To investigate the expression and distribution of follicular dendritic cell(FDC)and follic-ular helper T cells(Tfh)in mouse spleen and lymph nodes induced by foot-and-mouth virus-like particles(FMDV-VLPs),the recombinant pCMV-HA-HBcAg-VP1-VP4 plasmid was transfected into CHO-K1 cells to prepare FMDV-VLPs,and the recombinant FMDV VP1-VP4 protein was expressed and purified through a prokaryotic expression system.BALB/c mice were subcutaneous-ly immunized with FMDV-VLPs(VLP group)and recombinant FMDV VP1-VP4 protein(VP1-VP4 group),and PBS control group(PBS group)was set up.At 21 d post primary immunization(dpi),booster immunization was carried out.Spleen,shoulder lymph nodes,and submandibular lymph nodes were collected at 7,28,42,72 and 102 dpi,and frozen sections were prepared.Immu-nohistochemical staining was used to observe the expression and distribution of FDC and Tfh.The results showed that the number of FDC and Tfh cells in the VLP group in the spleen and lymph nodes showed a gradual increase from 7 to 42 dpi,and gradually decreased to non-immune levels starting from 72 dpi.The results indicate that FMDV-VLPs can induce the formation of GC in the spleen and lymph nodes,and the number of FDC and Tfh cells in GC can last for at least 42 d.This study provides a theoretical basis for the study of the immune memory response mechanism of B cells induced by FMDV virus-like particles.

Objective:This study aims to develop a questionnaire for transsexualism screening and validate its reliability and validity, to provide a culturally adapted screening tool for Chinese clinicians.Methods:Referencing internationally validated instruments related to transsexualism, items closely aligned with the diagnostic criteria of the International Classification of Diseases, 10th Revision (ICD-10) for transsexualism were extracted. Items reflecting Chinese family cultural characteristics were integrated. The overall structure of the questionnaire was refined through expert consultations. A total of 111 patients diagnosed with transsexualism according to ICD-10 diagnostic criteria (78 male-to-female (MtF), 33 female-to-male (FtM)) were recruited from the outpatient clinic of Shanghai Mental Health Center between June 2021 and April 2024. Additionally, 232 cisgender participants, whose self-reported gender identity aligned with their birth sex, were recruited via the Wenjuanxing platform from June 14 to 22, 2022, comprising 64 heterosexual males, 16 non-heterosexual males, 120 heterosexual females, and 32 non-heterosexual females. Both the transsexual and cisgender groups completed the screening questionnaire. The internal consistency reliability was assessed using Cronbach′s α coefficient, and the corrected item-total correlation (CITC) was employed to measure the relationship between individual items and the total score. Structural validity was verified through structural equation modeling (SEM) using AMOS software. The receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal screening cutoff value, with the area under the curve (AUC) used to evaluate diagnostic accuracy. Effect sizes (Cohen's d) were calculated to compare the average scores of the questionnaire across groups. Results:The Transsexualism Screening Questionnaire consists of 15 items including 4 reverse-scored questions, rated on a 5-point Likert scale. The Cronbach′s α coefficient was 0.953 and the CITC for all items exceeded the recommended threshold of 0.3. After rotation based on eigenvalues>1, one principal component explained 61.67% of the total variance. Confirmatory factor analysis indicated acceptable model fit (χ2/ df = 3.887, standardized root mean square residual (SRMR) = 0.064, root mean square error of approximation (RMSEA)=0.092, comparative fit index (CFI)=0.952, normed fit index (NFI)=0.936, Tucker-Lewis index (TLI)=0.943, incremental fit index (IFI)=0.952). Factor loadings for each item ranged from 0.435 to 0.914. ROC curve analysis revealed that the optimal cutoff values were a mean score of 2.83 and a total score of 42.5, achieving 100% sensitivity and 98.7% specificity, with a Youden index of 0.987. Effect size comparisons showed a Cohen′s d of 6.112 between MtF individuals and cisgender heterosexual males, and a Cohen′s d of 9.287 between FtM individuals and cisgender heterosexual females. Conclusion:The Transsexualism Screening Questionnaire exhibits acceptable reliability, validity, sensitivity, and specificity, and is suitable for screening transsexualism in the Chinese population.

To investigate the expression and distribution of follicular dendritic cell(FDC)and follic-ular helper T cells(Tfh)in mouse spleen and lymph nodes induced by foot-and-mouth virus-like particles(FMDV-VLPs),the recombinant pCMV-HA-HBcAg-VP1-VP4 plasmid was transfected into CHO-K1 cells to prepare FMDV-VLPs,and the recombinant FMDV VP1-VP4 protein was expressed and purified through a prokaryotic expression system.BALB/c mice were subcutaneous-ly immunized with FMDV-VLPs(VLP group)and recombinant FMDV VP1-VP4 protein(VP1-VP4 group),and PBS control group(PBS group)was set up.At 21 d post primary immunization(dpi),booster immunization was carried out.Spleen,shoulder lymph nodes,and submandibular lymph nodes were collected at 7,28,42,72 and 102 dpi,and frozen sections were prepared.Immu-nohistochemical staining was used to observe the expression and distribution of FDC and Tfh.The results showed that the number of FDC and Tfh cells in the VLP group in the spleen and lymph nodes showed a gradual increase from 7 to 42 dpi,and gradually decreased to non-immune levels starting from 72 dpi.The results indicate that FMDV-VLPs can induce the formation of GC in the spleen and lymph nodes,and the number of FDC and Tfh cells in GC can last for at least 42 d.This study provides a theoretical basis for the study of the immune memory response mechanism of B cells induced by FMDV virus-like particles.

Objective:This study aims to develop a questionnaire for transsexualism screening and validate its reliability and validity, to provide a culturally adapted screening tool for Chinese clinicians.Methods:Referencing internationally validated instruments related to transsexualism, items closely aligned with the diagnostic criteria of the International Classification of Diseases, 10th Revision (ICD-10) for transsexualism were extracted. Items reflecting Chinese family cultural characteristics were integrated. The overall structure of the questionnaire was refined through expert consultations. A total of 111 patients diagnosed with transsexualism according to ICD-10 diagnostic criteria (78 male-to-female (MtF), 33 female-to-male (FtM)) were recruited from the outpatient clinic of Shanghai Mental Health Center between June 2021 and April 2024. Additionally, 232 cisgender participants, whose self-reported gender identity aligned with their birth sex, were recruited via the Wenjuanxing platform from June 14 to 22, 2022, comprising 64 heterosexual males, 16 non-heterosexual males, 120 heterosexual females, and 32 non-heterosexual females. Both the transsexual and cisgender groups completed the screening questionnaire. The internal consistency reliability was assessed using Cronbach′s α coefficient, and the corrected item-total correlation (CITC) was employed to measure the relationship between individual items and the total score. Structural validity was verified through structural equation modeling (SEM) using AMOS software. The receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal screening cutoff value, with the area under the curve (AUC) used to evaluate diagnostic accuracy. Effect sizes (Cohen's d) were calculated to compare the average scores of the questionnaire across groups. Results:The Transsexualism Screening Questionnaire consists of 15 items including 4 reverse-scored questions, rated on a 5-point Likert scale. The Cronbach′s α coefficient was 0.953 and the CITC for all items exceeded the recommended threshold of 0.3. After rotation based on eigenvalues>1, one principal component explained 61.67% of the total variance. Confirmatory factor analysis indicated acceptable model fit (χ2/ df = 3.887, standardized root mean square residual (SRMR) = 0.064, root mean square error of approximation (RMSEA)=0.092, comparative fit index (CFI)=0.952, normed fit index (NFI)=0.936, Tucker-Lewis index (TLI)=0.943, incremental fit index (IFI)=0.952). Factor loadings for each item ranged from 0.435 to 0.914. ROC curve analysis revealed that the optimal cutoff values were a mean score of 2.83 and a total score of 42.5, achieving 100% sensitivity and 98.7% specificity, with a Youden index of 0.987. Effect size comparisons showed a Cohen′s d of 6.112 between MtF individuals and cisgender heterosexual males, and a Cohen′s d of 9.287 between FtM individuals and cisgender heterosexual females. Conclusion:The Transsexualism Screening Questionnaire exhibits acceptable reliability, validity, sensitivity, and specificity, and is suitable for screening transsexualism in the Chinese population.

Objective:To establish an in vivo infection model of West Nile virus (WNV) pseudovirus and evaluate the neutralizing activity of antibody WNV-XH1.Methods:A stable cell line that can package the WNV pseudovirus was established in the early stage to prepare the pseudovirus supernatant. The supernatant was concentrated and infected BHK21 cells to detect the titer of the pseudovirus. After intraperitoneal injection of the pseudovirus into C57BL/J mice, bioluminescence imaging was performed to observe the infection status of the pseudovirus in the mice. After simultaneous infection, blood was collected and ELISA was used to detect NS1 levels in mouse serum. The in vivo functional activity of antibody WNV-XH1 was evaluated using the established mouse infection model.Results:Fluorescence was detected in C57BL/J mice infected with WNV pseudovirus, and the NS1 levels in the peripheral blood serum of mice infected with pseudovirus were significantly higher than those of non infected mice (1.453±0.09vs0.305±0.018). After intravenous administration of WNV-XH1 antibody before the attack, the fluorescence signal in the mice decreased and the serum NS1 level decreased (0.384±0.015).Conclusions:A successful in vivo infection model of WNV pseudovirus was established, and it was confirmed that the antibody WNV-XH1 had a protective effect against WNV pseudovirus infection in vivo.

Objective:To construct a core muscle strength training plan for patients with lumbar degenerative diseases based on the concept of pre-rehabilitation, and provide a theoretical basis for core muscle strength training for patients with lumbar degenerative diseases.Methods:From January 2022 to June 2023 based on literature search and group discussion, develop a primary item pool for core muscle strength training plan for patients with lumbar degenerative diseases under the concept of pre-rehabilitation. Through two rounds of Delphi expert consultation, revise and establish the core muscle strength training plan for patients with lumbar degenerative diseases under the concept of pre-rehabilitation.Results:A total of 15 experts were consulted by letter, including 3 males and 12 females, aged 35-58 (41.38 ± 5.44) years old. The positive coefficients of two rounds of correspondence with experts were 1.00 and 0.93, the expert judgment coefficients were 0.78 and 0.90, the familiarity coefficients were 0.84 and 0.92, and the authority coefficients were 0.81 and 0.91. The Kendall coordination coefficients of two rounds of inquiry had statistical significance in terms of indicator rationality (0.378, 0.384), indicator importance (0.283, 0.291), and indicator operability (0.263, 0.375) (all P<0.05). The constructed perioperative nursing quality sensitive indicator system for minimally invasive spinal surgery patients included 3 primary indicators, 9 secondary indicators, and 17 tertiary indicators. Conclusions:The core muscle strength training plan for patients with lumbar degenerative diseases based on the concept of pre- rehabilitation is scientific, reliable, practical, and feasible, and can provide a theoretical basis for core muscle strength training for patients with lumbar degenerative diseases.

Objective:To understand the dilemma of active management in young and middle-aged postoperative patients with lumbar disc herniation, in order to provide reference for the formulation of active intervention program of self-health management meeting the needs of patients.Methods:Using the phenomenological research method, a total of 16 middle-aged and young patients with lumbar disc herniation were selected for semi-structured in-depth interviews, and the themes were analyzed and extracted by Colaizzi 7-step analysis method.Results:Three themes and nine sub-themes were extracted namely, inadequate disease response capacity and response resources (lack of disease symptom management capacity, limited access to disease management information, difficult use of disease management information, difficulty in maintaining positive self-management for a long time (forced to stop behavior change due to stress, lack of motivation to achieve good behavior change, doubts about the effectiveness of self-management) and multi-dimensional negative emotions (contrast between maintaining independence and dependence on others, fear of being misunderstood, fear of relapse) .Conclusions:Medical staff should provide comprehensive health information services for young and middle-aged postoperative patients with lumbar disc herniation, improve the out-of-hospital follow-up mechanism with the help of information technology, further improve family and social support strategies, reduce the difficulties faced in the process of active management and achieve long-term active disease management.

Objective To assess the trends and characteristics of CD 4 +T lymphocyte counts among patients with acquired immune deficiency syndrome ( AIDS) in Tianjin City.Methods The demographic and clinical characteristics of AIDS patients diagnosed in Tianjin Second People′s Hospital from 2005 to 2017 were analyzed.The CD4 +T lymphocyte count and the frequency of CD 4+T lymphocyte count ＜200 cells／μL were analyzed according to age , transmission route and education level.The chi-square test was used for counting data.The rank sum test was used for the data that did not conform to normal distribution .Results The 3 062 patients were aged (38.2 ±11.9) years.There were 2 867 males (93.6%) aged (37.8 ±11.8) years, and 195 female patients ( 6.4%) aged (43.3 ±12.6) years.The CD4+T lymphocyte counts of these patients presented an increasing trend from 2005 to 2017, with statistically significant differences among different years (Z＝18.871, P＜0.05).The frequency of CD4 +T lymphocytes ＜200 cells／μL showed a decreasing trend , with statistically significant difference in different years (χ2 ＝7.017,P＜0.05).The CD4+T lymphocyte counts in patients of all age groups showed an increasing trend from 2005 to 2017, with statistically significant differences (Z＝6.849, 9.532, 7.146, 6.874, 8.038, 11.249, and 10.059, respectively, all P＜0.05).The CD4+T lymphocyte counts in homosexual patients presented an increasing trend , with statistical significance in different years (Z＝8.038, P＜0.05).The CD4+T lymphocyte counts in patients who received education more than 13 years (include 13 years) presented an increasing trend , with statistical significance (Z＝4.573, P＜ 0.05).Conclusions The median CD4+T lymphocyte counts of AIDS patients receiving primary treatment in Tianjin city are increasing by years , while the proportion of severe immunosuppression is decreasing.Patients who are infected through homosexual transmission and those with high level of education seek medical care earlier.

Objective To analyze the pathogenic characteristics of sepsis in patients with hepatic failure, and to explore the risk factors for sepsis in patients with liver failure. Methods The data of 221 patients with hepatic failure admitted to Tianjin Second People's Hospital from January 2014 to December 2018 were retrospectively collected. The patients were divided into two groups according to whether they suffered from sepsis or not. The pathogeny results of blood culture in patients with sepsis were observed. The levels of white blood cell (WBC), neutrophil (Neut), platelet (PLT), lactic acid (Lac), C-reactive protein (CRP) and procalcitonin (PCT) were compared between the two groups. The risk factors for sepsis in patients with hepatic failure were analyzed by multivariate Logistic regression analysis. Results Among 221 patients, 27 cases had incomplete data and were excluded. Finally, 194 cases were enrolled in the analysis, including 52 in sepsis group and 142 in non-sepsis group. From 2014 to 2018, there were 11, 12, 11, 11 and 8 positive cases of sepsis in patients with liver failure. The positive rate of Gram-positive (G+) bacteria increased year by year (2, 3, 4, 5 and 4 cases of G+ bacteria from 2014 to 2018). There was no significant difference in demographic and medical history data, such as gender, age and history of diabetes mellitus between the two groups. Compared with non-sepsis group, Neut, Lac, CRP and PCT in sepsis group were significantly increased [Neut:0.81±0.09 vs. 0.74±0.15, Lac (mmol/L): 3.04±0.61 vs. 2.00±0.43, CRP (mg/L): 44.09±8.37 vs. 40.54±8.37, PCT (μg/L): 0.34±0.12 vs. 0.31±0.11], with significant differences (all P < 0.05). But there was no statistical difference in WBC or PLT between the two groups. The multivariate Logistic regression model incorporated the indicators with statistical significance in univariate analysis. The results showed that Lac was an independent factor of sepsis in patients with hepatic failure [odds ratio (OR) = 58.286, 95% confidence interval (95%CI) = 16.633-204.247, P =0.000]. Conclusions For patients with hepatic failure infection, the ratio of G+ bacteria increased year by year. Elevated Lac is an independent risk factor for sepsis in patients with liver failure.

Objective? To explore the effects of perioperative blood glucose management in orthopedic diabetic patients. Methods? Totally 75 diabetic patients receiving surgery and requiring blood glucose monitoring 7 times a day in the Department of Orthopedics, He'nan Provincial People's Hospital from October 2017 to February 2018 were included in the control group, who received blood glucose management using conventional methods. Another 79 patients of the same type hospitalized between March and June 2018 were selected into the observation group for whom a blood glucose team was built and an intervention protocol of perioperative blood glucose management was developed. Self-efficacy, blood glucose detection missing rate, patient's satisfaction and average length of hospital stay of the two groups were analyzed before and after intervention. Results? The self-efficacy score of the observation group was higher than that of the control group after intervention;the blood-glucose detection missing rate was lower in the observation group than in the control group; the average length of hospital stay was shorter in the observation group than in the control group; and patient's satisfaction was higher in the observation group than in the control group (P＜ 0.05). Conclusions? Blood glucose management in orthopedic diabetic patients helps to optimize the blood glucose management process, improve patients' self-management capability, reduce diabetic patients' operative risk, guarantee patients' safety, and improve the quality of medical service.