Nipah virus (NiV) and related viruses form a distinct henipavirus genus within the Paramyxoviridae family. NiV continues to spillover into the humans causing deadly outbreaks with increasing human-bat interaction. NiV encodes the large protein (L) and phosphoprotein (P) to form the viral RNA polymerase machinery. Their sequences show limited homologies to those of non-henipavirus paramyxoviruses. We report two cryo-electron microscopy (cryo-EM) structures of the Nipah virus (NiV) polymerase L-P complex, expressed and purified in either its full-length or truncated form. The structures resolve the RNA-dependent RNA polymerase (RdRp) and polyribonucleotidyl transferase (PRNTase) domains of the L protein, as well as a tetrameric P protein bundle bound to the L-RdRp domain. L-protein C-terminal regions are unresolved, indicating flexibility. Two PRNTase domain zinc-binding sites, conserved in most Mononegavirales, are confirmed essential for NiV polymerase activity. The structures further reveal anchoring of the P protein bundle and P protein X domain (XD) linkers on L, via an interaction pattern distinct among Paramyxoviridae. These interactions facilitate binding of a P protein XD linker in the nucleotide entry channel and distinct positioning of other XD linkers. We show that the disruption of the L-P interactions reduces NiV polymerase activity. The reported structures should facilitate rational antiviral-drug discovery and provide a guide for the functional study of NiV polymerase.
Nipah Virus/chemistry* ; Cryoelectron Microscopy ; Viral Proteins/genetics* ; RNA-Dependent RNA Polymerase/genetics* ; Phosphoproteins/genetics* ; Humans ; Models, Molecular ; Protein Binding

Objective? To explore the clinical application of information technology in the multidisciplinary chain management of surgical patient handover, in order to reduce the safety hazard in the process of surgical patient handover. Methods? In the contemporary controlled study, 300 patients were selected as the control group from February to July 2017 by cluster sampling, and 303 patients were selected as experimental group from February to July 2018. Traditional sectional handover method was adopted in the control group, to managed the patients＇ handover from each section. In the experimental group, based on the information communication platform between the surgery room and relevant clinical departments, by clinical electronic documents chain transfer method, quality inspection and supervision information feedback technology, to achieve shared decision and improvement of patients handover problems, we built the multidisciplinary management pattern. The two groups were compared for statistical difference from six aspects:the rate of acceptance specification, the accuracy of identity verification method, the rate of operation labeling verification, the accuracy of inventory of items, the evaluation of pipeline patency, and the evaluation of skin condition at the compression site. Results? The rate of standard delivery of surgical patient handover increased from 49.33% to 92.08% in the two groups. The experimental group was better than the control group in the rate of correct delivery of handover from the following five aspects: identity recognition, indication of surgical site, inventory of articles carried, unobstructed pipeline and skin state of the pressure site with statistical significance (P＜ 0.01). Conclusions? The multidisciplinary chain management model of surgical patient handover supported by information technology is effective in clinical application, which can significantly reduce the risk of hazard in patient handover and is worthy of clinical promotion.

Objective To study the effects of perioperative body temperature management on intraperitoneal hyperthermic perfusion chemotherapy patients with abdominal malignant tumor. Methods From June to Decmber 2016, a total of 120 intraperitoneal hyperthermic perfusion chemotherapy patients with abdominal malignant tumor who met the inclusion criteria were recruited and randomly divided into control group and observation group, with 60 cases in each. All the subjects were given routine operation nursing. On the basis of that, the observation group were given perioperative body temperature management. The body temperature, heart rate, pulse pressure and the difference of tumor markers of carcineombryonic antigen (CEA) and carbohydrate antigen19-9(CA199) before and after treatment were compared between the two groups. Results The difference value of temperature, heart rate and pulse pressure between 30 minutes after treatment and before treatment in the observation group were (3.7±0.4)℃, (12.4±2.7)bp/min and (5.6±1.9)mmHg respectively. The fluctuation of vital signs was lower than the control group, and the differences were statistically significant (t=6.062, 14.897, 10.392; P<0.01). The observation group patients' CEA was (52.8±2.4)μg/L, and CA199 was (106.1±5.3)U/ml after treatment, which were both lower than the control group, with statistical differences(t=31.415, 33.803; P< 0.05). Conclusions Perioperative body temperature management could significantly stabilize the body temperature, heart rate and pulse pressure, which could significantly promote intraperitoneal hyperthermic perfusion chemotherapy's curative effect for patient with abdominal malignant tumor.

Objective To analyze the application effect of disposable surgery retractor which made of high polymer medical plastic.Methods From January 2016 to October 2016,80 patients of HCC who were treated with hepatectomy under general anesthesia in our hospital were randomly divided into the control group and the observation group according to different retractor during surgery.The control group used the traditional abdominal retractor during the sugery.Meanwhile,the observation group used disposable surgery retractor.The application effect between the two groups were compared.Results The satisfaction rate of surgical exposure and effect in surgeon of the observation group were higher than those of the control group.The wound pain time of patients in perioperative period and 1 month after surgery and chronic pain incidence in postoperative 6 months between the two groups were evaluated.It turned out that the difference in average pain score was statistically significant (P<0.05).Conclusion The disposable surgical retractor can improve the satisfaction rate of surgeons with better surgical exposure,and it can significantly reduce the damage of wound tissue,which effectively relieves the postoperative pain,shortens the time of postoperative pain,and reduces the incidence of chronic pain.

Objective To explore the effective measures for the stability of micro-environmental indicators in clean operating department.Methods Professionals of clean technology were invited to participate in unit operation and maintenance of management.Besides, operating room managers conducted regular sampling analysis of five micro-environmental indicators, including temperature, humidity, differential pressure, illumination and decibel, in 100-level, 1 000-level, 10 000-level, 100 000-level clean operating rooms, and compared the test results with parameters of target environmental indicators regulated in national standards.Then the test results of annual bacteria subsidence from different operating rooms in clean operating department were compared.Results Under the management of professionals, the values of temperature, humidity, differential pressure, illumination and decibel from micro-environment in 100-level, 1 000-level, 10 000-level, 100 000-level clean operating rooms were in accordance with rated values in the industry with ( P>0.05);the annual bacteria subsidence in 100-level, 1 000-level, 10 000-level, 100 000-level clean operating rooms in 2013 was in accordance with the standards specified in GB50333 and clearly less than rated values.Conclusions Professional participating in the management and maintenance of micro-environment in clean operating department and irregular supervision and sampling test by operating room managers, the micro-environmental indicators in operation department can be well controlled.

Purpose: To observe the therapeutic effect of plum-blossom-magnet-needle synthetic therapy on benign prostatic hyperplasia (BPH). Method: 219 cases of BPH patients were randomly divided into two groups. There were 149 cases in treatment group, which treated by pressing, needling with plum-blossom-magnet-needle and putting effect-increasing pads on Prostate Reflex Area, bilateral Zhongliao (BL 32), Neck 1, Neck 7, Mingmen (GV 4) and Yongquan (KI 1). There were 70 cases in control group, which treated by orally taken Terazosin Hydrochloride (Gaoteling) tablets, 2 mg/time, twice a day. The therapeutic course was 4 weeks.After one therapeutic course, the therapeutic effect was evaluated. Results: The marked effect rate was 63.3% and total effective rate was 91.8%; in the control group, there were no markedly effective cases and the total effective rate was 72.7%. There was a significant difference between two groups (P<0.05). Conclusion: The plum-blossom-magnet-needle synthetic therapy had a significant therapeutic effect for the treatment of benign prostatic hyperplasia (BPH), so it was a safe and effective therapy for BPH.