Objective:To analyze and summarize the epidemiological and molecular characteristics of SARS-CoV-2 Delta variant, a variant of concern (VOC), in Henan Province in 2021 in order to provide a basis for epidemic prevention and control.Methods:According to the feedback of sequencing results from Chinese Center for Disease Control and Prevention, 111 patients infected with SARS-CoV-2 Delta VOC were selected from the Henan imported and local cases in 2021. Basic patient information was obtained from the pandemic website. The differences in age, gender, vaccination history, the number of vaccine doses and different clinical types were analyzed. Moreover, the differences in RT-qPCR results of ORF1 ab gene and N gene Ct values between cases of different genders and symptoms were analyzed statistically. Sequencing results of the nucleotide and S protein mutation sites were analyzed. Results:There was no significant difference in the gender distribution of 111 cases between different age groups (χ 2=2.217, P=0.529). There was also no significant difference in clinical types between patients with different vaccination history (χ 2=12.074, P=0.209). The Ct values of most SARS-CoV-2 nucleic acid-positive specimens were distributed in the lower range and the viral loads were higher. The difference in the Ct value of ORF1 ab gene between different gender groups was not statistically significant (χ 2=1.646, P=0.439), but were significantly different among asymptomatic, mild, normal, and severe cases (χ 2=13.257, P=0.039). There was no significant difference in N gene Ct value among cases of different genders or different symptoms (all P>0.05). The 111 patients in this study were mainly found through close-contact screening and full-staff nucleic acid screening and accounted for 62.2% (69 cases) of the total. The sequencing length coverage was basically greater than 99% (accounting for 90.1%, 100/111); the total number of nucleotide mutation sites was mostly in the range of 46-50 (86.4%, 89/103); the total number of S protein mutation sites was mostly 12 (82.5%, 85/103). The 103 Delta mutants all contained nine mutation sites, which were T19R, R158G, L452R, T478K, D614G, P681R, D950N, E156del and F157del, with a mutation rate of 100%. Conclusions:People were highly susceptible to the SARS-CoV-2 Delta in Henan Province in 2021. High viral load and increase in the ORF1 ab gene load would aggravate the clinical symptoms.

Objective:To investigate the level and changing trend of microparticles (MPs) in super-elderly infected patients, and explore its early warning effect on infection.Methods:The infected patients ≥ 85 years old admitted to the Second Medical Center of Chinese PLA General Hospital from December 2018 to March 2019 were selected as the observation group, and the healthy volunteers ≥ 85 years old in the same period were selected as the control group. Venous blood samples were collected at the 2nd hour, the 2nd day and the 7th day after fever, and the inflammatory markers such as white blood cell count (WBC), neutrophil percentage (NEUT), C-reactive protein (CRP) and procalcitonin (PCT) were measured. The levels of MPs were determined by flow cytometry. AnnexinⅤlabeled CD11b positive MPs (AnnexinⅤ +/CD11b + MPs) represented leukocyte microparticles (LMPs), and AnnexinⅤlabeled CD66b positive MPs (AnnexinⅤ +/CD66b + MPs) represented neutrophil microparticle (NMPs). The differences of each index at different time points between the two groups were compared, and the predictive value of each index to the infection of elderly patients was analyzed by receiver operating characteristic (ROC) curve. Results:A total of 38 subjects were enrolled, including 28 cases in the observation group and 10 cases in the control group. The levels of LMPs and NMPs in the observation group increased to the peak at the 2nd hour after fever, and were significantly higher than those in the control group [LMPs (cells/μL): 55.0 (28.8, 197.2) vs. 19.0 (13.5, 28.3), NMPs (cells/μL): 226.5 (123.3, 516.5) vs. 26.5 (22.0, 48.8), both P < 0.01]. With the control of the disease, LMPs and NMPs decreased gradually. The NMPs on the 2nd day was significantly lower than that at the 2nd hour of fever [cells/μL: 106.0 (40.0, 309.0) vs. 226.5 (123.3, 516.5), P < 0.05], and the LMPs and NMPs on the 7th day were significantly lower than those on the 2nd day [LMPs (cells/μL): 17.0 (12.5, 43.8) vs. 42.0 (13.0, 117.0), NMPs (cells/μL): 30.0 (15.8, 62.0) vs. 106.0 (40.0, 309.0), both P < 0.05]. There was no significant difference in the levels of LMPs and NMPs between the two groups on the 7th day. Among the inflammatory markers, the NEUT in the observation group was significantly higher than that in the control group at the 2nd hour of fever (0.70±0.09 vs. 0.59±0.04, P < 0.01), but there was no significant difference in WBC, CRP and PCT between the two groups. On the 2nd day, the inflammatory markers in the observation group reached the peak and were significantly higher than those in the control group [WBC (×10 9/L): 9.33±2.44 vs. 6.37±1.28, NEUT: 0.78±0.08 vs. 0.57±0.04, CRP (mg/L): 5.67±2.99 vs. 0.33±0.18, PCT (μg/L): 0.80±0.67 vs. 0.07±0.03, all P < 0.01]. On the 7th day, the inflammatory markers in the observation group decreased significantly, and there was no significant difference between the observation group and the control group. ROC curve analysis showed that the area under ROC curve (AUC) and 95% confidence interval (95% CI) of LMPs and NMPs on the day of fever were higher than those of WBC, NEUT, CRP and PCT [0.888 (0.763-1.000), 0.973 (0.931-1.000) vs. 0.679 (0.346-0.811), 0.829 (0.700-0.958), 0.607 (0.404-0.811), 0.554 (0.358-0.749)]. Conclusion:LMPs and NMPs are significantly increased in the early stage of fever, which can predict the incidence of infection in the super-elderly patients.

Objective:To understand the current status of new nurses' role pressure and the mental climate of nursing work environment, and analyze the effects of the mental climate of nursing work environment on new nurses' role pressure.Methods:In this cross-sectional study, the new nurses from 5 Class Ⅲ Grade B or above hospitals in Zhejiang Province between November and December 2019 were selected by convenient sampling, and investigated with the general information questionnaire, Newly Graduate Nurses' Role Conversion Pressure Questionnaire, and the Chinese version of the Spiritual Climate Scale. The effects of the mental climate of nursing work environment on new nurses' role pressure. Totally 450 questionnaires were distributed, and 423 valid questionnaires were collected, accounting for an effective recovery rate of 94.0%.Results:The total score of the 423 new nurses' role pressure was (85.53±9.54) , and the total score of mental climate was (63.52±7.46) . The total scores of role pressure of the new nurses was negatively correlated with the mental climate ( P<0.05) ; the results of univariate analysis showed statistically significant difference in role pressure scores of new nurses with different educational backgrounds, departments ( P<0.05) . Conclusions:New nurses have a high role pressure, and the role pressure is correlated with the mental climate of the work environment. Nursing managers can alleviate the role pressure of new nurses by establishing a good work environment and improving the spiritual and cultural atmosphere of the department.

Objective To study the effect of endovenous laser ablation combined with subfascial endoscopy therapy for venous ulcer of the lower limbs.Methods Clinical data of 112 patients undergoing endovenous laser ablation combined with subfascial endoscopy therapy for venous ulcer of the lower limbs from Oct 2011 to Feb 2016 was retrospectively evaluated.Results Patients had average 2-6 perforating veins in their affected lower limbs.Procedures were successful in all the patients,all the superficial varicose veins disappeared after 1 month and 1 year of ultrasound follow-up,perforating veins closed,ulcer healed,and chromatosis alleviated.Conclusion Endovenous laser ablation combined with subfascial endoscopy therapy for venous ulcer of the lower limbs is effective,safe and quick recovery.

Objective To explore the value of Oxford acute severity of illness score in evaluating the severity and prognosis of critical illness patients.Methods All adult patients admitted to the Department of Critical Care Medicine from August 2012 to July 2014 were retrospectively analyzed.The severity in survivors and non-survivors was evaluated by using Oxford acute severity of illness score and APACHE Ⅲ score,and then statistic analysis were performed.Results Of 470 patients,321 (68.297％) were male,the range of age and ((x) ±s) age were 18 to 97 years and (59 ± 18) years respectively,and 123 patients (26.170％) were in non-survivors group and 347 patients in survivors group.The area under the ROC of Oxford acute severity of illness score was 0.760 (95％ CI:0.712-0.808,P ＜ 0.001),and Youden index was biggest when Oxford acute severity of illness score was 30.5.The area under the ROC of APACHE Ⅲ score was 0.844 (95％ CI:0.806-0.882,P ＜ 0.01),and Youden index was biggest when APACHE Ⅲ score was 70.5.Mortality was high (above 70％) as Oxford acute severity of illness score increased (＞ 40),and Spearman r was 0.976 (P ＜ 0.01).Conclusions Oxford Acute Severity of Illness Score was useful to evaluating the severity and prognosis of critical illness patients and it was easy in clinical practice.

Objective To explore the clinical features of Marfan syndrome (MFS) and its virulence gene mutation of FBN1.Methods Clinical data of 2 children with MFS were retrospectively analyzed, and pertinent literatures were reviewed. Results Case one was a 1 year and 10 months old boy with a special face, bilateral lower eyelid edema, high palatal arch, slender fingers and toes. A little of moist rales in lung could be heard, and systolic accentuated in apex could be heard too. Echocardiography showed that aortic coronary sinus dilated, aorta and pulmonary artery broadened, left ventricular diverticulum, a small amount of mitral regurgitation,and moderate tricuspid regurgitation. Electrocardiogram showed incomplete right bundle branch block. Gene detection found a c.3037G>A mutation (p.Gly1013Arg) inFBN1. Case two was a 12 years old slender boy with spider-like ifnger/toe, high myopia, 2/6 systolic and diastolic murmur in the ifrst and two auscultation area in aortic valves. Echocardiography showed the aortic sinus signiifcantly broadened, aortic incompetence, mild pulmonary regurgitation and left ventricular enlargement. Gene detection found heterozygous mutation of c.1876G>A (p.Gly626Arg) in FBN1, which has not been reported.Conclusion The diagnosis of MFS can be conifrmed byFBN1 gene detection. A new mutation of c.1876G>A (p.Gly626Arg) was detected.

Objective To investigate the association between MPO gene single nucleotide polymorphisms (SNP) loci (rs2333227,-643G/A) and clinical characteristics in Kawasaki disease (KD) in Han population in central China. Methods A case-control study was performed. Two hundred and thirty-seven children with KD and 249 normal children were recruited. The polymorphism distribution of SNP was detected using PCR-RFLP. The clinical data of children with KD were collected. Results The frequency of SNP loci (rs2333227) genotypes (GG, GA, AA) was signiifcantly different between children with KD and normal children (P=0.039), the allele frequency was also signiifcantly different between two groups (P=0.012), and the G allele was the risk factor. Compared with other genotypes, KD children with GG genotype had higher frequency in hand-foot edema (P=0.029). The SNP polymorphism was also associated with peritoneal effusion (P=0.028), however this SNP polymorphism was not associated with conjunctival hyperemia, oral mucosa lesions, and coronary artery lesion (P>0.05), also was not associated to imaging characteristics of hepatomegaly, splenomegaly, and lobular pneumonia (P>0.05). Conclusion The SNP loci (rs2333227) in MPO gene was associated with KD susceptibility, the G allele was a risk factor, and the SNP polymorphisms is associated with some clinical characteristic.

Scientific research funds management is an important part of the construction of a clean and honest government.The Party committee should fulfill the main responsibility.Based on the practice of hospital management,this paper discusses how to implement the main responsibility of the Party committee in scientific research funds management.

Objective To investigate the effect of eicosapentaenoic acid(EPA)on the apoptosis of human colon cancer SW480 cells and the mechanisms.Methods Mitochondrial membrane potential was detected,the quan-tity of cytochrome C was analyzed by Elisa kit,and the expression of cleaved caspase -9 and caspase -3 was detected by Western Blot.Results After treatment with EPA (0μg/mL,42.1μg/mL,84.2μg/mL,168.4μg/mL),the mitochondrial membrane potential(Δψm)of SW480 cells were declined (P <0.05 ),the values were (99.71 ± 0.04)%,(95.04 ±0.10)%,(88.65 ±0.41)% and (73.60 ±1.20)%(t =5.161,6.302,4.601,5.198,all P <0.05).The quantity of cytochrome C in cytosol was increased significantly compared with no treatment group,and the values were (12.8 ±1.2)ng/mL,(115.5 ±3.5)ng/mL,(290.5 ±5.2)ng/mL and (262.0 ±12.5 )ng/mL in different EPA treatment groups(t =6.345,6.013,5.846,4.613,all P <0.01).The expression of cleaved caspase -9 and caspase -3 were significantly increased.Conclusion EPA inhibits SW480 cells growth and induces apoptosis in a dose dependent manner.This action may be mediated by mitochondria -mediated intrinsic apoptosis pathway,cyto-chrome C release,and caspase -9 and caspase -3 activation.

ObjectiveTo investigate the association between nucleotide polymorphisms ofGRIN3A gene and clinical characteristic of Kawasaki disease (KD) in children in Han population in central Chinese.MethodsA case-control study was performed. A total of 191 children with KD were recruited and 217 healthy children were served as controls. The distribution of SNP was determined by PCR-RFLP. Arterial lesions were detected by echocardiographic.ResultsThe distribution of three genotypes (CC, CG, GG) in SNP (rs7849782) was statistically difference between KD and control groups (P=0.034), and C allele was associated with KD susceptibility (OR=1.46, 95%CI: 1.10-1.92,P=0.007). In children with KD, the polymorphism of SNP loci was signiifcantly associated with oral mucosa lesions and coronary artery lesion (P<0.05), but not associated with conjuncti-val hyperemia, hand-foot edema, rash, and lymphadenopathy (P>0.05). The polymorphism of SNP loci was also associated with the levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) (P<0.05).ConclusionThe ploymorphism of SNP loci ofGRIN3A gene (rs7849782) was associated with the susceptibility of KD. The C allele was the risk factors. The poly-morphism of SNP was associated with oral mucosa lesions and coronary artery lesion, and may affect the levels of ESR and CRP.