Objective To explore the prevalence of 9 respiratory pathogens from March 2023 to February 2024,as well as the detection efficiency of various methods for pathogens.Methods A retrospective analysis was conducted on the detection of 9 pathogens in 38 948 patients who first presented with respiratory symp-toms from March 2023 to February 2024,as well as the detection efficacy of nucleic acid,antigen,antibody and other methods.Results Firstly,among 38 948 patients,a total of 8 345 cases(21.43%)were detected with at least one pathogen,of which 8 158 cases(20.95%)were detected with only one pathogen,and 187 cases(2.29%,187/8 158)were detected with two or more pathogens.The top three detection rates were SARS-CoV-2(20.37%),mycoplasma pneumoniae(MP,15.58%)and influenza A virus(IVA,10.79%).Secondly,among patients who detected at least one of the nine pathogens,the detection rate was 24.94%in autumn,21.45%in spring,18.54%in summer,and 19.22%in winter,and the difference in detection rates between the four seasons was statistically significant(P<0.001).Thirdly,except for the relatively high detection rates of SARS-CoV-2 in spring(51.24%)and summer(37.31%),and the highest detection rate of IVB in winter(11.28%),the detection rates of other pathogens were highest in autumn.Fourthly,there was a statistically significant difference in the total detection rates among the children group(31.83%),the youth group(12.48%),the middle-aged group(10.70%),and the elderly group(12.43%)(P<0.001).The detection rates of 7 pathogens,including MP,IVA,Influenza B virus(IVB),syncytial virus,CP,adenovirus,and parain-fluenza virus type 1,were highest in children,and there was a statistically significant difference in comparison between different age groups(P<0.05).The detection rate of SARS-CoV-2 in the children group(3.45%)was lower than that in other age groups(30.90%,29.09%,32.16%,P<0.001).There was no statistically significant difference in HPIV-3 between different age groups(P=0.478).Fifthly,there was no significant difference in overall detection rate between male and female(P>0.05).However,the detection rates of MP and CP in female were higher than those in male(P<0.05),while IVA in male was slightly higher than that in female(P=0.014).There were no significant differences in the detection rate of other 6 pathogens between female and male(P>0.05).Sixthly,the detection rate of MP antigen was lower than that of MP nucleic acid detection(P<0.001),and the detection rate of MP antibody detection was lower than that of MP nucleic acid detection(P<0.001).The detection rate of MP antibody detection increased significantly with the extension of time from initial symptoms to medical treatment(P<0.001).Seventhly,the detection rates of antigen of IVA,IVB,RSV and ADV were significantly lower than those of the corresponding nucleic acid(P<0.001),and the detection rates of nucleic acid testing for 4 kinds of pathogen was about 5 times that of the correspond-ing antigen testing(4.75-6.25 times).And the consistency of the detection rate between antigen detection and nucleic acid detection was poor(Kappa=0.046-0.239).Conclusion The prevalence of common respir-atory pathogens from March 2023 to February 2024 exhibits certain characteristics.Moreover,the detection ef-ficiency of different methods for pathogens varies greatly,and appropriate detection methods should be select-ed based on a thorough understanding of their performance.

Objective:To establish a rat model of diabetic microangiopathopathy and simulate the biochemical and pathological changes of diabetic retinal and renal microangiopathopathy.Methods:Forty healthy male Sprague-Dawley rats were randomly divided into blank group and model group (10 and 30 rats, respectively). After the rats in blank group and model group were fed ordinary diet and high-fat and high-sugar diet for 5 weeks, respectively, the rats in model group were injected with 1% streptozotocin (STZ) through the abdominal cavity at the dose of 35 mg/kg to establish a type 2 diabetes model. After modeling, the rats were continuously fed until the 10th week (4 weeks after modeling), the general conditions of the rats were observed, and samples were collected for follow-up experiments. Serum creatinine (CREA), triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), microalbuminuria, urinary creatinine (UCr) and urine sugar were detected. Calculate the kidney index and microalbumin/urinary creatinine ratio (UACR). Optical coherence tomography angiography (OCTA) was used to observe the vascular changes and non-perfusion area of retinal superficial capillary plexus. The morphological and structural changes of kidney and retina were observed by hematoxylin-eosin and periodate Scheff staining. The expression of nerve fibers and nucleus of Müller cells in rat retina was observed by immunofluorescence staining. Ultrastructural results of retina were observed by transmission electron microscope. Independent sample t test was used for comparison between groups. Results:Four weeks after modeling, compared with blank group, the body weight of rats in model group was significantly decreased, and random glucose was significantly increased, with statistical significance ( t=5.755, -51.291; P<0.05). Renal index, urinary glucose and UACR were significantly increased, while UCr was significantly decreased, with statistical significance ( t=10.878, 137.273, 3.482,-6.110; P<0.05). CREA decreased, TG, TC, HDL-C, LDL-C increased, and the differences were statistically significant ( t=-28.012, 33.018, 118.018, 13.585, 16.480; P<0.05). OCTA examination showed that there was no perfusion area of shallow retinal capillaries. The optical microscope showed that the inner boundary membrane of retina in model group was swollen and thickened, the surface was uneven, the inner and outer nuclear layer cells were disordered and the density decreased. Glomerular congestion was accompanied by cortical tubular epithelial swelling, widening of the mesangial area, and thickening of the basement membrane. The results of immunostaining showed that the inner and outer plexiform layers of the retina showed lamellar strong green fluorescence expression, and the inner and outer nuclear layers showed scattered dot green fluorescence expression. Transmission electron microscopy showed that the basal membrane of retinal microvessels in model group was slightly thickened, vascular endothelial cells edema, endothelial nucleus and perinucleus contraction, nuclear membrane contraction, mild mitochondrial swelling, vacuolation. Conclusion:High-glucose and high-fat feeding plus a single intraperitoneal injection of STZ 35 mg/kg can successfully establish a microangiopathic model of type 2 diabetes.

OBJECTIVE: To observe the clinical characteristics of mild and common COVID-19 patients infected with the Omicron variant, and to analyze related factors affecting the time to negative conversion of viral nucleic acid detection. METHODS: Clinical data of 1781 patients with coronavirus disease 2019 (COVID-19) admitted to a cabin hospital in Shanghai from April 12 to May 26, 2022, were retrospectively analyzed, including age, gender, height, weight, clinical symptoms, comorbid diseases, COVID-19 vaccination, treatment, and nucleic acid negative conversion time. Univariate and multivariate logistic regression analyses were used to analyze the influencing factors of nucleic acid negative conversion time. RESULTS: Among the 1781 patients, 995 were male and 786 were female, with a median age of 39 (30, 52) years. There were 727 patients (40.8%) with overweight and obesity [body mass index (BMI) > 24 kg/cm ²) and 413 patients (23.2%) had comorbid diseases. 205 cases (11.5%) were not vaccinated while 1576 cases were vaccinated. There were 1233 cases (69.2%) with one or more symptoms. The main clinical symptoms were cough (60.3%), expectoration (50.4%) and fever (36.9%). 1444 cases (81.0%) were treated with Chinese medicine, 78 cases (4.4%) were treated with western medicine, 14 cases (0.8%) were treated with integrated Chinese and western medicine, and 245 cases (13.8%) did not receive any medical treatment. All patients improved and were discharged. The median nucleic acid negative conversion time was 10.3 (7.4, 12.4) d. Univariate and multivariate analysis showed that, age ≥ 60 years ( OR＝1.537, 95% CI: 1.116 - 2.115, P<0.01), BMI > 24 kg/cm ² ( OR＝1.344, 95% CI: 1.106 - 1.634, P<0.01 ) and hypertension ( OR＝1.518, 95% CI: 1.094 - 2.106, P<0.05) were independent risk factors for prolonged nucleic acid negative conversion. COVID-19 vaccination ( OR=0.548, 95% CI: 0.398 - 0.755, P<0.01) was a protective factor, that is, vaccination shortened the time for the nucleic acid test to become negative. CONCLUSIONS The symptoms of the Omicron variant infection were relatively mild and occult. Age ≥ 60 years old, comorbid hypertension, no vaccination and BMI > 24 kg/cm ² are independent influencing factors for prolonged nucleic acid negative conversion.
Humans ; Female ; Male ; Middle Aged ; SARS-CoV-2 ; COVID-19/epidemiology* ; COVID-19 Vaccines ; Retrospective Studies ; China ; Hypertension/epidemiology* ; Nucleic Acids

Objective:To investigate the applicable effect of anatomical retroperitoneoscopic adrenalectomy in treating patients with adrenal tumors.Methods:A total of 112 patients with adrenal tumors admitted to the Department of urology of The Third Medical Center of Chinese PLA General Hospital from January 2016 to January 2021 were selected as research subjects，and they were divided into control group and study group according to the double-blind method，with 56 cases in each group. The patients in the control group were treated with laparoscopic transabdominal adrenalectomy，while the patients in the study group were treated with anatomical retroperitoneoscopic adrenalectomy. The clinical indicators of the two surgical methods were compared. Before and six hours after surgery，the serum levels of inflammatory factors including interleukin-6（IL-6），interleukin-1β（IL-1β），and hypersensitive C-reactive protein（hs-CRP）were detected by enzyme-linked immunosorbent assay（ELISA），and the electrolytes such as Na +，K +，and bicarbonate（HCO 3-）were detected by the America-made Medica electrolyte analyzer. The prognosis and incidence of complications in the two groups were observed. Results:Compared with the control group，the time spent in operation，the time spent for drainage tube placement and gastrointestinal function recovery，and hospital stay were all shorter in the study group（ P < 0.05 or P < 0.01）. After surgery，the serum levels of IL-6，IL-1β，and hs-CRP in the study group were significantly lower than those in the control group，and the levels of Na + and HCO 3- in the study group were also lower than those in the control group，while the K + level was higher than that in the control group，all with statistically significant differences（ P < 0.05 or P < 0.01）. The incidence of complications in the study group［3.57%（2/56）］was significantly lower than that in the control group［（14.29%（8/56）］，with statistically significant difference（ P < 0.05）. No recurrence or metastasis occurred in the two groups during the six-month follow-up after surgery. Conclusion:Anatomical retroperitoneoscopic adrenalectomy can better reduce the surgery trauma to patients with adrenal tumors，lessen the impact on the internal environment of patients，effectively promote the postoperative rehabilitation process，and has higher safety.

Objective:To investigate the applicable effect of anatomical retroperitoneoscopic adrenalectomy in treating patients with adrenal tumors.Methods:A total of 112 patients with adrenal tumors admitted to the Department of urology of The Third Medical Center of Chinese PLA General Hospital from January 2016 to January 2021 were selected as research subjects，and they were divided into control group and study group according to the double-blind method，with 56 cases in each group. The patients in the control group were treated with laparoscopic transabdominal adrenalectomy，while the patients in the study group were treated with anatomical retroperitoneoscopic adrenalectomy. The clinical indicators of the two surgical methods were compared. Before and six hours after surgery，the serum levels of inflammatory factors including interleukin-6（IL-6），interleukin-1β（IL-1β），and hypersensitive C-reactive protein（hs-CRP）were detected by enzyme-linked immunosorbent assay（ELISA），and the electrolytes such as Na +，K +，and bicarbonate（HCO 3-）were detected by the America-made Medica electrolyte analyzer. The prognosis and incidence of complications in the two groups were observed. Results:Compared with the control group，the time spent in operation，the time spent for drainage tube placement and gastrointestinal function recovery，and hospital stay were all shorter in the study group（ P < 0.05 or P < 0.01）. After surgery，the serum levels of IL-6，IL-1β，and hs-CRP in the study group were significantly lower than those in the control group，and the levels of Na + and HCO 3- in the study group were also lower than those in the control group，while the K + level was higher than that in the control group，all with statistically significant differences（ P < 0.05 or P < 0.01）. The incidence of complications in the study group［3.57%（2/56）］was significantly lower than that in the control group［（14.29%（8/56）］，with statistically significant difference（ P < 0.05）. No recurrence or metastasis occurred in the two groups during the six-month follow-up after surgery. Conclusion:Anatomical retroperitoneoscopic adrenalectomy can better reduce the surgery trauma to patients with adrenal tumors，lessen the impact on the internal environment of patients，effectively promote the postoperative rehabilitation process，and has higher safety.

Objective To understand the status quo of servant leadership behavior of head nurses in military hospital and its relationship with nurses′ intention to stay, and to make suggestions for maintaining the stability of military hospital nurses. Methods A total of 501 nurses from a military hospital (top three) were surveyed by self-designed general data scale, Head Nurses′Servant Leadership Behavior Scale and Turnover Intention Scale. Results The average score of servant leadership behavior was (80.39 ± 13.79) points, and the correlation coefficient between the head nurse service and the leave intention was-0.255 (P<0.01). Conclusions The servant leadership behavior of the head nurses in a military hospital is at a moderate level and it still can be ameliorated. Training can improve head nurses′capacity of the servant leadership behavior, which can reduce the turnover intention of the nurses in military hospitals.

Objective To investigate the vaginal microbilme characterization in women with human papillomavirus(HPV)16 and 18 infection and high-grade cervical intraepithelial neoplasia(CIN).Methods Three groups were set,including control group(without HPV infection and with colpitis),low-grade CIN group(with HPV 16 or/and 18 infection),and high-grade CIN group(with HPV 16 or/and 18 infection).Virginal microbial composition was determined by using 16S rRNA amplication sequencing and hierarchical clustering analysis among three groups was applied.Rank sum test was used to determine statistical significance.Results Diversity and complexity of bacteria was significantly elevated in high-grade group.Compared with the control,the growth of Lactobacillus crispatus(L.crispatus) and Lactobacillus casei(L.casei) was significantly decreased,while Lactobacillus iners(L.iners) was significantly increased in low-grade CIN group and high-grade CIN group,and both were proportionally correlated to the grade of the disease.Brucella canis(B.canis),as colonized bacteria,was significantly decreased in both low-grade and high-grade CIN groups,and the changes were proportional to the grade of disease.The growth of Dialistersuccinatiphilus(D.succinatiphilus),Gardnerella vaginalis(G.vaginalis) and Prevotellabivia(P.bivia) were significantly elevated and proportional to the grade of disease.Conclusion The diversity and complexity of virginal microbial composition could be significantly expanded in women with HPV infection and high-grade CIN.In contrast to the important role of lactobacillus in virginal health,L.inners could be pathogenic.The colonization of B.canis,D.succinatiphilus,G.vaginalis and P.bivia might be highly correlated with HPV chronic infection and further development of CIN.

Objective To investigate the expression of human papillomavirus E2 mRNA in cervical cytologi-cal specimens as well as the role of that in cervical carcinogenesis and its clinical significance in screening and evalat-ing prognosis of cervical lesions.Methods The expression of E2 mRNA in 582 cases of cervical cytological speci-mens with high risk human papillomavirus infection and cytological diagnosis of NILM,ASCUS and LSIL,was detected by RT -PCR.Thereafter,all cases were divided into the four groups by colposcopy and histopathological confirmation, including 414 cases of cervicitis,95 cases of CINⅠ,51 cases of CINⅡ,20 cases of CINⅢ and 2 cases of invasive cervical carcinoma as well.Results The expression of HPV -E2 mRNA decreased dramatically corresponding with pathological upgrading from groups of cervicitis to invasive cervical carcinoma (χ2 =132.72,P <0.05).The sensitiv-ity,specificity,positive predictive value and negative predictive value of HPV -E2 mRNA for screening potential cervical lesions in group of NILM,ASCUS and LSIL were 77.2%,96.8%,75.6%,96.0% and 81.0%,91.7%, 79.1%,92.6% as well as 95.9%,93.4%,94.7%,95.0% respectively.Conclusion Deletion of HPV -E2 induced by genetic disruption played an important role in the early stage of malignant transformation of cervical epithe-lial cells.Therefore,detection of the levels of HPV -E2 mRNA expression might be clinically valuable for the screen-ing and evaluating of prognosis in cervical lesions.

Objective This study aims to investigate the clinical value of percutaneous vertebroplasty (PVP)combined with strontium-89 (89 Sr)on patients with spinal malignant tumor.Methods Seventy four patients who were diagnosed as spinal malig-nant tumor were divided into two groups randomly.37 patients of the control group were treated by PVP only,and 37 patients of joint group were treated by PVP and 89 Sr together.Then the clinical effect of the joint group and control group was compared after treatment.Results After treatment,the quality of life,ratio of pain relief,clinical effect and survival time in joint group were dis-tinctly better than control group (P <0.05).Conclusion PVP combined with 89 Sr can be an effective and safe treatment for pa-tients with spinal malignant tumor.

This study was aimed to observe the influence on angiogenesis factor and expression of its receptor protein on estrogen-induced uterine fibroids rat models with Y i-Qi Xiao-Zheng (YQXZ) method, in order to explore the mechanism of this method in the inhibition of angiogenesis in the treatment of uterine fibroids. Castration and estro-gen-induced method were used in the establishment of guinea pig uterine fibroids rat model. And then, different doses of Chinese medicine of YQXZ method were given. The immunohistochemical method was used in the detection of microvessel density (MVD) and vascular endothelial growth factor (VEGF) protein expression of the uterine tissues. The RT-PCR method was used to detect the expression of VEGFR1 mRNA and VEGFR2 mRNA. Then, statistical analysis was given on indexes mentioned above. The results showed that compared with the normal control group, ex-pression of MVD, VEGF and VEGFR of uterine muscle tissues in the model group was significantly higher (P <0.01). Compared with the model group, Chinese medicine group of different doses showed different reducing. Among them, the high-dose group was the most obvious one. It showed that the high-dose Chinese medicine of YQXZ group was able to significantly inhibit the expression of MVD, VEGF and theirs receptors. It was concluded that YQXZ method can antagonize proliferation of the leiomyoma cell by inhibiting angiogenesis. Therefore, it may be one of the mechanisms of this method in the treatment of uterine fibroids.