Objective To evaluate the cross-neutralization effect of multivalent recombinant receptor-binding domain(RBD)dimer protein vaccine against SARS-CoV-2 variant strains, so as to provide an experimental basis for the development ofbroad-spectrum SARS-CoV-2 vaccines. Methods Twenty-two female SD rats were randomly divided into ZF2202(B) group(8 rats immunized with quadrivalent recombinant RBD dimer protein vaccine), ZF2202(A) group(6 rats immunized withbivalent recombinant RBD dimer protein vaccine) and normal saline control group(8 rats). The rats were immunized intra-muscularlyat0,21and42days,respectively,withadoseof0.25mL/rat.Fourteendaysafterthelastimmunization,theneutralizingantibodies against Delta, BA.4/5, BQ.1.1, XBB.1, EG.5 and BA.2.86 in serum of rats in ZF2202(B) and ZF2202(A) groupswere detected by pseudovirus neutralization assay, and the secretion of IFNγ and IL-4 in spleen lymphocytes of rats in ZF2202(B)and normal saline control groups were analyzed by ELISpot. Results The levels of neutralizing antibodies againstpseudovi-ruses BA.4/5, BQ.1.1, XBB.1, EG.5 and BA.2.86 in serum of rats in ZF2202(B) group were significantly higher than those inZF2202(A) group(U = 3, 1, 1, 1, 0, P = 0. 004 7, 0. 001 3, 0. 001 3, 0. 001 3, and 0. 000 7, respectively). Compared withnormal saline group, the number of specific spots of IFNγ secreted by spleen lymphocytes in ZF2202(B) group increased signifi-cantly(U = 4, P = 0. 001 4), and the number of IL-4 specific spots also increased significantly(t = 3. 775, P = 0. 002 1).Conclusion Both ZF2202(A) and ZF2202(B) provide cross-protective immunity against SARS-CoV-2 variants, whileZF2202(B)exhibitsbetterprotectiveeffectthanZF2202(A)ontheepidemicstrains,andexhibitsabroaderspectrumofefficacy.

Type 2 diabetes(T2DM) is the collective result of insulin resistance in both muscle and liver andβ cell function failure. Traditional pharmaceutical therapy fails in ceasing progressive decline in β cell function. Bariatric surgery has been widely accepted as an efficient measure to treat diabetes. However, the prevalent standards mainly based on body mass index can not meet the demand for promoting remission rate. Related factors should be included in prediction of post-operative remission, like end-point setting, T2DM status, biochemical index, and operative method etc. The combination of these factors can be used to benefit more patients with diabetes.

Existing laws in China indicate that the fault liability doctrine should be applied in tort lawsuits. However, there is currently the trend in the judicial field of applying strict liability with regard to medical institutions. Strict liability, realized chiefly through the reversal of the burden of relief, stresses the protection of the victims. By citing typical cases, the authors analyze the application of strict liability in medical malpractice disputes: ①Patients have no burden of relief on whether hospitals made errors in the harms brought about. ②There are limitations to reasons for hospitals to get exempted from liabilities; they cannot use reasonable care as pleas. ③The relationship between medical actions and patients' damages is presumed. The authors hold that although the use of strict liability may improve reasonable care by medical workers, yet when mature medical liability insurances are not in place, the application of strict liability in trials adds to the liability of medical institutions and their staff and cannot lead to genuine settlement of patient-doctor disputes. judicial institutions ought to apply strict liability in strict accordance with the law and avoid making compensations for patients at the compromise of judicial justice.

Objective To investigate the expression of nuclear factor-κB in alveolar macrophages of paraquat-induced rats and the effect of diallyl sulfide on it.Methods Forty five male wistar rats were randomly divided into three groups,namely control group,model group,and DAS treatment group (n =15 in each).The model of paraquat poisoning was reproduced by single does of 70 mg/kg given by intra-gastric administration,while the equal volume of normal saline (NS) was given to the rats in control group instead.The dose of 100 mg/kg of DAS was given to rats by intra-peritoneal injection in DAS treatment group.The equal volume of NS was given to the rats by intra-peritoneal injection in model group and control group instead.The rats of model group and DSA treatment group were exposed to paraquat once a day for 14 days.Five rats in each group were sacrificed at 3,7,14 days.Alveolar maerophages were harvested by bronchalveolar lavage (BAL).The protein content of BAL fluid were examined.The exprossion of NF-κB was measured with immunocytochemistry technique.Results Alveolar macrophage cultures were carried out by using differential adherence of isolated and purified alveolar macrophages,and after 30 minutes culture,more adherent macrophages can be seen.Compared with model group,the protein content of BAL fluid at dfferent intervals in the control group were obviously lower,especially on the 3 rd day (261.6 ± 17.16) μg/mL vs.(673.4 ± 151.9) μg/mL;7 d (265.6 ± 18.37) μg/mL vs.(581.3 ± 134.58) μg/mL;14 d (253.8 ± 11.43) μg/mL vs.(589.07 ± 33.85) μg/mL,P ＜ 0.05.Comparisons of protein content in BLA fluid between PQ group and DAS treatment group were on the 3 rd day (673.4 ± 151.9) μg/mL vs.(342.9 ±39.03) μg/mL;on the 7 th day (581.3 ± 134.58) μg/mL vs.(383.7 ±7.37) μg/mL,P＜0.05;on the 14 th day (589.07±33.85) μg/mL vs.(282.9±15.59) μg/mL,P＜0.05.The immunocytochemistry analysis revealed minimal NF-κBp65 expression in the cell cytoplasm in the control group,while high NF-κBp65 expression was found in nuclear in the model group.Minimal NF-κBp65 expression was found in the cell cytoplasm in the DAS treatment group,and integral A value was significantly lower in the DAS treatment groups than that in the model group (P ＜ 0.05).Conclusions Treatment with an intra-peritoneal injection of DAS is capable of attenuating the extent of PQ-induced ALI in rats by lowering BLA fluid protein content,inhibiting the expression of NF-κB in alveolar maerophages.

The gradually developing study methods included the application of socket-limb interface stress test, socket computer aided design and manufacture, finite element method, the building of prosthesis 3D-rigid body kinetic model, gait analysis, and the footplate force system.

Objective To investigate the features of gait in patients with lumbar disc herniation suffering low back pain radiating to the unilateral lower limbs during walking, and estimate the test-retest reliability of the plantar pressure distribution. Methods 32 patients of lumbar disc herniation with low back pain radiating to the unilateral lower limb were tested with the Footscan plantar system during normal walking for 5 times. The gait phases, contacting time of every plantar region and maximum force were recorded in both the uneffected and the affected lower limbs in patients. The reliability was estimated with the intraclass correlation coefficient (ICC). Results There were significant differences between the uneffected and the affected lower limbs in the gait phase except for the Initial Contact Phase. The Forefoot Contact Phase and Foot Flat Phase of the affected lower limbs were obvious shorter than the uneffected ones (P<0.01), while the Forefoot Push Off Phase was longer (P<0.01). Except for the region of Metatarsal 5, the contacting time of every plantar region of the affected lower limbs were lower than the uneffected ones (P<0.05). The maximum force of regions of Metatarsal 4, Metatarsal 5 and Heel Lateral were lower in the affected limbs than the uneffected ones (P<0.05). ICCs of gait phase, the contacting time of every plantar region and maximum force were generally over 0.76. Conclusion Differences were found in gait phase, the contacting time of every plantar region and maximum force between the uneffected and the affected lower limbs in patients with lumbar disc herniation. All the variables are reliable for test-retest.

Objective To evaluate T-lymphocyte subsets and sjTREC gene level in sepsis children and to provide a reasonable theoretical basis for immune regulation. Methods This prospective study was performed on children who were classified as sepsis group (n = 25), severe sepsis group (n = 23), and control group (n = 50). The T cell subsets were measured before the blood products,immune agents,and nutritional support were administrated. By real-time fluorescence quantitive-PCR method, the sjTREC levels of the patients with sepsis and healthy children were quantitatively detected respectively;then the sjTREC levels were absolutely quantified by two standard curve method. The results were demonstrated by sjTREC and endogenous reference gene (Cα) copies ratio (sjTREC/Cα× 2 × 1000) and statistically analyzed by SPSS 16. 0 software. Results The levels of CD3 +, CD4 +, and CD8 + T cells in severe sepsis group were lower than those in control group (P＜0.01). The level of sjTREC of severe sepsis group was 173.86 +38.37,which was significantly lower than those of sepsis group (345. 15 ± 66. 21) and control group (389. 42 ± 50. 20) (P ＜ 0. 01). Conclusion Children with severe sepsis have a range of T-lymphocyte subsets disorders and decreased thymic output function, so early immunotherapy can improve clinical outcome.

Objective To investigate pediatric infective endocarditis(IE) risk factors and the feature of pathogen.Methods We conducted a retrospective study of 46 cases who were diagnosed as IE from January 2000 to June 2007.Sixteen variables such as sex,primary disease,infectious site,complication,culture result and therapeutic measure were selected for logistic regression analysis.Results Forty-six IE patients accounted for 0.78‰ of all the hospitalized patients during the same period.Of 46 cases,40 had heart diseases.The incidence rate of left-sided endocarditis was higher than that of right-sided endocarditis.Twenty-four had positive blood culture result,one patient had positive culture from vegetation sample.The total positive culture rate was 54%.Gram-positive bacteria were found in 15 cases,and the most common organisms were α-hemolytic streptococcus.Gram-negative bacteria were in 7 cases and fungus infection was present in 3 cases.After antiboitic treatment,40 were cured,6 died.In the logistic regression model,the variables significantly associated with death included negative blood culture (OR=25.127,95%CI=1.110-363.236),hematological system disease (OR=28.620,95%CI=2.261-354.448) and multiple organ failure (OR=19.843,95%CI=0.786-221.754).Conclusion Streptococcus viridans is the most common pathogen in pediatric IE in our hospital.Higher incidence in the left heart than that in the right heart is found.Negative blood culture,hematological system disease and MOF are the risk factors in IE patients.

Objective To observe the preventive effects of 2.5% sodium bicarbonate solution on the patients who had upper respiratory tract infection caused by fungal with hormone treatment.Methods 36 patients of systemic lupus erythematosus,polymyositis/dermatomyositis were randomly divided into two groups:observer group with glucocorticoid treatment and using 2.5% sodium bicarbonate solution to clean the mouth,and control group only with glucocorticoid treatment.After 7 days,we observed the rate of fungal infection of the two groups.Results There was significant diffience on the rate of fungal infection between observer group and control group(P0.05).Conclusion Using 2.5% sodium bicarbonate solution to clean the mouth can effectively prevent the patients who has upper respiratory tract infection caused by fungal with hormone treatment and decrease the rate of fungal infection.

Objective Our purpose was to report Initial clinical application experience and assess the immediate and short-term effect of transcatheter closure secundum atrial septal defects (ASD) using Amplatzer atrial septal ocluder.Methods Procedures were perfomed under fluoroscopy and transesophageal echocardiography monitoring. Nine patients (3 male, 6 female) underwent attempted transcatheter closure of a ASD using the Amplatzer atrial septal ocluder device with 10F, 11F or 12F long sheath at a mediant age of 33.0?5.2 years (range 8 to 52 years) and weighed 22 kg or more. Other congenital cardiac anomanies which require surgery were excluded. The mediant diameter of ASD at its narrowest segement were mensureted with the balloon catheters was 23.3?6.2 mm (ranger 11 to 30 mm). Systolic pressures of pulmonary arteries were 24.4?5.5 mm Hg (24-46 mm Hg) with catheterization mensuration. After the procedure, TEE were perfomed immediately to find whether there any residual shunt retained. Follow-up evaluation was color flow mapping at 24 h, 1, 3 and 6-months after closure. Results Nine patients had successful device placement. Transesophageal echocardiography showed that 8 patients had complete immediate closure and one had a small residual shunt after the operation, and could get up in the next day. The complication of cerebral throumbus embolism occurred in one woman patient during the procedure. She accepted immediately thrombolysis therapy with urokinase and recovered after several days. Conclusion Transcatheter closure of secondum ASD using Amplatzer atrial septal occluder device is an effctive nonsurgical therapy method. The operation has specialities of simple, safe with a high succes rate of placement and a fine occlusion effect. Further clinical trias are underway.