ObjectiveTo investigate the effect of calycosin-mediated glucoprotein130/Janus kinase/signal transducer and activator of transcription factor （GP130/JAK/STAT） signaling pathway on oxidative injury of astrocytes in spinal cord. MethodAstrocytes in rat spinal cord were isolated and identified by immunofluorescence detection of glial fibrillary acidic protein （GFAP）. The cells were respectively pre-treated with 5， 10， 20 μmol·L^-1 calycosin for 12 h， and then 100 μmol·L^-1 H₂O₂ （24 h） was added to induce oxidative injury. Cell counting kit-8 （CCK-8） assay was employed to detect cell proliferation and select the optimal concentration of calycosin. The following experimental groups were designed： control group， model group （100 μmol·L^-1 H₂O₂）， calycosin group （20 μmol·L^-1 calycosin）， calycosin + LY294002 group （20 μmol·L^-1 calycosin + 10 μmol·L^-1 LY294002）， and calycosin + Stattic group （20 μmol·L^-1 calycosin + 3 μmol·L^-1 Stattic）. CCK-8 assay and immunofluorescence method were used to detect the proliferation of cells and flow cytometry was applied to detect cell apoptosis and cycle. The protein expression of phosphorylated （p）-JAK2， p-STAT3， p-protein kinase B （Akt）， GP130， and interleukin-6 （IL-6） was detected by Western blotting. ResultCompared with the control group， the model group showed low proliferation activity and high apoptosis rate of cells （P<0.05）. Compared with the model group， calycosin （20 μmol·L^-1） group displayed high proliferation activity and low apoptosis rate of cells （P<0.05）. Compared with calycosin （20 μmol·L^-1） group， both phosphatidylinosirtol-3-kinases （PI3K） inhibitor LY294002 and STAT3 inhibitor Stattic significantly reduced the proliferation activity and increased the apoptosis rate of cells （P<0.05）. The protein expression of p-JAK2， p-STAT3， p-Akt， GP130， and IL-6 in the model group was higher than that in the control group （P<0.05）， and the expression of the above indicators was lower in each treatment group than in the model group （P<0.05）. ConclusionCalycosin can promote the proliferation and inhibit the apoptosis of astrocytes with oxidative injury by inhibiting the phosphorylation of PI3K/Akt pathway and JAK2/STAT3 pathway.

Objective:To analyze the related researches on big data applied in nursing at home and abroad, and to explore its application status and development trends, in order to provide a reference for the development of nursing big data in China.Methods:Related articals of nursing big data collected from China National Knowledge Infrastructure (CNKI) , Wanfang database and Web of Science Core Collection were used as data sources. The search time limit was from the establishment of the database to September 30, 2019. Excel was used for statistical analysis of the year, country, institution and journal. VOSviewer was used for co-occurrence analysis of keywords and national cooperation, and draw visual graphs.Results:A total of 195 Chinese articals and 5 751 English articals were included. From 2001 to 2019, the research on nursing big data showed an overall growth trend. There were few related research in China with scattered research institutions, which were mainly published in nursing journals. The English articals on nursing big data mainly involved five fields, including health management, assessment and prediction, data mining technology, data analysis and cloud computing, and big data research platform; while Chinese articals mainly covered three fields, including information nursing, nursing quality management and application types of big data. The United States was at the center of national cooperation and dominated this field.Conclusions:The research on nursing big data in China is still in its infancy, and the research content is not focused enough. It can be further explored in standardizing nursing standard terms, building a diversified data monitoring platform and improving the information literacy of nursing staff, so as to accelerate the clinical application of nursing big data in China, and then provide accurate nursing services for patients.

Objective:To investigate the clinicopathological features and prognosis of pleomorphic giant cell adenocarcinoma (PGCA) of the prostate, and to strengthen the understanding of this rare variant.Methods:From January 2009 to December 2019, 383 pathological samples of prostate adenocarcinoma with Gleason scores of 8-10 were selected from the First Affiliated Hospital, Army Medical University. PGCA was screened by reviewing the histomorphology of hematoxylin and eosin stained sections. Then the expression of prostate specific markers and mismatch repair (MMR) proteins of PGCA were detected by immunohistochemistry (IHC), and microsatellite instability (MSI) status was detected through polymerase chain reaction (PCR)-capillary electrophoresis. Meanwhile, the clinicopathological characteristics, diagnosis, treatment and prognosis of PGCA were summarized and analyzed along with those reported in the literature.Results:Three patients with PGCA of the prostate were 68, 63 and 71 years old respectively, and case 1 had a history of transurethral resection of the prostate and oral bicalutamide 3 months before surgery. All 3 patients underwent radical prostatectomy and received endocrine therapy, radiotherapy and/or chemotherapy, and died at 18, 23, and 10 months after surgery, respectively. Histologically, both the usual prostate adenocarcinoma with Gleason score of 9-10 and the pleomorphic giant cell component with anaplastic characteristics were observed in 3 tumors, and the latter accounted for 90%, 10%, and 20%, respectively. Immunohistochemical staining showed that both components expressed epithelial markers (CK, CK8/18) and prostate-specific markers (NKX3.1, PSA, P504S) to varying degrees, and the expression of MMR proteins (MSH2, MSH6, MLH1 and PMS2) were not defective. MSI was not detected in the usual prostate adenocarcinoma and pleomorphic giant cell components obtained by microdissection in 3 cases. Combined with 10 cases reported in the literature, there were totally 13 cases of PGCA for reviewing. The patients were 45-81 years old, the average age was 66 years old, and the median age was 66 years old. During the follow-up period of 3-36 months, 7 cases relapsed/metastasized, 6 cases died within 23 months after diagnosis, and 4 of which died within 1 year.Conclusions:PGCA is a newly recognized rare variant of prostate adenocarcinoma. At present, all cases are accompanied with high-grade usual prostate adenocarcinoma with Gleason score of 9-10, but it is different from the latter in pathological morphology and clinical manifestations, by presenting high invasiveness and poor prognosis. PGCA is not sensitive to conventional endocrine therapy, radiotherapy or chemotherapy. Accurate diagnosis of PGCA is helpful to judge the prognosis of patients and guide the treatment.

Objective: To investigate the epidemiologic characteristics of Norovirus among adult patients suffering from infectious diarrhea in Shanghai, so as to provide evidence for developing related strategies on prevention and control of the disease. Methods: Diarrheal outpatients were monitored at the 'Intestinal clinic’ from 22 hospitals involved in the sentinel surveillance program in Shanghai. Information on demographic and epidemiologic features of the patients was collected while data and clinical, fecal specimens were collected and sent to the district CDC for Norovirus detection. Positive rates of Norovirus were also compared in various populations and seasons during 2013-2018. Multivariate logistic regression model was adopted to fit into the comparisons between non-Norovirus and Norovirus groups. Results: 19.28% of the 12 083 diarrheal cases were found to have carried the Norovirus, with GⅡgroup the most commonly identified genotype. Rates of detection was seen higher in males (20.78%) than in females (17.73%). 30-44 year-old were found having the highest positive rate (21.51%). The positive rates were found the highest (23.60%) in the year of 2015. All the above shown differences were statistically significant (P<0.05). Diarrheal patients affected with Norovirus would present watery stool (75.94%) and vomiting (35.84%). Data from the multivariate logistic analysis showed that factors as: being males, 30-44 years old, officials/clerks, in winter season and with histories of travelling etc., were related to higher risks on Norovirus infection. Conclusions Infectious diarrhea caused by Norovirus occurred all year round, with seasonal peaks seen in winter and spring, in Shanghai. Specific prevention and control measures should be taken on Norovirus- caused infectious diarrhea, according to the difference on age, gender and season.

Objective: To understand the seasonality and etiological characteristics of infectious diarrhea in adults from Shanghai. Methods: Adult patients with diarrhea who had visited the enteric disease clinics in 22 hospitals that carrying on the Diarrhea Comprehensive Surveillance sentinel programs in Shanghai during 2014-2017, were surveyed. Stool specimens were collected according to the different intervals of sampling and detected for 12 bacteria and 5 viruses. Concentration ratio and circular distribution method were used for data analysis. Results: From 2014 to 2017, a total of 9 573 stool specimens were collected from the targeted diarrhea patients ≥18 years old (n=96 067), through the Shanghai Diarrhea Comprehensive Surveillance program. The positive rate of detection was 46.44%. Seasonal peaks of infectious diarrhea were both seen in summer (bacteria peak, diarrheagenic Escherichia coli and Vibrio parahaemolyticus, etc.) and in winter (virus peak, Norovirus, etc.). Both bacterial and viral infections presented seasonal concentration (Raleigh’s test P<0.001) but more obvious with bacterial infection. Viral infection accounted for 60.19% of the cause of infectious diarrhea. The top five predominant pathogens appeared as Norovirus, Rotavirus, diarrheagenic Escherichia coli, Vibrio parahaemolyticus, and Salmonella spp.. Conclusions Among the adult outpatients with infectious diarrhea in Shanghai, obvious seasonality was seen, with peaks in both summer and winter. Viral infection with Norovirus in particular, appeared as the predominant source of infection. Active, continuous and comprehensive diarrhea-related surveillance programs would be able to monitor the changing dynamic of pathogen spectrum, and lead to the adoption of targeted preventive measures.

Objective: To conduct a viral pathogen surveillance program on pediatric inpatients less than five years old with acute gastroenteritis in Shanghai and to better understand the pathogenic spectrum and molecular features in the target population, for setting up programs on control, prevention, medication and vaccine applications of the diseases. Methods: Fecal samples were collected from inpatients less than 5 years old who were admitted to a pediatric hospital for having acute gastroenteritis. Information related to demographic, clinical and epidemiological features of the patients was also collected. Laboratory assays including ELISA, real-time PCR and nested PCR, were performed to detect the presence of pathogens as rotavirus, calicivirus, astrovirus and adenovirus. Results: A total of 1 018 samples were collected (male 671 and 347 female), with the positive detection rate as 40.57% which peaked from autumn till winter, annually. Calicivirus and rotavirus A presented with the highest detection rates (24.75% and 13.95% respectively). The lowest detection rate was found in the 0-6 month-olds (32.20%). 65% of the patients with positive virus had received antibiotic treatment prior to the hospitalization. However, no statistically significant difference was seen, regarding the rates of antibiotic medication in the virus positive or negative populations (P>0.05). Data from the Rotavirus genotype analysis revealed that G9P[8] genotype was the predominant strain, and causing majority of rotavirus infections in all the age groups. Conclusions Among the inpatients under 5 years of age in Shanghai, the positive detection rate for Calicivirus was higher than that for rotavirus group A, suggesting the necessity to carefully monitor the changes regarding the pathogenic spectrum and subtypes of the virus. Antibiotics should also be attentively administered, together with the development of suitable vaccine.

Accurate perioperative pressure injury risk assessment is the prerequisite for finding potential risks and early implementing individual preventive measure. Many scholars apply themselves to research on pressure injury assessment scales. However, there are still no accepted perioperative assessment scales at present. This paper reviewed three aspects on scale description, psychometrics indexes and scale evaluation of perioperative pressure injury risk assessment scales at home and abroad, to provide a reference for further deepening and refining perioperative assessment scales in China, so as to effectively guide clinical nursing work.

Objective: To clarify the potential pathogen for fever of unknown origin (FUO) in serum samples for which pathogenic agents were hardly identified with conventional exainatins. Methods: Random capturing the nucleic acid of pathogen was performed by utilizing the property of sequence non-dependence of next generation sequencing (NGS), followed by enrichment of nucleic acid with multiple displacement amplification (MDA). After sequencing, metagenomic analysis was applied to the raw data and the phylogenetic tree was built to identify the potential pathogen. Results: The result did not indicate common pathogens for FUO but showed the existence of Torque teno Viurs (TTV). Assembly was carried out to all sequencing reads. The coverage of consensus sequence on reference was calculated. Phylogenetic result indicated that all confidence sequences belonged to 3 genera (α TTV, β TTV and γ TTV). Conclusions The characteristics of genome, phylogenesis of TTV and TTV as signal at immunology level were analyzed and clarified. The possible explanation for detection of TTV in 3 genera may be that TTV itself or non-infectious factors caused the immunosuppression, which finally result e in rise of TTV detection.

The laboratories of National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, have developed a series of experimental method . These method have unique advantages over the national standard method and industry standard method . How to make these method become public products through legal procedures to serve disease prevention and control more extensively is an obligatory task for national virological laboratories. This article explores the establishment, verification, validation, and examination of virological non-standard method under laboratory certification and accreditation conditions through empirical research on the " RT-RAA method for detecting EV71/CA16 and other viruses" .

Heart specialists team has become one of the core concepts of diagnosis and treatment mode for cardiovascular diseases.Multidisciplinary collaboration has proved its beneficial effects on the diagnosis and treatment strategies, patient selection, follow-up and management of some cardiovascular diseases.At present,it is chiefly seen in the diagnosis and treatment of coronary artery revascularization and transcatheter aortic valve replacement.During implementation there still exist such problems as lack of awareness,attention and effective operation of the medical staff,and lack of an incentive mechanism, thus incurring controversies over such a model.Therefore further follow-up and improvements are expected in combination with the characteristics of China′s medical institutions.