Objective:To analyze the protective effect of a respiratory syncytial virus (RSV) vaccine based on bacterial outer membrane vesicle (OMV) in mice.Methods:The pre-fusion protein (preF) of RSV was linked to the surface of OMV through the transmembrane protein cytolysin A (ClyA) to form the nanovaccine OMV-preF. The morphological characteristics of OMV and OMV-preF were observed under a transmission electron microscope. OMV-preF was intramuscularly injected into BALB/c mice and the elicited humoral and cellular immune responses were evaluated. The protective effect of OMV-preF was assessed by challenging the immunized mice with RSV Long strain. One-way analysis of variance and Tukey test were used for statistical analysis.Results:The results showed that preF was stably expressed in OMV, and both OMV-preF and OMV exhibited a double-layer vesicle structures under the microscope. OMV-preF could significantly activate the cellular and humoral immune responses in mice, causing a significant increase in CD8 + T cells and CD19 + B cells as well as a significant increase in the serum level of specific IgG. The neutralizing antibodies produced in the immunized mice could significantly inhibit the replication of RSV Long strain in vivo. Conclusions:The nanovaccine OMV-preF can induce high-level humoral and cellular immune responses, and the antibodies produced following immunization can effectively inhibit viral replication. This study provides a new strategy for RSV subunit vaccines.

Objective:To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and 24-h urinary calcium excretion (24-h UCaE) and hypercalciuria in Chinese adults.Methods:This cross-sectional study was conducted from March 2022 to March 2023 in nine cities in China and included 1 239 residents. Demographic characteristics were collected through questionnaires and physical examinations, fasting blood samples were assessed for bone metabolism indicators, and 24-h urine samples were used to determine the 24-h UCaE. Multiple linear regression analysis was used to explore the relationship between serum 25(OH)D and 24-h UCaE and bone metabolism indexes. The relationship between serum 25(OH)D and hypercalciuria was analyzed using a multiple logistic regression model combined with restricted cubic spline modeling.Results:The mean participant age was (47.9±18.1) years, of which 453 (36.6%) were male. The percentages of vitamin D sufficiency, insufficiency, and deficiency were 7.6% (94/1 239), 29.0% (359/1 239), and 63.4% (786/1 239), respectively. The multiple linear regression model showed that after adjusting for the covariates the 24-h UCaE gradually increased with higher levels of 25(OH)D ( P overall <0.001, P nonlinear <0.001). The logistic regression analysis revealed that compared with the vitamin D deficient group, the OR for the prevalence of hypercalciuria in the vitamin D sufficient and vitamin D insufficient groups were 3.290 (95% CI 1.745 to 6.202) and 3.742 (95% CI 2.458 to 5.697), respectively. The results of the restricted cubic spline modeling showed a positive nonlinear relationship between 25(OH)D and the prevalence of hypercalciuria ( P overall <0.001, P nonlinear <0.001). The prevalence of hypercalciuria increased when 25(OH)D was >17.00 μg/L and peaked at 26.71 μg/L, after which there was a decreasing trend in the prevalence of hypercalciuria with increasing 25(OH)D. Conclusion:Associations between serum 25(OH)D levels and urinary calcium excretion and the prevalence of hypercalciuria were observed in the Chinese adult population.

Objective:To analyze the protective effect of a respiratory syncytial virus (RSV) vaccine based on bacterial outer membrane vesicle (OMV) in mice.Methods:The pre-fusion protein (preF) of RSV was linked to the surface of OMV through the transmembrane protein cytolysin A (ClyA) to form the nanovaccine OMV-preF. The morphological characteristics of OMV and OMV-preF were observed under a transmission electron microscope. OMV-preF was intramuscularly injected into BALB/c mice and the elicited humoral and cellular immune responses were evaluated. The protective effect of OMV-preF was assessed by challenging the immunized mice with RSV Long strain. One-way analysis of variance and Tukey test were used for statistical analysis.Results:The results showed that preF was stably expressed in OMV, and both OMV-preF and OMV exhibited a double-layer vesicle structures under the microscope. OMV-preF could significantly activate the cellular and humoral immune responses in mice, causing a significant increase in CD8 + T cells and CD19 + B cells as well as a significant increase in the serum level of specific IgG. The neutralizing antibodies produced in the immunized mice could significantly inhibit the replication of RSV Long strain in vivo. Conclusions:The nanovaccine OMV-preF can induce high-level humoral and cellular immune responses, and the antibodies produced following immunization can effectively inhibit viral replication. This study provides a new strategy for RSV subunit vaccines.

Objective:To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and 24-h urinary calcium excretion (24-h UCaE) and hypercalciuria in Chinese adults.Methods:This cross-sectional study was conducted from March 2022 to March 2023 in nine cities in China and included 1 239 residents. Demographic characteristics were collected through questionnaires and physical examinations, fasting blood samples were assessed for bone metabolism indicators, and 24-h urine samples were used to determine the 24-h UCaE. Multiple linear regression analysis was used to explore the relationship between serum 25(OH)D and 24-h UCaE and bone metabolism indexes. The relationship between serum 25(OH)D and hypercalciuria was analyzed using a multiple logistic regression model combined with restricted cubic spline modeling.Results:The mean participant age was (47.9±18.1) years, of which 453 (36.6%) were male. The percentages of vitamin D sufficiency, insufficiency, and deficiency were 7.6% (94/1 239), 29.0% (359/1 239), and 63.4% (786/1 239), respectively. The multiple linear regression model showed that after adjusting for the covariates the 24-h UCaE gradually increased with higher levels of 25(OH)D ( P overall <0.001, P nonlinear <0.001). The logistic regression analysis revealed that compared with the vitamin D deficient group, the OR for the prevalence of hypercalciuria in the vitamin D sufficient and vitamin D insufficient groups were 3.290 (95% CI 1.745 to 6.202) and 3.742 (95% CI 2.458 to 5.697), respectively. The results of the restricted cubic spline modeling showed a positive nonlinear relationship between 25(OH)D and the prevalence of hypercalciuria ( P overall <0.001, P nonlinear <0.001). The prevalence of hypercalciuria increased when 25(OH)D was >17.00 μg/L and peaked at 26.71 μg/L, after which there was a decreasing trend in the prevalence of hypercalciuria with increasing 25(OH)D. Conclusion:Associations between serum 25(OH)D levels and urinary calcium excretion and the prevalence of hypercalciuria were observed in the Chinese adult population.

Background The monitoring of external radiation individual doses for radiation workers is a statutory task and serves as an important basis for the diagnosis of occupational diseases in this occupational group. Ensuring the accuracy and reliability of monitoring data is crucial for safeguarding the health of radiation workers. Objective To evaluate and compare the capabilities and levels of external radiation individual dose monitoring conducted by radiation hygiene service institutions in Shanghai, to standardize relevant workflows, and to improve the accuracy and reliability of the monitoring service. Methods From 2021 to 2023, annual intercomparisons of external radiation individual dose monitoring capabilities were organized for radiation hygiene service institutions in Shanghai. The study subjects were 19 to 21 radiation hygiene service institutions registered in Shanghai for each year and they all participated in the intercomparisons. The monitoring subjects included 16 district-level centers for disease control and prevention (CDCs) and 13 third-party testing agencies. Monitoring capabilities were analyzed based on single-group performance, comprehensive performance, and Q-value. In the intercomparison, a thermoluminescent dosimetry system was used to perform irradiation tests on thermoluminescence dosimeter [made of lithium fluoride (magnesium, copper, phosphorus), LiF (Mg, Cu, P)], and monitoring data for X-rays and γ-rays at different doses and radiation conditions were analyzed following a standard procedure specified by GBZ 207−2016. Statistical methods included t-test and Kolmogorov-Smirnov test, with statistical significance set at P<0.05. Results From 2021 to 2023, the number of participating institutions was 19, 21, and 19, respectively, with an overall pass rate of 94.9% (56/59). Two institutions failed in 2022 and one in 2023. The number of institutions meeting the excellent standard in single-group and comprehensive performance was 9, 12, and 13, respectively, and the number of institutions ultimately rated as excellent was 3, 7, and 8,respectively, with an overall excellence rate of 30.5% (18/59) and an excellence conversion rate of 52.9%. The pass rates for single-group and comprehensive performance were both 98.3%. The number of groups with negative deviation was 1.86 times that of groups with positive deviation for X-rays, and 1.10 times for γ-rays. For X-rays, there was a statistically significant deviation between doses of less than 1.0 mSv and more than 1.0 mSv (P=0.01), while there was no significant difference in the single-group performance deviation between X-rays and γ-rays at the same dose. There was a statistically significant difference between the reported and reference values for X-rays in 2021 and 2022 (P<0.05), but no significant difference in 2023 (P>0.05); there was no significant difference between the reported and reference values for γ-rays over the three years (P>0.05). Conclusion Over the past three years, the external radiation individual dose monitoring capability intercomparison results of radiation hygiene service institutions in Shanghai have shown that the pass rate remains at a high level, with the excellence rate increasing year by year. However, some institutions still need to improve their monitoring capabilities, and further cooperation among institutions and training for technical staff are needed to enhance the capabilities and standardization of external radiation individual dose monitoring in Shanghai.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Background Individual monitoring of occupational external exposure is an essential part of the occupational health management of radiation workers, and is an important basis for the evaluation of individual absorbed dose and the diagnosis of occupational radiation diseases. Continuous participation of monitoring service providers in intercomparison is a fundamental quality assurance for routine monitoring, which can identify problems and improve them in time. Objective Taking the Laboratory of Radiation Protection in Shanghai Institute of Preventive Medicine as an example, to evaluate the performance of an individual occupational external dose monitoring system in the laboratory, identify influencing factors of the monitoring results, and provide a basis for improving the quality of daily monitoring by analyzing the process and results of a national intercomparison of individual dose monitoring. Methods According to the Testing criteria of personnel dosimetry performance for external exposure (GBZ 207-2016), and the relevant requirements of Class II (photon) inspection, a total of 20 groups of blind sample dosimeters were measured for four consecutive years from 2018 to 2021. The radiation energy source of each group was identified, and related personal dose equivalent H_p(10), the uncertainty of measurement results, and the deviation between the reported value and the reference value were calculated. The national intercomparison process and results of individual dose monitoring were also analyzed. Results The energy sources of the blind samples in the tested laboratory for four years were N100 or Cs-137. The reported dose values of the blind samples were 0.57-4.61 mSv, the combined uncertainties were 0.043-0.365 mSv, the expanded uncertainties (k=2) were 0.09-0.73 mSv, and the relative expanded uncertainties (k=2) were 13.8%-16.4%. The single-group performance ∣P_i∣ of 20 sets of blind samples in the four years was ≤0.10, the yearly comprehensive performance of 5 sets of blind samples was ≤0.10, and the yearly Q score of the test report was >15 points. The laboratory achieved excellent results in the national intercomparison of individual dose monitoring in four consecutive years, except the Q value not reaching full score. Conclusion The laboratory exhibits standardized data processing of individual dose monitoring, generates accurate and reliable results, and meets the requirements of relevant national standards; but it should continue to participate in the national intercomparison of individual dose monitoring, strengthen the angular response research of energy identified dosimeter, improve the monitoring ability of low-dose X-rays, analyze the key points of reducing the uncertainty of measurement results, and continuously improve the monitoring ability.

Objective:To explore the efficacy of balloon dilation percutaneous kyphoplasty (PKP) combined with prying reduction bone grafting in the treatment of thoracolumbar fractures, and its impact on patients′neurological function.Methods:The clinical data of 184 patients with thoracolumbar fractures from March 2017 to May 2020 in Cangzhou Integrated Traditional Chinese and Western Medicine Hospital of Hebei Province were retrospectively analyzed. Among them, 86 patients were treated with balloon dilation PKP combined with prying reduction and bone grafting (combined group), and 98 patients were treated with open reduction decompression and internal fixation (internal fixation group). The intraoperative bleeding volume, surgical time, intraoperative fluoroscopy frequency, efficacy and complications were recorded. One year after surgery, X-ray films were taken to measure the height of the anterior border and posterior border of vertebral body and the Cobb angle, and the pain visual analogue score (VAS), Barthel index and neurological Frankel grade were evaluated.Results:The intraoperative bleeding volume and surgical time in combined group were significantly higher than those in internal fixation group: (205.64 ± 45.63) ml vs. (180.37 ± 30.08) ml and (110.22 ± 28.91) min vs. (81.66 ± 20.77) min, and there were statistical differences ( P<0.01); there was no statistical difference in intraoperative fluoroscopy frequency between the two groups ( P>0.05). The total effective rate in combined group was significantly higher than that in internal fixation group: 91.86% (79/86) vs. 79.59% (78/98), the total incidence of complications was significantly lower than that in internal fixation group: 13.95% (12/86) vs. 38.78% (38/98), and there were statistical differences ( P<0.05 or <0.01). The height of the anterior border and posterior border of vertebral body 1 year after surgery in combined group were significantly higher than those in internal fixation group: (95.78 ± 1.59) mm vs. (62.74 ± 1.80) mm and (98.53 ± 3.80) mm vs. (95.06 ± 3.28) mm, the Cobb angle was significantly smaller than that in internal fixation group: (6.53 ± 2.80)° vs. (18.06 ± 2.68)°, and there were statistical differences ( P<0.01). The VAS and Barthel index 1 year after surgery in both groups improved significantly, and there were statistical differences ( P<0.01), but there were no statistical differences between the two groups ( P>0.05). The rate of neurological Frankel grade E 1 year after surgery in combined group was significantly higher than that in internal fixation group: 56.98% (49/86) vs. 23.47% (23/98), and there was statistical difference ( P<0.01). Conclusions:Compared with open reduction decompression and internal fixation, the balloon dilation PKP combined with prying reduction and bone grafting patients with thoracolumbar fractures is better for vertebral reduction and deformity repair, with higher safety, more significant pain relief, and better recovery of daily life and neurological function.

Objective:To isolate and culture WU polyomavirus (WUPyV), and to analyze the genome-wide evolutionary patterns, homology and population dynamics.Methods:Real-time quantitative PCR was used to detect the nasopharyngeal aspirate samples of hospitalized children with respiratory tract infection in Beijing Friendship Hospital during 2020 to 2022. Primary human airway epithelial cells cultured at the air-liquid interface were used to isolate and culture WUPyV. Whole genome sequence of the isolated strain was obtained by Sanger sequencing. For phylogenetic and evolutionary dynamics analysis, the whole genome was compared with the published whole genome sequences in GenBank database.Results:The detection rate of WUPyV was 4.7% (31/659) during 2020 to 2022, and a clinical strain BJ0593 of WUPyV type Ⅲc was successfully isolated. The homology of the whole genome and gene fragments of WUPyV was high. The average evolutionary rate of VP2 gene was about 1.256×10 -4 substitution/site every year, and the population dynamics of WUPyV tended to be flat in the last decade. Conclusions:This study successfully isolated a clinical WUPyV type Ⅲ strain for the first time, which provided the basis for further investigation on the molecular evolution and pathogenicity of WUPyV.