Diabetic KK-Ay mice were given glimepiride (GM) and glibenclamide (GB). After treatment, the visceral white fat content, insulin and hypothalamic neuropeptide Y (NPY) levels were significantly lower in GM group than those in GB group, suggesting that in addition to the lower insulin level stimulated by GM, the lower concentration of hypothalamic NPY seems to play a role in lessening increase in body fat of type 2 diabetic animals treated with GM.

Spore surface display is one of attractive microorganism surface display systems. With the advantage of resistance attribute and specific assembly pattern, the technology of spore surface display now is attracting more and more attention. According to the current reports and main achievements of spore surface display, the structure and assembly of spores, the principle for construction and some existing spore surface display systems were elaborated in this paper. Now with the unique property of spores, the technique is not only widely used in production of vaccines but also has great applied potential in the field of biocatalysis and cell-factory.
Bacillus subtilis ; genetics ; metabolism ; Biocatalysis ; Biotechnology ; methods ; Gene Expression Regulation, Bacterial ; Genetic Engineering ; methods ; Recombinant Proteins ; genetics ; metabolism ; Spores, Bacterial ; genetics ; metabolism ; Tetanus Toxoid ; genetics ; immunology

Objective:To explore the effects of the γ-aminobutyric acid(GABA) neurons and melanin-concentrating hormone (MCH) neurons of the nucleus accumbens (NAc)-lateral hypothalamic area (LHA) neural pathway on the rewarding feeding(palatable food sweat condensed milk) in the obesity rats.Methods:Total 142 male Wistar rats of SPF grade were divided into normal diet (ND) group ( n=68) and high-fat diet induced obesity (DIO) group ( n=74) according to the principle of body mass matching. The rats in the two groups were given normal diet and high-fat diet for 8 weeks. Eight weeks later, 6 DIO rats were randomly selected to observe the nerve projection from GABA neurons in NAc to MCH neurons in LHA by fluorogold retrograde tracing combined fluorescence immunohistochemistry. And the expressions of c-Fos and MCH in LHA after ingestion of sweet condensed milk(rewarding feeding) were observed by fluorescence immunohistochemistry (6 rats in each group). GABA receptor agonist Musimol or GABA receptor antagonist Bicuculine was microinjected into the nucleus of LHA to observe the effect of GABA on rewarding food intake in ND and DIO rats ( n=8 in each group), and the changes of rewarding food intake after blocking MCH signal ( n=8 in each group). SPSS 17.0 was used for statistical analysis, two-way ANOVA and post hoc Bonferroni test were used for comparison among multiple groups, and t-test was used for comparison between two groups. Results:After 8 weeks of high-fat diet modeling, the intake of delicious food in DIO rats was significantly higher than that in ND rats((12.52±2.29) mL, (7.45±1.23) mL, t=4.778, P<0.01) after satiety.The results of fluorogold retrograde tracing combined with fluorescence immunohistochemistry showed that GABA neurons in NAc projected nerve fibers to neurons in LHA, and GABA A receptors in some neurons in LHA coexisted with MCH.The results of NAc-LHA pathway on delicious food intake showed that the interaction between rat group and drug intervention was significant( F=9.869, P<0.01). Simple effect analysis showed that the intake of delicious food after microinjection of Musimol into LHA nucleus of ND rats was significantly lower than that of microinjection normal saline ((4.25±1.38) mL, (7.29±1.49) mL, P<0.01), while the intake of delicious food after injection of Bicuculine was significantly higher than that of microinjection normal saline((10.72±2.11) mL, (7.29±1.49) mL, P<0.05). The intake of delicious food after microinjection of Musimol into LHA nucleus in DIO group was significantly lower than that of microinjection normal saline((3.51±1.77)mL, (13.68±2.95) mL, P<0.01), but there was no significant difference between microinjection Bicuculine and microinjection normal saline ((14.83±3.44) mL, (13.68±2.95) mL, P>0.05). The results of blocking MCH signal on delicious food intake showed that the interaction effect between SNAP-94847 and Bicuculine intervention was not significant ( F=1.468, P>0.05). The main effect of SNAP-94847 intervention was significant ( F=15.880, P<0.01)and the main effect of Bicuculine intervention was significant ( F=6.930, P<0.05). After intracerebroventricular injection of MCH receptor blocker SNAP-94847, the delicious food intake of ND rats was significantly less than that of injection normal saline((4.78±1.72) mL, (7.63±2.77) mL, P<0.05), and it was not affected by pre injection of Bicuculine in LHA ((6.24±2.18) mL, (4.78±1.72) mL, P>0.05). In the DIO rats, the interaction effect between SNAP-94847 and Bicuculine intervention was not significant( F=0.006, P>0.05). The main effect of SNAP-94847 intervention was significant ( F=18.46, P<0.01) and the main effect of Bicuculine intervention was not significant ( F=2.059, P>0.05). After intracerebroventricular injection of MCH receptor blocker SNAP-94847, the delicious food intake of DIO rats was significantly lower than that of injection normal saline((6.89±2.11) mL, (12.19±4.36) mL, P<0.05), and it was not affected by pre injection of Bicuculine in LHA ((8.72±2.26) mL, (6.89±2.11) mL, P>0.05). Conclusion:GABAergic signal in NAc can regulate the expression of MCH in neurons of LHA. In the DIO rats, the sensitivity of MCH neurons in LHA to satiety signal decreases and the hedonic feeding increases.

Objective:To explore transition care needs among the parents of children with primary nephrotic syndrome and analyze the influencing factors.Methods:With convenient sampling method, parents of children with primary nephrotic syndrome were selected in the children's nephrology department of a tertiary grade A hospital in Shandong province. A total of 240 parents were enrolled in the study and they were investigated by using a self-designed questionnaire of transitional care needs of parents of children with primary nephrotic syndrome.Results:The total score of transitional care needs for parents was (4.12±1.08) points. The demand for disease knowledge, complication prevention and condition monitoring was the highest (4.67±0.53) points. 52.80% (113/214) of parents hope to receive transitional care services through network communication. 64.49% (138/214) of the parents want specialist doctors and nurses to provide nursing services for them. Multivariate stepwise regression analysis showed that age, education level, monthly income, hospitalization time and hormone use time of the children were the factors influencing the parents' demand for transitional care services ( P < 0.01). Conclusion:Parents of children with primary nephrotic syndrome have a high demand for transitional care. It is suggested to give full play to the leading role of professional medical teams and gradually form a hospital-community linkage transitional nursing mode; Parents of children with different age, education level, monthly income, hospitalization time and hormone use time have different needs for transitional care thus individualized transitional nursing for different patients are expected.

Objective:To investigate the status of the professional construction of head nurses in the tertiary hospitals of Shandong Province, and to master the professional cognition and attitude of the head nurses, and to provide reference for the formulation of the professional construction plan for the head nurses in the tertiary hospitals.Methods:A cross-sectional survey of 2 629 head nurses from 55 tertiary hospitals in Shandong Province was conducted using a self-designed questionnaire survey on the status of professional construction of head nurses in tertiary hospitals in Shandong Province.Results:The selection and training system of the head nurses in the tertiary hospitals in Shandong Province was mature. 93.00%(2 357/2 534) of the head nurses were undergraduate degrees, 18.40%(465/2 534) of the head nurses used all the working hours for nursing management, and 86.00%(2 179/2 534) were the main economic sources with the current position; 68.20%(1 728/2 534) were believed that the head nurse should be a trained nurse, 87.90%(2 227/2 534) thought that the head nurse′s professional construction was necessary, and the professional feasibility score was 77.93±19.75. The regression analysis showed that the factors affecting the head nurse′s own professional construction were age, satisfaction with salary satisfaction and self-worth ( P<0.05); 32.50%(257/791) of the head nurses suggested improving the management training system, 20.61%(163/791) recommended that the hospital should pay attention to the professional construction of the head nurse, and 7.33%(58/791) recommended establishing the standardization of professional standards. Conclusions:To improve the investment time of the head nurses and encourage the head nurses to continue the education management; the hospital should appropriately reduce the age requirements of the head nurses and improve the salary; establish a sound professional system and management training system for the head nurses, and comprehensively recommend the head nurses. Promote the professional development of the head nurse team

Objective To compare the difference of cutpoint and clinical significance of HbA1C for the diagnosis of abnormal glucose metabolism in two population groups with different ages.Methods According to oral glucose tolerance test(OGTT),the cutpoint and clinical significance of HbA1C for the diagnosis of type 2 diabetes and impaired glucose regulation(IGR)were investigated in the two population groups.Results The mean HbA1C of 1 064 young subjects in an academy and 1 671 aged subjects in a community were 5.31% ±0.41% and 5.79% ±0.71%,respectively.The cutpoints of HbA1C for diagnosis of diabetes were 5.7%(specificity 86.7%,sensitivity 66.7%)and 5.9%(specificity 73.8%,sensitivity 80.1%)in the two population groups,and 5.6% for diagnosis of IGR (specificity 82.8%,sensitivity 55.8%)and 5.7%(specificity 60.9%,sensitivity 64.3%),respectively.87.8%,78.7%,and 38.5% were diagnosed diabetes by current OGTT criteria at HbA1C levels of ≥5.7%,≥5.9%,and≥6.5%,IGR being 61.6%,39.6%,and 4.1%,and normal glucose tolerance being 24.4%,10.0%,and 0.4%.Conclusion The cutpoints of HbA1C for diagnosis of diabetes and IGR are different in populations with different ages and HbA1C levels.As one of diagnostic criteria for diabetes,HbA1C 6.5% with relatively higher specificity and lower sensitivity must be combined with fasting blood glucose,random blood glucose,and OGTT.

Objective To assess the tear film stability and morphological characteristics of the tarsal gland in myopic children.Methods In this prospective descriptive study,myopic children who performed refractive examinations in the Pediatric Ophthalmology & Refraction Clinic,Jinan Mingshui Eye Hospital from November 2021 to November 2022 were in-cluded.An Ocular Surface Disease Index(OSDI)questionnaire survey was carried out;tear meniscus height(TMH),non-invasive first breakup time(NIf-BUT)and images of the tarsal glands were obtained by OCULUS Keratograph 5M compre-hensive ocular surface analyzer.In addition,the atrophy and tortuosity of tarsal glands were scored to analyze the tear film stability and clinical characteristics of tarsal glands in myopic children.Results A total of 48 myopic children(91 eyes)aged from 7 to 16(10.25±2.23)years were recruited,including 27 males(56.25％)and 21 females(43.75％).The aver-age TMH was(0.19±0.04)mm(95％CI:0.18-0.19)and the average NIf-BUT was(5.40±2.62)s(95％CI:4.90-5.94);the TMH was positively correlated with NIf-BUT(r=0.223,P=0.034).The tarsal gland atrophy score was 1(0,1).The tortuosity score of the upper and lower tarsal gland was 0(0,1)and 0(0,0),respectively,with a statistically significant difference(Z=3.692,P＜0.001).In all subjects,49 eyes(53.85％)had tarsal gland atrophy,and 37 eyes(40.66％)had tarsal gland tortuosity.There were significant differences in TMH and NIf-BUT between children aged＜12 years and children aged ≥12 years(both P＜0.05).There was a significant difference in TMH between children with an OSDI score＜13 and children with an OSDI score ≥ 13(t=2.305,P=0.026).There was a significant difference in NIf-BUT between mild and moderate myopia children(t=2.300,P=0.024);the spherical equivalent was positively correlated with NIf-BUT(r=0.283,P=0.023).Conclusion Children with mild to moderate myopia show low tear film stability and a certain proportion of abnormal morphology in tarsal glands.In addition to the refractive status of children,attention should also be paid to ocular surface health in the refraction clinic.

{L-End}Objective To investigate the current status of long working hours of food-delivery workers from food-delivery platform, and analyze its impact on their health such as occupational stress, depressive symptoms, insomnia symptoms, fatigue accumulation, and life satisfaction. {L-End}Methods A total of 2 145 food-delivery workers from two food-delivery platforms in Guangzhou City were selected as the research subjects using convenience sampling method. The occupational stress, depressive symptoms, insomnia symptoms, fatigue accumulation, and life satisfaction were investigated using the Core Occupational Stress Scale, Patient Health Questionnaire-9 items, Self-sleep Management Questionnaire, Self-diagnosis Questionnaire of Fatigue Accumulation of Workers, and World Health Organization Five-item Well Being Index. {L-End}Results The median and the 25th and 75th percentiles of weekly working hours were 63 (49,77) hours. And 92.2% (1 978/2 145) of workers, who worked more than 40 hours per week, were long working hours workers. While 70.1% (1 504/2 145) workers, who worked 55 hours or more per week, were ultra-long working hours workers. The detection rate of occupational stress, depressive symptoms, insomnia symptoms, fatigue accumulation, and low life satisfaction was 30.1%, 27.5%, 34.7%, 40.8%, and 75.1%, respectively. The longer the weekly working hours of the research subjects, the higher the detection rate of occupational stress and fatigue accumulation (all P<0.01). The results of multivariate logistic regression analysis showed that ultra-long working hours (weekly working hours ≥55 hours) was the influencing factor of occupational stress and fatigue accumulation after excluding the influence of confounding factors among workers (all P<0.05). {L-End}Conclusion The food-delivery workers of food-delivery platforms generally work long hours. Ultra-long working hours is a risk factor for occupational stress and fatigue accumulation among these workers.

Objective:To explore the current needs for the personnel, service mode and service duration of continuous nursing services in patients with permanent colostomy and provide support for developing continuous nursing services.Methods:Totally 120 patients with permanent colostomy who were discharged after surgery and attended outpatient services in a ClassⅢ Grade A general hospital in Shandong province between January and December 2018 were selected by convenient sampling and investigated using a self-designed questionnaire for continuous nursing needs in patients with permanent colostomy.Results:The top 3 needs for continuing nursing services were telephone, outpatient service, and home follow-up. The top 3 needs for service personnel were interdisciplinary teams, doctors, and stoma therapists. The most demanding service duration after discharge was 3 to 6 months. The most demanding service time was from 18∶00 to 20∶00. In terms of service frequency, the telephone follow-up was once a week or once every two weeks; the home follow-up was once every 2 weeks; and the outpatient follow-up was once every 2 weeks or once a month.Conclusions:Clinical medical staff should explore more optimized continuous nursing service plans and promote the establishment of a high-quality and efficient continuous nursing service system based on the main needs of patients with permanent colostomy for continuous nursing services.

Objective:Based on the pathological model of acceptance and commitment therapy(ACT), to explore the correlation between cognitive fusion and resting-state spontaneous brain activity amplitude of low frequency fluctuation in patients with major depressive disorder(MDD).Methods:Patients with MDD ( n=19) and healthy controls (HCs, n=19)matched with gender, age, and years of education were enrolled from August 2022 to May 2023 in Hangzhou Seventh People's Hospital. 17-item Hamilton depression rating scale(HAMD-17) and cognitive fusion questionnaire(CFQ) were used to estimate the depressive symptoms and cognitive fusion of the participants. The amplitude of low frequency fluctuation(ALFF) data were collected on a 1.5 T-GE scanner. Based on DPABI v7.0 software of MATLAB 7.11.0 (R2018b), two independent sample t-test was used to compare the ALFF of the MDD group and HC group. ALFF values and the cognitive fusion scale scores were investigated by Pearson correlation analysis. Results:Compared with HCs, ALFF in patients with MDD was decreased relatively in the left triangular part of the inferior frontal gyrus(MNI: x, y, z=-36, 24, 21; t=-2.107, P=0.042), the right cuneus(CUN; MNI: x, y, z=12, -87, 24; t=-8.635, P<0.001) as well as the left calcarine fissure and surrounding cortex(MNI: x, y, z=-18, -57, 6; t=-14.188, P<0.001), while increased relatively in left superior occipital gyrus(MNI: x, y, z=-21, -72, 33; t=-7.253, P<0.001). There was a significant negative correlation between cognitive fusion and ALFF values of abnormal activity in left IFGtriang (belonging to ECN)( r=-0.57, P<0.05). Conclusion:There is a correlation between cognitive fusion and resting-state spontaneous brain activity ALFF in patients with MDD. Both cognitive fusion and depressive symptoms may affect patients' cognitive control deficits through multiple sources.