Objective To investigate the incidence and the risk factors for hospital-acquired pneumonia(HAP)in the elderly in Shanghai.Methods This was a muhicenter prospective clinical cohort study.A total of 5299 patients more than 65 years old.admitted into 31 secondary or tertiary hospitals in Shanghai,were enrolled.Measurements of the demographic and potential risk factors reflecting illness severity,nutrition,drug exposure,surgery and ventilation were performed.Pneumonia was classified by the definition of Chinese Medical Association.Risk factors were analyzed by univariate Pearson Chi-squared test and multivariable logistic regression analysis with backward(Likelihood ratio).Resuits Of the enrolled patients,2805 male and 2494 female,255(4.81%)developed hospital-acquired pneumonia.The incidence was 46.75/1000 hospitalizations.Among them 38 died:and the rough mortality was 14.90%.The incidence of HAP was higher in ICU(21.43%),hematology(12.17%),chest surgery(11.41%),and respiratory medicine(7.92%)departments.The mean of acute physiology and chronic health evaluation (APACHE Ⅱ)score was 8.3±3.4(5-31).Multivariable logistic regression analysis with backward (Wald)method found that admission into secondary hospitals.admission into ICU,history of chronic obstructive pulmonary disease≥10 years,immunosuppression,administration of antibiotics,insertion of nasogastric tube,mechanical ventilation,administration of H-2 antagonists or antacid and≤7 d,central nervous system diseases,depressed level of consciousness,supine position,albumin＜35g/L were independent risk factors of HAP in the elderly.Conclusion Hospital-acquired pneumonia in the elderly was the usual type of nosocomial infections.The risk factors identified from this study may prove useful to target future clinical interventions to prevent HAP in the elderly.

Objective To prepare specific mouse monoclonal antibodies against Homo sapiens dynein,axonemal, heavy chain 2 (DNAH2). Methods Firstly, recombinant plasmid encoding His tagged immunogen, targeting N-terminal sequence of DNAH2 protein (1-300 aa), in E. coli was constructed. IPTG was used to induce the expression of His-immunogen, which was then purified and immunized in BALB/c mice. Hybridoma cells were obtained through the fusion between myeloma cells and splenocytes isolated from BALB/c mice. Finally, ELISA and Western blot assays were performed to screen the positive hybridoma. Results IPTG was used efficiently to induce the expression of DNAH2 immunogen in E. coli. DNAH2 protein bands were detected in screened positive hybridoma. Conclusion Mouse monoclonal anti-DNAH2 antibody is prepared successfully.

Objective:To analyze the use and satisfaction of smart healthcare in public hospitals in Hangzhou from the perspective of patient experience.Methods:From August to September 2020, 501 patients from 2 class A tertiary hospitals and 5 community health centers in Hangzhou were randomly selected for questionnaire survey. The survey included their usage and satisfaction of smart healthcare. Based on SERVQUAL theory, the patient satisfaction scale included 5 dimensions of tangibility, reliability, reactivity, assurance, and empathy. The factors affecting patient satisfaction were analyzed by single factor and multi factor analysis.Results:The average score of patient satisfaction was 3.94±0.56. The satisfaction with tangibility(4.25±0.64), assurance(4.07±0.71)and reactivity(4.02±0.73)was higher, while the scoring of empathy(3.84±0.77)and reliability(3.52±0.70)were lower than the average score. The results of multiple linear regression analysis showed that patients′ educational level, occupational type and UTAUT score had a certain impact on satisfaction( P<0.05). Conclusions:The overall satisfaction of patients with smart healthcare in Hangzhou is high. In the future, we should pay more attention to big data security and personal privacy protection, upgrade the smart medical system, improve the hospital Internet platform, empower smart healthcare service system through digital technology, and promote the comprehensive digital transformation of health.

Objective:To investigate and analyze the status quo and influential factors of the elderly in the community.Methods:From July to September 2021, 543 elderly people were investigated in 9 community healthcare service centers in Hangzhou by using the Comprehensive Frailty Assessment Instrument (including four dimensions: physical, psychological, social, and environmental frailty) and the Social Support Rating Scale (including three dimensions: subjective support, objective support, and support availability). Independent sample t-test, analysis of variance, correlation analysis, and multiple linear regression were conducted to examine key determinants of frailty. Results:The total score of frailty among older adults in the community was (43.1±12.0). The results showed that the total score of social support was negatively associated with frailty of community-dwelling older adults ( r=-0.449, P<0.01); age ≥80 years old ( β=0.229, P<0.001) was positively associated with frailty; not living alone, children′s household support, children′s spiritual support, the accessibility of elderly care facilities within a 15-minute walk, and social support score were negatively associated with frailty ( β=-0.118, -0.081, -0.260, -0.155, -0.250,all P<0.05). Conclusion:The elderly in the community have a moderate degree of frailty, which affected by age, living condition, children′s support, the accessibility of elderly care facilities, and social support.

Development of thoracolumbar vertebra (TLV) and rib primordium (RP) is a common evolutionary feature across vertebrates, although whole-organism analysis of the expression dynamics of TLV- and RP-related genes has been lacking. Here, we investigated the single-cell transcriptome landscape of thoracic vertebra (TV), lumbar vertebra (LV), and RP cells from a pig embryo at 27 days post-fertilization (dpf) and identified six cell types with distinct gene expression signatures. In-depth dissection of the gene expression dynamics and RNA velocity revealed a coupled process of osteogenesis and angiogenesis during TLV and RP development. Further analysis of cell type-specific and strand-specific expression uncovered the extremely high level of HOXA10 3'-UTR sequence specific to osteoblasts of LV cells, which may function as anti-HOXA10-antisense by counteracting the HOXA10-antisense effect to determine TLV transition. Thus, this work provides a valuable resource for understanding embryonic osteogenesis and angiogenesis underlying vertebrate TLV and RP development at the cell type-specific resolution, which serves as a comprehensive view on the transcriptional profile of animal embryo development.