Objectives:To develop a risk prediction model for sudden cardiac arrest(CA)in children with congenital heart disease(CHD)after surgery and validate its predictive efficacy,providing a reference for the prevention of CA and risk stratification.Methods:Medical records were retrospectively analyzed from 5 029 children who were hospitalized in Fuwai Hospital,Chinese Academy of Medical Sciences from January 1,2020 to May 31,2022 and underwent CHD surgery.The patients were divided into two groups:those who experienced CA after surgery(n=33)and those who did not(n=4 996).A random forest model for predicting the risk of postoperative CA was established on the training dataset using R software,and the predictive effect of the model was evaluated on the validation dataset using indicators of predictive accuracy,sensitivity,specificity,positive predictive value,negative predictive value.Results:The incidence of CA in this center was 0.66%,survival rate is 72.73%.Using the random forest algorithm,the importance of risk factors for sudden CA after CHD surgery was ranked by variable importance scoring,with the following top 6 important predictive variables:blood pressure,lactate levels,heart rate,cardiac rhythm,arterial oxygen partial pressure,and blood oxygen saturation on the first day after surgery.The model established by the random forest algorithm on the training set was validated on the test set,yielding a predictive accuracy of 99.8%,specificity of 87.5%,sensitivity of 99.9%,kappa coefficient of 0.8225,positive predictive value of 99.9%,and negative predictive value of 77.8%.Conclusions:The established prediction model of sudden CA in children with CHD after surgery had good performance.It might help medical staffon decision making of early intervention,preventing the occurrence of CA,and improving the outcomes of children with high risk of CA post surgery.

Objective To explore the expert consensus on perinatal care management of infants with congenital heart disease(hereinafter referred to as"Consensus")in order to promote the standardization of integrated nursing.Methods The literature was systematically searched and several discussions were organized within the group to compile the first draft of the Consensus.From January to March 2024,20 experts in the clinical nursing,nursing management,clinical medicine and other fields of congenital heart disease were solicited through 2 rounds of Delphi,and 8 experts were invited to conduct a validation to revise the items to form the final Consensus.Results The recovery rates of the 2 rounds of questionnaires were 100％;the experts'authority coefficient was 0.89;the Kendall's W were 0.172,0.211,with statistical significance(P＜0.05).The Consensus included 8 first-level subjects,namely prenatal examination and consultation,postpartum screening,standardized referral,preoperative nursing,intraoperative nursing,postoperative nursing,other disease screening,health education and discharge follow-up.Conclusion The Consensus is scientific and rigorous,and it can provide a reference basis for clinical nursing staff to carry out the care and management of newborns with congenital heart disease.

The Janus kinase/signal transducers and activators of transcription (JAK-STAT) control natural killer (NK) cells development and cytotoxic functions, however, whether long non-coding RNAs (lncRNAs) are involved in this pathway remains unknown. We found that miR155HG was elevated in activated NK cells and promoted their proliferation and effector functions in both NK92 and induced-pluripotent stem cells (iPSCs)-derived NK (iPSC-NK) cells, without reliance on its derived miR-155 and micropeptide P155. Mechanistically, miR155HG bound to miR-6756 and relieved its repression of JAK3 expression, thereby promoting the JAK-STAT pathway and enhancing NK cell proliferation and function. Further investigations disclosed that upon cytokine stimulation, STAT3 directly interacts with miR155HG promoter and induces miR155HG transcription. Collectively, we identify a miR155HG-mediated positive feedback loop of the JAK-STAT signaling. Our study will also provide a power target regarding miR155HG for improving NK cell generation and effector function in the field of NK cell adoptive transfer therapy against cancer, especially iPSC-derived NK cells.

This study aims to establish a high-performance size-exclusion chromatography (HPSEC) method for determining the content of the classical swine fever virus (CSFV) E2 protein and screen the optimal stabilizer to enhance the stability of this protein. The optimal detection conditions were determined by optimizing the composition of the mobile phase, and characteristic chromatographic peaks were identified by SDS-PAGE and Western blotting. The specificity, repeatability, precision, linearity, limit of detection (LOD), and limit of quantitation (LOQ) of the method were assessed. The method established was used to determine the content of CSFV E2 protein antigen and vaccine. Differential scanning fluorimetry (DSF) was employed to screen the buffer system, pH, and salt ion concentrations, and sugar, amino acid, and alcohol stabilizers were further screened. The results showed that using a 200 mmol/L phosphate buffer provided the best column efficiency. An antigen-specific chromatographic peak appeared at the retention time of 18 min, which was identified as the CSFV E2 protein by SDS-PAGE and Western blotting. The method exhibited high specificity for detecting the CSFV E2 protein, with no absorbance peak observed in the blank control. The relative standard deviation (RSD) of the peak area for six repeated injections of the CSFV E2 protein was 0.74%, indicating good repeatability of the method. The RSD for repeated detection of two different concentrations of CSFV E2 protein samples by different operators at different time points was less than 2%, suggesting good intermediate precision of the method. The peak area of the CSFV E2 protein was linearly related to its concentration, with the regression equation showing R² of 1.000. The LOD and LOQ of the method were 14.88 μg/mL and 29.75 μg/mL, respectively. Application of the developed method in the detection of three batches of CSFV E2 protein antigen and three batches of vaccine demonstrated results consistent with those from the bicinchoninic acid (BCA) assay, which meant that the method could accurately determine the content of CSFV E2 protein antigen and vaccine. The DSF method identified 50 mmol/L Tris-HCl at pH 8.0 as the optimal buffer, and the addition of sugar and alcohol stabilizers further improved the stability of the CSFV E2 protein. The HPSEC method established in this study is simple, fast, and exhibits good accuracy and repeatability, enabling precise measurement of the CSFV E2 protein content. It is expected to play a crucial role in the quality control of the CSFV E2 vaccine. Furthermore, the strategy for improving the CSFV E2 protein stability, identified through DSF screening, has significant implications for enhancing the stability of the CSFV E2 vaccine.
Classical Swine Fever Virus/chemistry* ; Chromatography, Gel/methods* ; Animals ; Swine ; Viral Envelope Proteins/immunology*

Objective:To investigate the impacts of different surgical fixation sequences on the post-operative functional outcomes in patients with ankle fracture combined with Lisfranc injury.Methods:A retrospective study was conducted to analyze the 20 patients with ankle fracture and concomitant Lisfranc injury who had been treated between January 2014 and December 2023 at Department of Orthopedics, The 82nd Group Army Hospital of PLA. The cohort included 16 males and 4 females, with an age of (41.3±12.3) years. Patients were divided into 2 groups based on their surgical sequence: an ankle-first group ( n=12) treated first by open reduction and internal fixation of the ankle fracture and then by additional incision reduction and fixation of the Lisfranc injury, and a foot-first group ( n=8) treated first by open reduction and fixation of the Lisfranc injury and then by another incision for open reduction and internal fixation of the ankle fracture. The surgical time, intraoperative fluoroscopy frequency, postoperative Lisfranc articular step-off, postoperative arch height index (AHI), and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and incidence of traumatic arthritis at 1 year after surgery were compared between the 2 groups. Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (18.3±3.2) months after surgery. There was no statistically significant difference in surgical time or incidence of traumatic arthritis between the 2 groups ( P>0.05). In the ankle-first group, the intra-operative fluoroscopy frequency [(16.6±2.6) times] was significantly higher than that in the foot-first group [(13.6±2.5) times], and the postoperative Lisfranc articular step-off [0.0 (0.0, 0.8) mm], postoperative AHI [0.31 (0.29, 0.32)], and AOFAS ankle-hindfoot score at 1 year after surgery [(85.2±2.2) points] were all significantly better than those in the foot-first group [(1.3±1.3) mm, 0.29±0.01, and (81.0±4.1) points] (all P<0.05). Conclusion:In the treatment of ankle fracture combined with Lisfranc injury, prioritizing ankle fixation provides a stable biomechanical foundation for subsequent midfoot reduction, leading to improved functional recovery and radiographic outcomes, but requires increased intraoperative fluoroscopy.

Objective To explore the expert consensus on perinatal care management of infants with congenital heart disease(hereinafter referred to as"Consensus")in order to promote the standardization of integrated nursing.Methods The literature was systematically searched and several discussions were organized within the group to compile the first draft of the Consensus.From January to March 2024,20 experts in the clinical nursing,nursing management,clinical medicine and other fields of congenital heart disease were solicited through 2 rounds of Delphi,and 8 experts were invited to conduct a validation to revise the items to form the final Consensus.Results The recovery rates of the 2 rounds of questionnaires were 100％;the experts'authority coefficient was 0.89;the Kendall's W were 0.172,0.211,with statistical significance(P＜0.05).The Consensus included 8 first-level subjects,namely prenatal examination and consultation,postpartum screening,standardized referral,preoperative nursing,intraoperative nursing,postoperative nursing,other disease screening,health education and discharge follow-up.Conclusion The Consensus is scientific and rigorous,and it can provide a reference basis for clinical nursing staff to carry out the care and management of newborns with congenital heart disease.

Objective To explore the value of the corrected-size ratio(c-SR)value of intracranial volume computed tomography angiography(CTA)in predicting the risk of intracranial aneurysm rupture.Methods A total of 81 patients with aneurysms who had follow-up records were selected.Among them,39 patients with unruptured aneurysms and underwent regular follow-ups,while 9 patients with unruptured aneurysms opted for surgical intervention.Additionally,surgery was performed on 33 patients with ruptured aneu-rysms.Three-dimensional reconstruction of CTA was performed to obtain the morphological parameters of aneurysms.The initial size ratio(SR)value of aneurysm and the follow-up SR value or postoperative c-SR value were obtained.The changes in SR values of unruptured aneurysms were analyzed,the preoperative SR values and postoperative c-SR values of aneurysms were analyzed.Finally,the correla-tion between the intial SR value of unruptured aneurysms and the c-SR value of ruptured aneurysms was compared.Results No sig-nificant difference was observed between the initial SR value of unruptured aneurysms and the follow-up SR value(P>0.05).Simi-larly,no significant difference was noted between the preoperative SR value of unruptured aneurysms and the postoperative c-SR value(P>0.05).The preoperative SR value of ruptured aneurysms differed significantly from the postoperative c-SR value(P<0.05).There was a significant difference between the initial SR value of unruptured aneurysms and the postoperative c-SR value of ruptured aneurysms(P<0.05).The receiver operating characteristic(ROC)curve analysis was performed on the initial SR value of unrup-tured aneurysms and the postoperative c-SR value of ruptured aneurysms.The area under the curve(AUC)was 0.860 and the best cut-off value was 1.045.Conclusion Unruptured aneurysms remain stable for an extended period of time,exhibiting no significant change in morphological parameters.It can be concluded that surgical intervention does not affect the SR value of aneurysms.In the case of subarachnoid hemorrhage caused by ruptured aneurysms,the parent artery become thinner,then the preoperative SR value of ruptured aneurysms may be exaggerated,which results in the distortion of the preoperative SR value of ruptured aneurysms.However,the postoperative c-SR value is the true SR value before the rup-ture of aneurysms.

Objective To understand the changing composition and antibiotic resistance of bacterial species in the clinical isolates from outpatient and emergency department(hereinafter referred to as outpatients)and inpatient children over time in various hospitals,and to provide laboratory evidence for rational antibiotic use.Methods The data on clinically isolated pathogenic bacteria and antimicrobial susceptibility of isolates from outpatients and inpatient children in the CHINET program from 2015 to 2021 were collected and analyzed.Results A total of 278 471 isolates were isolated from pediatric patients in the CHINET program from 2015 to 2021.About 17.1％of the strains were isolated from outpatients,primarily group A β-hemolytic Streptococcus,Escherichia coli,and Staphylococcus aureus.Most of the strains(82.9％)were isolated from inpatients,mainly SS.aureus,E.coli,and H.influenzae.The prevalence of methicillin-resistant S.aureus(MRSA)in outpatients(24.5％)was lower than that in inpatient children(31.5％).The MRSA isolates from outpatients showed lower resistance rates to the antibiotics tested than the strains isolated from inpatient children.The prevalence of vancomycin-resistant Enterococcus faecalis or E.faecium and penicillin-resistant S.pneumoniae was low in either outpatients or inpatient children.S.pneumoniae,β-hemolytic Streptococcus and S.viridans showed high resistance rates to erythromycin.The prevalence of erythromycin-resistant group A β-hemolytic Streptococcus was higher in outpatients than that in inpatient children.The prevalence of β-lactamase-producing H.influenzae showed an overall upward trend in children,but lower in outpatients(45.1％)than in inpatient children(59.4％).The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn),carbapenem-resistant Pseudomonas aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 14％,11.7％,47.8％in outpatients,but 24.2％,20.6％,and 52.8％in inpatient children,respectively.The prevalence of multidrug-resistant E.coli,K.pneumoniae,Proteus mirabilis,P.aeruginosa and A.baumannii strains was lower in outpatients than in inpatient children.The prevalence of fluoroquinolone-resistant E.coli,ESBLs-producing K.pneumoniae,ESBLs-producing P.mirabilis,carbapenem-resistant E.coli(CREco),CRKpn,and CRPae was lower in children in outpatients than in inpatient children,but the prevalence of CRAba in 2021 was higher than in inpatient children.Conclusions The distribution of clinical isolates from children is different between outpatients and inpatients.The prevalence of MRSA,ESBL,and CRO was higher in inpatient children than in outpatients.Antibiotics should be used rationally in clinical practice based on etiological diagnosis and antimicrobial susceptibility test results.Ongoing antimicrobial resistance surveillance and prevention and control of hospital infections are crucial to curbing bacterial resistance.

Objective:To explore highly efficient ventilation protection technology for large-space workplaces adapted to the production process in composite material impregnation.Methods:A composite material impregnation room was selected as the research subject from August to December 2023. Occupational health investigation, on-site detection, and physical simulation of air distribution were used to analyze the distribution of the xylene concentrations in the impregnation room. In addition, the causes for excessive concentrations were analyzed, and the combination ventilation design of enclosed negative pressure cabinets and jet directional supply of fresh air was proposed. The concentration of xylene, the capture velocity and the differential pressure of ventilation facilities before and after the transformation were tested on the spot. The rationality of the airflow organization was determined through smoke testing, and the ventilation protection effects before and after the transformation were analyzed.Results:The time-weighted average allowable concentration ( CTWA) of xylene was reduced from 41.73 mg/m 3 to 7.78 mg/m 3, and the CTWA of xylene were reduced by 81.4%. The values of capture velocity at all areas were higer than 0.5 m/s, and the values of velocity unevenness in all regions were lower than or equal to 0.25. The differential pressure between the enclosed cabinet and the impregnation room corridor was -2 to -1 Pa. The overall velocity distribution at all areas was relatively uniform, the airflow organization was reasonable, and negative pressure was formed inside the enclosed cabinet. Conclusion:The combination ventilation design of xylene, the capture velocity and the differential pressure of ventilation facilities effectively reducing the xylene concentration in the workplace, and provide a reference for ventilation protection of xylene workplace.

Objective To investigate the distribution and antimicrobial resistance profiles of common pathogens isolated from cerebrospinal fluid(CSF)in CHINET program from 2015 to 2021.Methods The bacterial strains isolated from CSF were identified in accordance with clinical microbiology practice standards.Antimicrobial susceptibility test was conducted using Kirby-Bauer method and automated systems per the unified CHINET protocol.Results A total of 14 014 bacterial strains were isolated from CSF samples from 2015 to 2021,including the strains isolated from inpatients(95.3％)and from outpatient and emergency care patients(4.7％).Overall,19.6％of the isolates were from children and 80.4％were from adults.Gram-positive and Gram-negative bacteria accounted for 68.0％and 32.0％,respectively.Coagulase negative Staphylococcus accounted for 73.0％of the total Gram-positive bacterial isolates.The prevalence of MRSA was 38.2％in children and 45.6％in adults.The prevalence of MRCNS was 67.6％in adults and 69.5％in children.A small number of vancomycin-resistant Enterococcus faecium(2.2％)and linezolid-resistant Enterococcus faecalis(3.1％)were isolated from adult patients.The resistance rates of Escherichia coli and Klebsiella pneumoniae to ceftriaxone were 52.2％and 76.4％in children,70.5％and 63.5％in adults.The prevalence of carbapenem-resistant E.coli and K.pneumoniae(CRKP)was 1.3％and 47.7％in children,6.4％and 47.9％in adults.The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)and Pseudomonas aeruginosa(CRPA)was 74.0％and 37.1％in children,81.7％and 39.9％in adults.Conclusions The data derived from antimicrobial resistance surveillance are crucial for clinicians to make evidence-based decisions regarding antibiotic therapy.Attention should be paid to the Gram-negative bacteria,especially CRKP and CRAB in central nervous system(CNS)infections.Ongoing antimicrobial resistance surveillance is helpful for optimizing antibiotic use in CNS infections.