Objective:To understand the current knowledge, attitude, and practice (KAP) on influenza and influenza vaccine among pregnant women in Suzhou and to analyze its influencing factors to provide technical support data for public health strategies for promoting influenza vaccination in pregnant women.Methods:A questionnaire was designed, and a stratified sampling method was used to conduct a face-to-face survey among pregnant women at different stages of pregnancy who received antenatal examinations at different levels of medical institutions in Suzhou, Jiangsu Province, in 2023. KAP status and influencing factors were analyzed by χ2 test and logistic regression analysis. Results:A total of 2 195 valid questionnaires were collected in this survey. The M( Q1, Q3) of knowledge about influenza and influenza vaccine among pregnant women in Suzhou was 7.60 (5.23, 9.80) points, and the score range was 0.20-14.71 points, the passing rate was 34.12%, the awareness rate of influenza vaccine was 57.45%, and the vaccination rate of influenza vaccine was 1.91% within one year before the survey. The willingness to receive influenza vaccine during pregnancy was only 3.57%. Multivariate analysis of influenza and influenza vaccine-related knowledge scores showed that the passing rate was positively correlated with education level and gestational age. In contrast, family income was negatively correlated with living in rural areas, working as migrant workers, and having no medical insurance. Multivariate analysis of vaccination intention showed that decreased effectiveness of influenza vaccine and increased adverse reactions decreased vaccination intention during pregnancy. Conclusions:The pregnant women in Suzhou pay more attention to influenza, and vaccination rates and intentions are generally low. Pregnant women with early and second trimester of pregnancy, low education, living in rural areas, working as migrant workers, and not purchasing medical insurance are the key groups to popularize the knowledge about influenza and influenza vaccine.

Objective:To evaluate the therapeutic efficacy of modified Ω nail braces and traditional Winograd surgery.Methods:A retrospective analysis was conducted on the medical records of patients with ingrown toenails treated at the Department of Orthopedics of Beijing Tongren Hospital Affiliated to Capital Medical University and the Department of Hand and Foot Surgery, the Fourth People’s Hospital of Langfang City from November 2018 to November 2020. The subjects were divided into two groups: Winograd technique group (WTG) and modified Ω nail braces group (NBG). The basic information of the patients included gender, age, body mass index (BMI), affected side, stage of condition, combined deformity, water exposure, and foot sweating. The occurrence of complications, rate of patient satisfaction, duration of recovery, recurrence rate (the number of recurrences of ingrown nails / the total number of feet), and interval between recurrences were followed up after surgery. The statistical methods employed in this study included two-group t-test and Chi-square test. A significance level of 0.05 was adopted to determine statistical significance. Results:A total of 98 patients with 116 feet were enrolled in the study, comprising 47 cases with 55 feet in the WTG group [33 males and 14 females, age: (31.5±10.8) years] and 51 cases with 61 feet in the NBG group [29 males and 22 females, age: (33.3±13.4) years]. The average duration of nail brace usage in the WBG was (2.7±0.8) months, and the mean follow-up period was (12.3±1.1) months after dismantling. No complications were observed during the follow-up. The mean follow-up duration in the WBG was (12.5±0.9) months. Two patients experienced post-operative infection one week after the surgery, but recovered completely within 60 days through regular dressing changes. In 3 cases, wound exudation occurred following suture removal. However, normal wound healing was achieved with rest and local application of mupirocin ointment. After foot surgery, 2 cases presented with nail spines at a later stage of 2 months, without significant pain or need for further intervention. The two groups did not exhibit any significant differences in terms of gender, age, BMI, affected side, and stage (all P>0.05). The NBG group exhibited a significantly shorter average time of return to work compared to the WTG group [(0.5±0.4) d vs. (13.9±7.3) d], along with a higher patient satisfaction rate (95.1% vs. 83.6% ), both of which showed statistical significance ( P<0.05). No significant differences were observed between WTG and NBG regarding recurrence interval and recurrence rate ( P>0.05). Conclusion:The modified Ω nail brace is equally effective in the treatment of ingrown nails compared to Winograd surgery, but it offers a simpler, more convenient and noninvasive approach. Moreover, patients in the nail brace group exhibited higher satisfaction rates, faster recovery times, and no risk of surgical complications. Therefore, this method can be considered a viable option for treating ingrown nails.

Objective:To explore the influencing factors for poor prognosis in patients with severe traumatic brain injury (TBI).Methods:A retrospective analysis was performed; the clinical data of 389 patients with severe TBI admitted to Department of Neurosurgery, 900 th Hospital of PLA Joint Logistics Team from January 2018 to December 2022 were collected. Glasgow Outcome Scale (GOS) was used to evaluate the prognoses 6 months after discharge. Differences in clinical data between the good prognosis group (GOS scores of 4-5) and poor prognosis group (GOS scores of 1-3) were compared. Multivariate Logistic regression was used to analyze the independent influencing factors for poor prognosis in severe TBI patients, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of the regression model in severe TBI patients. Results:At 6 months after discharge, 182 patients (46.8%) had favorable prognosis and 207 patients (53.2%) had unfavorable prognosis. Compared with the good prognosis group, the poor prognosis group had significantly older age, lower Glasgow Coma Scale (GCS) scores, higher proportions of patients with subdural hematoma (SDH), cerebral hernia, cerebral infarction and encephalocele, higher blood glucose, lower albumin, lower K +, Ca 2+ and CO 2, higher international normalized ratio (INR) and C-reactive protein (CRP), lower lymphocyte/monocyte ratio (LMR), and higher neutrophil/lymphocyte ratio (NLR) and systemic immunoinflammatory index (SII, P<0.05). Multivariate Logistic regression analysis showed that age ( OR=1.045, 95% CI: 1.025-1.066, P<0.001), GCS score ( OR=0.487, 95% CI: 0.388-0.612, P<0.001), cerebral hernia ( OR=3.471, 95% CI: 1.604-7.511, P=0.002), blood glucose ( OR=1.109, 95% CI: 1.010-1.218, P=0.030), INR ( OR=8.073, 95% CI: 1.199-54.354, P=0.032) and high SII ( OR=8.311, 95% CI: 4.089-16.892, P<0.001) were independent influencing factors for poor prognosis in severe TBI patients. ROC curve showed that area under the curve of the regression model predicting poor prognosis in severe TBI patients was 0.935 (95% CI: 0.905-0.957, P<0.001), enjoying sensitivity of 88.89% and specificity of 85.16%. Conclusion:Severe TBI patients with advanced age, low GCS score, high INR and SII, elevated blood glucose, or cerebral hernia have poor prognosis.

Objective:To evaluate the therapeutic efficacy of modified Ω nail braces and traditional Winograd surgery.Methods:A retrospective analysis was conducted on the medical records of patients with ingrown toenails treated at the Department of Orthopedics of Beijing Tongren Hospital Affiliated to Capital Medical University and the Department of Hand and Foot Surgery, the Fourth People’s Hospital of Langfang City from November 2018 to November 2020. The subjects were divided into two groups: Winograd technique group (WTG) and modified Ω nail braces group (NBG). The basic information of the patients included gender, age, body mass index (BMI), affected side, stage of condition, combined deformity, water exposure, and foot sweating. The occurrence of complications, rate of patient satisfaction, duration of recovery, recurrence rate (the number of recurrences of ingrown nails / the total number of feet), and interval between recurrences were followed up after surgery. The statistical methods employed in this study included two-group t-test and Chi-square test. A significance level of 0.05 was adopted to determine statistical significance. Results:A total of 98 patients with 116 feet were enrolled in the study, comprising 47 cases with 55 feet in the WTG group [33 males and 14 females, age: (31.5±10.8) years] and 51 cases with 61 feet in the NBG group [29 males and 22 females, age: (33.3±13.4) years]. The average duration of nail brace usage in the WBG was (2.7±0.8) months, and the mean follow-up period was (12.3±1.1) months after dismantling. No complications were observed during the follow-up. The mean follow-up duration in the WBG was (12.5±0.9) months. Two patients experienced post-operative infection one week after the surgery, but recovered completely within 60 days through regular dressing changes. In 3 cases, wound exudation occurred following suture removal. However, normal wound healing was achieved with rest and local application of mupirocin ointment. After foot surgery, 2 cases presented with nail spines at a later stage of 2 months, without significant pain or need for further intervention. The two groups did not exhibit any significant differences in terms of gender, age, BMI, affected side, and stage (all P>0.05). The NBG group exhibited a significantly shorter average time of return to work compared to the WTG group [(0.5±0.4) d vs. (13.9±7.3) d], along with a higher patient satisfaction rate (95.1% vs. 83.6% ), both of which showed statistical significance ( P<0.05). No significant differences were observed between WTG and NBG regarding recurrence interval and recurrence rate ( P>0.05). Conclusion:The modified Ω nail brace is equally effective in the treatment of ingrown nails compared to Winograd surgery, but it offers a simpler, more convenient and noninvasive approach. Moreover, patients in the nail brace group exhibited higher satisfaction rates, faster recovery times, and no risk of surgical complications. Therefore, this method can be considered a viable option for treating ingrown nails.

On February 5,2024,the American Heart Association(AHA)released a scientific statement on the pharmacological management of cardiac arrhythmias in the fetal and neonatal periods.The statement discussed the mechanisms of arrhythmias,medication regimens,and fetal and neonatal aspects of pharmacokinetics.The statement proposed a consensus on drug treatment for arrhythmias in fetuses and newborns.This article interpreted the drug treatment part,and summarized the recommended medication and drug characteristics for fetal and neonatal arrhythmias to provide a reference for the drug treatment of fetal and neonatal arrhythmias in China.

Abstract: Objective To express Mycobacterium tuberculosis Rv2626c protein in Escherichia coli (E. coli) and study the antigenicity of the purified recombinant Rv2626c protein. Methods The amino acid sequence of Rv2626c protein from Mycobacterium tuberculosis H37Rv strain (accession number: CCP45424.1) in GenBank was retrieved and converted into the corresponding DNA sequence according to the codon preference of E. coli. This DNA sequence was synthesized and cloned into pET24a(+) plasmid to construct pET24a(+)-Rv2626c recombinant plasmid. This plasmid was transformed into E. coli BL21(DE3) cells, and the expression of Rv2626c protein was induced under various conditions of isopropyl β-D-thiogalactopyranoside (IPTG) concentrations, temperature, and period. The recombinant Rv2626c protein was identified by SDS-PAGE and Western Blot. The recombinant Rv2626c protein was purified by nickel chelate affinity chromatography and used to immunize violet blue rabbits to prepare anti-Rv2626c anti-serum. The specificity and titer of the serum were respectively detected by Western Blot and enzyme-linked immunosorbent assay (ELISA). Results The recombinant plasmid pET24a(+)-Rv2626c was successfully constructed. SDS-PAGE analysis showed that recombinant Rv2626c was expressed in the recombinant plasmid transformed E. coli with IPTG induction, with a molecular weight of about 14 500, and the size was consistent with the expectation. The optimal expression condition for recombinant Rv2626c protein was at 31 ℃ with 1.0 mmol/L IPTG for 6 hours. The target protein was mainly present in a soluble form, which was consistent with the results of Western blot. The hyperimmunized serum with recombinant Rv2626c protein vaccination showed good specificity, with a titer of 1∶ 256 000 detected by ELISA. Conclusions Mycobacterium tuberculosis Rv2626c protein is successfully expressed in E. coli, and the purified protein has good purity and antigenic activity, laying the foundation for further reveals of its biological functions.

Objective:To develop a national secondary reference material of Urea and Creatinine in frozen human serum as a standard for metrological traceability.Methods:According to JJF1343-2012 "General and Statistical Principles for Characterization of Reference Materials" and JJF 1006-1994 " Technical Norm of Primary Reference Material ", the homogeneity, stability, and commutability were evaluated;Using the JCTLM recommended methods, the value of the reference materials was assigned through collaboration with 6 accredited reference laboratories from Guangdong Provincial Hospital of Chinese Medicine, Beijing Aerospace General Hospital, Shenzhen Mindray Bio-Medical Electronics, Maccura Biotechnology, Beijing Leadman Biochemistry, and Zhejiang MedicalSystem Biotechnology. Uncertainty components including inhomogeneity, stability and value assignment were evaluated.Results:The results of one-way analysis of variance of homogeneity for the reference materials showed P>0.05, and the stability evaluation was less than the critical value of the t-test. The measured values were in the 95% confidence interval in the four conventional detection systems for commutability, and the certified values and expanded uncertainties were urea:(14.7±0.3) mmol/L ( k=2),Cr:(313.9±14.5) μmol/L ( k=2). Conclusion:The prepared secondary reference materials of urea and creatinine had promising homogeneity, stability, and commutable, the values of urea and creatinine concentration in reference materials were accurate and reliable.

Objective: To establish a nomograph model for prediction of cervical central lymph node metastasis (CLNM) among patients with thyroid papillary carcinoma (PTC), so as to provide the evidence for designing personalized treatment plans for PTC. Methods : The data of patients that underwent thyroidectomy and were pathologically diagnosed with PTC post-surgery in the Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University from 2018 to 2021 were collected. Patients' data captured from 2018 to 2020 and from 2021 were used as the training set and the validation set, respectively. Predictive factors were screened using a multivariable logistic regression model, and the nomograph model for prediction of CLNM risk was established. The predictive value of the model was evaluated using the receiver operating characteristic (ROC) curve and the adjusted curve. Results: Totally 1 820 PTC cases were included in the training set, including 458 cases with CLNM (25.16%), and 797 cases in the validation set, including 207 cases with CLNM (25.98%). The prediction model is p=ey/(1+ey), y=0.761 + 0.525 × sex + (-0.039) ×age + 0.351 × extrathyroid invasion + 0.368 × neck lymph node enlargement + 1.021×maximum tumor diameter + (-0.009) × TT4 + (-0.001) × anti-TPOAb. The area under the ROC curve was 0.732 for the training set and 0.731 for the validation set, and Hosmer-Lemeshow test showed a good fitting effect (P=0.936, 0.722). Conclusion The nomograph model constructed in this study has a high predictive value for CLNM among patients with PTC.

l-Heptopyranoses are important components of bacterial polysaccharides and biological active secondary metabolites like septacidin (SEP), which represents a group of nucleoside antibiotics with antitumor, antifungal, and pain-relief activities. However, little is known about the formation mechanisms of those l-heptose moieties. In this study, we deciphered the biosynthetic pathway of the l,l-gluco-heptosamine moiety in SEPs by functional characterizing four genes and proposed that SepI initiates the process by oxidizing the 4'-hydroxyl of l-glycero-α-d-manno-heptose moiety of SEP-328 ( 2) to a keto group. Subsequently, SepJ (C5 epimerase) and SepA (C3 epimerase) shape the 4'-keto-l-heptopyranose moiety by sequential epimerization reactions. At the last step, an aminotransferase SepG installs the 4'-amino group of the l,l-gluco-heptosamine moiety to generate SEP-327 ( 3). An interesting phenomenon is that the SEP intermediates with 4'-keto-l-heptopyranose moieties exist as special bicyclic sugars with hemiacetal-hemiketal structures. Notably, l-pyranose is usually converted from d-pyranose by bifunctional C3/C5 epimerase. SepA is an unprecedented monofunctional l-pyranose C3 epimerase. Further in silico and experimental studies revealed that it represents an overlooked metal dependent-sugar epimerase family bearing vicinal oxygen chelate (VOC) architecture.

Objective:To investigate the feasibility of individualized primary clinical target volume (CTV) delineation in intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC).Methods:Clinical data of 87 consecutive patients newly diagnosed with lateralized NPC in Jiangsu Cancer Hospital between October 2016 and February 2018 were retrospectively analyzed. Lateralized NPC is defined as tumor invasion not exceeding the contralateral wall. According to the tumor spread, the primary CTV was optimized as follows: CTV2 only covered the medial part of the contralateral pterygopalatine fossa, whereas the contralateral foramen oval was not included; on the level of parapharyngeal space, the contralateral side of CTV only covered the posterior lateral lymph nodes, whereas the contralateral internal jugular vein was not regularly covered. Failure patterns and 5-year survival [local control rate (LCR), progression-free survival (PFS) and overall survival (OS)] were evaluated by Kaplan-Meier method. Paired t-test and rank-sum test were used to analyze the dose variation in the optimized region and adverse reactions. Results:The median follow-up time was 59.5 months. The 5-year LCR, PFS, and OS were 98.9%, 86.5% and 92.1%, respectively. There was no local recurrence in the optimized area of CTV. Dosimetric comparison results showed that the doses of parotid gland, temporal lobe, cochlea and middle ear on the contralateral side were reduced by 13.45%, 9.14%, 38.83%, and 29.36%, respectively. Four cases (4.6%) developed grade 3 hearing loss, all on the ipsilateral side. The optimized scheme significantly alleviated the hearing loss on the contralateral side compared to that on the ipsilateral side ( P<0.001). Other grade 3 late adverse reactions included cranial nerve injury, subcutaneous fibrosis in the neck and visual impairment, with 1 case each. Conclusion:Individualized primary CTV for lateralized NPC is feasible and safe, with obvious dosimetric advantages and reduced adverse reaction rate, which is worthy of clinical promotion.