Objective To prepare the recombinant Echinococcus granulosus Polo-like kinase 2 (rEgPLK2) protein and evaluate its immunoprotective efficacy against cystic echinococcosis, so as to provide insights into research and development of novel vaccines against echinococcosis. Methods The Polo-like kinase (PLK) protein sequences were retrieved from 12 species in the NCBI protein database, including E. granulosus and E. multilocularis. Multiple sequence alignment was performed using the Clustal Omega program, and structural visualization and homology analysis were conducted using the ESPript 3.2 program. The recombinant plasmid pET-30a-EgPLK2 was transformed into BL21(DE3) competent cells. Protein expression was induced with isopropyl-β-D-thiogalactoside (IPTG), and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) was performed to characterize the expression and molecular weight of the rEgPLK2 protein. The purified rEgPLK2 protein was thoroughly emulsified with Freund’s complete adjuvant at a 1 : 1 volume ratio. Two New Zealand white rabbits were immunized with multipoint subcutaneous injection on the back at a dose of 300 μg per rabbit for primary immunization. For booster immunizations, the protein was emulsified with Freund’s incomplete adjuvant at a 1 : 1 volume ratio and administered on days 14, 28, and 42 after the primary immunization at a dose of 150 μg per rabbit. Serum was sampled from the rabbit ear vein on day 7 after the final immunization to yield anti-rEgPLK2 polyclonal antibodies. Antibody titer was determined by indirect enzyme-linked immunosorbent assay (ELISA), and antibody specificity was verified by Western blotting. The tissue localization of the EgPLK2 protein was detected in E. granulosus protoscoleces and adult worms using immunofluorescence assay (IFA). Eighteen 6- to 8-week-old female SPF-grade BALB/c mice were randomly divided into three groups, including the blank control group, rEgPLK2-ISA immunization group, and PBS-ISA adjuvant control group, of 6 mice each group. Mice in the rEgPLK2-ISA immunization group and PBSISA group received three primary immunizations via intramuscular injection, and animals in the rEgPLK2-ISA immunization group was inoculated with immunogens prepared by emulsifying rEgPLK2 protein with ISA 201 adjuvant at a 1 : 1 volume ratio (6 μg per mouse), while mice in the PBS-ISA adjuvant control group received an equal volume of PBS emulsified with ISA adjuvant at a 1 : 1 volume ratio. A fourth booster immunization was administered via intraperitoneal injection. Mice in the rEgPLK2-ISA immunization group received a booster immunization with 8 μg of rEgPLK2 protein per mouse, and animals in the PBS-ISA group received an equal volume of PBS, with immunizations given at 2-week intervals. Mice in the blank control group were given no treatment, and housed under standard conditions. Tail vein blood was collected from all mice 7 days after the final immunization, and levels of specific anti-rEgPLK2 IgG antibody and its subclasses (IgG1, IgG2a, IgG2b, IgG3) were measured by indirect ELISA. E. granulosus infection was modelled in mice through injection with 1 000 E. granulosus protoscoleces via intrahepatic portal vein in the rEgPLK2-ISA immunization group and PBS-ISA adjuvant control group 2 weeks after the last immunization. All mice were sacrificed and dissected. The number of cysts was counted in mouse livers, and the cyst reduction rate was calculated. Liver tissues were processed for paraffin sectioning and stained with hematoxylin and eosin (HE), and histopathological changes were examined under a light microscope. Results Sequence analysis revealed that EgPLK2 shared a high amino acid sequence homology with E. multilocularis PLK2 (EmPLK2) and contained the typical domains of the Polo-like kinase family, including the serine/threonine protein kinase catalytic domain (STKc) and Polo-box. The IPTG-induced rEgPLK2 protein was mainly expressed in the form of inclusion bodies, and the purified rEgPLK2 protein showed a relative molecular mass of approximately 70 kDa. The prepared rabbit anti-rEgPLK2 polyclonal antibody had a titer of 1 : 256 000, and Western blotting assay showed that this anti-body specifically recognized the rEgPLK2 protein with a relative molecular mass of approximately 70 kDa. Immunofluorescence assay showed that the EgPLK2 protein was localized in the excretory bladder and rostellum of E. granulosus protoscoleces, as well as the tegument, suckers, and inter-proglottid junctions of adult worms. Immunoprotective assay showed that the serum levels of specific anti-rEgPLK2 IgG, IgG1, IgG2a, and IgG2b antibodies were 2.92 ± 0.49, 0.33 ± 0.10, 0.31 (0.36), and 3.12 (1.73) in mice in the rEgPLK2-ISA immunization group, which were all significantly higher than those in the PBS-ISA adjuvant control group (0.14 ± 0.04, 0.07 ± 0.01, 0.12 ± 0.04, and 0.11 ± 0.04, respectively) (t = 19.28 and 8.46, Z = 3.75 and 4.15; all P values < 0.001); however, there was no significant difference in the serum anti-IgG3 antibody level between the rEgPLK2-ISA immunization group and the PBS-ISA adjuvant control group [0.07 (0.01) vs. 0.073 (0.07); Z = 0.69, P > 0.05)]. In the mouse model of E. granulosus infections, the area of hepatic lesions was reduced and the inflammatory infiltration was alleviated in the rEgPLK2-ISA immunization group than in the PBS-ISA adjuvant control group, and the number of hepatic cysts was higher in the PBS-ISA adjuvant control group than in the rEgPLK2-ISA immunization group [8.00 (2.00) vs. 1.00 (0.75); Z = −2.93, P < 0.01], with a cyst reduction rate of 80.40%. Indirect ELISA assay measured higher serum levels of specific anti-rEgPLK2 IgG (3.28 ± 0.48 vs. 0.11 ± 0.04; t = 15.86, P < 0.01), IgG1 (0.29 ± 0.02 vs. 0.09 ± 0.01; t = 15.67, P < 0.01), IgG2a [3.71 (1.09) vs. 0.08 (0.03); Z = 2.88, P < 0.01], and IgG2b antibodies [3.34 (1.01) vs. 0.08 (0.03); Z = 2.88, P < 0.01] in the rEgPLK2-ISA immunization group than in the PBS-ISA adjuvant control group, and there was no significant difference in the serum level of the specific anti-rEgPLK2 IgG3 antibody between the rEgPLK2-ISA immunization group and the PBS-ISA adjuvant control group (0.07 ± 0.01 vs. 0.07 ± 0.01; t = 1.29, P > 0.05). Conclusions The prokaryotic expression system has been successfully constructed for the EgPLK2 gene and the anti-rEgPLK2 polyclonal antibody has been obtained. The rEgPLK2 protein exhibits a high immunogenicity, and is effective to protect against E. granulosus infection, and inhibits cyst development, which is a promising candidate vaccine target against cystic echinococcosis.

Objective In order to understand the current status and influencing factors of perioperative pulmonary rehabilitation knowledge,attitude,and practice among Chinese thoracic surgery nurses,and to provide references for managers to take targeted measures to improve their pulmonary rehabilitation knowledge,attitude,and practice level.Methods From August to October 2023,a convenience sampling method and cross-sectional descriptive survey were used to anonymously survey 1 167 thoracic surgery nurses from tertiary-level A cancer specialty hospitals and tertiary-level A general hospitals in 24 provinces through the Wenjuanxing platform.A general information questionnaire and a knowledge,attitude and practice questionnaire for lung cancer perioperative pulmonary rehabilitation nurses were used,including knowledge dimension(14 items),belief dimension(6 items),and behavior dimension(14 items),totaling 34 items.Univariate analysis and linear regression multivariate analysis were used to determine the influencing factors of the knowledge,attitude and practice level of thoracic surgery nurses in perioperative pulmonary rehabilitation.Results 1 089 nurses completed the investigation.The total standard score and the dimension scores on knowledge,attitude,and behavior of the perioperative pulmonary rehabilitation questionnaire for thoracic surgery nurses were(80.45±11.84)(73.72±14.68)(89.61±11.38)and(83.46±14.48),respectively.The nature of the hospital,whether there is an administrative position,whether the department carries out ERAS,and whether they have received pulmonary rehabilitation training are the influencing factors of the perioperative pulmonary rehabilitation knowledge,attitude,and practice level of thoracic surgery nurses(P＜0.05).Conclusion The knowledge,attitude,and practice of perioperative lung rehabilitation among thoracic surgery nurses are generally at a moderate level.However,their knowledge of perioperative lung rehabilitation is relatively insufficient,and there are many influencing factors.Managers should strengthen pulmonary rehabilitation training for thoracic surgery nurses,improve their knowledge reserves and evidence conversion capabilities,and coordinate cross-integration among multidisciplinary teams to improve their knowledge,attitude and practice in perioperative pulmonary rehabilitation.

Objective In order to understand the current status and influencing factors of perioperative pulmonary rehabilitation knowledge,attitude,and practice among Chinese thoracic surgery nurses,and to provide references for managers to take targeted measures to improve their pulmonary rehabilitation knowledge,attitude,and practice level.Methods From August to October 2023,a convenience sampling method and cross-sectional descriptive survey were used to anonymously survey 1 167 thoracic surgery nurses from tertiary-level A cancer specialty hospitals and tertiary-level A general hospitals in 24 provinces through the Wenjuanxing platform.A general information questionnaire and a knowledge,attitude and practice questionnaire for lung cancer perioperative pulmonary rehabilitation nurses were used,including knowledge dimension(14 items),belief dimension(6 items),and behavior dimension(14 items),totaling 34 items.Univariate analysis and linear regression multivariate analysis were used to determine the influencing factors of the knowledge,attitude and practice level of thoracic surgery nurses in perioperative pulmonary rehabilitation.Results 1 089 nurses completed the investigation.The total standard score and the dimension scores on knowledge,attitude,and behavior of the perioperative pulmonary rehabilitation questionnaire for thoracic surgery nurses were(80.45±11.84)(73.72±14.68)(89.61±11.38)and(83.46±14.48),respectively.The nature of the hospital,whether there is an administrative position,whether the department carries out ERAS,and whether they have received pulmonary rehabilitation training are the influencing factors of the perioperative pulmonary rehabilitation knowledge,attitude,and practice level of thoracic surgery nurses(P＜0.05).Conclusion The knowledge,attitude,and practice of perioperative lung rehabilitation among thoracic surgery nurses are generally at a moderate level.However,their knowledge of perioperative lung rehabilitation is relatively insufficient,and there are many influencing factors.Managers should strengthen pulmonary rehabilitation training for thoracic surgery nurses,improve their knowledge reserves and evidence conversion capabilities,and coordinate cross-integration among multidisciplinary teams to improve their knowledge,attitude and practice in perioperative pulmonary rehabilitation.

Objective To explore the effect of Omaha system continuity nursing on the degree of pain and quality of life in patients undergoing arthroscopic rotator cuff repair.Methods A total of 110 patients who underwent arthroscopic rotator cuff repair at the First Affiliated Hospital of Wenzhou Medical University from September 2022 to May 2023 were selected.They were divided into intervention group and control group according to the random number table method,with 55 cases in each group.Patients in control group were given conventional continuous nursing,while patients in intervention group were given Omaha system continuity nursing.Both groups of patients were intervened for 6 months.The range of motion of shoulder joint,shoulder joint function,degree of pain and quality of life of two groups of patients before and after the intervention were compared.Results After the intervention,the range of motion of shoulder joint in intervention group was significantly greater than that in control group,University of California,Los Angeles shoulder joint score and the 8-item short form health survey were significantly higher than those in control group,and numerical rating scale score of pain was significantly lower than that in control group(P＜0.05).Conclusion Omaha system continuity nursing can improve shoulder joint mobility and function,alleriate pain,and improve quality of life for patients undergoing arthroscopic rotator cuff repair surgery.

Objective To explore the effect of Omaha system continuity nursing on the degree of pain and quality of life in patients undergoing arthroscopic rotator cuff repair.Methods A total of 110 patients who underwent arthroscopic rotator cuff repair at the First Affiliated Hospital of Wenzhou Medical University from September 2022 to May 2023 were selected.They were divided into intervention group and control group according to the random number table method,with 55 cases in each group.Patients in control group were given conventional continuous nursing,while patients in intervention group were given Omaha system continuity nursing.Both groups of patients were intervened for 6 months.The range of motion of shoulder joint,shoulder joint function,degree of pain and quality of life of two groups of patients before and after the intervention were compared.Results After the intervention,the range of motion of shoulder joint in intervention group was significantly greater than that in control group,University of California,Los Angeles shoulder joint score and the 8-item short form health survey were significantly higher than those in control group,and numerical rating scale score of pain was significantly lower than that in control group(P＜0.05).Conclusion Omaha system continuity nursing can improve shoulder joint mobility and function,alleriate pain,and improve quality of life for patients undergoing arthroscopic rotator cuff repair surgery.

Objective To investigate the curative effect of early hemoperfusion(HP)in treating patients with sepsis.Methods Early stage sepsis patients admitted to the First People's Hospital of Nanyang City Affiliated to Henan University from January 2020 to December 2022 were selected as the research subjects.These patients were randomly divided into experimental group(62 patients)and control group(31 patients).Early bundle therapy combined with continuous renal replacement therapy(CRRT)were used in both groups as the standard treatment,but only the standard treatment was used in control group.Based on the treatment of control group,the patients in experimental group were treated with HP,the"2-2-1"plan(on the first and second days,connecting resin HP device HA380 in series every 12 hours,and connecting one perfusion device in series on the third day)was applied.The white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukins(IL-6,IL-10),the hemodynamic indicators(systolic blood pressure,diastolic blood pressure),lactic acid(Lac),sequential organ failure assessment(SOFA),acute physiology and chronic health evaluationⅡ(APACHEⅡ),and the difference in intensive care unit(ICU)hospitalization time of the patients before admission and after 3 day treatment were compared between the two groups.The Kaplan-Meier method was used to draw survival curves and the difference in 28-day survival rates was compared between the two groups.Results After 3 days of treatment,the inflammatory indexes TNF-α,IL-6,IL-10,PCT,CRP,WBC and SOFA score,APACHEⅡscore,Lac in the experimental group all decreased significantly(all P<0.05).In the control group,only the PCT and CRP indexes significantly decreased compared with those before treatment(both P<0.05).Compared with the control group,the difference before and after the change of PCT,CRP,IL-6,IL-10 and SOFA score,APACHEⅡscore,Lac in the experimental group were significant[PCT(μg/L):12.31(6.95,42.69)vs.3.84(1.06,14.47),CRP(mg/L):78.69±64.60 vs.31.49±81.14,IL-6(ng/L):1 357.20(243.96,7 205.50)vs.110.00(-1 749.00,1 377.00),IL-10(ng/L):36.87(5.43,1 218.80)vs.2.67(-11.00,22.79),SOFA score:5(3,7)vs.1(-3,6),APACHEⅡscore:8(5,11)vs.5(-2,7),Lac(mmol/L):3.93±2.89 vs.2.42±2.89,all P<0.05].The clearance rate of inflammatory cytokines IL-6 and IL-10 in the experimental group was higher than that in the control group(IL-6:F=17.93,P<0.001,IL-10:F=6.62,P=0.012).The Kaplan-Meier curve showed the 28-day survival rate of the experimental group was higher than that of the control group(79.03%vs.58.06%),the differences were statistically significant(Log-Rank test:χ2=4.706,P=0.030).Multivariate Cox regression analysis showed that no HP treatment,Lac level before treatment and high APACHEⅡ score were risk factors for death Conclusion HP in the early interventional treatment of sepsis can reduce the levels of inflammatory cytokines and control the inflammatory storm.The HP"2-2-1"treatment frequency can effectively improve the prognosis of septic patients and increase their survival rate.

Objective To investigate the curative effect of early hemoperfusion(HP)in treating patients with sepsis.Methods Early stage sepsis patients admitted to the First People's Hospital of Nanyang City Affiliated to Henan University from January 2020 to December 2022 were selected as the research subjects.These patients were randomly divided into experimental group(62 patients)and control group(31 patients).Early bundle therapy combined with continuous renal replacement therapy(CRRT)were used in both groups as the standard treatment,but only the standard treatment was used in control group.Based on the treatment of control group,the patients in experimental group were treated with HP,the"2-2-1"plan(on the first and second days,connecting resin HP device HA380 in series every 12 hours,and connecting one perfusion device in series on the third day)was applied.The white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukins(IL-6,IL-10),the hemodynamic indicators(systolic blood pressure,diastolic blood pressure),lactic acid(Lac),sequential organ failure assessment(SOFA),acute physiology and chronic health evaluationⅡ(APACHEⅡ),and the difference in intensive care unit(ICU)hospitalization time of the patients before admission and after 3 day treatment were compared between the two groups.The Kaplan-Meier method was used to draw survival curves and the difference in 28-day survival rates was compared between the two groups.Results After 3 days of treatment,the inflammatory indexes TNF-α,IL-6,IL-10,PCT,CRP,WBC and SOFA score,APACHEⅡscore,Lac in the experimental group all decreased significantly(all P<0.05).In the control group,only the PCT and CRP indexes significantly decreased compared with those before treatment(both P<0.05).Compared with the control group,the difference before and after the change of PCT,CRP,IL-6,IL-10 and SOFA score,APACHEⅡscore,Lac in the experimental group were significant[PCT(μg/L):12.31(6.95,42.69)vs.3.84(1.06,14.47),CRP(mg/L):78.69±64.60 vs.31.49±81.14,IL-6(ng/L):1 357.20(243.96,7 205.50)vs.110.00(-1 749.00,1 377.00),IL-10(ng/L):36.87(5.43,1 218.80)vs.2.67(-11.00,22.79),SOFA score:5(3,7)vs.1(-3,6),APACHEⅡscore:8(5,11)vs.5(-2,7),Lac(mmol/L):3.93±2.89 vs.2.42±2.89,all P<0.05].The clearance rate of inflammatory cytokines IL-6 and IL-10 in the experimental group was higher than that in the control group(IL-6:F=17.93,P<0.001,IL-10:F=6.62,P=0.012).The Kaplan-Meier curve showed the 28-day survival rate of the experimental group was higher than that of the control group(79.03%vs.58.06%),the differences were statistically significant(Log-Rank test:χ2=4.706,P=0.030).Multivariate Cox regression analysis showed that no HP treatment,Lac level before treatment and high APACHEⅡ score were risk factors for death Conclusion HP in the early interventional treatment of sepsis can reduce the levels of inflammatory cytokines and control the inflammatory storm.The HP"2-2-1"treatment frequency can effectively improve the prognosis of septic patients and increase their survival rate.

Objective: To understand the level and risk factor of lead exposure among children in one city of Jiangsu. Methods: In northern Jiangsu Province, 373 children from 2 primary schools were enrolled and were tested for blood lead and heavy metal exposure. Lead exposure was tested in household dust of 46 children. A multivariate Logistic regression was used for lead exposure risk analysis. Spatial distribution of lead contamination in household dust was conducted and compared with the location of industrial enterprises. Results: The geometric mean of blood lead in 373 children was 25.80 mg/L,the blood lead of 3 children (0.8%) was more than 100 mg/L. Pencil biting ( OR=4.26, 95%CI=1.61-10.68, P <0.05) and lead contamination in surrounding environment ( OR=2.93, 95%CI=1.24-7.34, P =0.02) was positively related to high blood lead level in children. The geometric mean household dust lead concentrations in 46 children was 302.27 μg/mg, and household with high dust lead levels were mainly located around manufacturing enterprises. Conclusion Environmental factors correlate with blood lead level in children. Efficient strategies and public health policies are urgently needed to control and prevent environmental lead pollution. Families and schools should actively carry out health education to engourage children good hygiene habits, and effectively reduce lead exposure.

Objective To explore the inhibitory effect of pulsed ultrasound on skeletal muscle fibrosis after injury.Methods Thirty elderly male rats with gastrocnemius muscle injury were divided into an ultrasound group (UG) and a control group (CG) using a random number table.The injured muscles in the UG were treated using pulsed ultrasound (frequency 1 MHz,average strength 40 mW/cm2,duty cycle 20％) for 10 min daily from day 3 after the injury.The CG was given no treatment.On days 3,7,14,21 and 28 after the injury,histological and immunohistochemical analyses of the gastrocnemius muscles of both groups were performed.Results The collagen fiber mean optical density of the muscles increased gradually after the injury and reached its peak on day 21.It was significantly lower in the UG than in the CG on each test day.The expression of α-SMA increased gradually after the injury,but it too remained significantly lower in UG than that in CG.Conclusion Pulsed ultrasound may reduce collagen formation and α-SMA expression in injured skeletal muscle,and then inhibit muscle fibrosis.