Objective To compare the clinical application effect of bi -level positive airway pressure ( BiPAP) and nasal continuous positive airway pressure ( CPAP) in the treatment of preterm infants with neonatal respiratory distress syndrome ( NRDS) .Methods 64 neonates with NRDS were divided into the BiPAP group ( n=35) and NCPAP group (n=29) according to the randomized controlled study method.The blood gas index before and after 2,12 hours of treatment,the total time for ventilation,length of stay,and the incidence rate of abdominal disten-sion,gastroesophageal reflux,bronchopulmonary dysplasia,intraventricular hemorrhage,ventilator-associated pneumo-nia in the two groups were compared.Results The levels of pH and PaO2 in the BiPAP group were higher than those in the NCPAP group in noninvasive respiratory support for 2,12h(t=2.391,2.556,2403,2.355,P=0.020,0.013, 0.019,0.022).The incidence rates of hypoxemia,apnea,re-intubation mechanical ventilation rate after 12h in the BiPAP group were lower than those in the NCPAP group(t=5.049,4.988,4.215,P=0.025,0.026,0.040).The length of stay and mechanical ventilation time in the BiPAP group were shorter than those in the NCPAP group( t=-2.096,-2.669,P=0.041,0.010).Conclusion Compared with NCPAP,early application of BiPAP can obviously reduce the invasive respiratory support rate of children with NRDS with intubation.It is worthy of promotion.

Objective To establish a Chinese hamster model of babesia infection, to find the changing pattern of organs and biochemical parameters in Chinese hamster infected with Babesia, and to promote the detection and treatment of babesiosis.Methods Healthy 5-week old Chinese hamsters were infected by intraperitoneal injection of blood containing Babesia.Blood samples were collected at 0, 2, 4, 6, 8, 10, 12, 14, 16, 23, 30, and 37 days after infection from 5 hamsters at each time point.Blood smears were prepared to detect the parasites using Giemsa staining.ELISA assay was employed to test the IL-2 concentration.The blood biochemical indexes were detected using an automatic biochemical analyzer.DNA was extracted from the whole blood and REAL-TIME RCR was performed to determine the reproduction of Babesia.Aftert the animals were sacrificed, the heart, lung, spleen, liver, and kidney were taken to analyze the changes of organ coefficients.Results The highest level of Babesia in the hamsters occurred on day 4 after the Babesia injection, and then showing a decreasing tendency.However, there was a transient increase on the 12th day after infection.The liver and spleen displayed most extensive response to the infection showing hepatomegaly and splenomegaly, but the variation of heart and kidneys coefficients was within the norm.There were prominent changes of blood cells, especially leucocytes, with two peaks at day 10 and 23 after the Babesia infection.The peak changes of blood biochemical indexes occurred at day 12 after infection.The concentration of serum IL-2 reached a peak on the 10th day after infection.Conclusions The Chinese hamsters display typical characteristics of tick-borne diseases such as hepatomegaly and splenomegaly.The immunological system is activated along with the infection and reaches a highest stage in the second week.Afterwards the Babesia can live in the hamster body for a long period of time.The results of this study provide useful information supporting further studies on the detection, treatment and prevention of Babesiosis.

Objective:To explore the effect of bismuth containing triple therapy on serum gastrin (Gas), transforming growth factor-α (TGF-α), and high-sensitivity C-reactive protein (hs-CRP) levels in children with Helicobacter pylori (Hp) positive peptic ulcers.Methods:A total of 96 children with Hp positive peptic ulcers admitted to the Second Hospital of Jiaxing from January 2020 to December 2021 were selected as the study subjects. They were randomly divided into two groups using the remainder of a random number table. The control group (48 cases) received treatment with omeprazole, clarithromycin, and amoxicillin, while the observation group (48 cases) received treatment with bismuth containing triple therapy (amoxicillin+ metronidazole+ bismuth potassium citrate). After 10 days of treatment, the clinical efficacy of the two groups was evaluated The improvement time of clinical symptoms, Hp conversion rate, serum indicators (Gas, TGF-α, hs-CRP) before and after treatment, and incidence of adverse reactions were observed.Results:The total effective rate and Hp conversion rate of the observation group were significantly higher than those of the control group [95.83%(46/48) vs 81.25%(39/48), 97.92%(47/48) vs 83.33%(40/48), P<0.05]. The improvement time of upper abdominal pain, heartburn, and acid reflux symptoms was significantly shorter than that of the control group (all P<0.05). After 10 days of treatment, the serum Gas and hs-CRP levels in both groups significantly decreased compared to before treatment (all P<0.05), and the observation group was lower than the control group after treatment ( P<0.05); The levels of TGF-α in both groups increased compared to before treatment (all P<0.05), and the observation group was higher than the control group after treatment ( P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups [4.17%(2/48) vs 2.08%(1/48), P>0.05]. Conclusions:The triple therapy with bismuth containing agents has a better therapeutic effect on children with Hp positive peptic ulcers, and can promote ulcer mucosal repair by improving inflammatory response, with good safety.

Objective:To investigate the regulatory effect of vitamin D on the HMGB1/RAGE pathway and adipokine levels in a mouse model of obesity and asthma.Methods:This study was conducted at the Experimental Center of the Second Affiliated Hospital of Jiaxing University and the laboratory of Jiaxing University from February to September 2023. Thirty mice were marked with digital ear numbers and were randomly divided into five groups, with six mice in each group: Group Ⅰ (normal control group), Group Ⅱ (asthma group), Group Ⅲ (obesity and asthma group), Group Ⅳ (asthma + vitamin D group), and Group V (obesity and asthma + vitamin D group). An obesity mouse model was induced using a high-fat diet, while an asthma mouse model was induced through sensitization via intraperitoneal injection of ovalbumin and aerosol inhalation. The vitamin D intervention consisted of continuous intragastric administration of vitamin D (1 mL/d) for 2 weeks. Blood levels of interleukin-4, interleukin-6, interleukin-10, adiponectin, and leptin were determined using the enzyme-linked immunosorbent assay method. The expression of genes encoding high mobility group protein B1 (HMGB1) and the receptor for advanced glycation end products (RAGE) was detected using a quantitative reverse transcription polymerase chain reaction. All the obtained results were statistically analyzed using SPSS software.Results:The white blood cell count in bronchoalveolar lavage fluid (BALF) of Group Ⅱ was (1.34 ± 0.48) × 10 5/L, which was significantly lower than (4.07 ± 0.14) × 10 5/L in Group Ⅳ ( t = -18.28, P < 0.001). The white blood cell count in BALF in Group Ⅲ was (9.61 ± 0.91) × 10 5/L, which was significantly higher than (4.89 ± 0.38) × 10 5/L in Group V ( t = 11.75, P < 0.001). The percentage of eosinophils in BALF of Group II was (28.75 ± 1.94)%, which was significantly higher than (11.51 ± 1.99)% in Group Ⅳ ( t = 15.20, P < 0.001). The percentage of eosinophils in BALF of Group V was (12.50 ± 1.42)%, which was significantly lower than (29.80 ± 1.96)% in Group Ⅲ ( t = 17.74, P < 0.001). The ELISA results demonstrated that serum levels of interleukin-4, interleukin-6, interleukin-17, interleukin-1β, immunoglobulin E, and tumor necrosis factor-α in Group V were significantly lower than those in Group Ⅲ ( t = 15.24, 9.65, 2.26, 5.83, 10.86, 2.50, all P < 0.001). The serum level of interleukin-10 in Group Ⅲ was (4.97 ± 0.25) pg/mL, which was significantly lower than (8.84 ± 0.64) pg/mL in Group V ( t = -13.89, P < 0.001). The serum level of adiponectin in Group V was (1.95 ± 0.85) mg/L, which was significantly higher than (1.15 ± 0.13) mg/L in Group Ⅲ ( t = -12.67, P < 0.001). The HMGB1 expression level in lung tissue of Group Ⅳ was 1.42 ± 0.09, which was significantly lower than 1.91 ± 0.16 in Group Ⅱ ( t = 6.55, P < 0.001). The expression level of RAGE mRNA in lung tissue in Group Ⅳ was 1.35 ± 0.11, which was significantly lower than 1.55 ± 0.152 in Group Ⅱ ( t = 4.19, P < 0.05). The expression level of HMGB1 in lung tissue in Group V was 1.51 ± 0.10, which was significantly lower than 2.44 ± 0.10 in Group Ⅲ ( t = 1.02, P < 0.001). Conclusion:Vitamin D may alleviate lung injury by up-regulating the expression of HMGB1 and RAGE in a mouse model of obesity and asthma. This provides a new concept and method for the treatment and prevention of obesity and asthma.

Abstract： Objective　To elucidate the antigenic antibody reaction of recombinant expression of non-structural protein 1 (NS1) of Japanese encephalitis (JE) virus with various mosquito-borne flaviviruses, including JE virus, and the antigenic antibody reaction of serum samples of patients infected with JE virus in acute stage. Methods　In this study, Escherichia coli prokaryotic expression vector (pET) system was used to recombinant express Japanese encephalitis virus NS1 gene. Western Blot assay was performed to detect the antibody responses of the recombinantly expressed protein against a variety of mosquito-transmitted flaviviruses, including JE virus, as well as antigen-antibody reactions of serum from patients with acute JE virus infection. Results　The NS1 gene expression product of JE virus (P3 strain) was in the form of an inclusion body, and the denatured and renatured expression product was displayed as a single band in the denatured gel (polyacrylamide gel electrophoresis, PAGE), with a molecular weight of about 45 000. The results of further antigen-antibody analysis showed that the antigen/antibody hybridization reaction of the expression product with polyclonal or monoclonal antibody of JE virus (mosquito isolates, encephalitis isolates) and serum samples of patients with acute JE virus infection could be completely consistent. The recombinant product showed negative antigen/antibody hybridization reactions with mosquito-transmitted flaviviruses, such as dengue virus and yellow fever virus polyclonal antibodies, but positive reactions with polyclonal antibodies to West Nile virus and Murray Valley encephalitis virus. Conclusions　In this study, the recombinant expression of the NS1 protein of JE virus was successfully obtained, and the antigen/antibody reaction between the recombinant protein and samples of patients infected with mosquito-borne flavivirus and JE virus was analyzed. The study results provide important basic data for elucidating the antigen-antibody reaction between the NS1 protein of JE virus and mosquito-borne flavivirus. The recombinant expression protein obtained in this study provides an important material basis for further research on the function of JE virus NS1 protein.

Objective To explore the scientificity and feasibility of using weighted rank-sum ratio (RSR) method based on diagnosis-related groups ( DRGs) indicators in nursing performance evaluation. Methods Homepage data of medical records were extracted from inpatients discharged in 2017, and " CN-DRGs" burster was used to obtain the DRGs data. Data of medical safety were obtained from the nursing adverse event management system, while data of nursing grading information and medical expenses were obtained from the hospital information system, and the patient satisfaction was obtained in a questionnaire survey. Based on the indicators available, the weighted RSR was applied to evaluate the nursing performance from the 11 dimensions, namely workload, nursing competence, nursing quality, nursing personnel allocation, patient satisfaction, etc. Results The results of the weighted RSR showed that 43, 39, and 6 wards of total 88 wards of the hospital were rated as excellent, medium and poor grades respectively. The results of ANOVA showed that the difference of the 3 grades was significant (F=170. 391, P<0.001). The nursing performance evaluation results were consistent with the actual situation. Conclusions The evaluation of nursing performance with weighted RSR method based on DRGs indicators prove its practical application value, as this method can not only provide data support for nursing personnel allocation, but also provide reference for nursing quality evaluation and supervision.

OBJECTIVE: To develop a system for rapid detection of JAK2 V617F mutation among patients with myeloproliferative diseases. METHODS: Specific primers and TagMan probes were designed for the mutant and wild type alleles based on the principle of real-time PCR. A complete system including the method for detection and product for quality control were established through the evaluation of sensitivity and accuracy of the method, double-blind trial, and preparation of negative and positive controls through site-directed mutagenesis and molecular cloning. RESULTS: A system for rapid detection of the JAK V617F mutation has been developed. Compared with Sanger sequencing, the sensitivity and specificity of the method have both reached 100%. Meanwhile, 1000 normal samples and 1 case with the JAK2 V617F mutation were detected, which gave a population rate of 1‰. CONCLUSION The system was fast, accurate, cheap, high throughput, and easy to use. It can be utilized as a routine test. Although the JAK2 V617F mutation is rare in the population, it should be screened among myeloproliferative neoplasm patients.
Alleles ; DNA Mutational Analysis ; Double-Blind Method ; Humans ; Janus Kinase 2 ; genetics ; Mutation ; Myeloproliferative Disorders ; genetics ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity

Objective To evaluate the risk of 10?year risk of ischemic cardiovascular disease (ICVD) in patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu province. Methods From December 2013 to January 2014, a total of 15 624 patients with type 2 diabetes aged 35 years old and above, who received national basic public health service in Changshu county of Suzhou city, Huai′an and Qinghe districts of Huai′an city, Jiangsu province, were recruited by cluster sampling method. Face?to?face questionnaire survey, anthropometric and laboratory measurements were conducted to collect exposures to ICVD risk factors. Improved Ten Year Risk Assessment Table of ICVD in Chinese was used to assess the risk score and the absolute risk of developing ICVD. Results The participants were (62.2±9.7) years old, of which 6 137 were men (39.3%). Among the participants, the highest rate of exposure to ICVD risk factors was high systolic blood pressure (74.8%, n=11 685), followed by high total cholesterol (70.7%, n=11 051).The score of 10?year risk for ICVD was (10.4±3.3) and the median (P25-P75) value of absolute risk was 15.6% (6.8%-32.7%). 16.7% (n=2 602) participants were under extremely high risk of 10?year risk for ICVD, 23.8% (n=3 714) under high?risk and 24.0% (n=3 746) under middle?risk. Among the total risk score of ICVD, age (49.1%), hypertension (17.7%) and diabetes (15.5%) accounted for relatively high proportion, however, smoking (11.0%) was the most important risk factor except for age (47.4%) and systolic blood pressure (20.5%) in male participants. Conclusion Patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu Province have a high risk of developing ICVD for 10 years, especially in elderly, female, hypertension patients and male smokers.

Objective To evaluate the risk of 10?year risk of ischemic cardiovascular disease (ICVD) in patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu province. Methods From December 2013 to January 2014, a total of 15 624 patients with type 2 diabetes aged 35 years old and above, who received national basic public health service in Changshu county of Suzhou city, Huai′an and Qinghe districts of Huai′an city, Jiangsu province, were recruited by cluster sampling method. Face?to?face questionnaire survey, anthropometric and laboratory measurements were conducted to collect exposures to ICVD risk factors. Improved Ten Year Risk Assessment Table of ICVD in Chinese was used to assess the risk score and the absolute risk of developing ICVD. Results The participants were (62.2±9.7) years old, of which 6 137 were men (39.3%). Among the participants, the highest rate of exposure to ICVD risk factors was high systolic blood pressure (74.8%, n=11 685), followed by high total cholesterol (70.7%, n=11 051).The score of 10?year risk for ICVD was (10.4±3.3) and the median (P25-P75) value of absolute risk was 15.6% (6.8%-32.7%). 16.7% (n=2 602) participants were under extremely high risk of 10?year risk for ICVD, 23.8% (n=3 714) under high?risk and 24.0% (n=3 746) under middle?risk. Among the total risk score of ICVD, age (49.1%), hypertension (17.7%) and diabetes (15.5%) accounted for relatively high proportion, however, smoking (11.0%) was the most important risk factor except for age (47.4%) and systolic blood pressure (20.5%) in male participants. Conclusion Patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu Province have a high risk of developing ICVD for 10 years, especially in elderly, female, hypertension patients and male smokers.

Objective To investigate the mechanism of fibroblast growth factor(FGF)21 in liver lipid deposition.Methods HepG2 cells were divided into control group and induction group.Fatty liver cell model was constructed using oleic acid and palmitic acid in induction group.Lipid deposition under the microscope was observed between two groups by oil red O staining,and the protein expression of FGF21 and glutathione peroxidase 4(GPX4)in two groups were detected.FGF21 lentivirus-infected fatty liver cells were used as interference group,and scramble lentivirus-infected fatty liver cells were used as non-interference group.The expression level of FGF21 mRNA,lipid deposition and expression level of GPX4 protein were compared between two groups.Results Compared with control group,induction group had significant lipid deposition,significantly increased expression level of FGF21 protein,and significantly decreased expression level of GPX4 protein(P＜0.05).After the interference of FGF21 lentivirus,expression level of FGF21 mRNA was significantly decreased,lipid droplets were decreased,lipid deposition was significantly improved,and GPX4 protein expression level was significantly increased in interference group(P＜0.05).Conclusion FGF21 may promote liver lipid formation by inhibiting lipid peroxidation.