Objective To explore the detection significance of brain natriuretic peptide in peripheral blood of patients with coronary heart disease(CHD).Methods 260 patients with CHD were selected and divided into 95 cases of stable angina pectoris(SAP) group,85 cases of unstable angina pectoris(UAP) group and 80 cases of acute myocardial infarction(AMI) group according to angiographic and clinical diagnosis.Another 80 cases of healthy people which were taken medical examination were selected as the healthy control group.The peripheral blood plasma brain natriuretic peptide concentration of the study objects were detected,and the severity of coronary lesions was quantified by the coronary Gensini score.Results The peripheral blood brain natriuretic peptide average concentration of UAP group and AMI group was (498.00 ± 87.00) ng/L and (936.00 ± 102.25) ng/L,respectively,which were significantly higher than that of the SAP group [(213.46 ± 98.35) ng/L] and the control group [(97.63 ±20.07) ng/L] (t =8.78,12.01,6.26,2.38,all P ＜ 0.05).The peripheral blood brain natriuretic peptide concentration of patients with Gensini score≥20 points was significantly higher than that of the patients with Gensini score ＜20points(P ＜ 0.05).Conclusion The peripheral blood brain natriuretic peptide concentration of patients with CHD is correlated with coronary plaque stabilization and lesion severity.

Objective To explore the transfection efficiency of primary lymphocytes from human peripheral blood by different methods to acquire the method with higher transfection efficiency.Methods Mononuclear cells from human peripheral blood were isolated using Ficoll-Hypaque.Cell viability was detected by Trypan blue staining.Suspending lymphocytes were sucked out and were incubated in 24-well plate after cultured in 6-well plate for 2 h.Activated lymphocytes were transfected by electroporation with plasmid(PEGFP-N1).Resting or activated lymphocytes were transfected by lentivirus vector(LVGFP) single infection or repeated infection,respectively.Green fluorescence protein (GFP) was detected under the fluorescence microscopy and percentage of positive cells was checked by flow cytometry at different time points after infection.At the same time,the effectiveness of lentivirus infection was compared under different conditions.Results Purity of mononuclear cells isolated by Ficoll-Hypaque was 95 ％ and its viability was over 95 ％.The percentage of lymphocytes obtained with a uniform shape was 90 ％-95 ％.Scattered fluorescence was observed by electroporation under the conditions of voltage 2 100 V,pulse width 10 ms,pulse number 1 for lymphocyte,while fluorescent became weaker over time and no green fluorescent was observed after transfection for 72 h.After resting lymphocytes were infected once for 48 h by lentivirus vector,green fluorescent was not found and positive cells were less than 1％.1％-5 ％ of activated lymphocytes could express GFP after single lentivirus infection and the expression levels were enhanced with concentration increasing,while 5 ％-10 ％ of activated lymphocytes showed strong green fluorescent by repeated lentivirus infection.In contrast with electroporation,the fluorescent with lentivirus infection was stronger over time.Conclusion Repeated lentivirus infection could efficiently transfect exogenous genes into activated lymphocytes for stable expression.

Objective To use three different methods in attempt to estimate the biological dose of the patient partially exposed to 192Ir source at5.7 accident in Nanjing,so as to provide dosimetric information for clinical remedy of exposed patients in the emergency of a nuclear accident.Methods Peripheral blood samples were collected on days 5 after exposure.The biological dose was estimated by the yields of dicentrics plus rings ( dic + r),cytokinesis-block micronuclei (CBMN) assay and nucleoplasmic bridge plus FHC (NPB + FHC).The homogeneity of radiation exposure was examined by Poisson distribution of dicentrics.Results By using three different methods,the whole body equivalent dose was dic + r estimated to be 1.51 Gy (95％ CI 1.40-1.61),1.47 Gy (95％ CI 1.36-1.60) by CBMN and 1.30 Gy (95％ CI 1.00-1.60) by NPB + FHC,respectively.A non-poisson distribution was also detected,suggesting partial body radiation exposure.Conclusions The estimated whole body equivalent dose ot a non-uniform radiation exposure was consistent with clinical diagnosis,suggesting that the yields ofdic + r,CBMN,as well as NPB + FHC,are efficient approaches to the estimation of biological doses.

Objective To explore the natural attenuation pattern of three biological dose estimation indexes in vivo by investigating the effect on biological dosimetry of peripheral blood sampling at different time points from the victim partially exposed to 192Ir radiation source at5.7 accident in Nanjing.Methods Peripheral blood of the patient was collected on days 5,40 and 280 after exposure,respectively.The yields of dicentrics plus rings chromosomes (dic + r),cytokinesis-block micronuclei (CBMN) and nucleoplasmic bridge + fusion + horse shoe + circular(NPB + FHC) were analyzed.The dynamic reduction and dose estimation were both observed using the biomarkers mentioned above after exposure.Results Compared to the estimates on days 5 after exposure,the dose values estimated on days 40 and 280 decreased by 34％ and 49％ fordic + r method,48％ and 79％ for the CBMN assay,and 48％ and 75％ for NPN + FHC method,respectively.Conclusions Three biological dose estimation indexes show a progressive decrease in vivo,with the half-life of dic + r/cell being 40 days.The doses estimated using these three indexes on days 40 after exposure showed a relative deviation more than 20％ compared with those on days 5 after exposure.

Objective To investigate the effects of B lymphocyte-induced maturation protein-1 ( Blimp-1) on the number and function of splenic lymphocytes.Methods The mice with defective Blimp-1 in T cells were generated by cross-breeding B6.Blimp-1flox/flox mice with B6.Lck-Cre mice.The mononuclear lymphocytes isolated from spleen of T cell conditional Blimp-1 knockout (Blimp-1CKO) mice and wild type ( WT) C57/B6 mice were comparatively analyzed.Alterations of CD4+T and CD8+T cell subsets, the secre-tion of cytokines as well as the expression of C-C chemokine receptor type 7 ( CCR7 ) and Sphingosine-1-phosphate receptor 1 (S1P1) in mice from the two groups were analyzed by flow cytometry.The changes of CD19+B cell subsets were also detected.Results Compared with WT mice, the total numbers of mononu-clear cells, T and B lymphocytes were all significantly increased in Blimp-1CKO mice ( P<0.05) .The ab-solute numbers of CD4+T, CD8+T and CD19+CD5+CD1d+B cells in mice form Blimp-1CKO group were higher than those of the control group (P<0.05), however, no significant differences with the percentages of these cell populations were observed between two groups.Higher numbers and percentages of CD19+CD5+B cells were detected in mice from Blimp-1CKO group (P<0.01).The Blimp-1CKO mice showed increased secretion of IFN-γ, TNF-α, IL-17 and IL-2, but decreased expression of CCR7 on CD8+T cells as com-pared with WT mice (P<0.05).No significant differences with the changes of S1P1 were found between the two groups.Conclusion Blimp-1 played an important role in the maintenance of number, phenotype and function of T cells.Furthermore, not only T cells but also B cell subsets in mice were affected by the dele-tion of Blimp-1 in T cells.

Objective:To explore the status of depression symptoms and related factors of depressive symptoms in middle-aged and elderly disabled people in China and provide references on the preventive cares of depression.Methods:Research data were obtained from the 2018 follow-up data of China Health and Retirement Longitudinal Study(CHARLS).Disabled people were selected as the research object. The scores of center for epidemiological studies depression scale(CES-D) were used to evaluate depressive symptoms. Fourteen variables derived from the 3 dimensions of demographic characteristics, health status, and health related behaviors were utilized in this study.SAS 9.4 were used for descriptive analysis, univariate analysis and Logistic regression analysis.Results:A total of 1 708 middle-aged and elderly disabled people were included, among whom 932(54.5%)were diagnosed with depressive symptoms, and the score of CES-D was (11.45±7.19).Self-rated poor health, self-rated poor memory, life dissatisfaction, physical pain were the risk factors of depressive symptoms ( OR=1.87, 4.22, 1.83, 5.30, 1.75). Male, educational level (middle-high school, high school or above), sleeping duration (6-9 h) were the protective factors of depressive symptoms( OR=0.74, 0.72, 0.10, 0.56). Conclusion:Middle-aged and elderly disabled people in China have a high detection rate of depressive symptoms. Female, lower education background, inadequate amount of sleep, self-rated unsatisfactory healthy, self-rated poor memory, dissatisfaction towards life and suffering from physical pain may be more likely to have depressive symptoms in middle-aged and elderly people with disabilities.

Objective: To explore effects of allogeneic hematopoietic stem cell transplantation (HSCT) in combination with infusion of endothelial progenitor cells (EPC) on bone marrow inflammatory injury. Methods: 6-8 weeks BALB/c (H-2K^d) mice after lethal dose of irradiation (TBI) were subjected to allogeneic bone marrow transplantation (BMT group) or co-transplantation of EPC (EPC group) . Samples of bone marrow cells of mice in each group on days 7,14,21,28 after transplantation were obtained to detect EPC cultural and cell chimeric rates by flow cytometer. Mice were sacrificed on days 7, 14, 21 and 28 post HSCT to analyze bone marrow pathology by H&E staining, the infiltration of macrophages and neutrophils by Western blot, validation expression levels of inflammatory complexes nlrp1、nlrp6 and its downstream molecules casepase-1 by Q-PCR and Western blot. Results: Cell chimeric rate on day 7 after transplantation in EPC group[ (91.65±2.77) %] was significantly higher than in BMT group[ (83.69±1.26) %]. Alleviated osteomyelitis injury and inflammatory cell infiltration in EPC group were observed when compared with BMT mice. Also significant reductions of the levels of nlrp1、nlrp6、casepase-1 transcription complexes in EPC mice were noted when compared with BMT ones. Conclusion Co-transplantation of HSC and EPC could alleviate inflammatory cell infiltration and activation of the complex to promote the repair of bone marrow.

Objective To investigate the clinical efficacy of intratympanic corticosteroids(ITS)and hyperbaric oxygen therapy(HBOT)in patients with idiopathic sudden sensorineural hearing loss(ISSNHL)who had failed systemic corticosteroid(SS)treatment.Methods ISSNHL patients admitted to the Department of Otolaryngology,First People's Hospital of Linping District of Hangzhou city from January 2020 to January 2023 were retrospectively collected.According to the treatment plan,patients with ISSNHL were divided into SS group,HBOT group,and ITS group.The changes in hearing level[purity hearing threshold mean(PTA)]and hearing gain of ISSNHL patients before treatment(T0),day 5(T1)and after 3 months of treatment(T2)were observed and compared,and the total effective rate of treatment in different groups was compared.Univariate analysis was used to explore the influencing factors of the efficacy of patients with different treatment modalities of ISSNHL.Results A total of 156 ISSNHL patients were included,including 70 in the SS group,33 in the HBOT group and 53 in the ITS group.At T0,there was no significant difference in PTA among the three groups of patients(P>0.05).At T2,the level of PTA in the three groups of ISSNHL patients was significantly lower than that before treatment(P<0.05).The levels of PTA in the HBOT group and ITS group were significantly lower than those in the SS group(P<0.05).The level of PTA in the HBOT group was significantly lower than that in the ITS group(P<0.05).The hearing gain of the HBOT group and the ITS group was significantly higher than that of the SS group(P<0.05),and the hearing gain of the HBOT group was significantly higher than that of the ITS group(P<0.05).The total effective rate of HBOT group was significantly higher than that of ITS group(P<0.05),and the total effective rate of ITS group was significantly higher than that of SS group(P<0.05).In addition,vertigo was an influencing factor for poor hearing recovery in ISSNHL patients regardless of treatment regimen(P<0.05).Conclusion Both ITS and HBOT can improve the treatment efficiency of ISSNHL patients who have failed SS treatment and promote hearing recovery in ISSNHL.Compared with IST,HBOT has more significant efficacy,and it is recommended that clinical treatment be prioritized.Vertigo is an influencing factor for poor hearing recovery in patients with ISSNHL who have failed SS treatment,and should be focused on in clinical practice.

Objective To investigate the training expectations and training strategies of orthopedic clinical specialist nurses (OCSN).Methods Totally 5 020 orthopedic nurses from 342 hospitals from 30 provinces and cities were selected bv convenience sampling.Participants were investigated hy WeChat platform with self-designed questionnaire.Results A total of 4 982 effective questionnaires were collected.Among investigated nurses,13.7％ of them received orthopedic specialist nurses training;91.4％ believed that training should be carried out.Qualifications should be:college degree and above,senior nurse and above,at least 3 ～5 years of nursing experience,1～3 years of nursing experience in orthopedic department.For curriculum,public courses expected to be arranged were communieation skills,nursing teaching,nursing management,and nursing research;expected professional courses were functional exercises,pain management,extremity injury nursing,common treatment techniques in orthopedic department,traction nursing,and position nursing.It was suggested that training was divided into subspecialties and off-duty;classroom teaching,teaching rounds,case discussion and experience exchange were expected training methods;"theory-practice-theory-practice" was most preferable traiuing mode.The preferred teachers were orthopedic doctors,orthopedic head nurses,orthopedic specialist nurses,and senior orthopedic nurses.The length of training was expected to be three months,time for clinical practice should be greater than or equal to theoretical teaching,and the practice bases should be tertiary hospitals.Evaluation should be performed before completion,recertification could be later than completion,and the interval time of recertification should be within 5 years.Conclusion Training needs of orthopedic nurses for OCSN are strong.Training expectations(contents,length,modes and teachers) of orthopedic nurses should be considered when designing systematic training program on OCSN.

Objective To summarize the pathogenic characteristics and treatments of parvovirus B19 infection in patients after renal transplantation .Methods Twenty-two cases of parvovirus B19 infection after renal transplantation were diagnosed by quantitative polymerase chain reaction (qPCR) from March 2016 to January 2019 .And the pathogenic characteristics and treatments of parvovirus B19 infection after renal transplantation were analyzed .Results The overall incidence rate of parvovirus B19 after renal transplantation was 2 .97％ .The median diagnostic time was 39 (15～572) days .Administration of intravenous immunoglobulin (IVIG) ,conversion of immunosuppressants and other comprehensive regimens were adopted .Except for 1 patient dying from cardiovascular accident at 4 days post-diagnosis , the remainders were cured . The accumulative dosage of IVIG was (7 .7 ± 3 .8) g/kg in 5 patients with delayed conversion and un-conversion of immunosuppressants ,and (2 .7 ± 1 .9) g/kg in 16 patients with early conversion of immunosuppressants .During a follow-up period of (13 .0 ± 9 .1) months ,the level of hemoglobin remained stable .Conclusions Parvovirus B19 infection after renal is predominant immediately after transplantation .And the dosage of IVIG may be lowered by an early conversion of immunosuppressants after a definite diagnosis .