The paper discusses the necessity and feasibility to revise R49 Rehabilitation Medicine in Chinese Library Classification (3rd edition), and the guiding ideology, principle and reason for revision. It will helpful to improve the classification for rehabilitation medicine, and meet the practical needs more.

Objective To explore the advantage of mild hypothermia and beating heart bypass in patch therapy for atrial septal defect. Methods 92 patients with atrial septal defect were carried out surgical repairing by mild hypothermia and beating heart bypass. Results There was no death. There was 1 case complicated by cerebral air embolism;The consciousness recovered after 3 days of operation. There were 2 cases of pneumonia. Conclusion The patch therapy of mild hypothermia and beating heart bypass for atrial septal defect had small influence on internal environmental,fewer complications,and could be easy to carry out,and could be the first choice.

Objective To investigate the current status of uncertainty in illness in cardiac valvular surgery patients with cardiopulmonary bypass and analyze its influential factor,and provide reference for effective intervention.Methods A total of 208 cardiac valvular surgery patients with cardiopulmonary bypass were recruited from 4 cardiovascular surgery in Guangdong and were investigated with the self-designed questionnaire,Mishel Uncertainty in Illness Scale (MUIS),Connor-Davidson Resilience Scale (CD-RISC),Medical Coping Modes Questionnaire (MCMQ),in the preoperative day and the day before discharge.The data were analyzed by single-factor and multiple-factor analysis.Results The average score of uncertainty in illness in cardiac valvular surgery patients with cardiopulmonary bypass was 99.09±11.41,and 92.3％ of patients got a moderate uncertainty in illness level in the preoperative day.The average score of uncertainty in illness in the patients was 90.33± 10.32,and 91.8％ of patients got a moderate uncertainty in illness level in the day before discharge.Multiple linear regression indicated that,age,cardiac valvular disease types,number of cardiac valvular surgery,optimism and yield were the protective factors of uncertainty in illness level.Average monthly household income,self-improvement,scores of resilience and confront coping were the risk factors of uncertainty in illness level.Conclusion The level of uncertainty in illness in cardiac valvular surgery patients with cardiopulmonary bypass is moderate.Age,average monthly household income,cardiac valvular disease types,number of cardiac valvular surgery,resilience and coping style are factors influencing uncertainty in illness level of patients.

Objective To compare the detection performance of the modified serum test (TRUST) method and the traditional method in syphilis screening.Methods A series of TRUST high titer syphilis serum was diluted,and the positive rate of each method was calculated by using the improved method and the traditional method.Comparison of two detection methods of C50,C5 ～ C95 interval,as well as the accuracy of the density curve,and the consistency of the two methods were compared,and diagnostic performance were compared.Results The improved method of C50 was less than the traditional method of C50,and the improved method of C5 ～ C95 range was narrower than the traditional method,compared with the traditional method.The improved method of the non precision density curve was steeper than the traditional method,and the two confidence interval of the consistency degree of the 95％ methods was 73.4％ to 95.8％.The diagnostic sensitivity (SEN),diagnostic specificity (SPE),positive predictive value (PPV),negative predictive value (NPV) and diagnostic efficiency(DF) of the improved method were 64.29 ％,99.1％,85.71％,97.05 ％ and 96.39 ％,respectively.The SEN,SPE,PPV,NPV and DF of the traditional methods were 3.75 ％,98.49 ％,75 ％,96.18 ％ and 95 ％,respectively.The improved method was superior to the traditional methods in the two aspects of SEN and PPV (x2 =8.25,10.03,all P＜0.05),with the statistically significant difference.The improved method was slightly higher than the traditional method in SPE,NPV and DF (x2 =2.39,3.45,4.03,all P＞0.05),with the no statistically significant difference.Conclusion The precision,diagnostic sensitivity and diagnostic specificity of the improved method was higher than that of the traditional method,and it can be applied to the detection of large batch samples with the aid of the full automatic enzyme immunoassay instrument.The improved method can be used to replace the traditional method for syphilis screening.

Objective:To investigate the clinical characteristics and prognosis of the patients with nocardiosis.Methods:From January 2013 to July 2019, 44 patients with nocardiosis in Department of Infectious Diseases, Huashan Hospital, Fudan University in Shanghai were enrolled, and their clinical data were retrospectively analyzed, including baseline characteristics, clinical manifestations, underlying diseases history of glucocorticoid therapy, laboratory data (blood routine examination, procalcitonin, C-reactive protein, lymphocytes subsets, etc.), imaging changes, bacterial strain identification, treatment regimens and outcomes. According to the locations of infection, patients were divided into pulmonary nocardiosis, extrapulmonary single-organ nocardiosis and disseminated nocardiosis. The Mann-Whitney U test was used for comparison between two groups, and the Kruskal-Wallis H test was used for comparison among multiple groups. Results:Among the 44 cases of nocardiosis, 14 cases were pulmonary nocardiosis, 17 cases were extrapulmonary single-organ nocardiosis (including nine cases with central nervous system infection, six cases with skin and soft tissue infection, one case with abdominal abscess and one case with urinary tract infection) and 13 cases were disseminated nocardiosis (including four cases with bloodstream infection, six cases with central nervous system and lung or skin and soft tissue infection, three cases of lung and skin and soft tissue infection). Thirty-four cases had underlying diseases, and 27 cases received glucocorticoid or immunosuppressant treatment. The main symptom of 11 patients in pulmonary nocardiosis group was productive cough, while that of the patients in other two groups was fever. Nocardia species were mainly Nocardia brasiliensis, Nocardia nova and Nocardia farcinicaia. The white blood cell counts and neutrophils proportion were normal or slightly increased in 42 cases, and the platelets were normal or slightly decreased in 41 cases. Erythrocyte sedimentation rate increased in 19 cases, procalcitonin increased in 21 cases, C-reactive protein increased in 34 cases, and ferritin increased in 18 cases. A total of 34 patients were tested for lymphocyte subsets, of which 15 had CD4 + T lymphocytes decreased, 14 had CD8 + T lymphocytes increased, seven had B lymphocytes increased, seven had B lymphocytes decreased, and eight had natural killer cells decreased. The hemoglobin of patients with pulmonary nocardiosis was higher than that of patients with extrapulmonary infection, and the difference was statistically significant ( U=0.095, P=0.025). The imaging manifestations were mainly abscess and inflammatory exudation. Forty cases were cured or improved, one case was still on treatment, and three cases died. Conclusions:The clinical manifestations of nocardiosis involving various organs are non-specific. Standardized treatment could reduce the mortality of nocardiosis.

Objective:To investigate the clinical value of peripheral monocyte and neutrophil count in predicting the response of patients with metastatic non-small cell lung cancer (mNSCLC) to immunosuppressive checkpoint inhibitors (ICI).Methods:The clinical data of 34 adult mNSCLC patients who received nafulizumab or pabolizumab in Danzhou People's Hospital of Hainan Province from January 2017 to March 2019 were retrospectively analyzed. The correlation of the demographic characteristics, clinical data, hematological examination results in the first two weeks before the treatment and two weeks after ICI treatment with prognosis was recorded and observed.Results:The baseline mean monocyte count [(0.52±0.09)×10 9/L vs. (0.60±0.12)×10 9/L] and neutrophil count [(4.27±0.87)×10 9/L vs.(5.39±1.02)×10 9/L] of patients with ICI reaction were lower than those of patients without ICI reaction, and the differences were statistically different ( t = -2.572, -2.727, all P < 0.05). However, there was a negative correlation between the monocyte count of the patients who responded to ICI and the reaction time ( r = -0.507, P < 0.05). The median reaction time in patients with monocyte count >0.70×10 9/L was shorter than that in patients with monocyte count ≤0.70×10 9/L (8 weeks vs. 12 weeks, χ2=4.162, P = 0.041). There was no correlation between monocyte count and time of reaction duration, progression of free survival (PFS) and overall survival (OS) ( r = -0.214, 0.182, 0.232, all P > 0.05). The decrease rate of neutrophil count in response group was higher than that in non-response group (22% vs. 2%, P < 0.05). After the first administration, cutoff value of neutrophil count was 4.2×10 9/L; the response rate of patients with neutrophil count ≤ 4.2×10 9/L was higher than that of patients with neutrophil count > 4.2×10 9/L [86.7% (13/15) vs. 36.8% (7/19), χ2=6.657, P < 0.05]. Conclusion:Peripheral blood monocyte and neutrophil count can predict the response to ICI therapy in patients with mNSCLC.

Objective To explore the relationship between resilience and coping style of cardiac valvular postoperative patients with cardiopulmonary bypass.Methods A total of 208 cardiac valvular postoperative patients with cardiopulmonary bypass were recruited from 4 cardiovascular surgery in Guangdong and were investigated with the self-designed questionnaire,Connor-Davidson Resilience Scale (CD-RISC),Medical Coping Modes Questionnaire (MCMQ).Results The average score of resilience in cardiac valvular postoperative patients with cardiopulmonary bypass was (55.38±10.63)points.The average score of tenacity,strength and optimism were (28.21 ±5.87)points,(18.21 ±4.02)and (8.96± 1.85)points respectively.The average score of coping style of confrontation,avoidance and acceptance-resignation were(18.13±3.38),(16.95±1.75)and (9.24±2.47)points respectively.All the sub-scores of the resilience were positively correlated with confrontation,and all the sub-scores of the resilience were negatively correlated with avoidance and acceptance-resignation.Conclusions There is a certain degree of correlation between resilience and copping style of cardiac valvular postoperative patients with cardiopulmonary bypass.Nurses should enhance resilience of the patients,guide the patients to adopt effective coping styles,to promote disease rehabilitation and improve the quality of life.

Objective:To investigate high mobility group protein 1(HMGB1), tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels and their clinical significance in elderly patients with viral pneumonia.Methods:One hundred and sixty elderly patients with viral pneumonia admitted to the Sixth Hospital Affiliated to Anhui Medical University were enrolled as research subjects.In addition, 40 elderly people who underwent regular physical examination were considered as the control group.Patients with viral pneumonia were divided into the low-risk group, middle-risk group and high-risk group according to CURB-65 scores and pneumonia severity index(PSI)scores.HMGB1, TNF-α and IL-6 levels were compared between different groups.The correlations of CURB-65 scores and PSI scores with HMGB1, TNF-α, IL-6 levels were analyzed.Multivariate Logistic regression analysis was used to examine influencing factors for the severity of viral pneumonia in elderly patients.Results:HMGB1, TNF-α and IL-6 levels were higher in research subjects than in the control group.As the severity of viral pneumonia increased, so did HMGB1, TNF-α and IL-6 levels(all P<0.05). HMGB1, TNF-α and IL-6 levels in the severe viral pneumonia group were significantly higher than those in the non-severe viral pneumonia group( P<0.05). HMGB1, TNF-α and IL-6 levels were positively correlated with CURB-65 scores and PSI scores(CURB-65 score: r=0.463, 0.392 and 0.497, P=0.015, 0.003 and 0.025; PSI score: r=0.596, 0.515 and 0.381, P=0.007, 0.011 and 0.009). HMGB1, TNF-α and IL-6 levels were influencing factors for the severity of viral pneumonia in elderly patients( OR=1.344, 1.422 and 1.351, P=0.006, 0.015 and 0.009). Conclusions:HMGB1, TNF-α and IL-6 levels are closely correlated with the severity of viral pneumonia and are helpful for early assessment of viral pneumonia.

Objective:This paper aims to analyze the status of academic loyalty for authors of the nursing Sci-Tech periodicals, and to explore the corresponding training strategies.Methods:Academic loyalty for authors of the nursing Sci-Tech periodicals was surveyed by general information questionnaire and academic loyalty scale.The survey was conducted both online and onsite.Results:The score index of academic loyalty for authors of the nursing Sci-Tech periodicals is 79.43%, and the total score is 43.13±7.47.The scoring indicators of academic loyalty scale from low to high are academic ideal, academic effort and academic identity.Conclusions:The academic loyalty for authors of the nursing Sci-Tech periodicals is at a higher medium level. In order to improve the academic loyalty, we should establish scientific academic core values, respect academic ethics and norms, actively participate in academic activities, strengthen on-going professional knowledge learning, being accountable and responsible, nurture and cultivate academic spirit.

Background/Aims: Four-week treatment of linvencorvir (RO7049389) was generally safe and well tolerated, and showed anti-viral activity in chronic hepatitis B (CHB) patients. This study evaluated the efficacy, safety, and pharmacokinetics of 48-week treatment with linvencorvir plus standard of care (SoC) in CHB patients. Methods: This was a multicentre, non-randomized, non-controlled, open-label phase 2 study enrolling three cohorts: nucleos(t)ide analogue (NUC)-suppressed patients received linvencorvir plus NUC (Cohort A, n=32); treatment-naïve patients received linvencorvir plus NUC without (Cohort B, n=10) or with (Cohort C, n=30) pegylated interferon-α (Peg-IFN-α). Treatment duration was 48 weeks, followed by NUC alone for 24 weeks. Results: 68 patients completed the study. No patient achieved functional cure (sustained HBsAg loss and unquantifiable HBV DNA). By Week 48, 89% of treatment-naïve patients (10/10 Cohort B; 24/28 Cohort C) reached unquantifiable HBV DNA. Unquantifiable HBV RNA was achieved in 92% of patients with quantifiable baseline HBV RNA (14/15 Cohort A, 8/8 Cohort B, 22/25 Cohort C) at Week 48 along with partially sustained HBV RNA responses in treatment-naïve patients during follow-up period. Pronounced reductions in HBeAg and HBcrAg were observed in treatment-naïve patients, while HBsAg decline was only observed in Cohort C. Most adverse events were grade 1–2, and no linvencorvir-related serious adverse events were reported. Conclusions 48-week linvencorvir plus SoC was generally safe and well tolerated, and resulted in potent HBV DNA and RNA suppression. However, 48-week linvencorvir plus NUC with or without Peg-IFN did not result in the achievement of functional cure in any patient.