Abstract：Objective To establish a sensitive，rapid and convenient method for the detection of dengue antigen and assist clinical diagnosis of dengue. Methods In this paper，we developed a rapid detection method for dengue antigen based on microfluidic immune magnetic beads. Solidwork software was used to design microfluidic chip，which was prepared by mechanical processing and chemical sealing. Immunomagnetic beads of dengue antibody were prepared by chemical coupling reaction. Using HRP ⁃TMB ⁃H2O2 as color system，dengue NS1 antigen was detected on microfluidic chip carrier by double antibody sandwich method. Finally，57 clinical samples were tested by the novel method and traditional ELISA kit，and the accuracy of the method was analyzed，and the advantages and disadvantages of the two methods were compared. Results 20 minutes was needed to detect dengue NS1 antigen by using the novel ELISA method，and the reaction system only needed 10 μg beads and 10 μL samples. In the verification experiment，the method could distinguish the negative from the positive obviously. The positive sample had color rendering，while the negative and blank samples had no color rendering. In terms of detection performance，the coincidence rate between the new ELISA method and the traditional ELISA method reached 100%. Conclusion The novel ELISA detection platform had the advantages of simple，rapid，reagent and sample saving，high sensitivity，good stability and high accuracy，and could be used for the detection of dengue antigen.

Public cardiopulmonary resuscitation(CPR)is an important strategy and method to deal with sudden cardiac death outside hospital by relying on the wisdom and strength of the whole society in China. The article summarizes the definition of public CPR, the subject of implementation, the core of construction and the implementation steps. With the support and guidance of the government, the public should join together,with the construction of the first responder, automatic external defibrillator and comprehensive prevention and control system as the core, and promote the implementation of training,practice and scientific research to achieve the ultimate goal.

OBJECTIVE: To analyze the current status of tumor-related occupational protection knowledge among medical staffs in comprehensive hospitals. METHODS: A stratified random sampling method was used to select 572 medical workers from 24 comprehensive hospitals as study subjects, including 289 nurses and 283 medical doctors. The Survey on Occupational Protection Knowledge and Management of Hospital Tumors was used to investigate the research subjects. RESULTS: i) The awareness status of the tumor-related occupational protection knowledge: the awareness rate of sharps injuries that should be included in occupational protection management was as high as 93.7%, while the awareness rate of standard operating procedures for occupational protection in working post was only 32.9%. ii) Evaluation on the management of tumor-related occupational protection in the hospital: most medical personnel think that medical occupational protection is very important to medical quality and safety, and they are not satisfied with personal protective equipment(PPE), various protective facilities and medical devices. The satisfaction scores of subjects in the nursing group on the use of PPE, the convenience of PPE, the reliable quality of PPE, the use of occupational health protection facilities, and the degrees of satisfaction with the occupational protective functions of medical devices and materials were lower than those in the medical group(P<0.05). iii) The awareness status on the knowledge of the management of tumor-related occupational protection in medical staffs of hospital: The awareness rate of items that the hospital′s prominent warning signs for medical waste places, equipment and materials was 89.9%, and the awareness rate of items that the contents of occupational safety and personal protection in the operating procedures of the workplace can meet the protection needs was only 38.1%. The awareness rates of understood that occupational exposure management department has regular inspections and supervision for related work in various departments, and can easily obtain occupational protection standard procedures and emergency treatment plans, the purchase information of work injury insurance, hospital′s prominent warning signs for places, equipment and materials were setting up in the nursing group were higher than that of the medical group(P<0.05). CONCLUSION: Hospitals should strengthen the related training on occupational protection operation specification and protective measures, improve the protection awareness of medical staffs, and make them actively use medical equipment and consumables with occupational protection functions, so as to reduce occupational exposure.

Alzheimer's disease(AD) is a common form of neurodegenerative disease. Oxidative stress plays an important role in the pathogenesis and development of AD. Researchers found that aging, the mutation of presenilin 1(PS1) gene and environment may lead to excessive oxidative stress, and then promote the formation of Aβ in the brain. At the same time, the imbalance between the production and elimination of oxygen radicals can lead to the abnormal autophagy function in hippocampal neurons and induce cells from autophagy to death. The possible mechanism is that the disorder of Notch 1 pathway leads to the loss of antioxidant capacity and the increase of β-amyloid(Aβ) deposition, which result in the development of AD pathology. Further study of its underlying mechanism will provide strong theoretical support for multiple therapeutic treatments of AD including the regulation of oxidative stress response and autophagy balance through the Notch 1 pathway as well as timely use of γ-secretase modulator.

ObjectiveTo investigate the impact of preoperative frailty on the prognosis of patients with pancreatic cancer who underwent pancreaticoduodenectomy. MethodsA retrospective analysis was conducted on the clinical data of 435 pancreatic cancer patients who underwent pancreaticoduodenectomy at Sun Yat-sen Memorial Hospital of Sun Yat-sen University. Preoperative frailty was assessed using the FRAIL questionnaire. Binary logistics regression analysis was employed to identify factors influencing frailty， and Cox regression analysis was used to evaluate the effect of frailty on survival. According to the demographic characteristics， subgroup analyses were performed on the effect of frailty on prognosis of patients with pancreatic cancer with pancreaticoduodenectomy. ResultsAmong the 435 patients enrolled， 119 （27.4%） exhibited frailty， while 316 （72.6%） did not. Significant differences were observed between the two groups in various clinical parameters， including age， body mass index， American Society of Anesthesiologists （ASA） score， postoperative red blood cell transfusion， postoperative abdominal abscess， serum levels of glycoantigens 199， glycoantigens 125， and alpha fetoprotein， leukocyte count， neutrophil， high density lipoprotein （HDL） level， and pain intensity （P＜0.05）. Advanced age and an ASA score of Ⅲ were identified as risk factors for frailty， whereas HDL level was a protective factor. Non-frail patients had better postoperative survival times than frail patients. HDL was determined to be an independent protective factor for prognosis， while LDL was an independent risk factor. ConclusionsThis study demonstrates that preoperative frailty is a significant predictor of poor prognosis in pancreatic cancer patients who underwent pancreaticoduodenectomy.These findings suggest that preoperative frailty assessment and targeted interventions to improve nutritional and metabolic status could potentially enhance postoperative survival and quality of life in pancreatic cancer patients.

【Objective】 To study the differentiate expression genes and regulation signaling pathways related to the occurrence and development of dilated cardiomyopathy with heart failure, we used bioinformatics methods to explore gene chip in gene expression omnibus(GEO) and genes related to dilated cardiomyopathy in online mendelian inheritance in man(OMIM) . 【Methods】 GSE21610 and GSE29919 chip gene sets sequenced by Herz- &Diabeteszentrum NRW laboratory of the University of Bochum, Germany with myocardial biopsy specimens from clinical cases under the platform GPL570 and uploaded to GEO public database were selected to perform our study. Myocardial biopsy specimens from dilated cardiomyopathy with heart failure and normal cardiac function were regarded as the experimental group(14 and 21 cases, respectively) and the control group(12 and 8 cases, respectively). Up-regulated expression genes with the criteria: P < 0.05, were screened in GEO2R with the selected samples of two chips, which were then used to perform kyoto encyclopedia of genes and genomes(KEGG) pathways analysis, gene ontology(GO) function analysis, and protein-protein interaction(PPI) analysis, and the results were displayed through Volcano map, Venn map, Heat map, and Bubble charts with enrichment pathways drawn by R language packages. Meanwhile, KEGG pathways with the criteria: NOM. P < 0.05, and core genes relating to dilated cardiomyopathy with heart failure were performed through gene set enrichment analysis (GSEA). All candidate genes were then intersected with the reported genes in the OMIM, respectively, and clinical significance of these candidate genes was explored in relevant literatures. 【Results】 A total of 173 up-regulated expression genes with P < 0.05, were obtained by GEO2R, which are mainly related to inflammatory signals, cell proliferation and differentiation regulating, and classical apoptotic signaling pathways. These genes were intersected with the 754 reported genes in OMIM, and three reported up-regulated expression genes were obtained: NPPA for diagnosis of heart failure, APOA1 that associates with cytokine action, and COL6A1 that regulates lateral tubular remodeling. 158 and 46 core genes from KEGG pathways with NOM. P < 0.05 were obtained by GSEA, respectively, which were then intersected with the 754 reported genes in OMIM, and two core genes were obtained: PRKCA, enhancing myocardial contractility, and BMP2, promoting the development of heart failure. 【Conclusions】 Based on bioinformatics analysis, we found that the candidate genes PRKCA, BMP2, NPPA, and COL6A1 are likely to be closely related to the occurrence and development of dilated cardiomyopathy with heart failure, which can be used to reveal meaningful therapeutic clues and directions for the clinical treatment of dilated cardiomyopathy with advanced cardiac dysfunction.

OBJECTIVETo evaluate antifungal combination strategy in children with hematologic diseases and invasive fungal disease( IFD).

METHODSA retrospective clinical study was performed based on 67 childhood patients with hematologic diseases and IFD who firstly accepted combination antifungal therapy for ≥ 7 days during January 2012 and December 2014. Of them, 11 cases received combination of echinocandin with azole, 10 cases received combination of echinocandin with amphotericin B, and 46 cases received combination of azole with amphotericin B.

RESULTSOverall response rate was 79.1%. Univariate analysis revealed that granulocyte recovery (P=0.031), status of underling disease (P=0.023) and the duration of the therapy (P=0.046) were significantly associated with efficacy. Multivariate analysis showed that the independent prognostic factor was the duration of combination antifungal therapy (OR=0.229, 95% CI 0.061- 0.863, P=0.029). The response rates of echinocandin combined with azole, echinocandin combined with amphotericin B and azole combined with amphotericin B were 81.8%, 60.0% and 82.6%, respectively (P>0.05), and 12-week survival rates were 81.8%, 80.0% and 86.5%, respectively (P>0.05). The drug- related adverse reactions occurred 59 times in 34 patients. BUN increasing, hypokalemia and abnormal liver functions were considered the main side effects.

CONCLUSIONFor IFD in children with hematologic disease, to extend the duration of treatment (≥ 14 days) could significantly improve the curative effect. Combinations of echinocandin with azole, echinocandin with amphotericin B and azole with amphotericin B can be used as a combination treatment options. Combination of Azole with amphotericin B is efficacious, safe and economic treatment option considering efficacy, survival rate, cost and dosage form.

Amphotericin B ; administration & dosage ; therapeutic use ; Antifungal Agents ; administration & dosage ; therapeutic use ; Child ; Drug Therapy, Combination ; Echinocandins ; administration & dosage ; therapeutic use ; Hematologic Diseases ; microbiology ; Humans ; Mycoses ; drug therapy ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Brain Ischemia ; pathology ; physiopathology ; Humans ; Neoplasm Proteins ; metabolism ; Pyroptosis ; physiology ; Signal Transduction ; physiology

ObjectiveTo explore the correlation between serum albumin levels and coronary artery calcification （CAC） in patients with early-stage chronic kidney disease （CKD）， as well as the value of serum albumin levels in predicting the incidence and severity of CAC. MethodsThe study included 391 early-stage CKD patients who underwent coronary computed tomography angiography （CTA） at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between January 2019 and December 2022. Demographic and biochemistry data， as well as the coronary CTA results， were collected. Based on the coronary artery calcification score （CACS）， all patients were divided into non-CAC group （CACS=0， n=184） and CAC group （CACS>0， n=207）. All patients were further divided into 3 groups based on the serum albumin levels： group A （serum albumin levels<35 g/L， n=30）， group B （35 g/L≤ serum albumin levels< 40 g/L， n=198） and group C （serum albumin levels≥ 40 g/L， n=163）. Univariate and multivariate binary logistic regression analyses were conducted to investigate the association between serum albumin levels and CAC in early-stage CKD patients. Differences in CAC among groups were analyzed by using post-hoc multiple comparisons and ordinal logistic regression model analysis. ResultsPatients with CAC had significantly lower serum albumin levels than those without CAC （P<0.05）. There was a negative correlation between serum albumin levels and CACS in early-stage CKD patients （P<0.01）， as serum albumin decreased in levels， CAC increased in severity. ConclusionsOur study shows that early-stage CKD patients with lower serum albumin levels have a higher incidence of CAC. Low serum albumin level is an independent risk factor for CAC progression.

OBJECTIVE To provide technical support for improving recognition rate of adverse drug events （ADEs） related to traditional Chinese medicine （TCM） formula granules and decoction pieces among inpatient patients. METHODS By referencing the global trigger tool （GTT） whitepaper， literature on adverse reactions to TCM， and expert review opinions， ADE trigger items for TCM formula granules and decoction pieces used in the inpatients were established. GTT was applied to analyze ADEs in inpatients who had used TCM formula granules and decoction pieces in our hospital from August 2013 to August 2023， utilizing the Chinese Hospital Pharmacovigilance System. The effectiveness of GTT and the characteristics of these ADEs were analyzed. RESULTS A total of forty-eight triggers were established， including thirty-two laboratory test indexes， thirteen clinical symptoms， and three antidotes. Among the 1 682 patients included， GTT identified 652 potential ADEs， 284 true positive ADEs，with a trigger rate of 38.76% and a positive predictive value of 43.56%. After review by the auditor， 278 cases of ADEs were finally confirmed， with an incidence rate of 16.53%， significantly higher than the number of spontaneously reported ADEs during the same period （0）. The 278 cases of ADEs were mostly grade 1 （223 cases）， mainly involving hepatobiliary system， gastrointestinal system， blood- lymphatic system， etc；a total of 219 types of TCMs are involved，and the top five suspected TCMs used at a frequency higher than 1% were Poria cocos， Codonopsis pilosula， Atractylodes macrocephala， fried Glycyrrhiza uralensis， and Scutellaria baicalensis. CONCLUSIONS The established GTT can improve the recognition rate of ADEs for hospitalized patients using traditional Chinese medicine formula granules and decoction pieces.