{L-End}Objective To explore the chain mediating effect of team psychological safety atmosphere and professional calling in the relationship between humble leadership and voice behavior. {L-End}Methods A total of 812 nurses from five medical institutions in Guangdong Province were selected as the research subjects using the convenience sampling method. The Team Psychological Safety Atmosphere Scale, the Professional Calling Scale, the Hospital Version of Humble Leadership Scale and the Voice Behavior Scale were used to investigate the perceived team psychological safety atmosphere and sense of professional calling, the perceived humble leadership style and voice behavior of the nurses. {L-End}Results The score of team psychological safety atmosphere, professional calling, humble leadership, and voice behavior of 812 nurses was (58.0±7.6), (44.6±8.0), (50.4±9.2) and (37.0±5.9), respectively, with the scoring rate of 72.5%, 74.3%, 80.0%, and 74.0%, respectively. Bootstrap analysis showed that humble leadership could positively influence voice behavior ［standardized effect value (β)=0.28, 95% confidence interval (CI) 0.20-0.35］. Humble leadership could influence voice behavior through the separate mediating effects of team psychological safety atmosphere (β=0.13, 95%CI 0.09-0.18), professional calling (β=0.07, 95%CI 0.04-0.11), and the chain mediating effect of team psychological safety atmosphere and professional calling(β=0.06, 95%CI 0.04-0.08). {L-End}Conclusion The voice behavior of clinical nurses is at a moderately high level. Humble leadership can directly influence voice behavior and can influence voice behavior through the mediating effects of team psychological safety atmosphere and professional calling. Nursing managers can inspire the work passion of clinical nurses by changing their own leadership style and creating a good atmosphere for voicing opinions.

OBJECTIVETo study the epidemiology of genotyping Yersinia pestis isolated in the fulminant epidemics of human plague in Qinghai province in 2004.

METHODSPrimer pairs targeting the twenty-three different identified regions (DFRs) were designed to detect the presence or deletion of each DFR in 13 strains of Yersinia pestis isolated from the fulminant epidemic of human plague in Qinghai province in 2004.

RESULTSThere were 4 genomovars, i.e. Genomovar 8, 10, 15 and 16 in the 13 strains of Yersinia pestis identified. The genomovar of all the strains of Yersinia pestis isolated from Nangqian county was Genomovar 10. Among the two strains of Yersinia pestis isolated from Wulan county, the genomovar of one strain was Genomovar 8 and the other was Genomovar 10. The genomovars of all the strains of Yersinia pestis isolated from Qilian, Qumalai and Chengduo county belonged to Genomovar 16.

CONCLUSIONIt was demonstrated that the genotyping of Yersinia pestis appeared to be a powerful tool for investigating human plague epidemics.

China ; epidemiology ; Disease Outbreaks ; Genotype ; Humans ; Molecular Epidemiology ; Plague ; epidemiology ; Yersinia pestis ; genetics ; isolation & purification

OBJECTIVETo study the distribution of genomovars and microevolution of Yersinia pestis in the Qinghai-Tibet Plateau.

METHODSPrimer pairs targeting the twenty-two different regions(DFRs) were designed for detecting the presence or deletion of each DFR in 297 strains isolated from the Qinghai-Tibet Plateau.

RESULTS9 genomovars, i. e. Genomovar 1, 5, 6, 7, 8, 10, 11, new type and Ype-ancestor were identified in the Marmota himalayana plague focus of the Qinghai-Tibet Plateau. Among these genomovars, genomovar 5,8 and 10 were dominant types. The total rate of the three genomovars was 80.6% (204/253) and the genomovars in different regions were different. All of 44 strains of Y. pestis in the Microtus fuscus plague focus of the Qinghai-Tibet Plateau belonged to genomovar 14.

CONCLUSIONThe distribution of genomovars of Y. pestis in the Qinghai-Tibet plateau had remarkable characteristics geographically. Based on the distribution of genomovars of Y. pestis, the routes of transmission and microevolution of Y. pestis were proposed.

Biological Evolution ; China ; Geography ; Humans ; Plague ; transmission ; Yersinia pestis ; genetics

OBJECTIVETo evaluate the computed tomography (CT) findings of peritoneal tuberculosis mimicking advanced ovarian carcinoma for better understanding of the CT manifestations and accurate preoperative diagnosis.

METHODSCT findings of 18 cases with tuberculous peritonitis clinically simulating advanced ovarian cancer but pathologically proved otherwise were retrospectively reviewed.

RESULTS1. Masses with solid and cystic structures were found in 6 cases and tumor-like flakes were found in 7 cases in the adnexal regions. The solid components and tumor-like flakes were moderately to markedly enhanced with dynamic CT scanning. 2. The peritoneum was smooth and slightly thickened in 10 cases; irregular thickening was seen in 4 cases, and patches of calcification in 3 cases. Thickened peritoneum with pronounced enhancement was noted in 7 cases. 3. Omentum with flake-like thickening was noted in 11 cases, coarse reticulate thickening in 2 cases and omental cakes in 2 cases. The margin of the thickened omentum with enhancement was ill-defined. 4. Nodular and stripe-like thickening of the mesentery was noted in 16 cases. 5. Ascites was present in all of the 18 cases, being encapsulated in 14 of them. 6. Lymphadenopathy was seen in 9 cases, all at located in the diaphragmatic levels. Enhancement of the lymph nodes was marked in 8 of the 8 patients examined. They appeared as ring-like (> 1 cm in diameter) or uniform (

CONCLUSIONCT examination combined with clinical manifestations helps differentiate tuberculous peritonitis from advanced ovarian cancer.

Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Hyperplasia ; Lymph Nodes ; pathology ; Middle Aged ; Ovarian Neoplasms ; diagnostic imaging ; pathology ; Peritonitis, Tuberculous ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Objective To observe the expressions of multidrug resistance-associated protein (MRP) 1 in the hippocampus of the rat models with chronic epilepsy,and to explore whether antiepileptic drug oxcarbazepine(OXC) affects the expression of MRP1.Methods One hundred rats of 14 days old were randomly divided into model group(n =52) and the control group(n =48).The model group received intraperitoneal injection of kainic acid(KA) 1 mg/kg (0.5 g/L) to induce seizures,and the control group rats were injected the same dose of 9 g/L chloride.According to Lado standard classification of seizures,the young rats whose seizure degree was beyond 5 and became status epilepticus after intraperitoneal injection used as successful seizure models if they caught the spontaneous seizures after 2 weeks.When spontaneous seizures were developed,48 surviving KA rats were divided into KA group and KA + OXC group.Rats in the control group were divided into NS group and NS + OXC group.After spontaneous recurrent seizures,the treatment groups began to take drugs.Each group started to be sacrificed from the beginning of drug perfusion at different times and they were divided into the 4th week group,the 6th week group and the 8th week group.The expression of MRP1 in hippocampus(CA3 area) was detected by immunohistochemistry methods.Results 1.Epileptic performance:all rats injected with NS had no epileptic performance.In the chronic epilepsy,Ⅰ-Ⅴ Racine grade of spontaneous recurrent seizures were found in all rats with KA.The rats in KA group had higher epilepsy seizure frequency than those in KA + OXC group (P ＜ 0.05).2.The rats in NS group and NS + OXC group had fewer MRP1 positive cells,and there was no significant difference at all time points between NS group and NS + OXC group (P ＞ 0.05).The trend of expression in KA group and KA + OXC group gradually increased.The MRP1 positive cells in KA + OXC group compared with those in the KA group was significantly different in the 8th week(P ＜0.05),while there was no significant difference in the 4th week and the 6th week(all P ＞0.05).And there was a significant difference in the positive cells in KA group compared with those of KA group(P ＜0.05).The expression of MRP1 positive cells in KA + OXC group increased significantly compared with those in NA + OXC group(all P ＜ 0.05).Conclusions MRP1 plays an important role in resistance mechanisms of refractory epilepsy,while the expression of MRP1 can be induced by using OXC in a long term.

Objective To explore the plague epidemical trend of nearly a 10 years data in Qinghai province to provide basis for making the prevention and control measures. Method The regional distribution and time distribution of animal and human plague, monitoring and plague foci of survey data in Qinghai from 2001 to 2010 were analyzed with Excel software 2003. Results In Qinghai province, a total of 167 strains of Yersinia pestis were isolated from infected animals and insects in 10 years. Yersinia pestis was mainly distributed in Wulan,Delinha, Geermu, and Tianjun, along the Qinghai-Xizang railway. Human plague was occurred every year from 2001 to 2010 except 2002, 2007, 2008, and 2010. In the 10 years, there were 37 plague cases and 16 of these cases died, the mortality was 43.24％. The plague cases were mainly distributed in Nangqian, Qumalai, Chenduo,Zhiduo, Xinghai, Tongde, Tianjun, Wulan and Qilian. And these cases were found mostly in the period from May to October, especially in the period from August to October. Major clinical type of the plague cases was lung-type (62.16％,23/37). Conclusions The plague epidemic situation in Qinghai province is still severe, animal plague occurred year after year, and human plague outbreaks occasionally. Monitoring and early warning in the key areas should be strengthened, and the comprehensive measures of plague prevention and control should be carried out to reduce the incidence and prevalence of plague.

Objective To evaluate the protective effect of Yersinia pestis capsular antigen F1 and recombinant rV270 on mice after immunization with them.Methods According to body weight,40 female Balb/c mice aged 6 to 8 weeks were randomly divided into four experimental groups(Fl-10 μg + aluminum adjuvant,F1-20 μg + aluminum adjuvant,rV-10 μg + aluminum adjuvant,and rV-20 μg + aluminum adjuvant) and a control group,8 in each group.Mice in experimental groups were immunized with the natural antigen F1 and recombinant antigen rV270 adsorbed to 25％ aluminum adjuvant and the control group was immunized with the same amount of aluminum adjuvant.Each mouse was immunized at the hind leg muscle with 100 ml immunizing agent,then a booster immunization was done once on the 21st day after the first immunization.The blood of all mice was collected on the 8th week after the first immunization,serum antibody titers were detected by ELISA and the data of antibody titers were analyzed by t test for comparison between groups.At the same time the mice were injected subcutaneously with 2000-fold LD50 of Yersinia pestis virulent strain 141,after 14 days,the protective effect of immunization was analyzed.Results The control group did not produce antibody.Antibody geometric mean titers (GMT) of the F1-10 mg + aluminum adjuvant and F1-20 mg + aluminum adjuvant groups were 1 ∶ 30443.9,and 1 ∶21527.8,respectively,and compared between the two groups,the difference was not statistically significant (t =1.1282,P ＞ 0.05).The GMTs of the rV-10 μg + aluminum adjuvant and rV-20 μg + aluminum adjuvant groups were 1 ∶ 13957.3 and 1 ∶18100.9,respectively,and compared between the two groups,the difference was not statistically significant(t =0.9408,P ＞ 0.05 ).After subcutaneous injection with Yersinia pestis virulent strain 141,all mice died in the control group but all survived in the experimental group.Conclusion The immune activity of natural antigen F1 and recombinant rV270 is high,which can be used as the main component of subunit vaccine in the plague subunit vaccine study.

Abstract: Objective　To investigate the clustered regularly interspaced short palindromic repeats (CRISPR) genotypes and regional distribution of Yersinia pestis strains in the natural plague foci of Hainan Tibetan Autonomous Prefecture of Qinghai Province (referred to as "Hainan prefecture") and provide a scientific basis for plague prevention and control in this area. Methods　A total of 36 representative Yersinia pestis strains, which were isolated from different host animals and insect vectors from 1954 to 2009 in Hainan Prefecture, were selected as experimental subjects. The DNAs were extracted using the traditional sodium dodecyl sulfate decomposition and phenol-chloroform method. Three pairs of CRISPR primers (YPa, Ypb, YPc) were used for PCR amplification, sequencing and analysis of the DNA of the tested strains, respectively, as a means to identify the CRISPR genotypes of Yersinia pestis in Hainan Prefecture. Results　A total of 17 spacers were observed among 36 strains of Yersinia pestis, including 9 of YPa, 5 of YPb and 3 of YPc. All strains were divided into 5 CRISPR gene clusters (Cb2, Cb4 ', Ca7, Ca7 ', Ca35 ') and 6 genotypes (G1, G9, G22, G22-A1 ', G26-A1 ', G26-A1 'A4 -). The G26-a1 ' was the main genotype, which was distributed in Gonghe, Guide and Xinghai County, and the G22 is the second type, which was distributed in Gonghe and Guide County. Conclusions　The genetic polymorphism of CRISPR loci of Yersinia pestis strains in Hainan was high, and the regional distribution characteristics of Yersinia pestis strains with different genotypes were significant.

Abstract: Objective To investigate the current status of streptomycin resistance of Yersinia pestis caused by point mutations of rpsL gene in Qinghai, so as to provide theoretical basis for precise clinical medication and prevention of drug resistance of human plague outbreak in South area of Qinghai Province in the future. Methods A total of 104 representative strains of Yersinia pestis collected from plague patients, vector insects and intermediate hosts in South area of Qinghai Province from 1957 to 2009 were screened, isolated and cultured by Hiss agar plates. The DNA of representative Yersinia pestis was extracted by sodium dodecyl sulfate lysis and phenol-chloroform method. The primers forward primer and reverse primer and TaqMan-MGB probes probe1 [FAM] and probe2 [VIC] were designed for the rpsL gene of streptomycin resistance gene in China. Real-time PCR with TaqMan-MGB fluorescent probe was used to detect the mutations of rpsL gene in streptomycin resistance locus of 104 strains of Yersinia pestis in South area of Qinghai Province. Results The FAM test results of 104 strains in South area of Qinghai Province were positive, corresponding to the detection of rpsL (128 : A ), RFU peak >1 000,negative <200. VIC test results of all tested strains were negative, corresponding to the detection of rpsL (128:G), RFU peak <200, positive >1 000. That is, no strains with rpsL gene mutation related to streptomycin resistance were found in the 104 strains of Yersinia pestis in Qingnan Province. Conclusion This study provides basic data on the distribution of streptomycin resistance of Yersinia pestis in South area of Qinghai Province, and lays a foundation for preventing the occurrence of drug resistance and clinical treatment of Yersinia pestis in South area of Qinghai Province.

Objective To analyze the current situation and latent profiles of nurses'voice behavior in nurses,and explore the influencing factors of different types.Methods Through convenience sampling,812 nurses who worked in tertiary hospitals from 5 cities in Guangdong Province during April 2022 to June 2022 were recruited.The demographic questionnaire,the Voice Behavior Scale,the Humble Leadership Scale,and the Team Psychological Safety Climate Scale were used for investigation.Latent profile analysis was used to explore the latent profiles of nurses'voice behavior.The influencing factors of latent profiles were identified by multivariate Logistic regression.Results The total score of the voice behavior in 812 nurses is(37.04±5.88).Voice behaviors in nurses is divided into 3 latent classes,namely"conservation group"(27.83％),"balanced-risky group"(61.95％),and"the challenge group"(10.22％).The influencing factors include recruitment type,whether to assist in department management,humble leadership,team psychological safety climate(all P＜0.05).Conclusion The level of nurses'voice behavior is upper medium with heterogeneity,which can be divided into 3 latent profiles.Nurses managers should focus on nurses with conservation group and balanced-risky group and conduct early targeted prevention and care according to characteristics and influencing factors of different latent profile.