Objective To determine the levels of vitamin D in the peripheral blood of patients with systemic lupus erythematosus(SLE).Methods Seventy-eight cases of SLE were selected as SLE group,42 cases of chronic nephritis (CN) were as CN group,and 40 cases of healthy persons were as control group.Vitamin D levels were detected by enzyme-linked immunosorbant assay.The correlation of vitamin D levels in patients with SLE and 24 h urinary protein excretion,SLE disease activity (SLEDAI) score,anti-ds-DNA antibodies,complement C3 were analyzed,and the relationships between vitamin D levels and kidney damage were estimated.Results The vitamin D levels in SLE group were (13.3 ± 6.2) μ g/L,significantly lower than those in CN group [(21.4 ± 9.7) μ g/L] and control group [(20.8 ± 9.5) μ g/L] (P ＜ 0.05),and the difference was not statistically significant between CN group and control group (P ＞ 0.05).The vitamin D levels in SLE and lupus nephritis (LN) patients were significantly lower than those in SLE and non-LN patients [(9.8 ±6.1) μg/L vs.(15.9 ±7.8) μg/L,P ＜0.05].Vitamin D levels in SLE patients were negatively correlated with SLEDAI score,anti-ds-DNA antibodies and 24 h urinary protein excretion (r =-0.712,-0.682,-0.769,P ＜ 0.05),and were positively correlated with complement C3(r =0.608,P ＜ 0.05).Conclusions The vitamin D levels in SLE patients decrease significantly and have close relationship with disease activity.It can not only reflect disease activity,but also act as a useful marker to predict visceral involvement.

Objective To explore the risk factors of Pseudomonas aeruginosa infection in diabetic foot .Methods 136 patients with diabetic foot were divided into infection group (n=12) and control group(n=124) according to whether Pseudomonas aerugi-nosa infection existed .Their age ,gender ,body mass index (BMI) and complications were recorded ,and their hemoglobin ,fasting plasma glucose (FPG ) ,two hours postprandial blood glucose (2hPBG ) ,glycosylated hemoglobin A1c (GHbA1c) ,cholesterol , triglycerides ,low density lipid(LDL) ,high density lipid(HDL) ,serum albumin(SALB) were detected .Logistic regression analysis was employed to analyze the risk factors of Pseudomonas aeruginosa infection .Results Incidence of Pseudomonas aeruginosa infec-tion in diabetic foot was 8 .8% .Among them ,the infection incidences of elderly patients and patients with diabetic nephropathy were 11 .6% and 12 .7% ,respectively .Univariate analysis showed that male ,advanced age ,BMI ,duration of diabetes ,history of heart disease ,diabetic nephropathy ,FPG ,2hPBG ,GHbA1c ,low hemoglobin and low SALB were associated risk factors of Pseudomonas aeruginosa infection(P<0 .05) .After correction of confounding factors such as male ,BMI ,history of heart disease ,2hPBG and low hemoglobin ,advanced age ,duration of diabetes ,diabetic nephropathy ,GHbA1c and low SALB were independent risk factors for Pseudomonas aeruginosa infection(P<0 .05) .Conclusion Advanced age ,duration of diabetes ,diabetic nephropathy ,GHbA1c and low SALB are independent risk factors for Pseudomonas aeruginosa infection .

Objective To study the relationship between cardiovascular diseases (CVD) and ischemia modified albumin (IMA) in patients with type 2 diabetes mellitus (T2DM).Methods Ninety-six patients with T2DM were selected as T2DM group retrospectively,and 60 cases of healthy physical examination were selected as control group,the patient' s medical history data were collected,the IMA was detected and Doppler ultrasound examination was performed.The relationship between serum IMA level and some laboratory parameters were analyzed.Results Twenty-eight cases (29.2％,28/96) occurred CVD among 96 cases of T2DM patients.The level of IMA in T2DM group was higher than that in control group [(58.25 ± 11.84) kU/L vs.(23.38 ± 6.41) kU/L],there was significant difference (P ＜ 0.05).The levels of IMA in T2DM combined with CVD group (28 cases) and T2DM not combined with CVD group (68 cases) were(91.46 ± 13.63),(47.91 ± 9.38) kU/L; the level of IMA in T2DM combined with CVD group was higher than that in T2DM not combined with CVD group and control group,there was significant difference (P ＜ 0.05).All patients completed echocardiography,Spearman correlation analysis between IMA and echocardiography indicators showed that the level of IMA was positively correlated with left ventricular end-diastolic diameter (r =0.546,P =0.031),interventricular septal thickness (r =0.427,P =0.039),posterior wall diameter of left ventricle at end-diastolic (r =0.582,P =0.026) and left venifieular mass index (r =0.339,P =0.042),and IMA was negatively correlated with ejection fraction of left ventricle (r =-0.561,P =0.024).Multivariable Logistic regression analysis showed that IMA,high-sensitivity C reactive protein,diabetes duration,fasting blood glucose levels were independent risk factors for CVD.Conclusions Serum IMA level is significantly higher in T2DM patients.IMA level is a related risk factor for CVD.

Objective To investigate the correlation between homocysteine(Hcy) and atheroscIerosis (AS) in type 2 diabetic patients.Methods A total of 98 type 2 diabetic patients in Donghua Hospital Affiliated to Sun Yet-Sen University were enrolled in this study and served as diabetic group.Meanwhile diabetic patients were divided into aged group(aged ＞65 years old) and young and middle aged group(＜65 years old).Fortynine healthy volunteers were used as control group.Intima-media thickness(IMT) and atherosclerotic plaqlles of the extracranial common carotid artery were detected by high-resolution B-mode ultrasoograph.Fasting plasma glucose (FPG),postprandial 2 h glucose (2 hPG),glycosylated hemoglobin (HbA1 c),total cholesterol (TC),total triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),creactive protein(CRP) and Hcy were measured.Correlation analysis of Hcy and IMT with other parameters was performed.Results Hcy level in patients with type 2 diabetes were (34.15 ± 10.25) μmol/L,significantly higher than those in healthy control group((8.46 ± 3.62) μmol/L,P =0.014).Hcy level in age group((40.63 ± 11.78) μmol/L) was significantly higher than that of young and middle aged group((26.54 ±9.38) μmol/L,P =0.028).IMT value and plaque detection rate in elderly patients were (1.28 ±0.26) mm and 66.1％ (20/41),significantly higher than that in the young and middle aged group((1.02 ±0.20) mm and 38.9％,P =0.041,0.027).Multiple stepwise regression analysis showed that age (OR =1.46,95％ CI:1.18-6.36,P =0.029),duration of diabetes (OR =2.62,95％ CI:1.78-7.43,P ＜ 0.001),LDL-C (OR =1.54,95％CI 1.19-6.27,P =0.028),CRP(OR =1.38,95％ CI 1.11-4.84,P =0.032),Hcy(OR =2.45,95％ CI 1.34-6.61,P =0.018)) were independent risk factors for carotid AS.Conclusion The Hcy level significantly increase in type 2 diabetic patients.Hcy,age,duration of diabetes,LDL-C,CRP are independently risk factors of neck AS.

[Objective] To compare the disinfection effect of different disinfectants on disinfection effect of laryngeal endoscope,and seek for a more safe and effective disinfectant for laryngeal endoscope.[Methods] 180 laryngeal endoscope were divided into three groups with 60 of them in each group.Acidic electrolyzed oxidizing water(AEOW),2％ glutaraldehyde and orthophthalaldehyde were used for disinfection.Three minutes and five minutes after disinfection,the samples were got and underwent bacterial detection.The disinfection effect after three minutes and five minutes was compared.[Results] The qualified rate of disinfection and cost between AEOW,2％ glutaraldehyde and orthophthalaldehyde showed distinct difference.[Conclusions] Using acidic electrolyzed oxidizing water in the disinfection of laryngeal endoscope has advantages of fast,effective,low-cost,which can be applied in the clinical work.

PD-1/PD-L1 signaling pathway as a T cell immune response co-stimulatory signaling pathway plays an important role in adaptive immunity. PD-1 is a major co-receptor expressing on T cells, binding with its ligands(PD-L1 and PD-L2), PD-1 can inhibit T cell activation and protect the body against the attacks from its own immune system. In addition to adjusting and maintaining autoimmune tolerance, in tumor cells PD-L1 expression is up-regulated, while in the virus-infected T cells PD-L1 expression is also upregulated. PD-1 / PD-L1 are involved in the tumor and infectious pathogen immune evasion, thus blocking the PD-1 / PD-L1 signaling pathway has become a hot research of cancer and chronic diseases. Currently, there are several anti-PD-1 or PD-L1 monoclonal antibodies approved by the FDA to enter clinical studies, which have shown significant anti-cancer effect.

Objective To characterize the molecular characteristics of hemagglutinin (HA) and neuraminidase (NA) of influenza B viruses isolated in Jiangsu province,2011.Methods Thirteen strains of influenza B virus in different areas and epidemic period in Jiangsu province,2011 were selected for whole-genome sequencing,and analysis of molecule epidemic characteristics for HA and NA was carried out by bioinformatics method.Results Of the 13 randomly selected influeuza B strains,10 strains were assorted to Victoria lineage strains with NA genes from Yamagata lineage,and 3 strains belong to Yamagata lineage.Compared nucleotide and amino acid sequences of HA and NA genes with their vaccine strains respectiuely,196/197 glycosylation site appeared on HA1 gene in Yamagata/Victoria isolates virus.Conclusion Both B/Victoria and B/Yamagata lineage viruses co-circulated in Jiangsu province,and reassortant virus of Victoria lineage were predominant virus.

Objective Studies of the positioning,framework and weight of the performance of directors of third-grade public hospitals will pave the way for launching a study of the performance of these directors,and for the performance appraisal of the directors of third grade public hospitals.Methods The following methods are called into play:Meta-analysis of literature to summarize the research outcomes of the appraisal thinking and modeling for managers of public hospitals;the balance score card to design the theoretical base of public hospital performance framework;the Delphi Method to identify the functionality expected of public hospitals,and the thinking and framework for performance appraisal;in addition to experts consultancy to demonstrate via questionnaires.Results Positioning of directors performance appraisal of third-grade public hospitals comprises both desirable social effect outcomes and desirable operating status.This performance appraisal consists of such five dimensions as social satisfaction,effective management,asset operation,development sustainability,and employee recognition,totaling 12 performance objectives.Conclusion Scientific and reasonable design of the framework and weight of the perfofinance appraisal for managers of public hospitals is conducive to assuring the public interest nature for public hospitals.

Objective:To translate and revise the Workplace Breastfeeding Support Scale (WBSS) , and test its reliability and validity.Methods:Brislin translation mode was used to translate and back translate WBSS. The scale items were revised and improved through cultural debugging and pre-tests. From June to September 2020, convenience sampling was used to select 320 mothers of children from the Department of Children Health of Tongren Maternal and Child Health Hospital as the research object. The Chinese version of WBSS was used to investigate the breastfeeding support of the mothers of the children in the workplace. The critical ratio method and the correlation coefficient method were used to analyze the items of the scale, and the content validity index ( CVI) and exploratory factor analysis were used to evaluate the validity of the scale. The Cronbach's α coefficient, split-half reliability coefficient and test-retest reliability coefficient were used to evaluate the reliability of the scale. Results:The item-level CVI of the Chinese version of WBSS was from 0.833 to 1.000, and the average scale-level CVI of the scale was 0.958. The exploratory factor analysis extracted three common factors, and the cumulative variance contribution rate was 57.973%. The Cronbach's α coefficient of the Chinese version of WBSS was 0.805, and the split-half reliability coefficient was 0.800, and the test-retest reliability coefficient was 0.948. The final Chinese version of WBSS included 12 items in three dimensions (colleague support, environmental support, facility support) . Conclusions:The Chinese version of WBSS has good reliability and validity, and can be used to assess the status of breastfeeding support in the workplace.

Objective:To evaluate the value of Treponema pallidum ( Tp)-specific antibody index in the diagnosis, staging, and typing of neurosyphilis (NS). Methods:Fifty patients diagnosed with NS at the West China Hospital of Sichuan University from March 2020 to December 2022 were recruited as the experimental group, and 50 non-NS syphilis patients were enrolled during the same period as the control group. Cerebrospinal fluid (CSF) and matched serum samples along with clinical data were collected. Clinical and Laboratory Standards Institute (CLSI) EP06-Ed2 file was used to analyze the linear range of electrochemiluminescence immunoassay for Tp-specific antibody detection, and the Tp antibody index was calculate for all subjects. The correlation of Tp antibody index, IgG index, IgG synthesis rate, and albumin quotient with other clinical indicators was evaluated by the coefficient of correlation, and the diagnostic efficacy of these indicators in NS was analyzed using the receiver operating characteristic (ROC) curve. Results:All the deviations from linearity of electrochemiluminescence immunoassay for detecting Tp antibodies in serum and CSF samples were within the allowable deviation from linearity. Compared with the non-NS group, the NS group showed a significant increase in the Tp antibody index ( P<0.05), with no significant differences observed among the groups of different subtypes, severity, or receiving treatment or not ( P>0.05). Tp antibody index, IgG index, and IgG synthesis rate were positively correlated with serum Tp antibody, CSF Tp antibody, trace protein, and nucleated cell count ( P<0.05). Taking 14.99 as the cut-off value for NS diagnosis, the diagnostic sensitivity of Tp antibody index was 74.0% (95%CI: 60.5%-84.1%), and the specificity was 94.0% (95%CI: 83.8%-98.4%), with the area under the ROC curve of 0.897, which was larger than that of albumin quotient, IgG index, and IgG synthesis rate. Conclusions:This study finds a significant increase in the Tp antibody index in NS patients with good diagnostic sensitivity and specificity, providing reference for the diagnosis of NS.