Objective: To evaluate the immunogenicity and safety of co-administration with bivalent human papillomavirus (HPV) vaccine and hepatitis E virus (HEV) vaccine, so as to provide reference for optimizing the vaccination schedule. Methods: Females aged 18 to 25 years were recruited from September to October 2021 in Hengdian College of Film & Television in Zhejiang Province and randomly divided into the HPV+HEV group, the HPV group, and the HEV group. The vaccination procedures were one dose each at 0, 1, and 6 months. Immunogenicity was evaluated by detecting the geometric mean titers (GMT) of HPV16 IgG, HPV18 IgG, and/or HEV IgG antibodies before the first vaccination and one month after the full course of immunization, and comparing the difference in seroconversion, and the GMT ratio. The non-inferiority margin was set at a seroconversion difference of ≤5%, and the lower limit of the 95%CI of the GMT ratio was >0.5. Safety was evaluated by collecting conjunctive local reactions/events and systemic reactions/events within 7 days after each dose, non-conjunctive adverse events within 30 days after each dose, and serious adverse events throughout the observation period (0 to 7 months). Results: A total of 240 females were included, among whom 236 completed the full vaccination program, including 79 in the HPV+HEV group, 77 in the HPV group, and 80 in the HEV group. One month after the full course of immunization, the seroconversion rates of HPV16 IgG and HPV18 IgG antibodies in both the HPV+HEV group and the HPV group were 100%, and the differences in seroconversion rates were 0 (95%CI: -3.39%-+∞). The seroconversion rates of HEV IgG antibodies in both the HPV+HEV group and the HEV group were 100%, and the difference in seroconversion rates was 0 (95%CI: -3.27%-+∞). The GMT of HPV16 IgG and HPV18 IgG antibodies in the HPV+HEV group was 393.88 and 284.86 IU/mL respectively, which was not inferior to 489.39 and 341.24 IU/mL in the HPV group, and the GMT ratios were 0.80 (95%CI: 0.66-+∞) and 0.83 (95%CI: 0.68-+∞), respectively. The GMT of HEV IgG in the HPV+HEV group was 13.55 U/mL, which was not inferior to 12.72 U/mL in the HEV group, and the GMT ratio was 1.07 (95%CI: 0.92-+∞). The incidences of pain, pruritus, and induration in the HPV+HEV group were 54.43%, 21.52% and 40.51% respectively, which were significantly higher than 10.39%, 0, and 0 in the HPV group (all P<0.05). The incidences of redness/swelling, muscle pain/general weakness in the HPV+HEV group were 2.53% and 0, respectively, which were significantly lower than 12.50% and 16.25% in the HEV group (both P<0.05). Conclusion The co-administration of the bivalent HPV vaccine and HEV vaccine is not inferior to individual vaccination in terms of immunogenicity and safety, and the vaccination plan can be optimized through co-administration.

Objective:To compare the microbiology, clinical characteristics and therapeutic efficacy of native suppurative spondylitis (NVO) and postoperative suppurative spondylitis (PVO), and analyze the factors affecting the prognosis.Methods:All patients with suppurative spondylitis were retrospectively analyzed from December 2010 to December 2019. A total of 46 patients were enrolled in this study. They were divided into two groups. There were 30 cases in NVO group, 18 males and 12 females; The age was 50.47±20.45 years, aged 15-73 years. There were 16 cases in PVO group, 10 males and 6 females; The age was 52.13±18.80 years, aged 14-73 years. In group NVO, 23 cases (76.7%) were in lumbar vertebrae, 5 cases (16.7%) in thoracic vertebrae and 2 cases (6.7%) in cervical vertebrae; in group PVO, 11 cases (68.8%) in lumbar vertebrae and 5 cases (31.2%) in thoracic vertebrae. Twenty-eight patients had neurological dysfunction before surgery. There were 25 cases of grade D (16 cases in group NVO and 9 cases in group PVO) and 3 cases of grade C (1 case in group NVO and 2 cases in group PVO), following the instructions of American Spinal Injury Association (ASIA) neurological function classification. All patients were given bed rest, nutritional support and antibiotic therapy; surgical treatment for patients with poor outcomes or aggravated symptoms. The patients were followed up after operation, the observation indexes included leukocyte count, erythrocyte sedimentation rate and C -reactive protein to evaluate the postoperative curative effect. The internal fixation device was evaluated for looseness and fracture by imaging examination. At the same time, the changes of visual analogue scale, ASIA neurological function grade were recorded to evaluate the clinical efficacy.Results:Two patients in NVO group were treated with antibiotics, and all the other patients successfully completed the operation. The diseased tissues were sent for pathological examination during the operation. The results showed that they were diagnosed as suppurative spondylitis. All patients were followed up for 12-24 months. Both groups were treated with intravenous and oral antibiotics, and the time of antibiotic treatment in group PVO was longer than that in group NVO without significant difference ( t=1.74, P=0.088). The leukocyte, C-reactive protein, erythrocyte sedimentation rate, visual analogue scale (VAS), were significantly improved in both groups at different time points after operation ( P<0.05) . There was no significant difference in leukocyte, C -reactive protein, erythrocyte sedimentation rate or VAS score between the two groups at the same time point after operation ( P>0.05). The neurological function of patients after operation was significantly improved compared with that before operation. In group NVO, 16 cases recovered from ASIA grade D to grade E, 1 case from grade C to grade D; 9 cases in group PVO recovered from grade D to grade E and 2 cases recovered from grade C to grade D. Till the last follow-up, 3 patients in group NVO recurred, the recurrence rate was 10% (3/30); 7 patients in group PVO recurred, the recurrence rate was 43.8%; the recurrence rate of group PVO was higher than that of group NVO, the difference was statistically significant (χ 2=5.14, P=0.023). Among 39 patients with spinal internal fixation, 12.8% (1 NVO, 4 PVO) had recurrent infection after internal fixation. Therefore, re-operation was performed to remove the internal fixator for infection control, patients recovered after conservative treatment such as immobilization and systemic anti-infection By univariate analysis, multiple vertebral involvement and abscess formation ( OR=11.00, P=0.006; OR=9.00, P=0.047) were significantly associated with pyogenic spondylitis recurrence; there was a tendency for pyogenic spondylitis recurrence among microbial infection ( OR=1.87, P=0.416), spinal prosthesis ( OR=7.20, P=0.074) and allogenic bone ( OR=1.78, P=0.478), yet not obvious. Multivariate analysis indicated that multiple vertebral involvement ( OR=10.49, P=0.038) was a risk factor for pyogenic spondylitis recurrence. Conclusion:The treatment of PVO is more challenging than NVO, especially in the cases of spinal implant infection. Although the antibiotic treatment time of PVO is longer than that of NVO, the recurrence rate of PVO is higher. Longer antibiotic therapy and, if necessary, surgical debridement or removal of implants are important approaches to successful treatment of PVO.

Objective To construct safety culture evaluation system for intravenous treatment. Method On the basis of literature review and in-depth interview of two rounds using Delphi method , consensus was achieved to build an evaluation system for safety culture of intravenous treatment . Results The recovery rate from expert consultation questionnaires of two rounds was 90 . 00% and 94 . 40%, respectively . The expert′s authority coefficient was greater than 0 . 80 . The expert′s coordination coefficient was 0 . 308 , with significant difference statistically ( P < 0 . 05 ) . After two rounds of expert consultation , an evaluation index system for safety culture of intravenous treatment was formed , including five 5 primary indexes and 25 secondary indicators . The experts had consensus on the indexes . Conclusion The evaluation system can help us to understand the status quo of intravenous treatment′s safety culture so that we can make targeted improvement . It is of importance for guaranteeing the safety of patients with intravenous therapy .

Objective To investigate the incidence of sharp injury (SI)among health care workers(HCWs)in dif-ferent levels of hospitals in Gansu Province,so as to improve HCWs’precaution awareness,standardize behavior, and provide guide for making occupational precaution measures.Methods From January to December 2012,HCWs in 38 medical institutes in Gansu Province were selected with stratified random sampling,HCWs were surveyed through questionnaires and interview.Results A total of 11 358 questionnaires were received,the incidence of SI was 9.87%(n=1 121),case rate was 12.60%(n=1 431),the frequency of SI was 1.05 times/(person·month).SI rates of different genders,positions and years of working were statistically different (all P <0.05).The main medical devices cau-sing SI were syringe needle,venous transfusion scalp needle and surgical suture .SI caused by known sources were 1 099 times (76.80%);980 times (68.48%)of SI were induced by contaminated sources,474 (48.37%)of which were blood-borne diseases,bloodborne disease exposure accounted for 33.12%.Among bloodborne disease exposure,hepatitis B virus accounted for 74.25%,Treponema pallidun 13.10%,hepatitis C virus 12.01% ,and human immunodeficiency virus 0.64%.Conclusion There is a high incidence rate of SI among HCWs in Gansu Province,it is a very important public health problem which needs to be solved.

Objective To observe the effects of fluoride on testicular cell cycle and cell apoptosis of male rats.Methods Thirty-two healthy male Wistar rats,weighting 150-180 g,were randomly divided into 4 groups by body weight using random number table,normal sodium (control),the low-dose,medium-dose and high-dose groups(100,200,300 mg· kg-1· d-1 NaF,respectively) by intragastric administration for 90 days,and bodyweight was observed daily.After the last intragastric administration,all rats were killed by cervical dislocation.The testicular cell cycle and cell apoptosis were measured by flow cytometry.Results After 30 days exposure,the difference of body weight between groups was statistically significant(F =3.884,P ＜ 0.05).The body weights in low-and medium-dose groups[(235.00 ± 14.56),(235.44 ± 24.99)g] were significantly increased than that of high-dose group [(206.00 ± 18.16)g,all P ＜ 0.05].There was no significant difference of body weight between the groups at 0,60 and 90 days(F =0.501,0.578,1.893,all P ＞ 0.05).Compared with the control group[(43.10 ± 3.62)％],the percentages of G0/G1 stage cells were significantly increased in all the NaF-treated groups [(57.60 ± 7.26) ％,(52.80 ± 3.20) ％,(73.13 ± 4.08) ％] and the percentages of S stage cells were significantly decreased in all the NaF-treated groups [(10.58 ± 2.58)％,(9.35 ± 0.35)％,(9.55 ± 0.50)％] compared to the control group[(19.23 ± 0.61)％,all P ＜ 0.05].On the other hand,the percentage of G2/M stage cells decreased significantly in high-dose group[(17.18 ± 2.21)％] compared with the control group[(36.34 ± 5.05)％,P ＜ 0.05].The testicular cell apoptosis ratios in all the NaF-treated groups were higher than that in the control group,but only in medium-and high-dose groups[(71.03 ± 2.30)％,(71.90 ± 2.16)％],the difference was statistically significant compared with the control group [(60.80 ± 2.34)％,all P ＜ 0.05].Conclusion Chronic fluorosis can change testicular cell cycle and cell apoptosis and damage the reproductive system.