Objective To explore the role of Epstein-Barr virus (EBV) infection in the etiology of drug eruption. Methods PCR-Southern blot was used to detect EBV-specific DNA fragment BamH I -W in peripheral blood mononuclear cells of 32 patients with drug eruption and 30 age- and sex-matched normal controls. The mRNA expression of EBV lyric gene BZLF1 in EBV DNA-positive samples was measured by RT-PCR and Southern blot. ELISA was performed to detect EBV virus capsule antigen (VCA)-specific IgM. Results The positivity rate of EBV DNA was significantly higher in patients with drug eruption than in normal controls (78.13% (25/32) vs 10.00% (3/30), P < 0.01), while no significant difference was noted between patients with severe and mild drug eruption (P > 0.05). The expression of BZLF1 mRNA was detected in 3 out of 25 EBV DNA-positive patients; of the 3 patients, 1 suffered from mild drug eruption, and 2 from severe drug eruption. EBV VCA-specific IgM was observed in 6 of 32 patients with drug eruption, but not in any normal controls. No significant difference in the positivity rate of EBV VCA-specific lgM existed between patients with severe and mild drug eruption (P > 0.05). Conclusions There is an active infection of EBV in patients with drug eruption. EBV infection is probably an environmental factor affecting the development of drug eruption.

Am investigation was done to identify the best and safe dosage of magnesium isoglycurrhizinate in treating hepatitis B.All 1 50 cases suffering from hepatitis B were randomly divided into five groups as A,B,C,D,E.Cases in group A were treated with magnesium isoglycurrhizinate in 100 mg per day for two weeks sololy,and in group B,C,D,E in 150 mg,200 mg,250 mg and 300 mg respectively.The changes of symptoms,index of hepatic function,clinical effective rates and side-effects were observed from treatment beginning to the end.The results that revealed there were no different effects among groups B to E,but less therapeutic effects in group A,and no obvious side-effects in all groups,suggesting that 150 mg dosage of magnesium isoglycurrhizinate should be a safe and the best dosage for treating hepatitis B.

BACKGROUND:Carboxymethyl chitosan (CMCS),a chitin derivative,has a good application performance that makes it become a safe and effective hemostatic material.OBJECTIVE:To determine the hemostatic effect of CMCS and its biosecurity properties.METHODS:(1) CMCS powder was scattered on the caudal vein and liver wounds of Sprague-Dawley rats,and the hemostatic time was recorded as experimental group,while the time for natural haemostasis of the wound was recorded as control group.(2) CMCS powder was scattered on the tail,femoral artery and liver wounds of ICR mice,and the hemostatic time was recorded as experimental group,while the time for natural haemostasis of the wound was recorded as control group.(3) CMCS,Sodium dodecyl sulfate solution and distilled water were respectively applied on the skin of albino rabbits in a skin irritation test.(4) A delayed-type hypersensitivity test of CMCS was carried out by intradermal injection of CMCS in guinea pigs.(5) An intradermal irritation test was carried out by subcutaneous injection of normal saline containing CMCS and normal saline,respectively.Another intradermal irritation test was carried out by subcutaneous injection of the supernatant of CMCS olive oil extract and olive oil,respectively.RESULTS AND CONCLUSION:(1) Compared with the control group,the hemostatic time for caudal vein and liver wounds were significantly shortened in the Sprague-Dawley rats in the experimental group (P ＜ 0.01).(2) Compared with the control group,the time of hemostasis on the tail,femoral artery and liver wounds was significantly shortened in the ICR mice in the experimental group (P ＜ 0.05 or P ＜ 0.01).(3) The CMCS had no irritation to the skin of albino rabbits and no allergic reaction to the skin of guinea pigs.To conclude,the CMCS has good hemostatic effect on the wound in Sprague-Dawley rats and ICR mice,and has no skin irritation,allergic reactions and intradermal irritation reactions in albino rabbits and guinea pigs,which is a relatively safe hemostatic material.

lymphocytic thyroiditis.

Objective To investigate the role of human herpesvirus type 7 (HHV-7) in the development of drug eruptions.Methods Venous blood samples were collected from 35 patients with mild drug eruptions at acute stage,15 patients with severe drug eruptions at both acute stage and remission stage,as well as 50 healthy human controls.PCR was performed to detect HHV-7 DNA in peripheral blood mononuclear cells (PBMCs),and enzymelinked immunosorbent assay (ELISA) to determine the titer of anti-HHV-7 IgM antibody in serum.Statistical analysis was carried out by t test,one way analysis of variance,Chi-square test and q test.Results The detection rate of HHV-7 DNA was significantly higher in these patients with drug eruptions than in the healthy controls (82.00％ (41/50) vs.62.00％ (31/50),x2 =4.96,P ＜ 0.05),different among patients with severe drug eruptions (93.33％ (14/15)),patients with mild drug eruptions (77.14％ (27/35)) and the healthy controls (x2 =6.32,P ＜ 0.05),higher in the patients with severe drug eruptions than in the healthy controls (q =3.50,P ＜ 0.05),but not significantly different between the patients with severe drug eruptions at acute stage and those at remission stage (73.33％(11/15),P ＞ 0.05).The anti-HHV-7 IgM antibody titer was significantly increased in the patients with drug eruptions compared with the healthy controls ((69.319 0 ± 25.289 7) ng/L vs.(59.785 3 ± 22.438 2) ng/L,t =1.99,P ＜ 0.05),but no significant difference was observed among the patients with severe drug eruptions (74.340 7 ±31.411 2) ng/L),patients with mild drug eruptions ((65.479 1 ± 21.326 1) ng/L) and healthy controls (P ＞ 0.05) or between HHV-7 DNA-positive patients ((63.748 1 ± 27.239 1) ng/L) and-negative patients ((65.580 2 ± 36.258 4) ng/L,P ＞ 0.05).Conclusions Active HHV-7 infection exists in patients with drug eruptions,and may be associated with the development and aggravation of this entity.

Objective Midkine ( MK ) and nuclear factor-kappa B ( NF-kB ) play pivotal roles in tumorigenesis, which are considered as promising cancer biomarkers. The efficacy of MK and NF-kB as markers for diagnosis and prediction of synchronous metastasis in papillary thyroid cancer ( PTC ) was the aim of present investigation. Methods Seventy six cases of PTC and seventy cases of multi-nodular goiter ( MNG ) were retrieved. The PTC group was further divided into subgroup 1 (16 cases with synchronous metastasis) and subgroup 2 (60 cases without metastases). A retrospective review of clinical information, radiological examinations,131 I treatments and post-131 I-therapy scans were done. Immunohistochemistry of MK, NF-kB p65, and Ki-67 was performed on paraffin-embedded specimens and results were quantified. Diagnostic values of the parameters were conducted by receiver operating characteristic (ROC) curves. Diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were determined. Protein levels of MK and NF-kB p65 were then confirmed by Western blot. Results Immunoreactivities of MK and NF-kB p65, and positive percentage of Ki-67 were significantly higher in PTC group than in MNG group (all P<0. 01). ROC showed good differential diagnostic capabilities of all three parameters with diagnostic accuracies of 82. 192% , 80. 137% , and 84. 091%respectively. Moreover, all three parameters were significantly higher in subgroup 1 than those in subgroup 2 (all P<0. 01). ROC showed good predicting efficacies in synchronous metastasis of all three parameters with diagnostic accuracies of 82. 895% , 80. 263% , and 76. 316% respectively. By one-way analysis of variance, Western blot showed that MK and NF-kB p65 protein levels in lesions from subgroup 1 were significantly higher than those from subgroup 2, both were significantly higher than those in MNG lesions ( P<0. 01). Conclusion MK and NF-kB immunohistochemistry can potentially be used for differential diagnosis between PTC and MNG, and for prediction of synchronous metastases.

Objective:To develop a curriculum integration attitude assessment scale for students in nursing school of China and to test its reliability and validity.Methods:The first draft of scale was developed with the methods of literature review and Delphi technique. From June to November 2018, we selected 575 interns from three nursing schools undergoing curriculum integration in Heilongjiang Province as respondents by convenience sampling. The reliability and validity of this scale were tested.Results:The curriculum integration attitude assessment scale for nursing students included three dimensions and 20 items. The content validity index of the total scale was 0.943 and that of items ranged from 0.8 to 1.0. Exploratory factor analysis extracted three factors including value tendency, participation tendency and emotional tendency with 77.602% for the cumulative variance contribution.The Cronbach's α coefficient of the total scale was 0.928 and that of dimensions ranged from 0.942 to 0.954; the Spearman-Brown coefficient of the total scale was 0.879 and that of dimensions ranged from 0.921 to 0.933; the test-retest reliability coefficient of the total scale was 0.789 and that of dimensions ranged from 0.549 to 0.779.Conclusions:The curriculum integration attitude assessment scale for nursing students has high reliability and validity which can be used to assess nursing students' attitude with curriculum integration so as to provide a scientific basis for further optimize curriculum system and a reference for similar teaching assessment.

Objective:To re-evaluate the systematic reviews of the effectiveness of virtual reality technology in pain management in children.Methods:Using computers to search for systematic reviews of the effectiveness of virtual reality technology in pain management for pediatric patients in China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP, China Biology Medicine disc, Cochrane Library, PubMed, Embase, CINAHL and Web of Science. The retrieval period was from the establishment of the databases to November 4, 2022. Literature screening and data extraction were conducted independently by two researchers, methodological quality evaluation was performed for the included studies using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist, and the evidence quality rating was evaluated using Grades of Recommendations Assessment, Development and Evaluation (GRADE) system.Results:A total of 14 systematic reviews were included. AMSTAR 2 evaluation results showed that the methodological quality of 2 systematic reviews was low, and 12 were extremely low. GRADE was used to evaluate the quality of evidence of the outcome indicators, and the results showed that among the 26 outcome indicators included, 23.08% (6/26) were medium evidence, 76.92% (20/26) were low evidence, and the quality of no evidence was high.Conclusions:There is a lack of high-quality evidence to support the conclusion that virtual reality technology can relieve pain in children. The methodological quality and evidence quality of systematic reviews are low, and more standardized and rigorous studies need to be carried out in the future to further verify the application effect of virtual reality technology in pain management of children.

Objective To study the postpartum pelvic floor rehabilitation on the improvement of pelvic floor electrical physiological indexes and the prevention of female pelvic floor dysfunction in China. Methods A multicenter prospective randomized controlled study was carried out. From October 2011, postpartum women in five provinces were randomly assigned into treatment group and control group. The women in treatment group received electrical stimulation and biofeedback treatment. The women in control group performed pelvic floor muscle exercise at home. When 6 months and 12 months after delivery, comparing two groups of patients with pelvic floor electrical physiological indexes and pelvic organ prolapse quantitation measurements (POP-Q), to evaluate the effect of postpartum pelvic floor rehabilitation on the prevention of pelvic floor dysfunction. Pelvic floor impact questionnaire short form (PFIQ-7) and pelvic organ prolapse/incontinence sexual questionnaire-12 (PISQ-12) were used to evaluate the influence on quality of life and sexual life. Results Until June 2013, 324 women were participated, 124 in control group, 200 in treatment group. According to the baseline results, there was statistical significance in the results of pelvic floor electrical physiological indexes between the treatment and control groups in postpartum 6 months and 12 months; the proportion above level Ⅲ of type Ⅰ and type Ⅱ muscle fibers strength in the treatment group, it was from 41.5% (83/200) and 40.5% (81/200) to 76.3% (145/190) and 79.5% (151/190) in postpartum 6 weeks and postpartum 6 months, increased to 80.6%(58/72) and 80.6%(58/72) in postpartum 12 months, improved significantly comparing with the control group (P<0.01). According to Point Aa, treatment group and control group in the postpartum 6 weeks was (-2.2 ± 0.7) versus (-2.4 ± 0.6) cm, in postpartum 12 months (-2.5 ± 1.1) versus (-2.7 ± 0.6) cm, the improvement in treatment group was statistically significant (P<0.01). And the other points were not significantly different (P>0.05). There was no significant difference in the questionnaires in quality of life and quality of sexual life (P>0.05). Conclusion Neuromuscular electrical stimulation and biofeedback therapy in the early postpartum period could obviously improve pelvic floor electrical physiological indexes, and is beneficial to prevent the pelvic floor dysfunction.

ObjectiveTo assess the level of depression， anxiety and social support among grade three senior high school students under in-school quarantine during the COVID-19 pandemic， so as to provide references for targeted psychological intervention of them. MethodsA total of 724 grade three senior high school students from three key schools in Binzhou City， Shandong Province were selected using random sampling method. Generalized Anxiety Disorder （GAD-7）， Patients' Health Questionnaire Depression Scale-9 item （PHQ-9） and Perceived Social Support Scale （PSSS） were used to survey the psychological status including anxiety， depression and the level of social support. Partial correlation analysis was adopted to discuss the correlation of PSSS score with GAD-7 and PHQ-9 scores， meantime， the multiple linear regression analysis was conducted to explore the relationship between PSSS and PHQ-9 scores. ResultsAmong grade three senior high school students， 341 （48.64%） and 383 （54.64%） were found to have symptoms of anxiety and depression， respectively. PSSS total score as well as the dimension score of family support and other support of female students were higher than those of male students， with statistical significance （t=-3.431， -3.048， -4.482， P<0.01）. GAD-7， PSSS total scores and the dimension scores of family support and other support demonstrated statistical differences among grade three senior high school students with different selections of academic subjects for college entrance examination （F=1.992， 2.660， 2.074， 3.138， P<0.05 or 0.01）. PHQ-9 score was negatively correlated with the total score and each dimension score of PSSS （r=-0.329， -0.283， -0.284， -0.284， P<0.01）. The dimension score of family support and friend support in PSSS could negatively predict the PHQ-9 score （B=-0.213， -0.308， P<0.01）. ConclusionGrade three senior high school students under in-school quarantine during the COVID-19 pandemic suffer a high prevalence rate of anxiety and depression， while students with higher perceived social support scores report fewer symptoms of depression. Hence， improving the level of social support may alleviate depression in students.