Objective To investigate the effect of Sirt1 gene knockout on chronic kidney disease induced by 5/6 nephrectomy in mice and vascular endothelial growth factor (VEGF)/fetal liver kinase-1 (Flk-1) signaling pathway.Methods Twenty four male Sirt1 +/+ and Sirt1 +/-mice wererandomly divided into four groups:Sirt1+/+ mice with sham-operation (WT-Sham,n=6),Sirt1+/-mice with sham-operation (KO-Sham,n=6),Sirt1 +/+ mice with 5/6 nephrectomy (WT-Nx,n=6) and Sirt1 +/-mice with 5/6 nephrectomy (KO-Nx,n=6).Proteinuria was determined by urine collection from 8:00 to 8:00 the next day at 20 weeks.Serum creatinine (Scr),urea nitrogen (BUN) and the renal pathological changes were measured after 20 weeks.Expressions of Sirt1,collagen Ⅰ and transforming growth factor β(TGF-β) were used to analyze the changes of renal fibrosis by immunohistochemistry staining.Real-time PCR and Western blotting were used to measure the mRNA and protein expressions of Sirt1,fibronectin,collagen Ⅰ,VEGF and Flk-1 in kidney.Results Sirt1 expressed in glomernlar endothelial cells,podocytes,mesangial cells and renal tubular epithelial cells in Sirt1 +/+ mice,while Sirt1 expression intensity was significantly reduced in Sirt1 +/-mice.Compared with the WT-Sham group,WT-Nx group had increased proteinuria,BUN,Scr,glomernlar sclerosis index and tubulointerstitial fibrosis index at 12 weeks after operation (all P ＜ 0.01),and KO-Nx group had exacerbated the above up-regulations (all P ＜ 0.01).Compared with those in WT-Sham group,the expressions of fibronectin,collagen Ⅰ and TGF-β were up-regulated in WT-Nx group (all P ＜ 0.01),and were significantly augmented in KO-Nx group (all P ＜ 0.01).Compared with those in WT-Sham group,renal mRNA and protein expressions of VEGF and Flk-1 were decreased in WT-Nx group,and KO-Nx group aggravated their down-regulation (all P ＜ 0.01).Conclusions Sirt1 gene knockout can increase proteinuria and Scr,and aggravate renal pathology and renal fibrosis in 5/6 nephrectomized mice,which is associated with the inhibition of VEGF/Flk-1 signaling pathway.It is suggested that Sirt1 may be a potential therapeutic target of chronic kidney disease.

Objective: To study the hepatitis E virus(HEV) infection in pregnant women and the healthy blood donors in Jinan. Methods: A total of 651 blood samples from pregnant women who came for screening of hemolytic disease of newborn and 600 blood samples from blood donors were collected during June 2015 to October 2016. All the blood samples were tested for anti-HEV IgG and anti-HEV IgM antibodies by using enzyme-linked immunosorbent assay (ELISA). Results: Anti-HEV IgG was positive in 2.61% (17/651) of the blood samples from the pregnant women, and none of the samples were positive for anti-HEV IgM. The serum positive rates for anti-HEV IgG and IgM in blood donors were 16.33% (98/600) and 0.83% (5/600) respectively. The seroprevalence of the two groups was significantly different(χ²=70.43, P<0.0001). Conclusions The HEV infection rate in pregnant women was much lower compared with that in blood donors in Jinan; however, in view of the high mortality of HEV infection in pregnant women, it still cannot be neglected. The infection of HEV in blood donors of Jinan was confirmed, suggesting the potential risk of transfusion-transmitted HEV infection.

Objective To establish cell strain expressing the genes of HIV vpr and mutant HIV vpr-FS, and to explore cell apoptosis ability by HIV Vpr and Vpr-FS. Methods The recombinant plasmids were constructed by cloning HIV vpr and HIV vpr-FS genes into the eukaryotic expression vector pcDNA3.1respectively. To determine the primary structures of HIV vpr and HIV vpr-FS, plasmids were cleaved by restriction enzymes. After the plasmids were transfected into HeLa cells by liposome, the HeLa cells were selected with G418 selective medium, mRNA expression of HIV vpr or HIV vpr-FS of transfected cells was detected by RT-PCR, and Vpr and Vpr-FS protein expression were detected by Western blot assay respectively. The DNA content and the percentage of apoptosis in HeLa HIV vpr cell, HeLa HIV vpr-FS cell and HeLa pcDNA3.1 cell were monitored by flow cytometry and the DNA fragmentation was analyzed by agarose gel electrophoresis. Results BamH Ⅰ and Hind Ⅲ cleavaged products of pcDNA3.1-vpr and pcDNA3.1-vpr-Fincluded 342 bp length fragments suggesting that the length of DNA sequence containing HIV vpr (HIV vpr-FS) within pcDNA3.1 was the same as theoretical length. The HeLa cells transfected by pcDNA3.1-vpr or pcDNA3, l-vpr-FS and selected with G418 could express HIV vpr or HIV vpr-FS by RT-PCR, and express HIV Vpr or HIV Vpr-FS protein by Western blot. The results of flow cytometry and DNA fragmentation showed that there was significant different in the number of apoptotic cells between HeLa HIV vpr cell and HeLa HIV vpr-FS cell, but the difference between HeLa HIV vpr-FS cell and control group was not obvious. Conclusion Recombinant plasmids pcDNA3.1-vpr and pcDNA3. 1-vpr-FS were constructed successfully, and the cell strain expressing HIV Vpr and HIV Vpr-FS proteins was established. The HIV Vpr could induce host cell apoptosis, while the mutant of Vpr did not or weakened this ability. This study provides foundation for further study on HIV vpr gene.

Objective: To investigate milk consumption and associated factors in the national pilot counties of Nutrition Improvement Programme for Rural Compulsory Education Students (NIPRCES) in 2016, and to provide basic data for milk consumption improvement. Methods: Two primary and middle schools in each county were selected randomly from 50 key monitoring counties in 22 provinces in NIPRCES by three food supply modes (school-based, company-based, and others). Then 1 or 2 classes in each grade were selected randomly from grade 3 or above and junior schools. A total of 25 948 students were collected, milk consumption and related factors were investigated through student questionnaires. Results: Among the students surveyed, the proportion of students drank 1 to 3 packs of milk every week was highest (45.4%), only 29.1% students drank 4 or more packets of milk per week. The proportion of children in grades 3 and 4 who drank 4 or more packets of milk per week (35.7%) was higher than that of children in grades 5 and 6 (31.8%) and junior school (22.5%)(P<0.01). The proportion of boys who drank 4 or more packs of milk per week (30.7%) was higher than girls (27.5%) (P<0.01). Multivariate Logistic regression analysis showed that boys, primary school students in grades 3 to 6, non-resident students, students with both parents or one parent at home, students who had more meals per day, students who had breakfast every day, students who took snacks or drank beverages once or more per day, students who drank 4 or more cups of boiled water were more likely to drink 4 or more packs of milk each week. Conclusion Students in poor rural areas in China lack access to milk. It is recommended that targeted measures should be taken to encourage and promote rural students to drink enough milk.

Objective To investigate the curative effect of ultra early enteral nutrition (EN) supplemented with probiotics in patients with severe acute pancreatitis (SAP).Methods Seventy-five SAP cases admitted in Second People's Hospital of Nantong from December 2014 to June 2018 were enrolled and assigned into 24 h group (who received EN & probiotics at 24 h,n =25),72 h group (who received EN & probiotics at 72 h,n =25) and the control group (who received EN & probiotics on day 7,n =25).After admission,the levels of PCT,hs-CRP and endotoxin on day 1,4 and 8 were detected.APACHE Ⅱ score on day 3 after admission,complication rate,infection rate,hospitalization duration and mortality were recorded.Results On day 1 after admission,serum PCT,hs-CRP and endotoxin concentrations among three groups were of no significant differences.On day 4 after admission,the serum concentrations of PCT and edotoxin in 24 h group were significantly lower than those in 72 h group and the control group [(3.12 ± 1.45) μg/L vs (5.26±1.52),(6.07 ± l.59) μg/L;(0.24 ± 0.02) EU/ml vs (0.35 ±0.03),(0.46±0.04) EU/ml].The serum hs-CRP in 24 h group was significantly lower than that of the control group [(20.71 ±4.89) μg/L vs (28.37 ± 4.64) μg/L],and the difference was statistically significant (P ＜ O.05).The serum concentrations of hs-CRP in 24 h group and 72 h group was of no significant difference.On day 7 after admission,the serum concentrations of PCT,hs-CRP and endotoxin in 24 h group were significantly lower than those in 72 h group and the control group (P ＜0.05);the serum concentrations of PCT,hs-CRP and endotoxin in 72 h group were significantly lower than those of the control group,and all the differences were statistically significant (all P ＜ 0.05).The score of APACHE Ⅱ (day 3 after admission) [(15.1 ± 1.8)],complication rate (52％),infection rate (8％),length of stay [(19.7 ± 5.3) d] in 24 h group were all significantly lower than those of 72h group [(17.0 ± 2.0),72％,32％,(25.4 ± 6.8) d] and control group [(18.3 ±2.6),84％,44％,(38.7 ± 12.6) d],and all the differences were statistically significant (all P ＜0.05).Conclusions Ultra EN supplemented with probiotics in treating the patients with SAP could significantly reduce the level of serum PCT,hs-CRP and endotoxin,decrease complication rate and mortality,and shorten the time of hospitalization.

Objective:To summarize the best evidence for spasticity management in spinal cord injury patients, so as to provide references for clinical practice.Methods:PubMed, Embase, CLINICAL, BMJ Best Clinical Practice website, JBI Evidence-based Health Care Center database, National Institute for Health and Clinical Excellence, Ontario Guidelines Network, US National Guidelines Network, Scottish Interhospital Guidelines Network, UpToDate, Cochrane Library, CNKI, Wanfang Database, Medlive, China Biology Medicine disc and professional association websites were syatematically searched for clinical decisions, guidelines, evidence summary, systematic reviews and expert consensus or opinions on spasm management. The quality of the included studies was evaluated and the evidence content was extracted. The search period was from the establishment of the databases to February 28, 2023.Results:A total of 15 articles were included, including 2 clinical decision-making articles, 1 guideline, 3 expert consensus or opinions articles and 9 systematic evaluations. A total of 18 pieces of evidence were summarized from 4 aspects, such as regular evaluation, intervention measures, intervention principles, and effectiveness evaluation of patients with spinal cord injury.Conclusions:This study summarizes the best evidence for spasticity management in patients with spinal cord injury and provides an evidence-based basis for clinical work. It is recommended that when applying the evidence, an individualized spasticity treatment plan should be developed according to the needs of the patient and the actual clinical situation.

Objective:To explore the relationship between stress coping styles and disability levels in patients with spinal cord injury (SCI) .Methods:Totally 300 SCI patients who were hospitalized in the Spinal Surgery Department of three Class Ⅲ Grade A hospitals in Anhui Province from March 2021 to February 2022 were selected by convenience sampling. Data were collected using a general information questionnaire, the Spinal Cord Lesion-related Coping Strategies Questionnaire (SCL-CSQ), and the WHO Disability Assessment Schedule (WHODAS 2.0). Spearman correlation analysis was used to examine the relationship between stress coping styles and disability levels, and multiple linear regression analysis was employed to identify factors influencing disability levels in these patients.Results:A total of 300 questionnaires were distributed, with 269 valid responses received, yielding an effective response rate of 89.67% (269/300). The total score of WHODAS 2.0 for the 269 patients was [91.00 (72.50, 104.00) ], with an item mean score of [2.53 (2.01, 2.89) ], and an average score rate of 59.86%, indicating a moderate to high level of disability. The average score rate for positive stress coping (facing, seeking support, rationalization) was 67.30%, while for negative stress coping (rejection and denial, fantasy, dependency and compromise), it was 64.48%. Negative stress coping was positively correlated with disability levels ( P<0.05), while positive stress coping was negatively correlated with disability levels ( P<0.05). Multiple linear regression analysis showed that occupation, American Spinal Injury Association classification, facing, rejection and denial, and dependency and compromise were factors influencing disability levels in SCI patients ( P<0.05), explaining 50.4% of the total variance in disability levels. Conclusions:The disability level of SCI patients is moderate to high, and stress coping style is an influencing factor. Healthcare professionals should help patients avoid controllable stressors, cultivate effective stress coping strategies, prevent helplessness, to shorten the time window for disability development, and improve patients' quality of life.

Objective:To explore the effects of competency-based diversified training on the bedside nursing comprehensive ability aand transition shock of newly recruited nurses.Methods:A total of 62 newly recruited nurses from the Second Affiliated Hospital of Zhengzhou University in June 2018 were selected as the control group, and 70 newly recruited nurses from June 2019 were selected as the experimental group by cluster sampling. The control group received routine pre-job training, and the experimental group received diversified training based on the control group. After one year of training, the differences in the scores of bedside nursing comprehensive ability, post competency and transition shock between the two groups of nurses were analyzed.Results:After 1 year of training, the total scores and the scores of nursing problems, nursing evaluation, nursing plan, nursing theory, nursing operation and bedside nursing comprehensive ability in the experimental group were 12.20±1.76, 24.29±2.38, 13.54±1.88, 9.77±1.35, 15.14±2.30 and 79.24±6.59, which were all higher than those of the control group (10.26±1.55,22.31±1.84,10.45±1.58, 8.56±1.80, 13.27±2.38 and 69.82±4.09), the differences were statistically significant ( t value was 4.582-13.679, P<0.05). The total scores and the scores of each dimension of the Post-competency the experimental group were 31.46 ±4.32, 51.03± 4.64, 20.27± 3.78, 17.86±3.99, 58.43± 4.44, 179.37±9.97, which were all higher than those of the control group 24.76±4.12, 40.56±5.55, 16.61±2.88, 15.15± 2.96, 49.74±3.07, 146.66±17.98, the differences were statistically significant ( t value was 4.466-13.197, P<0.05). The scores of psychological knowledge, skills, social culture and development and the total scores of Transition shock in the experimental group were 30.90±3.15, 19.69±2.74, 32.17±3.06, 103.81±12.24, which were all higher than those in the control group (25.69±2.76, 15.92±3.24, 27.50±4.15, 88.32±11.54), the differences were statistically significant ( t value was 7.237-10.040, P<0.05). Conclusions:competency-based diversified training can effectively improve the bedside nursing comprehensive ability and post competency, reduce their transition shock, and has strong clinical reference significance.

Objective: To analyze the usage of catering software and the creation of recipes by schools, as part of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) 2013-2017. Methods: In each county of the 699 trial counties across 22 provinces in central and western area of China under the NNIPRCES, no less than 10% of primary and junior middle schools were randomly selected according to their catering mode (i.e., school feeding, food packages, and family feeding). School questionnaires were used to collect information concerning the schools and the creation of recipes. Results: From 2013 to 2017, the utilization rate of catering software was 11.7%, 8.0%, 17.8%, 16.9%, and 14.0%, respectively with significant differences(χ 2=345.09，P<0.01). The creators of school-meal recipes included schools, the Education Bureau, hospitals and colleges, the centers of disease prevention and control. Differences were observed in the proportion of recipe creators across school type, area, and catering mode, while annual trends also varied (P<0.01), as indicated by the following proportions: 74.9%, 20.0%, 3.7%, 1.3%, respectively. Food safety was identified as the main factor that needs to be considered when creating school recipes, the proportions of which were 58.0%, 78.4%, 70.6%, and 87.4% from 2014 to 2017. Conclusion From 2013 to 2017, the utilization rate and the frequency of catering software were both relatively low, and recipe creation was in need of professional guidance. It is necessary to strengthen the popularization of catering software and improve the nutritional knowledge and skills of canteen workers to ensure the quality of school meals.

Objective: To analyze changes of school canteen construction and canteen meal provision in surveilled schools after the initiation of the National Nutrition Improvement Program for Rural Compulsory Education Student (NNIPRCES), therefore to provide data basis for improving efficacy of school canteen meals. Methods: From 2012 to 2017, among the 699 trial counties in 22 provinces under NNIPRCES, at least 10% of elementary schools and middle schools with each food supply model (canteen meals, enterprise meals, and family meals) were randomly selected in each county in each year. Questionnaire survey was conducted to collect school canteen construction and meal provision information. The sample size were around 8 000 to 11 000 schools every year. Results: From 2012 to 2017, the proportion of schools that have canteens only, have both canteen and dining room, as well as those have canteen and dining room with tables and chairs significantly increased with years(χ 2=3 043.95, 6 383.85, 6 731.17, P<0.01). The proportion of schools having canteen increased from 59.5% in 2012 to 87.0% in 2017. The proportion of schools with canteen providing breakfast, lunch or dinner varied across years(χ 2=51.85, 144.96, 189.19, P<0.01). The varieties of food groups of three meals all significantly increased during 2012, 2014 and 2017(χ 2=702.30, 892.38, 550.55, P<0.01). The canteen construction indicators, proportion of canteens providing three meals, and food groups included in three meals all significantly differed between elementary schools and middle schools, also between schools of central area and western area(P<0.05). The changing patterns with year were significantly different in elementary schools and middle schools, and in schools of central area and western area(P<0.05). Conclusion After the implementation of NNIPRCES, canteen construction and food variety in canteen meals significantly improved during 2012 to 2017. However, there are still gaps between changes of canteen construction and canteen meal provision. It is necessary to overcome obstacles to further increase the proportion of schools with canteen offering meals and the variety of food of meals.