Objective:To construct a scientific, systematic, and clinically applicable evaluation system of quality-sensitive indicators for nursing care of patients with tracheostomy and swallowing disorders following brain injury, providing a basis for evaluating nursing care quality in this patient population.Methods:By reviewing the literature and qualitative studies, a draft evaluation indicator was formed based on nursing issues related to patients with swallowing disorders during their hospital stay, employing the "structure-process-outcome" three-dimensional quality management model as the theoretical foundation. Between July and September 2023, two rounds of Delphi method expert consultations were conducted to add, delete, and modify indicators, and the analytic hierarchy process was used to determine indicator weights.Results:A total of 18 experts participated in two rounds of consultations, with a questionnaire return rate of 18/18. All 18 experts were female, with an average age of (47.61 ± 8.17) years. The expert authority coefficients were 0.895 and 0.910, while the Kendall concordance coefficients were 0.304 and 0.138 (all P<0.001). The average importance values assigned to each level of indicators ranged from 4.28 to 5.00. The final nursing evaluation indicators for patients with tracheostomy and swallowing disorders following brain injury included 4 first-level indicators, 21 second-level indicators, and 45 third-level indicators. Conclusions:By combining evidence-based research, current situation surveys, qualitative studies, and the Delphi method, a successful nursing quality evaluation indicator system was established for patients with tracheostomy and swallowing disorders following brain injury. These indicators are scientific, systematic, and clinically operable, playing an important role in improving the quality of nursing care for patients with tracheostomy and swallowing disorders following brain injury.

Objective:To construct a scientific, systematic, and clinically applicable evaluation system of quality-sensitive indicators for nursing care of patients with tracheostomy and swallowing disorders following brain injury, providing a basis for evaluating nursing care quality in this patient population.Methods:By reviewing the literature and qualitative studies, a draft evaluation indicator was formed based on nursing issues related to patients with swallowing disorders during their hospital stay, employing the "structure-process-outcome" three-dimensional quality management model as the theoretical foundation. Between July and September 2023, two rounds of Delphi method expert consultations were conducted to add, delete, and modify indicators, and the analytic hierarchy process was used to determine indicator weights.Results:A total of 18 experts participated in two rounds of consultations, with a questionnaire return rate of 18/18. All 18 experts were female, with an average age of (47.61 ± 8.17) years. The expert authority coefficients were 0.895 and 0.910, while the Kendall concordance coefficients were 0.304 and 0.138 (all P<0.001). The average importance values assigned to each level of indicators ranged from 4.28 to 5.00. The final nursing evaluation indicators for patients with tracheostomy and swallowing disorders following brain injury included 4 first-level indicators, 21 second-level indicators, and 45 third-level indicators. Conclusions:By combining evidence-based research, current situation surveys, qualitative studies, and the Delphi method, a successful nursing quality evaluation indicator system was established for patients with tracheostomy and swallowing disorders following brain injury. These indicators are scientific, systematic, and clinically operable, playing an important role in improving the quality of nursing care for patients with tracheostomy and swallowing disorders following brain injury.

ObjectiveThis research focused on examining the distinctive characteristics of nutrient intake and dietary patterns among long-lived elderly individuals. Additionally， the study was aimed to explore the specific dietary components that may impact the skeletal muscle mass in this particular group. MethodsThis study was conducted in the Chongming area of Shanghai， China. A total of 206 long-lived elderly individuals aged 90 or above were recruited. The 3-day 24-hour dietary recall method was used to collect dietary information and general demographic data through face-to-face interviews with professional nutritionists. The skeletal muscle mass index（SMI） was measured by bioelectrical impedance analysis（BIA）， and low skeletal muscle mass was diagnosed based on the 2019 Asian Working Group for Sarcopenia criteria. T-test analysis， chi-square test， and logistic regression were used to analyze the relationship between dietary nutrient intake and skeletal muscle mass. ResultsIn terms of food intake categories， compared with the long-lived elderly people with normal muscle mass， the intake of cereals containing miscellaneous beans and vegetables in the long-lived elderly people with low muscle mass was significantly lower（P<0.05）. In terms of the nutrient intake， compared with the long-lived elderly people with normal muscle mass， the intake of total energy， carbohydrate， dietary fiber， vitamin D， folic acid， phosphorus， potassium， magnesium， iron， and manganese in the long-lived elderly people with low muscle mass was significantly lower（P<0.05）. After continuous adjustment for the covariates， multivariate logistic regression analysis found that the intake levels of folic acid and dietary fiber were important factors influencing skeletal muscle mass， Individuals with lower intake levels of folic acid and dietary fiber are at a higher risk of low muscle mass in long-lived elderly individuals ［OR_{folic acid T1}， _{dietary fiber T1} （95%CI）： 2.90 （1.11‒7.61）； 4.09 （1.53‒10.91）］. ConclusionThe consumption of cereals that include a variety of beans and vegetables was noticeably lower in the long-lived elderly individuals with lower muscle mass when compared to those with normal muscle mass. Furthermore， low levels of folic acid and dietary fiber intake are associated with an increased risk of low skeletal muscle mass.

C1 gases including CO, CO₂ and CH₄, are mainly derived from terrestrial biological activities, industrial waste gas and gasification syngas. Particularly, CO₂ and CH₄ are two of the most important greenhouse gases contributing to climate change. Bioconversion of C1 gases is not only a promising solution to addressing the problem of waste gases emission, but also a novel route to produce fuels or chemicals. In the past few years, C1-gas-utilizing microorganisms have drawn much attention and a variety of gene-editing technologies have been applied to improve their product yields or to expand product portfolios. This article reviewed the biological characteristics, aerobic or anaerobic metabolic pathways as well as the metabolic products of methanotrophs, autotrophic acetogens, and carboxydotrophic bacteria. In addition, gene-editing technologies (e.g. gene interruption technology using homologous recombination, group Ⅱ intron ClosTron technology, CRISPR/Cas gene editing and phage recombinase-mediated efficient integration of large DNA fragments) and their application in these C1-gas-utilizing microorganisms were also summarized.
Gene Editing ; Gases ; Carbon Dioxide ; Genetic Engineering ; Cloning, Molecular

Objective: To explore the application of digital technology in the restoration of partial edentulous patients with microstomia. Methods: A patient with microstomia was presented and seeking for the restoration of her full edentulous in the upper jaw and partial edentulous in the lower jaw (Kennedy Ⅲ). A digital intraoral scanning was used to obtain digital impressions of soft and hard tissues in the oral cavity. Computer aided design and 3D printing technology were used to design and fabricate the metal framework. Results : The patient had no difficulty to wear or take off the dentures. The maxillary and mandibular dentures showed good retention, stability, mastication function and articulation. There was no tenderness in the one week and one month′s follow-up. And the chewing efficiency was satisfactory Conclusion This case report successfully designed and fabricated mandibular removable partial dentures for patients with microstomia through intraoral scanning and 3D printing technology. Thus, this work provides a new method and idea for treating partial edentulous dentition with microstomia

Objective:To monitor iodine nutrition of women during late pregnancy and examine the correlation between maternal urine iodine concentration and newborn physical development.Methods:Prospective cohort study was conducted in 151 pregnant women at 28-34 weeks' gestation who accepted nutrition follow-up between December 2014 and August 2015. Participants were surveyed twice at enrollment and hospitalization for delivery respectively by iodine related food frequency method and 24 h diet diary and dietary nutrition software was used to calculate diet iodine consumption amount. Spot urine samples were taken three times totally every two weeks and data of antenatal care was recorded and the participants were divided into groups during this period. The physical development indexes and neonatal thyroid stimulating hormone (TSH) levels were obtained.Results:Maternal median urinary iodine concentration was 100.0 μg/L. Using urinary iodine levels 150 μg/L and 249 μg/L as cut-off points, participants were divided into three subgroups as iodine-insufficient, iodine-adequate and iodine-over, with incidences of 76.8% ( n=116), 19.2% ( n=29), and 4.0% ( n=6), respectively. Subgroup analysis showed no significant differences between the iodine-insufficient group ( n=116) and the iodine-sufficient group ( n=35) in neonatal weight [(3 295±370) vs (3 395±450)g, P=0.183], neonatal length [50.0(48.0, 50.0) vs 50.0(49.0, 51.0)cm, P=0.171], neonatal head circumference [34.5 (34.0, 35.0) vs 34.5(34.0, 35.0)cm, P=0.691], or neonatal thyroid stimulating hormone levels [(4.0±1.9) vs (4.2±2.5)mIU/L, P=0.438]. Conclusions:According to World Health Organization criteria, iodine deficiency rate in women during late pregnancy reaches 76.8%. In this study there is no significant difference in newborn physical development indexes among various pregnancy iodine nutrition statuses.

Objective: To investigate the change of autophagy level of bone marrow nucleated red blood cell (RBC) in patients with myelodysplastic syndromes (MDS) . Methods: Fifty-four MDS patients and thirty-three controls were enrolled in this study. The mitophagy were observed by transmission electron microscopy (TEM) . The level of autophagy-associated protein LC3B in GlycoA⁺ nucleated RBC was measured by flow cytometry. The expressions of ULK1 and mTOR mRNA in GlycoA⁺ nucleated RBC were measured by real-time PCR. The expression of the mitochondrial outer membrane protein TOM20 in GlycoA⁺ nucleated RBC was detected by Western blot. Results: Autophagosomes or autolysosomes were scarcely observed by TEM in MDS patients. The expression of LC3B in GlycoA⁺ nucleated RBC in high-risk MDS patients (0.22±0.12) was significantly lower than that in normal controls (0.43±0.22, P<0.001) , and lower than that in low-risk MDS patients (0.40±0.16, P=0.001) . The expression of AMPK [0.26 (0.60) ] in GlycoA⁺ nucleated RBC in high-risk MDS patients was significantly lower than that in controls [1.00 (2.07) , P<0.017) . The expression of ULK1 mRNA in GlycoA⁺ nucleated RBC in high-risk MDS patients [0.27 (3.31) ] was significantly lower than that in controls [1.07 (4.41) , P<0.017]. The level of mTOR mRNA in GlycoA⁺ nucleated RBC in high-risk MDS patients [1.82 (3.74) ] was significantly higher than that in controls [1.26 (1.38) , P<0.017]. The level of LC3B in GlycoA⁺ nucleated RBC was negatively correlated with the HGB (r=0.529, P=0.009) in high-risk MDS patients. The expression of mitochondrial outer membrane protein TOM20 in high-risk MDS patients was 9.42±4.42. Conclusion Autophagy is impaired in nucleated RBC of MDS patients.

Objective: To explore characteristic and function of peripheral blood mononuclear cells (PBMNC) -induced macrophages in patients with myelodysplastic syndrome (MDS) to couple with its progression. Methods: A total of 24 MDS patients (11 low-risk patients and 13 high-risk group patients) referred to Department of Hematology of Tianjin Medical University General Hospital and normal controls were enrolled from September 2014 to December 2015. PBMNC was stimulated with GM-CSF to transform to macrophages. The morphology of macrophages was observed by microscope. The quantity of macrophages, CD206 and SIRPα on surface of macrophages were detected by flow cytometry. The phagocytic function of macrophages was analyzed by fluorescence microscopy and flow cytometry. Results: The morphology of macrophages from MDS patients was abnormal. The percentage of transformed macrophages was (5.17±3.47) % in patients with MDS, which was lower than that in controls significantly[ (66.18±13.43) %, t=3.529, P=0.001]. The expression of CD206 on macrophages from MDS patients was significantly lower than that of controls[ (9.73±2.59) % vs (51.15±10.82) %, t=4.551, P<0.001]. The SIRPα level of macrophages from MDS patients was significantly lower than that of controls [ (0.51±0.09) % vs (0.77±0.06) %, t=2.102, P=0.043]. The phagocytic index and the percentage of phagocytic of macrophages from MDS patients were significantly lower than those of macrophages from normal controls[0.45±0.08 vs 0.92±0.07, t=-6.253, P=0.008; (23.69±3.22) % vs (42.75±2.13) %, t=-6.982, P=0.006 respectively]by flow cytometry. The phagocytic index of MDS patients was significantly lower than that of controls (0.24±0.04 vs 0.48±0.96, t=3.464, P=0.001) by fluorescence microscopy. Conclusion The quantity, recognization receptors and phagocytosis of PBMNC-induced macrophages decreased in MDS patients.

Objective: To generate monkeypox virus specific monoclonal antibodies for further establishing monkeypox virus immunofluorescence assay. Methods: Monkeypox virus A29 protein, vaccinia ortholog A27 protein and cowpox ortholog 162 protein were expressed in E. coli BL21 to screen antibodies. Synthetic monkeypox virus A29_{17 ~ 49} polypeptide was used to immune BALB/c mice. Monkeypox virus monoclonal antibodies were generated through fusion, cloning and screening techniques. Indirect ELISA was performed to test antibodies specificity and subtype. Results: A29, A27 and 162 proteins were highly expressed in E. coli and detected by Western blot. The three his-tagged proteins were purified using His-Bind affinity chromatography column. The purity of the proteins was all more than 90%. And 8 strains monkeypox virus specific monoclonal antibodies were screened by the three purified proteins. Two mAbs of 8 were IgG3 subtype and the rest were IgG1 subtype. Conclusions Eight strains of monkeypox virus specific monoclonal antibodies were generated, they can be used to further establish monkeypox virus immune immunofluorescence assay.

Objective To investigate the association between activity energy expenditure ( AEE ) and body composition in school-age children.Methods A total of 62 students ( Grades 3 and 4, aged 8 -10 years) from a primary school in Shanghai were enrolled in this study .AEE was estimated with a metabolic cart (energy metabolism determination system ).Body composition (body mass, body mass index, fat percentage, fat mass, fat-free mass, fat mass index, fat-free mass index, obesity degree) was evaluated by bioelectrical im-pedance analysis .The above indicators were compared between obese and non-obese students .Results There were no statistically significant differences in exercise time , total AEE and relative AEE between obese and non-obese boys [ (9.70 ±1.91) min vs.(10.00 ±1.97) min, t=0.336, P=0.739; (198.74 ±53.33) kJ vs.(171.54 ±41.75) kJ, t =-1.422, P =0.165; (0.46 ±0.09) kJ/(min· kg) vs.(0.51 ± 0.04) kJ/(min· kg), t=2.043, P=0.051], while obese boys had higher absolute AEE than non-obese boys [(20.06 ±3.14) kJ/min vs.(16.93 ±1.85) kJ/min, t=-2.910, P=0.007].Obese girls had shor-ter exercise time and lower relative AEE than non-obese girls [ (7.35 ±3.05) min vs.(9.98 ±1.82) min, t=2.509, P=0.027;(0.41 ±0.09) kJ/(min· kg) vs.(0.51 ±0.07) kJ/(min· kg), t=3.244, P=0.003 ] , whereas there were no statistically significant differences in total AEE and absolute AEE between obese and non-obese girls [ (129.29 ±71.13) kJ vs.(161.50 ±35.38) kJ, t =1.351, P =0.203; (16.82 ± 3.26) kJ/min vs.(16.17 ±2.00) kJ/min, t=-0.676, P=0.504].After controlling for age and gender, absolute AEE was significantly positively correlated with body mass index ( P=0.015 ) , obesity degree ( P=0.010), fat mass (P=0.047), fat-free mass (P=0.010), and fat-free mass index (P=0.003) in boys, but not in girls.Relative AEE was significantly negatively correlated with body mass index ( boys: P =0.000, girls: P=0.000), obesity degree (boys: P=0.002, girls: P=0.000), fat percentage (boys:P=0.000, girls:P=0.001), fat mass (boys:P=0.000, girls:P=0.000), fat-free mass (boys: P=0.002 , girls: P=0.022 ) , and fat mass index ( boys: P=0.000 , girls: P =0.000 ) in both boys and girls.Conclusions In obese children, AEE is correlated with body composition, with relative AEE reducing as obesity degree increasing.There may be complex relationships among body size , body composition, and energy metabolism in children.