Objective To analyze the current situation and latent profiles of nurses'voice behavior in nurses,and explore the influencing factors of different types.Methods Through convenience sampling,812 nurses who worked in tertiary hospitals from 5 cities in Guangdong Province during April 2022 to June 2022 were recruited.The demographic questionnaire,the Voice Behavior Scale,the Humble Leadership Scale,and the Team Psychological Safety Climate Scale were used for investigation.Latent profile analysis was used to explore the latent profiles of nurses'voice behavior.The influencing factors of latent profiles were identified by multivariate Logistic regression.Results The total score of the voice behavior in 812 nurses is(37.04±5.88).Voice behaviors in nurses is divided into 3 latent classes,namely"conservation group"(27.83％),"balanced-risky group"(61.95％),and"the challenge group"(10.22％).The influencing factors include recruitment type,whether to assist in department management,humble leadership,team psychological safety climate(all P＜0.05).Conclusion The level of nurses'voice behavior is upper medium with heterogeneity,which can be divided into 3 latent profiles.Nurses managers should focus on nurses with conservation group and balanced-risky group and conduct early targeted prevention and care according to characteristics and influencing factors of different latent profile.

Objective To explore the influencing factors of pregnancy outcome after re-pregnancy in patients with unexplained recurrent spontaneous abortion based on ultrasound endometrial receptability parameters and lymphocyte immunophenotype.Methods A total of 166 re-pregnant patients with unexplained recurrent spon-taneous abortion admitted to Nantong Maternal and Child Health Hospital from April to August 2022 were included in the study.According to the pregnancy outcome,the patients were divided into the delivery group and the abortion group.The endometrial receptability parameters and peripheral blood T lymphocytes were detected to screen the influencing factors of abortion.Results Among 166 patients,102 cases(61.45%)had successful delivery and 64 cases(38.55%)had abortion again.The delivery group showed thicker endometrial thickness,larger endometrial volume,and higher VFI,but lower CD4+ and CD4+/CD8+ compared to the abortion group(P<0.05).CD4+ and CD4+/CD8+ were observed to be the risk factors for pregnancy failure(P<0.05),and endometrial thickness,endo-metrial volume,and vascularized flow index(VFI)were found to be the protective factors for pregnancy failure(P<0.05).Conclusion The pregnancy outcome of patients with unexplained recurrent spontaneous abortion is related to endometrial thickness,endometrial volume,VFI,CD4+,and CD4+/CD8+.

Objective To explore the impact of temperature and environmental factors on the risk of deaths from cardiovascular and cerebrovascular diseases (CVD) in Wuhan during the course of high temperature. Methods The daily CVD death data and meteorological and atmospheric pollutant concentration data during the high temperature process in Wuhan from 2014 to 2019 were collected. The generalized additive models (GAM) were used to obtain the characteristics of meteorological factors, atmospheric pollutant concentrations, high impact factors and thresholds affecting the relative risk of CVD death. Results The analysis results showed that: (1) When the maximum temperature reached 36.7°C and the lowest temperature reached 25.3°C, the relative risk of CVD death increased significantly; (2) The risk of CVD death during the first high temperature process was the largest, and the average CVD excess mortality rate during the first high temperature process from 2014 to 2019 reached 21.7%; and (3) The average temperature, maximum temperature and PM₁₀ during the course of high temperature were important environmental factors that increased the risk of CVD deaths, and the relative risks were 1.14 (95% confidence interval (95% CI): 1.11-1.17), 1.11 (95% confidence interval (95% CI): 1.08-1.15, and 1.06 (95% confidence interval (95% CI): 1.02-1.09), respectively. Conclusion Temperature and PM₁₀ are important environmental factors that increase the risk of death from CVD during the high temperature process in Wuhan from 2014 to 2019, with the first annual high temperature process having the greatest impact on the risk of CVD death.

{L-End}Objective To explore the chain mediating effect of team psychological safety atmosphere and professional calling in the relationship between humble leadership and voice behavior. {L-End}Methods A total of 812 nurses from five medical institutions in Guangdong Province were selected as the research subjects using the convenience sampling method. The Team Psychological Safety Atmosphere Scale, the Professional Calling Scale, the Hospital Version of Humble Leadership Scale and the Voice Behavior Scale were used to investigate the perceived team psychological safety atmosphere and sense of professional calling, the perceived humble leadership style and voice behavior of the nurses. {L-End}Results The score of team psychological safety atmosphere, professional calling, humble leadership, and voice behavior of 812 nurses was (58.0±7.6), (44.6±8.0), (50.4±9.2) and (37.0±5.9), respectively, with the scoring rate of 72.5%, 74.3%, 80.0%, and 74.0%, respectively. Bootstrap analysis showed that humble leadership could positively influence voice behavior ［standardized effect value (β)=0.28, 95% confidence interval (CI) 0.20-0.35］. Humble leadership could influence voice behavior through the separate mediating effects of team psychological safety atmosphere (β=0.13, 95%CI 0.09-0.18), professional calling (β=0.07, 95%CI 0.04-0.11), and the chain mediating effect of team psychological safety atmosphere and professional calling(β=0.06, 95%CI 0.04-0.08). {L-End}Conclusion The voice behavior of clinical nurses is at a moderately high level. Humble leadership can directly influence voice behavior and can influence voice behavior through the mediating effects of team psychological safety atmosphere and professional calling. Nursing managers can inspire the work passion of clinical nurses by changing their own leadership style and creating a good atmosphere for voicing opinions.

Objective To investigate the effect of Water-soluble total alkaloids of Yimucao Injection(YITA)on postpartum uterine involution.Methods A guinea pig abortion model was established by drug method.0.17 g·kg-1 YITA was intragastrically administered to record the amount of bleeding and the contents of E2 and P in serum of guinea pigs after delivery.The uterine coefficient was calculated and the contents of NO,ET-1 and Ca2+ in uterine tissue were measured.The isolated uterine model and the in vivo uterine model were prepared by guinea pigs.The former was given YITA 0.05,0.1 and 0.2 mg·mL-1,and the latter was intramuscularly injected with YITA 10,20 and 40 mg·kg-1.The changes of uterine smooth muscle(USM)contractile activity,frequency and tension were recorded by biological function test system.Results Intragastric administration of YITA could decrease the uterine coefficient(P<0.001),NO content in uterine tissue and serum P content in guinea pigs with medical abortion(P<0.01),significantly increased ET/NO ratio(P<0.001);it tended to increase Ca2+ content in uterine tissue(P<0.1).In the isolated USM test,50 and 100 mg·L-1 YITA significantly increased USM contractile activity in guinea pigs(P<0.05),and 200 mg·L-1 YITA significantly decreased USM contractile minimum in guinea pigs(P<0.05)in the in vivo USM contractile test,YITA enhanced USM contractile activity,and 40 mg·kg-1 YITA significantly increased USM contractile activity and frequency in guinea pigs(P<0.05);10 mg·kg-1 YITA significantly increased USM contractile frequency in guinea pigs(P<0.05)and tended to increase motility(P=0.0569<0.1);20 mg·kg-1 YITA tended to increase frequency(P=0.0898,0.0699 respectively,<0.1).Conclusion YITA has the effect of promoting uterine involution,and the mechanism is related to the regulation of ET/NO balance and the direct promotion of USM contraction.YITA is an effective substance for uterine contraction and hemostasis with leonurus injection in the treatment of postpartum hemorrhage and uterine involution.

Objective:To study the willingness of county-level hospital physicians within a county medical alliance(alliance)to participate in county-township human resource integration for medical institutions, for furthering the development of such integration.Methods:Based on a discrete selection experiment, a questionnaire was designed for the selection of the work attributes that affect the participation of county-level hospital physicians in such an integration. On-the-job physicians from four county-level hospitals in a prefecture level city were selected by multi-stage stratified random sampling method as the survey objects, and a field questionnaire survey was conducted from November to December 2021. The mixed logit model was used to analyze the preference of physicians in county-level hospitals for five types of work attributes(work unit, monthly income, seniority required for professional title promotion, training opportunities, serving as middle-level and above administrators), the relative importance of each work attribute, and marginal willingness to pay with regard to their participation in the integration.Results:A total of 172 valid questionnaires were collected. When county-level hospital physicians participate in county-township human resource integration for medical institutions, their statistically significant job attributes and level preferences included monthly income, working unit of county-level hospitals, 7 years for professional title promotion, and more training opportunities ( P<0.001). The relative importance of monthly income ranked the highest among the five categories of work attributes, up to 55.55%. Conclusions:When physicians in county-level hospitals participate in the integration of county-township human resources, the most important was their monthly income, and economic incentives could enhance their willingness to participate.

Objective:To investigate the changes of dynamic functional connectivity between the default mode network (DMN) and executive control network (ECN) in the resting state in patients with alcohol use disorder (AUD).Methods:From September 2018 to June 2019, 23 cases of AUD group and 24 cases of healthy control (HC) group matched with age, gender, education level and handedness were collected at Renmin Hospital of Wuhan University. Mini-mental state examination (MMSE) and Michigan alcoholism screening test (MAST) were performed in all subjects for cognition and alcohol dependence score. All the subjects underwent T 1WI-3D structural imaging and resting state functional MRI (rs-fMRI) examination. Group spatial independent component analysis (ICA) was used to select the independent components of DMN and ECN. Then dynamic changes in the functional connectivity between the DMN and the DMN were obtained by sliding window approach and clustering method. Finally, the independent sample t test was used to compare the difference of general clinical data between the two groups, the linear correlation analysis was conducted in the parameter value and MMSE and MAST scores. Results:Compared with the HC group, the static functional connectivity analysis showed that the precuneus and posterior cingulate gyrus of the DMN were enhanced in the AUD group ( P=0.016, t=2.496). The DMN and ECN functional connectivity showed four different brain activity states, the proportion of state1 increased by 6.81% and state2 decreased by 6.83% in the AUD group, state3 and state4 were relatively stable. In state1, the internal functional connectivity of the DMN in the AUD group was enhanced, while the functional connectivity between DMN and ECN was mainly enhanced. In state2, the internal functional connectivity of the ECN was enhanced, and the connectivity between the DMN and ECN was mainly weakened. The mean dwell of state2 in the AUD group was negatively correlated with the MAST score ( r=-0.433, P=0.039). Conclusions:Dynamic functional connectivity patterns between DMN and ECN have been changed in patients with AUD. Dynamic functional connectivity can reveal transient changes in brain activity, which can provide certain imaging evidence for finding changes in AUD deep brain activity.

PURPOSE: Ferroptosis is a new mode of regulated cell death, which is completely distinct from other cell death modes based on morphological, biochemical, and genetic criteria. This study evaluated the therapeutic role of ferroptosis in classic chemotherapy drugs, including the underlying mechanism. MATERIALS AND METHODS: Cell viabilitywas detected by using the methylthiazoltetrazlium dye uptake method. RNAiwas used to knockout iron-responsive element binding protein 2, and polymerase chain reaction, western blot was used to evaluate the efficiency. Intracellular reduced glutathione level and glutathione peroxidases activitywere determined by related assay kit. Intracellularreactive oxygen species levelswere determined by flowcytometry. Electron microscopywas used to observe ultrastructure changes in cell. RESULTS: Among five chemotherapeutic drugs screened in this study, cisplatin was found to be an inducer for both ferroptosis and apoptosis in A549 and HCT116 cells. The depletion of reduced glutathione caused by cisplatin and the inactivation of glutathione peroxidase played the vital role in the underlying mechanism. Besides, combination therapy of cisplatin and erastin showed significant synergistic effect on their anti-tumor activity. CONCLUSION: Ferroptosis had great potential to become a new approach in anti-tumor therapies and make up for some classic drugs, which open up a new way for their utility in clinic.
Apoptosis ; Blotting, Western ; Carrier Proteins ; Cell Death ; Cisplatin* ; Drug Therapy ; Glutathione ; Glutathione Peroxidase ; HCT116 Cells ; Methods ; Oxygen ; Peroxidases ; Polymerase Chain Reaction

OBJECTIVE:To provide reference for safe drug use of paclitaxel in clinic. METHODS:The literatures about anaphylactic shock induced by paclitaxel were retrieved from China Hospital Knowledge Database during 2006-2016. After screening literatures which met inclusion criteria,the literatures were analyzed statistically in respects of the distribution of patient's gender and age,primary disease,distribution of occurrence time of anaphylactic shock,prophylactic drug use,route of administration and dosage,combined with chemotherapy drugs,prodromal clinical manifestations,first-aid measures and prognosis,etc. RESULTS:A total of 53 cases of anaphylactic shock induced by paclitaxel were included,among which there were 16 male and 37 female,aged 17-72 years;female patients over 40 year-old took up the highest proportion(30 cases,56.60%). The major primary diseases were lung cancer(15 cases,28.30%),breast cancer(12 cases,22.64%)and ovarian cancer(11 cases,20.75%). Anaphylactic shock mainly occurred within 5 min after intravenous dripping(34 cases,64.15%). 45 cases (84.90%)received antiallergic prophylactic program before using paclitaxel;53 patients were given intravenous dripping with single dose of 30-300 mg. Among 53 patients,25 patients were given paclitaxel alone,and other patients were given paclitaxel combined with chemotherapy drugs. The prodromal clinical symptoms of anaphylactic shock mainly involved cardiovascular system (123 case time,36.07%),skin and mucous membrane system(73 case time,21.41%)and respiratory system(67 case time, 19.64%). 2 patients(3.77%)died after rescue treatment. CONCLUSIONS:More attention must be paid to the occurrence of anaphylactic shock induced by paclitaxel.

Objective To investigate the effects of oral care using hydrogen peroxide and sodium bicarbonate to prevent neonatal ventilator associated pneumonia(VAP). Methods Totally 209 neonates were recruited and divided into the experimental group with 104 cases and the control group with 105 cases by using random number table method. Based on conventional mechanical ventilation nursing,the experimental group received oral care using 1.5%hydrogen peroxide combined with 2.5% sodium bicarbonate,Q8H,while the control group received oral care using only 2.5% sodium bicarbonate,Q8H. Positive results of bacteria detection in tracheal sputum culture,the incidence rate of VAP,mechanical ventilation time,hospitalization time and hospitalization costs were compared between two groups. Results After 48 hours of mechanical ventilation,the difference in positive results of bacteria detection in tracheal sputum culture between two groups was statistically significant(P<0.05). The difference of incidence rate of VAP between two groups showed no statistical significance(P>0.05) when the duration of the mechanical ventilation was 48 hours. While after 48 hours of the mechanical ventilation,the difference of the incidence rate of VAP between two groups was statistically significant(P<0.05). The differences in mechanical ventilation time and hospitalization time between two groups were statistically significant(P<0.05). The hospitalization costs of the experimental group was higher than that of the control group,while the difference showed no statistical significance(P>0.05). Conclusion The combined usage of hydrogen peroxide and sodium bicarbonate for oral care can effectively eliminate neonatal oral bacteria colonization and prevent neonatal VAP,so as to reduce the time of mechanical ventilation and hospitaliza-tion, and decrease hospitalization costs.