Antibacterial copper sulfide/graphene oxide nanosheets composite film promotes angiogenic and osteogenic differentiation in vitro / 中华创伤骨科杂志

Objective:To investigate whether the antibacterial copper sulfide (CuS)/graphene oxide (GO) nanosheets composite film can promote angiogenesis and osteogenesis in vitro. Methods:GO and CuS/GO nanosheets were synthesized and mixed into polyvinyl alcohol (PVA)/carboxymethyl cellulose (CMC) hydrogel films. The study was conducted in 4 groups: PVA/CMC/GO, PVA/CMC/CuS/GO, PVA/CMC (only PVA/CMC-based film) and blank control (no material). The PVA/CMC, PVA/CMC/GO and PVA/CMC/CuS/GO films were characterized by electron scanning microscopy and energy dispersive spectrometer. The biocompatibility of different films (PVA/CMC/CuS/GO films with concentrations of CuS/GO nanotablets of 0, 50, 100, 200, 400, and 800 μ g/mL) was evaluated by CCK-8, live/dead cell staining, and hemolysis test. The angiogenesis was evaluated by cell migration and tube forming test in vitro. Alkaline phosphatase and alizarin red staining were used to evaluate osteogenesis in vitro, and the expression of osteogenic genes was measured by immunofluorescence staining and RT-qPCR. In addition, the bacterial plate counting method and bacteriostatic circle method were used to evaluate the antibacterial activity of films. Results:In the PVA/CMC/GO and PVA/CMC/CuS/GO groups, the surface of the PVA/CMC-based film was smooth and flat whereas the nanosheets composite films were irregularly flaky and convex. The biosafety experiments showed that the PVA/CMC-based film composited with GO or CuS/GO nanosheets at the concentration of 100 μg/mL had good biocompatibility. The results of angiogenesis in vitro showed that the migration ratio of HUVEC cells in the PVA/CMC/CuS/GO group was significantly better than those in the PVA/CMC/GO, PVA/CMC and control groups ( P<0.001). In the experiment of tube forming area and length, the PVA/CMC/CuS/GO group was significantly better than the PVA/CMC/GO, PVA/CMC and control groups ( P<0.001). The osteogenic differentiation in vitro displayed that the alkaline phosphatase and alizarin red staining of MC3T3-E1 cells in the PVA/CMC/CuS/GO group were significantly better than those in the PVA/CMC/GO, PVA/CMC and control groups ( P<0.001). In addition, the fluorescence intensity of immunofluorescence staining in alkaline phosphatase and type Ⅰcollagen on MC3T3-E1 cells, and the mRNA expression levels of osteogenic related genes including alkaline phosphatase, bone morphogenetic protein 2, osteocalcin and osteopontin in the PVA/CMC/CuS/GO group were significantly higher than those in the PVA/CMC/GO, PVA/CMC and control groups ( P<0.001). The antibacterial assay showed that the PVA/CMC/CuS/GO group had a significantly greater antibacterial activity and a significantly larger inhibition zone against Gram-positive bacteria and Gram-negative bacteria than the PVA/CMC/GO, PVA/CMC and control groups ( P< 0.001). Conclusions:PVA/CMC films composited with GO or CuS/GO nanosheets demonstrate ideal biocompatibility and antibacterial properties which promote angiogenesis and osteogenic differentiation in vitro. In particular, antibacterial PVA/CMC/CuS/GO composite films with the coupling function of angiogenesis and osteogenesis are expected to provide a new strategy for infectious bone defects.

Current status of metabolomics in pediatric community-acquired pneumonia / 中国小儿急救医学

Community-acquired pneumonia(CAP) is one of the leading causes of death in children under 5 years of age.Early identification and clarification of its severity and appropriate therapeutic measures can improve survival, but there are limitations in the existing laboratory indices applied to diagnose CAP.Therefore, it is still necessary to find new and highly specific biomarkers that can identify the etiology and predict the severity of the disease before it worsens in children, and provides a basis for more effective therapeutic measures.Metabolomics provides a new way to search for biomarkers and pathogenesis through qualitative and quantitative analysis of metabolite changes in biological samples.This review summarized the latest research progress on metabolomics in childhood CAP, hoping to provide ideas for the early diagnosis and treatment of childhood CAP.

Analysis of clinical features of 36 children with necrotizing pneumonia / 中国小儿急救医学

Objective:To summarize the clinical features, diagnosis, treatment, and outcomes of necrotizing pneumonia(NP)in children, so as to improve the understanding of NP.Methods:Children with NP admitted to the Children′s Medical Center of Hunan Provincial People′s Hospital from December 2012 to June 2020 were selected and divided into respiratory support group(nine cases) and non-respiratory support group(27 cases) according to whether they received respiratory support; and they were also divided into pleural effusion group(28 cases) and non-pleural effusion group(eight cases) according to whether combined with pleural effusion.The clinical data of all children were collected, and the differences between different groups were compared.Results:There were thirty-six children with NP, included 14 boys and 22 girls, with a median age of 30(12, 49) months, and the disease duration was 34(25, 42)days.All children had cough, 34 cases had fever, and the fever peak was 39.5(39.1, 40.0) ℃.Laboratory tests(all peaks) showed that blood white blood cell count was 20.77(15.65, 28.35)×10 9/L, neutrophil count was 15.11(8.52, 20.65)×10 9/L, C-reactive protein(CRP) was 104.00(23.45, 146.50)mg/L, D-dimer was 5.12(1.88, 8.04)mg/L, and lactate dehydrogenase(LDH) was 347.95(284.68, 447.81)U/L.The detection rate of pathogens was 58.33%(21/36), and the most common was Staphylococcus aureus(28.57%, 6/21). Eight cases underwent surgical treatment, including five cases of thoracoscopic surgery and three cases of thoracotomy.All patients improved and were discharged from hospital.The differences in hospital stay, white blood cell count, CRP, procalcitonin and LDH levels between respiratory support group and non-respiratory support group were statistically significant, and the median age, white blood cell count, CRP, D-dimer and LDH between pleural effusion group and non-pleural effusion group were statistically significant(all P<0.05). Further multivariate Logistic regression analysis showed that LDH was a risk factor for NP children receiving respiratory support( P<0.05), the area under the ROC curve of LDH was 0.802, whose the cut-off value was 471.21 U/L.There were no statistically significant differences in the indexes between effusion group and non-pleural effusion group. Conclusion:Children with NP are prone to repeated high fever, high inflammatory markers, and a long course of disease.Staphylococcus aureus is the most common pathogen.Serum LDH≥471.21 U/L is an early independent predictor of respiratory support for NP.

Survey on job satisfaction and analysis of influencing factors of online contracted nurses / 中华医院管理杂志

Objective:To survey the job satisfaction of online contracted nurses who provide " Internet plus nursing services" for reference of hospital managers in improving their management mechanism in this regard.Methods:Based on the two-factor theory, a questionnaire was designed and a purposive sampling method was used to survey the online contracted nurses in Anhui province in April and May 2022. The motivational factors included such five dimensions as workload, work content, colleague relationship, doctor-patient relationship, and their own development, and the healthcare factors included such three dimensions as salary, job recognition and social status. The questionnaire data and job satisfaction scores were analyzed descriptively, and the correlation between the overall job satisfaction of the online contracted nurses, while each dimension was analyzed by Pearson correlation analysis, and the influence of each dimension on job satisfaction was analyzed by stepwise regression analysis.Results:A total of 335 valid questionnaires were recovered. The mean score of job satisfaction of online contracted nurses was (2.26±0.38), with the highest score of (2.56±0.53) for salary satisfaction and the lowest score of (1.78±0.67) for job recognition, and each dimension was positively correlated with job satisfaction ( r=0.34-0.88, P<0.01). Regression analysis showed that workload ( B=0.07), salary ( B=0.11), job content ( B=0.23), social status ( B=0.12), and self-development ( B=0.15) were the main factors affecting their job satisfaction ( P<0.01). Conclusions:The job satisfaction of online contracted nurses was at a medium level, mainly influenced by workload, salary, job content, social status and their own development. It is recommended that hospitals implement multiple targeted measures to improve the job satisfaction of online contracted nurses and promote the healthy development of " Internet plus nursing services" .

Evaluation of the applicability of the Zhang′s diagnostic criteria for atopic dermatitis in adolescents and adults from southern Jiangsu / 中华皮肤科杂志

Objective:To evaluate the applicability of the Zhang′s diagnostic criteria for atopic dermatitis (AD) in adolescents and adults from southern Jiangsu.Methods:A total of 1 769 patients were collected, who were newly diagnosed with eczema or AD in departments of dermatology of 7 hospitals in southern Jiangsu from May 2019 to May 2021. A standardized survey interview was conducted with patients by dermatologists using a self-designed questionnaire, which included patient′s personal information, relevant medical history, clinical characteristics, laboratory tests, etc. Using Hanifin-Rajka criteria as the gold standard, the sensitivity and specificity of the Williams criteria, Zhang′s criteria and Japanese Dermatological Association (JDA) criteria were evaluated, separately.Results:Among the 1 769 patients, there were 759 (42.9%) males and 1 010 (57.1%) females, aged 32.2 ± 8.2 years (range, 12 - 79 years) . Pruritus was the most common clinical feature among the AD patients (883/913, 96.7%) . When using the Hanifin-Rajka criteria as the gold standard, 913 (51.6%) subjects were diagnosed with AD; the sensitivity of Zhang′s criteria reached 92.6% (845/913) , and its specificity was 73.2% (627/856) ; the sensitivity of Williams′ criteria was 87.8% (802/913) , and its specificity was 81.3% (696/856) ; the sensitivity of JDA criteria reached 96.9% (885/913) , and its specificity was 68.9% (590/856) . The consistency in the diagnosis of AD was moderate between the Zhang′s criteria and Williams criteria (Kappa = 0.61, P = 0.009) , was relatively high between the Zhang′s criteria and JDA criteria (Kappa = 0.85, P = 0.001) , and was moderate between the Williams criteria and JDA criteria (Kappa = 0.51, P = 0.013) . Conclusions:Compared with the Hanifin-Rajka criteria, the Zhang′s criteria exhibit good sensitivity and specificity for the diagnosis of AD among adolescents and adults in southern Jiangsu. However, pruritus remains important for the diagnosis of AD.

Research progress on antioxidant mechanism of melatonin in reducing neonatal lung injury / 中华危重病急救医学

The etiology of neonatal lung injury is complicated. Because neonatal lungs are immature in the vesicles and alveolar period, they are easy to be injured by various factors. Clinically, the main manifestations of neonatal lung injury are refractory hypoxemia, respiratory distress, and decreased lung compliance, etc. In recent years, newborn treatment technology has been rapidly developed, but the incidence of neonatal lung injury is still very high, so more attention has been paid by the medical community. Oxidative stress refers to a state of imbalance between oxidation and antioxidant in the body. After newborns transition from amniotic fluid to the air, oxidative stress is relatively higher in the first few weeks of life, and oxidative stress injury will be further aggravated under the stimulation of adverse factors. Melatonin, as an important antioxidant factor in the human body, participates in many vital physiological and pathological processes, and can directly scavenge oxygen free radicals, enhance the activity of antioxidant enzymes, inhibit cell apoptosis. Researches have showed that the antioxidant properties of melatonin played an important role in neonatal lung injury, however, the specific mechanism has not yet been fully clarified. The aim of this article is to review the antioxidant effects of melatonin in neonatal lung injury and provide new ideas for the treatment of neonatal lung injury.

A Case of Hemophilia B with Abdominal and Pelvic Pseudotumor / 罕见病研究

Hemophilia B is a genetic disorder caused by coagulation factor Ⅸ(FⅨ) deficiency, mainly manifesting as joint, muscle and deep tissue bleeding. Hemophilia pseudotumor is a mass formed by soft tissue liquefaction and necrosis caused by repeated bleeding. Most pseudotumors occur in the bone and muscle. We report a case of hemophilia B with pseudotumor formation in the pelvis and abdomen, where lesion location is relatively rare. After active and effective hemostasis, the patient's hematuria symptom gradually improved. This case suggests that early and timely hemostatic treatment is crucial for patients with hemophilia.

A pace recognition method for exoskeleton wearers based on support vector machine-hidden Markov model / 生物医学工程学杂志

In order to improve the motion fluency and coordination of lower extremity exoskeleton robots and wearers, a pace recognition method of exoskeleton wearer is proposed base on inertial sensors. Firstly, the triaxial acceleration and triaxial angular velocity signals at the thigh and calf were collected by inertial sensors. Then the signal segment of 0.5 seconds before the current time was extracted by the time window method. And the Fourier transform coefficients in the frequency domain signal were used as eigenvalues. Then the support vector machine (SVM) and hidden Markov model (HMM) were combined as a classification model, which was trained and tested for pace recognition. Finally, the pace change rule and the human-machine interaction force were combined in this model and the current pace was predicted by the model. The experimental results showed that the pace intention of the lower extremity exoskeleton wearer could be effectively identified by the method proposed in this article. And the recognition rate of the seven pace patterns could reach 92.14%. It provides a new way for the smooth control of the exoskeleton.

Significance of cytokine imbalance in systemic onset juvenile idiopathic arthritis combined with macrophage activation syndrome / 中国医师进修杂志

Objective:To analyze cytokine pattern of systemic onset juvenile idiopathic arthritis (SOJIA) combined with macrophage activation syndrome (MAS) in children, and study the early diagnostic value in MAS.Methods:The clinical data of 157 children with SOJIA from January 2013 to March 2018 in Taizhou Hospital of Zhejiang Province were retrospectively analyzed. Among them, SOJIA combined with MAS was in 15 cases (SOJIA combined with MAS group), and simple SOJIA was in 142 cases (simple SOJIA group). The peripheral blood levels of interleukin (IL)-2, IL-4, IL-6, tumor necrosis factor (TNF)-α and interferon (IFN)-γ were measured by flow cytometry cytometric beads array. The characteristics of cytokine pattern was analyzed.Results:The IL-10 and IFN-γ in SOJIA combined with MAS group were significantly higher than those in simple SOJIA group: 40.5 (7.9, 236.9) ng/L vs. 4.1 (2.0, 98.7) ng/L and 55.8 (18.5, 500.0) ng/L vs. 4.4 (1.4, 30.1) ng/L, and there were statistical differences ( P<0.01); there were no statistical difference in IL-2, IL-4, IL-6 and TNF-α between 2 groups (P>0.05). Pearson correlation analysis result showed that IL-10 was positive correlated with IFN-γ in SOJIA children with MAS ( r = 0.638, P = 0.011). Receiver operating characteristic curve analysis result showed that the area under the curve (AUC) of IFN-γ in predicting MAS was 0.991, 95% CI 0.974 to 1.000, the optimal critical value was 18.45 ng/L, the sensitivity was 92.5%, and the specificity was 95.1%; the AUC of IL-10 in predicting MAS was 0.944 (95% CI 0.893 to 0.996), the optimal critical value was 7.75 ng/L, the sensitivity was 91.7%, and the specificity was 81.7%. Conclusions:The significant increased IL-10 and IFN-γ is helpful for the early diagnosis MAS in children with SOJIA.

Profibrotic effect of mast cells on hyperoxia-induced lung injury / 国际儿科学杂志

Bronchopulmonary dysplasia(BPD)is a chronic lung disease that usually occurs in premature infants who require mechanical ventilation, with a high mortality rate, and there is currently a lack of effective prevention and treatment methods.The pathological features of typical BPD are mainly severe airway injury, lung parenchymal inflammation, squamous epithelial metaplasia, and pulmonary fibrosis.Although the pathogenesis of BPD is not yet clear, a large number of mast cell aggregation can be observed in the fibrotic lung of premature infants.Studies have suggested that a series of inflammatory mediators released by mast cell degranulation under hyperoxia have an important impact on BPD.This article reviews the role and mechanism of mast cells in promoting fibrosis in BPD, and in order to provide new ideas for the treatment of BPD.

Recombinant human tumor necrosis factor-α receptorⅡ: IgG Fc fusion protein for the treatment of drug-induced toxic epidermal necrolysis: a multicenter clinical observation / 中华皮肤科杂志

Objective:To evaluate the efficacy and safety of recombinant human tumor necrosis factor-α receptorⅡ: IgG Fc fusion protein (rhTNFR:Fc) in the treatment of drug-induced toxic epidermal necrolysis (TEN) .Methods:From 2009 to 2018, 22 patients with TEN were enrolled from 8 centers such as the Second Affiliated Hospital of Soochow University, including 10 males and 12 females, whose age ranged from 22 to 75 years. These patients were subcutaneously injected with rhTNFR:Fc at a dose of 25 mg once every 3 days for 6 - 8 consecutive sessions, and the initial dose was doubled. The drug eruption area and severity index (DASI) score and DASI improvement indices (DASI50, DASI75 and DASI90) were assessed before treatment and on days 4, 7, 10, 13, 16, 19, 22 and 25 after treatment; cytometric bead array (CBA) technology was used to detect the level of tumor necrosis factor (TNF) -α in peripheral blood and blister fluid samples. During the treatment, body temperature, rash changes, liver and kidney function of patients were monitored, and adverse reactions were recorded. Statistical analysis was carried out by using repeated measures analysis of variance, paired t test and Pearson correlation analysis. Results:Of the 22 patients, the temperature stopped rising in 20 patients without infections 24 - 72 hours after the first treatment, and returned to normal after 48 - 120 hours. Among the 22 patients, new blisters stopped appearing 24 - 48 hours after the first treatment, the skin color changed from bright red to dark purple after 48 - 96 hours, and most skin lesions subsided after 2 weeks. After 2 - 4 weeks of treatment, levels of alanine aminotransferase and aspartate aminotransferase returned to normal in 19 patients with abnormal liver function. After 4 - 13 days of treatment, levels of creatinine and urea nitrogen stopped rising in 7 patients with abnormal renal function. During the treatment, the DASI score of the 22 patients gradually decreased ( F = 532.81, P < 0.01) , from 53.64 ± 8.67 before treatment to 2.05 ± 1.21 on day 25 after treatment ( t = 26.60, P < 0.001) . On day 10 after treatment, 22 patients (100%) achieved DASI50; on day 19, 22 (100%) achieved DASI75; on day 25, 20 (90.90%) achieved DASI90. The level of TNF-α in peripheral blood of the 22 patients gradually decreased along with the extension of treatment duration, from 33.95 ± 27.90 ng/L before treatment to 2.38 ± 0.79 ng/L on day 25. Before treatment, the level of TNF-α in blister fluid of 15 patients was 111.99 ± 99.41 ng/L, and the ratio of blister-fluid TNF-α level to peripheral blood TNF-α level was 1.83 - 28.21. Before treatment, no correlation was observed between the serum level of TNF-α and DASI score in the 22 patients ( P = 0.10) , while the blister-fluid TNF-α level was positively correlated with DASI score in the 15 patients ( r = 0.59, P = 0.02) . No acute adverse reactions were observed during the treatment. All the 22 patients completed the treatment and were discharged with complete recovery. During 6 months of follow-up after discharge, no recurrence or any complication was observed. Conclusion:rhTNFR:Fc is effective and safe for the treatment of drug-induced TEN.

Generation and preliminary characterization of chimeric antibodies against neuraminidase of H7N9 subtype influenza A virus / 中华实验和临床病毒学杂志

Objective@#To develop the chimeric antibodies against neuraminidase (NA) of H7N9 and to identify their biological activity and function.@*Methods@#The genes of variable regions of the light chain (VL) and heavy chain (VH) obtained by mouse hybridoma technology were cloned respectively into the expression VH and VL vectors bearing human-derived Cγ1, and Cκ1 and co-transfected into 293T cells. The chimeric antibodies were purified and their functions were investigated.@*Results@#Two chimeric antibodies, 1E2 and 3E3 against neuraminidase (NA) of H7N9 were obtained. Both antibodies recognized similar antigenic epitopes. MAb 1E2 and 3E3 could prevent the infectivity with H7N9 and H11N9 virus and reduce their size of viral plaque.@*Conclusions@#The chimeric antibodies specific for N9 could prevent the infection of N9 subtype influenza virus as well as the NAI-resistant mutants and could be a potential immunotherapy approach for H7N9 treatment.

Application of blended BOPPPS teaching model in the teaching of internal nursing / 中华医学教育探索杂志

Objective@#To explore the application and effect of blended BOPPPS teaching mode in medical nursing teaching.@*Methods@#A total of 80 nursing undergraduates of Grade 2014 in Hubei Medical University were divided randomly into teaching reform class and control class, with 40 students in each class. From February 2017 to July 2017, BOPPPS teaching was implemented in the teaching reform class, while traditional teaching was conducted in the control class. At the end of the experiment, Students in the two classes had questionnaire on the satisfaction of the teaching design, tests for self-learning ability and medical nursing level. SPSS 20.0 software was used for statistical analysis. Enumeration data between two classes were compared by chi-square test, while measurement data were compared by t test.@*Results@#①The number of students who were satisfied in the teaching reform class was 34 (85.0%), which was significantly higher than that of the control class (29, 72.5%). The difference has statistical significance. ② The self-learning dimensions and total score of the teaching reform class were (53.1±5.1), (52.4±4.8), (52.2±4.7), (51.9±4.7), (51.2±4.9) and (260.8±24.2), respectively, which were significantly higher than (48.6±4.3),(49.9±4.3), (49.7±4.1), (47.6±4.0), (47.1±3.9), and (242.9±20.6) of the control class. The differences were statistically significant (average P<0.05 or 0.01). ③The total scores (minutes) for regular assessments, theoretical examinations, and internal medicine education in the reform class were (26.1±2.3), (55.4±5.2), and (81.5±7.5) respectively, which was obviously higher than that(23.7±1.9), (52.6±4.6), (76.3±6.5) of the control class. The differences were statistically significant (average P<0.05 or 0.01).@*Conclusions@#The blended BOPPPS teaching focuses on the students, pays close attention to the students' attentiveness, participatory learning and goal achievement. This teaching model can improve students' satisfaction, self-learning ability and medical nursing study in a large extent.

Application of blended BOPPPS teaching model in the teaching of internal nursing / 中华医学教育探索杂志

Objective To explore the application and effect of blended BOPPPS teaching mode in medical nursing teaching. Methods A total of 80 nursing undergraduates of Grade 2014 in Hubei Medical University were divided randomly into teaching reform class and control class, with 40 students in each class. From February 2017 to July 2017, BOPPPS teaching was implemented in the teaching reform class, while traditional teaching was conducted in the control class. At the end of the experiment, Students in the two classes had questionnaire on the satisfaction of the teaching design, tests for self-learning ability and medical nursing level. SPSS 20.0 software was used for statistical analysis. Enumeration data between two classes were compared by chi-square test, while measurement data were compared by t test. Results①The number of students who were satisfied in the teaching reform class was 34 (85.0％), which was significantly higher than that of the control class (29, 72.5％). The difference has statistical significance.②The self-learning dimensions and total score of the teaching reform class were (53.1±5.1), (52.4±4.8), (52.2±4.7), (51.9±4.7), (51.2±4.9) and (260.8±24.2), respectively, which were significantly higher than (48.6±4.3), (49.9±4.3), (49.7±4.1), (47.6±4.0), (47.1±3.9), and (242.9±20.6) of the control class. The differences were statistically significant (average P<0.05 or 0.01). ③The total scores (minutes) for regular assessments, theoretical examinations, and internal medicine education in the reform class were (26.1±2.3), (55.4 ±5.2), and (81.5 ±7.5) respectively, which was obviously higher than that (23.7 ±1.9), (52.6 ±4.6), (76.3±6.5) of the control class. The differences were statistically significant (average P<0.05 or 0.01). Conclusions The blended BOPPPS teaching focuses on the students , pays close attention to the students' attentiveness , participatory learning and goal achievement . This teaching model can improve students' satisfaction, self-learning ability and medical nursing study in a large extent.

Construction and analysis of muscle functional network for exoskeleton robot / 生物医学工程学杂志

Exoskeleton nursing robot is a typical human-machine co-drive system. To full play the subjective control and action orientation of human, it is necessary to comprehensively analyze exoskeleton wearer's surface electromyography (EMG) in the process of moving patients, especially identifying the spatial distribution and internal relationship of the EMG information. Aiming at the location of electrodes and internal relation between EMG channels, the complex muscle system at the upper limb was abstracted as a muscle functional network. Firstly, the correlation characteristics were analyzed among EMG channels of the upper limb using the mutual information method, so that the muscle function network was established. Secondly, by calculating the characteristic index of network node, the features of muscle function network were analyzed for different movements. Finally, the node contraction method was applied to determine the key muscle group that reflected the intention of wearer's movement, and the characteristics of muscle function network were analyzed in each stage of moving patients. Experimental results showed that the location of the myoelectric collection could be determined quickly and efficiently, and also various stages of the moving process could effectively be distinguished using the muscle functional network with the key muscle groups. This study provides new ideas and methods to decode the relationship between neural controls of upper limb and physical motion.

Characterization and analysis of VH1-2-encoded heterosubtypic antibodies isolated from an avian H5N1 patient / 中华实验和临床病毒学杂志

Objective@#To isolate the cross-reactive antibodies against hemagglutinin of influenza virus and identify its biological function.@*Methods@#The antibodies gene reservoir of cross-reactive and H5N1 pseudotype particles neutralizing B cell circulating in peripheral blood of a human H5N1 case was recovered by in vitro B cell culture, screening, RT-PCR and expression vector cloning techniques. The Ab gene pairing was screened by transient transfection of human kidney 293T cells and detected using ELISA and neutralization test. The heterosubtypic antibodies were prepared and characterized.@*Results@#We discovered the VH1-2-based heterosubtypic antibodies from two B cell lineages could neutralize GX-H5N1 pseudotype particles and have broader binding with Group 1 (including H1, H5, H6 and H9) and H7 subtype.@*Conclusions@#Cross-reactive antibodies can be induced by H5N1 infection.

The curative effect of oseltamivir combined with Lingjiaowuhutang in 120 children with influenza / 中国医师进修杂志

Objective To observe the curative effect of oseltamivir combined with Lingjiaowuhutang in children with influenza. Methods One hundred and twenty cases of children with influenza were selected from November 2017 to December 2017 and they were divided into two groups, each with 60 cases. The patients in western medicine group were treated with oseltamivir alone , those in Chinese traditional medicine combined with western medicine group were treated with oseltamivir and Lingjiaowuhutang. The efficacy and duration of fever and cough were was compared between two groups. Results Thirty-three patients were confirmed influenza A and 87 patients were confirmed influenza B. The total effective rate in Chinese traditional medicine combined with western medicine group was significantly higher than that in western medicine group: 96.7% (58/60) vs. 86.7%(52/60), χ2= 3.927, P < 0.05. The duration of fever and cough in Chinese traditional medicine combined with western medicine group was significantly shorter than those in western medicine group: (30.18 ± 6.22) h vs. (36.24 ± 13.46) h, (120.18 ± 21.45) h vs. (143.14 ± 33.26) h, P < 0.05. Conclusions Oseltamivir combined with Lingjiaowuhutang in children with influenza has better efficacy and can shorten duration of disease. It is worthy of clinical application.

The effect of Qushi-Huaban granule for allergic purpura / 国际中医中药杂志

Objective To explore the effect of Qushi-Huaban granule for the allergic purpura and the impact on CD4+CD25+T cells. Methods A total of 80 children with allergic purpura from March 2014 to January 2016 were randomly divided into two groups, the control group and observation group, 40 in each group. The control group was given routine medicine andmontelukast chewable tablets. The observation group was treated with Qushi-Huaban granule on the basis of conventional therapy. The clinical effect, purpura recession time, recurrence rate before and after treatment were observed and compared. The serum levels of IFN-γ (interferon-γ, IFN-γ) and IL-5 were detected by ELISA. The expression level of CD4+CD25+ Treg were observed by flow cytometry before and after treatment. Results The effective rate of the treatment group [92.5% (37/40) vs. 72.5%(29/40), χ2=9.270] was significantly higher than control group (P＜0.01). After treatment, the serum IFN-γ levels in the observation group and the control group were significantly higher than those before treatment (t=3.960, 4.175, P＜0.05). The serum IL-5 levels of two groups were significantly lower than those before treatment (t=8.061, 8.776, P＜0.01).There was no significant differencein the serum INF-γ and IL-5 leves after treatment between two groups (P＞0.05). The regression time of purpura in the observation group (5.2 ± 1.1 d vs. 10.2 ± 2.4 d, t=12.460) was significantly shorter than that in the control group ( P＜0.01). The recurrence rate of the observation group was [7.4% (5/37) vs. 10.3% (3/29)] which was significantly lower than that of the control group, but the difference was not statistically significant (χ2=0.153, P=0.696). The CD4+CD25+T cells (t=7.367, 6.957, P＜0.05) and CD3+CD4+CD25+ T cells (t values were 9.080, 8.885, P＜0.05) of two groupswere significantly higher than those beforetreatment, butthere was no significant difference between the 2 groups after treatment ( P＞0.05). Conclusions The Qushi-Huaban granule combined with montelukast sodium for Henoch Schonlein purpura showed efficacy, and significantly increase the moisture level of T cell subsets.

Correlation analysis of drug resistance of Salmonella and enterotoxin genes in 132 children with diarrhea in Taizhou area / 中国基层医药

Objective To investigate the drug resistance of Salmonella and enterotoxin gene in diarrhea children of Taizhou.Methods 132 children with Salmonella infection who had fever ,diarrhea and other symptoms and were confirmed by fecal culture were selected .The Salmonella serotype , drug resistance analysis of 10 kinds of antibiotics,and enterotoxin gene (spvA,spvB,rck) were detected.Results 132 cases of Salmonella isolated from blood serological were identified a total of 10 serotypes,Salmonella typhimurium and Salmonella Enteritidis were the most common.In 132 strains of Salmonella ,the highest drug resistance rate was to ampicillin (51.82％) and ampicil-lin/sulbactam(51.52％),and had no resistance to imipenem ,ertapenem.In 132 strains of Salmonella,including sin-gle drug resistance of 27 strains(20.45％),the rest had two or more drugs resistance .In 132 strains of Salmonella, 132 strains were spvA positive(positive rate 100％),38 cases were spvB positive(positive rate 28.79％),45 cases were rck positive(positive rate 34.09％).The incidence rates of fever,dehydration and hematochezia in spvB positive children were significantly higher than those in spvB negative children (χ2 =6.022,6.661,6.978,all P<0.05).The incidence rates of fever and hematochezia in rck positive children were significantly higher than those in rck negative children (χ2 =9.134,12.673,all P<0.05).Conclusion Salmonella infection diarrhea children in the Taizhou area are mainly Salmonella typhimurium and Salmonella enteritidis infection ,the strains are highly resistant strains , enterotoxin spvB gene is correlated with the incidence rates of fever ,dehydration and hematochezia ,and rck gene is correlated with the incidence rates of fever and hematochezia .

The current status and influencing factors of compassion fatigue in clinical nurses / 中华护理杂志

Objective To investigate the current status and influencing factors of compassion fatigue in clinical nurses,and to provide theoretical references for prevention of nurse burnout and promotion of nurse retention.Methods Totally 992 clinical nurses from ten tertiary hospitals were enrolled through random cluster sampling to complete general information questionnaire,the Professional Quality of Life Scale (Pro-QOL-V),the Resilience Scale for Adults(RSA) and the Jefferson Scale of Empathy·Health Professionals(JSE-HP).Results The prevalence of moderate and high risk of secondary stress and burnout were 71.1％,73.2％,respectively;clinical nurses with work experience of 6 to 10 years presented the highest level of burnout(P＜0.01);lower empathy and resilience,as well as adverse work environment were risk factors of compassion fatigue.Multiple regression analysis showed that the influencing factors of nurse burnout were compassion satisfaction,secondary stress,resilience,workload,recognition,empathy,and payment,which explained 70.5％ of the total variance.Conclusion Secondary stress,burnout and compassion satisfaction in clinical nurses are influenced by nurses' empathy,resilience and work environment,and nursing administrators should pay attention to receiving recognition as positive predictors of burnout,except for workload and payment.