ving CQI(P＜0.05).Conclusion CQI program effectively reduces CRBSI incidenee in cancer patients with PICC.

OBJECTIVETo study whether the abilities of hepatitis C virus (HCV) E2 gene immunization to induce humoral and cellular immune responses to E2 protein were affected by hepatitis B virus (HBV) preS gene when they fused in DNA-immunized mice.

METHODSMice were immunized with E2, preS-E2 (preS gene was upstream of E2 gene), and E2-preS (preS gene was downstream of E2 gene) gene by their eukaryotic expression vectors, respectively. The anti-E2 or anti-preS antibodies were detected using the E2 and preS antigens. The cellular immune response to E2 protein in immunized mice was presented by its survival time after injecting SP2/O myeloma cells expressing HCV E2 protein into the abdominal cavity.

RESULTSChimeric E2 and preS gene immunization can induce mice to develop anti-preS and anti-E2 antibodies. The number of the mice developing anti-E2 antibody and the antibody titers in preS-E2 gene-injected group were higher than those in E2-preS gene-immunized group. However, the mice injected with E2 gene did not develop the detectable anti-E2 antibodies until 12 weeks after DNA immunization. After the mice was injected with target cells, the average survival time of the mice in the group immunized with E2 gene alone was longer than that of the group injected with E2 gene fused with HBV preS and was significantly longer than that of the control (P < 0.05).

CONCLUSIONHBV preS might be a humoral enhancer that can affect the abilities of HCV E2 protein to induce immune responses in DNA-immunized mice.

Animals ; Antibody Formation ; drug effects ; Hepacivirus ; chemistry ; Hepatitis B Surface Antigens ; genetics ; pharmacology ; Hepatitis B virus ; chemistry ; genetics ; Immunity, Cellular ; drug effects ; Male ; Mice ; Mice, Inbred BALB C ; Protein Precursors ; genetics ; pharmacology ; Recombinant Fusion Proteins ; immunology ; Viral Envelope Proteins ; genetics ; pharmacology

Objective:The surveillance results of brucellosis in Lushan County, Pingdingshan City, Henan Province are analyzed to provide basis for formulating prevention and control strategies.Methods:Retrospective analysis method was used to collect the surveillance data from Lushan County Center for Disease Control and Prevention and Animal Husbandry Department from 2011 to 2019. Descriptive statistical analysis was made on the serological, pathogenic of brucellosis.Results:From 2011 to 2019, 15 943 high-risk people were investigated, and 10 834 were serologically tested, with a positive detection rate of 23.11% (2 504/10 834). Among them, the positive detection rate of brucellosis serum increased rapidly in 2013 and decreased after 2016. The positive detection rate was 25.87% (1 593/6 157) in men and 19.48% (911/4 677) in women. The age of positive detection was mainly 40-< 70 years old, accounting for 70.45% (1 764/2 504). The positive detection rate of farmers in all occupations was the highest, which was 25.97% (2 242/8 634). There were significant differences in the positive detection rates among different gender, age and occupation (χ 2=61.163, 27.855, 257.412, P < 0.01). A total of 578 blood samples from patients with acute brucellosis were isolated and cultured, 215 strains of Brucella were detected, and the positive detection rate was 37.20%. Conclusions:The high-risk group of human brucellosis in Lushan County, Pingdingshan City is middle-aged and elderly male farmers engaged in aquaculture. It is suggested that the joint prevention and control measures should be strengthened, the health education of high-risk groups should be strengthened, and comprehensive prevention and control measures should be taken to control the occurrence and prevalence of brucellosis.

BACKGROUND:Sepsis is one of the main causes of mortality in intensive care units(ICUs).Early prediction is critical for reducing injury.As approximately 36%of sepsis occur within 24 h after emergency department(ED)admission in Medical Information Mart for Intensive Care(MIMIC-IV),a prediction system for the ED triage stage would be helpful.Previous methods such as the quick Sequential Organ Failure Assessment(qSOFA)are more suitable for screening than for prediction in the ED,and we aimed to find a light-weight,convenient prediction method through machine learning. METHODS:We accessed the MIMIC-IV for sepsis patient data in the EDs.Our dataset comprised demographic information,vital signs,and synthetic features.Extreme Gradient Boosting(XGBoost)was used to predict the risk of developing sepsis within 24 h after ED admission.Additionally,SHapley Additive exPlanations(SHAP)was employed to provide a comprehensive interpretation of the model's results.Ten percent of the patients were randomly selected as the testing set,while the remaining patients were used for training with 10-fold cross-validation. RESULTS:For 10-fold cross-validation on 14,957 samples,we reached an accuracy of 84.1%±0.3%and an area under the receiver operating characteristic(ROC)curve of 0.92±0.02.The model achieved similar performance on the testing set of 1,662 patients.SHAP values showed that the five most important features were acuity,arrival transportation,age,shock index,and respiratory rate. CONCLUSION:Machine learning models such as XGBoost may be used for sepsis prediction using only a small amount of data conveniently collected in the ED triage stage.This may help reduce workload in the ED and warn medical workers against the risk of sepsis in advance.

Alport syndrome (AS), also known as "eye-ear-kidney syndrome or hereditary nephritis", is a common hereditary disorder. AS is caused by pathogenic mutations of type Ⅳ collagen genes ( COL4α3, COL4α4 and COL4α5), leading to defects in the basement membrane of glomeruli, cochlea, and ocular lens. Patients present with hematuria, proteinuria, and progressive renal failure. With the redefinition of AS and the clinical application of high-throughput sequencing technology, the prevalence of AS may be much higher than the previously recognized. The specific pathogenic mechanism of AS is unknown. Recent studies have showed that type Ⅳ collagen gene mutation may lead to kidney injury by causing abnormal basement membrane components, lipid deposition, energy metabolism disorders, endoplasmic reticulum stress, inflammation and fibrosis. Renin-angiotensin system inhibitor is the main therapy of AS, but the effect is not satisfactory. The new therapeutic strategies mainly include inhibition of abnormal collagen signal transduction, reduction of endoplasmic reticulum stress in podocytes, regulation of energy metabolism, antioxidant stress, anti-inflammation and fibrosis, gene and stem cell therapy. The paper reviewed the research progress on pathogenesis and new therapies of AS.

Objective:To discuss the feasibility of offering specialized courses of critical care medicine in undergraduate clinical medicine education, so as to alleviate the shortage of critical care medicine staffs and lay a foundation for improving the success rate for the treatment of critical cases.Methods:The undergraduates majoring in clinical medicine from 2008 to 2011 in Guizhou Medical University (the former Guiyang Medical College) were enrolled. After they had been enrolled in the undergraduate education for 3 years and were ready for Grade four, which meant basic medicine teaching had been completed and clinical medicine teaching was about to start, they were introduced and preached to each discipline, including critical care medicine. The undergraduates were free to choose professional direction of clinical training in Grade four. Students majoring in clinical medicine from 2012 to 2014 were free to choose their major direction when they entered the school.Results:From September 2011 to July 2019, the university had cultivated 246 undergraduates majoring in clinical critical care medicine from 2008 to 2014, and the critical care medicine professional team of affiliated hospital had undertaken 540 teaching hours. By July 2019, all students had graduated on time, with an employment rate of 100%. Forty students took postgraduate programs in our school and other schools, accounting for 16.3%.Conclusions:Professional education of critical care medicine in the undergraduate course of clinical medicine can mobilize students' interest in learning and subjective initiative, which is conducive to career selection. During the clinical training, the students can identify and timely cure critical care cases in the early stage, and partly alleviate the current shortage of critical care medical staffs.