Objective To analyze the prevalence and genetic characteristics of influenza A(H3N2) viruses in the city of Xiangyang in 2022-2023, and to provide a scientific basis for predicting the epidemic and mutation of influenza virus. Methods Throat swab specimens of the influenza like cases were collected from national influenza monitoring sentinel hospitals in Xiangyang every week. RNA was extracted from the specimens for influenza diagnosing using real-time RT-PCR．Viruses were isolated from H3N2 positive specimens, and HA and NA genes were amplified and sequenced．3D modeling analyses were conducted. Results The gene phylogenetic tree showed that the H3N2 isolates in 2022-2023 belonged to 3C.2a1b.2a1 and 3C.2a1b.2a2 branches, respectively. The A(H3N2) influenza virus strains all had amino acid point mutation sites on important antigenic determinants of HA protein. The epitope mutations of the 2022 A(H3N2) strain mainly occurred in regions B, C, and D. The epitope mutations of the A(H3N2) strain in 2023 mainly occurred in regions C and D. Different glycosylation sites of HA gene were found in 2022-2023 strains. No variation was found in key amino acid sites associated with neuraminidase inhibitor resistance. The difference of overall structure was not obvious in the three-dimensional simulation structure diagram. Conclusion The A(H3N2) influenza strains isolated in this study have shown antigenic drift, especially the mutation of HA, which may affect the protective effect of the vaccine on the local population and lead to influenza epidemic. The variations of HA and NA suggest that close attention should be paid to the epidemic and genetic variation of H3N2 subtype influenza virus, to provide a scientific basis for the selection of influenza virus vaccine strains and the prevention and control of influenza.

Objective:To explore the central venous catheter maintenance compliance among nurses in Class Ⅱ and Ⅲ hospitals in Hunan Province.Methods:From January to March 2022, 297 nurses from 22 Class Ⅱ and Ⅲ hospitals in Hunan Province were selected as the research subject by convenience sampling. Nurses were surveyed using the self-made Central Venous Catheter Maintenance Compliance Questionnaire. Multiple linear regression was used to analyze the influencing factors of nurse compliance with central venous catheter maintenance, the items of the Central Venous Catheter Maintenance Compliance Questionnaire were analyzed.Results:A total of 297 questionnaires were distributed, and 268 valid questionnaires were collected, with an effective response rate of 90.24%. The hospital level, specialized training in intravenous therapy, and age were the influencing factors on the compliance of nurses with central venous catheter maintenance. Analyzing specific items, only 34.3% (92/268) of nurses correctly executed the item "alcohol cotton pads were recommended", and only 66.4% (178/268) of nurses correctly performed the item "sterile gauze dressings should be replaced at least every two days".Conclusions:There is a certain gap in the central venous catheter maintenance compliance among nurses at all levels of hospitals, and there is a need to improve compliance in disinfection of infusion joints and replacement of sterile gauze dressings. We should strengthen the training of specialist nurses, especially the training of nurses in ClassⅡ hospitals on specialized skills related to intravenous therapy.

【Objective】 To investigate the confirmatory status of HIV-1 antibody detection and Western blot (WB) test among voluntary blood donors in Wuhu, and to explore the strategies and methods to further ensure blood quality and safety. 【Methods】 Blood samples were preliminarily screened by ELISA and NAT, and the reactive samples were sent to Wuhu CDC for further WB test of HIV-1 antibody. The confirmation results of HIV-1 antibodies of voluntary blood donors in Wuhu in the past 10 years were retrospectively collected. The characteristics of WB bands of positive samples were analyzed, and the demographic characteristics of HIV-infected voluntary blood donors were sorted out. 【Results】 A total of 354 864 blood samples from voluntary blood donors in Wuhu during January 2011 to May 2021 were investigated, among which 42 were confirmed HIV positive (HIV-1 antibody positive in 41, and solo HIV-RNA reactive in 1), with a total HIV positive rate of 11.8/100 000(42/354 864). Statistical differences were found in gender [males 97.6% (41/42) vs females 2.4% (1/42)], marital status [unmarried 17.3/100 000 vs married 8.0/100 000] and occupation [staff/workers 37.5/100 000 vs students11.4/100 000 vs others 7.7/100 000]. Among the positive samples, the yield rate of WB bands gp160 was 100% (41/41), both gp41 and p24 were 97.6% (40/41),, and p55 was the lowest 46.3% (19/41). P51 and P66 presented the highest yield consistency (Kappa=1.000, P<0.05). Four samples were solo HIV-RNA reactive, and one of them was>5 000 cps/mL by viral load (VL) testing, indicating HIV window period infection. 【Conclusion】 HIV infection statistically affected male donors more than females in Wuhu area, and most were early infection that revealed by WB band analysis. NAT plays an important role in the detection and confirmation of HIV infection during the window period, and is essential for blood safety.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Objective:To evaluate the application of computer-assisted design and three-dimensional printing technique in reconstruction of maxillary defects with individual free fibular flap.Methods:A total of 13 patients, 7 males and 6 females with age from 12 to 55 years old, underwent the reconstruction of maxillary defects after subtotal or total maxillectomy for benign or malignant tumors between January 2016 and December 2018 were reviewed. Ther were 4 cases of subtotal maxillectomy and 9 cases of total maxillectomy. Before operation, osteotomy line was planned on three-dimensional images. A three-dimensional individual resin fibula model based on mirror images of the healthy side maxilla was obtained to fabricate an anatomically adapted osteomyocutaneous fibula free flap using computer-assisted design and forming. Oral, nasal, and eye functions and facial appearance were evaluated.Results:The 13 cases were followed up for 5-40 months, all flaps were alive except one due to flap failure and all cases were tumor free confirmed by CT or MRI. Ten patients could eat normal food without nasal food return, and 3 cases had palatal fistula. Eleven cases showed good speaking functional results. All cases had normal eye positions, no cases with diplopia and loss of vision. With evaluation by VAS, an average score of 8 was obtained, and most of patients were satisfied with their postoperative facial appearances.Conclusion:Reconstruction of maxillary defects by free fibular flap designed by three-dimensional printing and computer-assisted technique not only restored oral, nasal and eye functions, but also showed satisfactory facial appearance.

Objective To observe the retinal reattachment of suprachoroidal injection with sodium hyaluronate in the treatment of rhegmatogenous retinal detachment (RRD).Methods Twelve eyes of 12 patients with RRD diagnosed by the examinations of B-mode ultrasound,binocular indirect ophthalmoscope,OCT and scanning laser ophthalmoscope in West China Hospital of Sichuan University from October 2018 to February 2019 were included in this study.There were 7 males and 5 females,aged from 15 to 66 years,with the mean age of 32.40± 14.81 years.There were 4 eyes with BCVA＜0.1,4 eyes with BCVA 0.1-0.4,4 eyes with BCVA＞0.4.The extent of retinal detachment involves 1 to 4 quadrants.All eyes were injected with sodium hyaluronate via suprachoroidal space under non-contact wide-angle system.Surgery was performed by the same ophthalmologist with extensive surgical experience.During the operation,the retinal hole was handled with scleral freezing and laser photocoagulation.The follow-up was 2 months.The retinal reattachment was observed.Results Of the 12 eyes,6 eyes (50.00％) were anatomically reattached,4 eyes (33.33％) ere partly anatomically reattached with subretinal fluid,2 eyes (16.67％) were not reattached.The holes in 4 eyes of partly anatomically reattached with subretinal fluid were located on the choroidal pad and the holes were closed,in addition,the subretinal fluid gradually absorbed over time.Two eyes failed in retinal reattachment received vitrectomy with silicone oil tamponade or sclera buckling surgery.No severe complications such as endophthalmitis and choroidal hemorrhage were found at follow-up visits.Conclusion Suprachoroidal injection of sodium hyaluronate is an effective and safe treatment for RRD,which can promote retinal reattachment.

Objective Microneedle fractional radiofrequency (MFR) is a novel method for reju-venation that combines radiofrequency and microneedles .The aim of this study was to evaluate pro-spectively the efficacy and safety of MFR in the treatment of facial photoaging .Methods Between De-cember 2017 and December 2018 ,a total of 24 female subjects with facial photoaging aged 45 to 60 (45 .9 ± 8 .7)years ,the course of 1 to 20 (8 .88 ± 5 .06) years ,were collected from the Department of Dermatology ,Pepole's Hospital of Xinjiang Uygur Autonomous Region .They received 3 treatments at 4-week intervals .Global scores for photoaging (GSP) were evaluated at baseline ,after 1 treatment and 3 treatments respectively .Facial wrinkles ,skin texture ,pigmentation ,telangiectasia ,and skin tightness were evaluated by the 4-point method after 1 treatment and 3 treatments respectively .Visual analogue scale (VAS) was used for self-assessment of pain during treatment .At the third treatment self assessment on the degree of satisfaction with therapeutic effects was conducted in subiects .The adverse reactions were evaluated at every treatment immediately and the third day and seventh day .Results The GSP score of 24 subjects before treatment was (2 .83 ± 0 .92) ,(2 .25 ± 0 .95) after 1 treatment ,and (1 .67 ± 0 .48) after 3 treatments .The difference between before and after 1 treatment was statistically significant (t = 2 .17 , P < 0 .05) ,and between before and after 3 treatments , the difference was statistically significant (t = 5 .52 , P < 0 .05) .There were statistically significant differ-ences in facial wrinkles ,skin texture and skin tightness improvement scores between the first treat-ment and the third treatment (t = 5 .48 ,3 .88 ,5 .46 , P < 0 .05) .There were statistically significant differences in pigmentation and telangiectasia scores between the first treatment and the third treat -ment (t = 2 .46 and 2 .17 ,P < 0 .05) .After the third treatment ,the VAS value was 3 .2 ± 1 .2 ,indica-ting mild to moderate pain .The total satisfactory rate of the 24 subjects was 83 .33％ .The subjects had no adverse reactions .Conclusions MFR can effectively improve the symptoms of facial photoaging without obvious adverse reactions .

Obstructive sleep apnea syndrome (OSAS) increases the risk of post-surgery complications. This study uses Berlin Questionnaire (BQ) to identify Chinese adult surgical patients who are at a high risk of OSAS and to determine if the BQ could be used to detect potential high risk of adverse respiratory events in the post anesthesia care unit (PACU). Results indicated that only 11.4% of the patients were considered at a high risk of OSAS. Age and body mass index are the key factors for the risk of OSAS prevalence in China and also gender specific. Furthermore, the incidence of adverse respiratory events in the PACU was higher in patients with high risk of OSAS than others (6.8% vs. 0.9%, P < 0.001). They also stayed longer than others in the PACU (95 ± 28 min vs. 62 ± 19 min, P < 0.001). Age, high risk for OSAS, and smoking were independent risk factors for the occurrence of adverse respiratory events in the PACU. The BQ may be adopted as a screening tool for anesthesiologists in China to identify patients who are at high risk of OSAS and determine the potential risk of developing postoperative respiratory complications in the PACU.
Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Anesthesia Recovery Period ; Berlin ; Body Mass Index ; China ; epidemiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Sex Distribution ; Sleep Apnea, Obstructive ; epidemiology ; Surgical Procedures, Operative ; adverse effects ; Surveys and Questionnaires ; Young Adult

The pathogenic and therapeutic effect of gut microbiome is a hot topic in recent years .Many researchers gradually focused on the relationship between the eating disorder and the gut microbiome .The gradual in-depth studies show that gut microbiome can intervene in the host′s metabolic state by multiple approaches to regulate appetite and bring new inspiration for the treatment of dis -eases.In this article, we review all important findings in this field and discuss the mechanism how gut microbiome effects appetite regu -lation.

Objective To detect different animal erythrocyte hemolysins titer,and compare the application of these hemolysins in immunological experimental teaching,for selecting the better method of preparing high titer hemolysin for experimental teaching of medical immunology.Methods A total of 40 experiment rabbits were divided into 4 groups in this study,and immunized by sheep red blood cell(SRBC) and porcine red blood cell(PRBC) through different immunization procedures to prepare the hemolysin,detect and compare these 4 groups hemolysins titer by the complement hemolysis test.Results Rabbit Anti-SRBC in the group A was 1∶4 800,rabbit Anti-PRBC in the group B was 1∶1 200,rabbit Anti-SRBC in the group C was 1∶1 000,rabbit Anti-PRBC in the group D was 1∶200.Conclusion The hemolysin titer of the rabbit Anti-PRBC was lower than that of the rabbit Anti-SRBC by the same immunization procedures,and the immunization procedure by intradermal multi-point and auricular vein injection is the better method of preparing high titer hemolysin,so PRBC could replace SRBC as antigen,and immunize the rabbits for preparing hemolysin,which could be used in experimental teaching of medical immunology.