Objective To understand the situation of dental cone beam computed tomography (CBCT) quality control testing phantoms in radiation health technical service institutions in Guangdong province, analyze the differences among different phantoms, and provide a reference for dental CBCT quality control testing. Methods The testing phantoms of 49 radiation health technical service institutions were used as the research objects. The designated CBCT equipment was used for scanning and imaging. The Z-score method was used to evaluate the high-contrast resolution, low-contrast resolution, and distance measurement deviation of each phantom. Results The satisfaction rates of various items for the phantoms in 49 institutions ranged from 85.7% to 100%. The distance measurement deviations of four institutions were “suspicious”, and the high-contrast resolution of four institutions and the distance measurement deviation of one institution were “unsatisfactory”. Conclusion The overall performance of dental CBCT quality control testing phantoms in radiological health technical service institutions in Guangdong province is satisfactory. However, there are still some phantoms with poor results in items such as distance measurement deviation and high-contrast resolution. The structural design, material selection, and manufacturing process of the phantom may all affect the results of quality control testing. Therefore, appropriate phantoms, optimized exposure conditions, and suitable reconstruction algorithms should be used in CBCT quality control testing to ensure accurate and reliable measurements.

Objective:To explore the effect of bladder rehabilitation strategy based on detrusor function rating in patients with benign prostatic hyperplasia (BPH) .Methods:From January to September 2022, 118 BPH patients who underwent transurethral resection of prostate in the Urology Surgery Department of the First Affiliated Hospital of Zhengzhou University were selected by convenience sampling. According to the random number table method, patients were divided into a control group and an observation group, with 59 cases each. The control group was given routine bladder rehabilitation, and the observation group was given bladder rehabilitation strategy based on detrusor function rating. The intervention expectation was three months. The urodynamic parameters, International Prostate Symptom Score (IPSS), Urinary Symptom Disturbance Score (USDS), urinary tract infection rate and readmission rate were compared between the two groups.Results:The maximum urinary flow rate and detrusor pressure at the maximum urinary flow rate after intervention in the observation group were higher than those before intervention and in the control group, and the differences were statistically significant ( P<0.05). There was no statistical difference in the distribution of detrusor contractile function and the classification of bladder dysfunction between the two groups after intervention ( P>0.05). The IPSS and USDS scores after intervention in both groups were lower than before intervention, and the IPSS and USDS scores after intervention in the observation group were lower than those in the control group, with statistically significant differences ( P<0.05). The rates of urinary tract infection in the control group and the observation group were 35.59% (21/59) and 15.25% (9/59) respectively, and the readmission rates were 40.68% (24/59) and 18.64% (11/59) respectively, with statistical differences ( P<0.05) . Conclusions:The bladder rehabilitation strategy based on detrusor function rating can effectively improve the bladder detrusor function of BPH patients, alleviate lower urinary tract symptoms, and reduce the postoperative urinary tract infection rate and readmission rate.

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*

Clinical data (including clinical phenotype and gene mutation characteristics) of a case of epileptic encephalopathy carrying the RHOBTB2 gene mutation treated at the Department of Pediatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University in June 2020 was analyzed retrospectively.Relevant literatures were reviewed as well.A male patient aged 3 months and 12 days presented with repeated convulsions for 2 days.The main symptoms included afebrile epileptic status, featuring eye deviation to the left, and limb tonic-clonic jerk lasting for about 30 minutes.Physical examinations showed that the child could not control his head and cried lowly.The whole exome sequencing data revealed a novel heterozygous variation in exon 7 of the RHOBTB2 gene: c.1448G>A(p.Arg483His). Seizures were controlled by the treatment of Levetiracetam combined with Topiramate, but remained growth retardation.The prognosis of epileptic encephalopathy caused by the RHOBTB2 gene mutation is poor, and most children have dyskinesia and microcephaly.

Objective:To explore the mediating effect of perceived patient safety culture on job burnout and safety behavior among nurses in Emergency Departments of ClassⅢ hospitals.Methods:This study was a cross-sectional study. From February 26 to March 14, 2021, 455 Emergency Department nurses from 39 hospitals in 9 provinces/municipalities were selected as the participants by a combination of purposeful sampling and convenience sampling. 455 Emergency Department nurses was conducted through WeChat using the General Information Questionnaire, Maslach Burnout Inventory (MBI) , Hospital Survey on Patient Safety Culture (HSOPSC) , and the Nurse Safety Behavior Questionnaire (NSBQ) . A total of 428 valid questionnaires were collected, with a valid recovery rate of 94.07%.Results:Among 428 Emergency Department nurses, the scores of job burnout, perceived patient safety culture and nurse safety behavior were 52 (38, 64) , 150 (139, 166) and 54 (49, 58) , respectively. The job burnout score of Emergency Department nurses was negatively correlated with the perceived patient safety culture score ( r=-0.661, P<0.01) and the safety behavior score ( r=-0.513, P<0.01) . There was a positive correlation between the perceived patient safety culture score and the safety behavior score of Emergency Department nurses ( r=0.482, P<0.01) . The perceived patient safety culture of Emergency Department nurses has a mediating effect between their job burnout and safety behavior, accounting for 34.90% of the total effect. Conclusions:Nurses in Emergency Department of Class Ⅲ hospitals have moderate job burnout, and there is room for improvement in their safety behaviors and perceived patient safety culture. In the relationship among the three, perceived patient safety culture has a certain mediating effect between job burnout and safety behavior of nurses. In Emergency Department nursing management, a series of measures can be taken to prevent or reduce the job burnout of nurses, strengthen the construction of patient safety culture and other measures to improve the safety of nursing behavior.

Myeloid-derived suppressor cells (MDSC) are a heterogeneous population of immature myeloid cells that are generated from the blockade differentiation of myeloid cells during pathological conditions. MDSC are regulatory immune cells with a potent immunosuppressive function, and play an important role in the development of various diseases including tumor, autoimmune diseases and trauma. Interestingly, emerging evidence shows that respiratory tract infections by viruses, bacteria and fungi can cause MDSC expansion and activation. MDSC levels are closely related to the symptoms of diseases caused by respiratory pathogens. Further investigation on the role and molecular mechanism of MDSC expansion and activation in respiratory tract infections will contribute to the development of novel strategies for the prevention and treatment of diseases caused by respiratory pathogens. Here, we summarized the role of MDSC in respiratory viral, bacterial and fungal infections and the relevant molecular mechanisms, aiming to provide a reference for further investigating the role of MDSC in respiratory tract infections.

Objective:To investigate the isolation rate, antimicrobial resistance phenotype, and molecular type characteristics of Klebsiella pneumoniae from infectious diarrhea outpatients in Tai’an. Methods:A total of 866 stool samples were collected from infectious diarrhea cases in sentinel hospitals in 6 counties of Tai’an from 2013 to 2017. The strains were isolated from stool samples of the cases and identified by biochemical test. Micro broth dilution method was used to detect the drug resistance of the strains. The molecular typing was conducted by using pulsed field gel electrophoresis (PFGE).Results:The detection rate of Klebsiella pneumoniae in the stool samples was 7.97 % (69/866), with significant differences among the 6 counties ( χ2=39.627, P=0.000). Sixty- eight out of the 69 strains were resistant to 15 antibiotics with resistance rate 98.55 %(68/69). The resistance to ampicillin (AMP) was highest (84.06 %) (58/69), followed by sulfamethoxazole (SOX) (72.46 %)(50/69). There were 40 drug resistance profiles, and the predominant resistance profile was AMP-SOX detected ( n=10). The multi-drug resistant (MDR) strains accounted for 33.33 % (23/69). The 69 strains could be divided into 65 PFGE patterns, and no predominant PFGE pattern or cluster was observed. Conclusions:Klebsiella pneumoniae was detected in the stool samples of diarrhea- syndrome outpatients, indicating the risk for community-acquired infection; the strains were resistant to multiplex antibiotics, with wide drug-resistance profiles and high multi-drug resistance rates. The PFGE patterns were diverse, which showed no correlation with drug resistance profiles. Our study indicated that it necessary to strengthen the surveillance and detection of Klebsiella pneumoniae from diarrhea outpatients, which could facilitate the prevention of the emergence and spread of drug resistance strains and the protection of susceptible population.

Objective To observe the expression of Protein Kinase C Delta (PKCδ) and NF-E2-related factor 2 (Nrf2) in the liver of arsenic poisoning rats induced by coal-burning,and explore their roles.Methods According to body weight (80-100 g),thirty Wistar rats (half male half female) were divided into five groups of 6 each using random number table method,the control group,and drinking arsenic,low,medium and high arsenic contaminated grain groups.The control group was fed normally for 3 months;drinking arsenic,low,medium and high arsenic contaminated grain groups were fed respectively with 100 mg/L As2O3 solution and different concentrations of arsenic-containing feed (25,50 and 100 mg/kg).At the end of the experiment period,non-anticoagulant whole blood 2 ml from peripheral vein was collected.Malondialdehyde (MDA) contents,activities of superoxide dismutase 1 (SOD1) and glutathione peroxidase (GPx) were detected.After sacrificing the animals,the liver was separated and then diacylglycerol (DAG) contents,mRNA and protein expressions of PKCδ and Nrf2 were determined,and the correlation was analyzed by Pearson.Results There were significant differences in serum MDA contents,SOD1 and GPx activities among groups (F =26.441,3.327,120.645,P ＜ 0.05).The serum MDA contents in arsenic-exposed groups were higher than that of the control group (P ＜ 0.05).However,activities of SOD1 and GPx1 were lower than those in the control group (P ＜ 0.05).There were significant differences in liver DAG contents,Nrf2 mRNA expression levels among groups (F =8.237,8.656,P ＜ 0.05).DAG contents in the liver tissues of the drinking arsenic,low,medium and high arsenic contaminated grain groups were respectively (2.67 ± 0.25),(2.36 ± 0.19),(2.54 ± 0.22) and (2.69 ± 0.32) μg/L,which were significantly higher than that in the control group [(2.05 ± 0.24) μg/L,P ＜ 0.05].The expression levels of Nrf2 mRNA in liver tissue were respectively 1.16 ± 0.09,1.09 ± 1.20,1.14 ± 0.15 and 1.27 ± 0.16,which were higher than that in the control group (0.94 ± 0.08,P ＜ 0.05).There were significant differences in the expression of pPKCδ protein in the cell membrane and cytoplasm of liver tissue between groups (F =15.925,6.699,P ＜ 0.05).The protein expression levels of pPKCδ in the cell membrane of liver tissue were 0.49 ± 0.06,0.33 ± 0.05,0.37 ± 0.06 and 0.50 ± 0.08,respectively,which were significantly higher than that in the control group (0.28 ± 0.04,P ＜ 0.05).The protein expression levels of pPKCδ in the cytoplasm were 0.38 ± 0.06,0.31 ± 0.05,0.35 ± 0.05 and 0.36 ± 0.05,respectively,which were higher than that in the control group (0.24 ± 0.05,P ＜ 0.05).There were significant differences in the expression of Nrf2 and pNrf2 in cytoplasm and nucleus of liver tissues among groups (F =9.024,9.709,10.396,25.532,P ＜ 0.05).The protein expression levels of Nrf2 in the cytoplasm were respectively 0.76 ± 0.09,0.58 ± 0.07,0.64 ± 0.09 and 0.73 ± 0.07,which were higher than that of the control group (0.52 ± 0.08,P ＜ 0.05),except the low arsenic contaminated grain group.The protein expression levels of pNrf2 in the cytoplasm were respectively 0.50 ± 0.07,0.43 ± 0.06,0.48 ± 0.06 and 0.54 ± 0.07,which were higher than that in the control group (0.32 ± 0.06,P ＜ 0.05).The expression levels of Nrf2 protein in the nucleus were respectively 0.44 ± 0.07,0.41 ± 0.06,0.47 ± 0.06 and 0.54 ± 0.09,which were higher than that in the control group (0.30 ± 0.05,P ＜ 0.05).The protein expression levels of pNrf2 in the nucleus were respectively 0.35 ± 0.04,0.29 ± 0.04,0.41 ± 0.05 and 0.43 ± 0.06,which were higher than that in the control group (0.20 ± 0.03,P ＜ 0.05).The correlation analysis showed that DAG contents and the protein expression of pPKCδ in the cell membrane and the cytoplasm were positively correlated (r =0.663,0.604,P ＜ 0.05).Furthermore,the protein expression of pPKCδ in the cell membrane and pNrf2 in the cytoplasm and nucleus were also positively correlated (r =0.642,0.670,P＜ 0.05).Conclusions Arsenic could induce oxidative stress liver injury,and upregulate the mRNA and protein expression of Nrf2.Moreover,arsenic could also increase the protein expression of pPKCδ and DAG content,and then promote pPKCδ membrane transposition,phosphorylate Nrf2,and induce its nuclear transposition,which could regulate oxidative stress reaction.

Objective To analyze the clinical diagnosis and treatment data of 20 children with hypophosphatemic rickets (HR) in order to improve the clinical diagnosis and treatment of HR.Methods The retrospective analysis of clinical data of 20 cases with HR who were hospitalized at Children's Hospital of Nanjing Medical University from May,2010 to April,2016 was performed to summarize the clinical characteristics.All patients were analyzed for the phosphate regulating gene with homologies to endopeptidase on the X chromosome(PHEX) gene by direct sequencing.If no mutations were detected,multiplex ligation-dependent probe amplification analysis was performed.Results All of the 20 cases with HR showed different degrees of growth retardation and typical X-ray rickets.After treatment,the clinical features were improved.Height standard deviation score (HSDS) was improved significantly with longer treatment time,and the difference was statistically significant(P =0.027).There was a correlation between the blood phosphorus fluctuation and secondary hyperparathyroidism(P ＜ 0.05).Nineteen cases had PHEX gene mutations.Truncating mutations was the most frequent mutation type,and 4 new mutations were found.Conclusions Clinical characteristics,laboratory test results and X-ray examination are important clinical index for the diagnosis of HR,and PHEX gene test can be used as an important auxiliary diagnostic tool.Early diagnosis and treatment can significantly improve the clinical manifestations of the patients.

Objective To investigate the role of peroxiredoxin 3 (PRX3) in early pregnancy.Methods We collected serum and villus tissues from ninety patients at first trimester.Enzyme-linked immunosorbent assay,real-time PCR,and Western Blotting were applied to examine the PRX3 level in above samples.Results The serum PRX3 in pregnant women was significantly higher than in non -pregnant controls.The expression of PRX3 in villus tissues was increased with gestational progression.Conclusion The oxidative stress was increased in pregnant women.PRX2 plays an active role in antioxidant defense of villus tissues.