Vitamin D binding protein ( VDBP) is a multi-functional plasma globulin which binds to the vitamin D ( VD) in the circulation system and transporting the latter to various effective organs to exert its biological functions .Studies have found that VD and its carrier VDBP are associated with the risk of various cancers such as breast cancer , prostate cancer , and colorectal cancer however , lacking sufficient epidemiological evidences so far .Furthermore , it is still controversial regarding how VD controls and affects cancer progression.In addition, studies have also demonstrated that VDBP derived macrophage-activating factor (GcMAF) is a potent lymphokine in cancer treatment .Nonetheless, the relationship between VDBP and cancer including the VDBP polymorphism, VDBP plasma concentration are still unclear; more studies are needed to further uncover its role in cancer development and progression , thus providing new evidences for cancer diagnosis, treatment, and prognosis.

Objective Through application of clinical pathway in hospitalization patients undergoing uterectomy, we aimed to study the efficacy of clinical pathway in uterectomy patients. Methods 120 patients randomly sampled into the experimental group and the control group with 60 in each. The experimental group received diagnosis, treatment, nursing and rehabilitation according to the clinical pathway table, patients in the control group received routine nursing interventions. The average hospitalization days, medical costs, patient satisfaction degree, disease cognition, first exercise time after operation and medical disputes were compared between the two groups. Results The average hospitalization days and hospitalization costs of the experimental group were obviously lower than those in the control group, patients' satisfaction degree, knowledge of health and first functional exercise time in the experimental group were better than those of the control group, while the medical disputes in the experimental group were obviously de -creased in the experimental group. Conclusions Application of clinical pathway in nursing care for uterectomy patients can effectively decrease hospitalization days, medical costs and disputes. It is also helpful for patients to cooperate with doctors in diagnosis, treatment, nursing, thus increase the satisfaction degree of patients, ensure the reasonable use of medical resources and promote the sustainable improvement of nursing quality.

Operation rules of sterilizing are put forward.Responsible persons with working licenses are selected.The cleanout,packing,loading of pre-sterilized goods are standardized.Sterilizing effects(physical monitoring,chemical monitoring,biological monitoring,B-D test) are inspected.Requirements in maintenance and metrology test are raised.The content and methods for quality control of sterilized goods by using decontamination device are introduced systematically.It is instructive to enhance decontamination quality and lower infection rate in hospitals.

Objective To perform the amplification ,sequencing and prokaryotic expression of APH (3′′)‐Ⅰ and AAC (2′)‐Ⅰgenes from the clinically isolated gzch810 strain(SM gzch810)of Stenotrophomonas maltophilia to provide the basic materials for the next step functional test .Methods The SM gzch810 genome chromosome was extracted ,the APH (3′′)‐Ⅰ ,AAC (2′)‐Ⅰ whole genes were amplified by PCR and sequenced after being cloned into pMD18‐T vector .The recombination were subcloned into pGEX‐4T‐1 vector and the expression of the recombinant APH (3′′)‐Ⅰ and AAC (2′)‐Ⅰ were analyzed by SDS‐PAGE .Results The 800bp and 550bp DNA fragments of APH(3′′)‐Ⅰ ,AAC(2′)‐Ⅰ gene were amplified from SM gzch810 by PCR and sequenced ;the sequence comparison analysis showed that DNA and amino acid sequence identities of APH (3′′)‐Ⅰand AAC (2′)‐Ⅰ genes with other strains were 91% and 95% respectively .The sequence of APH (3′′)‐Ⅰand AAC(2′)‐Ⅰ of SM gzch810 were submitted to GenBank(accession number :HQ315852 and HQ315853);two major protein bands corresponding to the expected recombinant GST‐TP fusion proteins (56 × 103 and 46 × 103 respectively) were identified by SDS‐PAGE .Conclusion APH(3′′)‐Ⅰand AAC(2′)‐Ⅰgene of SM gzch810 are successfully cloned and expressed ,which lays a good foundation for further detecting corresponding antibi‐otic resistance and functional evaluation of above two kinds of recombinant E .coli .

Objective To explore the relationship among social support, postpartum depression and quality of life of puerperal women. Methods A total of 348 puerperal women were investigated with Postnatal Social Support Questionnaire,Edinburgh Postnatal Depression Scale (EPDS) and WHO Quality of Life-BREF (WHOQOL-BREF). Results Pearson correlation analysis showed that there was a significant positive correlation between social support and the quality of life (r=0.483, P < 0.01), and a significant negative correlation to postpartum depression (r=-0.243, P < 0.01),and a significant negative correlation between postpartum depression and quality of life (r=-0.408, P<0.01). Intermediary effect of postpartum depression was tested. Conclusions A good social support system is benefit to improve depression scores for EPDS, and promote the life quality in puerperal women.

Objective To understand the molecular epidemiology of penicillin resistance Streptococcus pneumonia (PNSP) isolated from children in Guangzhou area to provide the experimental basis for clinical prevention and control of Streptococcus pneumonia infectious diseases.Methods Specific primers were designed according to Genebank,penicillin binding protein(PBP) genes PBP1A,PBP1B,PBP2A,PBP2B,PBP2X,PBP3 were amplified by PCR.The sequencing analysis was performed.The PCR products were digested by Hinf I,and the restriction fragment length polymorphism (RFLP) was analyzed.Results DNA of PNSP was successfully extracted,the PCR results showed that in 50 strains of PNSP,the positive rates of bacterial strains containing PBP1A,PBP1B,PBP2A,PBP2B,PBP2X and PBP3 were 48.9%,64.4%,71.1%,31.1%,40.0% and 31.1% respectively.The sequencing showed that their homologies with known sequences in GenBank were 99%,98%,100%,97%,95% and 100% respectively.Using RFLP in Hinf I showed that PBP1A,PBP1B,PBP2A and PBP3 only had one kind of genotype,PBP2B and PBP2X had two kinds of genotypes,the positive rates were 71.4%,28.6%,66.7% and 33.3% respectively.Conclusion The gene distribution of PNSP strains among children in Guangzhou is dominated by PBP2A,PBP1B and PBP1A,there are two subtypes in PBP2B,PBP2X when digested by Hinf I,in which the predominant subtype >65%.

Objective:To investigate the effect of nurse-led stress inoculation training on fear of self-injecting and self-testing and self-management behaviors in elderly type 2 diabetic patients and provide reference for diabetes nursing care.Methods:A total of 110 elderly type 2 diabetic patients of Department of Endocrinology of Hainan People′s Hospital from January 2018 to January 2020 were divided into experimental group and control group according to odd and even numbers, with 55 patients in each group. The control group received routine nursing care, while the experimental group implemented nurse-led stress inoculation training for 4 weeks. The intervention effect was assessed by Diabetes Fear of Injecting and Self-testing Ouestionnaire (D-FISQ) and Diabetes self-management behaviors among older (DSMB-O), respectively.Results:In the study, one patient in the experimental group fell off, and finally included 54 cases in the experimental group and 55 cases in the control group. After intervention, the fear of self-injecting scores, fear of self-testing scores, and total D-FISQ scores were 13.15 ± 3.02, 15.67 ± 3.59 and 28.81 ± 5.08 in the experimental group, significantly lower than those in the control group (15.25 ± 3.18, 17.56 ± 3.92 and 32.82 ± 4.89), the difference was statistically significant ( t=3.55, 2.63, 4.19, P<0.05). Active exercises, current medication, blood glucose monitoring, dealing with problem, active response, reducing risks scores and total DSMB-O scores were 2.39 ± 0.49, 2.39 ± 0.49, 2.20 ± 0.81, 4.41 ± 0.92, 4.70 ± 1.13, 5.06 ± 0.79 and 25.28 ± 2.57 in the experimental group, significantly higher than those in the control group (3.95 ± 0.85, 2.11 ± 0.85, 1.51 ± 0.50, 3.95 ± 0.78, 4.13 ± 1.43, 4.38 ± 1.16 and 22.09 ± 2.24), the difference was statistically significant ( t values were 2.10-6.90, P<0.05). Conclusions:Nurse-led stress inoculation training can effectively alleviate fear of self-injecting and self-testing and promote self-management behaviors of elderly patients with type 2 diabetes.

Objective To establish and optimize a loop-mediated isothermal amplification (LAMP) method for the rapid detection of Escherichia coli and its microbial toxin.Methods The LAMP reaction system and reaction conditions were determined by optimizing LAMP reaction,and the optimized LAMP system was used for the detection.Results Primers targeting shiga toxin (stx) gene and O157 antigen gene rfbe were designed.The established and optimized LAMP amplification system contained 1.2 mmol/L dNTPs,10 mmol/L MgSO4,0.4 mol/L betaine,1 μl 10 × Bst DNA polymerase Buffer,8 U Bst DNA polymerase fragment,2 μl DNA template,and the ratio of inner-primer (FIP and BIP) and outerprimer (F3 and B3) were 8∶ 1.Time and temperature for LAMP was 60 min,60 ℃.The sensitivity was 103 times higher than polymerase chain reaction (PCR),reached 5 × 101 CFU/ml.When LAMP was applied to 19 reference strains,102 EHEC strains,the specification was 100％ while identification rate of rfbe,stx1 and stx2 gene reached 100％,95.2％,92.9％.Conclusions The LAMP method showed a promising prospect for the rapid detection of common nosocomial pathogens microbial toxin.

Group B streptococcus ( GBS) is the most common cause of neonatal invasive infections in western countries , leading to severe pneumonia , sepsis and meningitis with high mortality and morbidity . Neonatal GBS infections are mainly transmitted from mother to baby .Since the end of 1990 s, prevention strategies of antenatal GBS screening and intrapartum antibiotic prophylaxis ( IAP) have been implemented by European and American area , decreasing the incidence of neonatal GBS disease significantly .The harm of GBS to neonates has been recognized and valued in recent years in China , but the authorized prevention measures are still lacking.Efficacy of IAP-based prevention depends on the accuracy of GBS screening results during pregnancy .Here, the GBS prevention guideline or consensus recommended by European and American CDC, including the screening strategies , detection methods, sample collection, storage and transportation were interpreted .

Objective:To establish a classification model for rapid identification of hypervirulent subtype ST17 clones of Group B Streptococcus (GBS) using matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS).Methods:In a retrospective study, 235 strains of GBS strains were selected from multiple centers in China during 2015-2018. For model generation,45 strains of ST17 and 50 strains of non-ST17 (20 ST19, 15 ST12 and 15 ST10 strains) were enrolled as the modeling group. The remaining 90 main ST strains (40 ST17, 16 ST10, 17 ST12 and 17 ST19) were served as validation group. 50 GBS strains classified as other minor ST subtypes were regarded as taxonomic groups. MS spectra were collected by Bruker mass spectrometry, and then loaded for model generation and verification, and screening of differential peptide peaks by genetic algorithm (GA) and model verification on ClinProTools 3.0 software.Results:The recognition rate for ST17-GA model were 99.4% with cross validation value of 96.9%. Among the ten differential peptide peaks for the classification model, the weights of both two main peptide peaks m/z 2 956 and m/z 5 912 were greater than 1, while the weights of the all other eight peptide peaks were less than 0.5. Model validation showed only one of the ST17 was misjudged as non-ST17 strain, resulting in diagnostic accuracy of 98.9%, sensitivity of 97.5% and specificity of 100%, positive predictive value of 100% and negative predictive value of 98.0%, respectively. For other sporadic STs, 42.0% (21/50) of them were misdiagnosed as ST17 subtype.Conclusion:A MALDI-TOF MS classification model for hypervirulent subtype of ST17 GBS strains has been successfully established with good diagnostic efficacy.