急性脑梗死患者外周血中性粒细胞/淋巴细胞比值与颈动脉易损斑块的关系

目的探讨急性脑梗死(ACI)外周血中性粒细胞/淋巴细胞比值(NLR)与颈动脉易损斑块的关系。方法选取2016年9月—2018年1月于哈尔滨医科大学附属第一医院卒中病房住院的ACI患者271例。根据颈动脉超声检查分为无斑块组及有斑块组,其中有斑块组分为稳定斑块组及易损斑块组,比较各组一般资料,中性粒细胞计数、淋巴细胞计数、NLR值的差异。结果斑块组吸烟史、NLR、中性粒细胞计数高于无斑块组,淋巴细胞的计数低于无斑块组(P<0.05)。易损斑块组NLR、中性粒细胞计数及低密度脂蛋白高于稳斑块组,而淋巴细胞的计数低于稳定斑块组(P<0.05)。NLR、低密度脂蛋白是颈动脉易损斑块的独立影响因素(P<0.05),NLR值每增加1个单位,斑块为易损斑块的可能性是原来的1.400(95%CI:1.124,1.744)倍,低密度脂蛋白每增加1个单位,斑块为易损斑块的可能性是原来的2.867(95%CI:1.238,6.640)倍。NLR对ACI患者颈动脉易损斑块的ROC曲线下面积为0.65(95%CI:0.567,0.728),最佳截断点为2.79,此时的敏感性为0.69(95%CI:0.593,0.777),特异性为0.59(95%CI:0.465,0.684)。结论NLR增高对于评估ACI患者颈动脉粥样硬化易损斑块具有一定的参考价值。

Hydrogen sulfide-induced enhancement of gastric fundus smooth muscle tone is mediated by voltagedependent potassium and calcium channels in mice

AIM:To investigate the effect of hydrogen sulfide(H2S)on smooth muscle motility in the gastric fundus.METHODS:The expression of cystathionineβ-synthase(CBS)and cystathionineγ-lyase(CSE)in cultured smooth muscle cells from the gastric fundus was examined by the immunocytochemistry technique.The tension of the gastric fundus smooth muscle was recorded by an isometric force transducer under the condition of isometric contraction with each end of the smooth muscle strip tied with a silk thread.Intracellular recording was used to identify whether hydrogen sulfide affects the resting membrane potential of the gastric fundus in vitro.Cells were freshly separated from the gastric fundus of mice using a variety of enzyme digestion methods and whole-cell patch-clamp technique was used to find the effects of hydrogen sulfide on voltage-dependent potassium channel and calcium channel.Calcium imaging with fura-3AM loading was used to investigate the mechanism by which hydrogen sulfide regulates gastric fundus motility in cultured smooth muscle cells.RESULTS:We found that both CBS and CSE were expressed in the cul tured smooth muscle cel ls from the gastric fundus and that H2S increased the smooth muscle tension of the gastric fundus in mice at low concentrations.In addition,nicardipine and aminooxyacetic acid(AOAA),a CBS inhibitor,reduced the tension,whereas Nω-nitro-L-arginine methyl ester,a nonspecific nitric oxide synthase,increased the tension.The AOAA-induced relaxation was significantly recovered by H2S,and the Na HS-induced increase in tonic contraction was blocked by 5 mmol/L4-aminopyridine and 1μmol/L nicardipine.Na HS significantly depolarized the membrane potential and inhibited the voltage-dependent potassium currents.Moreover,Na HS increased L-type Ca2+currents and caused an elevation in intracellular calcium([Ca2+]i).CONCLUSION:These findings suggest that H2S may be an excitatory modulator in the gastric fundus in mice.The excitatory effect is mediated by voltagedependent potassium and L-type calcium channels.

A paradox:Insulin inhibits expression and secretion of resistin which induces insulin resistance

AIM: To confirm whether insulin regulates resistinexpression and secretion during differentiation of 3T3-L1preadipocytes and the relationship of resistin with insulinresistance both in vivo and in vitro.METHODS: Supernatant resistin was measured duringdifferentiation of 3T3-L1 preadipocytes. L6 rat myoblastsand hepatoma cell line H4IIE were used to confirm thecellular function of resistin. Diet-induced obese ratswere used as an insulin resistance model to study therelationship of resistin with insulin resistance.RESULTS: Resistin expression and secretion wereenhanced during differentiation 3T3-L1 preadipocytes.This cellular differentiation stimulated resistin expressionand secretion, but was suppressed by insulin. Resistinalso induced insulin resistance in H4IIE hepatocytes andL6 myoblasts. In diet-induced obese rats, serum resistinlevels were negatively correlated with insulin sensitivity,but not with serum insulin.CONCLUSION: Insulin can inhibit resistin expressionand secretion in vitro, but insulin is not a major regulatorof resistin in vivo . Fat tissue mass affects insulinsensitivity by altering the expression and secretion ofresistin.

Effectiveness of the flipped classroom on the development of self-directed learning in nursing education:a meta-analysis

Objectives: To examine the best practice evidence of the effectiveness of the flipped classroom（FC） as a burgeoning teaching model on the development of self-directed learning in nursing education.Data sources: The relevant randomized controlled trial（RCT） and non-RCT comparative studies were searched from multiple electronic databases including PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature（CINAHL）, Cochrane Central Register of Controlled Trials（CENTRAL）, Wanfang Data, China National Knowledge Infrastructure（CNKI）, and Chinese Science and Technology Periodical Database（VIP） from inception to June 2017.Review methods: The data were independently assessed and extracted for eligibility by two reviewers. The quality of included studies was assessed by another two reviewers using a standardized form and evaluated by using the Cochrane Collaboration’s risk of bias tool. The self-directed learning scores（continuous outcomes） were analyzed by using the 95% confidence intervals（Cls） with the standard deviation average（SMD） or weighted mean difference（WMD）. The heterogeneity was assessed using Cochran’s I;statistic.Results: A total of 12 studies, which encompassed 1440 nursing students（intervention group = 685, control group = 755）, were eligible for inclusion in this review. Of 12 included studies, the quality level of one included study was A and of the others was B. The pooled effect size showed that compared with traditional teaching models, the FC could improve nursing students’ selfdirected learning skill, as measured by the Self-Directed Learning Readiness Scale（SDLRS）, Self-Directed Learning Readiness Scale for Nursing Education（SDLRSNE）, Self-Regulated Learning Scale（SRL）, Autonomous Learning Competencies scale（ALC）, and Competencies of Autonomous Learning of Nursing Students（CALNS）. Overall scores and subgroup analyses with the SRL were all in favor of the FC.Conclusions: The result of this meta-analysis indicated that FCs could improve the effect of self-directed learning in nursing education.Future studies with more RCTs using the same measurement tools are needed to draw more authoritative conclusions.

Gastric nNOS reduction accompanied by natriuretic peptides signaling pathway upregulation in diabetic mice

AIM: To investigate the relationship between neuronal nitric oxide synthase (nNOS) expression and the natriuretic peptide signaling pathway in the gastric fundus of streptozotocin (STZ)-induced diabetic mice.

Construction of a Talent Cultivation Mode for Traditional Chinese Medicine Nursing Inheritance

Objective:To explore and build traditional Chinese medicine(TCM)nursing inheritance on the talent training scheme,the foundation for cultivating outstanding talents of TCM nursing inheritance.Methods:The modified Delphi method was used for conducting two rounds of consultation with 15 TCM nursing experts to formulate training plan.Results:The questionnaire recovery rates of two rounds of expert enquiry were 100.00%,with high experts enthusiasm,experts coefficients were 0.83 and 0.81,respectively.Kendall coordination coefficient were 0.26 and 0.30,respectively(P<0.01).After two rounds of expert consultation,the TCM nursing inheritance talent training scheme was finally formed,including 3 first-level indicators,7 second-level indicators and 24 third-level indicators.Conclusion:Construction of talent cultivating program of TCM nursing inheritance is scientific and feasible,with a certain reference value.

Prevalence of frailty among nursing home residents in China:a systematic review and meta-analysis

Background:The prevalence of frailty among nursing home residents is high.However,in China,prevalence of frailty keeps unknown in this population.The purpose of this meta-analysis is to assess the prevalence of frailty and prefrailty and find out the factors related to the prevalence of frailty among nursing home residents in China.Methods:We searched both English(PubMed,Cochrane Library,Embase,Web of Science and Scopus)and Chinese(CNKI,WanFang,SinoMed,and VIP)databases from their inception date until 15 September 2020.Two reviewers independently screened literature,extracted data,and evaluated the risk of bias included studies.Stata12.0 software was used to conduct meta-analysis.Results:A total of 16 studies were included in this review,involving 7,777 nursing home residents.The prevalence of frailty ranged from 29.2% to 66.6% in the included studies.The pooled prevalence of frailty and prefrailty were 49%(95%CI:43-55%)and 42%(95%CI:34–50%),respectively.The assessment tool(P<0.001),gender(P<0.001),self-rated health(P<0.001)and type of institution(P<0.001)were significantly associated with the prevalence of frailty among nursing home residents in China.Conclusions:The prevalence of frailty among nursing home residents in China was relatively high.Considering the adverse health outcomes of frailty,nursing home administrators should screen frailty regularly,identify the risk factors of frailty,take actions accordingly and improve the frailty status for older adults.

Impact of self-directed learning readiness and learning attitude on problem-solving ability among Chinese undergraduate nursing students

Objective: To explore the effects of self-directed learning readiness and learning attitude on problem-solving ability among Chinese undergraduate nursing students. Methods: A convenience sampling of 460 undergraduate nursing students was surveyed in Tianjin, China. Students who participated in the study completed a questionnaire that included social demographic questionnaire, Self-directed Learning Readiness Scale, Attitude to Learning Scale, and Social Problem-Solving Inventory. Pearson’s correlation analysis was performed to test the correlations among problem-solving ability, self-directed learning readiness, and learning attitude. Hierarchical linear regression analyses were performed to explore the mediating role of learning attitude. Results: The results showed that learning attitude (r=0.338, P<0.01) and self-directed learning readiness (r=0.493, P<0.01) were positively correlated with problem-solving ability. Learning attitude played a partial intermediary role between self-directed learning readiness and problem-solving ability (F=74.227, P<0.01). Conclusions: It is concluded that nursing educators should pay attention on students’ individual differences and take proper actions to inspire students’ self-directed learning readiness and learning attitude.

Effect of Same-dose Single or Dual Field Irradiation on Damage to Miniature Pig Parotid Glands

Aim To evaluate the effect of single or dual field irra- diation （IR） with the same dose on damage to miniature pig parotid glands. Methodology Sixteen miniature pigs were divided into two IR groups （n=6） and a control group （n=4）. The irradi- ation groups were subjected to 20 Gy X-radiation to one parotid gland using single-field or dual-field modality by linear accelerator. The dose-volume distributions between two IR groups were compared. Saliva from parotid glands and blood were collected at 0, 4, 8 and 16 weeks after irradiation. Parotid glands were removed at 16 weeks to evaluate tissue morphology.Results The irradiation dose volume distributions were significantly different between single and dual field irradi- ation groups （t----4.177, P=0.002）, although dose volume histogramin （DVH） indicated the equal maximal dose in parotid glands. Saliva flow rates from IR side decreased dramatically at all time points in IR groups, especially in dual field irradiation group. The radiation caused changes of white blood cell count in blood, lactate dehydrogenase and amylase in serum, calcium, potassium and amylase in saliva. Morphologically, more severe radiation damage was found in irradiated parotid glands from dual field irradi- ation group than that from single field irradiation group. Conclusion Data from this large animal model demons- trated that the radiation damage from the dual field irradiation was more severe than that of the single field irradiation at the same dose, suggesting that dose-volume distribution is an important factor in evaluation of the radiobiology of parotid glands.

Role of academic self-efficacy in the relationship between self-directed learning readiness and problem-solving ability among nursing students

Objective: Problem-solving should be a fundamental component of nursing education because It is a core ability for professional nurses. For more effective learning, nursing students must understand the relationship between self-directed learning readiness and problem-solving ability. The aim of this study was to investigate the relationships among self-directed learning readiness, problemsolving ability, and academic self-efficacy among undergraduate nursing students.Methods: From November to December 2016, research was conducted among 500 nursing undergraduate students in Tianjin, China,using a self-directed learning readiness scale, an academic self-efficacy scale, a questionnaire related to problem-solving, and selfdesigned demographics. The response rate was 85.8%.Results: For Chinese nursing students, self-directed learning readiness and academic self-efficacy reached a medium-to-high level,while problem-solving abilities were at a low level. There were significant positive correlations among the students' self-directed learning readiness, academic self-efficacy, and problem-solving ability. Furthermore, academic self-efficacy demonstrated a mediating effect on the relationship between the students' self-directed learning readiness and problem-solving ability.Conclusions: To enhance students' problem-solving ability, nursing educators should pay more attention to the positive impact of self-directed learning readiness and self-efficacy in nursing students' education.

One-decoy state reference-frame-independent quantum key distribution

Reference-frame-independent quantum key distribution(RFI-QKD)has been proven to be very useful and practical under realistic environment.Here,we present a scheme for one-decoy state RFI-QKD based on the work of Rusca et al.[Appl.Phys.Lett.112,171104(2018)],and carry out investigation on its performance under realistic experimental conditions.Numerical simulation results show that the one-decoy state RFI-QKD can achieve comparable performance in terms of secret key rate and transmission distance as the two-decoy state correspondence under practical experimental conditions.On contrast,it does not need to prepare the vacuum state in the former case,substantially reducing the experimental complexity and random number consumptions.Therefore,our present proposal seems very promising in practical implementations of RFI-QKD.

The prevalence of depression among the empty-nest elderly in China:a meta-analysis of cross-sectional studies

Empty-nest elderly are those who have no children or whose children are away from home,and they have to live alone or with their spouses.The prevalence of depression in the elderly is worrying,especially in the empty-nest elderly.This study aimed to examine the prevalence of depression among the empty-nest elderly in China and explore the factors that influence depression among the empty-nest elderly.Methods:We searched both international(PubMed,Cochrane Library,Embase,and Web of Science)and Chinese(CNKI,WanFang,SinoMed,and VIP)databases from their inception date until 12 April,2020,and collected cross-sectional studies on the prevalence of depression among the empty-nest elderly in China.Two reviewers independently screened the literature,extracted the data,and evaluated the risk of bias included in the study.Meta-analysis was performed using Stata12.0 software.Results:Twenty-seven cross-sectional studies were included in the meta-analysis.The pooled prevalence of depression among the empty-nest elderly in China was 41%(95%CI:32%–50%).Subgroup analysis revealed that the Geriatric Depression Scale versions,sampling methods,living areas,gender,age,chronic diseases,and living arrangements were associated with the prevalence of depression among the empty-nest elderly in China.Conclusions:The prevalence of depression among the empty-nest elderly in China was relatively high.Researchers could explore more reasons for the differences in the prevalence of depression among the empty-nest elderly from multiple perspectives in the future.Relevant departments should identify and routinely evaluate the negative emotions of the empty-nest elderly.Meanwhile,community nurses should care for the emotional needs of the empty-nest elderly,carry out targeted mental health education,and promote the realization of healthy aging.

Research status and influencing factors of nurse bullying in the workplace:A literature review

This paper aims to review the status quo of nurse bullying,explore the factors affecting nurse bullying and provide references for the formation of targeted intervention measures,so as to promote nurses'occupational health and the development of nursing career.Through sorting out and summarizing,the current research on nurse bullying can be summarized into conceptual analysis,current situation investigation,qualitative research and intervention research,among which the current situation investigation is the main one.The factors influencing nurses'bullying can be divided into individual,organizational and social factors.We propose future research should be conducted on multiple levels in combination with the actual situation of each country,and psychological,ethical and other disciplines should be integrated to curb bullying at the source according to the influencing factors.

Development of a frailty scale for elderly people in China

Objective：The aim of this study was to develop a frailty scale for the elderly in China and to examine its reliability and validity.Methods：The method of convenient sampling was used to select 375 elderly individuals in different communities of Tianjin,China.EuroQpl-5D was used to evaluate the criterion validity.Cronbach＇s αcoefficients,correlation analysis,exploratory factor analysis,criterion-related validity,and internal consistency were used to evaluate the reliability and validity of the scale.To evaluate the test—retest reliability,30 old people were re-evaluated after 2 weeks.Results：The final version of the frailty scale（FI-35） consisted of 35 items.Eleven factors were extracted by a principal factor analysis and varimax rotation,with a cumulative contribution of 86.00%.Eleven dimensions were positively correlated（r = 0.130-0.541,P 〈 0.01）.Cronbach＇s α coefficient was 0.952,and the alpha coefficients of 11 dimensions ranged from 0.730 to 0.992.The test-retest reliability was0.874 for the total scale.The split-half reliability of the scale was 0.808.Structural equation modeling was used to perform a confirmatory factor analysis,and various parameters were all acceptable.Conclusions：FI-35 met the requirement of scale development and showed good reliability and validity;thus,it can be used as an efficient frailty measurement tool for Chinese elderly.

Analysis of the one-decoy-state SARG04 quantum cryptography protocol in the presence of afterpulse effects

The SARG04 quantum key distribution protocol can offer greater robustness against photon number splitting attacks than the BB84 protocol that is implemented with weak pulses.In this paper,we propose a tight key analysis for the SARG04 protocol,by considering the one-decoy method and investigating its performance under the influence of a detector afterpulse.Our results demonstrate that an increase in block size leads to a slight increase in both the secure key rate and the maximum transmission distance.Importantly,the detector afterpulse plays a crucial role in practical applications and has a more pronounced effect on the SARG04 protocol compared to the BB84 protocol.

Security of quantum key distribution with virtual mutually unbiased bases

In a perfect quantum key distribution(QKD)protocol,quantum states should be prepared and measured with mutually unbiased bases(MUBs).However,in a practical QKD system,quantum states are generally prepared and measured with imperfect MUBs using imperfect devices,possibly reducing the secret key rate and transmission distance.To analyze the security of a QKD system with imperfect MUBs,we propose virtual MUBs to characterize the quantum channel against collective attack,and analyze the corresponding secret key rate under imperfect state preparation and measurement conditions.More generally,we apply the advantage distillation method for analyzing the security of QKD with imperfect MUBs,where the error tolerance and transmission distance can be sharply improved.Our analysis method can be applied to benchmark and standardize a practical QKD system,elucidating the security analysis of different QKD protocols with imperfect devices.

Delayed error verification in quantum key distribution

Quantum key distribution(QKD)provides an unconditional secure key generation method between two distant legitimate parties Alice and Bob based on the fundamental properties of quantum mechanics,in the presence of an eavesdropper Eve.Since key reconciliation cannot always assure that the reconciled keys between Alice and Bob are identical,error verification is an important step in QKD.In this paper,we propose a scheme of delayed error verification using extra keys gained by privacy amplification with an arbitrarily small failure probability.The proposed scheme simplifies the post-processing procedure in QKD,which can be applied in practical QKD systems.

Practical Reference-Frame-Independent Measurement-Device-Independent Quantum Key Distribution Systems Against the Worst Relative Rotation of Reference Frames

Reference-frame-independent measurement-device-independent QKD(RFI-MDI-QKD), immune to both the slow unknown drift of reference frames and detector side channel attacks, can generate information-theoretic secure keys. Despite its natural resistance to the slow drift of reference frames, the performance of practical RFI-MDI-QKD systems descends with the increasing drift of reference frames. In this paper, we demonstrate the worst relative rotation of reference frames for practical RFI-MDI-QKD systems, and investigate their performance against the worst-case scenario,both of which are unclear to date. Simulation results show that, practical RFI-MDI-QKD systems can achieve quite good performance even against the worst-case scenario, which clearly demonstrates that it is possible to implement practical MDI-QKD systems with freely drifting reference frames.

Improving the Performance of Practical Decoy-State Measurement-Device-Independent Quantum Key Distribution with Biased Basis Choice

Statistical fluctuations are unavoidable in realistic quantum key distribution (QKD) due to finite-size effect. Based on the four-intensity proposal on measurement-device-independent QKD (MDI-QKD) in [Phys. Rev. A93 (2016) 042324], we particularly analyze the scenario that only three intensities are used, namely a three-intensity decoy-state MDI-QKD with biased basis choice. After performing full parameter optimization method, simulations results demonstrate that this scenario can obtain distinct enhancement compared with the conventional unbiased threeintensity decoy-state method, e.g. Xu et al.’s [Phys. Rev. A 89 (2014) 052333]. Furthermore, results also show that it works more efficiently by using HSPS than using WCS at longer transmission distance.