Objective:To explore the distribution of HIV-1 genetic subtypes and drug resistance profiles among HIV-1 infected patients with antiretroviral treatment (ART) failure in Henan Province and to provide evidence for optimizing ART regimens.Methods:HIV-1 infected patients who had received ART for at least 6 months with viral loads (VL) ≥200 copies/ml in 18 cities of Henan from January to December 2023. The plasma samples were collected, and partial pol gene sequences and full-length integrase ( int) gene sequences of HIV-1 were amplified using nested RT-PCR. HIV-1 subtypes were determined using the REGA HIV-1 subtyping tool, and drug resistance mutations were analyzed using the Stanford University HIV Drug Resistance Database ( http://hivdb.stanford.edu/). Chi-square tests and multivariate logistic regression were used to identify risk factors associated with drug resistance of HIV-1 infected patients. Results:Among 697 HIV-1 infected patients with ART failure, 14 HIV-1 genetic subtypes were identified. Subtype B was predominant (58.68%, 409/697), followed by CRF01_AE (21.95%, 153/697) and CRF07_BC (12.91%, 90/697). The overall drug resistance rate was 72.31% (504/697), with CRF55_01B exhibiting a resistance rate of 91.30% (21/23). Non-nucleoside reverse transcriptase inhibitors (NNRTIs) had the highest resistance mutation rate (67.29%, 469/697), followed by nucleoside reverse transcriptase inhibitors (NRTIs)(56.81%, 396/697), protease inhibitors (PIs)(5.74%, 40/697), and integrase strand transfer inhibitors (INSTIs)(2.75%, 19/691). The results of multivariate analysis showed that the positive correlation factor for drug resistance in HIV-1 infected individuals with failed ART was baseline CD4 +T lymphocyte counts <200 cells/μl (a OR=3.84, 95% CI: 1.69-8.72), and the negative correlation factor was ART duration of 3-5 years (a OR=0.32, 95% CI: 0.13-0.77), the initial treatment ART protocol used two types of NRTIs plus one type of PIs (a OR=0.14, 95% CI: 0.05-0.43) and two types of NRTIs plus one type of INSTIs protocol (a OR=0.12, 95% CI: 0.03-0.57). Conclusions:The drug resistance rate of HIV-1 infected patients with ART failure was relatively higher in Henan Province in 2023. Strengthening the monitoring of HIV-1 drug resistance is of great significance to improve the ART effect of HIV-1 infected patients.

Senecavirus A (SVA) is a major viral pathogen causing disease in pigs, and effective monitoring of SVA infection is critical for disease control. In this study, we aimed to develop a reliable ELISA method for rapidly detecting neutralizing antibodies against SVA. We used HEK293F cells to express an SVA-specific porcine Fab antibody and verified the biological activity of the Fab antibody by indirect ELISA, immunofluorescence assay, virus neutralization test, and Western blotting. The Fab antibody was biotinylated and used as a competitive antibody to establish a competitive ELISA (C-ELISA) for detecting neutralizing antibodies against SVA. We then evaluated the C-ELISA in terms of sensitivity, specificity, repeatability, and result agreement rate with the VNT. The results showed that we successfully prepared an SVA-specific porcine Fab antibody, which showed high affinity for SVA. We named this antibody 1M33Fab and designated it as Bio-1M33Fab after biotin labeling. The assay conditions were optimized as follows: the coating concentration of SVA particles being 1 μg/mL, the working concentration of Bio-1M33Fab being 0.5 μg/mL, the optimal serum dilution of 1:10, and the optimal dilution of enzyme-labeled avidin being 1:30 000. At a percent inhibition (PI) of 47%, the assay demonstrated the highest sensitivity (96.88%) and specificity (100%), with no cross-reactivity observed with the positive sera of major porcine viral diseases. The intra-assay coefficient of variation ranged from 1.12% to 7.34%, while the inter-assay coefficient of variation ranged from 1.10% to 8.97%, indicating good repeatability. In the detection of 224 clinical pig serum samples, C-ELISA and VNT showed a result agreement rate of 93.75%. In conclusion, we successfully develop a C-ELISA method for detecting neutralizing antibodies against SVA by using a porcine-derived Fab antibody, which lays a foundation for the development of detection kits.
Animals ; Swine ; Antibodies, Neutralizing/immunology* ; Enzyme-Linked Immunosorbent Assay/methods* ; Immunoglobulin Fab Fragments/immunology* ; Antibodies, Viral/immunology* ; Picornaviridae/immunology* ; Humans ; HEK293 Cells ; Swine Diseases/diagnosis* ; Picornaviridae Infections/diagnosis*

OBJECTIVE To explore the early detection of large vestibular aqueduct syndrome(LVAS)in children by applying several audiological indicators.METHODS Ninety-two children with hearing loss(aged 1-70 months)were enrolled and divided into an LVAS group(45 cases)and a control group(47 cases).Eleven audiological indicators were statistically analyzed:lateral of hearing loss,the degree of hearing loss,configuration of hearing loss;ABR air-conduction threshold;ABR air-bone gap;ASSR average threshold;ASSR thresholds at 0.5,1,2,and 4 kHz;and tympanogram type.Indicators showing significant two-group differences were used to construct a visualized multifactorial linear prediction model using the R language.RESULTS Nine indicators demonstrated statistically significant differences between groups(P<0.05):laterality,configuration of hearing loss,ABR air-conduction threshold,ASSR average threshold,ASSR thresholds at all frequencies(0.5,1,2,4 kHz),and tympanogram type.A prediction model was established.When the total model score ranged between 200 and 240 points,the predicted LVAS risk probability was 0.1 to 0.99.The consistency index(C-index)was 0.85,indicating good predictive ability of the model.CONCLUSION The identified nine audiological indicators are valuable for the early detection of LVAS in children.The developed model can estimate LVAS risk.After refinement,this model holds potential to support early clinical diagnosis and intervention.

Objective To analyze the correlation between serum levels of C-X-C motif chemokine 5(CXCL5),Toll-like receptor 4(TLR4),and matrix metalloproteinase-3(MMP-3)with the degree of joint destruction and serum uric acid(SUA)levels in gouty arthritis patients with different clinical characteristics,and to evaluate their predictive value for severe GA.Methods A total of 212 GA patients(GA group)diagnosed at Xi'an People's Hospital between June 2023 and June 2025 were enrolled,along with 212 healthy individuals(control group).Predictive value was assessed using receiver operating characteristic(ROC)curve analysis,and correlation was assessed using Pearson method.Results Serum levels of CXCL5,TLR4,and MMP-3 were significantly higher in the GA group compared to the control group(P<0.05).Statistically significant differences in serum levels of CXCL5,TLR4,and MMP-3 were observed among GA patients with different clinical stages,affected joints,presence of tophi,disease duration,and annual attack frequency(P<0.05).The severe GA group had higher levels of CXCL5,TLR4,and MMP-3 compared to the mild GA group(P<0.05).GA patients were at higher risk for severe disease when serum CXCL5,TLR4,and MMP-3 levels exceeded 612.56 pg/mL,11.15 ng/mL,and 12.06 ng/mL,respectively.The combined prediction of severe GA by CXCL5,TLR4,and MMP-3 yielded an area under the curve(AUC)of 0.963.Compared to low-expression patients,those with high expression of CXCL5,TLR4,and MMP-3 had a 2.758-fold,2.184-fold,and 2.227-fold increased risk of severe GA,respectively.CXCL5,TLR4,and MMP-3 were identified as influencing factors for the disease severity(P<0.05).The high SUA group had significantly higher serum levels of CXCL5,TLR4,and MMP-3 compared to the low SUA group(P<0.05).Conclusion GA patients exhibit high serum expression of CXCL5,TLR4,and MMP-3,which are significantly associated with clinical features,the degree of joint destruction,and SUA levels,demonstrating considerable clinical value.

ObjectiveTo develop a reliable and valid health self-management competence assessment questionnaire for primary and secondary school students in Shanghai, so as to provide an effective tool to evaluate and improve their health management competencies. MethodsBased on the theory and process of scale development, an initial item pool was formed. After two rounds of Delphi consultation with 22 experts in related fields, assessment indicators suitable for evaluating the health self-management ability of Shanghai primary and secondary school students were determined. A total of 666 students were selected using stratified cluster sampling method to carry out the survey. The questionnaire content was refined and items were screened for reliability and validity analyses. ResultsAfter the two rounds of Delphi expert consultation, the original three-dimensional structure (individual management behaviors, personal health cognition and self-management environment) was revised into four dimensions: self-health cognition, self-health skills, self-will quality and self-action level. The initial 50 items were reduced, merged, or newly created, yielding a final 30-item questionnaire. Expert response rates for the two rounds of Delphi consultation were 86.36% and 90.91%, respectively, with an expert authority coefficient of 0.91. The KMO value was 0.936 and Bartlett’s sphericity test yielded a P value of <0.001, indicating that the questionnaire demonstrated good construct validity. The results of internal consistency testing showed that the overall Cronbach’s α coefficient was 0.932, and the split-half reliability coefficient was 0.920. The Cronbach’s α coefficient of each dimension ranged from 0.716 to 0.884, and the split-half reliability coefficient ranged from 0.733 to 0.900. Finally, an evaluation scale with 30 items across 4 dimensions was constructed. ConclusionThe health self-management competence evaluation scale for primary and secondary school students in Shanghai demonstrates good homogeneity and high reliability. It can be used as a tool for evaluating the health self-management competency of primary and secondary school students in Shanghai and provide theoretical support for targeted health interventions.

Objective:To explore the distribution of HIV-1 genetic subtypes and drug resistance profiles among HIV-1 infected patients with antiretroviral treatment (ART) failure in Henan Province and to provide evidence for optimizing ART regimens.Methods:HIV-1 infected patients who had received ART for at least 6 months with viral loads (VL) ≥200 copies/ml in 18 cities of Henan from January to December 2023. The plasma samples were collected, and partial pol gene sequences and full-length integrase ( int) gene sequences of HIV-1 were amplified using nested RT-PCR. HIV-1 subtypes were determined using the REGA HIV-1 subtyping tool, and drug resistance mutations were analyzed using the Stanford University HIV Drug Resistance Database ( http://hivdb.stanford.edu/). Chi-square tests and multivariate logistic regression were used to identify risk factors associated with drug resistance of HIV-1 infected patients. Results:Among 697 HIV-1 infected patients with ART failure, 14 HIV-1 genetic subtypes were identified. Subtype B was predominant (58.68%, 409/697), followed by CRF01_AE (21.95%, 153/697) and CRF07_BC (12.91%, 90/697). The overall drug resistance rate was 72.31% (504/697), with CRF55_01B exhibiting a resistance rate of 91.30% (21/23). Non-nucleoside reverse transcriptase inhibitors (NNRTIs) had the highest resistance mutation rate (67.29%, 469/697), followed by nucleoside reverse transcriptase inhibitors (NRTIs)(56.81%, 396/697), protease inhibitors (PIs)(5.74%, 40/697), and integrase strand transfer inhibitors (INSTIs)(2.75%, 19/691). The results of multivariate analysis showed that the positive correlation factor for drug resistance in HIV-1 infected individuals with failed ART was baseline CD4 +T lymphocyte counts <200 cells/μl (a OR=3.84, 95% CI: 1.69-8.72), and the negative correlation factor was ART duration of 3-5 years (a OR=0.32, 95% CI: 0.13-0.77), the initial treatment ART protocol used two types of NRTIs plus one type of PIs (a OR=0.14, 95% CI: 0.05-0.43) and two types of NRTIs plus one type of INSTIs protocol (a OR=0.12, 95% CI: 0.03-0.57). Conclusions:The drug resistance rate of HIV-1 infected patients with ART failure was relatively higher in Henan Province in 2023. Strengthening the monitoring of HIV-1 drug resistance is of great significance to improve the ART effect of HIV-1 infected patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

11β-Hydroxylase deficiency(11β-OHD) is a relatively rare type of autosomal recessive hereditary disease congenital adrenal cortical hyperplasia. This article reports the diagnosis and treatment of a case of 11β-OHD combined with subacute thyroiditis leading to severe hypokalemia treated in our hospital, along with a review of relevant literature.

Objective To understand the dilemma and coping experience of pediatric nurses participating in medication safety management,so as to provide a reference for improving the quality of medication safety management.Methods This study was a descriptive phenomenological study.The puiposive sampling method was used to conduct semi-structured interviews with 21 pediatric nurses from in a tertiary A hospital in Nanjing from January to February 2024.The interview data were extracted,coded,cluster screened,interpreted and verified by the Colaizzi seven-step analysis method.Results In terms of the dilemmas of pediatric nurses involved in medication safety management,there were 3 themes,including knowledge and skills,environment and resources,understanding and cooperation,and 7 sub-themes.In terms of coping experience of pediatric nurses involved in medication safety management dilemma,there were 3 themes,including responsibility and emotion,communication and collaboration,system and supervision,and 4 sub-themes.Conclusion Pediatric nurses will encounter various difficulties and actively adopt various coping strategies when participating in medication safety management.It is recommended that nursing managers strengthen education and training,quality management,continuously improve nurses'safety responsibility awareness and empathy ability,encourage parents of children to participate in medication safety management,and actively improve the pediatric working environment,continuously strengthen organizational support,and promote communication and collaboration to ensure medication safety.

OBJECTIVE To investigate the effect of pharyngeal cavity and genoglossus muscle exercises in patients with mild obstructive sleep apnea syndrome(OSAHS)left over after palatopharyngoplasty with diastolic cardiac dysfunction.METHODS A total of 75 patients with mild OSAHS left after palatopharyngoplasty with diastolic cardiac dysfunction from January 2021 to August 2023 were selected for retrospective study.Among them,37 patients underwent pharyngeal cavity and mentoglossum muscle exercise(observation group),while 38 patients did not(control group).Using postoperative data as baseline value.mean blood oxygen saturation(MSpO2),lowest oxygen saturation(LSpO2),sleep efficiency,apnea index(AI),sleep latency,apnea hypopnea index(AHI),hypopnea index(HI),microarousal index(MAI),rapid eye movement latency,arterial blood pressure of carbon dioxide(PaCO2),pH,arterial partial oxygen pressure(PaO2),left ventricular end-systolic diameter(LVDs),blood lactic acid,left ventricular ejection fraction(LVEF),Tei index,left ventricular end-diastolic diameter(LVDd),daytime Epworth sleepiness scale(ESS)score,Pittsburgh sleep quality index(PSQI)score and incidence of adverse cardiovascular events(MACE)were compared at baseline and 3 months later.RESULTS After 3 months,AHI,HI and AI in observation group were lower than those in control group,and MSpO2 and LSpO2 were higher than those in control group(P<0.05);Sleep efficiency of observation group was higher than control group,daytime ESS score,PSQI score and MAI were lower than control group(P<0.05).There were no significant differences in PaCO2,LVDd,PaO2,blood lactic acid,sleep latency,pH,LVEF,rapid eye movement latency,LVDd,Tei index between the observation group and the control group(P>0.05).The incidence of MACE in the observation group was 5.41%(2/37),compared with 13.16%(5/38)in the control group,there was no significant difference(P>0.05).CONCLUSION In patients with mild OSAHS left after palatopharyngoplasty with diastolic cardiac dysfunction,the exercise of pharyngeal cavity and genoglossus can improve hypopnea,alleviate clinical symptoms and improve sleep quality,but it has limited effect on the improvement of cardiac function.