Objective:To investigate the effects of micro video combined with situational experience health education program in elderly diabetic patients.Methods:Totally, 100 elderly diabetic patients were enrolled from January to December in 2018 in Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine. They were assigned to experimental group ( n=50) and control group( n=50) by random number table. The control group received routine health education, while the experimental group received micro video combined with situational experience health education program. The intervention effects were assessed by Chinese version of Tilburg Frailty Indicator and Summary of Diabetes Self Care Action. Results:Finally, 45 cases were included in the experimental group and 47 cases in the control group. There was no significant difference between the two groups before intervention ( P>0.05). After intervention, the scores of physical frailty, psychological frailty, social frailty and total frailty were (2.60 ± 1.19) points, (1.24 ± 0.87) points, (1.11 ± 0.83) points and (4.96 ± 1.76) points in the experimental group, significantly lower than in the control group (3.45 ± 1.18) points, (1.96 ± 0.86) points, (2.06 ± 0.79) points and (7.47 ± 1.57) points. The difference was statistically significant ( t values were 3.32-7.23, P<0.01); the scores of diet, exercise, blood glucose monitoring, medication, foot care dimension and total self-care activities were (20.36 ± 2.22) points, (12.02 ± 2.33) points, (5.07 ± 0.81) points, (9.98 ± 1.99) points, (7.53 ± 1.10) points and (54.96 ± 4.49) points in the experimental group, significantly higher than in the control group (18.96 ± 2.12) points, (10.47 ± 2.24) points, (3.85 ± 0.83) points, (8.62 ± 1.69) points, (6.60 ± 1.12) points and (48.49 ± 4.07) points. the difference was statistically significant ( t values were 3.10-7.25, P<0.01). Conclusions:Micro video combined with situational experience can improve frailty status and self-care activities in elderly patients with diabetes.

Objective To investigate the distribution and drug resistance of carbapenem-resistant Enterobacteriaceae ( CRE) isolated from children in China. Methods CRE strains were collected in 10 ter-tiary children's hospitals of China from January 1, 2016 to December 31, 2017. Antimicrobial susceptibility of the clinical strains was detected with disk diffusion method ( KB method) and automated method. The re-sults were analyzed according to the Clinical and Laboratory Standards Institute ( CLSI) Standards published in 2017. WHONET 5. 6 software was used to retrospectively analyze the distribution characteristics and drug resistance of these strains. Results A total of 3065 CRE clinical strains were isolated from children with an overall prevalence of 7. 7％ and among them, 13. 5％ were isolated in neonatal group and 5. 8％ in non-neo-natal group. The detection rate of CRE in 2017 was higher than that in 2016 (9. 7％ vs 5. 7％). Among the 3065 CRE strains, there were 1912 strains of Klebsiella pneumoniae (62. 0％), 667 strains of Escherichia coli (22. 0％), 206 strains of Enterobacter cloacae (7. 0％), 56 strains of Klebsiella aerogenes (1. 8％) and 47 strains of Serratia marcescens (1. 5％). Most of the strains were isolate in neonatology departments including neonatal intensive care units (NICU) and intensive care units (ICU), accounting for 44. 8％ and 19. 7％, respectively. Respiratory tract (61. 8％), urine (19. 4％) and blood (5. 7％) specimens were the main sources of CRE isolates. Results of antimicrobial susceptibility test showed that the CRE strains were highly resistant to carbapenem antibiotics such as imipenem, meropenem and ertapenem, as well as penicillins and most cephalosporins (79. 6％-100％), especially those isolated in the neonatal group (P<0. 05). Children had relatively low resistance rates to aminoglycosides such as amikacin (19. 7％) and fos-fomycin (11. 9％), fluoroquinolones such as levofloxacin (37. 7％) and ciprofloxacin (43. 3％), and tige-cycline (3. 8％). Currently, no polymyxin B-resistant strains were isolated. Conclusions The prevalence of common CRE strains in children in 2017 was higher than that in 2016, especially in newborns. Drug re-sistance in CRE strains isolated from neonates to common antibiotics was more severe, suggesting that great attention should be paid to it and timely measures should also be taken.

Objective To investigate the Demodex infection status and influencing factors in medical students in Wuhu City. Methods The mite specimens were collected by the cellophane tape method,and the influencing factors were investigated through the questionnaires. Results A total of 316 medical students were surveyed,117 students were infected with Demodex mite,and the total infection rate was 37.03%. There was no significant difference between the male and female in the infection rate( χ2 = 0.00,P > 0.05). Of the 117 infected cases,the infection rate of simple Demodex folliculorum was 51.28%,the infec-tion rate of simple Demodex brevis was 24.79%,and the rate of mixed infections was 23.93%. The rate of the mild infection (83.76%)was significantly higher than that of the moderate infection(12.82 %)and that of the severe infection(3.42%). The infection rate in the forehead was the highest(29.41%). Among the students with the oily skin,the infection rate of Demodex mite was related to sex. The infection rate of simple Demodex brevis in the male(3.70%)was lower than that in the female (16.42%)( χ2 = 6.92,P < 0.05),while the rate of the mixed infections in the male(17.28%)was higher than that in the fe-male(4.48%)( χ2 = 5.91,P < 0.05). The infection rate of facial skin with symptoms(51.80%)was higher than that of normal facial skin(33.05%)( χ2 = 9.14,P < 0.01). There was no significant difference between the infection rate of Demodex mite and the living habits and other factors. Conclusions There is some infection of Demodex in the medical students. The infection rate of facial skin with symptoms is higher than that of the normal facial skin. So we should strengthen the prevention and treat-ment of Demodex infection in medical students.

Objective To evaluate the clinical value of fetal intelligent navigation echocardiography (5D Heart) in the display of key diagnostic elements in basic fetal echocardiographic views.Methods Using volume probe,3D volume datasets of the 209 normal singleton fetuses in the second and third trimesters were acquired from a four-chamber view.After processing the datasets by using 5D Heart,9 cardiac diagnostic planes were acquired and then the image qualities of key diagnosis elements of the heart and great vessels were graded by 3 doctors with different experiences of performing fetal echocardiography.Results Two hundred and sixty-two volume datasets were acquired from 209 normal fetuses,including 53 volume datasets collected when cardiac apex was in different directions,satisfactory datasets failed to be acquired in 27 fetuses because of the maternal obesity,the artifacts of fetal movement,or other influencing factors.Two hundred and thirty-one volume datasets of 182 fetuses could be used for 5D Heart analyzing and displaying,and the displaying rate of 9 standard diagnostic views was up to 88.2％.No significant difference was found when comparing the grading results of one observer in different periods of time,the grading results between two experienced doctors and the grading results among the experienced doctor and one relatively inexperienced doctor (P ＞ 0.05).Conclusions 5D Heart has high reliability and repeatability in obtaining fetal echocardiographic diagnosis views and displaying fetal elemental diagnostic information.

Objective To evaluate the value of fetal intelligent navigation echocardiography with color flow imaging ( 5D Heart Color) in the display of key diagnostic elements in basic fetal echocardiographic views . Methods The heart volumes datasets of 220 fetuses were collected and the offline analysis was conducted . Pearson correlations was used to compare the detection rate of blood flow element between 5D Heart Color software and color Doppler flow imaging(CDFI) in basic fetal echocardiographic views ,and the detection rate of blood flow between normal fetuses ( control group ) and fetuses with cardiovascular abnormalities( case group) . Bland-Altman analysis was used to prove consistency and reliability of the results . Results Totally 384 fetal heart volume datasets were collected from 220 fetuses ,and 317 volume datasets of 200 cases could be used for the analysis ,with the acquiring success rate of 82 .6％ . 5D Heart Color software and CDFI showed a close correlation in displaying key cardiovascular blood flow information in key fetal echocardiographic diagnosis sections ( r =0 .88 , P <0 .05) ;The detection rates of blood flow elements in control group and case group were 91 .9％ and 87 .3％ ,respectively , with an average of 89 .6％( r = 0 .9 , P < 0 .05 ) . Bland-Altman analysis showed close consistency between inter- and intra-observations in the detection rates of blood flow elements ,and their 95％ confidence intervals were ( -0 .1/+0 .09) and ( -0 .09/+0 .1) ,respectively ,and the points outside the 95％ confidence interval were 5 .4％(17/231) and 5 .7％ (18/231) ,respectively . Conclusions 5D Heart Color software shows similar usefulness in the displaying key blood flow elements ,comparing with CDFI , demonstrating higher reliability and repeatability in displaying fetal echocardiographic diagnosis views and diagnostic blood flow elements .

Objective To evaluate the value of fetal intelligent navigation echocardiography ( 5D Heart) and Virtual Intelligent Sonographer Assistance ( VIS-Assistance ? ) in the display of key diagnostic elements in basic fetal echocardiographic views . Methods The heart volumes data of 209 normal fetuses were collected and then the offline analysis was conducted . Processing of the built-in VIS-Assistance ? for each diagnosis plane was optimized . The display success rate and image quality difference of diagnosis images and diagnosis elements before and after the VIS-Assistance ? processing as well as the repeatability between observers were analyzed and compared . Results Totally 262 fetal heart volume data were collected from 209 fetuses ,and 231 volume data of 182 cases could be used for the analysis ,with the acquiring success rate of 88 .2% . For the display rate of 8 diagnosis sections of the 231 fetal heart volume data before and after VIS-Assistance ? processing ,abdominal transverse section at stomach level showed no significant difference ,while the other diagnostic sections showed significant differences ( all P < 0 .05) ,and the display rate after the processing was higher than that before the processing . For the image quality scores of diagnosis sections before and after VIS-Assistance ? processing ,abdominal transverse section at stomach level showed no significant differences ,while other diagnostic sections showed significant differences ( all P < 0 .01) ,and the image quality scores after the processing were higher than those before the processing . According to Bland-Altman analysis ,95% credibility interval of the total scores of 8 sections measured by different observers before and after VIS-Assistance ? were ( - 0 .17/ + 0 .18 ) and ( - 0 .17/ + 0 .18 ) , respectively ,6 .06% (14/231) and 3 .89% (9/231) of the points were outside the 95% credibility interval , and the rest had high consistency . Conclusions 5D Heart and VIS-Assistance ? technology can significantly improve the display rate of diagnostic section and image quality of element structures , and has high reliability and repeatability in obtaining fetal cardiac diagnosis sections and displaying fetal elemental diagnostic information .

Objective To construct prokaryotic expression systems of genes of intact rotavirus non -structural protein 4 (NSP4) and 86 to 175 amino acid peptide of NSP4 (NSP486-175) and to identify the bio-activities of the recombinant expression products .Methods Colloidal gold assay was used to screen group A rotavirus antibody-positive stools , from which the viral RNA was extracted and transcribed into cDNA .Then NSP4 gene and NSP486-175 gene were amplified by PCR and inserted into pET-28a(+) vector to construct the prokaryotic expression plasmids of pET-28a(+)-NSP4 and pET-28a(+)-NSP486-175 , which were transformed into E.coli BL21( DE3) and inducted by IPTG .The expressed NSP486-175 protein was purified by Ni-NTA af-finity chromatography and examined by Western blot .Fluo-3 AM ester was used to label intracellular free Ca2+( [ Ca2+] i) in Caco-2 cells and laser scanning confocal microscopy was performed to detect the effect of NSP486-175 protein on [Ca2+]i.Results DNA sequencing indicated that NSP4 gene and NSP486-175 gene were consistent with the corresponding sequences in NCBI .The intact NSP4 had difficulty in expressing in E.coli. NSP486-175 protein mainly existed in soluble form with a relative molecular weight of 10×103 .Fluorescence in-tensity and distribution were changed by exogenous addition of NSP 486-175 to cultured Caco-2 cells.Conclu-sion The expression vectors of pET-28a(+)-NSP4 and pET-28a(+)-NSP486-175 were successfully construc-ted and the target protein could induce [Ca2+]i imbalance.This phenomenon preliminarily indicates that the prokaryotic expressed NSP486-175 protein has biological activity and can be further used to elucidate rotavirus pathogenic mechanisms and perform vaccine research .

Objective To evaluate the efficacy and safety of sunitinib as post-operative adjuvant therapy in patients with high-risk renal cell carcinoma (RCC).Methods A total of 60 patients with resected,histologically confirmed clear cell RCC were enrolled in this study.Patients received orally sunitinib either at a dose of 50 mg on treatment schedule (once daily for 4 weeks followed by 2 weeks off) or at a dose of 37.5 mg once daily for three 6-week cycles from 1 month after surgery.Results All the 60 patients tolerated Sunitinib treatment well and no patient discontinued treatment due to adverse events.Most adverse events were grade Ⅰ to Ⅱ.The most frequently reported adverse events were neutropenia (56.7％),thrombocytopenia (53.3％),leucopenia (48.3％),hand-foot syndrome (46.7％) and hypertension (36.7％).The most frequently reported grade 3 or 4 toxicities were thrombocytopenia (25.0％),neutropenia (15.0％),hand-foot syndrome (11.7％) and leucopenia (8.3％).The majority of adverse events occurred within the first 1-2 cycles of sunitinib treatment,and was ameliorated 1 month after 3 cycles finished.No irreversible adverse event was observed.As of April 5,2012,no recurrence occurred in patients except one death due to cerebrovascular accident unrelated to treatment,with both 6-month and 9-month disease-free survival rate of 100％.Conclusions Myelosuppression occurred less frequently in high-risk RCC patients treated with sunitinib as operative adjuvant therapy than in advanced RCC patients,with a better benefit trend.However,long-term follow-up data are needed to further confirm the efficacy of sunitinib in the adjuvant setting.

Protein A and protein G are two well-defined immunoglobulin (Ig)-binding proteins (IBPs), which show affinity for specific sites on Ig of mammalian hosts. Protein A and protein G contained several highly homologous IgG-binding domains which had been demonstrated to have function to bind to IgG. Whether combinations of Ig-binding domains of various IBPs could produce useful novel binding properties remains interesting. We constructed a combinatorial phage library which displayed randomly-rearranged A, B, C, D and E domains of protein A, B2 and B3 domains of protein G. Four rounds molecular evolution of this library directed by all four human IgG subclasses respectively generated a common arrangement of D-C respectively which didn't exist in SpA. The dynamic loss of control phages and increase of the phages displaying two or more binding domains, especially the selective enrichment of D-C and strict selection of its linking peptides demonstrated the efficient molecular evolutions and the significance of the selected D-C arrangement. The phage binding assays confirmed that D-C possessed a binding advantage with four human IgG subclasses compared to SpA. In this work, a novel combination of Ig-binding domains, D-C, was obtained and presented the novel Ig binding properties which provided a novel candidate molecule for the purification, production and detection of IgG antibodies and a new approach for the further study of structures and functions of IBPs.
Amino Acid Sequence ; Antibody Specificity ; Bacterial Proteins ; immunology ; metabolism ; Binding Sites ; Binding, Competitive ; Evolution, Molecular ; Immunoglobulin G ; immunology ; metabolism ; Molecular Sequence Data ; Peptide Library ; Sequence Alignment ; Staphylococcal Protein A ; immunology ; metabolism

We constructed a phage-displayed random mutation library of Tat38-61(51N/55N), for studying the molecular evolution screening of HIV-1 Tat38-61 epitope. We used primers containing the random nucleotide sequences, and introduced the random mutations at the sites of 51 and 55 amino acids coding sequences into full-length Tat sequences by overlapping PCR. With the randomly mutated full-length Tat as template, the Tat38-61(51N/55N) mutants which contained recognition sequences for the Xba I in both ends were amplified by PCR using the designed primers. The mutants were cloned into Xba I site in the phagemid vector pCANTAB5S, then the recombinants were transformed into E. coli TG1, a phage-displayed the random mutation library of Tat38-61(51N/55N) was constructed by the rescue of help virus M13KO7. The results showed that the library consisted of about 5.0 x 10(6) colonies and the phage library titer was 2.65 x 10(12) TU/mL. More than 56.50% colonies in the library were positive for insertion. Sequence analysis showed that the nucleotides encoding amino acids at the sites of 51 and 55 distributed randomly. The constructed mutation library could meet the requirements for the following molecular evolution screening, and might prepare the Tat mutants for the further study of new Tat vaccine candidates.
AIDS Vaccines ; immunology ; Escherichia coli ; genetics ; metabolism ; HIV-1 ; genetics ; Humans ; Mutation ; Peptide Fragments ; biosynthesis ; genetics ; immunology ; Peptide Library ; Recombinant Proteins ; biosynthesis ; genetics ; immunology ; tat Gene Products, Human Immunodeficiency Virus ; biosynthesis ; genetics ; immunology