Gallbladder carcinoma is the most common malignancy in biliary tract.Early dissemination,rapid and silent progression and delayed diagnose could portend a dismal prognosis.The 5-year survival rate is less than 10％.Clarifying the etiological feature can improve the early diagnosis.Comprehending surgical indications of benign lesions can provide the methods for rational prophylactic resections.Standardized treatment of accident gallbladder carcinoma could improve the patients' prognosis.Efficient serologic markers could be used for early diagnosis and screening.

Objective:Evaluate the main factors affecting the quality of life of children and adolescents with type 1 diabetes.Methods:The System retrieval from the establishment of the library to March 19, 2019 in the Chinese journal full-text database, China Biomedical Literature Database, Weipu Journal Full Text Database, Wanfang database, PubMed, Webscien database on the study of factors affecting the quality of life of children and adolescents with type 1 diabetes, using RevMan5.3 and Stata12.0 software, used the inclusion of the literature Meta analysis.Results:According to the inclusion and exclusion criteria, a total of 17 documents were included, with a total sample size of 11266 cases. The combined effect of the effect sage factors of quality of life in children and adolescents with type 1 diabetes and 95% CI were gender 0.31 (0.20-0.42), age 0.22 (0.08-0.36), age of onset 0.07 (0.01 - 0.12), and whether it was an only child 0.62 (0.33 - 0.91), household annual income - 0.45 (-0.66 -- 0.24), blood sugar control 0.66 (0.50 - 0.82), number of insulin injections per day -0.22 (-0.39 --0.04), HbA1c0.39 (0.33 - 0.46). Conclusion:Gender, age, age of onset, household annual income, blood sugar control, number of insulin injections per day, HbA1c were the main factors affecting the quality of life of children and adolescents with type 1 diabetes. To provide reference for hospitals, families, communities, schools to take a variety of practical measures.

Objective:To evaluate the value of capillary electrophoresis in the diagnosis and differential diagnosis of benign and malignant monoclonal gammopathies (MGs).Methods:A retrospective analysis of the capillary electrophoresis test results of 2 445 newly diagnosed patients at the Affiliated Hospital of Qingdao University from January 2016 to June 2020 was carried out. Capillary zone electrophoresis and immunosubtractive assay were used to detect serum monoclonal protein (MP). The clinical diagnosis and other information of the patients were collected from the clinical database of the Affiliated Hospital of Qingdao University. Kruskal-Wallis rank sum test was used to compare the different amount of monoclonal protein among multiple groups. Receiver operator characteristic curve (ROC) was used to analyze the diagnostic sensitivity and specificity of the monoclonal protein of each type. Youden index was used to calculate the cut-off values.Results:Among the 2 445 patients, 1 183 were positive for monoclonal protein, of which 944 cases were diagnosed as malignant MG, 174 were monoclonal gammopathy of undetermined significance (MGUS), and 65 cases were monoclonal gammopathy of renal significance (MGRS). The percentages of M protein types from high to low is immunoglobulin G(IgG)-κ, IgG-λ, IgA-λ, IgA-κ, free λ light chain, free κ light chain, IgM-κ, double clone, and IgM-λ. The levels of MP of IgG, IgA, IgM and FLC in the malignant MG group were all higher than those in the MGUS group, with statistical significance( P<0.01). The MP levels of IgG and IgA types in malignant MG group were higher than that in MGRS group ( P<0.01). ROC curve analysis showed that the MP of IgG, IgA, IgM and FLC types had good diagnostic efficacy for malignant MG ( P<0.01), and their AUC values were 0.947 (95 %CI 0.926-0.968), 0.930 (95 %CI 0.895-0.966), 0.844 (95 %CI 0.722-0.967) and 0.865 (95 %CI 0.781-0.950), respectively. For IgG, the cut-off value was 14.24 g/L, and the diagnostic sensitivity and specificity were 88.5% and 90.1%, respectively. The cut-off value of IgA was 8.88 g/L, and the sensitivity and specificity of IgA were 87.9% and 81.4%, respectively. For IgM, the cut-off value was 26.93 g/L, and the sensitivity was 64.4% and the specificity was 90.9%. For FLC, the cut-off value, diagnostic sensitivity, and specificity was 7.08 g/L, 85.9%, and 77.8%, respectively. Conclusions:Capillary electrophoresis immunotyping technique can be used to diagnose malignant MG such as multiple myeloma (MM) and non-Hodgkin′s lymphoma (NHL), as well as to screen and track diseases like MGUS and MGRS. Serum MP level can be used to distinguish malignant MG from benign MG effectively.

Background and Objectives: This study investigated the relative incidence of contrast induced nephropathy (CIN) and long-term outcomes between iso-osmolar contrast media (IOCM) and low-osmolar contrast media (LOCM) undergoing elective percutaneous coronary intervention (PCI). Methods: A total of 9,431 patients receiving elective PCI were enrolled in the cohort. The patients were divided into IOCM group and LOCM group. Propensity score matching (PSM) was applied to minimize the selection bias between groups. Results: The multivariate analysis showed that the use of IOCM compared with LOCM did not affect the CIN incidence (odds ratio [OR], 0.912; 95% confidence interval [CI], 0.576–1.446; p=0.696). After PSM, the incidence of CIN was 1.5% and 4.0% in IOCM group (n=979) and LOCM group (n=979), respectively, p=0.001. IOCM significantly reduced the incidence of CIN compared with LOCM (OR, 0.393; 95% CI, 0.214–0.722; p=0.003). After 2 years of follow-up, the all-cause mortality was higher in IOCM group than LOCM group (2.1% vs. 0.9%, p<0.001). Cox regression analysis showed IOCM was not independent risk factor of 2-years all-cause mortality (OR, 0.849; 95% CI, 0.510–1.412; p=0.528). After PSM, the difference of all-cause death between groups disappeared (1.7% vs. 1.9%, p=0.739). Cox regression analysis showed that the use of IOCM compared with LOCM did not affect the incidence of 2-year all-cause mortality (OR, 1.037; 95% CI, 0.534–2.014; p=0.915). Conclusions Compared with LOCM, IOCM significantly reduced the incidence of CIN after elective PCI, but had no significant effect on 2-year all-cause mortality.

Background and Objectives: This study investigated the relative incidence of contrast induced nephropathy (CIN) and long-term outcomes between iso-osmolar contrast media (IOCM) and low-osmolar contrast media (LOCM) undergoing elective percutaneous coronary intervention (PCI). Methods: A total of 9,431 patients receiving elective PCI were enrolled in the cohort. The patients were divided into IOCM group and LOCM group. Propensity score matching (PSM) was applied to minimize the selection bias between groups. Results: The multivariate analysis showed that the use of IOCM compared with LOCM did not affect the CIN incidence (odds ratio [OR], 0.912; 95% confidence interval [CI], 0.576–1.446; p=0.696). After PSM, the incidence of CIN was 1.5% and 4.0% in IOCM group (n=979) and LOCM group (n=979), respectively, p=0.001. IOCM significantly reduced the incidence of CIN compared with LOCM (OR, 0.393; 95% CI, 0.214–0.722; p=0.003). After 2 years of follow-up, the all-cause mortality was higher in IOCM group than LOCM group (2.1% vs. 0.9%, p<0.001). Cox regression analysis showed IOCM was not independent risk factor of 2-years all-cause mortality (OR, 0.849; 95% CI, 0.510–1.412; p=0.528). After PSM, the difference of all-cause death between groups disappeared (1.7% vs. 1.9%, p=0.739). Cox regression analysis showed that the use of IOCM compared with LOCM did not affect the incidence of 2-year all-cause mortality (OR, 1.037; 95% CI, 0.534–2.014; p=0.915). Conclusions Compared with LOCM, IOCM significantly reduced the incidence of CIN after elective PCI, but had no significant effect on 2-year all-cause mortality.

Objective To establish sensitive indicators for the evaluation of emergency nursing quality in patients with acute aortic dissection.Methods Based on the three-dimensional quality theory model of"structure-process-outcome",evidence-based nursing methods were used to synthe-size evidence and conduct two rounds of expert consultation to determine sensitive indicators for the quality of emergency nursing in patients with acute aortic dissection.Results The effective recovery rates of the two rounds of expert consultation questionnaires were 100.00％and 94.12％,respective-ly.The judgment basis coefficients(Ca)of the experts who participated in the two rounds of consul-tation were 0.893 and 0.914,respectively,and the familiarity coefficients(Cs)were 0.902 and 0.921,respectively,and the authority coefficients(Cr)were 0.898 and 0.918,respectively.The Kendall coefficients of the first round of consultation experts for the first,second,and third-level indi-cators were 0.212,0.247,and 0.327,respectively,and were 0.225,0.349,and 0.257,respec-tively in the second round of consultation experts.Finally,the sensitive indicators for the quality of e-mergency nursing of AAD patients were constructed,including 3 first-level indicators,8 second-level indicators,and 29 third-level indicators.Conclusion The sensitive indicators for the quality of e-mergency nursing of AAD patients constructed in this study can be used as a basis for evaluating the quality of emergency nursing in patients with acute aortic dissection.

Objective To establish sensitive indicators for the evaluation of emergency nursing quality in patients with acute aortic dissection.Methods Based on the three-dimensional quality theory model of"structure-process-outcome",evidence-based nursing methods were used to synthe-size evidence and conduct two rounds of expert consultation to determine sensitive indicators for the quality of emergency nursing in patients with acute aortic dissection.Results The effective recovery rates of the two rounds of expert consultation questionnaires were 100.00％and 94.12％,respective-ly.The judgment basis coefficients(Ca)of the experts who participated in the two rounds of consul-tation were 0.893 and 0.914,respectively,and the familiarity coefficients(Cs)were 0.902 and 0.921,respectively,and the authority coefficients(Cr)were 0.898 and 0.918,respectively.The Kendall coefficients of the first round of consultation experts for the first,second,and third-level indi-cators were 0.212,0.247,and 0.327,respectively,and were 0.225,0.349,and 0.257,respec-tively in the second round of consultation experts.Finally,the sensitive indicators for the quality of e-mergency nursing of AAD patients were constructed,including 3 first-level indicators,8 second-level indicators,and 29 third-level indicators.Conclusion The sensitive indicators for the quality of e-mergency nursing of AAD patients constructed in this study can be used as a basis for evaluating the quality of emergency nursing in patients with acute aortic dissection.

Diabetic retinopathy(DR)is a common ocular chronic microvascular complication of diabetes mellitus and is the leading blinding fundus disease in people over 40 years of age.Current studies have shown that neuroglial vascular u-nit(NGVU)injury causes a variety of characteristic fundus changes in DR patients,including exudation,cotton wool spots,microangioma,bleeding,and neovascularization.Recent studies have confirmed that retinal NGVU injury in DR pa-tients occurs before retinal microangiopathy and is closely related to impaired visual function,so NGVU is expected to be a potential therapeutic target for the prevention and treatment of early DR in the future.In this paper,the research progress on the relationship between NGVU and DR treatment is reviewed,intending to provide new research directions for the pre-vention and intervention of early DR progression.

Natamycin is a polyene macrolide antibiotics with strong and broad spectrum antifungal activity. It not only effectively inhibits the growth and reproduction of fungi, but also prevents the formation of some mycotoxins. Consequently, it has been approved for use as an antifungal food preservative in most countries, and is also widely used in agriculture and healthcare. Streptomyces natalensis and Streptomyces chatanoogensis are the main producers of natamycin. This review summarizes the biosynthesis and regulatory mechanism of natamycin, as well as the strategies for improving natamycin production. Moreover, the future perspectives on natamycin research are discussed.
Antifungal Agents/pharmacology* ; Fungi ; Natamycin ; Streptomyces

Objective:To determine the erythromycin resistance of Bordetella pertussis isolates and their ptxP1 and ptxP3 phenotypic composition and compare clinical manifestations of children with pertussis caused by the two types of strains. Methods:This was a cross-sectional study, the pertussis cases diagnosed using bacterial culture from January 2019 to December 2022 in Beijing Children′s Hospital and the First People′s Hospital of Wuhu were collected.Any suspected Bordetella pertussis colonies were identified by the slide agglutination test.The susceptibility of isolates to erythromycin was detected by the E-test and K-B test.The ptxP gene was amplified by polymerase chain reaction and sequenced to determine its genotype. t-test, Mann-Whitney U-test, Chi-square test and Fisher′s exact test were use to statistical analysis. Results:A total of 192 strains of Bordetella pertussis were identified, including 188 (97.9%) erythromycin-resistant strains.Among the 188 strains, 30.3%(57/188) belonged to the ptxP1 genotype and 69.7%(131/188) belonged to the ptxP3 genotype.In children aged below 1 year old, the incidence of paroxysmal cough caused by infection with the ptxP3 strain was higher than that with the ptxP1 strain (57.1% vs.29.4%, P<0.05), and children infected with the ptxP3 strain were more likely to develop apnea or asphyxia (23.8% vs.17.6%), post-tussive vomiting (44.4% vs.32.4%), whooping cough (72.0% vs.50.0%) and pneumonia or bronchitis (85.7% vs.73.5%) compared to those infected with the ptxP1 strain, but the differences were not statistically significant(all P>0.05). In children aged 1 year old and above, the white blood cell count of children infected with the ptxP1 strain was higher than that of infections with the ptxP3 strain [13.5(9.9, 24.5)×10 9/L, 10.3 (7.0, 16.4)×10 9/L, P<0.05], and children infected with the ptxP1 strain were more likely to contract other pathogen infections than those infected with the ptxP3 strain (17.4% vs.4.4%, P>0.05). Conclusions:ptxP3 erythromycin-resistant Bordetella pertussis has become the main pathogen of pertussis.Infants with pertussis caused by the ptxP3 erythromycin-resistant strain show more significant manifestations and a higher possibility of severe symptoms than those infected with the ptxP1 erythromycin-resistant strain.