Objective To improve the survival rate and life quality of peritoneal dialysis(PD)patients,we es-tablished a retraining model based on ADDIE model,including optimizing the content,form and frequency.Methods From January 1,2022 to May 3,2023,based on the 5 stages of ADDIE model,we investigated the needs of pa-tients,invited 55 experts in the peritoneal dialysis field to design the final draft of the retraining model through 2 rounds of Delphi expert consultations,and 23 peritoneal dialysis patients were preexperimented to evaluate and re-vise the retraining model.Results The questionnaire recovery rates of the 2 rounds of expert consultation were 100％and 96.36％,respectively.The coordination coefficients of the first-level catalog were 0.379 and 0.384,and the coordination coefficients of the second-level catalog were 0.446 and 0.427,respectively.The Chi-square test showed that P＜0.05,indicating statistical significance.The content of the retraining model included 4 sections,33 subdirectories and 9 training forms,which were combined online and offline.The training frequency was different due to the different contents,and the single content of a single training form was mainly 15 min.Conclusion The PD patient retraining model constructed in this study is scientific,reliable and innovative.Its content is easy to un-derstand and diverse in forms.The training duration and frequency are in line with the memory rule,and the eval-uation takes into account both process and result.

Objective:To evaluate main performance indexes and application value of a domestic blood nucleic acid test system for blood screening,so as to ensure the safety of blood screening in the system of blood bank.Methods:Twenty samples were selected from Langfang Center Blood Bank in January 2022,and 6703 blood specimens of voluntary blood donors from Langfang Blood Bank between 2022 and 2023 were simultaneously selected.According to the requirements of the"Technical Operating Procedures for Blood Stations(2019 Edition)"and the standard for medical medicine industry"Nucleic Acid Amplification Test Reagents(kits)",the performances of stability,analytical specificity,sensitivity,precision,anti-interference ability and against cross-contamination ability of nucleic acid test system were verified for the analysis of clinical application.Results:The coincidence rate of the nucleic acid test system was 100%for 20 negative plasma samples.The coincidence rates of the sensitivities of Hepatitis B virus deoxyribonucleic acid(HBV DNA),Hepatitis C virus ribonucleic acid(HCV RNA)and Human immunodeficiency virus ribonucleic acid(1+2)(HIV 1+2 RNA)were respectively 100%,and percentages of the coefficient of variation(CV%)of the precision of them were respectively 1.57%,0.75%and 1.49%.When the system conducted nucleic acid test,the hemolytic plasma with a hemoglobin concentration level of 400mg/dl and the blood specimen with triglyceride concentration levels of 3 000 mg/dl did not affect the analysis performances of the standard substances of HBV-DNA(9.0 IU/ml),HCV-RNA(30.0 IU/ml)and HIV-RNA(135.0 IU/ml)of low concentration level.There were not cross-contaminations when 10 positive samples at high concentration(1 000 IU/ml)were cross-lined with 11 negative samples to conduct test.A total of 16(0.24%)reactive specimens were checked out from 6 703 specimens by Nucleic Acid Test(NAT)Technique under mixed mode.Conclusion:Nucleic acid test system must conduct performance verification before it is put into use,so as to ensure the safety of blood screening.The currently domestic nucleic acid test system can meet the requirements of screening blood safety.The performance verification of nucleic acid test system has great value in ensuring the safety of blood screening.

Objective: To analyze the usage and influencing factors of quantified recipes in schools in the pilot areas of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES), and to provide references for student meal quality improvement. Methods: In 726 national pilot counties in 22 provinces where the NIPRCES was implemented, a total of 7 808 schools were included in the analysis as the survey objects in 2019. Data, including the usage of quantified recipes in schools and related factors, were collected through questionnaires. Multivariate Logistic regression was used to analyze the influencing factors of the schools use of quantified recipes. Results: Among the national pilot counties where the NIPRCES was implemented, 66.6 % of the monitored schools used quantified recipes, of which 69.7% of schools in the central region used quantified recipes, it was higher than that in the west region(65.2%) ( χ 2=15.13, P <0.01). Multivariate Logistic regression analysis showed that factors such as the schools in the central region, county based schools, the training frequency of canteen with 1-2 times per semester or once or more per month, regular training of nutrition knowledge, recipes provided by other departments, consideration of nutrition matching when formulating recipes, using catering software, providing local dietary allowances were positively correlated with the use of quantified recipes in schools( OR=1.31,0.72,1.44,1.73,1.75,3.20,2.15,2.72,1.17,P <0.05). Conclusion The proportion of using quantified recipes of schools in the NIPRCES area was relatively low, which might be affected by factors including the regional economic level, canteen training, and recipes sources. It is recommended to strengthen the construction of professional teams and canteen training. Schools need to be encouraged to use quantified recipes and promote school catering scientifically to improve healthy growth of students.

Objective: To analyze the status of parents sharing meal expenses in the national pilot areas of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) and its influencing factors, so as to provide scientific data for promoting the proper implementation of the NIPRCES and the healthy development of students. Methods: In the 726 national pilot counties in 22 provinces where the NIPRCES was implemented, 8 109 primary and junior high schools were selected as the survey objects and included in the analysis according to the three feeding methods of canteen feeding, enterprise feeding and mixed feeding. Data such as the basic information of the schools and counties, and the status of parents sharing meal expenses were collected through questionnaires. Multivariate Logistic regression analysis was used to analyze the influencing factors of parents sharing meal expenses. Results: In the national pilot areas of the NIPRCES, schools where parents shared meal costs accounted for 30.2% of all monitored schools in 2019. In central and western areas, the proportion of schools where parents shared meal costs were 51.5% and 20.3%, respectively. In schools where parents shared meal costs, no matter in primary school or junior high school, the difference in the amount of meal expenses shared by parents of students in middle and western schools was statistically significant ( χ 2= 181.78 , 89.54, P <0.01). Among 38.7% of the parents of primary school students in the central region shared meal expenses of ≥2 yuan, and 47.5% of the parents of primary school students in the western region. Multivariate Logistic regression analysis showed that the parents of schools in the central region, junior high schools or nine year system schools, canteen feeding or other feeding, large school size, the nutritious meal subsidy used for lunch, middle and high family income level, medium and low input level of the monitoring counties, monitoring counties with other nutrition public welfare projects and insufficient working funds share a higher proportion of meal expenses ( OR=3.22, 1.51, 1.36, 1.74, 3.74, 1.38, 11.58, 2.40, 3.15, 1.50, 2.12, 3.36, 1.34, P < 0.05). Conclusion The proportion of meals shared by parents of school students in the NIPRCES implementation area was relatively low, which may be affected by factors such as economic level, feeding mode, school scale, etc.

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.

Objective To compare the predicted efficiency ofmacular hole closure index (MHCI) calculated by 2 different methods for postoperative anatomical outcomes after idiopathic macular hole (MH) surgery.Methods This is a prospective exploratory clinical study.A total of 63 patients (63 eyes) with idiopathic MH,who received vitrectomy,inner limiting membrane peeling and gas tamponade,were enrolled in this study.All the patients received optical coherence tomography (OCT) examination at each visit to measure the MHCI using the formula MHCI=(M+N) /BASE,M and N is the distance from outer limiting membrane break points to the beginning points of detached photoreceptor from retinal pigment epithelium of both side of the hole,respectively.BASE is the length of MH base.MHCI1 was measured by built-in caliper of OCT software,MHCI2 was measured by ImageJ software.The minimum macular diameter (MHD) was measured by built-in caliper of OCT software.Based on the OCT images,the anatomical outcomes were classified grade A (bridge-like shape closure),grade B (complete closure) and grade C (poor closure).Grade A and B are considered as good closure,grade C as poor closure.Patients were followed up at 3,6 and 12 months after surgery.The closure grades at last visit were the final outcome.The relationship between MHCI 1,MHCI2 and closure grades was analyzed.And the predicted efficiency of MHD,MHCI1 and MHCI2 for anatomical outcomes after the surgery was studied.Results The mean MHCI1 was 0.68±0.21 (0.30-1.35),MHCI2 was 0.95±0.26 (0.41-1.55),and MHD was (476.24±210.18) μm (127-956 μm).MHCI1 and MHCI2 were both negative correlated with the closure grades (r=-0.665,-0.691;P＜0.001).The receiver operating characteristic (ROC) curve analysis ofMHCI1,MHCI2 and MHD for the prediction of good or poor closure showed that area under the curve (AUC) was 0.928,0.957 and 0.916 respectively,and 0.505,0.67 and 559 μm were set as the lower cut-offvalue.The sensitivity was 96.2％,92.3％ and 90.9％ respectively,and specificity was 81.8％,72.7％ and 76.9％ respectively.Accordingly,the ROC curve analysis for the prediction of grade A or B closure showed that AUC was 0.840,0.847 and 0.653 respectively,and 0.705,0.965 and 364 μm were set as the upper cut-off value.The sensitivity was 80.0％,82.9％,63.4％ respectively and specificity was 75.0％,85.7％,65.9％.Conclusion MHCI1 and MHCI2,measured by built-in caliper of OCT software or ImageJ software,both have good predictive efficiency for the anatomical outcomes of MH surgery.

Objective To summarize the clinical characteristics of children with coronary artery aneurysms (CAA) and thrombosis in Kawasaki disease (KD),in order to explore the safe and effective thrombolytic therapy and its prognosis.Methods The clinic,treatment and follow-up data of 210 patients with KD between January 2006 and December 2016 were retrospectively reviewed in the Department of Pediatrics,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology.The clinic signs and laboratory data for CAA with thrombosis were analyzed.The characteristics of CAA were monitored by tltrasound.All KD patients with thrombus received intravenous antithrombotic therapy,including urokinase,heparin,and oral Warfarin,and anti-platelet treatment.The effectiveness of antithrombotic treatment was evaluated by measuring the ability to dissolve the thrombus.Results Fourteen cases in 210 patients with KD developed CAA,and had associated thrombosis.In these 14 patients,the largest diameter of CAA was 18.5 mm,and the average value was 12.6 mm.There was no special blood analysis in CAA with thrombus.Moreover,typical KD symptoms and acute myocardial infarction were not found in CAA with thrombosis.Thrombus occurred in giant aneurysms,and 2 patients had multiple thrombosis.After thrombolytic therapy,12 cases in the 14 patients had successful thrombolysis,2 patients had thrombus organization and coronary artery stenosis.Conclusions Neither clinical features nor laboratory data could reliably predict CAA associated thrombosis.Thrombus was easily formed in giant CAA.Frequent and periodly follow-up are important to detect thrombosis in KD patients with giant coronary artery.Therapy with adequate intravenous antithrombotic therapy and anti-platelet treatment earlier can effectively dissolve thrombus in KD patients,and avoid deterioration.

AIM:We investigated how AT 1-R stimulated by mechanical stresses induces cardiac fibrosis .METHODS:We produced in vivo cardiac pressure overload model in angiotensinogen knockout ( ATG-/-) mice and in vitro mechanically-stretched cell model in cultured neonatal cardiac cells of ATG-/-mice both lack the participation of Ang II .RESULTS: Pressure overload for 4 weeks in ATG-/-mice induced myocardial hypertrophy accompanied by the significant interstitial fibrosis , however , the TGF-β, a key regulatory factor of fibrosis, was not significantly increased in these ATG-/-mice.Meanwhile, the inhibitor for AT1-R significantly inhibited mechani-cal stress-induced cardiac fibrosis in these ATG-/-models whereas inhibition of TGF-βdid not.CONCLUSION:The results showed that mechanical stress-induced fibrotic responses through AT 1-R required the phosphorylation of Smad 2 but not the involvement of TGF-β.

OBJECTIVETo investigate the effects of nano-lead exposure on learning and memory and iron homeostasis in the brain of the offspring rats on postnatal day 21 (PND21) and postnatal day 42 (PND42).

METHODSTwenty adult pregnant female Sprague-Dawley rats were randomly divided into control group and nano-lead group. Rats in the nano-lead group were orally administrated 10 mg/kg nano-lead, while rats in the control group were administrated an equal volume of normal saline until PND21. On PND21, the offspring rats were weaned and given the same treatment as the pregnant rats until 42 days after birth. The learning and memory ability of offspring rats on PND21 and PND42 was evaluated by Morris water maze test. The hippocampus and cortex s amples of offspring rats on PND21 and PND42 were collected to determine iron and lead levels in the hippocampus and cortex by inductively coupled plasma-mass spectrometry. The distributions of iron in the hippocampus and cortex were observed by Perl's iron staining. The expression levels of ferritin, ferroportin 1 (FPN1), hephaestin (HP), and ceruloplasmin (CP) were measured by enzyme-linked immunosorbent assay.

RESULTSAfter nano-lead exposure, the iron content in the cortex of offspring rats on PND21 and PND42 in the nano-lead group was significantly higher than those in the control group (32.63 ± 6.03 µg/g vs 27.04 ± 5.82 µg/g, P<0.05; 46.20 ±10.60 µg/g vs 36.61 ± 10.2µg/g, P<0.05). The iron content in the hippocampus of offspring rats on PND42 in the nano-lead group was significantly higher than that in the control group (56.9 ± 4.37µg/g vs 37.71 ± 6.92µg/g, P<0.05). The Perl's staining showed massive iron deposition in the cortex and hippocampus in the nano-lead group. FPNl level in the cotfex of offspring rats on PND21 in the nano-lead group was significantly lower than that in the control group (3.64 ± 0.23 ng/g vs 4.99 ± 0.95 ng/g, P<0.05). FPN1 level in the hippocampus of offspring rats on PND42 in the nano-lead group was significantly lower than that in the control group (2.28 ± 0.51 ng/g vs 3.69 ± 0.69 ng/g, P<0.05). The escape latencies of offspring rats on PND21 and PND42 in the nano-lead group were longer than those in the control group (15.54 ± 2.89 s vs 9.01 ± 4.66 s; 6.16 ± 1.42 s vs 4.26 ± 1.51 s). The numbers of platform crossings of offspring rats on PND21 and PND42 in the nano- lead group were significantly lower than those in the control group (7.77 ± 2.16 times vs 11.2 ± 1.61 times, P<0.05; 8.12 ± 1.51 times vs 13.0 ± 2.21 times, P<0.05).

ONCLUSIONn Nano-lead exposure can result in iron homeostasis disorders in the hippocampus and cortex of offspring rats and affect their learning and memory ability.

Animals ; Cerebral Cortex ; drug effects ; metabolism ; Female ; Hippocampus ; drug effects ; metabolism ; Homeostasis ; Iron ; metabolism ; Lead ; toxicity ; Learning ; drug effects ; Maternal Exposure ; adverse effects ; Memory ; drug effects ; Pregnancy ; Rats ; Rats, Sprague-Dawley

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Humans ; Induction Chemotherapy ; Leukemia, Myeloid, Acute ; drug therapy ; Middle Aged