Objective To study on immunity function in infectious mononucleosis (IM) children infected by Epstein-Barr virus (EBV) and its relationship with clinic and prognosis.Methods Serum immunoglobulin was detected by immunoradiometric nephelometry,expressions of C D3+,CD4+,CD8+,CD19+,CD23+ on T-lymphocytes subset in peripheral blood were measured by flow cytometry in 50 IM (IM group)who was in acute and convalescent period,and compared with 50 healthy controls (control group).Results The levels of IgA,IgG,IgM in IM group with acute period were (0.75 ± 0.65),(7.55 ± 2.05),(1.85 ± 0.55)g/L,in IM group with convalescent period were (0.95 ± 0.55),(8.85 ± 2.25),(1.75 ± 0.65) g/L.In control group,those were (1.25 ± 0.75),(10.65 ± 2.55),(1.80 ± 0.50) g/L.IgA and IgG in IM group with acute period were significantly lower than those in IM group with convalescent period and control group (P ＜0.01),but IgM was no significant difference among them (P ＞0.05).The levels of CD3+,CD4+,CD8+,CD4+/CD8+,CD19+,CD23+ in IM group with acute period were 0.6050 ± 0.0850,0.2080 ± 0.0315,0.6520 ± 0.0520,0.45 ± 0.35,0.0580 ± 0.0205,0.0250 ± 0.0135,in IM group with convalescent period were 0.7220 ± 0.0820,0.3575 ± 0.0375,0.3565 ± 0.0565,1.45 ± 0.45,0.1580 ± 0.0280,0.0625 ± 0.0225.In control group,those were 0.7530 ± 0.0830、0.4850 ± 0.0450、0.3275 ± 0.0575 1.48 ± 0.55、0.1850 ± 0.0560、0.0805 ± 0.0175.CD3+,CD4+,CD4+/CD8+,CD19+,CD23+ in IM group with acute period were significantly lower than those in IM group with convalescent period and control group (P ＜ 0.05),but CD8+ was significantly higher than that in IM group with convalescent period and control group (P ＜0.05).Conclusion The abnormality of immunoglobulin and T-lymphocytes subset in children infected by EBV is obvious.

OBJECTIVE To explore the safe and effective dose of sirolimus (Rapamycin,Sir) and its effect on seizure comorbidities. METHODS Immature C57BL/6 mice at postnatal 10 d of age were administered with kainic acid(KA) 12.0 mg · kg-1 intraperitoneally by a single injection to induce acute seizure. Sir 0.3, 1.0 and 3.0 mg · kg-1 was injected 24 h after seizure every other day until 3 d, 1 week, 3 weeks, 5 weeks and 6 weeks. Western blotting analysis was used to detect the expression and phos?phorylation level of S6 protein and to determine the minimum effective dose of Sir. Effect of the mini?mum effective dose of Sir on cognitive function and body growth was observed by several evaluations. Immunofluorescent intensity of Doublecortin (DCX) immunofluorescent staining was conducted to evaluate the development of neurons in the hippocampus. Morris water maze was used to assess the cognitive function. Tail suspension test, O maze and new object recognition test were used to study the anxiety-like behaviors of mice. RESULTS The result of Western blotting showed that Sir 0.3 mg · kg-1 had no significant effect on the phosphorylation of S6 protein in normal mice or KA mice, whereas 1.0 and 3.0 mg · kg- 1 could significantly inhibit the phosphorylation of S6 protein in KA mice (P<0.05). Sir 1.0 mg·kg-1 had no obvious effect on DCX-positive cells or body wass. Morris water maze showed that KA-induced seizure resulted in prolonged escape latency and swimming length (P<0.05), and a decreased crossing number of target quadrant (P<0.05). Sir 1.0 mg·kg-1 significantly reversed the deficit of cognitive function of KA-induced seizure mice (P<0.05), whereas no significant difference was found between Sir group and normal control group. Compared with normal control group, model group showed increased freezing time in tail suspension test (P<0.05), decreased migration length and reten?tion time in open arms in O maze (P<0.05), decreased retention time and touch frequency with new objects, migration length and average speed in new object recognition test (P<0.05). Sir 1.0 mg · kg-1 significantly reversed the above anxiety and depression status, whereas no significant difference was found between sirolimus group and normal control group. CONCLUSION Sir 1.0 mg · kg-1 inhibits the abnormal activation of mTOR pathway and the formation of epilepsy comorbidity in immature mice. Along with its mild side effect in development, Sir 1.0 mg · kg-1 will be an ideal dose to be used in the treatment of seizure in immature mice.

Objective To improve hand hygiene compliance among health care workers(HCWs)through continu-ous quality improvement,and effectively reduce the incidence of healthcare-associated infection(HAI).Methods Continuous quality improvement was performed by adopting plan-do-check-action(PDCA)cycle,all HCWs were trained,hand hygiene was stressed,periodical and random checking was conducted.Results After the implementa-tion of PDCA cycle,the acknowledge rate of hand hygiene enhanced from 48.00% to 63.99%;hand hygiene com-pliance rate enhanced from 65.11% to 82.40%,the difference were both significant(χ2=12.75,259.65,respective-ly,both P<0.05).The daily consumption of instant hand antiseptic per 1 000 bed day increased obviously,which was 2.95-fold of pre-implementation.Conclusion Continuous quality improvement through PDCA cycle can effec-tively improve hand hygiene compliance rate of HCWs.

Objective To investigate the effect of chemotherapy combined with amino acid on quality of life(QOL)in elderly patients with non-small cell lung cancer(NSCLC). Methods Seventy-four elderly patients with NSCLC were divided randomly into experimental group and control group.The same NP(cisplatin+vinorelbine)chemotherapy was carried out in all the 2 groups for 3 cycles.Except of chemotherapy,experimental group were treated with amino acid 500 ml/d in the same time,while control group recieved chemotherapy only.After 3 monthes,the QOL was analyzed using Chinese Version of European Organization for Researeh and Treatment of Cancer(EORTC)core questionnaire(QLQ-C30)and specific lung cancer module QLQ-LC13,and therapeutic effectiveness was evaluated according to WHO standard as well. Results After chemotherapy,the body function,mood function,social function were better in experimental group than in control group(all P＜0.05),the effective rate was 87.8%,83.8%and 77.0%in experimental group;77.0%,45.9%and 45.9%in control group.Insomnia(8.1%),suppressed appetite(5.4%),weary(47.3%)were less serious in experimental group than in control group(17.6%,17.6%and 59.5%)(all P＜0.05).The primary symptoms were cough,emptysis,thoracalgia and dyspnoea in both 2 groups before chemotherapy.All the symptoms were alleviated after chemotherapy.Some patients have side effects such as tongue pain,alopecie,hand and foot tingle.But the number of patients with tongue pain was less in experimental group(8.3%)than in control group(18.4%).The chemotherapy effect had no difference by the WHO standard. Conclusions The QOL of elderly patients with NSCLC can be improved by chemotherapy combined with amino acid treatment,and the treatment with amino acid 500 ml/d is safety.

AIM To study the therapeutic effects of Neiyi Kangfu Tablets (Trionycis Carapax,Ostreae concha,Rhei Radix et Rhizoma,etc.) on adenomyosis and its possible mechanism of action.METHODS The mouse model for adenomyosis was set up by the pituitary allograft,and received the gavage of Neiyi Kangfu Tablets,Dan'e Fukang Decoction (Salviae miltiorrhizae Radix et Rhizoma,Curcumae Rhizoma,Paeoniae Radix rubra,etc.) and gestrinone,respectively,for three months.Western blot,real-time PCR,IHC were used to measure the expression of GPER-Ras-STAT3 in ectopic endometrium and entopic endometrium.RESULTS High doses of Neiyi Kangfu Tablets could significantly lower GPER protein and gene expression;down-regulate the Ras and STAT3 protein expression;reduce the lesion severity score of ectopic tissue morphology.Its curative effect was better than Dan'e Fukang Decoction and gestrinone.CONCLUSION Neiyi Kangfu Tablets may control the development of ectopic lesions by inhibiting the GPER-Ras-STAT3 pathway activity and weakening the production of estrogen.

Objective: To investigate the influencing factors of depressive symptoms among rural elderly patients with chronic diseases in China, so as to provide insights into depression prevention and control among the rural elderly patients with chronic diseases. Methods: The basic demographics, health status, and lifestyle of rural residents at ages of 65 years and older who had at least one chronic disease were retrieved from The Chinese Longitudinal Healthy Longevity Survey (CLHLS) database in 2018, and participants' depressive symptoms were assessed with The Center for Epidemiological Studies Depression-10 (CES-D-10) scale. Factors affecting the depressive symptoms were identified with a multivariable logistic regression model. Results: Totally 5 146 rural elderly patients with chronic diseases were enrolled, including 2 373 men (46.11%) and 2 773 women (53.89%). The prevalence of depressive symptoms was 27.13%. Multivariable logistic regression analysis identified having two and more children (OR=0.614, 95%CI: 0.387-0.975), living alone (OR=1.450, 95%CI: 1.192-1.764), life satisfaction (general, OR=1.933, 95%CI: 1.651-2.264; low, OR=5.366, 95%CI: 3.488-8.254), self-assessed health status (general, OR=2.697, 95%CI: 2.284-3.185; poor, OR=5.338, 95%CI: 4.262-6.685), disability in instrumental activities of daily living (OR=1.592, 95%CI: 1.328-1.908), sleep duration (normal, OR=0.502, 95%CI: 0.429-0.586; too long, OR=0.494, 95%CI: 0.405-0.603), exercise (OR=0.721, 95%CI: 0.607-0.856), watching TV (OR=0.787, 95%CI: 0.664-0.933), and gardening activities (OR=0.781, 95%CI: 0.626-0.975) as factors affecting depressive symptoms among rural elderly patients with chronic diseases. Conclusions The prevalence of depressive symptoms was 27.13% among rural elderly patients with chronic diseases. Number of children, living style, life satisfaction, health status, sleep duration, exercise, watching TV, and gardening activities are associated with the development of depressive symptoms among rural elderly patients with chronic diseases.

Objective To investigate the effect of mesenchymal stem cells (MSCs) on subcutaneous xenograft tumors in mice with Lewis lung cancer. Methods MSCs isolated from bone marrow of C57BL/6 mice were made into single cell suspension and were cultured in vitro. The cells of the 4th to 5th passage were used for the subsequent experiments. Fifty six C57BL/6 mice were inoculated subcutaneously with Lewis lung cancer cells, and were grouped into Group D0 (MSCs were given simultaneously with inoculation)and Group D10(MSCs were given 10 d after inoculation). Group D0 included three subgroups (n=8): Group 1 with inoculation of tumor cells, Group 2 with inoculation of tumor cells and MSCs, and Group 3 with inoculation of tumor cells and tail intravenous injection of MSCs. Group D10 included four groups: Group 4 with inoculation of tumor cells and injection of MSCs in tumors, Group 5 with equivalent PBS (the control of Group 4), Group 6 with inoculation of tumor cells and tail intravenous injection of MSCs, and Group 7 with equivalent PBS (the control of Group 6). The time of tumor formation and the volume of tumor were observed and compared among the groups. ResultsIn Group D0, earlier onset of tumor development was observed in Group 2 as compared to Group 1 and Group 3 (P<0.05), while there was no significant difference on the volume of tumor in the three groups (P>0.05). In Group D10, the volume of tumors were larger in Group 4 compared to the control (P<0.05), while there was no significant difference on the volume of tumors between Group 6 and the control (P>0.05). Conclusion Inoculating mixture of MSCs and Lewis lung cancer cells accelerates tumor formation,and injection of MSCs in tumors stimulates the growth of tumors.

Objective:To investigate the effects of oxycodone multimodal analgesia on quality of awakening and hemodynamics in patients undergoing laparoscopic gynaecological surgery.Methods:Ninety patients who underwent laparoscopic ovarian cyst removal in Weihai Central Hospital from September 2018 to March 2019 were included in this study. They were randomly divided into observation and control groups, with 45 patients in each group. Both groups were given intravenous flurbiprofen axetil (1 mg/kg) for preemptive analgesia. Combined intravenous and inhalation anesthesia was used. The depth of anesthesia was monitored. The observation group was intravenously given 0.10 mg/kg oxycodone and the control group was intravenously given 5 μg sufentanil. Quality of awakening, hemodynamic indexes, postoperative pain score, and incidences of nausea and vomiting were compared between the two groups.Results:Cough score in the observation group was significantly lower than that in the control group [(1.1 ± 0.4) points vs. (1.7 ± 0.7) points, t = -4.99, P < 0.05]. Ramsay Sedation Scale score in the observation group was significantly higher than that in the control group [(3.6 ± 1.0) points vs. (2.8 ± 0.8) points, t = 7.44, P < 0.05]. At 0 (T 1) and 5 minutes (T 2) after extubation, systolic blood pressure in the observation group was (117.7 ± 18.2) mmHg and (118.1 ± 16.2) mmHg, respectively, which were significantly lower than (134.2 ± 16.2) mmHg and (134.5 ± 15.2) mmHg in the control group ( t =-4.54, -4.95, both P < 0.05). There were no significant differences in the incidences of nausea and vomiting between the two groups (both P > 0.05). At 6 and 12 hours after surgery, visual analogue scale score in the observation group was (2.5 ± 0.8) points and (1.1 ± 0.5) points, respectively, which were significantly lower than (3.4 ± 0.9) points and (1.9 ± 0.8) points in the control group ( t = 5.01, -5.68, both P < 0.05). Conclusion:Oxycodone multimodal analgesia for laparoscopic gynaecological surgery can improve the quality of awakening, decrease systolic blood pressure, reduce the degree of postoperative pain, and does not increase the incidences of postoperative nausea and vomiting.

Objective:To investigate the effect of dexmedetomidine combined with butorphanol on perioperative analgesia in patients subjected to cardiac surgery.Methods:Sixty-three patients who underwent elective cardiac surgery in Weihai Central Hospital from June 2019 to August 2020 were included in this study. They were divided into propofol + sufentanil group ( n = 21), dexmedetomidine + sufentanil group ( n = 23) and dexmedetomidine + butorphanol group ( n = 19) according to different analgesic methods. Postoperative analgesic satisfaction, Visual Analogue Scale score, hemodynamic changes (heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure) and adverse reactions were compared among the three groups. Results:The satisfaction rate of postoperative analgesia in the dexmedetomidine + butorphanol group was 94.7% (18/19), which was significantly higher than 61.9% (13/21) in the propofol + sufentanil group and 60.8% (14/23) in the dexmedetomidine + sufentanil group ( χ2 = 6.16, 6.57, both P < 0.05). At 4, 12, 24 and 48 hours after tracheal extubation, Visual Analogue Scale score in the dexmedetomidine + butorphanol group were significantly lower than that in the propofol + sufentanil group and dexmedetomidine + sufentanil group (both P < 0.05). At the time of tracheal extubation and at 5 minutes after tracheal extubation, heart rate, respiratory rate, systolic blood pressure and diastolic blood pressure in the dexmedetomidine+butorphanol group were significantly lower than those in the propofol + sufentanil group and dexmedetomidine + sufentanil group (both P < 0.05). The incidence of adverse reactions in the dexmedetomidine + butorphanol group was 10.5% (2/19), which was significantly lower than 23.8% (5/21) in the propofol + sufentanil group and 30.43% (7/23) in the dexmedetomidine + sufentanil group [30.4% (7/23), χ2=21.94, P < 0.001]. Conclusion:Dexmedetomidine combined with butorphanol in cardiac surgery can not only stabilize postoperative blood pressure and heart rate, but also lower the degree of pain and is highly safe.

Objective:To compare and analyze the effects of impulse oscillometry (IOS) and pulmonary function test (PFT) in the assessment of asthma control in children.Methods:A cross-sectional study of 323 children with bronchial asthma who visited the outpatient pediatric clinic of Shandong Provincial Hospital Affiliated to Shandong First Medical University from March to December 2020 was conducted.The patients were divided into the control group (123 cases) and the uncontrolled group (200 cases) according to the Childhood Asthma Control Test (C-ACT) score.In both groups, PFT and IOS were performed.The PFT test included the forced expiratory volume in one second (FEV 1), force expiratory volume in one second/forced vital capacity (FEV 1/FVC), peak expiratory flow (PEF), the instantaneous forced expiratory flow at 50% of forced vital capacity (FEF 50), the instantaneous forced expiratory flow at 75% of forced vital capacity (FEF 75), and maximum mid expiratory flow (MMEF). In the IOS test, the total respiratory impedance at 5 Hz (Z5), respiratory resistance at 5 Hz (R5), respiratory resistance at 20 Hz (R20), reactance at 5 Hz (X5), respiratory resistance at 5 Hz-respiratory resistance at 20 Hz (R5-R20), reactance area (AX), and resonance frequency (Fres) were measured.The data obtained were analyzed statistically using SPSS 25.0 software. ANOVA or Mann- Whitney U rank-sum test was used to compare data between groups.Receiver′s operating characteristic (ROC) curves were drawn to determine the predictive value of PFT and IOS parameters for uncontrolled asthma. Results:(1) According to the comparison results of PFT indexes between the two groups of children with asthma, the levels of FEV 1, FEV 1/FVC, PEF, FEF 50, FEF 75, MMEF in the control group were all higher than those in the uncontrolled group [(104.41±12.38)% vs.(98.89±16.61)%, 100.50 (94.40, 103.50)% vs.96.00 (89.83, 101.88)%, (100.29±15.31)% vs.(93.19±18.43)%, 85.60(70.60, 96.60)% vs.72.35 (57.08, 91.10)%, 67.20 (53.60, 81.70)% vs.56.80 (41.10, 74.73)%, 80.70 (66.80, 95.10)% vs.69.50 (54.03, 90.05)%] (all P<0.01). (2) According to the comparison results of IOS indices between the two groups, the levels of Z5, R5, R20, R5-R20, X5, AX and Fres in the control group were lower than those in the uncontrolled group {68.58 (63.29, 77.43)% vs.81.27(70.93, 91.96)%, 68.91(62.94, 77.60)% vs.80.61 (70.02, 89.29)%, 75.78 (67.50, 87.55)% vs.82.97 (71.50, 95.50)%, 0.51 (0.43, 0.59) [kPa/(L·S)] vs.0.62 (0.53, 0.74) [kPa/(L·S)], 69.31 (59.93, 79.14)% vs.86.48 (70.00, 102.48)%, 1.11 (0.76, 1.60) kPa/L vs.2.14 (1.42, 2.85) kPa/L, 18.21 (16.06, 19.56) Hz vs.20.56 (18.92, 22.81) Hz} (all P<0.01). (3) In the control group, 31 children (25.20%) had pulmonary dysfunction.(4) In the uncontrolled group, 95 children (47.50%) had pulmonary ventilation dysfunction.Only 20 children (10.00%) had a R5 larger than 120% of the predicted value and/or a R20 larger than 120% of the predicted value.(5) According to the ROC analysis results of the IOS indices for predicting asthma exacerbations, all of the areas under the ROC (AUC) of Z5, R5, R5-R20, X5, AX and Fres were greater than 0.7.AX had the highest value in predicting asthma exacerbations (AUC=0.785, 95% CI: 0.735-0.835), with sensitivity of 78.50% and specificity of 64.20%.All of the AUCs of PFT indices were smaller than 0.7.FEF 50 and MMEF had the largest AUC. Conclusions:PFT and IOS have good sensitivity in evaluating the level of asthma control in children, and IOS has good value in predicting asthma exacerbations.AX has the highest predictive value for asthma exacerbations.Asthma control levels of children should be evaluated using not only subjective (such as C-ACT score) but also objective (e.g.PFT, IOS) indices.