Objective To investigate the clinical characteristics of inguinal abscess caused by Actinotignum schaa-lii(A.schaalii),and improve the clinical recognition and attention on skin and soft tissue infection caused by this bacterium.Methods Clinical data of a patient with inguinal abscess caused by A.schaalii were reviewed.Biologi-cal characteristics of the bacterium were observed,and antimicrobial susceptibility testing was conducted.PubMed database was retrieved using"Actinobaculum schaalii"and"Actinotignum schaalii"as keywords.Meanwhile,Chi-na National Knowledge Infrastructure,Wanfang,and VIP databases were retrieved using corresponding Chinese re-trieval terms.Clinical data of skin or soft tissue infections caused by A.schaalii were summarized and analyzed.Results After literature retrieval and screening,38 cases from 13 literatures were finally included,out of which 33 patients with A.schaalii infection were treated with antimicrobial agents and/or incision drainage,and the treat-ment effect was good.Conclusion A.schaalii is an opportunistic pathogen.There are few reports on skin or soft tissue infections caused by it.Currently,the identification of this bacterium relies on mass spectrometry technology or gene sequencing.Clinical attention should be paid to the detection of this bacterium,and appropriate antimicrobial agents should be selected for its treatment.

Objective:To evaluate the effectiveness of a rotation training program for primary care general practitioners (GPs) in Taizhou, China, designed around three core competencies.Methods:A longitudinal study was conducted. A total of 111 primary care GPs participating in the 1st to 5th sessions of the Taizhou GP rotation training program at Taizhou Hospital (the designated training center) in Zhejiang Province from July 2022 to December 2024 were included. Based on the World Organization of Family Doctors (WONCA) competency model, combined with literature review and expert consultation, 15 potential training components were identified. A needs assessment survey among primary care GPs was then conducted, leading to the finalization of three core competencies for the training: ①Evidence-based management of common diseases, frequently-occurring diseases, and common symptoms; ②Early identification, management, and referral of critically ill patients; ③Chronic disease management and health promotion capabilities. A 4-month full-time immersion training program was structured around these competencies, comprising three phases: theoretical training (1 week), clinical comprehensive skills training (14 weeks), and primary care practice training (1 week). Assessments included a pre-and post-training theoretical knowledge test and a final clinical assessment. The final assessment utilized a three-station Objective Structured Clinical Examination (OSCE) evaluating patient consultation, clinical reasoning & decision-making, and clinical procedural skills. A self-administered satisfaction survey was also distributed post-training.Results:The 111 participants were predominantly aged 30-49 years (72.1% (80/111)), held bachelor′s degrees (87.4% (97/111)), were licensed physicians (78.4% (87/111)), and had junior or intermediate professional titles (87.4% (97/111)). Post-training theoretical scores were significantly higher than pre-training scores (76.26±7.00 vs. 69.94±6.40, t=-10.45, P<0.001). All participants 100%(111/111) passed the final OSCE assessment. The mean scores for the OSCE stations were: patient consultation 85.99±7.30, clinical reasoning & decision-making 82.72±7.61, and clinical procedural skills 89.60±5.65. Satisfaction rates were 100.0% (111/111) for the overall program, the three-phase design, the core competency training content, theoretical training, clinical skills training, and clinical rotation departments. Satisfaction was 98.2% (109/111) for the 4-month full-time duration, 99.1% (110/111) for the "2+X" clinical rotation model (2 weeks each in General Practice and Emergency Medicine+elective rotations in 4 other departments), and 97.3% (108/111) for the primary care practice base. Conclusions:The competency-based rotation training program for primary care GPs in Taizhou effectively enhanced participants′ theoretical knowledge and clinical practical skills, and achieved high levels of participant satisfaction. This model offers valuable insights for optimizing primary care GP training in similar settings.

Objective To investigate the clinical characteristics of inguinal abscess caused by Actinotignum schaa-lii(A.schaalii),and improve the clinical recognition and attention on skin and soft tissue infection caused by this bacterium.Methods Clinical data of a patient with inguinal abscess caused by A.schaalii were reviewed.Biologi-cal characteristics of the bacterium were observed,and antimicrobial susceptibility testing was conducted.PubMed database was retrieved using"Actinobaculum schaalii"and"Actinotignum schaalii"as keywords.Meanwhile,Chi-na National Knowledge Infrastructure,Wanfang,and VIP databases were retrieved using corresponding Chinese re-trieval terms.Clinical data of skin or soft tissue infections caused by A.schaalii were summarized and analyzed.Results After literature retrieval and screening,38 cases from 13 literatures were finally included,out of which 33 patients with A.schaalii infection were treated with antimicrobial agents and/or incision drainage,and the treat-ment effect was good.Conclusion A.schaalii is an opportunistic pathogen.There are few reports on skin or soft tissue infections caused by it.Currently,the identification of this bacterium relies on mass spectrometry technology or gene sequencing.Clinical attention should be paid to the detection of this bacterium,and appropriate antimicrobial agents should be selected for its treatment.

Objective:To evaluate the effectiveness of a rotation training program for primary care general practitioners (GPs) in Taizhou, China, designed around three core competencies.Methods:A longitudinal study was conducted. A total of 111 primary care GPs participating in the 1st to 5th sessions of the Taizhou GP rotation training program at Taizhou Hospital (the designated training center) in Zhejiang Province from July 2022 to December 2024 were included. Based on the World Organization of Family Doctors (WONCA) competency model, combined with literature review and expert consultation, 15 potential training components were identified. A needs assessment survey among primary care GPs was then conducted, leading to the finalization of three core competencies for the training: ①Evidence-based management of common diseases, frequently-occurring diseases, and common symptoms; ②Early identification, management, and referral of critically ill patients; ③Chronic disease management and health promotion capabilities. A 4-month full-time immersion training program was structured around these competencies, comprising three phases: theoretical training (1 week), clinical comprehensive skills training (14 weeks), and primary care practice training (1 week). Assessments included a pre-and post-training theoretical knowledge test and a final clinical assessment. The final assessment utilized a three-station Objective Structured Clinical Examination (OSCE) evaluating patient consultation, clinical reasoning & decision-making, and clinical procedural skills. A self-administered satisfaction survey was also distributed post-training.Results:The 111 participants were predominantly aged 30-49 years (72.1% (80/111)), held bachelor′s degrees (87.4% (97/111)), were licensed physicians (78.4% (87/111)), and had junior or intermediate professional titles (87.4% (97/111)). Post-training theoretical scores were significantly higher than pre-training scores (76.26±7.00 vs. 69.94±6.40, t=-10.45, P<0.001). All participants 100%(111/111) passed the final OSCE assessment. The mean scores for the OSCE stations were: patient consultation 85.99±7.30, clinical reasoning & decision-making 82.72±7.61, and clinical procedural skills 89.60±5.65. Satisfaction rates were 100.0% (111/111) for the overall program, the three-phase design, the core competency training content, theoretical training, clinical skills training, and clinical rotation departments. Satisfaction was 98.2% (109/111) for the 4-month full-time duration, 99.1% (110/111) for the "2+X" clinical rotation model (2 weeks each in General Practice and Emergency Medicine+elective rotations in 4 other departments), and 97.3% (108/111) for the primary care practice base. Conclusions:The competency-based rotation training program for primary care GPs in Taizhou effectively enhanced participants′ theoretical knowledge and clinical practical skills, and achieved high levels of participant satisfaction. This model offers valuable insights for optimizing primary care GP training in similar settings.

Objective To investigate the expression of long non-coding RNA(LncRNA)nuclera-enriched autosomal transcript(NEAT1)in children with retinoblastoma(Rb)and the effect of down-regulation of NEAT1 in Rb cell Y79 on cell biological function.Methods A total of 83 children with Rb who were diagnosed and treated in Huangshi Central Hospital from March 2015 to March 2021 were collected as the research object.During the same period,50 healthy children(control group)were selected in the children's health center.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the expression of NEAT1 in serum.The differences in the expressions of NEAT1 in serum between Rb children and the control group,and the differences in the expressions of NEAT1 in serum among Rb children with different clinical indicators,were analyzed.Y79 cells were cultured and were divided into si-NEAT1 group(transfected with interference sequence of NEAT1),si-NC group(transfected with control sequence)and Ctl group(only add transfection reagent).The qRT-PCR,MTT,flow cytometry and Transwell were used to detect the NEAT1 expression,cell proliferation,apoptosis,migration and invasion.Results The expression level of NEAT1 in the serum of children with Rb(1.43±0.28)was higher than that in the control group(1.01±0.21),with significant difference(t=9.116,P＜0.001).The expression levels of NEAT1 in serum of children with Rb with Intraocular International Retinoblastoma classification(IIRC)stage CDE,poor differentiation,optic nerve infiltration and lymph node metastasis were higher than those in children with Rb with AB,medium to high differentiation,no optic nerve infiltration and lymph node metastasis,with significant differences(t=2.190～3.693,all P＜0.05).The area under the curve for diagnosing Rb based on NEAT1 expression in serum was 0.882(95％CI:0.826～0.937).When the expression level of NEAT1 was 1.20,the sensitivity and specificity were 80.00％and 79.52％,respectively.Compared with the si-NC group(1.03±0.09)and the Ctl group(1.02±0.15),the expression level of NEAT1 in the si-NEAT1 group(0.35±0.06)was decreased,with significant differences(t=14.829,9.994,all P＜0.001).The absorbance A values in the si-NEAT1 group at 24,48,72 and 96h were significantly lower than those in the si-NC group and the Ctl group(t=si-NC=2.796～4.362,tCtl=2.641～5.555,all P＜0.05),while the apoptosis rate in the si-NEAT1 group was significantly higher than those in the si-NC group and the Ctl group,and the differences were statistically significant(t=4.999,3.915,all P＜0.05).Compared with the si-NC group and the Ctl group,the number of migrating cells(116.50±9.35 vs 132.00±7.32,134.00±7.95)and the number of invasive cells(96.33±8.94 vs 117.67±12.39,119.17±10.05)in the si-NEAT1 group were reduced,and the differences were statistically significant(tsi-NC=3.196,3.421,tCtl=3.492,4.159,all P＜0.05).Conclusion The expression level of NEAT1 in the serum of children with Rb was elevated,which may have a certain diagnostic value for children with Rb.Silencing the expression of NEAT1 in Y79 cells could reduce cell proliferation,accelerate cell apoptosis,and inhibit cell migration and invasion.

Objective:To investigate how medical staff recognize and understand the nursing quality evaluation in robot-assisted arthroplasty so as to provide reference and evidence for construction of a nursing quality evaluation system for robot-assisted arthroplasty.Methods:The descriptive phenomenological research method was used for this qualitative research. From May to October, 2021, 6 doctors and 9 nurses from Operating Room, Laoshan Campus, Hospital Affiliated to Qingdao University were interviewed in a semi-structured way about the nursing quality evaluation for robot-assisted arthroplasty. The data were sorted out by Nvivo12.0 qualitative analysis software, and the interview data were analyzed while the themes and topics refined according to the Colaizzi seven-step analysis of phenomenological data.Results:Three themes were extracted. ① The first theme was related to the quality evaluation of nursing structure, including 2 topics: nursing staff allocation and nursing quality management in operating room. ② The second theme was related to the quality evaluation of nursing process, including 4 topics: environment and facilities, nosocomial infection control, management of patients' operative safety, and specialized operative nursing. ③ The third theme was related to the quality evaluation of nursing outcomes, including 3 topics: satisfaction for operating room nursing, incidence of adverse events and patients' benefits.Conclusion:The themes and topics for nursing quality evaluation in robot-assisted arthroplasty extracted from the perspective of medical staff can provide reference for construction of a reasonable, scientific, efficient and comprehensive nursing quality evaluation index system.

To understand the adverse reactions of Kan,glaite injection and its incidenceand explore the factors affecting the safety of Kan,glaite Injection in clinical use.Methods A noninterventional and prospective hospital based monitoring study and nested case-control study were conducted.All hospitalized cancer patients receiving Kan.glaite injections from 28 hospitals in northeast, north, central,east, south, southwest, northwest regions of China from September 2013 to September 2014 were enrolled in this study. The main monitoring contents included the general status of patients, the drug administration (including indications and combined use), medication safety, and so on. Patients developing adverse reactions related to Kan,glaite injection distributed in the case group and patients who did not develop adverse reactions were randomly selected and distributed into the control group with a ratio of l : 3 , and the factors that affect the safe use of Kan,glaite injection were analyzed.Results A total of 5 022 cancer patients were entered into the study, including 2 926 males and 2 096 females with age from 9 t0 95 years and their average age was (60 + 12) years. The top five tumors were lung cancer (1 456 patients,28.99%) ,intestinal cancer (867 patients,17.26% ) , marmuary cancer ( 372 patients, 7.41% ) , gastric cancer ( 346 patients, 6.89%) , and liver cancer (335 cases,6.67%). There were 3 863 patients (76.92% ) with tumor stage III and IV, 348 patients with allergic history (6.93%) ; 2 524 patients were complicated with other diseases (50.26% ) ; 4 687 patients (93.33%) had combined drug therapy.During the monitoring period,751(14.95%) of 5 022 patients developed adverse events and of them, 18 cases met the criteria of causality of adverse reactions, including 7 cases of phlebitis, 3 cases of nausea and vomiting, 3 cases of chills, 2 cases of rash, 1 case of palpitation, 1 case of transammase increase, and l case of fever. The incidence of adverse reactions was 0.36%. Univariate analysis showed that the incidence of adverse reactions in patients with combined diseases was higher than that in patients without combined diseases (X2=5.4723,P=0.019),the incidence of adverse reactions in patients with combined western medication was higher than that in patients with combined westem and Chinese medication (P=0.002).Logistic regression analysis showed that the influencing factors of adverse reactions were coexisting diseases (OR=1. 636, 95%C/:1.100-2.433,P= 0.013)and combined medication (OR=1.475,95%C/:1.108-1.965,P=0.027).Nested case-control study showed that the influencing factors of adverse reactions induced by Kan.glaite injection were radiotherapy (OR= 1.864,95% C/:0.930-3.736,P<0.01)and corubined medication (OR=1.622,95% C/:1.102-2.389,P<0.01) .Conclusions The incidence of adverse reactions of Kan,glaite injection in clinical application is lower and the safety is good. Coexisting diseases, combined medication and radiotherapy are main factors affecting its clinical safety.

To understand the adverse reactions of Kan,glaite injection and its incidenceand explore the factors affecting the safety of Kan,glaite Injection in clinical use.Methods A noninterventional and prospective hospital based monitoring study and nested case-control study were conducted.All hospitalized cancer patients receiving Kan.glaite injections from 28 hospitals in northeast, north, central,east, south, southwest, northwest regions of China from September 2013 to September 2014 were enrolled in this study. The main monitoring contents included the general status of patients, the drug administration (including indications and combined use), medication safety, and so on. Patients developing adverse reactions related to Kan,glaite injection distributed in the case group and patients who did not develop adverse reactions were randomly selected and distributed into the control group with a ratio of l : 3 , and the factors that affect the safe use of Kan,glaite injection were analyzed.Results A total of 5 022 cancer patients were entered into the study, including 2 926 males and 2 096 females with age from 9 t0 95 years and their average age was (60 + 12) years. The top five tumors were lung cancer (1 456 patients,28.99%) ,intestinal cancer (867 patients,17.26% ) , marmuary cancer ( 372 patients, 7.41% ) , gastric cancer ( 346 patients, 6.89%) , and liver cancer (335 cases,6.67%). There were 3 863 patients (76.92% ) with tumor stage III and IV, 348 patients with allergic history (6.93%) ; 2 524 patients were complicated with other diseases (50.26% ) ; 4 687 patients (93.33%) had combined drug therapy.During the monitoring period,751(14.95%) of 5 022 patients developed adverse events and of them, 18 cases met the criteria of causality of adverse reactions, including 7 cases of phlebitis, 3 cases of nausea and vomiting, 3 cases of chills, 2 cases of rash, 1 case of palpitation, 1 case of transammase increase, and l case of fever. The incidence of adverse reactions was 0.36%. Univariate analysis showed that the incidence of adverse reactions in patients with combined diseases was higher than that in patients without combined diseases (X2=5.4723,P=0.019),the incidence of adverse reactions in patients with combined western medication was higher than that in patients with combined westem and Chinese medication (P=0.002).Logistic regression analysis showed that the influencing factors of adverse reactions were coexisting diseases (OR=1. 636, 95%C/:1.100-2.433,P= 0.013)and combined medication (OR=1.475,95%C/:1.108-1.965,P=0.027).Nested case-control study showed that the influencing factors of adverse reactions induced by Kan.glaite injection were radiotherapy (OR= 1.864,95% C/:0.930-3.736,P<0.01)and corubined medication (OR=1.622,95% C/:1.102-2.389,P<0.01) .Conclusions The incidence of adverse reactions of Kan,glaite injection in clinical application is lower and the safety is good. Coexisting diseases, combined medication and radiotherapy are main factors affecting its clinical safety.

OBJECTIVETo compare the clinical efficacy of the lymph node dissection patterns of the reverse and the traditional cabbage in hand-assisted laparoscopic D2 radical gastrectomy (HALG).

METHODSFrom December 2010 to October 2013, 194 patients with HALG in Chengdu Military General Hospital were enrolled in this study. According to the pattern of lymph node dissection, 108 patients were performed with the reverse procedure which took spleen as starting point, from left to right, and 86 patients were performed with the traditional cabbage procedure which took the abdominal cavity as the center, from both sides to middle. A retrospective comparative analysis was made on the intra- and post-operative data between the two groups.

RESULTSAll the patients were successfully performed with HALG, and no peri-operative death occurred. There were no significant differences in the incision length [(7.0 ± 0.2) cm vs. (6.9 ± 0.3) cm], the operative time [(170.9 ± 33.8) minute vs. (174.6 ± 22.4) minute], dissected lymph node number (17.6 ± 7.5 vs. 17.1 ± 5.8) and post-operative complications [(6.5%(7/108) vs. 8.1%(7/86)] between the reverse group and cabbage group (all P>0.05). However, less blood loss [(204.6 ± 98.2) ml vs. (259.1 ± 122.6) ml, P<0.01] and shorter postoperative hospital stay [(9.0 ± 1.7) day vs. (10.5 ± 4.0) day, P<0.01] were observed in reverse group as compared to cabbage group. During 1 to 6 months follow-up, no death case was found in reverse group, while 1 case died due to upper gastrointestinal bleeding 48 days after operation in cabbage group.

CONCLUSIONEfficacy is similar between the two HALG procedures in lymph node dissection, while reverse procedure has certain advantages, such as less blood loss and faster recovery.

Gastrectomy ; methods ; Hand-Assisted Laparoscopy ; Humans ; Length of Stay ; Lymph Node Excision ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms ; surgery

The Ebola virus is highly infectious and can result in death in ≤ 90% of infected subjects. Detection of the Ebola virus and diagnosis of infection are extremely important for epidemic control. Presently, Chinese laboratories detect the nucleic acids of the Ebola virus by real-time reverse transcription-polymerase chain reaction (RT-PCR). However, such detection takes a relatively long time and necessitates skilled personnel and expensive equipment. Enzyme-linked immunosorbent assay (ELISA) of serum is simple, easy to operate, and can be used to ascertain if a patient is infected with the Ebola virus as well as the degree of infection. Hence, ELISA can be used in epidemiological investigations and is a strong complement to detection of nucleic acids. Cases of Ebola hemorrhagic fever have not been documented in China, so quality-control material for positive serology is needed. Construction and expression of human-mouse chimeric antibodies against the nucleoprotein of the Ebola virus was carried out. Genes encoding variable heavy (VH) and variable light (VL) chains were extracted and amplified from murine hybridoma cells. Genes encoding the VH and VL chains of monoclonal antibodies were amplified by RT-PCR. According to sequence analyses, a primer was designed to amplify functional sequences relative to VH and VL chain. The eukaryotic expression vector HL51-14 carrying some human antibody heavy chain- and light chain-constant regions was used. IgG antibodies were obtained by transient transfection of 293T cells. Subsequently, immunological detection and immunological identification were identified by ELISA, immunofluorescence assay, and western blotting. These results showed that we constructed and purified two human- mouse chimeric antibodies.
Animals ; Antibodies, Monoclonal ; genetics ; immunology ; Cloning, Molecular ; Ebolavirus ; genetics ; immunology ; Hemorrhagic Fever, Ebola ; immunology ; virology ; Humans ; Immunoglobulin Heavy Chains ; genetics ; immunology ; Mice ; Nucleoproteins ; genetics ; immunology ; Viral Proteins ; genetics ; immunology