Objective To identify the biological and molecular biological characteristics of SN7 virus isolated from Niviventer Confucianus in Sichuan province. Methods Monoclonal antibody, PRNT and PCR antigenicity analysis and genotyping of SN7 strain were performed. M and S segments of SN7 genome were also cloned and sequenced. The sequences were compared with those of other strains of Hantavirus. Results It was difficult to identify SN7 by using monocloncal antibody, PRNT and PCR. With sequence comparison, we found that strain SN7 had high homology(80.2%～87.1% of M segment and 76.6%～92.0% of S segment) with HTN type strains, and relatively low homology(70.0%～71.6% of M segment and 71.0%～72.2% of S segment) with SEO type strains. Strain SN7 was believed to belong to HTN type. Conclusions SN7 is a new subtype strain of HTN type viruses. It is possible that Hantavirus has immune escape in its natural hosts.

Objective To evaluate the efficacy and safety of acupuncture as adjuvant treatment in the management of diabetic foot (DF).Methods We searched MEDLINE,Embase,CENTRAL,SinoMed,VIP,CNKI and WANFANG database.We also searched the bibliographies of retrieved articles and correlated proceedings and collected the literatures of DF of clinically randomized or quasi-randomized control trials of acupuncture as adjuvant treatment.After the data was extracted independently by 2 reviewers,we performed meta-analysis by using RevMan 5.1 software.Results Seven studies included 626 patients who met the inclusion criteria,and all employed clinical effects as evaluation indicator.Meta-analysis showed that acupuncture as adjuvant treatment could obviously improve the total effectiveness rate(RR =1.29,95％ CI:1.20,1.38,P ＜ 0.00001)and the recovery rate(RR =1.92,95％ CI:1.60,2.30,P ＜ 0.00001 ).No adverse reactions occured.Conclusions The limited current evidence shows that acupuncture as adjuvant treatment is safe and effective in the treatment of DF.Due to the poor quality of original studies,a prudent choice is suggested.Further studies with high quality and large samples according to CONSORT are also warrant.

Objective: To investigate the trends of chronic obstructive pulmonary disease (COPD) incidence and mortality in China from 1992 to 2021 with age, period and birth cohort, so as to provide insights into the prevention and control of COPD. Methods: The crude incidence rates, crude mortality rates, standardized incidence rates and standardized mortality rates of COPD in China from 1992 to 2021 were collected through the Global Burden of Disease Study 2021 database. The impacts of age, period and cohort on the incidence and mortality of COPD were analyzed using an age-period-cohort model. Results: The standardized incidence rates of COPD in China ranged from 271.24/105 in 1992 to 215.62/105 in 2021, and the standardized mortality rates ranged from 226.08/105 in 1992 to 73.23/105 in 2021, both showing downward trends. Age-period-cohort analysis showed that the incidence and mortality rates of COPD increased with age. The incidence rates rose more rapidly after the age of 35 years, from 138.45/105 in the age group of 35-<40 years to 2 538.61/105 in the age group of 85-<90 years. The mortality rates rose more rapidly after the age of 60 years, from 73.73/105 in the age group of 60-<65 years to 1 053.88/105 in the age group of 85-<90 years. The incidence and mortality risks of COPD declined with time. Compared with the period of 2002-2006, the incidence (RR=0.866, 95%CI: 0.845-0.888) and mortality risks (RR=0.418, 95%CI: 0.394-0.445) of COPD were the lowest in 2017-2021. The incidence and mortality risks of COPD declined with the year of birth. Compared with the 1950-1954 birth cohort, the incidence (RR=0.530, 95%CI: 0.404-0.694) and mortality risks (RR=0.042, 95%CI: 0.007-0.276) of COPD were the lowest in the 2002-2006 birth cohort. Conclusion The incidence and mortality rates of COPD in China from 1992 to 2021 increased with age, but decreased with time and the year of birth.

Objective To study the effects of the interaction of advanced glycation end products (AGEs) and the receptor of AGEs (RAGE) on apoptosis of mice podocytes. Methods Podocytes were exposed to soluble AGEs such as bovine serum albumin (BSA), carboxymethyl-lysin (CML)-BSA, AGE-BSA and matrix-bound AGEs (AGE-modified collagen Ⅳ ), and to different concentrations of AGE, such as 10 mg/L, 50 mg/L, 100 mg/L. Apoptosis was assessed by TUNEL staining. Fluorescence-activated cell sorting (FACS) was used for the quantification of apoptotic andnecrotic podocytes after Annexin V-fluorescein isothiocyanate (FITC) and propidium iodide (PI) labeling. Apoptosis was described as the ratio of apoptotic cells to the total number cells under the high-power field, siRNA was transfected into podocytes through combining Dharmacon on Targetplus SMART pool siRNA reagents and Amaxa RNAi nucleofection kit. Results The apoptosis rate was higher in podoeytes exposed to either CML-BSA or AGE-BSA than that exposed to BSA. There was a two- to three-fold increase in apoptosis when podocytes were cultured in AGE-modified collagen Ⅳ as compared with native collagen Ⅳ. The apoptotic response of podocytes to AGE-BSA exposure occurred in a dose-dependent manner. Podocyte necrosis occurred only at the highest concentration of AGE-BSA(100 mg/L). AGE-BSA failed to induce apoptosis in podocytes transfected with RAGE siRNA. RAGE-specific gene knockdown did not significantly reduce the apoptosis of podocytes cultured in AGE-modified collagen IV. Conclusions The AGE-RAGE interaction plays a major role in the apoptosis of podocytes triggered by soluble AGEs, but not by matrix-bound AGEs. Reduction of AGE burden and RAGE expression may be important therapeutic approaches to prevent the progression of kidney disease.

Objective To investigate whether the inhibition of caveolin-1 (Cav-1) phosphorylation will regulate effectively nuclear factor-erythroid 2-related factor (Nrf2) signal pathway and downstream effector molecules and protest against ventilation induced lung injury (VILI) in an animal model in vivo. Methods Ninety male Sprague-Dawley (SD) rats were randomly divided into nine groups (each n = 10): sham group in which rats did not receive ventilation but received tracheotomy; lung protective ventilation (PV) for 1 hour or 2 hours group; mechanical ventilation (MV) at high volume tidal (VT, 40 mL/kg) for 1 hour or 2 hours group; protein tyrosine kinase inhibitor PP2 or rosiglitazone (Rsg) pretreatment + high VT ventilation for 1 hour or 2 hours groups. The two pretreatment groups were given intraperitoneal injection PP2 15 mg/kg or intragastric administration of Rsg 5 mg/kg 1 hour before ventilation respectively. The rats were sacrificed after model reproduction, and bronchoalveolar lavage fluid (BALF) was collected. Pulmonary vascular permeability was measured by Evans blue (EB). The levels of tumor necrosis factor-α (TNF-α), activator protein-1 (AP-1), nuclear factor-κB (NF-κB), and interleukin-8 (IL-8) in BALF were determined by enzyme linked immunosorbent assay (ELISA). Then the lung tissues were collected, the lung wet/dry ratio (W/D) was calculated, the changes in pathology was observed with light microscope, and myeloperoxidase (MPO) activity was determined by colorimetric analysis. Nrf2 mRNA was determined by reverse transcription-polymerase chain reaction (RT-PCR). The expressions of Cav-1 tyrosine residues 14 phosphorylation (pCav-1-Y14), Cav-1, peroxisome proliferators-activated receptor γ (PPARγ) and claudin-5 as well as Nrf2 in cytoplasm and nucleus were determined by Western Blot. The positive expressions of PPARγ and claudin-5 in lung tissues were assayed with immunohistochemistry staining. Results There were no obvious pathological changes in the lung tissue in sham group and PV groups, and there were no significant differences in all the parameters between the two groups either. However, the injury in lung tissue was severe in the high VT groups in which W/D ratio, EB contents, MPO activity, and TNF-α, AP-1, IL-8, NF-κB levels in BALF as well as the protein expressions of Cav-1 and pCav-1-Y14 were significantly higher than those of sham group and PV groups, and the protein expressions of PPARγ and claudin-5 were significant lower than those of sham group and PV groups with a dose-dependent manner; but Nrf2 expressions in cytoplasm and nucleus did not show a statistical increase. After pretreatment of PP2 or Rsg, W/D ratio, MPO activity, EB contents, TNF-α, AP-1, IL-8, and NF-κB in BALF were significantly decreased as compared with those of high VT group, and RT-PCR showed significant up-regulation of Nrf2 mRNA in lung tissues too. Moreover, there was a statistically significant increase in expressed Nrf2 proteins in nucleus in PP2 or Rsg groups as compared with those of high VT groups [Nrf2 in nucleus (gray value): 0.61±0.06, 0.56±0.06 vs. 0.31±0.02 at 1 hour, 0.38±0.06, 0.43±0.07 vs. 0.22±0.03 at 2 hours; all P < 0.05], but no significant difference was found in the expression of Nrf2 protein in the cytoplasm among all groups. The protein expressions of pCav-1-Y14 in PP2 pretreatment groups were significantly lower than those of high VT groups (gray value: 0.89±0.04 vs. 1.48±0.02 at 1 hour, 0.86±0.02 vs. 1.31±0.01 at 2 hours; both P < 0.05); but expressed PPARγ proteins and expressed claudin-5 proteins in PP2 or Rsg pretreatment groups were significantly higher than those of high VT groups [PPARγ (gray value): 0.34±0.07, 0.42±0.13 vs. 0.17±0.07 at 1 hour, 0.38±0.09, 0.33±0.07 vs. 0.16±0.03 at 2 hours; claudin-5 (gray value): 0.33±0.05, 0.38±0.07 vs. 0.14±0.03 at 1 hour; 0.30±0.06, 0.31±0.04 vs. 0.17±0.04 at 2 hours; all P < 0.05]. Conclusions The inhibition of Cav-1-Y14 phosphorylation can increase the expression of Nrf2 in the nucleus, then result in an increase in the protein expressions of PPARγ and claudin-5 of its effector molecules. This effect can reduce the inflammation and capillary permeability of lung tissue in the model of VILI.

ObjectiveTo determine whether the inhibition of caveolin-1 tyrosine residues 14 (Cav-1-Y14) phosphorylation with protein tyrosine kinase inhibitors (PP2) will upregulate heme oxygenase-1 (HO-1) activity to protect against ventilation induced lung injury in vivo of an animal model.Methods Fifty-four male Sprague-Dawley (SD) rats were randomly divided into nine groups (eachn = 6). Group A served as normal control group, in which rats did not receive ventilation but tracheotomy. Groups B1 and B2 received lung protective ventilation respectively for 1 hour or 2 hours. Groups C1 and C2 received high tidal volume (40 mL/kg) ventilation for 1 hour or 2 hours, respectively. The group D1 or D2 also received high tidal volume ventilation for 1 hour or 2 hour respectively, but they were given PP2 1 hour before high tidal volume ventilation. The groups E1 and E2 also received high tidal volume ventilation respectively for 1 hour or 2 hours, but tyrosine kinase inhibitor PP2 and HO-1 inhibitor zinc protoporphyrinⅨ(ZnPPⅨ) were given to animals 18 hours before high tidal volume ventilation. All the animals were sacrificed after ventilation, and the specimens of lung tissues and bronchoalveolar lavage fluid (BALF) were harvested. Then the changes in pathology of lung tissue was observed, and diffuse alveolar damage scores (DAD) were calculated, myeloperoxidase (MPO) activity was measured by colorimetric analysis, lung wet/dry ratio (W/D) was estimated. The expressions of phosphorylated caveolin-1 (P-Cav-1-Y14), caveolin-1 (Cav-1) and HO-1 were determined by Western Blot. The expressions of high mobility group B1 (HMGB1) and advanced glycation end product receptor (RAGE) in lung tissues were assayed with immunohistochemistry staining. The levels of tumor necrosis factor-α(TNF-α) in BALF were measured by enzyme linked immunosorbent assay (ELISA).Results There was no significant difference in all the parameters between group A and groups B. Compared with group B1, DAD score, W/D ratio, the activity of MPO and the concentration of TNF-α in BALF in group C1 were significantly increased [DAD score:7.97±0.59 vs. 0.55±0.13, W/D ratio: 5.70±1.61 vs. 5.04±0.63, MPO (U/g): 1.82±0.14 vs. 0.77±0.26, TNF-α(ng/L): 370.10±29.61 vs. 54.38±8.18, allP< 0.05], and the injury in ventilation 2 hours group was more serious than that in ventilation 1 hour group. Compared with groups C, all the parameters in groups D were significantly decreased. The parameters in groups E were significantly higher than those in groups A, B, and D, but no significant difference was found as compared with groups C. Compared with groups B, the protein expressions of Cav-1 and P-Cav-1-Y14 (gray value) in groups C were significantly increased (1 hour: 1.49±0.02 vs. 1.26±0.13, 1.34±0.02 vs. 0.87±0.04;2 hours: 1.58±0.02 vs. 1.27±0.27, 1.31±0.01 vs. 0.95±0.02, allP< 0.05), and the expression of HO-1 protein (gray value) was significantly decreased (1 hour: 0.59±0.02 vs. 1.10±0.01, 2 hours: 0.49±0.01 vs. 1.20±0.02, both P< 0.05). No significant difference in Cav-1 protein expression between groups D as well as groups E and groups C. The protein expression of P-Cav-1-Y14 in groups D and E was significantly lower than that in groups C. The protein expression of HO-1 in groups D was significantly higher than that in groups C, but the phenomenon was not found in groups E as compared with groups C. Compared with group A, the positive expression of HMGB1 and RAGE in lung tissue in groups C and E was significantly increased, but no significant difference was found between groups B as well as groups D and group A.Conclusion Cav-1-Y14 phosphorylation is the key factor for ventilator induced lung injury, which can not only lead to a decrease in vascular barrier function, but also inhibit the activity of HO-1 enzyme, thus further aggravates inflammatory injury of the lung as induced by mechanical ventilation.

BACKGROUND:During the research of ABO blood type antigen, the overwhelming majority samples of same ABO gene express a normal and same ABH antigen. But a certain amount samples with the same ABO genetic background show different antigen intensity expression as for different family or individuals. The ABO blood type has complex expression regulation mechanism. Analysis of ABO blood group serology and genetic background of these rare bi-specific AB phenotype specimens, and further studying on epigenetics may partly revealed ABO gene expression mechanism. OBJECTIVE:To study methylation of CpG island and explore the relationship between ABO gene promoter coding glycosyltransferase with dual donor specificity and ABH antigen expression. METHODS:Six samples detected as CisAB or B(A) phenotype were studied in this paper. The whole code sequences and promoter sequence of ABO gene were amplified respectively. The level of CpG methylation in promoter of ABO gene was further detected with bisulfite treatment method. RESULTS AND CONCLUSION:Among the six bi-specific AB phenotype samples, two previously-identified CisAB05/B(A)06 al eles with nt803C>G on the basis of B101 al ele sequence could be seen, and three additional methylated sites nt-33(30%), nt+27(50%) and nt+49(50%) were found between the two regions of CpG island in promoter of ABO gene. Two CisAB01 al eles with nt803C>G mutation on the basis of A101 sequence were found at nt-26C(10%). Other two B(A)04 al eles contained nt640A>G mutation on the basis of B101 sequence were found in the whole code sequences regions, and six additional methylated sites nt-33(10%), nt+16(50%), nt+57(60%), nt+59(60%), nt+68(60%) and nt+74(60%) were found between the two samples. No abnormity was identified in the promoter region of ABO gene. Our results indicated that the differential methylation levels in the CpG island of ABO gene promoter region may affect ABH antigens expression on the red cel membrane even if the samples had the same ABO genetic background.

Objective: To translate the Maternal Blue Scale (MBS) into Chinese, and evaluate the reliability and validity. Methods: The MBS was translated back-translated, culturally adapted and pre-tested according to the Brislin translation model to develop the Chinese version of MBS. Postpartum women from obstetrics centers in three tertiary general hospitals in Shandong Province were selected using convenience sampling method to assess the reliability and validity of the Chinese version of MBS. Content validity was evaluated based on expert ratings. Criterion-related validity was evaluated using the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) as the criterion. Structural validity was evaluated using exploratory and confirmatory factor analyses. Reliability was assessed by calculating Cronbach's α and split-half reliability. Receiver operating characteristic (ROC) curve was plotted to evaluate predictive validity. Results: Totally 500 questionnaires were allocated, and 479 valid ones were recovered, with an effective recovery rate of 95.80%. The Chinese version of MBS consisted of 32 items across 6 dimensions: mother-infant communication, infant feeding, role adaptation, maternal responsibilities, family acceptance and social support. The item-level content validity index ranged from 0.900 to 1.000, and the scale-level content validity index/average was 0.990. The correlation coefficient between the Chinese version of MBS scores and the Chinese version of EPDS scores was 0.675 (P<0.05). Exploratory factor analysis extracted 6 common factors, with a cumulative variance contribution rate of 74.581%. Confirmatory factor analysis indicated good model fit, with a root mean square error of approximation of 0.014, a goodness of fit index of 0.896, a comparative fit index of 0.996, an incremental fit index of 0.996, a normed fit index of 0.913, and a Tucker-Lewis index of 0.995. The overall Cronbach's α was 0.924, and the split-half reliability was 0.765. The Cronbach's α of each dimension ranged from 0.809 to 0.956, and the split-half reliability ranged from 0.807 to 0.966. The area under the ROC curve was 0.909 (95%CI: 0.880-0.937). At the optimal cutoff score of 75.5, the Youden index reached its maximum of 0.698, with a sensitivity of 0.874 and a specificity of 0.824. Conclusion The Chinese version of MBS has good reliability and validity, and it is suitable to evaluate maternal blue among Chinese postpartum women.

Objective To investigate the multi-slice spiral computed tomography (MSCT) features of crush maxillofacial frac-tures in the massive Wenchuan earthquake. Methods MSCT data of 85 patients with crush maxillofacial fractures caused by earth-quake were retrospectively analyzed. The anatomic distribution of fractures was evaluated. Results In 85 patients, single bone frac-tures (59 patients) were more common than multiple bone fractures (26 patients) (P<0.05). The fractures involved isolated mid-face, isolated mandible, and both were found in 49 patients (57.6%), 24(28.2%), and 12(14.2%), respectively. Midface frac-tures were most frequent (P<0.05). The fractures of condyle, posterolateral and anterior wall of maxillary sinus, zygomatic arch and lateral orbital wall accounted for 47.1%(24/51) ,41.5%(22/53) , 37.7%(20/53),71.9% (23/32) and 63.2%(24/38) of the total fractures of the corresponding maxillofacial bones. Conclusion Isolated bone fracture and midface factures are the main fea-tures of crush maxillofacial fractures resulted from the massive earthquake. MSCT and three-dimensional reconstruction images can demonstrate maxillofacial fractures well.

Objective To investigate the resistant mechanism of carbapenem-resistant Escherichia coli and its relationship with endogenous infection. Methods Two carbapenem-resistant Escherichia coli strains were isolated from blood and stool of a same patient, respectively. The minimal inhibition concentrations (MIC) of the two isolates against imipenem and meropenem were determined by E-test. The susceptibility against other antimicrobial agents were done by disc diffusion method. Isoelectric focusing electrophoresis (IEF), polymerase chain reaction (PCR) amplification,cloning and sequencing, conjugation, Southern blotting were carried out to analyze the encoding gene of β-lactamases. Homology analysis of the two strains was done by pulsed field gel electrophoresis (PFGE). Results MIC against imipenem and meropenem of the two strains were both≥32 mg/L.Both strains produced KPC-2 (pI 6.7) and SHV-12 (pI 8.2) β-lactamases. blaKPC2gene was located on a 54 kb transferable plasmid. PFGE showed that the two Escherichia coli strains were derived from the same clone. Conclusions The resistance and enzyme digestion map of chromosome DNA of the two Escherichia coli strains are coincident. The Escherichia coli septicemia of this patient is probably an endogenous infection caused by the immigration of Escherichia coli from the gut.