Objective:To understand intensive care unit(ICU)doctors'opinions and suggestions on implementing palliative care,and provides a reference basis for the implementation of palliative care in Chinese ICU.Methods:A purposive sampling technique was used to conduct one-on-one semi-structured interviews with 11 ICU doctors.Colaizzi's phenomenological analysis method was utilized to code,classify,interpret,and comprehensively analyze the interview data.Results:A total of 4 themes and 18 sub-themes was extracted,including cognitive biases toward palliative care,the belief that implementing palliative care in the ICU has significant humanistic implications(palliative care practice is the most perfect embodiment of medical humanities,palliative care in the ICU can alleviate patient pain and reduce invasive operations,palliative care can achieve comfortable care for ICU patients,palliative care focuses on maintaining the dignity of ICU patients,palliative care can pay attention to the inner voice of ICU patients,and implementing palliative care will help to more effectively allocate resources),difficulties faced by ICU in carrying out palliative care(lack of clarity in relevant policies at the legal level,closed management environment in the ICU,insufficient manpower in the ICU and lack of palliative care professional team,inadequate understanding of ICU patients'families,lack of death education,not included in medical insurance payments,and lack of communication skills of young doctors),strategies to promote the development of palliative care in the ICU(ICU palliative care can be piloted first,the development of ICU palliative care screening tools will help with the development of palliative care,the palliative environment and the handling of death procedures can be further optimized,and the application and implementation of scientific methods to shorten the gap between evidence and practice of palliative care).Conclusions:The integration of palliative care and ICU in China is still blank.The significance of implementing palliative care in ICU should be emphasized,ICU doctors'knowledge and skills of palliative care should be improved from multiple perspectives,patient preference should be emphasized to improve the knowledge and acceptance of palliative care of ICU patients'families,and the promotion of palliative care in ICU clinical practice should be pioneered and piloted.

Objective To analyze the risks and related influencing factors of early screening for lung cancer,and to study prognostic factors based on survival conditions,in order to ultimately provide baseline data for the prevention and treatment of lung cancer.Methods A cluster sampling method was used to select 40 to 75 year old registered residence residents in 10 districts and 6 counties of Zhengzhou City in 2020 as screening objects.Through voluntary participation and filling in evaluation questionnaires,high-risk groups of lung cancer were evalu-ated,and then three screening tests(tumor markers,low-dose spiral CT and lung function)were performed on high-risk groups.Finally,we will adopt an active and passive follow-up approach to collect information on diag-nosed lung cancer patients.Statistically describe the screening data and describe the epidemiological results of different characteristic populations;Using multivariate logistic regression method for statistical analysis,compare the differences in various results of different factors.Results 50128 cases of early screening for lung cancer in Zhengzhou City were evaluated in 2020,with a completion rate of 100.26%.The average age of the survey was(59.86±17.67)years old,and the gender ratio was 0.81∶1.The high-risk detection rate is 30.15%.Multivariate logistic regression analysis showed that males(smoking)(OR=5.43,95%CI:5.20～5.67),individuals with a history of tobacco exposure(OR=3.82,95%CI:3.67～3.98),first-degree relatives who had previously suffered from lung cancer(OR=12.06,95%CI:11.02～13.20),and other populations were more susceptible to lung cancer(all P<0.05).Conclusion Male(smoking),exposure to secondhand smoke,cancer in first-degree relatives,previous diagnosis of other tumors,symptoms of lung infection,"chest tightness,shortness of breath,and difficulty breathing in daily life",and"significant psychological trauma in the past 3 years"are independent risk factors for lung cancer,which should be given special attention and effective intervention measures should be taken.

Radiotherapy is widely used in the management of advanced colorectal cancer (CRC). However, the clinical efficacy is limited by the safe irradiated dose. Sensitizing tumor cells to radiotherapy via interrupting DNA repair is a promising approach to conquering the limitation. The BRCA1-BARD1 complex has been demonstrated to play a critical role in homologous recombination (HR) DSB repair, and its functions may be affected by HERC2 or BAP1. Accumulated evidence illustrates that the ubiquitination-deubiquitination balance is involved in these processes; however, the precise mechanism for the cross-talk among these proteins in HR repair following radiation hasn't been defined. Through activity-based profiling, we identified PT33 as an active entity for HR repair suppression. Subsequently, we revealed that BAP1 serves as a novel molecular target of PT33 via a CRISPR-based deubiquitinase screen. Mechanistically, pharmacological covalent inhibition of BAP1 with PT33 recruits HERC2 to compete with BARD1 for BRCA1 interaction, interrupting HR repair. Consequently, PT33 treatment can substantially enhance the sensitivity of CRC cells to radiotherapy in vitro and in vivo. Overall, these findings provide a mechanistic basis for PT33-induced HR suppression and may guide an effective strategy to improve therapeutic gain.

Insufficient remyelination due to impaired oligodendrocyte precursor cell (OPC) differentiation and maturation is strongly associated with irreversible white matter injury (WMI) and neurological deficits. We analyzed whole transcriptome expression to elucidate the potential role and underlying mechanism of action of lipocalin-2 (LCN2) in OPC differentiation and WMI and identified the receptor SCL22A17 and downstream transcription factor early growth response protein 1 (EGR1) as the key signals contributing to LCN2-mediated insufficient OPC remyelination. In LCN-knockdown and OPC EGR1 conditional-knockout mice, we discovered enhanced OPC differentiation in developing and injured white matter (WM); consistent with this, the specific inactivation of LCN2/SCl22A17/EGR1 signaling promoted remyelination and neurological recovery in both atypical, acute WMI due to subarachnoid hemorrhage and typical, chronic WMI due to multiple sclerosis. This potentially represents a novel strategy to enhance differentiation and remyelination in patients with white matter injury.
Mice ; Animals ; Remyelination/physiology* ; Oligodendrocyte Precursor Cells/metabolism* ; White Matter ; Subarachnoid Hemorrhage/metabolism* ; Lipocalin-2/metabolism* ; Early Growth Response Protein 1/metabolism* ; Oligodendroglia/metabolism* ; Mice, Knockout ; Cell Differentiation/physiology* ; Brain Injuries/metabolism*

Objective To study anxiety and depression status in patients with industrial hand injury at admission and look into the influencing factors. Method A total of 154 patients who had industrial hand injury were enrolled in the investigation by self-rating anxiety scale (SAS)and self-rating depression scale (SDS)into mental status of patients once at admission. Results The incidence rates of anxiety and depression were 40.9%(63/154)and 37.0%(57/154),respectively.21.4%(33/154)of the patients had both anxiety and depression.The data from SPSS22.0 software and multivariate Logistic regression analysis showed that anxiety and depression were closely related to age,hand function and education.Conclusion The incidences of anxiety and depression in patients with hand injury and work-related injury is significantly higher than that of healthy people, which is closely related to their age, education and hand function.

Objective To explore a scientific and practical nursing plan for patients with severed finger reunion in their rehabilitation.Methods Based on literature research as well as the investigation and analysis of rehabilitation training in patients with severed finger reunion, we combined the existing rehabilitation nursing plan and investigation results together, to draft a rehabilitation nursing plan for patients with severed finger reunion. The medical, nursing and rehabilitation specialist were selected and two rounds of Delphi expert consultation were taken, to revise the draft of rehabilitation nursing plan. Results The questionnaire collecting rates of two rounds of expert consultation were 95. 00% and 94. 11%; the authority degree was 0. 79 and the coordination coefficient was 0.49 and 0.43. The significant test result of the coordination coefficient was P<0.05, and the evaluation results were desirable. The rehabilitation nursing plan developed by this paper contains 3 first-grade indicators, 11 second-grade indicators and 22 third-grade indicators.Conclusions The process of making rehabilitation nursing plan is scientific and simple, and it can be used for rehabilitation nursing and effect assessment in clinical patients with severed finger reunion.

OBJECTIVETo evaluate the effect of outbreaks control in school settings after a 2 dose varicella vaccine immunization strategy implemented in Beijing.

METHODSEpidemiological data of varicella outbreaks in school and kindergarten settings, which were reported by all 16 districts (county) during 2007-2013 according to the technical management norms of Beijing, was collected. The first dose and second dose varicella vaccine coverage rate of eligible children after the 2 dose varicella vaccine immunization strategy implementation were estimated through BJIIMS. Based on above we analyzed the changes of outbreak quantity, case quantity and the distribution characteristics between the pre-adjustment era (2007-2011 years) and late adjustment era (2013) of the 2 dose immunization strategy.

RESULTSIn pre-adjustment era (2007-2011 years), an average of 74 (95% CI: 60-89) outbreaks was reported and 964 (95% CI: 812-1 116) cases were involved per year. In late adjustment era (2013): Outbreaks (35) declined 52.7%, involved cases (371) declined 61.5%; Outbreaks epidemic duration shortened from 22 days of pre-adjustment era to 18 days; Outbreaks involved 10-24 cases declined 64.7% (from 34 to 12); Outbreaks involved ≥ 25 cases declined 71.4% (from 7 to 2); Outbreaks of different school type as well as different regions without exception declined dramatically. Cumulative one-dose vaccine coverage in children of 2-6 yr of age was 89.6% (812 859/907 579), and cumulative second-dose vaccine coverage in children of 4-7 yr of age was 44.3% (289 764/647 732).

CONCLUSIONImplementation of a 2 dose varicella vaccine immunization strategy effectively controlled outbreaks in school and kindergarten settings.

Chickenpox ; Chickenpox Vaccine ; Child ; Child, Preschool ; Disease Outbreaks ; Epidemics ; Humans ; Schools ; Students ; Vaccination

Objective To evaluate the effect of propofol preconditioning on endoplasmic reticulum stress induced by hypoxia-reoxygenation (H/R) in HEPG2 cells.Methods HEPG2 cells were randomly divided into 4 groups using a random number table:control group (group C),propofol group (group P),H/R group and H/R + propofol preconditioning group (group PP).In group C,the cells were cultured routinely for 42 h.In group H/R,after being cultured routinely for 6 h,the cells were exposed to 1％ O2 + 5％ CO2 + 94％ N2 for 12 h followed by 12 h reoxygenation.In group PP,the cells were cultured for 6 h in the culture medium containing propofol 10 μmol/L (final concentration),and then H/R was induced.The cell viability was detected by MTT assay.The expression of immunoglobulin heavy chain-binding protein (BIP),C/EBP homologous protein (CHOP) and activated caspase-3 was determined by Western blot.The expression of BIP,CHOP and caspase-3 mRNA was determined by RT-PCR.Results Compared with group C,the cell viability was significantly decreased,and the expression of BIP,CHOP and activated caspase-3 protein and mRNA was up-regnlated in H/R and PP groups,and no significant changes were found in the parameters mentioned above in group P.Compared with group H/R,the cell viability was significantly increased,and the expression of BIP,CHOP and activated caspase-3 protein and mRNA was down-regulated in PP group.Conclusion Propofol preconditioning can promote the cell proliferation and attenuate H/R injury to HEPG2 cells through inhibiting endoplasmic reticulum stress.

Objective To prepare a kind of superparamagnetic iron oxide (SPIO) and doxorubicin loaded multifunctional polymer microbubbles (MPMBs),and to explore its potential application as an ultrasound(US)/magnetic resonance (MR) imaging contrast agent in vitro.Methods The MPMBs and normal polymer microbubbles (PMBs) were made by double emulsion and freeze-drying methods.The physical property,drug encapsulation efficiency and the drug-loading efficiency of MPMBs were determined,and the release property and US/MR imaging enhancement of MPMBs were observed.Results The MPMBs had a regular shape and narrow size distribution.The drug encapsulation efficiency was (60.20±2.69) ％,and the drug-loading efficiency was (6.02 ± 0.27) ％.The in vitro release experiment showed that ultrasound can promote the release of doxorubicin in MPMBs.US imaging in vitro showed that the enhancement of MPMBs was better than PMBs,and MR imaging in vitro conformed that MPMBs could well enhance MR imaging.Conclusions The MPMBs is a multifunctional contrast agent with the treatment function as well as US/MR dual-mode imaging enhancement effect.

Objective To evaluate the effect of propofol on the endoplasmic reticulum stress-mediated apoptosis during focal cerebral ischemia-reperfusion (I/R) in rats.Methods Eighty adult male Sprague-Dawley rats,weighing 240-280 g,were randomly divided into 4 groups (n =20 each):shame operation group (group S) ; focal cerebral I/R group (group FCIR); propofol pretreatment group (group P); intralipid pretreatment group (group Ⅰ).Focal cerebral I/R was induced by 4 h middle cerebral artery occlusion followed by reperfusion.Propofol was infused at a rate of 12 mg· kg-1 · h-1 starting from 30 min before ischemia until 15 min of ischemia in group P,while intralipid was given instead of propofol in group I.Neurological deficit scores (NDSs) were measured at 6 h of reperfusion in 10 rats chosen from each group and the rats were then sacrificed.Their left brains were removed for determination of brain water content.The left 10 rats were sacrificed and their brains were immediately removed for determination of the expression of C/EBP homologous protein (CHOP),Bcl-2,and activated caspase-3 in the left hippocampi by Western blot.Results Compared with group S,NDSs and brain water content were significantly increased,the expression of CHOP and activated caspase-3 was up-regulated,and the expression of Bcl-2 was down-regulated in group FCIR,NDSs was increased in group P (P ＜ 0.05).Compared with group FCIR,NDSs and brain water content were significantly decreased,the expression of CHOP and activated caspase-3 was down-regulated,and the expression of Bcl-2 was up-regulated in group P,and no significant change was found in each parameter in group Ⅰ (P ＞ 0.05).Conclusion Propofol can reduce focal cerebral I/R injury through inhibition of the endoplasmic reticulum stress-mediated apoptosis in rats.