OBJECTIVE To investigate the effect and mechanism of gracillin from Reineckia carnea on autophagy in non- small cell lung cancer A549 cells. METHODS Using A549 cells as subjects， the effects of different concentrations of gracillin （0.25， 0.5， 1， 2， 4 μmol/L） on the proliferation of cells were detected by CCK-8 after being treated for different time （12， 24， 48 h）. Compared with the control group without medication， the effect of gracillin （2 μmol/L） on the formation of autophagosomes in cells was observed by transmission electron microscope after 24 h of exposure. The aggregation of GFP-LC3 on autophagosome membrane was detected by GFP-LC3 plasmid transfection after being treated with gracillin （0.25， 0.5， 1， 2 μmol/L） for 24 h. Quantitative real-time PCR and Western blot assay were used to detect the mRNA and protein expressions of family with sequence similarity 102 member A（FAM102A）， the expressions of autophagy-related proteins [p62， Beclin-1， microtubule-associated protein 1 light chain 3B （LC3B）]， and the expressions of phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway-related proteins in A549 cells after being treated with gracillin （0.25， 0.5， 1 and 2 μmol/L） for 24 h. RESULTS Gracillin significantly inhibited the proliferation of A549 cells in a concentration- and time-dependent manner. The IC50 was 2.55 μmol/L at 24 h. After 24 h of gracillin treatment， autophagosomes with bilayer membrane structure were found in the cell cytoplasm， and GFP-LC3 green fluorescent spots on autophagosome membrane were obvious， representing an increasing trend as drug concentration. Compared with the control group， mRNA and protein expressions of FAM102A （0.5， 1， 2 μmol/L groups）， protein expression of Beclin-1 （1， 2 μmol/L groups） and LC3B-Ⅱ/LC3B-Ⅰ ratio （2 μmol/L group） were significantly increased in different concentrations of gracillin groups， while the protein expression of p62 （1， 2 μmol/L groups）， and the protein phosphorylations of Akt （1， 2 μmol/L groups） and PI3K （2 μmol/L group） were all decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS Gracillin can promote excessive autophagy in A549 cells by up-regulating mRNA and protein expressions of FAM102A and inhibiting PI3K/Akt signaling pathway， thus inhibiting cell proliferation.

Objective To construct a key nursing technology system for the treatment of patients exposed to nuclear radiation in hospitals,and provide technical guidance and support for emergency nursing rescue in hospitals of nuclear radiation accidents.Methods A research group was composed of a team with rich experience in nuclear radiation accidents.Based on 4 scenarios of nuclear radiation accidents(including external irradiation,internal irradiation,external contamination,internal contamination),the literature search was conducted to form the first draft of the system.Delphi method was used to complete 2 rounds of expert letter consultation,and the final draft of the key nursing technology system for hospital treatment of patients with nuclear radiation exposure was constructed according to the revised opinions of experts.Results A total of 16 experts completed 2 rounds of correspondence.The effective recovery rates were 100％and 80％;the recommendation rates were 65％and 50％;the authority coefficients(Cr)were 0.778 and 0.797;the coefficient of variation(CV)of the 2 rounds of expert letter consultation was ≤0.25.Finally,a key nursing technology system for in-hospital treatment of patients with nuclear radiation exposure was formed,including 5 first-level indicators,26 second-level indicators and 74 third-level indicators.Conclusion The constructed key nursing technology system for hospital treatment of patients with nuclear radiation exposure is highly practical and scientific,and it is conducive to the formation of standardized nuclear radiation exposure treatment procedures,and provides a theoretical basis for the training and evaluation of nursing staff related to nuclear radiation exposure.

Objective To study the application effect of quality control circle(QCC)in reducing the dissatisfaction rate of physical examination clients in health management center.Methods To establish QCC,selected the health check-up popula-tion in our hospital in September-2019 and March-2020,through the questionnaire investigation and analysis,compare the dis-satisfaction of the clients before and after the quality control circle.Results After carrying out QCC activities,the dissatisfaction of physical examination clients was significantly lower than that before QCC,and the difference was statistically significant(P＜0.05).Conclusion The activities of QCC in the health management center can effectively improve the quality of the physical examination work and reduce the dissatisfaction of the customers in the physical examination.It is of great significance to the health management.

Objective:To investigate the expression level and application value of anti-carbamylated protein(CarP)antibody in rheumatoid arthritis(RA).Methods:Demographic data and laboratory test results of RA patients,non-RA patients and healthy controls in the physical examination center were re-viewed from December 2018 to June 2019 in the Rheumatology and Immunology Department of the Peo-ple's Hospital of Xinjiang Uygur Autonomous Region.The serum concentrations of anti-CarP antibodies in all the subjects were measured by ELISA and statistically analyzed.Results:A total of 259 subjects were included in this study,including 158 in the RA group(45 serum-negative RA patients),59 in the non-RA group and 42 in the healthy control group.The concentration of anti-CarP antibody in RA group[8.31(5.22,15.26)U/mL]was higher than that in non-RA group[4.50(3.35,5.89)U/mL]and healthy control group[3.46(2.76,4.92)U/mL].The concentration of anti-CarP antibody in non-RA group was not significantly different from that in healthy control group(P=0.10).Receiver operating characteristic(ROC)curve analysis showed that the sensitivity of anti-CarP antibody in the diagnosis of RA was 58.2％,and the specificity was 93.1％.The sensitivity of the combined detection of anti-CarP antibody,anti-cyclic peptide containing citrulline(CCP)antibody and rheumatoid factor(RF)was 82.3％,and the specificity was 96.5％.The positive rate of anti-CarP antibody in serum-negative RA patients was 44.4％(20/45).Univariate Logisitic regression analysis showed that age,C-reactive pro-tein(CRP),erythrocyte sedimentation rate(ESR),RF,glucose-6-phosphate isomerase(GPI),anti-CCP antibody and anti-CarP antibody were risk factors for RA.Multivariate Logisitic regression analysis showed that anti-CCP antibody and anti-CarP antibody were independent risk factors for RA.Spearman correlation analysis showed that there was no significant correlation between anti-CarP antibody and swol-len joint count(SJC),tenderness joints count(TJC),ESR,disease activity score for 28 joints(DAS28),clinical disease activity index(CDAI),simplified disease activity index(SDAI).The concentration of anti-CarP antibody in RA with bone erosion(n=88)was higher than that in RA without bone erosion(n=70),and there was significant difference between the two groups(P＜0.05).Conclusion:Anti-CarP antibody is an effective serological marker for the diagnosis of RA.The combined detection of RF,anti-CCP antibody and anti-CarP antibody can improve its diagnostic value,and anti-CarP antibody may be an effective assistant diagnostic tool for serum negative RA.The high serum concentration of anti-CarP antibody in patients with RA may indicate an increased risk of bone erosion and should be treated early,but further cohort studies are needed for follow-up observation.

Objective:To explore the application effect of portable device of airway humidification on patients with head and neck tumor who underwent tracheostomy.Methods:A total of 100 patients with head and neck tumors who underwent tracheostomy at Department of Head and Neck Surgery of Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College from October 2021 to May 2023 were selected as the study subjects.They were randomly divided into the control group and the observation group by using a random number table method,with 50 cases in each group.The control group received conventional nebulization inhalation for airway humidification,and the observation group adopted portable device of airway humidification with 0.45%sodium chloride solution to conduct sustained airway humidification.The effect of airway humidification,occurrence of phlegm scabs,injury and bleeding of airway,tracheal tube obstruction,and comfort level of patients after surgery were observed and compared between the two groups.Results:The satisfaction rates of the patients of observation group at the 1st,2nd,3rd,4th,and 5th day after surgery were 84.0%,88.0%,92.0%,96.0%and 96.0%for humidification of wet sputum,which were better than those of control group,and the differences were statistically significant(x2=46.240,64.103,70.560,67.919,74.227,P<0.05),respectively.The formations of phlegm scabs were respectively 1,5,1 and 1 cases at the 2nd,3rd,4th,5th d after surgery in observation group,which were less than those in control group,and the differences were statistically significant(x2=7.111,23.926,21.760,17.344,P<0.05),respectively.The numbers of airway injury bleeding and overall tracheal tube obstruction at the 2nd d after surgery in the observation group were respectively 2 cases and 1 case,which were significantly less than those in the control group,and the differences were statistically significant(x2=4.000,5.982,P<0.05),respectively.The comfort levels of airway humidification and suction phlegm,and overall comfort evaluation were respectively(17.96±0.75)scores,(16.06±1.05)scores and(34.04±1.63)scores in the observation group,which all were lower than those in the control group,and the differences were statistically significant(t=9.843,17.298,15.792,P<0.05),respectively.Conclusion:The portable device of airway humidification has a significant effect on airway humidification of patients with head and neck tumors who undergo tracheostomy,which can reduce the occurrence of phlegm scabs,and reduce the number of overall tracheal tube obstruction,and improve comfort level of patient with head and neck tumors who undergo tracheostomy.

Objective:To investigate the prevalence of hyperuricemia (HUA) in Bozidun Kirghiz township of Xinjiang Aksu region, and to explore the risk factors for the occurrence of HUA in the local area.Methods:A cross-sectional survey study was conducted by randomly selecting 9 villages in Bozidun Kirgiz Township by the whole-group sampling method and questionnaire were distributed to the households. The questionnaire included: demographic information, history of past illness, personal history, and all subjects were measured for height, weight, blood pressure, abdominal circumference, etc. The diagnostic of HUA if the serum uric acid (SUA) level >420 μmol/L in men or >360 μmol/L in women. The incidences of HUA in different age, sex, food type and life style behavior were analyzed. T test, non-parametric test and Chi-square test were used to analyze the differences among the groups, and logistic regression was used to analyze the risk factors. Results:①A total of 2 138 subjects were surveyed, among which 68 patients were with HUA, the prevalence of HUA in Bozidun Kirghiz township, Aksu region in the general population was 3.18%(68/2 138); the prevalence rate in men was 4.60%(45/978), 45 patients were identified; and the prevalence rate in women was 1.98%(23/1 160), 23 patients were identified. The peak age of HUA in male and female patients was 51~60 years old. ②The prevalence of HUA was lower in those who consumed dairy products ( χ2=6.91, P=0.017), nuts ( χ2=8.43, P=0.038) and eggs ( χ2=7.38, P=0.023), and lower in those who consumed more. Different intake of cereals ( χ2=0.87, P=0.647), meat( χ2=0.82, P=0.662), vegetables and fruits( χ2=5.22, P=0.073) had no effect on the prevalence of HUA.③In terms of different life behaviors, the prevalence of HUA in men who had been smoking was higher than those who had never smoked (57.78%, 28.89%, 13.33%, χ2=8.16, P=0.017). In the relationship between drinking and HUA, the prevalence rates of male always drinking, ever drinking and never drinking were 80.00%, 11.11% and 3.89%, respectively, the difference was statistically significant ( χ2=6.67, P=0.038). ④Multi-factor logistic regression analysis showed that high BMI, old age, high TG, increased Cr and increased WBC were risk factors for the occurrence of HUA [ OR(95% CI)=1.13(1.04, 1.23), 1.03(1.00,1.05),1.39(1.00, 1.93), 1.03(1.02, 1.05), 1.27(1.07, 1.49), all P<0.05]. Conclusion:The prevalence of HUA in Bozidun Kirgiz township in Aksu prefecture of Xinjiang is lower than that in other areas with continental climate. High BMI, old age, high TG, increased Cr and increased WBC count are risk factors for the development of HUA .

Objective To investigate the interventional effect and mechanism of a novel ampelopsis hydrogel on dampness-heat accumulation syndrome of gouty arthritis. Methods A total of 90 patients with gouty arthritis who met the diagnostic criteria of western medicine and were differentiated as damp-heat accumulation syndrome of traditional Chinese medicine(TCM) were randomly divided into treatment group, control group and blank group, with 30 patients in each group. The blank group was treated with etoricoxib only, the control group was treated with etoricoxib combined with ampelopsis hydrogel, and the treatment group was treated with etoricoxib combined with external application of ampelopsis hydrogel. The clinical efficacy, time to symptom improvement, safety, comfort, changes in syndrome scores of TCM, serum inflammatory factors[C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), erythrocyte sedimentation rate (ESR)], NF-κB signaling pathway-related proteins, Visual Analogue Scale (VAS) scores for pain, and joint mobility were compared among the three groups before and after treatment. Results The total effective rates in the treatment group and control group were 93.33% and 90.00%, respectively, which were higher than 70.00% in the blank group (P < 0.05). The time for improvement of pain, redness, tenderness, and limited joint mobility in the treatment group was shorter than that in the control group and blank group (P < 0.05). After 7 days of treatment, the TCM syndrome score in the treatment group was lower than that in the control group and blank group, and the levels of serum CRP, TNF-α, and ESR and the expressions of NF-κB signalingpathway-related proteins P50 and P65 in the treatment group and control group were lower than those in the blank group (P < 0.05). After 7 days of treatment, the VAS score in the treatment group was lower than that in the control group and blank group, and the comfort score in the treatment group was higher than that in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P>0.05). Conclusion The effect of ampelopsis hydrogel in treating gouty arthritis is better than that of ampelopsis paste, and its mechanism may be related to the regulation of the NF-κB pathway and inhibition of inflammatory factor expression. The hydrogel is easy to use, hygienic, and comfortable, and is expected to become a safe, effective, and convenient external medicine for gouty arthritis.

Objective:To evaluate the efficacy and safety of eltrombopag standard therapy in the treatment of patients with connective tissue disease (CTD) associated with thrombocytopenia who were non-responder to recombinant human thrombopoietin (rhTPO) or relapsed after discontinuation of rhTPO.Methods:Retrospectively analysis of clinical data of 4 cases presented with CTD associated with thrombocytopenia who were non-responder to rhTPO or relapsed after discontinuation of rhTPO, and then treated with eltrombopag from November 2017 to June 2022. The literature were reviewed on eltrombopag in the treatment of CTD associated with thrombocytopenia.Results:The platelet count of 4 patients increased to more than 30×10 9/L after 2 weeks administration of eltrombopag. The median time was 32 (14, 41) days for platelet counts returning to normal level. The dosage of eltrombopag was gradually reduced to maintain normal platelet count, which was helpful for tapering of glucocorticoid and other immunosuppressant. No adverse event was observed during the treatment. Conclusion:Eltrombopag is safe and effective for CTD associated with thrombocytopenia, for patients who are non-responders to rhTPO or relapsed after discontinuation of rhTPO treatment in particular.

Hepatocellular carcinoma is a malignant tumor with a high incidence and morta-lity, which adversely affects the life quality of patients. For hepatocellular carcinoma, surgical trea-tment is advocated to stop the proliferation and metastasis of tumor cells by removing the diseased tissue and prolong the survival time. At the same time, the combination of scientific nursing services during surgery can ensure the smooth completion of surgery, reduce the occurrence of complica-tions, and promote early recovery of patients. The authors review the application and progress of dual-linked collaborative care model in patients undergoing liver cancer surgery, with the aim of providing reference for clinical research on the nursing plan for patients undergoing liver cancer surgery.

Objective:To understand the views and suggestions of medical staff on the key nursing techniques and norms of in-hospital treatment of patients with nuclear exposure, so as to provide reference for the continuous optimization of follow-up processes.Methods:From September to October 2021,purpose sampling was adopted to select doctors and nurses who engaged in medical emergency rescue of nuclear exposure-related work in two divisions of the Nuclear Accident Medical Emergency Center of the National Health Commission as the research subjects, using a combination of online and offline methods to carry out semi-structured interviews with 6 research subjects,using content analysis methods in descriptive research for data analysis.Results:A total of four themes were refined including the need for the establishment of nursing technology and process specification for nuclear accident emergency rescue specialty; the need for specialized training of nursing technology in nuclear accident emergency rescue; the need for the construction of specialized nursing team for nuclear accident emergency rescue; the need to strengthen the closeness of multi-team cooperation.Conclusions:The current in-hospital care technology and processes for nuclear exposed patients need to be further refined and standardized, and in the future, we need to establish a perfect in-hospital care technology and processes for nuclear exposed patients, and according to the corresponding technology and processes, strengthen nursing staff professional training and simulation training in nuclear accident emergency rescue, and establish a nuclear emergency rescue professional nursing team to promote the development of nuclear accident emergency rescue nursing specialists.