Objective:To investigate the effect of immune cells in blood and PD-L1 expression in tissues on prognosis of patients with post-surgery of advanced adenocarcinoma of esophagogastric junction(AEGJ)and hyperthermic intraperitoneal chemotherapy(HIPEC)treatment,and to explore the relationship between immune cells and PD-L1 level in patients with post-surgery and HIPEC treatments.Methods:A total of 46 patients with advanced AEGJ surgery and adjuvant HIPEC in the First Affiliated Hospital of Hebei North University from January 2018 to June 2019 were enrolled.Transcriptome sequencing technology was used to examine levels of blood immune cells in patients with AEGJ postoperative adjuvant HIPEC.Immunohistochemistry was applied to detect expression of PD-L1 in tissues of AEGJ,and corresponding statistical methods were used to observe the prediction of immune cells and PD-L1 levels on prognosis of patients with AEGJ,and correlation with each other.Results:As of June 30,2022,the cancer-specific survival rate(CSS),relapse free survival rate(RFS),median CSS and median RFS were 28.26％,45.65％,31 months and 24 months,respective-ly.Positive expression of PD-L1 was 52.17％,ratios of RFS and CSS between positive and negative level of PD-L1 were 16.67％,77.27％and 54.17％,90.91％,respectively;the median time of RFS(12 months vs 37 months)and CSS(24 months vs 37 months)in PD-L1 positive expression was less than those in PD-L1 negative expression separately.A total of 22 kinds of immune cells were exam-ined in this study,compared with CPS<1 group,levels of CD8+T cells,dendritic cells activated and resting NK cells were significantly decreased in CPS≥1 group(all P<0.05),while M2 macrophages in the former group were lower than those in the latter group(0.013±0.012 vs 0.033±0.003,P<0.001).Results of ROC curve showed that CD8+T cells and M2 macrophages were predictor of patients with AEGJ treatments prognosis(AUC=0.690 and 0.698,respectively).COX multivariate regression analysis revealed that CD8+T cell was an independent protective factor for CSS of AEGJ and HIPEC[HR=0.590,95％CI(0.248～0.7080],while M2 macrophage was the risk factors for AEGJ and HIPEC[HR=6.448,95％CI(1.440～9.165)].Positive expression of PD-L1 was positively correlated with level of M2 macrophages(R=0.44,P<0.01),while negatively associated with level of CD8+T cells(R=-0.47,P<0.05).Conclusion:Adjuvant HIPEC therapy maybe regulate the function of M2 macrophage and CD8+T cells,among which the level of M2 macrophage is positively related to PD-L1 expression.The increasing of M2 macrophage cells may be the risk factor for the prognosis of AEGJ patients with surgery and HIPEC-treatment.

Objective:To investigate the effect of immune cells in blood and PD-L1 expression in tissues on prognosis of patients with post-surgery of advanced adenocarcinoma of esophagogastric junction(AEGJ)and hyperthermic intraperitoneal chemotherapy(HIPEC)treatment,and to explore the relationship between immune cells and PD-L1 level in patients with post-surgery and HIPEC treatments.Methods:A total of 46 patients with advanced AEGJ surgery and adjuvant HIPEC in the First Affiliated Hospital of Hebei North University from January 2018 to June 2019 were enrolled.Transcriptome sequencing technology was used to examine levels of blood immune cells in patients with AEGJ postoperative adjuvant HIPEC.Immunohistochemistry was applied to detect expression of PD-L1 in tissues of AEGJ,and corresponding statistical methods were used to observe the prediction of immune cells and PD-L1 levels on prognosis of patients with AEGJ,and correlation with each other.Results:As of June 30,2022,the cancer-specific survival rate(CSS),relapse free survival rate(RFS),median CSS and median RFS were 28.26％,45.65％,31 months and 24 months,respective-ly.Positive expression of PD-L1 was 52.17％,ratios of RFS and CSS between positive and negative level of PD-L1 were 16.67％,77.27％and 54.17％,90.91％,respectively;the median time of RFS(12 months vs 37 months)and CSS(24 months vs 37 months)in PD-L1 positive expression was less than those in PD-L1 negative expression separately.A total of 22 kinds of immune cells were exam-ined in this study,compared with CPS<1 group,levels of CD8+T cells,dendritic cells activated and resting NK cells were significantly decreased in CPS≥1 group(all P<0.05),while M2 macrophages in the former group were lower than those in the latter group(0.013±0.012 vs 0.033±0.003,P<0.001).Results of ROC curve showed that CD8+T cells and M2 macrophages were predictor of patients with AEGJ treatments prognosis(AUC=0.690 and 0.698,respectively).COX multivariate regression analysis revealed that CD8+T cell was an independent protective factor for CSS of AEGJ and HIPEC[HR=0.590,95％CI(0.248～0.7080],while M2 macrophage was the risk factors for AEGJ and HIPEC[HR=6.448,95％CI(1.440～9.165)].Positive expression of PD-L1 was positively correlated with level of M2 macrophages(R=0.44,P<0.01),while negatively associated with level of CD8+T cells(R=-0.47,P<0.05).Conclusion:Adjuvant HIPEC therapy maybe regulate the function of M2 macrophage and CD8+T cells,among which the level of M2 macrophage is positively related to PD-L1 expression.The increasing of M2 macrophage cells may be the risk factor for the prognosis of AEGJ patients with surgery and HIPEC-treatment.

AIM: To explore the synthesis of thermo-sensitive poly N-isopropylacry-lamide(PNIPAAm)and the petri dish grafted with PNIPAAm hydrogels by the electron accelerator, as well as the growth conditions and the biological characteristics of rabbit corneal stromal cells on thermo-sensitive PNIPAAm hydrogels, and the cell sheets obtained from the PNIPAAm hydrogels.METHODS: NIPAAm monomer was dissolved in 2-propanol at concentrations of 55% with 0.5% N,N'-Methylenebisacry-lamide(MBA). Solution(70 μL)was added and spread uniformly over 35 mm petri dish. These dishes were immediately subjected to irradiation. After follow-up treatment, rabbit corneal stromal cells were cultured on thermo-sensitive petri dish in vitro.RESULTS: According to the monomer formula and radiation synthesis scheme in this experiment, PNIPAAm can be synthesized on the surface of the petri dish. Rabbit corneal stromal cells grew well in the thermo- sensitive surface and can be separated into sheets.CONCLUSION: The single and multilayer carrier-free cell sheets can be obtained from the use of thermo-sensitive petri dish.

COVID-19 has been prevalent for three years. The virulence of SARS-CoV-2 is weaken as it mutates continuously. However, elderly patients, especially those with underlying diseases, are still at high risk of developing severe infections. With the continuous study of the molecular structure and pathogenic mechanism of SARS-CoV-2, antiviral drugs for COVID-19 have been successively marketed, and these anti-SARS-CoV-2 drugs can effectively reduce the severe rate and mortality of elderly patients. This article reviews the mechanism, clinical medication regimens, drug interactions and adverse reactions of five small molecule antiviral drugs currently approved for marketing in China, so as to provide advice for the clinical rational use of anti-SARS-CoV-2 in the elderly.

Neonatal skin care is still an important aspect of newborn care. At present, although there are nursing standards for various types of neonatal skin problems, there are different reports on complete evidence-based neonatal skin care practices. The American Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) developed and published the fourth edition of the Evidence- based Clinical Practice Guideline for Neonatal Skin Care in 2018. The guideline gives detailed guidance on the assessment of neonatal skin, identification of risk of neonatal skin damage, intervention of neonatal skin care, method of promoting neonatal skin development, and treatment of neonatal skin damage. However, nurses in China know little about this guideline. In order to facilitate nurses' understanding and application of this guideline to guide clinical practice, the content of this guideline is specially interpreted.

Background The current oil production determines oil workers’ occupational noise exposure. Without effective protection, noise will affect various aspects of worker’s body functions, including acting on the adrenal cortex system and resulting in renal function damage. Objective To evaluate the associations of noise exposure and its cumulative exposure level with renal function impairment of oil workers. Methods Oil workers from a collective medical examination in a hospital were selected as the study subjects. In accordance with the national standard Measurement of Physical Agents in the Workplace Part 8: Noise (GBZ/T 189.8—2007), noise exposure was measured three times at the oil workers' work site, and their average value was calculated to obtain the cumulative noise exposure (CNE). A questionnaire survey was conducted to collect general information such as socio-demographic characteristics, family history, lifestyles, and occupational history. All blood biochemical indicators were measured in the fasting state. Renal function impairment was judged based on the glomerular filtration rate. The relationship between CNE and renal function was analyzed using receiver operating characteristic curve (ROC) for workers with noise exposure. Results A total of 2 917 subjects were included in the study and their prevalence of renal function impairment was 14.2%. The univariate analysis results suggested statistically significant differences in the prevalence of renal function impairment among the oil workers grouped by having hypertension or not, gender, age, marital status, marital status, smoking, and alcohol consumption (P＜0.05); the prevalence of renal impairment was significantly higher in those with abnormal values of uric acid, total cholesterol, triglycerides, high-density lipoprotein, and fasting glucose than in those with normal values (P＜0.05); the oil workers with noise exposure [n=1565, 53.7%, equivalent sound level ≥80 dB(A)] showed a higher prevalence of renal function impairment than those without (P＜0.05). The results of multiple logistic regression analysis showed that being female (OR=2.811, 95%CI: 1.960-4.030), age at 31 years and above (OR_31-40=3.502, 95%CI: 1.402-8.751; OR_41-50=4.255, 95%CI: 1.759-10.291; OR_≥51=7.179, 95%CI: 2.864-17.996), showing abnormal uric acid (OR=5.932, 95%CI: 4.486-7.843), having hypertension (OR=1.593, 95%CI: 1.230-2.063), alcohol consumption (OR=2.648, 95%CI: 1.346-5.212), and smoking (OR=1.816, 95%CI: 1.133-2.911) had higher risks of developing renal function impairment; besides, those exposed to noise had 1.351 times (95%CI: 1.073-1.702) higher risks of developing renal function impairment than non-exposed individuals. Noise-exposed oil workers in the renal impairment group had higher noise exposure intensity and CNE compared to the noise-exposed oil workers in the normal renal function group (P＜0.05), and the workers had an increased risk of renal function impairment when the CNE was >95.85 dB(A)·year versus CNE ≤ 95.85 dB(A)·year (OR=2.583, 95%CI: 1.956-3.411). Conclusion Exposure to noise, higher noise exposure intensity, and higher level of CNE may be associated with developing renal function impairment in oil workers. Oil workers with CNE above 95.85 dB(A)·year are at an increased risk of renal impairment.

AIM: To study the distribution of CYP2C9∗3 and VKORC1-1639G>A gene polymorphism in Han population in Anhui province and their influence on the stable dose of warfarin. METHODS: The blood samples of 1 169 patients from 6 tertiary general hospitals in 5 areas of Anhui province from January 2020 to December 2021 were selected, the genotype of CYP2C9∗3 and VKORC1-1639G>A was detected by fluorescent staining in situ hybridization technique. RESULTS: The distribution of CYP2C9∗3 genotypes in 1 169 patients: the frequencies of AA, AC and CC genes were 90.16%, 9.24% and 0.60%, respectively; The distribution of VKORC1 genotype: the frequencies of AA, AG and GG genes were 84.26%, 14.71% and 1.03% respectively; There was no significant difference between the two genotypes in gender, age and regional distribution (P>0.05). The average daily warfarin dose of CYP2C9∗3 AA genotype in 755 patients with stable warfarin dose was (3.02±0.59) mg/d, which was significantly higher than patients with AC genotype and CC genotype; The average daily warfarin dose of patients with VKORC1-1639AA genotype was (2.72±0.40) mg/d, which was significantly lower than that of patients with AG genotype and GG genotype (P<0.05). And the difference was statistically significant (P<0.05); There are significant differences in gender, age and clinical diagnosis between patients with stable dose of warfarin and those without stable dose (P<0.05). CONCLUSION: CYP2C9 and VKORC1 genotypes are associated with the stable dose of warfarin. Clinical anticoagulation therapy guided by CYP2C9 and VKORC1 genotypes can provide guidance for individualized medication of warfarin.

Objective:To analyze the distribution and drug sensitivity of pathogens in bronchoalveolar lavage fluid(BALF)of children with severe community acquired pneumonia(CAP)in Qingdao from 2018 to 2020.Methods:The clinical data of 482 children with severe CAP in Qingdao admitted to Women and Children′s Hospital of Qingdao University were collected.BALF was collected by bronchoscopy for detection of bacteria and mycoplasma.Results:(1)Bacterial infection was detected in 139 cases(27.84%), mycoplasma infection in 119 cases(24.69%), and virus infection in 141 cases(29.25%). (2)The detection rates of bacteria and virus infection in the 1-12 months old group were higher.The detection rate of mycoplasma pneumoniae was the highest in the group over 5 years old.(3)A total of 139 strains were positive in bacterial culture of lavage fluid under bronchoscope: 55 strains(39.57%) of gram-negative bacilli and 84 strains(60.43%) of gram-positive cocci.Streptococcus pneumoniae was the most common gram-positive bacteria.Haemophilus influenzae was the most common gram-negative strain.(4)Streptococcus pneumoniae and Staphylococcus aureus were highly sensitive to amoxicillin clavulanate potassium, vancomycin and linezolid.The resistance rate to erythromycin was high(100%). (5)Haemophilus influenzae, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae were highly sensitive to meropenem and cefoperazone sulbactam.They were highly resistant to amoxicillin, ampicillin and cefuroxime(>80%).Conclusion:Severe CAP in Qingdao area is mainly caused by virus and bacteria within 1 year old.Mycoplasma pneumoniae infection is the main cause of children over 5 years old.Respiratory syncytial virus, adenovirus and parainfluenza virus are main causes of virus infection.Streptococcus pneumoniae and haemophilus influenzae are the main pathogens, which are more sensitive to vancomycin, linezolid, meropenem and cefoperazone sulbactam, but resistant to erythromycin and amoxicillin.

Humans ; Lung ; Pneumoconiosis/diagnostic imaging* ; Radiography ; Tomography, X-Ray Computed

Objective: To explore the imaging changes of lung lesions in patients with imported COVID-19 patients when reaching the discharge standard. Method: The clinical and CT imaging data of 60 patients with imported COVID-19 cured and discharged from January to February 2020 in Anhui Province were retrospectively collected. The clinical characteristics of the patients and the characteristics of chest CT images at discharge were analyzed. Results: Fever (57 cases) and cough (55 cases) were the main symptoms in 60 patients. At the initial diagnosis, 5 cases were mild, 53 were ordinary, and 2 were severe. In 5 light patients, 3 cases were negative in the whole course of CT examination, 2 cases were negative in the first time and abnormal in the second time. . The first CT imaging features of 55 patients (53 common type and 2 severe type)were mainly bilateral lung involvement (51 cases), multiple lesions (33 cases), more common under the pleura (40 cases), and ground glass opacities were the most common. (55 cases). The clinical features of chest CT in clinical outcomes are that the ground glass shadow in the lung gradually fades and was completely absorbed (19 cases); the scope of ground glass shadow in the lung expanded and progressed to crazy-paving, consolidation shadow, and the lesion gradually absorbs again followed by Fibrous cord shadows (27 cases); ground-glass opacities in the lungs quickly progressed to a consolidation and then slowly absorbed . Most of the lesions were accompanied by more residual fibrous cord shadows (4 cases). In 2 severe patients, the lesions in the lungs were larger ground glass, and a big amount of fibrous foci remained after slowly absorption. Conclusion Chest CT plays an important role in the diagnosis and treatment of imported COVID-19, and the degree of lung involvement seen on CT images is in good agreement with clinical outcome.