Objective:To understanded the pathogen spectrum and epidemiological characteristics of common respiratory viruses in hospitalized patients with severe acute respiratory infection (SARI) in Lanzhou, in order to provide a reference for the prevention, control and treatment of SARI cases in Lanzhou.Methods:From January 2011 to December 2020, 2 571 samples including throat swabs, sputum and a small amount of alveolar lavage fluid from SARI cases in the First Hospital of Lanzhou University, and data and clinical information were collected at the same time, the monitored population was divided into 5 age groups (0 year-, 1 year-, 5 years-, 15 years-, 60 years-), and the nucleic acid detection of common respiratory viruses was performed by multiplex real-time PCR.Results:A total of 9 viruses were detected in 2 571 samples, with a total positive rate of 24.66%. Among them, the top 4 viruses were respiratory syncytial virus (8.71%), rhinovirus (4.60%), influenza virus (4.40%), and parainfluenza virus (3.85%). The 0 year-group had the highest proportion of infants (36.37%), the highest positive detection rate (26.95%), the highest detection rate of respiratory syncytial virus (13.05%) were found in this group, and in the 5 years-group rhinovirus detection rate was the highest (6.13%). The 15 years-group and 60 years- group had the highest detection rates of influenza virus, which were 9.75% and 6.35%. The difference in positive detection rate between different age groups was statistically significant( χ2=12.11, P=0.038). The peak incidence was in winter and spring every year. Conclusions:The virus with the highest infection rate of SARI cases in Lanzhou was respiratory syncytial virus. Different age groups have different dominant viruses. Winter and spring are the epidemic seasons.

Objective To observe the effect of new vomit-receiving device in department of neurosurgery. Methods A total of 44 patients with vomiting symptoms in our department in May 2015 were randomly divided into the observation group (n=23) and the control group (n=21). The observation group used a new type of vomit-receiving device to carry out vomiting nursing, while the control group was treated with conventional vomiting nursing. The number of cases of vomiting and the number of occurrence times were observed. Results Observation group of 23 cases with no vomit leaks occur, and the control group 21 patients vomit leaked out in 16 cases, the incidence of vomit were leaked by 72.73% (χ2=27.53, P < 0.01), vomiting leaked rate was 40.74% (22/54) (χ2 = 32.49, P < 0.01), including who prepared to receive tools but not timely for 16 times, receive tools leakage for 5 times, no enough capacity of receive tool for 1 times. The total score of patients′ satisfaction in the observation group was 78, while the total score of patients in the control group was 57. The difference was statistically significant (t=2.80, P＜0.01). The total nursing time of the observation group was 68 min, and that of the control group was 347 min,the difference was statistically significant (t=-5.73, P＜0.01). Conclusions The new vomit-receiving device can effectively reduce the incidence of vomit substance leakage, and the installation is easy to install, easy to operate and conducive to the management of vomit. It greatly improves the efficiency of nursing, and effectively improves the satisfaction of patients and their families to nursing.

Objective To understand the correlation between health beliefs and family environment of stroke patients. Methods A questionnaire survey was carried out on 115 stroke patients with the first onset of stroke by using the special health belief simple table (SF-HBMS) and the family environment scale (Chinese version FES-CV), and the correlation was analyzed. The scores of each subscale of the family environment were compared with the domestic norm. Results The total score of health belief (75.15 ± 10.20) was at the middle level. There were significant differences in age (F=8.41), education level (F=4.44), complications (F=4.05), family history (t=2.68) and first visit time (F=3.76) among different characteristics of health belief scores (P < 0.01 or 0.05). The score of intimacy (6.23 ± 1.27) in family environment, emotional expression score (5.30 ± 1.97), success score (5.88 ±1.62), cultural score (4.54 ± 2.20) and organizational score (5.60 ±1.67) were all lower than the domestic norm and spear. The score of shield score (3.16 ± 2.00) was higher than that of domestic norm (P<0.01 or 0.05), and the total score of health belief was positively correlated with family intimacy (r=0.190), emotional expression (r=0.204), culture (r=0.206) and tissue (r=0.227) (P<0.05), and was negatively correlated with the contradiction (r=-0.186, P<0.05); regression analysis, whether there were family history (β=0.338, P<0.01), first onset time (β=0.242, P<0.01), family intimacy (β=1.614, P<0.05), emotional expression (β=1.114, P<0.05) were the factors affecting the health belief level of first stroke patients. Conclusions The level of health belief is closely related to family environment. It is suggested that the clinical medical staff should pay attention to the negative emotion and family psychological intervention, provide psychological support for the patients and their families, promote the promotion of their health beliefs, and reduce the rate of recurrence and disability.

Objective:To investigate the preventive effect of airflow shock on micro-smoke in patients with mechanical ventilation through oral tracheal intubation.Methods:Using simple random sampling method, 76 patients who underwent mechanical ventilation through oral tracheal intubation in Tianjin First Central Hospital from March 2019 to August 2019 were selected as subjects. They were divided into two groups by the random number table method with 38 cases in each group. The observation group was treated with airflow shock method and intermittent glottic suction. The control group was treated with intermittent glottic suction. The total amount of retentate on the 24 h capsule and the suction tube on the capsule were compared. The incidence of catheter blockage, bacterial culture of the upper respiratory tract and lower respiratory tract secretion, ventilator-associated pneumonia (VAP) incidence rate, and changes in vital signs of patients before and after operation.Results:The incidence of VAP, the total amount of retentate on the 24 h capsule, the incidence of catheter blockage was 2.9% (1/34), (19.37 ± 5.52) ml, 17.6% (3/34) in the observation group, and 20.0% (7/35), (14.98 ± 3.77) ml, 25.7% (12/35) in the control group, the difference between the two groups was statistically significant ( χ2 values were 4.896, 7.239, t value was 5.315, P<0.05 or 0.01). The positive rate of pathogens in the sac retentate culture was 54.6% (113/207), 149 pathogens, the positive rate of lower respiratory tract secretion pathogen was 12.6% (26/207), and 37 pathogens. The pathogens of the two groups were similar. Gram-negative bacilli mainly, the main dominant bacteria were Acinetobacter baumannii, Pseudomonas aeruginosa and Stenotrophomonas maltophilia, and there was no significant difference in the ratio of the main pathogens in the sac retentate and lower respiratory tract secretions between the two groups ( P>0.05). There was no significant difference in heart rate, systolic blood pressure, diastolic blood pressure and respiratory changes between the two groups before and after operation ( P>0.05). Conclusions:The airflow impact method combined with the suction under the glottal can effectively remove the airbag wrinkles and the retentate accumulated on the capsule, which can reduce the incidence of suction tube obstruction on the capsule, prevent the occurrence of micro aspiration and reduce the incidence of VAP.

Background:Irritable bowel syndrome(IBS)is a commonly seen functional gastrointestinal disorders(FGIDs),and can reduce the quality of life and has some effects on patients'psychology. Aims:To investigate the disorder of sleep and psychological status in patients with IBS and IBS overlapping other FGIDs,and to analyze their risk factors. Methods:Questionnaires were conducted among FGIDs patients from January 2014 to December 2014 in 6 hospitals at Tianjin. Pittsburgh sleep quality index(PSQI)was used to assess sleep quality,anxiety and depression were assessed by self-rating anxiety scale(SAS)and self-rating depression scale(SDS),respectively. Two-factor Logistic regression analysis was used to analyze the risk factors of sleep disorder in patients with IBS overlapping other FGIDs. Results:A total of 1 117 patients with FGIDs completed the questionnaires,including 32 IBS patients(2. 9%)and 113 patients(10. 1%)with IBS overlapping other FGIDs. The percentages of sleep disorder,psychological disorder,and combination of the two were 59.4%,93.8% and 59.4% in IBS group,respectively;and 82.3%,95.6% and 78.8% in IBS overlapping other FGIDs group,respectively. Gender,age and severity of symptoms were the risk factors of sleep disorder in patients with IBS overlapping other FGIDs(P=0.014,P=0.049,P=0.025). Conclusions:Both IBS patients and IBS overlapping other FGIDs patients are associated with varying degrees of sleep disorder and/or psychological disorder. Gender,age and severity of symptoms may be the risk factors of sleep disorder in IBS overlapping other FGIDs patients.

Objective:To analyze the relationship between maternal mutations in basal core promoter region of hepatitis B virus (HBV) genotype C and intrauterine transmission.Methods:We collected information on general demographic characteristics and process of delivery among 399 pairs of consecutive HBsAg-positive mothers and their neonates, from the Third People’s Hospital of Taiyuan in Shanxi province, China. Fluorescence quantitative polymerase chain reaction (FQ-PCR) and Electro-chemiluminescence immuno-assay (ECLIA) kits were used to detect both maternal and neonatal HBV DNA and serological markers in the peripheral blood. From 113 mothers with HBV DNA load ≥10 6 IU/ml, we selected 22 mothers whose neonates were with intrauterine transmission and randomly selected the same number of mothers whose neonates were without intrauterine transmission, as controls. The whole-length HBV DNA were extracted, amplified, cloned, sequenced and genotyped. Finally, a total of 39 mothers with genotype C of HBV were selected for mutation analysis. Results:Thirty-nine cases of genotype C (88.63 %) were finally included in the study, with 19 cases in the intrauterine transmission group and 20 cases as controls. Rates of A1762T/G1764A double mutations were significantly different between the intrauterine transmission group and the control group (7.53 % vs. 27.72 %, P<0.001). Results from the multivariate analysis showed that the A1762T/G1764A double mutations had reduced the risk of intrauterine transmission (a OR=0.065, 95 %CI: 0.006-0.746, P=0.028). Maternal A1762T/G1764A double mutations appeared to be possibly associated with neonatal HBeAg ( P=0.050). Conclusion:A1762T/G1764A double mutations of HBV DNA from the genotype C of those HBsAg-positive mothers could reduced the risk of HBV intrauterine transmission during pregnancy.

Objective:To analyze the virus genome mutation of mothers with C genotype HBV and explore its relationship with HBV intrauterine transmission.Methods:A total of 399 mothers carrying HBV and their newborns hospitalized in the obstetrics department of the Third People's Hospital of Taiyuan from 2011 to 2013 were selected. Necessary information about mothers and children was obtained through a questionnaire survey and medical records. HBV DNA and HBV serological markers were detected by quantitative fluorescence PCR and electrochemiluminescence. Within 24 hours after birth and before active/passive immunization, those with positive HBsAg and/or HBV DNA in femoral venous blood were determined as HBV intrauterine transmission. According to the requirements of cloning and sequencing, mothers' HBV DNA load should be ≥10 6 IU/ml. Among 54 cases of HBV intrauterine transmission, 22 pairs of mothers and their newborns meeting the requirements of cloning and sequencing were used as the intrauterine transmission group. The same number of mothers and their newborns without intrauterine transmission was selected as the random seed method's control group. After PCR amplification of HBV DNA, gene cloning, and sequencing, the gene mutation analysis of mothers with C genotype HBV was performed. Results:Among the 44 samples, 39 (88.63%, 39/44) were genotype C, 2 were genotype B, and 3 were mixed genotype B, and C. A total of 406 clone beads from 42 mothers with C genotype HBV were analyzed for gene mutation, including 204 in the intrauterine transmission group and 202 in the control group. The base substitution mutation rate of PreS1, S, C, and P regions in the HBV intrauterine transmission group were significantly lower than those in the control group ( χ 2 ranged from 8.67 to 40.73, P<0.05). The mutation rate of base deletion in PreC and X regions in the HBV intrauterine transmission group was lower than that in the control group ( χ 2 values were 17.82 and 34.78, P<0.001). Two clones in the X region had 31 bp insertion mutations between nt1644 and nt1645, and two clones had 27 bp insertion mutations between nt1649 and nt1650, all of which took place in the control group. Conclusions:The base substitution mutations in the PreS1, S, C, and P segments of the HBV genome in mothers with C genotype HBV were associated with the occurrence of intrauterine transmission of HBV. Deletion mutations in the PreC region, insertion and deletion mutations in the X region may reduce intrauterine transmission risk.

Objective:To explore the effects of neonatal stimulator of interferon genes (STING) innate immune signaling pathway of HBsAg-positive mothers on non/hypo-response to hepatitis B vaccine (HepB) in their infants.Methods:From November 2019 to June 2022, HBsAg-positive mothers and their infants in the Third People's Hospital of Taiyuan were recruited as the study subjects. The epidemiological and clinical data were collected by questionnaire survey and medical records review. The key molecular proteins of STING innate immune signaling pathway (STING, pIRF3) and immune cells associated with vaccine response (DC, T and B and plasma cells) in neonatal cord blood were detected by flow cytometry. Follow up was conducted for infants for 1-2 months after the full vaccination of HepB. Serum hepatitis B surface antibody (anti-HBs) was detected by chemiluminescence microparticle immunoassay. Unconditional logistic regression model, nomogram and Bayesian network model were used to evaluate the effect of STING innate immune signaling pathway on non/hypo-response to HepB and related factors in infants, and the relationship between various factors.Results:A total of 195 pairs of HBsAg-positive mothers and infants were recruited, the rate of non/hypo-response to HepB in the infants was 12.31% (24/195). High maternal HBV DNA load, low expression of neonatal STING, low expression of pIRF3 and low percentage of plasma cells were risk factors for non/hypo-response to HepB in the infants ( OR=4.70, 3.46, 3.18 and 2.20, all P<0.05). The nomogram constructed by these factors had good predictive efficacy (area under curve=0.81, 95% CI: 0.63-0.83). The results of Bayesian network model showed that the infants with a high maternal HBV DNA load had a higher conditional probability of low STING expression (62.50%) and a higher conditional probability of low pIRF3 expression (58.54%). The conditional probabilities of low expression of DC, T, B and plasma cells were 53.16%, 60.20%, 68.42% and 57.14%, respectively. Conclusion:Maternal HBV DNA might inhibit STING innate immune signaling pathways in infants and immune cells associated with HepB response, resulting in non/hypo-response to HepB in infants of HBsAg-positive mothers.

Objective: To retrospectively analyze the potential correlation between cardiac magnetic resonance (CMR) imaging and clinical features and idiopathic arrhythmia in patients with straight back syndrome (SBS). Methods: Patients receiving CMR imaging examination from April 2015 to March 2016 at our department (n=1 432) were screened, 76 patients met the diagnosis criteria of flat chest (anteroposterior diameter/transthoracic diameter (APD/TTD) ratio<0.37 at the T8 vertebra). After excluding 33 patients with structural heart disease, 43 SBS patients were divided into two groups: SBS without obvious morphological change in the heart (group A, n=19) and SBS with morphological change of the heart (group B, n=24). CMR images were analyzed, focusing the heart morphological changes induced by SBS. The clinical data were collected to comprehensively analyze the medical history, electrocardiogram and electrophysiological examination in order to observe the relationship between SBS induced heart morphological change and the arrhythmia type and origin. Results: There were 21 male patients in this cohort, mean age was (28.5±11.5) years (13-58 years). APD/TTD ratio was similar between the two groups (0.30±0.03 vs. 0.29±0.04, P>0.05). LVEF tended to be lower in group B than in group A ((47.48±12.77)%vs. (59.31±9.04)%, P>0.05) . In group B, there were 15 patients with left ventricular enlargement, 2 with left ventricular wall thickening, 5 with uncoordinated ventricular wall motion, 5 with tricuspid regurgitation, 3 with mitral regurgitation, 2 with myocardial fibrosis, 5 with increased trabecular and 16 with decreased left ventricular function. Direct compression sign of right ventricle (disappeared precordial fat tissue space, secondary right atria enlargement and tricuspid regurgitation) and left atria (with or without secondary left ventricular enlargement and mitral regurgitation) were evidenced in patients of group B. CMR revealed that the arrhythmia origin corresponded the compression site of the heart in 8 cases (42.1%) in group A and 13 cases (54.2%) in group B, not corresponded to the compression site in 6 patients (31.6%) in group A and in 7 patients (29.2%) in group B, not attributable in 5 patients (26.3%) in group A and 4 patients (16.7%) in group B. The percent of arrhythmia origin corresponded the compression site of the heart tended to be higher in group B as compared to group A (P>0.05). Conclusion SBS can induce changes of cardiac morphology and cardiac function. SBS induced cardiac compression is linked with the development of arrhythmias and might be one of the reasons of arrhythmias in these patients.

Objective:To understand the current situation of psychological crisis vulnerability among elderly individuals with multimorbidity and analyze the factors that influence it, to provide insights for improving their coping abilities.Methods:A cross-sectional survey design was conducted at Renmin Hospital of Wuhan University from May 1 to November 30, 2022.The attitudes toward aging, sense of meaning of life, and vulnerability to psychological crisis were analysed among outpatients and inpatients.Statistical analysis was performed on the questionnaire results, and the influencing factors of vulnerability to psychological crisis in elderly patients with co-morbidities were analyzed using one-way linear regression and multivariate linear regression.Additionally, the correlation between aging attitudes, sense of meaning of life, and vulnerability to psychological crisis was examined using Pearson correlation analysis.Results:A total of 685 questionnaires were distributed, and 602 valid questionnaires were collected, resulting in a valid recovery rate of 87.9%.The total score for the sense of meaning of life in elderly co-morbid patients was(39.2±8.3), while the total score for aging attitudes was(80.2±13.5).The total score for psychological crisis vulnerability was(69.4±12.8), indicating a medium-high level of vulnerability.The results of multiple linear regression analysis revealed that the factors influencing psychological crisis vulnerability in elderly multimorbidity, in descending order, were residence status, economic situation, marital status, age, type of chronic disease, and hospitalization history in the past six months.Psychological crisis vulnerability in elderly multimorbidity showed a negative correlation with the sense of meaning of life and the attitude of aging( r=-0.315, -0.264, both P<0.01), while the attitude of aging exhibited a positive correlation with the sense of meaning of life( r=0.515, P<0.01). Conclusions:The vulnerability of elderly individuals with multimorbidity to psychological crises is influenced by several factors.Healthcare professionals should prioritize individuals who are elderly, residing in nursing institutions, widowed, financially disadvantaged, experiencing multiple illnesses, and not currently hospitalized.