Objective To understand the sanitary status of the air conditioning system of public places and to discuss the countermeasure.Methods Fifty public places where the air conditioning system were used were selected as the research objects in September 2008.The questionnaires about the hygienic management, the air conditioning system and the cooling tower were used to investigate the basic situations of the air conditioning system in public places,and Legionella pneumophila(Lp) of cooling water in the cooling tower was detected.Results All the fifty public places didn't establish complete sanitary management system.90% of the cooling towers were less than one kilometer from the residential areas, schools, kindergartens, agedness flats and hospitals.And 18% of the cooling towers were less than one hundred meters from the walking streets and entertainment plaza.Moreover,8% of the public places had not fresh air, the air purification wasn't installed in 74% of the public places and sterilization equipments, and automatic or on-line sterilization equipments in the cooling towers weren't installed in all the public places.In addition, the positive rate of Legionella pneumophila in the cooling towers was 89.58%.Thereinto, the positive rate of Lp1 type(79.07%) of Legionella pneumophila was significantly higher than that of Lp2-Lp14 type(11.63%) as well as that of Lp1 type and Lp2-Lp14 type(9.30%)(P0.05).Conclusion The air conditioning systems of public places are being faced with some sanitary problems and the cooling water in the cooling tower was polluted with Legionella pneumophila.Therefore,it is suggested that its sanitary management should be reinforced and the sterilization management of cooling water as well as the shield between the cooling towers and the circumferences should be taken into account.

BACKGROUND:Notch singling pathway is very important for cellproliferation and differentiation, but its role is stil unknown during chondrogenesis of human umbilical cord mesenchymal stem cells. OBJECTIVE:To investigate the effect of N-[N-(3,5-difluorophenacetyl-L-alanyl)]-(S)-phenylglycinet-butyl ester (DAPT) on inducing human umbilical cord mesenchymal stem celldifferentiation into chondrocytes. METHODS:Human umbilical cord mesenchymal stem cells were isolated from human umbilical cord, then were induced to differentiate into chondrocytes. There were four experimental groups:non-induced group, high-glucose Dulbecco’s modified Eagle’s medium containing 5%fetal bovine serum and 1%double antibody;induced group, induced medium containing 6.25 mg/L insulin, 6.25 mg/L transferrin, 10μg/L transforming growth factor beta 1, 0.1μmol/L dexamethasone, 50 mg/L vitamin C, 5%fetal bovine serum and 1%double antibody;dimethyl sulfoxide group, induced medium containing 0.1%dimethyl sulfoxide;DAPT group, induced medium containing 5μmol/L DAPT. RESULTS AND CONCLUSION:After chondrogenic induction, the morphology of human umbilical cord mesenchymal stem cells became polygon and positive for toluidine blue and immunofluorescence staining;the expression of Jag-1, PS-1, Notch-1 and Hes-1 decreased significantly (P<0.01). After the addition of DAPT, compared with the induced group, the relative gene expression of Jag-1, PS-1 and Hes-1 decreased markedly (P<0.01), the relative gene expression of Notch-1 decreased obviously as wel (P<0.05), and the contents of proteoglycan and col agen type II proteins decreased significantly (P<0.01). At the same time, the relative gene expression of proteoglycan decreased obviously (P<0.05), and the relative gene expression of col agen type II decreased in part. Notch signaling pathway exists in human umbilical cord mesenchymal stem cells, once chondrogenesis begins, the signaling strength wil decline rapidly. DAPT may prevent human umbilical cord mesenchymal stem cells from differentiating into chondrocytes by Jag-1-Notch-1-Hes-1 pathway.

Objective To investigate the effect of comprehensive nursing intervention on the quality of life of patients suffering from hypertension. Methods A total of 120 cases of essential hypertension were evenly randomized into observation group and control group. Both groups received conventional antihypertensive drug and nursing, and additionally, the observation group was given intervention of comprehensive nursing including dietary regulation, exercise training, emotional care and medication instruction. The intervention lasted 3 months. Before and after the intervention, traditional Chinese medicine ( TCM) symptom classifying list and World Health Organization ( WHO) QOL-BRIEF were applied to evaluate the therapeutic effect of the two groups. The changes of blood pressure, clinical manifestation and the quality of life were also compared between the two groups. Results (1) After intervention, the systolic pressure and diastolic pressure were both improved in the two groups ( P<0.05 or P<0.01 compared with those before treatment) , and the improvement in the observation group was superior to that in the control group (P<0.01). (2) After intervention, the scores of TCM symptom scores and QOL-BRIEF total scores were improved in the two groups ( P<0.05 or P<0.01 compared with those before treatment) , and the improvement in the observation group was superior to that in the control group ( P<0.01). Conclusion TCM comprehensive nursing intervention can effectively relieve hypertension and improve the quality of life of hypertension patients.

Objective To summarize the liver biopsy and clinical features of patients with liver injury of unknown origin,and to investigate the value of ultrasound-guided percutaneous liver biopsy in the diagnosis of liver injury of unknown origin.Methods A retrospective analysis was performed for the clinical data and ultrasound-guided percutaneous liver biopsy results of 94 patients with liver injury of unknown origin who were admitted to Zhongshan Hospital,Xiamen University,from January 2018 to February 2023.According to the proportion of the patients with different final diagnoses,the patients were divided into autoimmune liver disease(AILD)group,metabolic associated fatty liver disease(MAFLD)group,drug-induced liver injury(DILI)group,alcoholic liver disease(ALD)group,and unknown group.An analysis of variance was used for comparison of normally distributed continuous data between multiple groups,and the Bonferroni analysis or the Dunnett'T3 test was used for further comparison between two groups;the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups;the Fisher's exact test was used for comparison of categorical data between multiple groups.Results All 94 patients with liver injury of unknown origin underwent ultrasound-guided percutaneous liver biopsy after admission,among whom 90 patients(95.7%)had a confirmed diagnosis based on liver biopsy and clinical features.There were 43 patients(45.7%)with AILD,21(22.3%)with MAFLD,15(16.0%)with DILI,6(6.4%)with ALD,1(1.1%)with AILD and MAFLD,1(1.1%)with hemochromatosis,1(1.1%)with Budd-Chiari syndrome,1(1.1%)with congenital hepatic fibrosis,and 1(1.1%)with idiopathic portal hypertension,while 4 patients(4.3%)still had an unknown etiology after liver biopsy.There were significant differences between the patients with top five diagnoses in age(F=4.457,P<0.05),body mass index(BMI)(F=3.245,P<0.05),aspartate aminotransferase(AST)(H=11.128,P<0.05),gamma-glutamyl transpeptidase(GGT)(H=24.789,P<0.05),alkaline phosphatase(ALP)(H=26.013,P<0.05),IgG(H=19.099,P<0.05),IgM(H=21.263,P<0.05),AMA-M2 positive rate(P<0.05),and ANA positive rate(P<0.05).Compared with the MAFLD group,the AILD group had significantly higher age,AST,GGT,and ALP and a significantly lower BMI;compared with the MAFLD group and the DILI group,the AILD group had significant increases in IgG and IgM;the AILD group had significant increases in the positive rates of AMA-M2 and ANA compared with the other four groups.Conclusion AILD,MAFLD,and DILI are the most common causes in patients with liver injury of unknown origin.Ultrasound-guided percutaneous liver biopsy plays an important role in determining the cause of liver injury of unknown origin,but it is still needed to make a comprehensive analysis based on clinical history,different types of liver injury,laboratory markers,and imaging data.

Objective To explore the effects of modified vaginal douche for preventing radiotherapy complications in patients with cervical cancer receiving radiotherapy.Methods Totally 100 patients with cervical cancer receiving radiotherapy were recruited and divided into the experimental group (n=50)and the control group (n=50). The experimental group received vaginal irrigation with modified vaginal douche. The control group received conventional vaginal irrigation.The degree of vaginal cleanliness and the incidence rate of radiotherapy complications were compared between the control group and the experimental group.Results There was a significant difference between the two groups on the degree of vaginal cleanliness (P<0.01). The incidence of vaginitis and vaginal stenosis in the experimental group was 4% and 2%, which was lower than those in the control group (22%, 16%), and the differences were statistically significant (x2=9.890,5.132;P<0.05).Conclusions Compared with traditional vaginal douche,modified vaginal douche is more effective in patients with cervical cancer receiving radiotherapy,and can significantly reduce the incidence of radiotherapy complications.

Objective To understand and analyze the epidemiological and pathogenic characteristics of foodborne diseases in Changzhou in the past five years, so as to provide evidence for prevention and control measures. Methods All foodborne disease surveillance information reported by Changzhou foodborne disease sentinel hospital from 2016 to 2020 was collected through the ^“Foodborne Disease Surveillance and Reporting System^”. The distribution of reported cases and etiological results was described, and the possible factors affecting pathogen detection results were analyzed. Results A total of 14 931 cases of foodborne diseases were reported, mainly distributed in summer and autumn, and peaked in July and August. The age group of reported cases was 25-34 years old, and the occupations were mainly workers, and farmers and migrant workers, accounting for 23.2% and 36.9%, respectively. Among the reported cases of 3 120 anal swabs were collected and tested for etiology , of which 291 specimens were positive, with a positive detection rate of 9.32%. Among the 291 positive results of 118 cases of norovirus were detected, with a detection rate of 6.03% . 66 cases of salmonella were detected, with a detection rate of 2.12% . 25 cases of vibrio parahaemolyticus were detected, with a detection rate of 0.80% . 7 cases of diarrhea-causing Escherichia coli was detected, with a detection rate of 0.22% ; and 5 cases of shigella was detected, with a detection rate of 0.16% . Single factor analysis of the results of pathogen detection showed that there were no statistical differences in the distribution of positive pathogen detection rate between males and females, and between different suspicious exposed foods (all P>0.05). There were statistical differences in different age groups, occupations, seasons and eating places (all P<0.05). Multivariate Logistic regression analysis showed that age and season were correlated with the detection rates of pathogenic microorganisms (all P<0.05) , and age was negatively correlated with the positive rate of pathogenic microorganisms (OR=0.863). The detection rates in the first and fourth quarters were higher than those in the second and third quarters. Conclusion Summer and autumn are the seasons with high incidence of foodborne diseases in Changzhou. Norovirus is the main pathogen. Age and season are closely related to the detection results of pathogenic microorganisms. Comprehensive prevention and control measures should be implemented for key population in summer and autumn to reduce the occurrence and outbreak of foodborne diseases.