【Objective】 To develop the Visual Cognitive Ability Assessment Scale for Preschool Children and to evaluate its reliability and validity, in order to provide reference for clinical evaluation of visual cognitive ability of preschool children. 【Methods】 1) From November 2021 to February 2022, construct the dimension framework was constructed and the pool of scale items was compiled according to the theory. 2) In March to June 2022, items were screened preliminarily through group discussion and Delphi method. In August 2022, the entries was revised by a pre-survey in a small sample (n=50). 3) Parents of children aged 4 - 7 from 8 kindergartens in 4 main urban areas of Nanjing were investigated by stratified cluster random sampling method in September to December 2022. The valid sample of the first survey (n=344) was analyzed to conduct item analysis and re-test reliability analysis, the valid sample of the second survey (n=695) was tested for reliability and confirmatory factor analysis, then the scale was finally compiled and evaluated. 【Results】 1) The scale contained 19 items in 4 dimensions:visual memory, discerning vision, spatial vision and visual integration. All items passed the project analysis test. 2) The Cronbach′s α coefficient of each dimension ranged from 0.604 to 0.886, and the Cronbach′s α coefficient of the whole scale was 0.917. During the two surveys, the scores of each item were correlated, and the average retest reliability coefficient was 0.601 (P< 0.05). 3) Content validity index (S-CVI) at scale level was 0.91, and item level content validity index (I-CVI) ranged from 0.8 to 1.0. After several rounds of model modification, the confirmatory factor model fit well. 【Conclusion】 The reliability and validity of the Visual Cognitive Ability Assessment Scale for Preschool Children are acceptable and meet the requirements of the scale, which provides a practical tool for clinical screening of visual and cognitive disorders.

Objective:To evaluate the detection ability of two kinds of high-throughput method to determine neutralizing antibodies based on a microneutralization test (MNT).Methods:Serum samples were collected from the early phase and follow-up period (117 samples in total) for neutralizing antibody testing. They were tested using MNT, pseudovirus neutralization assay (PBNA), competitive inhibition assay (including enzyme-linked immunosorbent assay (ELISA) and chemiluminescence immunoassay (CLIA)) to evaluate the correlation coefficients and threshold values for the effectiveness of these high-throughput neutralizing antibody assays.Results:The correlation coefficients for PBNA, ELISA, and CLIA relative to MNT were 0.760, 0.778, and 0.725, respectively, for individuals infected with 2019-nCoV. The area under the ROC curve was 0.901 for a cutoff value of 50 for the PBNA assay, 0.934 for a cutoff value of 1∶8 for the ELISA assay and 0.838 for a cutoff value of 1.28AU/ml for the CLIA assay when the threshold value for the microneutralization test was taken as 1: 10 (less than 1: 10 is considered negative).Conclusions:The high-throughput method for the detection of COVID-19 neutralizing antibodies are scientific and feasible, and provide an important technical tool for the regular prevention and control of the epidemic.

Objective:To summarize experience of nursing in radiofrequency ablation (RFA) for adrenocortical adenoma with Cushing′s syndrome combined steroid-induced diabetes mellitus.Methods:The key of preoperative nursing was precise glucose control by using insulin pump. Focus on patients psychological intervention. It was important for closely monitor the change of blood pressure, cortisol levels and biochemical index to prevent acute complications such as adrenal crisis during RFA. Pay attention to postoperative nutrition management for reduce blood glucose fluctuation and adverse reactions of hydrocortisone at postoperative.Results:No severe complications occurred during this procedure. After twenty-day nursing and treatment, the patient′s blood glucose control was stable, and the symptoms related to Cushing′s syndrome gradually disappeared.Conclusion:The ultrasound guided radiofrequency ablation in adrenocortical adenoma with Cushing′s syndrome combined with steroid-induced diabetes mellitus was a feasible, safe, and minimally invasive treatment. The key to effectively reduce postoperative complications and ensure the success of the operation. Are adequate preoperative preparation and strict monitor.

Objective: To investigate the pyroptosis induced by different enteroviruses in human neuroblastoma cells SH-SY5Y and the differences among them. Methods: SH-SY5Y cells were infected with nine strains of enterovirus respectively, including enterovirus A71 (EV-A71), Coxsackievirus A (CA), Coxsackievirus B (CB), Echovirus (Echo). The cellular morphology of infected and control groups were observed and activity of Caspase-1 of infected and control groups were detected by flow cytometry at 48 h post infection. Results: The activity of Caspase-1 induced by EV-A71 was higher than control (P<0.001), and the activity of Caspase-1 induced by EV-A71 isolated from severe case was significantly higher than that induced by EV-A71 isolated from common case (P<0.001). The activity of Caspase-1 induced by CA was at a lower level. The activity of Caspase-1 induced by CB and Echo were both significantly higher than that induced by EV-A71 and control (P<0.001). Cytopathic effects (CPE) were found to be related with the activity of Caspase-1. Conclusions EV-A71, CB and Echo all could induce pyroptosis mediated by Caspase-1 in SH-SY5Y cells, but the ability of CA to induce pyroptosis was at a lower level, which may provide evidences for further study on mechanism of neuropathy caused by enterovirus.

Objective To summarize theskill practice as the coremethods and training effect in tumor specialist nurse training , and to explore the suitable effective methods and pattern of China′s national conditions of specialist nurse training in China, for providing a reference for conducting cancer specialist nurse training. Methods Reviewed and analyzed tumor specialist nurse training method to make clear the training effect from 2012 to 2013, 100 students was investigated by using questionnaires , which contain 15 aspects, before and after the training respectively. designskill practice as the coreof the training content (160 hours) and theoretical classes (80 hours), established training evaluation criteria and the organization management system. Results All 100 students had grasped maintenance technology, observation of the complications of treatment, infusion port of the maintenance, the use of chemotherapy drugs, health education for patients with PICC catheter, and the use of effective order, the grasp rate was 100%. Complications rate was decreased significantly after using PICC catheter, (the rate of catheter related blood stream infections and the rate of thrombosis was reduced from the top 35%and 12%before training to 4%and 1%after training respectively (P<0.05). Conclusions In order to train more practical clinical nurse specialists, reduce the complications, raise the overall level of nursing profession, and improve the quality of nursing after using PICC catheter. Skill practice as the core methods in tumor specialist nurse training should be advocated.

Objective To investigate the eating problems of outpatient infants,preschool age children(1 to 7 years old) enrolled in the Department of Child Health Care,Nanjing Maternal and Child Health Hospital Affiliated to Nanjing Medical University,and to analyze its correlation with children's physical development,so as to establish strategies for preventing abnormal eating habit in children.Methods A toll of 2458 children met the criteria,and caregivers (mothers) completed the Children's Eating Behavior Questionnaires (CEBQ) in Department of Child Health Care,Nanjing Maternal and Child Health Hospital Affiliated to Nanjing Medical University were selected and the children's sociodemographic data and the morbidity of children eating problems were investigated.The correlation between children's body mass index(BMI) with children's eating problems was determined by using Chi-square test and multiple regression analysis.Results About 66.2％ (1627/2458 cases) had normal weight,and 10.8％ (257/2458 cases) and 8.5 ％ (210/2458 cases) were overweight (BMI ＞ P85-P95) or obese (BMI ≥ P95),respectively.The prevalence of eating behavior problems was detected during 25-36 months.For 1-to-7-year-old children,the highest detection rate of eating problems was inattention and eating at non-permanent locations,occupying 64.7％ (1590/2458 cases)and 50.5％ (1241/2458 cases),respectively;the prevalence rate of preferring to junk food was the lowest,accounting for 19.3％ (474/2458 cases).The children's eating problems had a high association with the children's BMI.Among them,children with eating problems,such as difficultly in accepting the varying food stuff[at the age of 12 month,odds ratio(OR)=11.50,95％ confidence interval(CI):1.84-72.16] and eating at non-permanent locations(at 25-36month,OR=1.77,95 ％ CI:1.11-2.83),were prone to be wasting away;children with eating problems,such as preferring to junk food (at 12 month,OR=5.08,95 ％ CI:1.43-18.00;13-18 month,OR=2.17,95 ％ CI:1.06-4.44),rarely eating vegetables or fruit (19-24 month,OR=4.06,95％CI:1.46-11.31) and inattention (12 month,OR=3.85,95 ％ CI:1.52-9.79),were associated with overweight or obesity (all P＜0.01).Conclusions There was a high prevalence of eating problems in children between 12-84 month(1-7 years old) in Nanjing.Improper children's eating behaviors can increase the risks of wasting away or children's overweight/obesity.

Objective To establish a double-antibody sandwich ELISA for the rapid detection of shiga toxin typeⅡ ( StxⅡ) in shiga toxin-producing Escherichia coli ( STEC) infection. Methods A pool of murine hybridomas was used to screen out the optimal antibody pair for the establishment of double-anti-body sandwich ELISA. The established ELISA system was used to detect StxⅡin the culture supernatants of 16 clinical strains of STEC. Specificity and sensitivity of the established ELISA system were also evaluated. Results Two antibodies, S2D8 and S2C6, were successfully screened out, based on which the double-anti-body sandwich ELISA was set up. StxⅡand its variants rather than StxⅠwas detected in the culture super-natants of STEC with a lowest detection limit of 4 ng/ml. Its performance was consistent with that of commer-cial colloidal gold test kit, indicating the characteristics of good specificity and sensitivity. Conclusion The S2D8/S2C6-based ELISA laid a foundation for researches which designates the shiga toxin as a potential can-didate on the diagnosis and therapy of STEC infection.

Objective To evaluate the practicability of using CRISPR/Cas9 genome editing tech-nology for inhibition of hepatitis B virus ( HBV) replication. Methods Two sgRNA targeting sites were de-signed for the S region of HBV genome. The CRISPR/Cas9 expression plasmids specific for HBV were con-structed and then transfected into a cell line expressing HBV genome(HepG2-N10). The cytotoxicity of cells transfected with different expression plasmids were detected by MTT assay. The levels of hepatitis B surface antigen ( HBsAg ) were determined by using chemiluminescent immunoassay ( CLIA ) . The expression of HBV at mRNA level was analyzed by quantitative real-time PCR ( qRT-PCR) . The qPCR was performed for the detection of extracellular and intracellular HBV DNA. The next-generation sequencing ( NGS) Illumina MiSeq Platform was used to analyze HBV genome editing. Results No significant cytotoxic effects were de-tected in HepG2-N10 cells transfected with different expression plasmids. Compared with the cells carrying pCas-Guide-GFP-Scramble, the levels of HBsAg in the supernatants of transfected cell culture harboring pCas-Guide-GFP-G1 and pCas-Guide-GFP-G2 were decreased by 24. 2% (P<0. 05) and 16. 9% (P>0. 05), respectively. The levels of HBsAg in cells transfected with pCas-Guide-GFP-G1 and pCas-Guide-GFP-G2 were respectively decreased by 16. 4% (P>0. 05) and 32. 1% (P>0. 05) as compared with that of pCas-Guide-GFP-Scramble transfected group. The expression of HBV at mRNA level was inhibited as indica-ted by the results of qRT-PCR. Moreover, the levels of extracellular HBV DNA were respectively suppressed by 23% (P>0. 05) and 35% (P<0. 05), and the levels of intracellular HBV DNA were respectively sup-pressed by 7. 2% (P>0. 05) and 18% (P>0. 05). Different types of insertion/deletion mutation were de-tected in HBV genome by high-throughput sequencing. Conclusion HBV-specific CRISPR/Cas9 system could inhibit the expression of HBV gene and the replication of virus. Therefore, the CRISPR/Cas9 genome editing technology might be used as a potential tool for the treatment of persistent HBV infection.

Shiga toxin 2 (Stx2) toxoid produced by formaldehyde treatment of purified toxin was used to immunize BALB/c mice for monoclonal antibody (MAb) production.The neutralizing activities of positive clones against Stx2 were screened by in vitro cytotoxicity assay.The isotype and specificity of resultant clone was determined,and its efficacy to neutralize the activity of purified Stx2 was evaluated by in vitro and in vivo toxicity model.Lastly,its spectrum of activity against Stx2 variants was also accessed by mouse toxicity model.It was demonstrated that one of the 12 positive MAb clones against Stx2,designating $2C4 had neutralizing activity.S2C4 belongs to the immunoglobulin G1 subclass and has a K light chain,and it reacts with the A subunit of Stx2 and does not bind to Stx2 B subunit or to Stx1.S2CA could efficiently neutralize the cytotoxicity of Stx2 to Veto cells and mice.It also protected mice against lethal doses of Stx2 variants challenge including Stx2c and Stx2vha.S2C4 is a promising candidate molecule in preventing the progression of hemolytic-uremic syndrome (HUS) mediated mainly by Stx2 in Stx-producing Escherichia coli(STEC)infection.

Objective To purify Shiga toxin Ⅱ (STX Ⅱ) of enterohaemorrhagic Escherichia coli (EHEC) O157: H7 by affinity chromatography, and characterize its biological function. Methods The immno-affinity chromatography column was prepared by STX Ⅱ A subunit-specific antibody S1D8 coupling to Sepharose 4B matrix. The purity and specificity of STX Ⅱ molecule secreted by EHEC O157:H7 were detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot, respectively. The purified toxin was serially diluted and the toxic activities to Vero cell line and mice were observed. The 50% cytotoxic dose (CD50) for Vero cell line and 100% lethal dose (LD100) for mice were calculated. The protection effect of anti-STX Ⅱ polysera to the mice against the purified toxin challenge was also observed. Results STX Ⅱ was successfully purified from culture supernatant of EHEC O157:H7 using affinity chromatography scheme. The relative molecular weights of STX Ⅱ A and B subunits were 32 000 and 7 500 confirmed by SDS-PAGE, respectively. The purified toxin could react with monoclonal antibodies against STX Ⅱ A and B subunits, respectively.The toxin was cytotoxic to Vero cell with CD50 of 20 ng/L and lethal to mice with LD100 of 5 ng.The toxin could be neutralized by anti-STX Ⅱ polysera in vivo. Conclusion STX Ⅱ is successfully purified and its toxic effects are confirmed in both cell line and mouse model.