Objective To investigate atypical lymphocyte and lymphocyte subsets in children with infectious mononucleosis(IM)and its relationship with the clinical symptoms by retrospective method.Methods Two hundred and six children were diagnosed as infectious mononucleosis.Atypical types,lymphocyte subsets,and clinical symp-toms and their relationship were evaluated and analyzed.Results In the IM children CD +3 increased,CD +3 CD +4 decreased,CD +3 CD +8 increased and NK cells decreased.The control group was (64.23 ±6.26 )%,(32.96 ± 8.68)%,(20.25 ±7.45)%,(14.68 ±5.4)%,the IMgroup was (84.13 ±14.64)%,(18.45 ±5.14)%,(54.46 ± 16.82)%,(4.65 ±1.50)%,the difference was statistically significant(P <0.001).92.9% patients had more 10%atypical lymphocytes.The children with more than 20% atypical lymphocytes had higher CD +3 CD +v8 and NK cells decreased,(58.78 ±16.67)%,(3.28 ±1.57)%.The difference with the atypical cells more than 10% less than 20% and the group less than 10% has statistically sighnificant which were (54.53 ±15.12)%,(4.55 ±1.64)%, (50.25 ±14.23)%,(5.13 ±1.84)% (P <0.001).The serious type of IM children had higher ratio of increased CD +3 CD +8 and decreased NK cells and had statistically significant compared with the light group,which were (57.78 ± 15.45)%,(3.18 ±1.61)%,(51.09 ±12.26)%,(4.68 ±1.82)%,(20.25 ±7.45)%,(14.68 ±5.46)%(P <0.001).Conclusion The infectious mononucleosis can cause abnormal immune functions.The ratio of atypical lym-phocytes,CD +3 ,CD +3 CD +4 ,CD +3 CD +8 and NK cells numbers can be viewed as a monitoring index of the disease.

Objective:To study the effect of GABA and A receptor agonist THIP on proliferation and apoptosis of cytokine-induced killer (CIK) cells.Methods:CIK cells were cultured by routine method,and then treated with different concentrations of GABA and THIP.The proliferation of CIK cells were investigated by MTT assay.The apoptosis,cell cycle and immunophenotype were investigated by flow cytometry.Results:GABA could inhibit the proliferation of CIK cells in a dose-dependent manner and affect the distribution of cell cycle of CIK cells(P

Objective To understand the epidemiological distribution and epidemic situation of brucellosis cases in Zhejiang Province in 2003 - 2012. Methods Questionnaires of confirmed brucellosis cases, annual reports of prevention and control work of brucellosis in the cities and monitoring points were collected and analyzed in 2003 - 2012. Population distribution, regional distribution, infection sources and routes of infection, aetiology and clinical symptoms and signs of the brucellosis cases were analyzed descriptively. Results A total of 323 brucellosis cases were reported in 2003 - 2012, the average annual incidence rate was 0.070/one hundred thousand, the incidence rate in 2012(0.190/one hundred thousand) was high. There were 272 people of the 323 brucellosis cases were from occupational populations, accounting for 84.21%(272/323); people worked in buying, slaughtering and trafficking of livestock products were majority of the cases, accounting for 65.02%(210/323); and unoccupational population was accounting for 15.79%(51/323). Regional distribution of brucellosis was gradually spreading; the average incidence rate of Shaoxing City was the highest ( 0 . 226/one hundred thousand ) . Three hundred patients were infected by sheep, accounting for 92.88%(300/323), and only 7.12%(23/323) of the patients were infected by cattle. Two hundred and eighty-seven acute phase patients of brucellosis were checked by blood culture, and thirty-nine Brucella melitensis strains and two Brucella abortus strains were detected. The chronicity survey of 120 confirmed cases of brucellosis were conducted, chronicity rate was 3.33%(4/120). Conclusions Trends in the epidemic situation of brucellosis in Zhejiang Province has continued to spread. The main source of infection is sheep from the North. Occupational populations are major populations at risk. The key of prevention and control is to strengthen the active monitoring of occupation personnel , health education and behavior intervention.

Objective:To understand the epidemiological characteristics of brucellosis in non-occupational population reported in Hangzhou, and provide basis for diagnosis and further prevention and control of brucellosis in non-occupational population.Methods:The basic information, epidemiological characteristics, clinical characteristics and laboratory test data of brucellosis patients reported in Hangzhou from 2008 to 2019 were collected retrospectively. The data were obtained from the case questionnaire of confirmed brucellosis and annual report of brucellosis prevention and control work of Hangzhou Center for Disease Control and Prevention over the years. The epidemiological characteristics, clinical characteristics and diagnosis of brucellosis in non-occupational population were analyzed.Results:From 2008 to 2019, 76 cases of brucellosis in non-occupational population were reported in Hangzhou, accounting for 34.23% (76/222) of the total reported brucellosis cases. In the 76 cases of brucellosis in non-occupational population, there were 47 males and 29 females, the ratio of male to female was 1.62∶1.00; the age was (47.37 ± 16.04) years old, ranging from 6 to 84 years old. The peak incidence of brucellosis in non-occupational population was from March to May, accounting for 59.21% (45/76); the main routes of infection were direct contact and digestive tract, accounting for 80.26% (61/76). The main clinical symptoms were fever (100.00%, 76/76), hyperhidrosis (73.68%, 56/76) and muscle and joint pain (69.74%, 53/76); the diagnosis time was 27 (14, 49) d, and the longest diagnosis time was 190 d. Among them, 39 cases were misdiagnosed, accounting for 51.32% (39/76). Sixty suspected Brucella strains were identified by routine culture of automatic blood culture apparatus in hospital laboratory, and 54 strains of Brucella melitensis were identified by typing, with a coincidence rate of 90.00%. The blood culture rate of patients from 2015 to 2019 (88.46%, 46/52) was significantly higher than that from 2008 to 2014 (58.33%, 14/24), the difference was statistically significant (χ 2=8.968, P < 0.05). Conclusions:From 2008 to 2019, the onset of brucellosis in non-occupational population is seasonal in Hangzhou, the infection mode is diverse, the clinical symptoms are not typical, and it is easy to be misdiagnosed. Blood culture for suspected brucellosis patients in high incidence season is conducive to the early diagnosis of brucellosis.

Objective To investigate the urinary iodine level and thyroid function during different trimesters of pregnancy in Hangzhou residents and to provide evidence for monitoring iodine nutrition or screening thyroid function. Methods The urinary iodine level and thyroid function of 395 subjects from 5 hospitals in Hanzhou were investigated. The urinary iodine level was measured by arsenic-cerium contact process method. The serum TSH, FT3 and FT4 were measured by chemiluminescence method. Results (1) The urinary iodine median concentration during pregnancy in the 1st, 2nd and 3rd trimesters were 170.3, 170.2, 162.4 μ/L respectively, all significantly lower than that of non-pregnant women (251.9 μg/L, all P < 0.05); (2) The mean value of TSH during the 1st trimester of pregnancy was significantly lower than that of non-preguant women (P < 0.05). The mean values of FT4 and FT3 in the 2nd and the 3rd trimesters of pregnancy were significantly lower than those of the control (P < 0.05); (3) During 2nd trimester, there were 8.7% (9/104, in FT4) and 9.6% (10/104, in FT3) pregnant women below normal lower range while during 3rd trimester, these figures reached 22.7% (22/97) and 17.5% (17/97) resfectively. Conclusions More than half of the pregnant women in Hangzhou have good nutritional status of iodine. There are significant differences in thyroid hormone levels between the non-pregnant and pregnant women as well as between gestation periods. Therefore, it is necessary to establish a trimester-specific reference range of thyroid hormones for normal pregnancy. The screening for thyroid function is recommended for pregnant women besides monitoring routine urinary iodine.

This study was aimed to construct the recombinant adenovirus containing rat insulin-like growth factor 1(rIGF-1), and then to investigate its expression in islet beta-cells. RNA was extracted using Trizol from rat livers. rIGF-1 cDNA was obtained using RT-PCR. The purified RT-PCR products and pAdTrack-CMV were digested using Bg1 II and EcoR V and religated by T4 DNA ligase, then transformed into electro-competent JM109 bacteria and selected on Kanamycin LB plates. This plasmid pAd-CMV-rIGF-1 was linearized by PmeI and co-transformed into electro-competent BJ5183 bacteria with pAdEasy-1 and selected on Kanamycin LB plates. After having been screened, the extracted plasmid of positive bacteria was transfected into HEK 293 cells with liposome and was identified by the green fluorescence protein (GFP) expression. The recombinant adenovirus encoding rIGF-1 was named Ad-rIGF-1, and the viral particles were further amplified, purified, and its titer was about 4.0 x 10(8)pfu/ml. Ad-rIGF-1 was transfected into rat pancreatic beta cell lines- RINm5F cells, RT-PCR was carried out to detect the transfer genes, rIGF-1 protein in cells culture supernatants was detected by ELISA method, and its concentration was 91.6 +/- 26.8 ng/ml. rIGF-1 was present in Ad-rIGF-1-infected RINm5F cells as measured by Western blotting. The recombinant adenovirus vector containing rIGF-1 was constructed successfully, and the rIGF-1 protein was expressed by RINm5F cells. This method provided the mechanism of rLGF-1 to prevent beta cell from impairmentand to treat the case of type 1 diabetes.
Adenoviridae ; genetics ; metabolism ; Animals ; Cell Line ; Diabetes Mellitus, Type 1 ; therapy ; Genetic Therapy ; Genetic Vectors ; genetics ; Insulin-Like Growth Factor I ; biosynthesis ; genetics ; Islets of Langerhans ; metabolism ; Rats ; Recombinant Proteins ; biosynthesis ; genetics ; Transfection

Objective:To investigate the effect of Relative Bedrest Condition Morita Therapy(RBCMT) on the improvement of depression and anxiety symptoms and personality in patients with recurrent depression disorder.Methods:Seventy patients with recurrent depressive disorder hospitalized in Kailuan Mental Health Center were randomly divided into study group and control group( n=35 in each group) from June to October, 2019.The study group was given RBCMT on the basis of conventional treatment and nursing.The Eysenck personality questionnaire (EPQ), Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to assess the clinical symptoms and personality characteristics of the patients and to analyze and compare them. Results:(1) EPQ score in each dimension: There were significant differences within group among different time in introverted and extroverted dimension (study group: baseline: 46.14±10.99, the fifth weekend: 50.43±8.86, the eighth weekend: 53.86±7.08, F=6.291, P=0.003.Control group: baseline: 45.29±8.99, the fifth weekend: 48.29±8.31, the eighth weekend: 50.29±7.57, F=3.211, P=0.044) and neuroticism dimension score (study group: baseline: 60.14±5.49, the fifth weekend: 53.29±4.53, the eighth weekend: 50.57±4.33, F=36.809, P<0.001.Control group: baseline: 60.29±6.18, the fifth weekend: 55.86±6.00, the eighth weekend: 53.14±5.30, F=13.353, P<0.001) among different time points in the group.Neuroticism scores between the two groups at the same time were statistically significant(the fifth weekend: F=4.095, P=0.047, the eighth weekend: F=4.940, P=0.030). After 8 weeks of inclusion, there was a statistically significant difference between the two groups in the score of introverted and extroverted dimension ( F=4.157, P=0.045). There was no significant difference in the score of spiritual quality dimension at different time within the group or at the same time point between the groups.(2)HAMD score: There were statistically significant differences within group among different time(study group: baseline: 32.00±4.04, the fifth weekend: 15.23±5.01, the eighth weekend: 9.31±3.15, F=282.376, P<0.001.Control group: baseline: 31.91±4.59, the fifth weekend: 17.86±5.11, the eighth weekend: 11.17±3.64, F=195.019, P<0.001), and the differences between the two groups at the same time were statistically significant (the fifth weekend: F=4.724, P=0.033, the eighth weekend: F=5.205, P=0.026). (3)HAMA score: There were statistically significant differences within group among different time(study group: baseline: 18.69±8.87, the fifth weekend: 10.34±5.34, the eighth weekend: 7.97±2.98, F=28.679, P<0.001.Control group: baseline: 18.60±8.02, the fifth weekend: 13.31±6.35, the eighth weekend: 10.37±4.86, F=14.241, P<0.001). The difference between the two groups at the same time point was statistically significant (the fifth weekend: F=4.161, P=0.045, the eighth weekend: F=8.315, P=005). (4)Multiple linear regression results indicated that RBCMT ( β=-0.312, t=-2.360, P=0.022) and introverted and extroverted dimension personality ( β=-0.334, t=-2.355, P=0.022) were the influencing factors of HAMA. Conclusion:Compared with the conventional treatment, the Relative Bedrest Condition Morita Therapy can reduce the anxiety symptoms and improve the depressive symptoms by enhancing the extraversion personality characteristics of the patients.

Objective:To study the efficacy of bisoprolol fumarate tablets combined with tiotropium bromide powder aerosol inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pulmonary heart disease and its effect on high-sensitivity C-reactive protein (hs-CRP) and brain natriuretic peptide (BNP).Methods:From June 2016 to October 2021, 96 patients with AECOPD complicated with pulmonary heart disease admitted to the Affiliated Hospital of Jining Medical University were randomly divided into a control group and an observation group with 48 patients in each group. The patients in both groups were treated with oxygen inhalation, expectorant, cough relieving, asthma relieving and empirical antibiotics. The control group was treated with atomized inhalation of tiotropium bromide powder, and the observation group was treated with bisoprolol fumarate tablets on the basis of the control group. The left ventricular ejection fraction (LVEF), 6-minute walking distance (6MWD), 1 s forced expiratory volume (FEV 1), forced vital capacity (FVC), serum hs-CRP, BNP and other factors were compared between the two groups after treatment, and the total effective rate and adverse drug reaction of the two groups were counted. Results:After treatment, the total effective rates of the observation group and the control group were 91.67%(44/48) and 77.08%(37/48), respectively, with a statistically significant difference ( P<0.05). After treatment, the LVEF of the observation group and the control group were (43.15±6.04)% and (38.96±5.67)% respectively, the 6MWD was (294.86±30.11)m and (261.35±25.88)m, the FEV 1 was (2.36±0.69)L and (1.75±0.52)L, the FVC was (3.58±0.51)L and (2.96±0.45)L, the hs-CRP was (4.47±1.25)mg/L and (7.86±2.01)mg/L, and the BNP was (418.25±32.25)ng/ml and (496.52±43.21)ng/ml; ESR was (16.78±2.11)mm/h and (21.02±1.69)mm/h, ET-1 was (54.26±6.45)ng/ml and (73.21±8.24)ng/ml, and Interleukin 6 was (22.63±8.45)ng/L and (31.85±12.24)ng/L, respectively, with statistical significance ( P<0.05). The total incidence of adverse drug reaction in the observation group and the control group was 8.33%(4/48) and 4.17%(2/48), respectively, with no statistically significant difference ( P>0.05). Conclusions:Bisoprolol fumarate tablets combined with tiotropium bromide powder aerosol inhalation in the treatment of AECOPD complicated with cor pulmonale can improve the heart and lung function of patients, regulate the expression level of hs-CRP, BNP and other factors, improve the efficacy, and do not increase adverse reactions.

Objective:To analyze the risk factors of acute kidney injury (AKI) in patients with septic shock in intensive care unit (ICU), construct a predictive model, and explore the predictive value of the predictive model.Methods:The clinical data of patients with septic shock who were hospitalized in the ICU of the Affiliated Hospital of Jining Medical College from April 2015 to June 2019 were retrospectively analyzed. According to whether the patients had AKI within 7 days of admission to the ICU, they were divided into AKI group and non-AKI group. 70% of the cases were randomly selected as the training set for building the model, and the remaining 30% of the cases were used as the validation set. XGBoost model was used to integrate relevant parameters to predict the risk of AKI in patients with septic shock. The predictive ability was assessed through receiver operator characteristic curve (ROC curve), and was correlated with acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure assessment (SOFA), procalcitonin (PCT) and other comparative verification models to verify the predictive value.Results:A total of 303 patients with septic shock were enrolled, including 153 patients with AKI and 150 patients without AKI. The incidence of AKI was 50.50%. Compared with the non-AKI group, the AKI group had higher APACHEⅡscore, SOFA score and blood lactate (Lac), higher dose of norepinephrine (NE), higher proportion of mechanical ventilation, and tachycardiac. In the XGBoost prediction model of AKI risk in septic shock patients, the top 10 features were serum creatinine (SCr) level at ICU admission, NE use, drinking history, albumin, serum sodium, C-reactive protein (CRP), Lac, body mass index (BMI), platelet count (PLT), and blood urea nitrogen (BUN) levels. Area under the ROC curve (AUC) of the XGBoost model for predicting the risk of AKI in patients with septic shock was 0.816, with a sensitivity of 73.3%, a specificity of 71.7%, and an accuracy of 72.5%. Compared with the APACHEⅡscore, SOFA score and PCT, the performance of the model improved significantly. The calibration curve of the model showed that the goodness of fit of the XGBoost model was higher than the other scores (the calibration curve had the lowest score, with a score of 0.205).Conclusion:Compared with the commonly used clinical scores, the XGBoost model can more accurately predict the risk of AKI in patients with septic shock, which helps to make appropriate diagnosis, treatment and follow-up strategies while predicting the prognosis of patients.

OBJECTIVE: To analyze the risk factors of in-hospital death in patients with sepsis in the intensive care unit (ICU) based on machine learning, and to construct a predictive model, and to explore the predictive value of the predictive model. METHODS: The clinical data of patients with sepsis who were hospitalized in the ICU of the Affiliated Hospital of Jining Medical University from April 2015 to April 2021 were retrospectively analyzed,including demographic information, vital signs, complications, laboratory examination indicators, diagnosis, treatment, etc. Patients were divided into death group and survival group according to whether in-hospital death occurred. The cases in the dataset (70%) were randomly selected as the training set for building the model, and the remaining 30% of the cases were used as the validation set. Based on seven machine learning models including logistic regression (LR), K-nearest neighbor (KNN), support vector machine (SVM), decision tree (DT), random forest (RF), extreme gradient boosting (XGBoost) and artificial neural network (ANN), a prediction model for in-hospital mortality of sepsis patients was constructed. The receiver operator characteristic curve (ROC curve), calibration curve and decision curve analysis (DCA) were used to evaluate the predictive performance of the seven models from the aspects of identification, calibration and clinical application, respectively. In addition, the predictive model based on machine learning was compared with the sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE II) models. RESULTS: A total of 741 patients with sepsis were included, of which 390 were discharged after improvement, 351 died in hospital, and the in-hospital mortality was 47.4%. There were significant differences in gender, age, APACHE II score, SOFA score, Glasgow coma score (GCS), heart rate, oxygen index (PaO₂/FiO₂), mechanical ventilation ratio, mechanical ventilation time, proportion of norepinephrine (NE) used, maximum NE, lactic acid (Lac), activated partial thromboplastin time (APTT), albumin (ALB), serum creatinine (SCr), blood urea nitrogen (BUN), blood uric acid (BUA), pH value, base excess (BE), and K⁺ between the death group and the survival group. ROC curve analysis showed that the area under the curve (AUC) of RF, XGBoost, LR, ANN, DT, SVM, KNN models, SOFA score, and APACHE II score for predicting in-hospital mortality of sepsis patients were 0.871, 0.846, 0.751, 0.747, 0.677, 0.657, 0.555, 0.749 and 0.760, respectively. Among all the models, the RF model had the highest precision (0.750), accuracy (0.785), recall (0.773), and F1 score (0.761), and best discrimination. The calibration curve showed that the RF model performed best among the seven machine learning models. DCA curve showed that the RF model exhibited greater net benefit as well as threshold probability compared to other models, indicating that the RF model was the best model with good clinical utility. CONCLUSIONS The machine learning model can be used as a reliable tool for predicting in-hospital mortality in sepsis patients. RF models has the best predictive performance, which is helpful for clinicians to identify high-risk patients and implement early intervention to reduce mortality.
Humans ; Hospital Mortality ; Retrospective Studies ; ROC Curve ; Prognosis ; Sepsis/diagnosis* ; Intensive Care Units