Abstract: Objective　To explore the correlation between levels of hypersensitive C-reactive protein (hs-CRP) and procalcitonin (PCT) in serum and alveolar fluid and severity of disease in children with lobar pneumonia. Methods　A total of 112 children diagnosed with lobar pneumonia from September 2020 to September 2021 were selected as the research subjects. The levels of hs-CRP and PCT in serum and alveolar fluid were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The children were divided into severe group (clinical pulmonary infection score, CPIS≥6 points) and mild group (CPIS<6 points) according to the severity of disease, and further classified into good prognosis group (cured, improved) and poor prognosis group (uncured) according to their treatment outcomes. The correlation of levels of hs-CRP and PCT in serum and alveolar fluid with disease severity in children and their predictive value on prognosis were analyzed. Results　The levels of serum hs-CRP and PCT in severe group were (17.73±3.26) μg/L and (8.59±1.84) μg/L, which were significantly higher than corresponding (12.58±3.09) μg/L, and (5.62±1.59) μg/L in mild group (P<0.05); the levels of hs-CRP and PCT in alveolar fluid in severe group were (21.25±4.18) μg/L and (8.71±1.54) μg/L, which were significantly higher than corresponding (13.79±2.76) μg/L and (5.38±1.69) μg/L in mild group (P<0.05). The levels of hs-CRP and PCT in serum and alveolar fluid were positively correlated with CPIS scores (r=0.398, 0.441; 0.475, 0.586, P<0.05). The levels of hs-CRP and PCT in serum in poor prognosis group were (20.09±4.20) μg/L and (13.35±2.91) μg/L, which were significantly higher corresponding (8.75±2.19) μg/L and (6.28±1.31) μg/L in good prognosis group (P<0.05). The levels of hs-CRP and PCT in alveolar fluid were (23.70±4.29) μg/L and (10.73±2.04) μg/L, which were higher than corresponding (15.08±3.56) μg/L and (5.79±1.10) μg/L in poor prognosis group (P<0.05). There was no significant difference in AUC between combined detection of serum indicators and combined detection of alveolar perfusion fluid indicators in predicting the prognosis of children with lobar pneumonia (P>0.05). Conclusions　The levels of hs-CRP and PCT in serum and alveolar fluid of children with lobar pneumonia are significantly increased and positively correlated with the severity of disease. However, the predictive value of the combined detection of serum indicators and combined detection of alveolar perfusion fluid indicators for the prognosis of children with lobar pneumonia is comparable.

Objective To screen the arsenic content situation of drinking water in lower reaches of Yellow River and survey the amount of threatened people drinking high arsenic water and the condition of endemic arsenism.Methods Four counties of Yuncheng,Jiaxiang,Dongchangfu and Boxing were selected to colleft the water samples by CroOSS-sectional survey method.The water arsenic content wag determined by semi-quantitative rapid kit.All water samples having arsenic were re-determined by atomic fluorescence spectrometry.And the nurober of threatened people who drinking high arsenic water were investigated.Results In 4765 water wells screened,303 water samples had contained arsenic,arsenic content of 35 samples Was≥0.030 mg/L,12 samples were exceeding the international standard (arsenic content≥0.050 ms/L),they distributed in 3 counties of Dongchangfu,Yuncheng and Jiaxiang.The residents drinking water wells of arsenic content≥0.030 mg/L were surveyed by epidemiological investigation.And in the 28 villages 13 032 residents and 11 Bu8picious patient8 wlere checked out.Conclusion The wells with excesive water arsenic content are existing in the lower reaches of Yellow River and people suspicious of endemic arsenism need to be further identified.

Objective: To explore the relationship between NLRP3 inflammasome and atrial fibrillation (AF) by examining peripheral blood level of NLRP3 inlfammasome and other inlfammatory factors in relevant patients.
Method: A total of 60 AF patients were enrolled and divided into 2 groups: Paroxysmal AF (PAF) group and Non-paroxysmal atrial fibrillation (nPAF) group, n=30 in each group;in addition, there was a Control group including 26 healthy subjects from physical examination. NLRP3 expression in peripheral blood mononuclear cells (PBMCs) was measured by lfow cytometry;blood levels of IL-1β, IL-6, CRP and NT-proBNP were detected by ELISA. The correlations among different factors were studied by liner regression analysis and the differences were compared among groups.
Result:①Compared with Control group, PAF and nPAF groups had increased PBMCs level of NLRP3 and blood levels of IL-1β, IL-6, CRP, NT-proBNP, P<0.05, while NLRP3 level was similar between PAF group and nPAF group, P>0.05.②PAF and nPAF groups showed elevated blood level of NT-proBNP than Control group, P<0.05. ③PBMCs level of NLRP3 was positively related to left atrial diameter (r=0.579, P<0.05) and negatively related to left ventricular ejection fraction (r=-0.490, P<0.05) in both AF groups.
Conclusion: ① NLRP3 inflammasome was closely related to AF, which may provide a therapeutic target for AF treatment. ② AF was closely related to inflammatory response. ③ Downstream product of NLRP3 may cause the inlfammatory response which could induce the occurrence, development and maintenance of AF in relevant patients.

Objective To observe the curative effect of captopril and metoprolol in the treatment of chronic Keshan disease (CKD). Methods One hundred and ninty-five patients with CKD chosen from Juxian, Wulian, Yishui, Pingyi, Sishui and Zoucheng in Shandong Province were randomly assigned to control group, captopril group and metoprolol group according to NYHA cardiac functional grading. All cases were given diuretics, digitalis and vasodilating agents as routine treatment. On this basis, captopril and metoprolol was administered in captopril group and metoprolol group respectively. After 12 months of follow-up visit, the causes of cardiac death, hospitalization status and the changes of heart size, electrocardiogram, blood pressure and heart rate were all observed. Results It was found that the mortality of captopril group and metoprolo] group was 4.76% (3/63), 5.00% (3/60) respectively, both lower than the control group 10.61%(7/66). But this difference had no statistically significance(P=0.39). Besides, the hospitalization days of each year in captopril group and metoprolol group was respectively (19.12± 20.35) and(18.86±21.52)days, much more reduced than in the control group[(21.45±21.74)days, q=3.17, 3.38, P<0.05]. The detection rate of cardiothoracic ratio decreased in captopril group and metoprolol group [45% (27/60) and 40.4% (23/57)] After treatment showed more pronounced amelioration than the control group [18.6% (11/59), χ2=9.51,6.59, all P<0.0125], still the detection rate of cardiomegaly and invariability had no significant difference among three groups (χ2=2.50,4.75, all P>0.05). The elimination coefficient of ectopic rhythm in metoprolol group [56.5% (13/23)] was pronounced higher than the control group and captopril group [23.8% (5/21), 22.7% (5/22)], but differences had no statistically significance(P=0.0358,0.0331, all P>0.0125). Significant differences were found in systolic blood pressure(SBP), diastolic blood pressure(DBP) and heart rate(HR) in three groups prior and post-treatment(F=47.51,44.23,80.66, all P<0.01). The interaction of therapy and treatment time had influence on SBP and HR (F=3.19,37.44, all P<0.05), but had no influence on DBP(F=2.21, P> 0.05). There was no difference in SBP, DBP or HR among three groups before treatment(F=0.28,0.57,1.80, all P>0.05). After treatment, SBP and DBP in captopril group, metoprolol group and the control group[(109.0±10.9), (112.2±12.8), (114.7±13.2)mm Hg, (69.3±7.2), (72.1±9.5), (73.3±9.3)mm Hg] were all lowered compared with pre-treatment[ (117.1±13.4), (119.0±14.4), (117.6±14.1)mm Hg and (74.2±10.2), (76.3±10.8), (75.4±11.1)mm Hg, t=4.79,4.47,2.08,5.12, 4.32,2.15, all P<0.05]. HR was reduced in metoprolol group, being [(66.2±7.7), (75.9±11.5)times/min] before and after treatment(t=10.81, P<0.01), while it remained unchanged in captopril group and control group[(70.6±8.0), (72.6±10.5) times/min and (71.9±10.4), (73.8± 12.2)times/min, t=1.77,1.74, all P>0.05]. After treatment, both SBP and DBP of captopril group were significantly lower than that in the control group (q=3.52,3.56, all P<0.05); HR was reduced in metoprolol group, lower than that in captopril group and control group(q=5.44,3.73, all P<0.01). Conclusions Having a tendency of depressing mortality, captopril and metoprolol can reverse or delay myocardial remodeling and reduce admission rate in a safe,reliable and economic way, and are worth to be widely used in the treatment of chronic Keshan disease.

OBJECTIVETo evaluate the microleakage of fiber post and core systems after high-speed handpiece preparation at different time points.

METHODSThe crowns of forty-five extracted human premolar were removed and the roots were endodontically treated. The samples were devided into five groups. Root canal preparation was performed on each premolar followed by fiber post cementation and core build up. Tooth preparation was applied at 5 min in group 1, at 15 min in group 2 and at 30 min in group 3 after post cementation. Five teeth with only 5 mm apical sealing were served as a positive control group, and ten with fiber post and core build-up but no coronal preparation were taken as a negative control group. Microleakage was evaluated using a fluid filtration system. The bonding interface was observed by scanning electronic microscope (SEM).

RESULTSThe microleakage was significantly increased after coronal preparation with high-speed handpiece. The negative control group has less leakage [(1.50 × 10(-6) ± 0.37 × 10(-6)) µl×min(-1)×Pa(-1)] than the groups with coronal preparation (P < 0.05); Group 1 leaked significantly more [(6.02 × 10(-5) ± 1.02 × 10(-5)) µl×min(-1)×Pa(-1)] than group 2 [(1.50 × 10(-5) ± 0.26 × 10(-5)) µl·min(-1)×Pa(-1)] and group 3 [(1.50 × 10(-5) ± 0.39 × 10(-5)) µl×min(-1)×Pa(-1)] did (P < 0.05). Corresponding to microleakage, the micro gaps between the resin cement and dentine in group 1 were wider than those in the other groups. The coronal section was wider than the apical part.

CONCLUSIONSHigh-speed handpiece had negative effects on microleakage of fiber post and core systems. Coronal preparation should be performed 15 min or more after post cementation.

Cementation ; Dental Bonding ; Dental Leakage ; Dentin-Bonding Agents ; Humans ; Microscopy, Electron, Scanning ; Post and Core Technique ; instrumentation ; Resin Cements ; Root Canal Preparation ; Time Factors

Objective To observe the electrocardiogram changes of threatened crowds in Keshan disease (KSD) endemic area in Shandong province. Methods In 2008,inhabitants from 21 villages of Zoucheng,Sishui,Tengzhou, Yishui, Pingyi, Wulian, Juxian and Qingzhou regions were selected as subjects undergoing electrocardiogram. No less than 100 people were chosen from each village and the examination rate was not lower than 85%. Results Among the 3378 inhabitants investigated,460 cases showed abnormal electrocardiogram and the total incidence of abnormal electrocardiogram was 13.62% (460/3378). The relatively high incidence was T-wave changes,QRS low voltage and ST-T changes,the detection rate being respectively 2.69% (91/3378), 1.92% (65/3378) and 1.72% (41/3378). The highest incidence of abnormal electrocardiogram (26.76%,55/213),the intermediate(21.50%,43/200) and the lowest(5.50%,12/218) was respectively found in Pingyi,Qingzhou and Sishui. Conclusions The threatened crowds in KSD endemic area in Shandong province are still in a state of high abnormal electrocardiogram detection,and electrocardiogram is of great value in the evaluation of KSD patients.

Objective To study the current situation of emergency nurses' structural empowerment,competency,job satisfaction,and their correlative factors.Methods Literature review, interview and questionnaire were used to establish the emergency nurses' structural empowerment and competency model.300emergency nurses were structurally empowered,and their quality of care and job satisfaction was compared before and after.Results The quality of care and job satisfaction after structural empowerment was (98.45 ±1.36) and (98.19 ± 2.63 ),both of which were higher than that before structural empowerment (95.33 ±2.47) and (93.81 ± 4.54),and the differences were statistically significant (t =-4.468,16.136,respectively; P ＜ 0.05).After structural empowerment,there was great improvement in emergency nurses' selfevaluation,as well as their ability of critical thinking,receiving information,communication and health education,while there was little improvement in their ability of social support,logical reasoning and innovation.Conclusions Establishing structural empowerment and competency model for emergency nurses helps them position themselves and promote their development,as well as provides reference to select and train professional nurses for hospitals.

Objective To construct a recombinant human platelet-derived growth factor-B (PDGF-B) adenoviral vector and to transfect it into human periodontal ligament stem cells (PDLSC).Methods The recombinant plasmid pAd-PDGF-B was constructed by homologous recombination and confirmed by restriction endonucleases digestion.Recombinant adenovirus was packaged in HEK293 cells.PDLSC were transfected with recombinant adenovirus and PDGF-B expression was confirmed.Expression of collagen type Ⅰ gene was determined by quantitative analysis of the products of RT-PCR.The cell proliferation was determined with MTr eolorimetric assay.Results The recombinant plasmid pAd-PDGF-B was confirmed by restriction endonucleases digestion.EGFP expression was observed on the third day after transfecting,and the expression of PDGF-B was detected.Immunohistochemical methods revealed that PDGF-B was expressed in PDLSC.Levels of expression of collagen type Ⅰ gene were increased significantly by transfer of the exogenous PDGF-B gene to PDLSC.At the same time,findings indicated that Ad-PDGF-B stimulated PDLSC proliferation.MTT assay indicated the absorbance of PDLSC by stimulating with Ad-PDGF-B was (0.68±0.02),P＜0.01.Conclusions Using the AdEasy system,the human PDGF-B recombinant adenovirns can be rapidly obtained.These results indicate that recombinant adenoviruses encoding PDGF-B transgenes could modulate proliferative activity of PDLSC,enhance the high expression of collagen type Ⅰ and lay the foundation for periodontal tissue regeneration and dental implant gene therapy.

OBJECTIVETo observe the serial changes of condition and related factors of Keshan disease (KSD) and provide the scientific basis for disease control and further research.

METHODSThe villages in KSD epidemic area of Juxian, Yishui, Pingyi, Zoucheng counties were selected. Since 1990, every five-year was counted as a stage. For the first to third stage, 3-14 year-old residents and over 14 year-old suspicious patients were selected as surveillance subjects. And in the fourth stage, all residents were selected as surveillance subjects. The same group of surveillance subjects in each stage were observed consecutively for 5 years. Surveillance contents included physical checkup, electrocardiogram (ECG) and Xray. At the same time, the selenium (Se) concentration in hair, wheat, corn and sweet potato was measured. The economic income and grain availability were also investigated.

RESULTSTotally, 14,510 cases were visited during 18 years. The incidence of KSD was 3.02% in the first stage, 2.31% in the second stage, 3.57% in the third stages and 3.65% in the fourth stage. Totally, 14,510 cases were examined by ECG, 809 cases showed the abnormal ECG and the total incidence of abnormal ECG was 5.49%. The incidence of abnormal ECG was 3.52% -5.24% from 1990 to 2004 but was 10.97%-10.91% from 2005 to 2007. 732 of hair samples, 701 of wheat samples, 615 of corn samples and 643 of sweet potato samples were collected and the Se concentration was determined by the fluorescent method. Se levels in hair samples had increased (P < 0.05) year by year but Se levels in food have not changed significantly. The economic income and grain availability had increased gradually from 535.8 yuan and 254.6 kg per person in 1990 to 2968.0 yuan and 602.0 kg per person in 2007.

CONCLUSIONThe condition of KSD was in a stable situation in Shandong Province. Related factors improvement should be an important environmental condition.

Adolescent ; Cardiomyopathies ; epidemiology ; prevention & control ; Child ; Child, Preschool ; China ; epidemiology ; Electrocardiography ; Female ; Hair ; chemistry ; Humans ; Incidence ; Male ; Nutritional Status ; Selenium ; analysis ; deficiency

Objective To investigate the current condition of Keshan disease(KD), and inner and outer environmental selenium (Se) levels in Shandong Province, in order to provide scientific evidence for the research, prevention and control work. Methods Inhabitants from 20 villages of 8 counties in KD endemic areas were selected as subjects undergoing general physical examination and electrocardiogram (ECG). Suspicious cases were followed up by chest X-ray radiographs. Meanwhile the Se contents in hair, wheat, corn and sweet potato were measured. Results Ninety one patients with KD, including 82 with latent KD and 9 with chronic KD, were screened out of 2613 inhabitants. The total incidence of KD was 3.48% (91/2613), while the incidence of latent and chronic KD was 3.14%(82/2613) and 0.34%(9/2613) respectively. No new cases of acute or sub-acute KD were found. A total of 368 abnormal ECCs were discovered and the rate of abnormal ECG detected among surveyed population was 14.08% (368/2613). Out of 113 suspects who took X-ray, 57 cases had cardiomagaly. In 217 samples of hair, 228 samples of wheat, 214 samples of corn and 190 samples of sweet potato that were collected, the Se contents were determined by fluorescence. The average Se content in hair, wheat,corn and sweet potato were (0.406±0.090), (0.026±0.009), (0.023±0.010), (0.024±0.006)mg/kg respectively. Conclusions Current condition of KD in Shandong Province remains relatively stable. Se content was increased in the hair, nearly achieving the level in normal areas, but remains low in food.