We expressed multi-epitope chimeric protein of CARDS toxin protein of Mycoplasma pneumonia (Mp) in prokaryotic cells,and purified and investigated its immunoreactivity.A recombinant multi-epitope chimeric gene including ten critical epitopes was connected by linker and cloned into prokaryotic expression vector pET-28a(+),and transformed into E.coli BL21(DE3) cells for expression under induction of IPTG.The antigenicity of expressed recombinant protein was identified with 6 × His monoclonal antibody and human positive serum by Western blot.The recombinant expression vector pET-CARDS was constructed and the about 30 kDa recombinant chimeric protein expressed in BL21(DE3) successfully.Western blot analysis showed that it can react respectively with 6 × His monoclonal antibodies and human positive serum.This study showed that the chimeric CARDS protein has an obvious immunoreactivity and a potential to be a new antigen for the diagnosis of Mp infection.

Objective:To assess the impact of caudal regional anesthesia on complications after hypospadias repair with tubularised incised plate urethroplasty (TIP).Methods:A total of 125 cases with hypospadias undergoing TIP surgery from June 2017 to June 2019 at Beijing Children′s Hospital, Capital Medical University, were reviewed, aged 12-75 months, American Society of Anesthesiologists Ⅰ orⅡ grade.Totally, 86 cases had distal and 39 cases suffered from proximal hypospadias.Caudal anesthetics were used in 42 cases (caudal anesthesia group) and general anesthetics were used in 83 cases (general anesthesia group). All cases were repaired by TIP procedure.The children with urethral fistula and urethral stricture were followed up for 6 months, and multivariate statistical analyses were performed.Results:There were 11 cases of urethral fistula after hypospadias surgery, with 8 cases (9.64%)in the general anesthesia group and 3 cases (7.14%) in the caudal anesthesia group.There were no significant differences between the 2 groups ( χ2=0.223, P=0.636), and 12 cases of urethral stricture, with 8 cases(9.64%) in the general anesthesia group and 4 cases(9.52%) in the caudal anesthesia group.There were no significant differences between the 2 groups ( χ2=0.001, P=0.984). Based on multivariable Logistic regression, urethral fistula was associated with proximal hypospadias ( OR=0.036, 95% CI: 0.003-0.511, P=0.014), and the width of glans( OR=0.469, 95% CI: 0.220-0.998, P=0.049). Urethral stricture was correlated with proximal hypospadias( OR=0.004, 95% CI: 0.000-0.146, P=0.002), the width of urethral plate( OR=0.004, 95% CI: 0.000-0.422, P=0.020), and the duration of catheter( OR=72.976, 95% CI: 1.802-2 594.790, P=0.023). Conclusion:Caudal regional anesthesia appears to have no impacts on urethral fistula and stricture after hypospadias repair.

Objective To study and analyze the correlation between hemorrhage in patients underwnet cardiac surgery under extracorporeal circulation and the application of tranexamic acid.Methods A total of 185 patients treated with cardiac surgery under extracorporeal circulation were selected and divided into observation group (tranexamic acid were employed in the surgery,n=81) and the control group (tranexamic acid were not employed in the surgery,n=104).The common blood indexes and the blood coagulation indexes levels of hematocrit (HCT),the platelet count (PLT),the prothrombin time (PT),the activated partial prothrombin time (APTT),the fibrinogen (FIB) of the patients before the surgery and at 24 h after the surgery were detected and compared.The extracorporeal circulation time,the aortic clamping time,the heparin application amount in surgery,the protamine application amount in surgery of the patients were recorded and compared.The bleeding amount,the transfusion amount of concentrated red blood cells,the transfusion amount of plasma,the transfusion amount of platelet before the surgery and at 24 h after the surgery as well as the reoccurrence of thoracic surgery due to bleeding of the patients in the two groups were observed and compared.The incidence of acute renal failure,renal failure,neurological complications,low cardiac output syndrome,twice intubation,pulmonary infection and the hospitalization mortality of the patients in the two groups were observed and compared.Results The HCT,PLT,FIB levels at 24 h after the surgery of the patients in the two groups were significantly lower than those before the surgery (P<0.05).The PLT level at 24 h after the surgery in the control group was significantly lower than that in the observation group (P<0.05).The bleeding amount,the transfusion amount of blood,the reoccurrence of thoracic surgery due to bleeding in the control group were significantly higher than those in the observation group (P<0.05).There were no significant differences of surgery related indexes between the two groups (P>0.05).There were no significant differences in incidence rates of postoperative complications and hospitalization mortality between the two groups (P>0.05).Conclusion The application of tranexamic acid in the cardiac surgery under extracorporeal circulation can effectively reduce the postoperative bleeding and blood transfusion volume,protect blood coagulation function.

Objective To study and analyze the correlation between hemorrhage in patients underwnet cardiac surgery under extracorporeal circulation and the application of tranexamic acid.Methods A total of 185 patients treated with cardiac surgery under extracorporeal circulation were selected and divided into observation group (tranexamic acid were employed in the surgery,n=81) and the control group (tranexamic acid were not employed in the surgery,n=104).The common blood indexes and the blood coagulation indexes levels of hematocrit (HCT),the platelet count (PLT),the prothrombin time (PT),the activated partial prothrombin time (APTT),the fibrinogen (FIB) of the patients before the surgery and at 24 h after the surgery were detected and compared.The extracorporeal circulation time,the aortic clamping time,the heparin application amount in surgery,the protamine application amount in surgery of the patients were recorded and compared.The bleeding amount,the transfusion amount of concentrated red blood cells,the transfusion amount of plasma,the transfusion amount of platelet before the surgery and at 24 h after the surgery as well as the reoccurrence of thoracic surgery due to bleeding of the patients in the two groups were observed and compared.The incidence of acute renal failure,renal failure,neurological complications,low cardiac output syndrome,twice intubation,pulmonary infection and the hospitalization mortality of the patients in the two groups were observed and compared.Results The HCT,PLT,FIB levels at 24 h after the surgery of the patients in the two groups were significantly lower than those before the surgery (P<0.05).The PLT level at 24 h after the surgery in the control group was significantly lower than that in the observation group (P<0.05).The bleeding amount,the transfusion amount of blood,the reoccurrence of thoracic surgery due to bleeding in the control group were significantly higher than those in the observation group (P<0.05).There were no significant differences of surgery related indexes between the two groups (P>0.05).There were no significant differences in incidence rates of postoperative complications and hospitalization mortality between the two groups (P>0.05).Conclusion The application of tranexamic acid in the cardiac surgery under extracorporeal circulation can effectively reduce the postoperative bleeding and blood transfusion volume,protect blood coagulation function.

We investigated serotype and resistance of Salmonella during pig slaughtering in Shandong Province,China,providing basic data for the risk assessment of Salmonella and for guiding the clinical medication.We used rapid classification kit to identify Salmonella serotype,adopted broth microdilution method to detect the resistance of 13 kinds drugs belong to 8 categories.Result showed that the identified 9 kinds of serotype were mainly S.derby and S.typhimurium.The resistance to 13 kinds drugs of 298 Salmonella were different.The higher percentage of tetracycline drugs as Doxycycline(DOX) and Tetracycline(TE) were 97.99％ and 80.20％,respectively,which was most sensitive to Colistine E.The resistant rate was only 2.01 ％,following by Amoxicillin/Clavulanic acid and Ofloxacin which were 2.35 ％ and 4.03％,and the multiple resistant rate was 81.88％.TE-DOX was the regnant drug-resistant spectrum.In conclusion,the predominant serotype of Salmonella in links of pig slaughtering in Shandong Province is S.derby,and resistance is different to the different drugs.The drug resistance of different slaughter links exist significant differences,multiple drug resistance is serious,and drug-resistant spectrum are varied.

Objective:To investigate the effects of remimazolam on hemodynamics during the induction of general anesthesia and postoperative cognitive function in patients undergoing cardiac valve replacement surgery.Methods:A randomized controlled study was conducted involving 80 patients who underwent heart valve replacement surgery at Yan'an University Affiliated Hospital from January 2020 to December 2023. The patients were randomly assigned to either a control group or an observation group, with 40 patients in each group. The control group received routine general anesthesia, while the observation group received additional remimazolam during the routine anesthesia process. Hemodynamic parameters were compared between the two groups at different time points: heart rate and mean arterial pressure were recorded before anesthesia induction (T1), at the beginning of anesthesia induction (T2), 5 minutes after anesthesia induction (T3), at the time of tracheal intubation (T4), and 5 minutes after tracheal intubation (T5). The level of anesthesia during induction was compared between the two groups. Cognitive function in both groups was evaluated before and immediately after surgery. Additionally, the incidence of anesthesia-related adverse events during the perioperative period was compared between the two groups.Results:At T4 and T5, the heart rates in the observation group were (79.23 ± 10.22) beats/min and (78.54 ± 9.94) beats/min, respectively, and the mean arterial pressures were (115.64 ± 21.04) mmHg (1 mmHg = 0.133 kPa) and (108.61 ± 17.99) mmHg. Both values were significantly lower than those in the control group [heart rate: (84.51 ± 10.35) beats/min, (84.31 ± 10.08) beats/min, mean arterial pressure: (130.06 ± 19.25) mmHg, (121.62 ± 18.61) mmHg, t = 2.30, 2.58, 3.20, 3.18, all P < 0.05]. The time taken for the EEG bi-frequency index to drop below 60 and the EEG bi-frequency index before tracheal intubation in the observation group were both significantly lower than those in the control group ( t = 3.03, 3.14, both P < 0.05). Immediately after surgery, the Mini-Mental State Examination (MMSE) score in the control group showed a significant decrease ( t = 6.43, P < 0.05), while the MMSE score in the observation group did not change significantly ( t = 0.60, P > 0.05). Moreover, the immediate postoperative MMSE score in the observation group [(26.98 ± 2.97) points] was significantly higher than that in the control group [(23.15 ± 2.78) points, t = -5.95, P < 0.05]. There was no statistically significant difference in the incidence of anesthesia-related adverse events between the two groups (χ2 = 0.66, P > 0.05). Conclusion:Remimazolam can maintain hemodynamic stability during the induction of anesthesia in patients undergoing cardiac valve replacement surgery, facilitate the rapid attainment of satisfactory sedation, and reduce immediate postoperative cognitive dysfunction. Furthermore, the use of remimazolam in conjunction with routine general anesthesia does not significantly increase anesthesia-related risks, demonstrating a high level of safety.

Objective:To analyze the relationship between renin-angiotensin-aldosterone system (RAAS) gene polymorphisms and susceptibility to essential hypertension (EH) in military secret service personnel.Methods:In October 2019, military secret service personnel (162 people) who were recuperating in a sanatorium from January to December 2017 were selected as the research subjects, all of whom were Han and male. The patients (79 people) who were diagnosed with EH according to the diagnostic criteria of hypertension in the "Chinese Guidelines for the Prevention and Treatment of Hypertension" (2016 Revised Edition) were the case group, and the people with normal blood pressure (83 people) were the control group. Occupational epidemiological investigation was conducted, 5 ml of fasting cubital venous blood was collected, genomic DNA was extracted by phenol-chloroform method, and RAAS gene polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism method. The distribution differences of genotype and allele frequency between groups were compared, and the relationship between genotype, allele frequency and EH was analyzed.Results:The average age of military secret service personnel was (38.2±5.3) years old, and there was no statistical significance in the average age and the age distribution over 40 years old of the case group and the control group ( P>0.05) . There were significant differences in the distribution of AGT gene M235T locus, ACE gene I/D polymorphism genotype and allele between the case group and the control group ( P<0.05) . The TT genotype with AGT gene M235T locus ( OR=3.28, 95% CI: 1.21-8.91) and DD genotype with ACE gene ( OR=2.86, 95% CI: 1.17-7.00) were risk factors for EH in military secret service personnel. Conclusion:The TT genotype of AGT gene M235T and the DD genotype of ACE gene may be the susceptibility genotypes of military secret service personnel for EH.

Objective To investigate the correlation between vitamin A,E,D and folic acid levels and concomitant preeclampsia(PE)in patients with gestational diabetes mellitus(GDM).Methods A total of 108 patients with GDM complicated with PE were used as the PE group,and another 108 GDM patients without PE were used as the GDM group.A total of 108 normal pregnant women with normal pregnancy test were used as the normal control group.The general information and vitamin A,E,D and folic acid levels were compared between the three groups.According to the severity of the disease,the PE group was subdivided into the mild-moderate PE group(62 cases)and the severe PE group(46 cases),and vitamin A,E,D and folic acid levels were compared between these two groups.Results Systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),fasting insulin(FINS)were increased in turn in the normal control group,the GDM group and the PE groups(P＜0.05),and vitamins A,E,D and folic acid levels were decreased in turn(P＜0.05).Triglyceride,total cholesterol and glycated haemoglobin were higher in the PE group than those in the GDM group and the normal control,and high density lipoprotein(HDL)cholesterol was lower than that in the GDM group and the normal control group(P＜0.05).Vitamin A,vitamin E,vitamin D and folic acid levels were lower in the severe PE group than those in the mild to moderate PE group(P＜0.05).Higher levels of vitamin A,vitamin E,vitamin D and folate were protective factors for GDM patients with severe PE.Folic acid showed higher predictive efficacy and specificity in single indicator analysis.Vitamin A showed high predictive specificity.The combined prediction of four indicators for severe PE in GDM patients was more effective than each individual indicator.Conclusion Serum vitamin A,E,D and folate levels are significantly lower in patients with GDM complicated with PE,and the combination of all four may improve the predictive value of severe PE complicated with GDM.

Objective:To analyze the relationship between renin-angiotensin-aldosterone system (RAAS) gene polymorphisms and susceptibility to essential hypertension (EH) in military secret service personnel.Methods:In October 2019, military secret service personnel (162 people) who were recuperating in a sanatorium from January to December 2017 were selected as the research subjects, all of whom were Han and male. The patients (79 people) who were diagnosed with EH according to the diagnostic criteria of hypertension in the "Chinese Guidelines for the Prevention and Treatment of Hypertension" (2016 Revised Edition) were the case group, and the people with normal blood pressure (83 people) were the control group. Occupational epidemiological investigation was conducted, 5 ml of fasting cubital venous blood was collected, genomic DNA was extracted by phenol-chloroform method, and RAAS gene polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism method. The distribution differences of genotype and allele frequency between groups were compared, and the relationship between genotype, allele frequency and EH was analyzed.Results:The average age of military secret service personnel was (38.2±5.3) years old, and there was no statistical significance in the average age and the age distribution over 40 years old of the case group and the control group ( P>0.05) . There were significant differences in the distribution of AGT gene M235T locus, ACE gene I/D polymorphism genotype and allele between the case group and the control group ( P<0.05) . The TT genotype with AGT gene M235T locus ( OR=3.28, 95% CI: 1.21-8.91) and DD genotype with ACE gene ( OR=2.86, 95% CI: 1.17-7.00) were risk factors for EH in military secret service personnel. Conclusion:The TT genotype of AGT gene M235T and the DD genotype of ACE gene may be the susceptibility genotypes of military secret service personnel for EH.

Objective:To analyze the level of self-management and its influencing factors in patients with systemic lupus erythematosus (SLE).Methods:A cross-sectional study. From January to December 2021, patients with SLE in the Department of Rheumatology and Immunology in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine were selected as the study objects by convenience sampling method. A total of 135 questionnaires were distributed in this study, 135 were recovered, and 128 were valid. The general data of the patients were collected, and the self-management level, self-efficacy, family care and meaning in life of the patients were evaluated with the chronic disease self-management behavior scale, general self-efficacy scale (GSES), family adaption partnership growth affection resolve index (APGAR) and the meaning in life questionnaire (MLQ). Multiple linear regression analysis was applied to explore the factors affecting the self-management of SLE patients.Results:The total score of chronic disease self-management behavior scale in the 128 SLE patients was (28.77±6.58) points. Pearson correlation analysis showed strong correlation between self-efficacy, sense of life meaning and self-management ( r=0.748, 0.717, both P<0.001), there was a moderate correlation between family care and self-management ( r=0.560, P<0.001). Multiple linear regression analysis showed that educational level ( β′=0.457), disease activity ( β′=-0.211), self-efficacy ( β′=-0.372), family care ( β′=-0.510), meaning in life ( β′=-0.386) were influencing factors of self-management level in patients with SLE (all P<0.05). Conclusions:The self-management level of SLE patients needs to be improved. Disease activity, self-efficacy, meaning in life and other factors can affect the patients′ self-management level.