Objective To clone, express and purify the extracellular carbohydrate recognition do-main(CRD) of Dectin-1 in mouse peritoneal macrophages and to further investigate its ability to recognize and bind to β-glucans. Methods The Dectin-1 CRD gone was amplified by RT-PCR from RNA of mouse peritoneal macrophages and cloned into prokaryotic expression vector pET28a (+), the constructed pET-CRD recombinant plasmid was transformed into Escherichia coli BL21 (DE3) and the fusion protein was in-duced to express. After affinity purification and renaturation, the fusion protein was incubated with Candida albicans yeast and its ability to recognize and bind to β-glucans in the cell wall of fungi. Results The fu-sion protein could recognize β-glucans in the fungal cell wall. Conclusion The recombinant expression plasmid pET28a-CRD was successfully constructed and the fusion protein was induced. The fusion protein is able to recognize and bind to β-glucans in the fungal cell wall, thus laying a good foundation for fungal de-tection and the exploration of the biological role of β-glucans.

AIM:To investigate whether KCNE 2 participates in the development of pathological hypertrophy .METHODS:Bidirectional ma-nipulations of KCNE2 expression were performed by adenoviral overexpression of KCNE 2 or knockdown of KCNE2 with RNA interfer-ence in PE-induced neonatal rat ventricular myocytes .Then overexpression of KCNE 2 in mouse model of left ventricular hypertrophy in-duced by transverse aortic constriction (TAC) by ultrasound microbubble-mediated gene transfer were used to detect the therapeutic function of KCNE2 in the development of hypertrophy .RESULTS:KCNE2 expression was significantly decreased in PE-induced hy-pertrophic cardiomyocytes and in hypertrophic hearts produced by TAC .Knockdown of KCNE2 in cardiomyocytes reproduced hypertro-phy, whereas overexpression of KCNE2 attenuated PE-induced cardiomyocyte hypertrophy .Knockdown of KCNE2 increased calcineurin activity and nuclear NFAT protein level , and pretreatment with nifedipine or FK 506 attenuated decreased KCNE 2-induced cardiomyo-cyte hypertrophy .Overexpression of KCNE 2 in heart by ultrasound microbubble-mediated gene transfer suppressed the development of hypertrophy and activation of calcineurin-NFAT and MAPK pathways in TAC mice .CONCLUSION:These findings demonstrate that cardiac KCNE2 expression is decreased and contributes to the development of hypertrophy via activation of calcineurin -NFAT and
MAPK pathways .

AIM:To investigate the regulation mechanism for insufficient KChIP 2 expression induces Ito,f downregulation and arrhythmogene-sis in cardiac hypertrophy .METHODS:Bidirectional manipulations of MG 53 expression were performed by adenoviral overexpression of MG53 or knockdown of MG53 with RNA interference in neonatal rat ventricular myocytes with or without PE stimulation .Ito,f was re-corded with patch clamp in whole-cell mode 48 h after adenoviral transfection .Then the WT or MG53 knockout ( MG53 -/-) mouse model of left ventricular hypertrophy induced by transverse aortic constriction ( TAC) were used to detect the susceptibility to ventricu-lar arrhythmia.RESULTS: Here, we show muscle-specific MG53 regulates KChIP2 expression and Ito,f densities, where they are downregulated in hearts from MG53 knockout mice and MG53 knockdown rat cardiomyocytes , but upregulated in MG53 overexpressed cells.MG53 expression is decreased in phenylephrine ( PE)-induced cardiomyocyte hypertrophy and restoration of MG 53 rescues PE-induced downregulation of KChIP2 and Ito,f.Furthermore, MG53 is decreased in a mouse model of hypertrophy induced by transverse aortic constriction and ablation of MG 53 increases the susceptibility to ventricular arrhythmia by exaggerating Ito,f remodeling.CON-CLUSION:These findings establish MG53 as a novel regulator of Ito,f and its central role in arrhythmogenesis in hypertrophy .

Objective To investigate the status of nutritional risk and nutritional support in general surgery patients, and to explore their association with postoperative complications and length of hospital stay.Methods From January 2014 to February 2015, 853 inpatients in general surgical wards in the Second Hospital of Hebei Medical University were enrolled.Nutritional Risk Screening 2002 (NRS 2002) was used to estimate nutritional status of patients.The patients were divided into 2 groups based on whether they received nutritional support.The length of hospital stay in days and postoperative complications were recorded.The association of nutritional risk and nutritional support with complications and length of hospital stay were analyzed.Results In the 853 surgery patients, the prevalence of nutritional risk was 31.1％ (265/853) and that of malnutrition was 5.4％ (46/853).The incidence of postoperative complications was 14.2％ (121/853).The patients with nutritional risk had a significantly higher incidence of postoperative complications compared to those without nutritional risk [29.8％ (79/265) vs.7.1％ (42/588) , P ＜ 0.000] , and a longer hospital stay [(12.5 ±6.4) days vs.(4.2 ±3.9) days, P ＜0.001].In the 853 patients, 27.3％ (233/853) received nutrition support.In the patients with nutritional risk, those on nutritional support had a significantly lower incidence of complications compared with those not on nutritional support [16.7％ (32/192) vs.64.4％ (47/73), P＜0.05] and shorter hospital stay [(7.5±4.6) days vs.(16.3±8.5)days, P ＜ 0.05].Conclusions According to NRS 2002 result, a fairly high percentage of general surgery patients may have nutritional risk.Patients with decreased body mass, less dietary intake, and at higher age may be more likely to have nutritional risk.Nutritional risk may be associated with a higher incidence of postoperative complications and longer hospital stay.Patients at nutritional risk appear to be more likely to benefit from nutritional support.

Objective: To construct a prediction model for preeclampsia (PE) risk in twin-pregnant women, so as to provide the basis for early screening and prevention of PE. Methods: A total of 467 twin-pregnant women who underwent prenatal examination and delivered at Huzhou Maternal and Child Health Hospital were selected. Sixty cases with preeclampsia (PE) were included in the case group, and 60 women without PE were included in the control group. General information, blood biochemical indicators and uterine artery resistance index (UtA-RI) were collected. A logistic regression model was used to screen predictive factors and establish a nomogram. The Bootstrap method was performed for the internal validation; the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis were employed to evaluate the discrimination, calibration and clinical utility of the nomogram, respectively. Results: In the case group, there were 47 individuals (78.33%) aged younger than 35 years, 21 individuals (35.00%) with pre-pregnancy body mass index (BMI) of 25 kg/m2 and above, and 33 individuals (55.00%) with in vitro fertilization. In the control group, there were 57 individuals (95.00%) aged younger than 35 years, 8 individuals (13.33%) with pre-pregnancy BMI of 25 kg/m2 and above, and 39 individuals (65.00%) with natural pregnancy. Multivariable logistic regression analysis identified age, pre-pregnancy BMI, method of conception, placental growth factor (PLGF) and UtA-RI as risk prediction factors for PE in twin-pregnant women. The established nomogram had an area under the ROC curve of 0.827 (95%CI: 0.755-0.899), a sensitivity of 0.767, a specificity of 0.733, a good discrimination and calibration, and a relatively high clinical net benefit. Conclusion The nomogram established by age, pre-pregnancy BMI, method of conception, PLGF and UtA-RI has a good predictive value for the risk of PE in twin-pregnant women.

Objective:To explore the effect of the teaching reform of "Community Nursing" in our school in different grades of nursing undergraduates.Methods:A total 174 nursing students in Grade 2009, 2010 and 2013, from School of Nursing at Shanghai Jiao Tong University were selected. Various teaching methods were carried out, including continuously carding teaching content, gradually adopting a community assessment approach, participating in community health education, and developing family health education plans and student-centered teaching methods. At the end of the course, all students completed the self-design curriculum evaluation questionnaires. By comparing the evaluation of teaching reform in different grades, the effect of the teaching reform scheme was analyzed. One-way analysis of variance and student Newman Keuls method were performed to compare the differences among different grades with SPSS 19.0 software.Results:The scores of the five dimensions of "curriculum organization", "teaching content", "teaching form", "teaching evaluation" and "teaching arrangement" were much higher in Grade 2013 and 2010 than in Grade 2009 ( P<0.05). After the teaching reform, students' satisfaction with the curriculum organization was improved; simplifying the teaching content reduced the repetition between courses; implementing the diversified teaching form enhanced students' participation; adopting a diversified teaching evaluation system expanded students' understanding of learning content; integrating different teaching locations and equipment brought real service experience to students. Conclusion:The series of teaching reforms of "Community Nursing" have achieved positive results in adjusting the curriculum framework, focusing on community nursing, improving students' participation, combining varied assessment methods and developing multiple teaching points and have been recognized by the students, so that the results may provide a reference for the next teaching rounds of "Community Nursing" with the fourth edition.

Objective: To investigate and analyze the influencing factors associated with transition time to achieve full oral feeding for premature infants in neonatal intensive care unit (NICU). Methods: A total of 251 NICU hospitalization preterm infants and their mothers meeting the inclusion criteria in Shanghai First Maternal and Infant Health Care Hospital were collected. Finding the medical records to obtain the basic information of the premature infants and feeding conditions, the Self-rating Anxiety Scale (SAS) and the Beck Depression Scale-Ⅱ(BDI- Ⅱ) was used to assess the mothers′ anxiety and depression. Results: The transition time to achieve full oral feeding of NICU preterm infants was (5.31±2.93) days. Greater gestational age (β=-0.484, P<0.01), time of breast milk feeding through mouth (β=0.042, P=0.003) had a positive effect on the transition time to achieve full oral feeding. Congenital heart disease (β=0.587, P=0.050), maternal anxiety (β=0.206, P<0.01), depression (β=0.727, P<0.01) and interaction between maternal anxiety and depression (β=0.014, P<0.01) were risk factors of longer time to achieving full oral feeding. The multiple linear regression accounting for a total of 58.2% of all the variation. Conclusions Oral feeding progression in premature infants was influenced by many factors. Gestational age can be the indicators of implementing oral feeding. It is beneficial to initiate oral feeding and feed with breast milk early. If the infants have heart diseases, oral feeding progression would be retardant. Maternal anxiety and depression may prolong the transition time to achieve full oral feeding. Control the factors which affect oral feeding progression, pay attention on mothers′ emotion and formulate appropriate feeding intervention for premature infants to promote full oral feeding are of great importance.

Objective:The present study was aimed to evaluate the nutritional risk using nutritional risk screening 2002 (NRS2002) score and to investigate the impact of nutrition support on clinical outcome in hospitalized patients.Methods:Six hundred and ninety four hospitalized patients were recruited.NRS 2002 was applied to evaluate the nutritional risk of patients.Meanwhile,the effect of nutrition support on complication rate was evaluated between different types of patients.Results:14.0％ of patients had malnutrition and the incidence of nutritional risk was 27.5％.Patients with nutritional risk had a higher complication rate (P ＜0.01).Totally,22.0％ (153/694) patients received nutrition support,including 81.7％ patients with nutritional risk and 18.3％ patients without nutritional risk.Patients with nutritional risk benefited from nutrition support,as shown by lower complication rate and shorter length of hospital stay.In patients with nutritional risk,complication rate was lower in enteral fed patients compared to parenteral fed patients.Conclusion:With nutritional risk screening,patients' nutritional status can be evaluated and appropriate nutrition support can be performed.Compared to those without nutritional risk,patients with nutritional risk will benefit more from nutrition support,as indicated by lower complication rate and reduced length of hospital stay.

Acute organophosphorus pesticide poisoning (AOPP) is one of the common critical diseases.In order to improve the rate of clinical cure, in recent years, many new treatment methods in clinical are recognized.In this paper, we will make a overview from the mechanism of AOPP, the application of classical drug cholinesterase reactivators, anticholinergicdrugs, other new applications such as fat emulsion for AOPP and blood purification therapy, combination therapy of Chinese and Western medicine, comprehensively elaborate the application of these drugs and treatment methods in clinical and therapeutic effect.

Objective:To investigate the incidence and its related influencing factors of cervical squamous intraepithelial lesion in patients with repeated uterine prolapse.Methods:A total of 200 patients with grade Ⅲ-Ⅳ repeated uterine prolapse treated by surgery at Jintan Hospital Affiliated to Jiangsu University from January 2017 to June 2019. The patients received vaginal hysterectomy. The clinical data and postoperative pathological results of patients were collected to observe the incidence of cervical squamous intraepithelial lesion, and the influencing factors of cervical squamous intraepithelial lesion were analyzed.Results:Of the 200 patients with grade Ⅲ-Ⅳ repeated uterine prolapse, 20 cases (10.0%) had cervical squamous intraepithelial lesion, including 17 cases of low-grade squamous intraepithelial lesion and 3 cases of high-grade squamous intraepithelial lesion. The differences of age, disease course of uterine prolapse, birth times, proportion of family history of tumor, proportion of cervicitis, high-risk human papillomavirus (HPV) infection rate, classification of uterine prolapse, and the proportion of flushing before husband's sexual life between patients with cervical squamous intraepithelial lesion and patients without squamous intraepithelial lesion were statistically significant (all P < 0.05). The logistic analysis showed that disease course of uterine prolapse ( OR = 2.381, 95% CI 1.337-9.050, P = 0.002), cervicitis ( OR = 1.242, 95% CI 1.113-3.015, P = 0.032), high-risk HPV infection ( OR = 1.425, 95% CI 1.124-6.234, P = 0.020), and uterine prolapse classification ( OR = 1.632, 95% CI 1.204-7.624, P = 0.015) were independent influencing factors associated with cervical squamous intraepithelial lesion in patients with repeated uterine prolapse. Conclusion:The incidence of cervical squamous intraepithelial lesion in patients with repeated uterine prolapse is high, and the risk of cervical squamous intraepithelial lesion is increased in patients with disease course >10 years or grade Ⅳ uterine prolapse.