Objective To perform on-site calibration of high-pressure ionization chambers and NaI(Tl) γ spectrometers in state-controlled atmospheric radiation environment automatic continuous monitoring stations and verify the reliability of the online radiation environment monitoring system. Methods ¹³⁷Cs, ⁶⁰Co, and ²⁴¹Am were used as γ reference radiation sources to measure the metrological performance of high-pressure ionization chambers in nine state-controlled atmospheric radiation environment automatic monitoring stations in Hubei Province, China. The performance metrics included background radiation, response, and repeatability. Additionally, the correlation between dose rate and humidity was analyzed, and the energy resolution and activity response of NaI(Tl) γ spectrometers were measured. Results Among the nine state-controlled atmospheric radiation environment automatic monitoring stations, the background radiation of high-pressure ionization chambers ranged from 58.2 nGy/h to 82.6 nGy/h. The response of the high-pressure ionization chambers ranged from 0.94 to 1.08, fulfilling the requirement of 1.0 ± 0.2. The repeatability of high-pressure ionization chambers ranged from 0.43% to 3.80%, satisfying the requirement of not exceeding 10%. A significant correlation was observed between dose rate and humidity, with a correlation coefficient of 0.4476. For NaI(Tl) γ spectrometers, the energy resolution ranged from 6.8% to 7.9%, fulfilling the requirement of not exceeding 9% for the 661.7 keV energy peak of ¹³⁷Cs. The NaI(Tl) γ spectrometers showed 1.4% to 1.8% s⁻¹·Bq⁻¹ activity response to ²⁴¹Am and 6.6‰ to 8.4‰ s⁻¹·Bq⁻¹ activity response to ⁶⁰Co. Conclusion The online monitoring systems in the nine state-controlled atmospheric radiation environment automatic monitoring stations are stable and reliable, providing accurate radiation environment monitoring data for public awareness.

Objective:To explore the heterogeneity among keloids before and after radiotherapy and identify the changes of key cell subpopulations and their interactions utilizing single cell RNA sequencing technology.Methods:Four patients provided a total of 12 samples, each consisting of keloid tissue before and after radiotherapy and the normal skin tissue adjacent to the untreated keloid. The keloid was divided into left and right sides from the midline, and the left-side keloid was fractionally irradiated with 20 Gy electron beam in total in 4 consecutive days. The right-side keloid was irradiated with 10 Gy in 2 fractions before surgery and 10 Gy in 2 fractions after surgery.Results:A total of 25 573 fibroblasts were analyzed and categorized into nine subgroups (fibroblasts 1-9). The proportion of fibroblast-2 increased after radiotherapy ( t=4.70, P<0.05). The number of classical monocytes and macrophages increased after radiotherapy, but there was no significant difference due to the shorter time of sample taking at 2 d after radiotherapy ( P>0.05). Macrophages (4 723 cells) were further divided into four categories. CellPhoneDB analysis showed that type-3 macrophages interacted significantly more closely with fibroblasts than type-1 and type-2 macrophages. The most prominent signaling pathways for the interactions between type-3 macrophages and major fibroblast subtypes were the collagen signaling pathway and the chemerin signaling pathway. These interactions were more pronounced in the keloid samples after radiotherapy. Conclusions:The interactions between type-3 macrophages and fibroblasts (such as fibroblast-2) may serve as an important point for future studies on radio-sensitization of keloids.

Periodontitis imparting the increased risk of atherosclerotic cardiovascular diseases is partially due to the immune subversion of the oral pathogen, particularly the Porphyromonas gingivalis (P. gingivalis), by inducing apoptosis. However, it remains obscure whether accumulated apoptotic cells in P. gingivalis-accelerated plaque formation are associated with impaired macrophage clearance. Here, we show that smooth muscle cells (SMCs) have a greater susceptibility to P. gingivalis-induced apoptosis than endothelial cells through TLR2 pathway activation. Meanwhile, large amounts of miR-143/145 in P.gingivalis-infected SMCs are extracellularly released and captured by macrophages. Then, these miR-143/145 are translocated into the nucleus to promote Siglec-G transcription, which represses macrophage efferocytosis. By constructing three genetic mouse models, we further confirm the in vivo roles of TLR2 and miR-143/145 in P. gingivalis-accelerated atherosclerosis. Therapeutically, we develop P.gingivalis-pretreated macrophage membranes to coat metronidazole and anti-Siglec-G antibodies for treating atherosclerosis and periodontitis simultaneously. Our findings extend the knowledge of the mechanism and therapeutic strategy in oral pathogen-associated systemic diseases.
Animals ; Mice ; Endothelial Cells ; Toll-Like Receptor 2 ; Macrophages ; Apoptosis ; Atherosclerosis ; Myocytes, Smooth Muscle ; MicroRNAs

Objective:To investigate the family management level of children with bronchiolitis obliterans and analyze its influencing factors, so as to provide reference for clinical medical staff to adopt targeted nursing and health education programs.Methods:This was a cross-sectional study. From January 1, 2019, to April 30, 2022, 201 families of bronchiolitis obliterans children hospitalized in Hunan Children's Hospital were selected as the research objects, and the General Data Questionnaire, Family Management Scale, Coping Style Scale of Parents, and Chronic Disease-Related Health Literacy Scale was used to investigate. Single-factor analysis and multiple regression analysis were used to analyze the influencing factors of bronchiolitis obliterans children's family management level.Results:The total score of bronchiolitis obliterans children's family management was (179.67 ± 9.92) points, the total score for parents' coping style was (177.14 ± 22.19) points, and the total score for health literacy was (102.95 ± 8.60) points. Multiple regression analysis showed that age, disease course, family residence, parents' education level, family monthly income, parents' coping style, and health literacy level were the influencing factors of family management level (all P<0.05). Conclusions:The family management ability of parents of children with bronchiolitis obliterans needs to be further improved. It is suggested that medical staff should formulate corresponding measures according to the age, course of the disease, family residence, parents' education level, etc., carry out targeted health education and home management training, improve the parents' health literacy level, and guide them to deal with diseases positively, to improve their family management level and promote the recovery of children's diseases.

Objective:To analyze the accuracy of lung ultrasound and chest X-ray in the diagnosis of neonatal pulmonary disease.Methods:We prospectively collected newborns that needed chest X-ray examination to diagnose pulmonary disease from twelve neonatal intensive care units across the country between June 2019 and April 2020.Each newborn was examined by lung ultrasound within two hours after chest X-ray examination.All chest X-ray and lung ultrasound images were independently read by a radiologist and a sonographer.When there was a disagreement, a panel of two experienced physicians made a final diagnosis based on the clinical history, chest X-ray and lung ultrasound images.Results:A total of 1 100 newborns were enrolled in our study.The diagnostic agreement between chest X-ray and lung ultrasound(Cohen′s kappa coefficient=0.347) was fair.Lung ultrasound(area under the curve=0.778; 95% CI 0.753-0.803) performed significantly better than chest X-ray(area under the curve=0.513; 95% CI 0.483-0.543) in the diagnosis of transient tachypnea of the newborn( P<0.001). The accuracy of lung ultrasound in diagnosing neonatal respiratory distress syndrome, meconium aspiration syndrome, pneumonia and neonatal pulmonary atelectasis was similar to that of chest X-ray. Conclusion:Lung ultrasound, as a low-cost, simple and radiation-free auxiliary examination method, has a diagnostic accuracy close to or even better than that of chest X-ray, which may replace chest X-ray in the diagnosis of some neonatal lung diseases.It should be noted that both chest X-ray and lung ultrasound can only be used as auxiliary means for the diagnosis of lung diseases, and it is necessary to combine imaging with the clinical history and presentation.

Objective:To explore the value of the aMAP risk score (age, male, albumin -bilirubin, and platelets) to predict early recurrence within one year after microwave ablation in patients with small hepatocellular carcinoma. Methods:This was a retrospective study that enrolled 142 patients diagnosed with hepatocellular carcinoma who were treated with microwave ablation in the Department of Hepatology Unit of Nanfang Hospital, Southern Medical University from July 2016 to July 2021. The cohort enrolled 121 male and 21 female patients, including 110 patients that were <60 years old. All the patients were followed-up after microwave ablation to evaluate residual tumor and recurrence of tumor by computed tomography or magnetic resonance imaging. The observation indices mainly included general data and imaging data of patients. Using the X-tile tools, patients were divided into two groups: a high aMAP score group and a low aMAP score group. Multivariate Cox regression analysis was conducted for comparison of independent risk factors.Results:Multivariate Cox regression showed that high aMAP score, maximum tumor diameter >20 mm, and high AFP were the independent risk factors of early recurrence (all P<0.05). Kaplan-Meier survival curves showed that the median recurrence-free survival was 25.5 months in the low aMAP score group and 6.1 months in the high aMAP score group ( P=0.001). Conclusions:The aMAP score could predict the early recurrence within 1 year of small hepatocellular carcinoma after microwave ablation. Patients with high aMAP score should undergo rigorous postoperative follow-up evaluations..

Objective:To investigate the current situation of nurses′ professionalism in secondary and tertiary general hospitals, analyze its influence factors, and establish norms of nurses′ professionalism in secondary and tertiary hospitals, so as to provide references for evaluation the level of professionalism in nurses.Methods:From May to December 2016, the nurses′ professionalism evaluation system was used to investigate 3 315 nurses in 35 secondary and tertiary general hospitals in 14 cities of 7 regions in China by using random cluster sampling, and the corresponding norm, classification norm and delimitation norm were defined.Results:The average norm scores of nurses′ professionalism in the secondary and tertiary general hospitals was (71.02 ± 16.70), and the average norm scores of each dimension were professional ethics (18.97 ± 4.52) , comprehensive capabilities (17.99 ± 4.46), professional skills (17.07 ± 4.80), professional emotions (16.98 ± 4.70) . According to the differences in characteristics, the classification norms for different gender, age, working years, educational background, professional title, position, department, marital status, with or without children were formed. The level of nurses′ professionalism was divided into five grades: the total score in the interval [90.92, 100.00] was excellent, in the interval [78.31, 90.92) was good, in the interval [64.27, 78.31) was general, in the interval [50.49, 64.27) was relatively poor, in the interval [0.00, 50.49) was poor.Conclusions:Nurses′ professionalism in secondary and tertiary hospitals was in the general level and affected by a variety of factors, medical managers and nursing managers should take corresponding measures to improve nurses′ professionalism.

To improve the standard of quality control of tazobactam and its preparations in China, national reference standard of tazobactam impurity A was developed. After tazobactam impurity A was synthesized, its structure was validated by infrared (IR), mass spectrometry (MS) and nuclear magnetic resonance (NMR), and its content uniformity and short-term stability were measured and investigated. Then, water content and residue on ignition of impurity A were determined, and its purity was determined using high performance liquid chromatography (HPLC) with 10 mmol/L ammonium acetate solution-acetonitrile (98∶2) as the mobile phase. Mass balance method was used to determine the content of the first batch of tazobactam impurity A national standard substance. Meanwhile, nuclear magnetic quantitative method was used to calculate the content, which was mutually verified with the mass balance method. The developed reference material of tazobactam impurity A is consistent with the maximum degradation impurity in tazobactam system applicability solution and the reference material of tazobactam related substance A contained in USP41. Within the 95% confidence range, the ratio of inter- and intra-bottle variance of impurity A after separation was 0.61 (< F0.05(11,12)), proving that the uniformity was satisfying. The contents of organic impurity, water content and inorganic impurity in impurity A were 0.90%, 1.24% and 0.25%, respectively. The content of impurity A was determined to be 97.6% by mass balance method, which was basically consistent with the result of nuclear magnetic quantitative method (97.1%). Under the condition of 25 °C, the area normalized purity of impurity A was 99.1% at 0, 3, 5 and 10 days, proving that the sample was stable at room temperature for 10 days. Finally the first batch of national standard substance of tazobactam impurity A was established successfully.

Objective:To explore the establishment and evaluation method of recurrent infection model of herpes simplex keratitis (HSK).Methods:To determine the optimal duration of the ultraviolet light irradiation, 12 healthy BALB/c mice were randomized into 3 minutes group, 2 minutes and 45 seconds group, and 2 minutes and 30 seconds group based on the duration of the ultraviolet light irradiation according to random number table method, with 4 mice in each group.Another 72 healthy BALB/c mice were randomized into blank control group, model group and recurrence group according to random number table method, with 24 mice in each group.The 72 mice were scratched a # symbol on their right corneas with scalpel.Then the eyes in the blank control group were treated with 5 μl of normal saline solution, while the eyes in the model group and recurrence group were treated with 5 μl of herpes simplex virus I (HSV-1) suspension.All the 72 mice were not intraperitoneally injected with HSV-1 xenogeneic serum antibody.Five weeks after the initial infection, the mice in the recurrence group were irradiated at ultraviolet B-302 nm for the optimal duration.The feasibility of establishing HSK recurrence model induced by this method was evaluated by the score of ocular surface symptoms, and the cytopathic effect (CPE) lesion analysis of Vero cells cultured in corneal wiping fluid from the mice in the model group and recurrence group.The use and care of the animals complied with the Statement of the Association for Research in Vision and Ophthalmology (ARVO). The study protocol was approved by the Ethics Committee of Shanghai University of Traditional Chinese Medicine (No.PZSHUTCM190222039).Results:The optimal duration of the ultraviolet light irradiation was 2 minutes and 45 seconds.Within one week, HSK syndromes appeared in the mice injected with HSV-1 virus in the model group and recurrence group, and then gradually disappeared after one week.Before inducing recurrence, slit lamp examination was performed, and there was no spontaneous recurrence of HSK in the model group and recurrence group.The mice in the recurrence group relapsed within one week after ultraviolet light irradiation.The symptom scores of ocular surface lesions in the blank control group, model group and recurrence group were 0.333±0.471, 1.500±0.764 and 2.667±0.943 at one day after ultraviolet light irradiation, 0.000±0.000, 0.833±0.373 and 5.167±2.267 at three days after ultraviolet light irradiation, and 0.167±0.373, 1.000±0.577 and 3.000±1.155 at seven days after ultraviolet light irradiation, respectively.The symptom score of ocular surface lesions was higher in the recurrence group than the blank group and the model group at three days after ultraviolet light irradiation, and the differences were statistically significant (both at P<0.05). Morphological changes such as floating and gathering were found in the Vero cells after being cultured in corneal wiping fluid.The positive rate of CPE lesion was 71% (17/24) in the recurrence group, which was significantly higher than 8% (2/24) in the model group, and the difference was statistically significant ( P<0.01). Combining the two indicators, the success rate of recurrence in established models could reach 71%. Conclusions:Ultraviolet light irradiation can successfully induce the recurrence of viral keratitis in HSK mice without injection of neutralizing serum antibody.

OBJECTIVE：To provide reference for r ational use of TCM decoction piece. METHODS ：Electronic questionnaire survey was conducted on the use （dose，ingredient number ）of TCM decoction piece prescriptions in 12 TCM hospitals from 10 provinces（regions，cities）. Through the hospital information system ，416 100 outpatient prescriptions of TCM decoction piece were collected from the First Affiliated Hospital of Henan University of TCM （our hospital ）during May 2016 to Apr. 2019，and were analyzed in terms of prescription dose ，the number of ingredients and use of TCM decoction pieces. At the same time ，the use of TCM decoction piece prescription were analyzed in different departments ，and the clinical application status of TCM decoction pieces prescription were investigated and relevant suggestions were put forward. RESULTS ：The average dose of TCM decoction piece prescriptions in 12 hospitals were 129.60-245.00 g，and the average number of ingredients were 11.90-18.25；the average dose of TCM decoction piece prescriptions in pediatric department was lower than other departments. The average dose of TCM decoction piece prescriptions in our hospital was 242.21 g；55.75％ of the prescription dose were distributed in 201-300 g，and 15.22％ were over 300 g. The average number of ingredients in prescriptions was about 15，and the prescriptions with 11-20 ingredients accounted for 87.75％，those with more than 20 ingredients accounted for 6.64％. Top 20 TCM decoction pieces in TCM prescriptions of our hospital had different degrees of overdose. Three decoction pieces with the highest frequency of overdose were Radix Curcumae processed by vinegar （85.51％），Atractylodes macrocephala stir-fried with bran （82.10％）and A. macrocephala（79.13％）. The number of TCM decoction piece prescriptions in internal medicine department accounted for 40.84％ in our hospital ；there were a lot of TCM prescriptions with dose exceeding 300 g（11.98％ and 18.69％）and the number of ingredients exceeding 18（14.60％ and 9.53％）in internal medicine department and surgery department. The proportion of pediatric TCM decoction piece prescriptions with more than 18 ingredients accounted for 24.09％. CONCLUSIONS ：The overall dosage of TCM decoction piece prescriptions is relatively high ，the number of ingredients is too much ，and the overdose of single-flavored TCM decoction piece is common. Internal medicine department and surgery department should focus on controlling the number of and the dosage of single-flavored decoction pieces of TCM prescriptions to standardize the prescribed dosage. Gynecology department needs to focus on controlling the dosage of single-flavored TCM pieces and pediatrics department should pay special attention to the use of prescription ingredients ，so as to ensure a more scientific and reasonable standard for the clinical application of TCM decoction piece.