Search

The explosive growth of medical data has dramatically increased the demand for computing power, resulting in insufficient spectrum resources and communication overload. Hospitals need to invest much money to expand computing resources. Various diseases require varying degrees of multi-sensor and continuous monitoring. Take venous thromboembolism (VTE) patients in the intensive care unit (ICU) as an example, enlargement of the right heart, widening of the pulmonary artery, and abnormal results of myocardial enzyme examination maybe lead to sudden death within a short time in the ICU inpatient ward. Steady and dynamic health monitoring is essential. Patients’ immediate risk perception can significantly improve medical efficiency and reduce adverse consequences. How to provide a more efficient and secure full-time monitoring scheme, dynamically adjust the workload, and allocate computing tasks and requests reasonably is a practical problem to be solved urgently. First, this paper defines a task similarity to measure the similarity between different task packages and determine the priority of tasks to avoid forwarding highly similar task packages and reduce energy consumption. Second, the edge gateway caching mechanism with a self-attention mechanism is constructed, which changes the centralized scheduling mode of traditional cloud computing, devolves the coordination function to the edge, and divides the network into multiple local sub-networks. The central node of the sub-network determines the scheduling scheme. The experimental results show that the system can ensure the quality of service and use the edge’s limited computing resources, effectively shield the inefficient data transmission requirements, reduce the use cost and medical quality, and has a specific theoretical and practical value.

Background: The knowledge about the effect of different prostate biopsy approaches on the prostate cancer detection rate (CDR) for patients with gray-zone PSA is limited. We aimed to compare CDR in different biopsy approaches for patients with rising prostate-specific antigen (PSA) levels in the gray zone. Methods: In this retrospective study, we identified 228 patients receiving transrectal prostate biopsy (TRB) compared with 216 receiving transperineal prostate biopsy (TPB) between 2016 and 2022. We also identified 110 patients receiving additional targeted biopsies following the systematic TPB. Clinical parameters were recorded, including age, PSA derivates, prostate volume (PV), and needle cores. Data was fitted into a propensity score matching (PSM), adjusting for potential confounders. Results: TPB outperformed TRB in CDR (49.6% vs. 28.3%, P = 0.001). The clinically significant prostate cancer (CSPCa) detection rate showed no significant difference between TPB and TRB (78.6% vs. 68.8%, P = 0.306). In stratified analysis, TPB outperformed TRB in CDR when the age of patients was 65-75 years (59.0 % vs. 22.0%, P < 0.001), when PV was 25-50ml (63.2% vs. 28.3%, P < 0.001), and when needle cores were no more than 12 (58.5% vs. 31.4%, P = 0.005). The CDR (P = 0.712) and the detection rate of CSPCa (P = 0.993) showed no significant difference among systematic, targeted, and combined biopsies. Conclusion: TPB outperformed TRB in CDR for patients with gray-zone PSA. However, targeted biopsy added no additional benefits following systematic TPB.

Entosis was proposed to promote aneuploidy and genome instability by cell-in-cell mediated engulfment in tumor cells. We reported here, in epithelial cells, that entosis coupled with mitotic arrest functions to counteract genome instability by targeting aneuploid mitotic progenies for engulfment and elimination. We found that the formation of cell-in-cell structures associated with prolonged mitosis, which was sufficient to induce entosis. This process was controlled by the tumor suppressor p53 (wild-type) that upregulates Rnd3 expression in response to DNA damages associated with prolonged metaphase. Rnd3-compartmentalized RhoA activities accumulated during prolonged metaphase to drive cell-in-cell formation. Remarkably, this prolonged mitosis-induced entosis selectively targets non-diploid progenies for internalization, blockade of which increased aneuploidy. Thus, our work uncovered a heretofore unrecognized mechanism of mitotic surveillance for entosis, which eliminates newly born abnormal daughter cells in a p53-dependent way, implicating in the maintenance of genome integrity.

Objective: To assess the occupational injuries and psychological support received by nurses and to investigate the relationship between the two. Method: This was a nation-wide cross-sectional study of nurses working across 1858 hospitals in China. Data were collected using an online structured, self-administered questionnaire between 2016 and 2017. Results: Nearly half of respondents had experienced aggressive behavior from patients or their attendants; 13.4% respondents had experienced aggressive behavior on more than three occasions. 78.96% respondents had experienced needle-stick injuries and 51.22% had experienced psychological trauma. 20.5% respondents believed that hospitals do not pay any attention to occupational safety. 86.1% respondents expressed the need for little or moderate psychological support. Nurses who had experienced aggressive behavior expressed a greater need for psychological support. Nurses working at hospitals that adequately addressed the occupational safety issues expressed the lowest need for psychological support. Conclusion: We found a high prevalence of psychological stress and occupational injuries among nurses. Nursing managers need to address this issue and implement interventions to prevent and reduce injuries. RESUMO Objetivo: Avaliar os acidentes de trabalho e o apoio psicológico recebido pelos enfermeiros e investigar a relação entre os dois. Método: Este foi um estudo transversal nacional de enfermeiras que trabalham em 1858 hospitais na China. Os dados foram coletados por meio de um questionário online estruturado e autoaplicável entre 2016 e 2017. Resultados: Quase metade dos entrevistados experimentou comportamento agressivo por parte dos pacientes ou de seus acompanhantes; 13,4% dos entrevistados experimentaram comportamento agressivo em mais de três ocasiões. 78,96% dos entrevistados sofreram ferimentos com agulhas e 51,22% sofreram traumas psicológicos. 20,5% dos entrevistados acreditam que os hospitais não dão atenção à segurança do trabalho. 86,1% dos entrevistados expressaram a necessidade de pouco ou moderado apoio psicológico. Enfermeiros que vivenciaram comportamento agressivo expressaram maior necessidade de apoio psicológico. Os enfermeiros que trabalham em hospitais que abordam de forma adequada as questões de segurança do trabalho expressam a menor necessidade de apoio psicológico. Conclusão: Encontramos alta prevalência de estresse psicológico e lesões ocupacionais entre os enfermeiros. Os gerentes de enfermagem precisam abordar essa questão e implementar intervenções para prevenir e reduzir lesões. RESUMEN Objetivo: Evaluar las lesiones ocupacionales y el apoyo psicológico que reciben las enfermeras e investigar la relación entre ambos. Método: Este fue un estudio transversal a nivel nacional de enfermeras que trabajaban en 1858 hospitales en China. Los datos se recopilaron mediante un cuestionario autoadministrado estructurado en línea entre 2016 y 2017. Resultados: Casi la mitad de los encuestados había experimentado un comportamiento agresivo por parte de los pacientes o sus asistentes; El 13,4% de los encuestados había experimentado un comportamiento agresivo en más de tres ocasiones. El 78,96% de los encuestados había experimentado lesiones por pinchazos de aguja y el 51,22% había experimentado un trauma psicológico. El 20,5% de los encuestados cree que los hospitales no prestan atención a la seguridad laboral. El 86,1% de los encuestados expresó la necesidad de un apoyo psicológico escaso o moderado. Las enfermeras que habían experimentado un comportamiento agresivo expresaron una mayor necesidad de apoyo psicológico. Las enfermeras que trabajan en hospitales que abordaron adecuadamente los problemas de seguridad ocupacional expresaron la menor necesidad de apoyo psicológico. Conclusión: Encontramos una alta prevalencia de estrés psicológico y lesiones ocupacionales entre enfermeras. Los gerentes de enfermería deben abordar este problema e implementar intervenciones para prevenir y reducir las lesiones.

Aim This study aimed to assess the overall status of burnout in nurses in China on a national scale and investigate the demographic characteristics related to burnout and the relationships between demographics, job satisfaction and burnout. Methods This was a national cross-sectional study conducted by the Chinese Nursing Association between July 2016 and July 2017. Data were collected using a structured, self-administered questionnaire. Results A total of 51 406 registered nurses in 311 Chinese cities completed the questionnaire. Fifty per cent of the participants suffered burnout, and 33.8% of nurses had high scores on emotional exhaustion, 66.6% had high scores on depersonalization and 93.5% had low scores on personal accomplishment; 16.2% reported a high level of job satisfaction, only 0.4% was satisfied with their jobs and 70.7% intended to leave their jobs. Marital status, educational level, income and years of working experience affected job burnout. Nurses with a high level of burnout were more likely to have a high degree of job dissatisfaction and intend to leave their jobs. Conclusion We found a high prevalence of burnout among nurses in China. Nursing managers need to pay more attention to job burnout and its influencing factors. Interventions to reduce nurse burnout should be implemented.

Entosis was proposed to promote aneuploidy and genome instability by cell-in-cell mediated engulfment in tumor cells. We reported here, in epithelial cells, that entosis coupled with mitotic arrest functions to counteract genome instability by targeting aneuploid mitotic progenies for engulfment and elimination. We found that the formation of cell-in-cell structures associated with prolonged mitosis, which was sufficient to induce entosis. This process was controlled by the tumor suppressor p53 (wild type) that upregulates Rnd3 expression in response to DNA damages associated with prolonged metaphase. Rnd3 compartmentalized RhoA activities accumulated during prolonged metaphase to drive cell-in-cell formation. Remarkably, this prolongedmitosis-induced entosis(mintosis) selectively targets non-diploid progenies for internalization, blockade of which increased aneuploidy. Thus, our work uncovered a heretofore unrecognized mechanism of mitotic surveillance for entosis, which eliminates newly-born abnormal daughter cells in a p53-depedent way to maintain genome integrity.

Imaging-guided percutaneous microwave ablation (MWA) with high thermal efficiency comprises rapid, successful management of small renal cell carcinomas (RCCs) in selected patients. Ultrasound Committee of Chinese Medical Association, Interventional Oncology Committee of Chinese Research Hospital Association developed evidence-based guidelines for MWA of RCCs after systematically reviewing the 1969–2019 literature. Systematic reviews, meta-analyses, randomized controlled trials, cohort, and case–control studies reporting MWA of RCCs were included and levels of evidence assessed. Altogether, 146 articles were identified, of which 35 reported percutaneous MWA for T1a RCCs and 5 articles for T1b RCCs. Guidelines were established based on indications, techniques, safety, and effectiveness of MWA for RCCs, with the goal of standardizing imaging-guided percutaneous MWA treatment of RCCs.Key pointsMicrowave ablation is recommended for managing small renal cell carcinoma in selected patients.Imaging protocols are tailored based on the procedural plan, guidance, and evaluation.Patient’s selection evaluation, updated technique information, clinical efficacy, and complications are recommended to standardize management.A joint task force (multidisciplinary team) summarized the key elements of the standardized report. Microwave ablation is recommended for managing small renal cell carcinoma in selected patients. Imaging protocols are tailored based on the procedural plan, guidance, and evaluation. Patient’s selection evaluation, updated technique information, clinical efficacy, and complications are recommended to standardize management. A joint task force (multidisciplinary team) summarized the key elements of the standardized report.

We performed a systematic review and meta-analysis of heme oxygenase 1 gene (HO-1) promoter polymorphisms and susceptibility to coronary artery disease (CAD) based on eligible studies retrieved from electronic databases from 2002 to 2013. Eleven studies, involving 10,170 patients with CAD and 6,868 controls, were included. Overall, no significantly decreased risk of CAD was found in persons with the SS genotype of the HO-1 (GT)n repeat length polymorphism compared with those with the LL + SL genotype. However, decreased risks of CAD were observed in the Asian subgroup, the coronary-artery-narrowing ≥50% subgroup, the myocardial infarction subgroup, the age- and sex-matched subgroup, and the good-quality-reports subgroup. The primary heterogeneity in the studies came from age and sex matching and the extent of coronary stenosis. CAD risk was significantly decreased for persons with the AA genotype of the T(-413)A single-nucleotide polymorphism versus those with the TT genotype, but most of the studies showed that the allele distribution was inconsistent with Hardy-Weinberg equilibrium. In this meta-analysis, we found that the (GT)n SS genotype was associated with decreased risk of CAD after controlling for biases due to age and sex matching, extent of coronary stenosis, ethnicity, and study quality. The relationship between the T(-413)A single-nucleotide polymorphism and CAD should be interpreted more cautiously.

Morphine has been considered as an important medicine to treat acute heart failure (AHF) for a long time. This study was designed to explore the usage rate of morphine in emergency department and its influence on the prognosis of the elderly patients with AHF in china. A prospective investigation of elderly patients with AHF, who were treated and admitted from emergency room of the General Hospital of the People's Liberation Army (GHPLA) in China, were performed. The patients were divided into two groups: control group and morphine treatment group. The relationships between the usage of morphine and clinical factors such as demographic characters of patients and past history were analyzed. The effect of morphine on mechanical ventilation, hospitalization stay and the mortality of patients were also evaluated. The usage rate of morphine was 50% in the emergency room. The patients on the morphine treatment group were more likely to have past history of coronary heart disease, type 2 diabetes mellitus (T2DM) and stroke than those of the control group (p < 0.05). The patients on morphine treatment group had higher troponin-T values compared with those of the control group (p < 0.05). Morphine usage was not an independent risk factor of mortality (OR: 2.172, p: 0.187, 95% CI: 0.686 to 6.879). The Odd ratio of morphine usage for mechanical ventilation incidence was 3.01 (95%CI, 1.22 to 7.41). High prevalence of morphine usage was found in the elderly AHF patients from emergency room of GHPLA in China. Morphine is still a safe medicine in early treatment on the elderly patients with AHF with mechanical ventilation in China. Key words: Morphine, acute heart failure, mechanical ventilation, mortality.

To investigate the diagnostic value of TruScreen (TS) as a novel option for cervical lesions screening.A total of 218 cases were selected between 2013 December and 2014 November from outpatients of the Department of Gynecology, PLA General Hospital. Using histopathology as the gold standard for diagnosis, the diagnostic efficacy of TS was compared with that of high-risk human papillomavirus (Hr-HPV) test.(1) In 218 patients, there were 193 Hr-HPV positive cases accounting for 88.5%, 94 TS positive cases accounting for 43.1%. According to the histopathology, there were 112 cases of cervical intraepithelial neoplasia (CIN)1+, 71 cases of CIN2+, accounting for 51.4% and 32.6%, respectively. (2) The sensitivity of Hr-HPV was 98.2% and specificity was 21.7%. The sensitivity of TS was 51.8% and specificity 66.0%. (3) Sensitivity of TS for triaging cases of atypical squamous cells of undetermined signification (ASC-US) was 43.9%, specificity 65.7%, diagnostic accordance rate 53.9%. Those indexes for triaging cases of equivalent or more than atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H) were 56.3%, 66.2% and 61.3%. With regard to Hr-HPV test, those indexes for triaging cases of equivalent or more than ASC-H were 97.2%, 32.4% and 64.8%.Hr-HPV test shows higher sensitivity while TruScreen shows higher specificity for cervical lesions screening. More studies with larger sample size are still needed to evaluate which method is a better triage tool.

To explore the correlation of food intolerance and hyperlipidemia.A cross-sectional survey was conducted from August 2008 to June 2009. It recruited a total of 11 434 adults from Health Sciences Center at our hospital. Non-conditional Logistic regression model was utilized for determining odd ratio (OR) and 95% confidencer interval (CI). And statistic analysis was performed with SPSS 13.0.Among them 6 897 participants were food intolerance positive and 4 537 food intolerance negative. The prevalence of food intolerance was 60.32%. Age, gender, smoking, body mass index, total cholesterol, triglycerides and high density lipoprotein (HDL) cholesterol were significantly different between positive and negative ones (all P0.05). Multiple regression analysis showed that food intolerance was significantly correlated with age, gender, body mass index, but negatively with hyperlipidemia. Compared with age group ≤ 40 years, the OR (95%CI) of age groups 41-50, 51-60 and60 years were 1.125(1.021-1.238), 1.350(1.207-1.510) and 1.564(1.279-1.912) respectively. Compared with males, the OR (95%CI) of females was 1.528(1.382-1.689). Compared with normal weighters, the OR (95%CI) of low weighters was 1.720 (1.147-2.580). Compared with normal blood lipids, the OR (95%CI) of hyperlipidemia was 0.879 (0.810-0.955).Food intolerance may be negatively correlated with hyperlipidemia in healthcare population.

To explore the prevalence of food intolerance and its determinants in healthcare elderly in China.A cross sectional survey was carried out from August 1(st), 2008 to June 30(th), 2009, that including 736 60-year-olds from a Health Management Research Institute, Chinese PLA General Hospital. Data was double entried in computer and organized by EpiData 3.0. Non conditional logistic regression model was used for odd ratio (OR) and 95% CI, with the use of SPSS 13.0.The three leading foodstuff on intolerance were crab, egg and shrimp, with the prevalence rates as 35.9% , 28.8% and 15.1% respectively. Results from the multiple regression analysis showed that the crab intolerance was associated with Helicobacter pylori infections (P0.05). The OR(95%CI) of Helicobacter pylori infections (DOB≥4) was 1.544 (1.139-2.091).The three leading intolerance foods were egg, crab and shrimp. Crab intolerance was associated with Helicobacter pylori infections. To reduce the risk of crab intolerance, it was necessary to control the infection caused by Helicobacter pylori.

Atorvastatin, a hydroxymethylglutaryl-CoA reductase inhibitor, and endothelin-1 (ET-1) receptor antagonist have been separately indicated to ameliorate disease progression in atherosclerosis. However, no study has evaluated the effect of their combination on atherosclerosis. The objective of the current study was to evaluate the direct in vivo effects of a combination regimen of atorvastatin and ET-1 receptor antagonist on male New Zealand white rabbit models of atherosclerosis (injury-induced). Thirty-two atherosclerotic rabbits were divided into four experimental groups: (a) injury group - fed high-fat diet; (b) ET-1 receptor antagonist preventive group - fed high-fat diet, but with intragastric administration of the ET-1 receptor antagonist, darusentan; (c) combined preventive group - fed high-fat diet, but with intragastric administration of both darusentan and atorvastatin; and (d) treatment group - fed high-fat diet for the first 8 weeks, followed by normal diet and intragastric administration of both darusentan and atorvastatin up to 16 weeks. A further eight non-atherosclerotic rabbits were fed normal diet and classified as the control group. At the end of 8 and 16 weeks, compared with the injury group, the combined preventive group had significant reduction in both the concentration of serum lipids and inflammatory factors and atherosclerosis formation, indicative of a multifaceted anti-atherosclerotic impact. The relative area of atherosclerotic lesions in the injury group (30.84%) was significantly higher than the control group (4.62%; p < 0.05). The combined preventive group showed a significantly robust effect on lowering serum lipid, inflammatory cytokines, and maintained homeostatic balance of free radicals, and important downstream effectors like ET-1 and matrixmetalloproteinase-9. Our data show that atorvastatin and ET-1 receptor antagonist co-administration may decrease lipid levels, stabilize plaques and relieve vascular inflammation. By reducing the plaque burden, this regimen may minimize the risk of atherosclerotic plaque rupture or arterial occlusion.