Objective:To explore the effects of informatization traceability management combined with performance assessment in the nursing management of Disinfection Supply Center.Methods:In March 2021, the Disinfection Supply Center of the First Affiliated Hospital of Zhengzhou University implemented the informatization traceability management combined with performance assessment. Convenient sampling method was used to select 172 medical devices disinfected and sterilized by the Disinfection Supply Center before implementation (from March 2020 to February 2021) and 166 medical devices disinfected and sterilized by the Disinfection Supply Center after implementation (from March 2021 to February 2022) for statistical analysis. We compared the cleaning qualified rate, sterilization qualified rate, packaging qualified rate, distribution qualified rate, management effects, adverse event rate of device management, and performance assessment results before and after the implementation of the informatization traceability management combined with performance assessment.Results:The cleaning qualified rate, packaging qualified rate and distribution qualified rate after implementation were higher than those before implementation, and the differences were statistically significant ( P<0.05) . The recovery and classification time, device information registration time, ex-warehouse inspection time and manual operation time after implementation were shorter than those before implementation, and the differences were statistically significant ( P<0.05) . The device damage rate, label error rate and device loss rate after implementation were lower than those before implementation with statistical differences ( P<0.05) . The scores of theoretical assessment and operational skill assessment after implementation were higher than those before implementation with statistical differences ( P<0.05) . Conclusions:The combination of informatization traceability management and performance assessment can improve the nursing management effects of the Disinfection Supply Center, significantly increase the qualified rate of cleaning, packaging and distribution, and boost the performance assessment results of nurses, which helps to reduce the incidence of adverse events in device management.

Objective To investigate the independent risk factors for acute severe cholangitis and related protective factors, and to construct a risk prediction scoring model for acute severe cholangitis. Methods A retrospective analysis was performed for the clinical data of 381 patients with acute cholangitis who were admitted to Department of Hepatobiliary Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, from January 2016 to July 2021, among whom there were 273 patients with non-severe cholangitis and 108 patients with severe cholangitis. Univariate and multivariate logistic regression analyses were used to screen out the independent risk factors for acute severe cholangitis and related protective factors, and then a logistic regression model was established. The receiver operating characteristic (ROC) curve was used to evaluate the discriminatory ability of the model, the calibration curve was used to evaluate the prediction accuracy of the model, and decision curve analysis (DCA) was used to evaluate the clinical value of the model. Moreover, the enhanced Bootstrap method was used to perform internal validation of the model and evaluate the performance of the model in internal validation. The model was visualized by the construction of Web calculator, nomogram, and scoring system. The two-independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. Results The univariate and multivariate logistic regression analyses showed that total bilirubin (TBil) (odds ratio [ OR ]=1.014, 95% confidence interval [ CI ]: 1.009-1.020, P < 0.001), percentage of neutrophils ( OR =1.128, 95% CI : 1.088-1.175, P < 0.001), and age ( OR =1.053, 95% CI : 1.027-1.082, P < 0.001) were independent risk factors, and albumin (Alb) ( OR =0.871, 95% CI : 0.817-0.924, P < 0.001) was a protective factor. The above independent risk factors and protective factor were included in the logistic regression analysis for model fitting, and the predictive model obtained had an area under the ROC curve (AUC) of 0.925 (95% CI : 0.897-0.952), with a specificity of 0.817 and a sensitivity of 0.935 at the optimal cut-off value of 0.245. The calibration curve showed that the predicted probability of the model was approximately equal to the actual probability, with a Brier value of 0.098, and the decision curve analysis showed that the model had a higher net income within the threshold probability interval of 0.1-0.9. Internal validation showed an AUC internal validation of 0.915 and a Brier value internal verification of 0.106. Conclusion TBil, percentage of neutrophils, and age are independent risk factors for acute severe cholangitis, while Alb is a protective factor. The established risk prediction scoring model has good discriminatory ability, calibration, and clinical value and can identify patients with acute severe cholangitis at an early stage, which provides a reference for subsequent diagnosis and treatment.

Objective:To explore the effects of cluster intervention guided by key points of control on cleaning quality of reused surgical instruments, and provide new clinical ideas for improving the cleaning quality of reused surgical instruments.Methods:The surgical instruments used and sent to the Central Sterile Supply Department (CSSD) at the First Affiliated Hospital of Zhengzhou University were selected. The 224 samples handled according to traditional device processing procedures (between January and May 2019) were included into the control group, while 224 samples handled with cluster intervention guided by key points of control (from June to October 2019) were included into the observation group. The cleaning quality of surgical instruments was compared between the two groups.Results:The cleaning qualification rate of reused surgical instruments was affected by multiple factors such as hospital level, management model, staffing, supervision and management, equipment, methods, and cleaning time. The cleaning qualification rate of the observation group was 98.21% (220/224) , which was higher than 91.52% (205/224) of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The cluster intervention strategy guided by key points of control can effectively improve the cleaning quality of reused surgical instruments.

Objective To investigate the effect and its underlying mechanism of Linagliptin on mild cognitive impairment (MCI) in elderly type 2 diabetes mellitus (T2DM) patients.Methods Montreal Cognitive Assessment(MoCA)scale was used to prospectively screen T2DM patients for MCI in our hospital from December 2016 to June 2017,and a total of 98 elderly T2DM patients with MCI were recruited.They were randomly divided into the linagliptin group(Linagliptin + metformin,n=50)and the non-linagliptin group(gliclazide + metformin,n =48).Serum fasting plasma glucose (FPG),glycosylated hemoglobin(HbAlc),blood lipids and amyloid β-protein 1-42 (Aβ1-42) levels were determined,and MoCA score and homeostasis model assessment of insulin resistance(HOMA-IR)were calculated,and were compared between the two groups before and after 24 weeks of treatment.Results In the linagliptin group,serum FPG,HbA1c,HOMA-IR,Aβ1-42 levels were significantly decreased and MoCA score was increased after 24 weeks of treatment as compared with pre-treatment [(7.29± 1.00) mmol/L vs.(9.16 ± 1.60) mmol/L,(7.19 ± 0.99) ％ vs.(9.36 ± 1.07) ％,(3.05 ± 1.12) vs.(4.05±1.30),(0.463±0.093)g/L vs.(0.528±0.110)g/L,(24.48± 1.18) vs.(23.22± 1.37),all P＜0.05].In the non-linagliptin group as control,FPG and HbA1c levels were decreased after 24 weeks of treatment as compared with pre-treatment[(7.23±1.09)mmol/L vs.(9.20± 1.75) mmol/L,(7.23±1.03)％ vs.(9.69± 1.18)％,both P ＜ 0.05],while there was no significant difference in HOMA IR,Aβ1-42 level and MoCA score[(3.95 ± 1.00) vs.(4.19± 1.13),(0.517± 0.113)g/L vs.(0.526±0.119)g/L,(23.21±1.18) vs.(23.00±1.32),all P＞0.05].It is worth to pay close attention to the key discovery of this paper that HOMA-IR and Aβ1-42 levels were significantly lower and MoCA score was significantly higher in the linagliptin group than in the non-linagliptin group after 24 weeks of treatment(all P＜0.05).Conclusions Linagliptin as one of DPP-4 enzyme inhibitors can improve the cognitive function in elderly patients with T2DM,which might be relevant to reducing serum Aβ level and improving HOMA-IR.DPP-4 enzyme inhibitor may be a good option for treatment of mild cognitive dysfunction in T2DM patients in the future.

The activation of the proto-oncogene STAT3 is strongly controlled under physiological conditions. However, obtained evi-dence revealed that STAT3 is persistently activated in cancer cells and contributes to cancer initiation and progression. Studies demon-strated the various functions of activated STAT3 in promoting cancer development and aggravation, including cancer cell proliferation, invasion and metastasis, drug resistance, epithelial-mesenchymal transition, regulation of the tumor microenvironment, and promo-tion of the self-renewal and differentiation of cancer stem cells. Canonically, STAT3 is regulated by signaling pathways mediated by cy-tokines and growth factors. Many studies determined that STAT3 was also regulated by G protein-coupled receptors, cadherin engage-ment, Toll-like receptors, microRNA, and acetylation. We summarized the recent developments in the research on the regulation of STAT3 activation.

Objective:To determine the distribution of T-lymphocyte subpopulations in peripheral blood and its relationship with disease-free survival (DFS) of patients with different molecular subtypes of invasive breast cancer (IBC). Methods:Data and plasma samples of 372 female patients with IBC treated at Tianjin Medical University Cancer Hospital and Institute between January 2008 and August 2009 were obtained. CD4+/CD8+ratio and the amount of regulatory T cells (Treg cells) and natural killer cells (NK cells) were measured through flow cytometry. Results:A total of 133 (35.8%), 124 (33.3%), 48 (12.9%), and 67 cases (18.0%) presented luminal type A, luminal type B, HER-2 over-expression, and triple-negative type breast cancer (TNBC), respectively. In TNBC, a longer DFS was observed when the peripheral CD4+/CD8+ratio was high or when the level of Treg cells was low (CD4+/CD8+P<0.05 and Treg P<0.05). However, CD4+/CD8+and Treg are not independent prognostic factors for the DFS of TNBC cases. In other molecular subtypes of breast cancer, CD4+/CD8+ratio and the amount of Treg cells are not correlated with DFS (P>0.05). The level of NK cells is unrelated to the DFS of breast cancer with the four molecular subtypes (P>0.05). Conclusion:CD4+/CD8+ratio and the amount of Treg cells in peripheral blood may predict DFS of TNBC but are not considered as independent prognostic factors.

This work summarizes the research development and molecular mechanism of Ebp1, a member of the proliferation-associated 2G4 family, in tumor proliferation and invasion. This research serves as a basis and support for further research on the mechanism of tumor proliferation and invasion. The low expression of Ebp1 in various cancers promotes tumor proliferation and invasion. Ebp1 inhibits E2F1, cyclin D1, and cyclin E transcription by interacting with Rb, human histone deacetylase 2, and the transcriptional repressor Sin3A. This inhibition triggers cell cycle arrest and suppresses cell proliferation. Ebp1 also influences cancer invasion and migration. However, the underlying mechanisms remain unknown and require further exploration.

Objective To explore the regulatory effects of HTLV-1 ( human T-cell leukemia virus type 1 ) Tax protein on the expression of HMGB 1 ( high mobility group box 1 ) gene in T cells .Methods Total RNA and protein were extracted from Tax +-T cells ( TaxP ) , Tax--T cells ( TaxN ) and Jurkat cells which were stably transfected with pCMV-Tax and pCMV-Neo, respectively.Then, the expression levels of HMGB1 mRNA and protein in different CD 4+T cells were analyzed by real-time PCR and Western blot (WB).By using liposome-mediated method, pGL3-HMGB1-luc reporter genes and pGL3-neo-luc were tran-siently transfected into TaxP and TaxN cells and the basal transcriptional activity was observed in different T cells.Additionally, pCMV-Tax and pGL3-HMGB1-luc reporter genes were also co-transfected into Jurkat cells and the regulatory effects of Tax protein on HMGB 1 gene was detected .The chromatin immunoprecipi-tation (ChIP) assay was used to identify HMGB1 genomic sites directly targeted by Tax .Results The ex-pression levels of HMGB1 mRNA and protein in Tax+-T cells ( TaxP) were higher than those in Tax--T cells (TaxN).The transcription regulation trends for HMGB1 gene in TaxN and TaxP cells were similar but not identical in diverse T cells.pHLuc3 (containing -504-+83 HMGB1) showed the highest transcriptional ac-tivity of HMGB1 gene in both TaxP and TaxN cells , but HMGB1 transcriptional activity of pHLuc 6 in TaxP cells was significantly stronger than that in TaxN cells .Luciferase assays also showed that Tax protein promo-ted the transcription of HMGB1 gene in a dose-dependent manner .The ChIP assay further confirmed that Tax protein enriched at the HMGB1 region of -1163--1043.Conclusion The region of nt -504--383 is essen-tial for the basal promoter activity of -1163-+83 HMGB1 gene originated from pHLuc 6 reporter plasmid , and Tax protein enriched probably at the HMGB 1 site of -1163--1043 enhances HMGB1 transcription.

10.3969/j.issn.1000-8179.2013.12.002

Objective To obtain the change of bcl-2/bax/fas/fasL in splenic lymphoctyes with different lasting time of hypoxicischemic brain damage (HIBD). Methods The newborn rat were divided into 6 groups by the time of being HIBD model randomly, includes 1/6/12/24/48/72 hour(s) (8 for every group),and control groups were established at the same time point. The following four apoptosis related genes bcl-2/bax/fas/fasL were tested by real time PCR. Results ( 1 ) bcl-2: the mRNA expressions of HIBD groups were lower than control groups at the same time ( P<0.01 ). Eliminated the control effects, the mRNA expressions of HIBD groups were differernt by the modeling time(P ＜0.01 ). (2)bax: the mRNA expressions of HIBD groups were higher than control groups at the same time( P ＜0.01 ), and in control group the expression of 6 h was much higher than any other groups (P<0.01 ). Eliminated the control effects, the mRNA expressions of H IBD groups were different by the modeling time( P<0.01 ). (3)bcl-2/bax: the ratios of HIBD groups were lower than control groups at the same time( P ＜0.05 ), the ratios in control groups were higher than 1 ( except for 1 h); while in HIBI) groups the ratios were lower than 1; Eliminated the control effects, the ratios were different in all the groups. (4)fas: the mRNA expressions of HIBD groups were higher than control groups at the same time ( P ＜0.01 ), and both were maximum at 6 h. (5)fasL: the mRNA expressions of HIBD groups were higher than control groups in 1 h and 6 h ( P<0.01 ), while lower than control group at other time points( P<0.01 ),the expression of 24 h was the maximum of control groups and 12 h was the maximum of HIBD groups. (6)fas/fasL: the ratios of HIBD groups were higher than control groups( P ＜0.01 ) (except for 6 h), and the ratios in control groups were lower than 1 ( P<0.01 ) ( except for 6 h), and not concentrated, while in HIBD groups were higher than 1 ( except for 24 h), between 0.69 to 5.65. Conclusion Pro-apoptosis genes ( include bax/fas/fasL) were promoted by HIBD, while anti-apoptosis gene(bcl-2) was inhibited. The maximum of pro-apoptosis genes became early in HIBD. Both the pro- and anti-apoptosis genes got their maximum at 6 h and 12 h of HIBD. The apoptosis suppression was the main effects in control groups from the ratio of bcl-2/bax, which was lower than 1. The apoptosis promotion was the main effects in HIBD groups from the ratio of bcl-2/bax, which was higher than 1, especially at 12 h. Thefas/fasL effect which is the major way of lymphocytes apoptosis was strengthened in HIBD.