Tuberculosis （TB） and human immunodeficiency virus infection / acquired immune deficiency syndrome （HIV/AIDS） are both serious global public health threats. Early detection of infected persons and/or patients through TB/HIV bi-directional screening is crucial for prevention and control strategy in China and globally. In recent years， with the promotion and application of new TB and HIV detection technologies worldwide， TB/HIV bi-directional screening technologies and strategies have made remarkable changes. This expert consensus introduces the significance and challenges of TB/HIV bi-directional screening， summarizes important progress of research and applications， and makes recommendations on screening measures and procedures to further strengthen TB/HIV bi-directional screening in China.

Objective:To explore the real experience of parturients with pernicious placenta previa and placenta increta undergoing cesarean section from diagnosis to childbirth, so as to provide theoretical basis for clinical treatment and nursing decision-making.Methods:This study was a qualitative study. From November 2022 to January 2023, purposive sampling was used to select 13 parturients with pernicious placenta previa and placenta increta in the Department of Obstetrics of the First Affiliated Hospital of Zhengzhou University for semi-structured in-depth interviews. After collecting and organizing interview data, the Colaizzi 7-step analysis method was used to analyze the data, in order to understand the real experiences of parturients with pernicious placenta previa and placenta increta undergoing cesarean section.Results:The real experience of parturients with pernicious placenta previa and placenta increta undergoing cesarean section was extracted into three themes and 12 sub-themes. The first theme was the difficulties in seeking medical advice, with a complex and tortuous inner experience (the sub-themes include the unknown and fear in the early stages of diagnosis, the difficult struggle to make medical decisions, the arduous journey to protect the fetus, the physical and mental pain during the perioperative period, the joy of being born in a desperate situation, and concerns about the newborn and the new family pattern). The second theme was the personal positive coping experience during pregnancy and childbirth (the sub-themes include actively seeking disease information and professional support, quickly changing roles and completing role adaptation, evoking past experiences and reflecting resilient multipara traits). The third theme was to effectively utilize family social support (the sub-themes include trust and compliance with medical institutions to meet disease diagnosis and treatment needs, receiving professional guidance from medical and nursing staff to eliminate negative psychology and meet knowledge needs, benefiting from spouse and family support to meet life and emotional needs) .Conclusions:Parturients with pernicious placenta previa and placenta increta undergoing cesarean section can actively cope with the disease during pregnancy and childbirth, but still have negative emotions. Medical and nursing staff should promptly anticipate potential risks, provide correct information, professional guidance, and assistance to pregnant and postpartum women and their families, and eliminate their negative psychology among them.

Objective:To explore the diagnostic value of quantitative analysis of contrast-enhanced ultrasound for deep venous thrombosis of lower extremity after total hip arthroplasty.Methods:A total of 150 patients suspected of deep venous thrombosis of lower extremity undergoing total hip arthroplasty treatment in Jiaozhou Central Hospital of Qingdao from June 2021 to June 2022 were selected. Color Doppler ultrasound diagnostic instrument was used to examine the deep vein vessels of the lower limbs of patients, and quantitative analysis of contrast-enhanced ultrasound was performed to record the color Doppler detection results of patients. Quantitative parameters of contrast-enhanced ultrasound including time to peak (TIP), derived peak intensity (DPI), slope of ascending branch of curve (C) were compared between patients with deep vein thrombosis of lower extremities and normal patients. According to the onset time of symptoms of lower extremity thrombus group, patients were divided into acute stage, subacute stage and chronic stage, and the thrombus elasticity score and thrombus strain ratio among the three subgroups were compared.Results:Angiography results showed that 82 patients were diagnosed with deep vein thrombosis of lower extremities. The Kappa = 0.904, sensitivity was 95.00%, specificity was 91.43%, accuracy was 93.33%, positive prediction rate was 92.68%, and negative prediction rate was 94.12% by using contrast-enhanced ultrasonography and angiography in the diagnosis of deep vein thrombosis of lower extremity. The Kappa = 0.616, the sensitivity was 77.55%, specificity was 88.46%, accuracy was 81.33%, positive prediction rate was 92.68%, negative prediction rate was 67.65% by using ultrasonography and angiography in the diagnosis of deep venous thrombosis of lower extremities. The TIP level in patients with deep venous thrombosis of lower limbs was higher than that in normal patients, the DPI and C levels were lower than that in normal patients: (40.21 ± 12.34) s vs. (13.50 ± 4.59) s, (- 32.27 ± 7.56) dB vs. (- 11.33 ± 3.07) dB, (1.88 ± 0.40) dB/s vs. (4.75 ± 1.34) dB/s, there were statistical differences ( P<0.05). There were 28 cases of acute stage thrombosis, 22 cases of subacute stage thrombosis, and 32 cases of chronic stage thrombosis. There were statistically significant differences in thrombus elasticity score and thrombus strain ratio among patients with lower extremity thrombosis at different periods. Thrombus elasticity score and thrombus strain ratio of patients with acute stage thrombus were the lowest. Conclusions:Quantitative analysis of contrast-enhanced ultrasound has good consistency in the diagnosis of lower extremity deep vein thrombosis after total hip arthroplasty, and has certain clinical significance for staging diagnosis of lower extremity deep vein thrombosis.

Humans ; East Asian People ; Surveys and Questionnaires ; Vitiligo/epidemiology*

Objective:To construct and evaluate the effect of precise oral nutrition guidance program for colorectal cancer patients with accelerated rehabilitation after operation.Methods:This study was a quasi experimental study. A total of 116 patients with colorectal cancer from department of Colorectal Surgery, Jiangsu Cancer Hospital from March to Deamber, 2021 were selected by convenience sampling method. They were divided into two groups according to their admission time, the experimental group (58 cases), was given precise oral nutrition guidance program after colorectal cancer surgery based. In the control group, 58 cases were treated with the conventional dietary guidance for rapid rehabilitation. The gastrointestinal tolerance rate, the compliance rate of oral nutritional supplements, the first defecation time after operation, albumin, total albumin, prealbumin and other nutritional indexes were compared between the two groups before and after intervention.Results:Finally, 111 cases were included, induding 56 in the experimental group and 55 in the control group. The compliance rate of oral nutritional supplements after intervention in the experimental group was 73.2% (41/56), higher than that in the control group 40.0%(22/55), and the difference between the two groups was statistically significant ( χ2 = 12.47, P<0.05). The first defecation time after operation in the experimental group was (29.51 ± 5.52) h, while in the control group was (61.48 ± 8.39) h, the difference between the two groups was significant ( t = -12.06, P<0.05). The postoperative enteral nutrition tolerance rate of the experimental group was 91.1% (51/56), which was higher than the 69.1%(38/55) in the control group, the difference between the two groups was statistically significant ( χ2 = 8.44, P<0.05). The serum total protein, albumin and prealbumin levels of the experimental group at discharge were (66.56 ± 5.15), (46.78 ± 7.62) g/L and (276.07 ± 53.57) mg/L, compared with the (60.27 ± 4.37), (39.12 ± 6.41) g/L and (230.14 ± 44.58) mg/L in the control group, the differences were statistically significant ( t = 6.66, 5.02, 4.91, all P<0.05). Conclusions:The implementation of precise oral nutrition guidance program is conducive to guiding the clinical practice of oral nutritional supplements in patients with colorectal cancer after surgery, improving patient compliance, reducing gastrointestinal intolerance, promoting intestinal function recovery, and improving nutritional status of patients.

The study utilized a cross-sectional design. Data was retrieved from the American Academy of Family Physicians fellowship training directory, including program names, areas of focus, program length, and program descriptions. The collected data was categorized and analyzed based on areas of focus and training duration. The program descriptions were also analyzed qualitatively using Nvivo12 software. A total of 532 programs were included in the study:295 programs (55.5%) were ACGME-certified, while 237 programs (44.5%) were not. The majority of programs, 468 (87.9%), were clinically oriented, while 64 programs (12.1%) were non-clinical. Among ACGME-certified programs, the largest number of programs were in sports medicine (121 programs), followed by geriatrics (52 programs). Among non-certified programs, the largest number of programs was in obstetrics (66 programs), accounting for 27.8% of all non-certified programs. Qualitative research found that fellowship programs were diverse, reflecting the societal demands of healthcare service. Moreover, a significant emphasis was placed on empowering teaching and research abilities.The family medicine fellowship programs in the United States cover a wide range of disciplines and meet both the professional interests of doctors and the needs of patients. As China continues to implement its tiered medical system, it can learn from the experience of the United States and develop general practice subspecialty training programs, thereby improving the service capacity of general practitioners and improve the quality of healthcare.

Objective:To explore the real psychological experience of nurses in ClassⅢ Grade A hospitals in Henan Province participating in flood disaster rescue, with a view to providing a reference basis for the establishment of disaster nursing training system and the psychological intervention of rescue nurses.Methods:From August to September 2021, 13 nurses who participated in the flood disaster rescue in two ClassⅢ Grade A general hospitals in Zhengzhou were selected for semi-structured in-depth interviews using the objective sampling. The qualitative research phenomenological method was used to sort out, summarize and analyze the data.Results:A total of three themes were extracted, including the negative psychological experience when the disaster occurred, the positive response experience during the flood disaster rescue process, and the self-reflection and cognitive after the disaster situation stabilized.Conclusions:The nurses who participate in the flood disaster rescue mainly have negative psychological experience in the early stage of the flood disaster rescue. The sense of professional pride and social responsibility in the process of flood disaster rescue impels them to adopt positive coping strategies and finally achieve the growth of psychology and ability. The managers should pay attention to the psychological and social support of the disaster rescue nurses, do well in the popularization of flood knowledge and the training of disaster rescue skills in advance, so as to improve the emergency response ability and rescue practice ability of the flood rescue nurses.

New threats posed by the emerging circulating variants of SARS-CoV-2 highlight the need to find conserved neutralizing epitopes for therapeutic antibodies and efficient vaccine design. Here, we identified a receptor-binding domain (RBD)-binding antibody, XG014, which potently neutralizes β-coronavirus lineage B (β-CoV-B), including SARS-CoV-2, its circulating variants, SARS-CoV and bat SARSr-CoV WIV1. Interestingly, antibody family members competing with XG014 binding show reduced levels of cross-reactivity and induce antibody-dependent SARS-CoV-2 spike (S) protein-mediated cell-cell fusion, suggesting a unique mode of recognition by XG014. Structural analyses reveal that XG014 recognizes a conserved epitope outside the ACE2 binding site and completely locks RBD in the non-functional "down" conformation, while its family member XG005 directly competes with ACE2 binding and position the RBD "up". Single administration of XG014 is effective in protection against and therapy of SARS-CoV-2 infection in vivo. Our findings suggest the potential to develop XG014 as pan-β-CoV-B therapeutics and the importance of the XG014 conserved antigenic epitope for designing broadly protective vaccines against β-CoV-B and newly emerging SARS-CoV-2 variants of concern.
Angiotensin-Converting Enzyme 2 ; Antibodies, Neutralizing ; Antibodies, Viral ; COVID-19 ; Epitopes ; Humans ; SARS-CoV-2/genetics* ; Spike Glycoprotein, Coronavirus/genetics*

Objective:To investigate the incidence of post-traumatic stress disorder (PTSD) in hospitalized high-risk pregnancy patients and its related influencing factors.Methods:This study was a cross-sectional study. A total of 503 high-risk pregnancy patients who were hospitalized in Department of Obstetrics of the First Affiliated Hospital of Zhengzhou University from May to December 2020 were selected as the research objects by the convenient sampling method. Post-Traumatic Stress Checklist-Civilian Version (PCL-C) , Social Support Scale and Connor-Davidson Resilience Scale (CD-RISC) were used to investigate. Multiple linear regression analysis was used to analyze the influencing factors of PTSD in hospitalized high-risk pregnant patients.Results:A total of 503 questionnaires were sent out, 503 were recovered, 32 invalid questionnaires were excluded and 471 valid questionnaires were valid. The PCL-C score of 471 high-risk pregnant patients was (30.52±10.29) and 87 cases were PTSD positive during pregnancy. The social support score and CD-RISC score of pregnant patients with high-risk pregnancy were negatively correlated with total score of PCL-C and scores of 3 dimensions ( P<0.05) . The results of multiple linear regression analysis showed that social support, psychological resilience and pregnancy risk level were influencing factors of PTSD in hospitalized high-risk pregnant patients ( P<0.05) . Conclusions:Pregnancy risk level, psychological resilience and social support are the influencing factors of PTSD in pregnant patients with high-risk pregnancy.

Objective To explore the therapeutic effect of Gansu tablets combined with entecavir on patients with severe hepatitis B and the effect on patients’ immune function. Methods A total of 108 cases of severe hepatitis B patients who were treated in our hospital from January 2018 to January 2019 were randomly divided into two groups: entecavir group and combination treatment group, 54 cases each. Entecavir group was treated with entecavir, and combination treatment group was treated with Gansu tablets and entecavir. The levels of AST, GGT, alt, FIB, APTT, Pt, GSH Px, LPO and MDA in serum were measured by enzyme-linked immunosorbent assay. T-lymphocyte subsets were measured by cell analyzer. The therapeutic effect and adverse reactions were compared between the two groups. Results The levels of AST, GGT and ALT in the combined treatment group were significantly lower than those in the entecavir group (P < 0.05). After treatment, the FIB level of patients in the combined treatment group was higher than that in the entecavir group, and the APTT and Pt levels were lower than those in the entecavir group (P<0.05). After treatment, the GSH PX level of the combined treatment group was higher than that of entecavir group, and the LPO and MDA levels were lower than that of entecavir group (P<0.05). After treatment, the level of CD8 + was lower than that of entecavir group, and the level of CD4 + and CD3 + was higher than that of entecavir group (P<0.05). The total effective rate of the combined treatment group was higher than that of the entecavir group (P < 0.05). The incidence of adverse reactions in the combined treatment group was slightly higher than that in the entecavir group, but the difference was not statistically significant (P>0.05). Conclusion The use of Gansu tablets combined with entecavir in the treatment of severe hepatitis B patients was able to improve liver function, improve coagulation function, reduce oxidative stress injury, and improve the immune function of patients, demonstrating a potential clinical application value.