Objective To investigate the clinical significance of HCV core antigen (HCV-cAg )in hepatitis C screening. Methods From October 2014 to October 2015 ,a total of 8000 serum samples were collected from the outpatient and inpatient. HCV-cAg and hepatitis C antibody (HCV-Ab) were detected by using ELISA.The positive samples of HCV-cAg or HCV-Ab were performed the confirmative diagnostic detection by PCR.Results Among 8000 serum samples ,82 positive samples were screened out ,in which 73 cases were HCV-RNA positive by elementary screening with the standard of HCV-cAg or HCV-Ab positive ,a-mong which 72 were HCV-RNA positive and and 9 cases were HCV-RNA negative by HCV-RANA confirmation.The sensitivity and specificity of HCV-cAg were 45.83% and 99.98% ,sensitivity and specificity of HCV-Ab were 94.44% and 99.90% ,which of HCV-cAg and HCV-Ab combined detection were 100.00% and 98.86% respectively.Conclusion HCV-cAg and HCV-Ab play complementary role in HCV screening.Their combined detecting contributes to increase the screening rate of HCV.

Abstract Objective:To induce cardiac transplantation tolerance by parabiosis in allogeneic rats and study the mechanism of the allograft tolerance.Methods: Spleen cells 2 x 10~8 of DA and LEW rats were injected from ones to the others via the glossal vein.2 day later cyclophos-phamide(CP) 80 mg/kg was injected intraperioneally. On the third day the operation of parabiosis was carried out and then separated after 1 week.The LEW rats received DA cardiac heterotopic allografts.The survival was observed and monitored.The tolerant mechanisms were investi-gated by detection of chimerism,MLR cell-transferred tests in vivo and IL-2 reverse.Results:The cardiac allograft survival was significantly pro-longed; The detection of chimerism showed that the formation of tolerance is correlative to chimerism. MLR and cell-transferred tests in vivo demonstrated that the inhibited immune response of recipient rats is specific for donors, and suppressie cell exists in the recipient rats. The exog-enous IL-2 reverse showed that the tolerance mechanisms are relative to energy. Conclusion: The parabiosis can induce tolerance in rats and prolong rats cardiac allograft survival.The transplantation tolerance include several mechanisms.

Objective To investigate the change rule and correlation of heme oxygenase-1(HO-1)/carbon monoxide(CO)and the influence of simvastatin and amlodipine in athemsclemtic progress.Methods The rabbits received 1％cholesterol diet(n=24)for eight weeks.After eight weeks,rabbits were fed with normal diet for eight weeks.The rabbits in model group(n=8)were administrated with cholesterol diet.The rabbits in simvastatin group(n=8)were administrated with simvastatin.The rabbits in amlodipine group(n=8)were administrated with amlodipine.The levels of serum lipids and plasma carbon monoxide were obtained at the beginning,the 8th week and the 16th week.The expression of heme oxygenase-1 in the thoraoia aortic tissue were observed with immunohistochemistry technique.Results By the end of 16th week,the levels ofserum lipids and plasma carbon monoxide in model group were obviously increased,however,the expression of heine oxygenase-1 were markedly decreased.Compared with model group.The levels～rurfl lipi&and plasma carbon monoxide in simvastatin group were significantly decreased,while the expression of heme oxysenase-1 in aortic great reduced.The levels flerum lipids in amlodipine group were not significant ckmged,the levels of plasma carbon monoxide were obviously decreased,while tlle expression ofheine oxygenase-1 in aortic great reduced.Conclusions In atheresclerofic progress,heme oxygenase-1(HO-1)/carbon monoxide(CO)appared the reciprocal relationship,and amlodipine may suppress athemsclemtie progress by decreasing the system.

Aim To study the change of blood pressure in 1079 workers for fifteen years and the effect of anti-hypertension drugs therapy. Methods We investigated the blood pressure of 1079 workers who were enrolled in six organizations in the year 1983 and 1998 respectively. Results During the 15 years: (1)Mean value of blood pressure: systolic blood pressure increased 22 mmHg in man and 16.9 mmHg in women; diastolic blood pressure increased 9 mmHg in man and 12.7 mmHg in women (P<0.05);(2)The incidence of hypertension increased by 25.03% in man and 28.28% in women;(3)The prevalence rate of hypertension is 27.9 percent in people with initially normal blood pressure (1.86%/y) and 72.6 percent in initially broder line hypertension (4.84%/y);(4)The control rate of hypertension is 2.9 percent;(5)The incidence of stroke is highly related to hypertension (P<0.001);(6)46.6 percent patients had a regular drug therapy, mainly reserpini complex(25.2%);(7)Drug therapy has no obviously effect of the control of hypertension and the incidence of stroke. Conclusion Both the mean value of BP and the incidence of hypertension were increased with age. The control rate of hypertension was low and the drug therapy shows little advantage. We should do mach more works to popularize the knowledge of the prevention of hypertension. Improve people's self-prevention. Regular cheek should be given to the hypertension patients.

Objective To study the recovery of the outer hair cells in the bat cochlea after gentamicin exposure.Methods Bats were injected with a daily dose of gentamicin for 15 consecutive days and bromodeoxyuridine (BrdU)was given from day 16 to day 40 of this recovery phase. Hearing was assessed by overt acoustic behavior and auditory brainstem responses analysis, which was performed one day prior to the first injection and a day after the last injection (day 16). On day 40 animals were sacrificed for detection of cells that could take up BrdU. Results After 15 days of gentamicin treatment, all of the animals were proved to be deafened with significant increases of ABR thresholds,compared with control group. The findings in immunocytochemical stained samples and scanning electron microscopy revealed that BrdU labeled nuclei were observed in the cochlea in all of the deafened animals most commonly in the regions of the first-row and second-row Deiter's cells (DCs) and occasionally in the regions of the third-ruw DCs.Conclusion We suggest that, under sufficient drug and enough time, the bat cochlear supporting cells can directly transdifferentiate into the outer hair cells after aminoglycoside exposure. This transdifferentation process is essential for repair of outer hair cells and recovery of normal function after gentamicin exposure.

Objective:To analyze the application value of metagenomic next-generation sequencing (mNGS) in the detection of pathogenic bacteria in brain abscesses.Methods:The data of patients with brain abscess in Tianjin Huanhu Hospital from January 2019 to December 2021 were retrospectively analyzed. All patients underwent stereotaxic abscess puncture and drainage. According to the different methods of pathogen detection, they were divided into bacterial culture group (bacterial culture only) and mNGS group (bacterial culture with mNGS). The clinical symptoms, abscess site, bacterial culture and mNGS results, antibiotic application protocol and prognosis of the patients were analyzed. The bacterial detection results of the two groups were analyzed, and the antibiotic application and prognosis were compared. χ 2 test, exact probability method and Mann Whitney test were used to compare the difference between the two groups. Results:A total of 43 patients with brain abscess were enrolled, including 21 cases in bacterial culture group and 22 cases in mNGS group. The positive rate of bacteria culture group was 42.9% (9/21), the positive rate of bacteria culture group was 45.5% (10/22), and the positive rate of mNGS detection was 100% (22/22). Only 3 cases in the bacterial culture group could have a clear bacterial source, while 17 cases in the mNGS group could have a clear bacterial source according to the bacterial results, showing a significant statistical difference between the two groups (χ 2=19.69, P<0.001). The return time of bacterial culture was 7.0 (4.0,7.0) days, and the average return time of mNGS was 1.5 (1.5,1.5) days, the difference of bacterial return time between the two groups was statistically significant ( Z=0.00, P<0.001). The cost of antibiotic use in bacterial culture group was 24.00 (5.60,31.00) thousands yuan, and the cost of antibiotic use in mNGS group was 12.00 (2.10, 20.00) thousands yuan, and there was significant statistical difference between them ( Z=5.22, P=0.026). Conclusions:MNGS can quickly and accurately identify the types and sources of brain abscess pathogens, guide the clinical application of antibiotics more targeted, reduce the cost of antibiotic use, and is an effective method for the detection of brain abscess pathogenic bacteria.

Objective:To investigate the clinical manifestations, pathogenesis,diagnosis and treatment of negative pressure hydrocephalus (NPH).Methods:A retrospective analysis was performed on the 5 patients with NPH admitted to the Department of Neurosurgery, Tianjin Huanhu Hospital from January 2019 to December 2021. All of the patients underwent lumbar puncture and ventricular puncture to test the pressure. Three patients underwent endoscopic third ventriculostomy (ETV), the outcome of the patients was observed.Results:The pressure of subarachnoid was not equal to intraventricular, and the pressure of intraventricular was negative. Cisternography showed cerebrospinal fluid circulation obstruction in all 5 cases. The symptoms of 1 patient were improved after external negative pressure drainage, 3 patients were improved after further ETV and 1 patient had pulmonary infection without further surgical treatment.Conclusion:With the obstruction of cerebrospinal fluid circulation, the pressure of lateral ventricle and subarachnoid is different, when the pressure of brain or subarachnoid drop, the ventricular expansion under the effect of pressure gradient, intraventricular pressure drop even for the negative pressure. CT cisternography provides strong evidence for the diagnosis of this disease. External ventricular drainage with negative pressure and ETV are effective treatment methods.

Objective:Exploring the dilemmas faced by adolescents with type 1 diabetes mellitus in self-management during the transition to adult healthcare, to inform healthcare professionals in the delivery of transitional care interventions.Methods:Using descriptive qualitative research methods, in-depth interviews were conducted from August to December 2023 to adolescents with type 1 diabetes mellitus (selected by objective sampling) who met the inclusion and exclusion criteria in the Department of Endocrinology of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine and the Shenzhen Children′s Hospital, and the data were analysed inductively using directed content analysis.Results:A total of 12 adolescents with type 1 diabetes mellitus were included for interview, 6 males and 6 females, aged 12-18 years. The self-management dilemmas for adolescents with type 1 diabetes in the transition to adult healthcare can be summarised into 4 themes and 10 sub-themes: disease management dilemmas (weak awareness of disease management, insufficient disease-related knowledge and competence, low adherence to disease management, and restriction of daily activities), role adaptation difficulties (lack of perceived transition to the healthcare role, difficulty in transitioning to the family role, and maladaptation to the social role), negative emotions Inadequate social support system (lack of school support, limited accessibility of social organisations, insufficient socio-economic support).Conclusions:Adolescents with type 1 diabetes mellitus face multiple dilemmas in disease self-management during the transition to adult healthcare, and healthcare professionals should pay attention to transition self-management education, improve patients′ awareness of transition self-management and their ability to participate in it, formulate a transition preparation plan, build an emotional support network, and improve the social security system, so as to help juvenile patients with type 1 diabetes master the method of self-management and make a successful transition to adulthood.

This article reviews the relevant researches of cardiac rehabilitation nurses at home and abroad, and summarizes the clinical role, work content, ability training and career development of cardiac rehabilitation nurses in cardiac rehabilitation staging, and aims at providing a reference for the theoretical and practical research of the domestic cardiac rehabilitation nurse training system.

Mechanical ventilation is a commonly used clinical life support technology. While providing patients with life support can also cause complications of mechanical ventilation. Therefore, the machine should be removed in time when the patients' primary disease is cured or improved. Foreign research proves that nurse-led programmed weaning has many advantages compared with traditional doctor-led weaning, but there are a little researches in China. This article summarizes the development process, development status, advantages, limitations and prospects of nurse-led programmed weaning in mechanical ventilation patients, aiming at providing a reference for the development of nurse-led programmed weaning in China.