The clinical value of time to positive of blood culture as indicator for neonatal sepsis / 中国新生儿科杂志

Objectives:To study the clinical significance of time to positive (TTP) of blood culture for neonatal sepsis.Methods:From August 2016 to June 2019, a retrospective study was conducted in patients with positive blood cultures admitted to the Neonatology Department of our hospital. The patients were assigned into different groups according to the species of pathogen, types of neonatal sepsis and the samples contaminated or not. TTP of different groups were analyzed.Results:A total of 307 cases with positive blood cultures were identified from 10 035 cases with blood culture specimens. Among the 307 cases, 162 were contaminated (the contaminated group) and 145 (1.4%) were diagnosed of neonatal sepsis (the pathogenic group). The proportion of TTP <24 h, 24~<48 h, 48~<72 h and ≥72 h in the 145 sepsis cases were 90.3% (131/145), 7.6% (11/145), 1.4% (2/145) and 0.7% (1/145), respectively. The median TTP was 9.0 h in early-onset sepsis (EOS) group and 11.5 h in late-onset sepsis (LOS) group. The median TTP of the contaminated group was 24.5 (19.9, 30.5)h, which was longer than 11.1 (8.1,16.2)h of the pathogenic group ( P<0.05). The median TTP of Gram (+) group was 14.0 (9.4,18.8)h, which was longer than 9.6 (7.5,11.3)h of Gram (-) group ( P<0.05). The median TTP of fungi group was 32.5 (25.5, 39.0) h, which was longer than 10.6 (8.1, 15.5)h of bacteria group ( P<0.05). Conclusions:Different pathogens has different TTP for neonatal sepsis. If blood culture maintains negative for more than 72 h, empiric use of antibiotics may be discontinued for patients of suspected sepsis without specific clinical manifestations or other lab results.

Investigation and analysis of HbA1c among voluntary blood donors in Hunan Province / 中国输血杂志

【Objective】 To understand the abnormalities of HbA1c in the blood donor population in order to improve blood quality and blood donor safety. 【Methods】 The qualified voluntary blood donors, from April 2021 to March 2022, were recruited from Yueyang Central Blood Station, Loudi Central Blood Station and Chenzhou Central Blood Station. The baseline data and HbA1c screening results of blood donors were collected for cross-sectional analysis. 【Results】 Among 1 397 eligible blood donors, 30.0% (419/1397) was in the prediabetes range (HbA1c 5.7%~6.4%) and 5.3% (74/1397) was in the diabetes range (HbA1c≥6.5%). Logistic regression analysis showed that age (OR=1.073, 95%CI: 1.058~1.088, P<0.05, BMI (OR=1.096, 95%CI: 1.060~1.133, P<0.05), gender (OR=2.392, 95%CI: 1.482~3.303, P<0.05, smoking (OR=2.216, 95%CI: 1.818~3.743, P<0.05), drinking (OR=3.615, 95%CI: 2.240~4.990, P<0.05), and education level (OR=0.077, 95%CI: 0.022~0.278, P<0.05) were the influencing factors of HbA1c in blood donors. 【Conclusion】 Among the blood donors in Hunan, 35.3% had abnormal HbA1c (diabetes and prediabetes). HbA1c screening of blood donors is helpful to improve the health management of blood donors, and may also help to improve the storage quality of red blood cells and reduce the occurrence of adverse reactions to blood transfusion in patients.

Study on the current situation of comprehensive medical and health medical services at primary medical institutions of a city / 中华医院管理杂志

Objective:To evaluate the current situation of comprehensive medical and health services of primary medical institutions in a city under the policy of family doctor contracted service, and explore the influencing factors and put forward improvement strategies, for the reference to improve the medical and health service level of primary medical institutions.Methods:In January 2021, 18 primary medical institutions in 3 counties(cities, districts) of a city in Shandong province were selected by stratified sampling method, and 60-70 contracted residents were selected from each institution for questionnaire survey. The questionnaire covered two dimensions: service provision(19 items) and metion frequency of health problems(12 items). According to the principle of information saturation, qualitative interviews were conducted with 20 family doctors and 15 contracted residents to identify the current service needs and existing problems. Descriptive analysis was used for all data, and single factor analysis of variance and multiple linear regression analysis were used for influencing factors of comprehensive service scores of primary medical institutions.Results:1 098 contracted residents were included in this study, and the comprehensive service score was 3.15±0.42. The vaccination, maternal health care and health education scored higher with 3.80±0.54, 3.70±0.64, 3.78±0.57 respectively; The dermatology, mental health counseling and family sickbed scored lower, with 2.27±1.20, 2.97±1.01 and 1.92±1.18 respectively. Contracted institution, gender, age and marital status were the influencing factors of comprehensive service scores( P<0.05). Residents′ needs for family sickbeds, psychological counseling and fall prevention had not been met. Conclusions:The primary medical institutions of the city had provided better basic public health services, while unmet needs were demand for home sickbeds, psychological counseling and fall prevention. We should take effective measures to increase the service supply based on the needs of residents, and provide more comprehensive medical and health services for residents at primary medical institutions.

Study on patient experiences of residents contracted with family doctor services in a city / 中华医院管理杂志

Objective:To evaluate and analyze the patient experience of residents contracted with primary medical institutions, for providing a basis for improving quality of contracted family doctor services.Methods:Using the Chinese version of the primary care assessment tools(PCAT), a household survey was conducted on 1 400 contracted residents in 9 community health service centers and 9 township health centers in a city from May to June 2020, and their medical experience in primary medical institutions was statistically analyzed. At the same time, interviews were conducted with institutional managers and family doctors. Descriptive statistics and one-way ANOVA were used for data analysis.Results:1 333 valid questionnaires were collected, and the effective recovery rate was 95.2%.The total PCAT scoring was 25.17. Seven dimensions of first contact, continuous, coordination, comprehensiveness, patient and family centered, community-oriented and cultural competence scored in average 3.57, 3.68, 3.54, 3.40, 3.72, 3.67 and 3.59 respectively.372 people(47.1%) had not been referred by the contracted institution before going to the superior hospital or specialized hospital. There were significant differences in the scores of four core dimensions in different types of institutions, age, education level, occupation and income( P<0.001). Conclusions:Given the initial progress of contracted family doctor services in the city, there is still room for improvement. It is suggested to further improve the comprehensiveness, coordinationand accessibility of services, and promote the high-quality development of contracted family doctor services.

Analysis on the current situation of medical preventive integration at primary medical institutions in a city / 中华医院管理杂志

Objective:To explore the current status of medical preventive integration at primary medical institutions, analyze the problems of medical prevention integration, and put forward optimization suggestions.Methods:From June to July 2020, 169 primary medical institutions in a city were selected as the survey objects to conduct a questionnaire survey on the basic information of institutions and the evaluation indicators of medical preventive integration. The evaluation index system of medical preventive integration was divided into a factual survey and a sensory survey. In addition, 32 relevant personnel were interviewed on the current situation of medical preventive integration at primary medical institutions. The reliability and validity of the data were tested and analyzed, while descriptive analysis and classification extraction analysis were carried out.Results:The reliability and validity analysis proved the data reliability. The factual survey extracted three common factors, namely organization management, performance appraisal distribution and information management. The sensory survey extracted two common factors, namely working mode and personnel training. In terms of organization, management and working methods, the degree of medical preventive integration was low. Among them, 53.8% of the institutions had formulated the medical preventive integration norms, and only 41.4% of them had shared residents′ health information in time.Conclusions:The degree of medical preventive integration of primary medical institutions in the city still need to be improved. In the future, we should strengthen the top-level design, establish the norms and cooperation mechanism of medical preventive integration, improve the awareness of medical preventive integration of medical personnel, improve the information level, and to build a new service model integrating disease prevention, medical treatment and health management.

Study on contract renewal willingness and influencing factors of contracted residents to family doctor service in Shandong Province / 中华医院管理杂志

Objective:To understand the willingness of contracted residents to renew the family doctor contract service in Shandong Province, and to explore its influencing factors.Methods:From July to August 2020, 1 500 contracted residents in 3cities of Shandong Province were investigated by questionnaire survey.Descriptive statistical analysis, Mann-Whitney U test and binary logistic regression model were used to analyze the contracted residents′ cognition, utilization, satisfaction evaluation and renewal intention of family doctor contract service. Results:1 445 valid questionnaires were obtained, of which 682(47.2%)were willing to renew their contracts.The results of binary logistic regression analysis showed that marital status, educational level, time to see a doctor in contracted institutions, optimism about the development prospect of contracted service policy, whether the proportion of medical insurance reimbursement increased after signing the contract, whether follow-up work was carried out on time, satisfaction with family doctor service attitude and satisfaction with the effect of disease treatment were factors affecting the willingness of contracted residents to renew the contract.Conclusions:The contracted residents in Shandong Province have a high willingness to renew their contracts. On the basis of consolidating and improving the policy cognition and confidence of the contracted residents, we should actively optimize and improve the contracted service quality, ensure the sense of service access of contracted residents, and continuously and effectively realize the comprehensive promotion of the contracted services of family doctors.

Research of Taurine in improving the differentiation of neural stem cells in fetal rats with intrauterine growth restriction / 中华实用儿科临床杂志

Objective To investigate the effect of Taurine on the differentiation of neural stem cells(NSCs)in fetal rats with intrauterine growth restriction( IUGR),and to explore the neuroprotective mechanism of Taurine. Methods IUGR fetal rats models were established with low protein diet. NSCs from subventricular zone( SVZ)were isolated and cultured in υitro. The NSCs were divided into 3 groups:normal control group,IUGR group,and IUGR+Taurine group. The cells were examined by adopting immunofluorescence for counting βⅢ-tubulin protein,glial fibril-lary acidic protein(GFAP)and myelin basic protein(MBP)-positive cells. Protein levels of βⅢ-tubulin and GFAP were detected by using Western blot. Results (1)The number of βⅢ-tubulin protein positive cells in normal control group,IUGR group and IUGR+Taurine group were(18. 50 ± 0. 64)%,(15. 61 ± 0. 76)% and(18. 42 ± 0. 82)%, respectively;the number of GFAP positive cells in normal control group,IUGR group and IUGR+Taurine group were (72. 19 ± 0. 82)%,(74. 87 ± 0. 67)% and(71. 68 ± 0. 92)%,respectively;and the differences were statistically sig-nificant(F＝49. 103,44. 643,all P<0. 01). Compared with the normal control group,βⅢ-tubulin protein positive cells in IUGR group decreased significantly(P<0. 01),but GFAP positive cells in IUGR group increased significantly (P<0. 01). Compared with IUGR Group,βⅢ-tubulin protein positive cells in IUGR+Taurine group increased sig-nificantly(P<0. 01),but GFAP positive cells in IUGR+Taurine group decreased significantly(P<0. 01). There was no significant difference between groupⅠand groupⅢ(all P>0. 05).(2)The levels of βⅢ-tubulin protein in nor- mal control group,IUGR group and IUGR+Taurine group were 0. 44 ± 0. 02,0. 33 ± 0. 03 and 0. 42 ± 0. 02,respective-ly;and the levels of GFAP protein in normal control group,IUGR group and IUGR+Taurine group were 1. 13 ± 0. 02, 1. 50 ± 0. 04,1. 21 ± 0. 01,respectively;and the differences were statistically significant(F＝45. 191,234. 525,all P<0. 01). Compared with normal control group,the levels of βⅢ-tubulin protein in IUGR group decreased significantly (P<0. 01),but the levels of GFAP in IUGR group increased significantly(P<0. 01). Compared with IUGR group, the levels of βⅢ-tubulin protein in IUGR+Taurine group increased significantly(P<0. 01),but the levels of GFAP in IUGR+Taurine group decreased significantly(P<0. 01). There was no significant difference between normal control group and IUGR+Taurine group(all P>0. 05). Conclusions Taurine can promote the differentiation of NSCs toward neurons in IUGR fetal rats,and maintain the normal proportion of all differentiated cells.

Therapeutic oligonucleotides: a review / 生物工程学报

Oligonucleotides are widely used as effective tools to regulate gene expression and drugs for targeted gene therapy. Therefore, they are potentially useful for the treatment of viral, tumor and hereditary diseases. Therapeutic oligonucleotides include antisense oligonucleotide, small interference RNA (siRNA), Ribozyme, DNAzyme, anti-gene, CpG, decoy and aptamer. Therapeutic oligonucleotides usually carry certain modifications, such as phosphorothioates, fluoro or locked nucleic acids, to enhance the stability and specificity, and reduce the side-effects, because natural oligonucleotides have poor stability in vivo, low specificity and side effects. Now oligonucleotides are usually manufactured by chemical synthesis, with low purity and high cost. Here, we review a novel thermocyclic reaction for the amplification of oligonucleotides, referred to as Polymerase-endonuclease Amplification Reaction (PEAR) catalyzed by two thermostable enzymes. PEAR is simple, efficient, and stable. Comparing with traditional chemical synthesis, PEAR-based enzymatic production of oligonucleotides could be a robust alternative method for the large-scale production of therapeutic or non-therapeutic oligonucleotides.

Screening, characterization and expression of microbial urate oxidase / 生物工程学报

Urate oxidase (Uox), an enzyme catalyzing oxidation of uric acid to allantoin, is widely used as diagnostic reagents and for treatments of uarthritis and hyperuricemia diseases. In our study, a higher Uox producer, bacterial strain OUC-1, was isolated from soil samples. The 16S rRNA gene sequence of strain OUC-1 showed 99% identity to the homologous fragments of Bacillus fastidiosus. After purification, Uox showed the optimal pH and temperature was 10.0 and 40 °C. The Km value of Uox was (0.15±0.04) mmol/L (n=5) with uric acid as the substrate. Uox activity was enhanced by Mg²⁺, and seriously inhibited by Zn²⁺ and SDS. Then the uox gene of B. fastidiosus OUC-1 was amplified and sequenced. The 3D structures of Uox, predicted with SWISS-MODEL, showed a homotetramer structure with a subunit molecular weight of 35.38 kDa. Finally, the gene coding for the B. fastidiosus Uox was successfully cloned and heterologously expressed in E. coli, which provides theoretical basis and technical support for improvement of Uox in the future.

Risk factors of acute bilirubin encephalopathy in neonates with severe hyperbilirubinemia / 中国新生儿科杂志

Objective To study the risk factors of acute bilirubin encephalopathy (ABE) in neonates with severe hyperbilirubinemia (total serum bilirubin ≥ 427.5 μmol/L).Method Clinical information of neonates with severe hyperbilirubinemia admitted to the Neonatal Department of Baoan Maternal and Child Health Hospital in Shenzhen from December 2013 to October 2017 were collected.The enrolled cases were grouped as ABE and the control group (without ABE).The risk factors for ABE were compared between the two groups and the Logistic regression analysis was used to evaluate the independent risk factor.Result A total of 104 neonates were recruited.There were 32 cases in the ABE group and 72 cases in the control group.The level of total serum bilirubin and indirect bilirubin,the ratio of total bilirubin/albumin,the incidence of glucose-6-phosphate dehydrogenase deficiency and metabolic acidosis and sepsis,the rate of using traditional Chinese medicine and the failure of treatment in other hospitals and non-resident population were all significantly higher in the ABE group than the control (P ＜ 0.05).Logistic regression analysis showed that total serum bilirubin (OR =1.013,95％ CI 1.007 ～ 1.020) and sepsis (OR =6.343,95％ CI 1.801 ～22.338) were the independent risk factors for ABE.Conclusion The severe hyperbilirubinemia infants,particularly with sepsis,are at higher risk of developing acute bilirubin encephalopathy.

Study on MICA/B gene polymorphism in northern Hunan Han population / 中华微生物学和免疫学杂志

Objective To study on the characterization of MICA/B genetic polymorphism in a northern Chinese Hunan Han population.Methods Ninty-five unrelated individuals were involved in this study and MICA/B genotypes were determined by two methods:PCR-sequence-specific primers (PCR-SSP) and PCR-sequence-based typing (PCR-SBT).Results In northern Hunan Han population,eleven MICA alleles were found,among which MICA * 010 (28.95％),MICA * 008 ∶ 01 (20.53％) and MICA * 002 ∶ 01 (15.79％) were the common alleles.Five MICA-STR(short tandem repeat) alleles were found,among which MICA * A5 (37.89％) and MICA * A5.1 (21.05％) predominated.In this population,ten MICB alleles were found.The common alleles were MICB * 005 ∶ 02/* 010 (58.42％),MICB * 002 ∶ 01 (10.00％),and MICB * 008 (7.89％).Two kinds of MICA-MICB haplotypes were MICA * 004-MICB * 004 ∶ 01 and MICA * 010-MICB * 005 ∶ 02/010 in significant linkage disequilibrium.This study also showed MICA/B gene with high polymorphism in different populations.Conclusion MICA/B alleles distribution in northern Hunan Han population with its unique characteristics.