one cases of both MFAMLs and CCRCCs had the significant enhancement in the early corticomedullary phase,which were hypovascular tumors,whereas the mean amount of tumor enhancement was greater in CCRCC than in MFAML in both the early corticomedullary and the corticomedullary phases(CCRCC:175 HU,196 HU;MFAML:125 HU,145 HU;P＜0.05.MFAML usually showed homogeneous enhancement(n=15)rather than heterogeneous enhancement(n =9),whereas most CCRCC showed heterogeneous enhancement(n =17)rather than homogeneous enhancement(n =7),P＜0.05).Enhancement pattern was not a significant predictor.Within the 13 MFAML cases,8 cases had sufficient blood supply(6 cases showed obvious wash-in-and-wash-out,2 cases were with prolonged enhancement),5 cases with hypovascular showed a pattern of prolonged or gradual enhancement,while 21 CCRCC cases had sufficient blood supply and 71％ of them showed obvious wash-in-and-wash-out.High tumor attenuation on unenhanced scans(MFAML:17 patients (75％);CCRCC:2 patients(8％),P=0.002,OR=0.010)and threshold enhancement values of 129.5 HU in the corticomedullary phase(MFAML:5 patients(20％);CCRCC:20 patients(83％),P =0.004,OR =0.057)were valuable predictors for differentiating MFAML from CCRCC at multivariate logistic regression analysis.Conclusions MSCT is useful in differentiating MFAML from CCRCC,with high tumor attenuation on unenhanced scans and threshold enhancement values of 129.5 HU in the corticomedullary phase being the most valuable CT findings.75％ of MFAMLs with sufficient blood supply also show a pattern of wash-in-and-wash-out,which can easily misdiagnosed as a renal cancer.

Objective To investigate the effect of gender and age on the apparent diffusion coefficient (ADC) of normal adult pancreas.Methods A total of 383 patients with normal pancreas (290 male,93 female,range from 21 to 78 years of age) were enrolled in this study.The subjects were divided into four groups based on different age (≤40 years,41-50 years,51-60 years and ＞60 years) with patient number of 56,108,139 and 80,respectively.Breath-hold single-shot echo-planar DWI (b value =0,500 s/mm2) was performed to determine ADCs on all patients.The average ADCs was calculated by four ADCs measured from the head to tail part of the pancreas in each patient.Patients with different age or gender were analyzed by independent-samples t test.Effect of gender on ADCs was analyzed using the Mann-Whitney U test.Relationship between ADCs and age was analyzed using Spearman rank-order correlation test,and Kruskal-Wallis H test was used to compare the ADCs among 4 age groups.Results The median pancreatic ADC values in female group(n =93) [1.60 × 10-3 mm2/s (1.47 × 10-3-1.77 × 10-3) mm2/s] was higher than that in male group (n =290) [1.57 × 10-3mm2/s(1.41 × 10-3-1.74 × 10-3)mm2/s].Mann-Whitney U test results showed the mean ADCs was similar between the two groups (Z =1.335,P =0.182).The age distribution was similar between the male [(52 ± 10) years of age] and female [(51 ± 11) years of age]groups (t =0.267,P=0.790).The age spectrum showed that there was no correlation between the average ADC values and age (r =0.016,P =0.752).The median ADC values of the four age groups were 1.58 ×10-3,1.54 × 10-3,1.59 × 10-3 and 1.57 × 10-3 mm2/s,respectively.Kruskal-Wallis H test showed no significant difference of mean ADCs among the age groups (x2 =2.15,P =0.542).Conclusion There is no correlation of ADCs between age and gender in normal adult pancreas.