Objective To explore the preventive effect of early bowel intervention on the gastrointestinal dysfunction in patients with invasive mechanical ventilation.Methods Sixty patients with invasive mechanical ventilation were equally randomly divided into the observation group and the control group.patlents in the control group were treated by conventional nursing care,while Patients in the observation group were given the early bowel intervention including abdominal massage and stimulation of rectum.The two groups were compared in terms of gastrointestinal dysfunction.Result The rate of gastrointestinal dysfunction in the observation group was significantly lower than that of the control group(P<0.05).Conclusion The early bowel intervention may effectively promote intestinal peristalsis,protect the intestinal digestion, absorption of nutrients and mucosal barrier function and prevent gastrointestinal dysfunction in patients with invasive mechanical ventilation during enteral nutrition.

Objective To investigate the effects of Xuanfeitongfufang Decoction on expressions of MD-2, NF-κB protein and its mRNA in lung of the rats with acute lung injury caused by LPS. Methods Wistar rats were randomly divided into normal group, model group, dexamethasone group and Xuanfeitongfufang Decoction large-, medium-, small-dose group, each group had eight rats. The ALI rat model was established by LPS tail-intravenous injection (6 mg/kg). The rats in Xuanfeitongfufang Decoction groups were pretreated by Xuanfeitongfufang Decoction (15.12, 7.56, 3.78 g/kg) for 3 days before LPS induced ALI. The rats in dexamethasone group were pretreated by dexamethasone (5 mg/kg). MD-2, NF-κB protein and its mRNA were measured by immunohistochemistry and PCR. The histopathology of the lung injury was observed by light microscope. Results Compared with normal group, the expression of MD-2, NF-κB protein and its mRNA were obviously increased in model group (P<0.01). Compared with model group, the expression of MD-2, NF-κB protein and its mRNA were obviously decreased in Xuanfeitongfufang Decoction groups and dexamethasone group (P<0.01), and there was no obvious difference between Xuanfeitongfufang Decoction groups and dexamethasone group. Light microscope observation indicates that there were large areas of pulmonary hemorrhage and necrosis in model group. While in Xuanfeitongfufang Decoction group and dexamethasone group, the pathological manifestations were much more ameliorated than those of the model group. The lung bronchiale inflammation appeared occasionally, and the edema was lightly. Conclusion Xuanfeitongfufang Decoction can lessen the injury of lung tissue and has protective effects on rats with ALI, the mechanism is possibly related to the inhibition of the expressions of MD-2 and NF-κB protein and its mRNA in injured lung tissues.

Objective Survey the classification on diseases of patients in hospital. Discuss personnel arrange-ment of nursing staff. Methods Survey and star sickbed number,CD rate/month,nurse number accounted on nursing level and sickbed-nurse ratio in 2007, discuss personnel arrangement of nursing staff. Results It is different that the nurse number accounted by two means, Z=2.234,P=0.025. The correlation about CD rate and nurse number in theories: r=0.782,p=0.004, nurse number in theories= CD ratex0.51-17.11, F=16.543,p=0.003.Conclusion CD rate should be reasonable personnel arrangement of nursing staff.

This study was designed to investigate the polymorphism of intron 22 (CA)n repeat within FVIII gene in Dai, Yi and Han populations of Yunnan province. PCR, DNA sequencing technique and PAGE were used in this study. The results showed that three different alleles corresponding to 24, 25 and 26 dinucleotides were found at this locus and the allele frequency ranged from 1.20% to 57.7% in Dai and from 16.43% to 63.00% in Yi populations. In Han population, five different alleles with 24, 25, 26, 27 and 28 (CA)s were found, the allele frequency ranged from 8.97% to 32.00%. Heterozygotes of intron 22 (CA) repeat within FVIII gene were not found in the three populations. In conclusion, it was obvious that the locus cannot be acted as DNA genetic marker of FVIII gene in the three populations in Yunnan.

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.

Objective:To investigate the diagnostic value of independent and combined subtests of the psychometric hepatic encephalopathy score (PHES) in mild hepatic encephalopathy(MHE) of patients with liver cirrhosis, so as to optimize the PHES.Methods:This was a prospective, multicenter and real-world study which was sponsored by the National Clinical Research Center of Infectious Diseases and the Portal Hypertension Consortium. Twenty-six hospitals from 13 provinces, autonomous regions and municipalities countrywide participated in this study, induding Tianjin Third Central Hospital, the Fourth People′s Hospital of Qinghai Province, the Second Affiliated Hospital of Baotou Medical College, the Third People′s Hospital of Taiyuan, the Fifth Medical Center of PLA General Hospital and so on. From October 2021 to February 2022, outpatients and hospitalized patients with liver cirrhosis and no obvious hepatic encephalopathy were consecutively enrolled. All patients received 5 PHES subjects in the same order: number connection test(NCT)-A, NCT-B, digit symbol test(DST), line tracing test(LTT) and serial dotting test(SDT), and the scores were calculated. The total score of PHES <-4 was taken as the cut-off value for diagnosing MHE. Compare the differences in each subtest between MHE group and non-MHE group. Receiver operating characteristic curve(ROC) and area under the curve(AUC) was performed to assess the diagnostic value of independent and combined subtests in MHE. Mann-Whitney U test and DeLong test were used for statistical analysis. Results:A total of 581 patients with liver cirrhosis were enrolled, 457 were diagnosed as MHE, and the incidence of MHE was 78.7%. The results of NCT-A, NCT-B, SDT, LTT, DST of MHE group were 60.00 s(47.01 s, 88.00 s), 90.45 s(69.32 s, 125.35 s), 74.00 s(57.65 s, 96.60 s), 74.72(60.00, 98.61) and 27.00(20.00, 36.00), respectively. Compared those of non-MHE group(34.00 s(29.15 s, 44.48 s), 50.00 s(40.98 s, 60.77 s), 50.00 s(41.07 s, 63.03 s), 46.23(38.55, 59.42) and 42.00(34.00, 50.75)), the differences were statistically significant( Z=12.37, 12.98, 9.83, 11.56, 10.66; all P<0.001). The AUC(95% confidence interval(95% CI)) of subtests of PHES NCT-B, NCT-A, LTT, DST and SDT alone in MHE diagnosis were 0.880(0.849 to 0.910), 0.862(0.828 to 0.896), 0.838(0.799 to 0.877), 0.812(0.772 to 0.851) and 0.788(0.743 to 0.832), respectively. The combination of 2 PHES subtests significantly increased the diagnostic efficacy. Among them the diagnostic efficacy of the combination of NCT-B and LTT was the best, the AUC(95% CI) was 0.924(0.902 to 0.947), the specificity was 91.9% and the sensitivity was 79.2%, which was better than a single PHES subtest (NCT-A, NCT-B, SDT, LTT and DST) and the combination of NCT-A and DST(AUC was 0.879, 95% CI0.847 to 0.910) which was recommended by guidelines on the management of hepatic encephalopathy in cirrhosis, the differences were statistically significant ( Z=3.78, 3.83, 5.57, 5.51, 5.38, 2.93; all P<0.01). Furthermore, compared between the combination of NCT-B and LTT and the combination of 3 subests of PHES, only the diagnostic efficacy of combination of NCT-B, LTT and SDT (AUC was 0.936, 95% CI 0.916 to 0.956) was better than that of the combination of NCT-B and LTT, the difference was statistically significant( Z=2.32, P=0.020). Conclusion:Based on the diagnostic efficacy and clinical feasibility of PHES subtests and their combinations, the combination of NCT-B and LTT is recommended for the diagnosis of MHE.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.