Objective Exploring the use of thromboelastography(TEG)to assess the risk of bleeding in patients with acute leukemia(AL)undergoing platelet transfusion refractoriness(PTR).Methods To investigate the differences in TEG parameters between the PTR group and the non-PTR group in adult AL patients,and compare the differences in PLT and TEG parameters between the bleeding group and the non-bleeding group in the PTR group.Results A total of 58 AL patients were positive for platelet-related antibodies,and the proportion of PTR was 48.28%.A total of 20 patients with PTR were transfused with large-dose immunoglobulin,the effective rate was 40%,and 26 patients with PTR were transfused with matching platelets,the effective rate was 42.62%.This study observed the difference of TEG parameters between the PTR group and the non-PTR group,and the results showed that there were no significant differences in PLT,R value,K value,α Angle and MA value before and after platelet transfusion in the PTR group.The PLT and MA values of the non-PTR group were significantly different before and after transfusion(P＜0.05),while the R value,K value and α Angle were not significantly different.The PLT and MA values of the non-PTR group were significantly higher than those in PTR group after transfusion(P＜0.05).Analysis and comparison of PLT and TEG parameters between the bleeding group and the non-bleeding group in patients with PTR showed that there was no significant difference in PLT value,R value,K value and α Angle of TEG,while MA value in the non-bleeding group was higher than that in the bleeding group,with significant difference(P＜0.05).Conclusions Platelet count alone cannot accurately reflect the risk of bleeding in AL patients with PTR.TEG can effectively predict and evaluate the bleeding risk in AL patients,among which the maximum amplitude index has the most significant clinical significance,which is of great significance for disease evaluation and treatment guidance.

Objective: To compare the efficacy of using “distal acupoints only” vs. “local acupoints mainly combined with distal acupoints” in cases of acute low back pain (ALBP). Methods: A total of 102 eligible patients aged 18–65 years with ALBP lasting less than 6 weeks will be randomized in a 1:1 ratio to the distal acupoints only group (DPOG) and the local acupoints mainly combined with the distal acupoints group (LPMG). During a 4-week treatment period, patients in the DPOG will receive acupuncture at distal acupoints only (Houxi [SI 3] and Yaotongxue [EX-UE 7]) twice a week, while those in the LPMG group will receive acupuncture at local acupoints (mainly Shenshu [BL 23] and Dachangshu [BL 25]) combined with distal points (Weizhong [BL 40]). The patients in both groups will be evaluated at every session of treatment, and the follow-up will be performed for 3 months. The primary outcome measure will be the change in ALBP intensity, assessed using visual analogue scale scores before and after treatment. The secondary outcome measure will be the evaluation of functional disability using the Oswestry Disability Index. Discussion This study compares the DPOG and LPMG to explore the feasibility of the DPOG in the treatment of ALBP.

The update of multi-omics technology is a key means to promote the rapid development of accurate health model in the whole life cycle.It can formulate dynamic and accurate nursing measures and provide massive data information from the perspective of nursing biology of health and disease.At present,clinical nursing research faces many challenges such as insufficient application and transformation ability of multi-omics technology.This paper introduces the multi-omics technology,reviews the application status of multi-omics technology in cancer nursing,maternal and child nursing,chronic metabolic disease nursing and symptom management,and puts forward the cross integration and prospect of multi-omics technology and nursing research,so as to strengthen the information mining ability of nurses at different levels of health and disease,and provide an important basis for accelerating the clinical transformation of precision nursing.

Objective:To compare the differences in lung function between sanitation workers and the general population undergoing routine physical examinations, and to analyze the risk factors for restricted airflow and severity of the condition in sanitation workers.Methods:This study is a large cross-sectional study called "Shanxin Respiratory Health Screening for Ten Thousand People". A total of 1 036 sanitation workers (sanitation group) and 6 701 individuals from the general population undergoing routine physical examinations (control group) were selected as the original study subjects from June 2021 to April 2022 (before matching). Both groups underwent pre-bronchodilator lung function tests, and the differences in lung function characteristics between the two groups were compared. The sanitation group also completed a questionnaire survey. Multivariate and ordinal multinomial logistic regression analysis were used to analyze the risk factors for airflow limitation and its severity.Results:A total of 1 027 individuals from the sanitation group and 999 individuals from the control group were included in the study. There were no significant differences in age, gender, height, weight, and body mass index (BMI) between the two groups (all P>0.05). The rate of airflow restriction was significantly higher in the sanitation group compared to the control group (22.88% vs 8.81%, P<0.001). In the sanitation group, there was no statistically significant difference in a self-assessment test for chronic obstructive pulmonary disease (CAT) scores between individuals with airflow restriction (235 cases) and those without airflow restriction (792 cases) [(1.50±2.50) vs (1.15±2.03) points, P=0.084]. There were no statistically significant differences in forced vital capacity (FVC) as a percentage of predicted value (FVC%pred) between the two groups. However, the sanitation group had significantly lower %pred for forced expiratory volume in one second (FEV 1%pred), FVC/FEV 1 ratio (FEV 1/FVC%pred), forced expiratory flow at 50% of FVC (FEF 50%%pred), forced expiratory flow at 75% of FVC (FEF 75%%pred), and maximal mid-expiratory flow (MMEF%pred) compared to the control group (all P<0.05). The rates of abnormal FEF 50%%pred, FEF 75%%pred, and MMEF%pred were significantly higher in the sanitation group compared to the control group (17.62% vs 10.31%, 17.04% vs 10.01%, 27.26% vs 18.41%, all P<0.001). Small airway parameters and the rate of airflow restriction were significantly higher in past and current smokers of the sanitation group compared to never smokers (all P<0.05). Multifactorial analysis showed that high BMI ( OR=0.929, 95% CI: 0.885-0.974) was a protective factor for airflow restriction, while high smoking index was a risk factor ( OR=1.020, 95% CI: 1.011-1.030). Ordered multinomial logistic regression analysis showed that high BMI ( OR=0.925, 95% CI: 0.882-0.971) was a protective factor for the severity of airflow restriction, while high smoking index ( OR=1.020, 95% CI: 1.011-1.029) was a risk factor for the severity of airflow restriction. Conclusions:The incidences of airflow limitation and small airway abnormalities in sanitation workers are higher than that in general physical examination population. High smoking index and low BMI are independent risk factors for airflow limitation and its severity.

Objective:To explore the distribution of pathogenic bacteria during perioperative period of kidney transplantation(KT)patients and examine drug resistance of major clinical pathogens to commonly used antibiotics to provide references for empirical medication of pathogenic bacteria infection after KT.Methods:From January 1, 2020 to June 30, 2021, 251 patients undergoing deceased donation KT on kidney transplant ward were selected.Clinical samples were collected and distribution and drug resistance of pathogenic bacteria examined for analyzing the incidence of possible donor-derived infections and predicting prognoses.Results:The detection rate of pathogens was 12.18%(367/3 014). A total of 225 non-repetitive strains were isolated.Gram-positive bacteria, Gram-negative bacteria and fungi accounted for 48.89%(110/225), 43.11%(97/225)and 8.00%(18/225). The proportion of lavage fluid in all isolated bacteria was 49.78%(112/225). And Staphylococcus epidermidis and Klebsiella pneumoniae predominated.Drainage fluid accounted for 24.88%(56/225)and Pseudomonas putida and Staphylococcus haemolyticus predominated.Urine accounted for 18.67%(42/225)with a dominance of Enterococcus faecium; blood accounted for 6.22%(14/225)with a dominance of S. epidermidis.All detected pathogens showed varying degrees of resistance.The resistance rates of E. faecium to ampicillin, vancomycin and linezolid were 93.33%(28/30), 6.45%(2/31)and 38.71%(12/31). The resistance rates of K. pneumoniae and Acinetobacter baumannii to carbapenems were 71.43%(20/28)and 80.00%(12/15). The incidence of possible donor-derived infection was 3.59%(9/251)and there was no mortality.Conclusions:The detection rate of pathogenic bacteria is high in KT patients during perioperative period.There is a diverse distribution of isolates of different specimen types and all detected pathogens show varying degrees of drug resistance.Clinicians should regularly analyze the distribution characteristics and causes of drug-resistant bacteria.And antibiotics should be optimized according to the results of drug sensitivity.

Objective To investigate the activation of mammalian target of rapamycin (mTOR) signaling pathway in placental tissues of gestational diabetes mellitus (GDM) women and in JEG3 cells after high glucose treatment. Methods Placental tissues were collected from 60 singleton pregnant women at term, who underwent elective cesarean section in Peking University First Hospital from December 2016 to June 2017, including 30 GDM women (GDM group) and 30 normal glucose tolerance (NGT) women (NGT group). Expressions of mTOR, Rictor, Raptor, S6 kinase (S6K) and phosphorylated-S6K (p-S6K), which were mTOR signaling pathway-related molecules in those placental tissues were detected by real-time fluorescence quantitative polymerase chain reaction, Western blotting and immunohistochemistry. At the same time, JEG3 cells were treated with glucose of different concentrations (5.5, 10.0, 15.0, 25.0 and 50.0 mmol/L) for 24 h, and the expressions of mTOR, S6K and p-S6K were detected by Western blotting. Two independent samples t-test, one-way analysis of variance test and Spearman correlation analysis were used for statistical analysis. ResuLts Compared with the NGT group, the pre-pregnancy body mass index(BMI), neonatal birth weight, fasting blood glucose(FBG), and 1 h and 2 h post-load blood glucose in oral glucose tolerance test (OGTT) of the GDM group were significantly increased [pre-pregnant BMI: (21.6±2.7) vs (23.4±3.5) kg/m2, t= － 2.192; neonatal birth weight: (3 337.5±347.7) vs (3 618.3±580.9) g, t=－2.727; FBG: (4.6±0.4) vs (5.2±0.8) mmol/L, t=－3.947; 1 h glucose level: (7.4±1.2) vs (9.6±1.9) mmol/L, t=－5.332; 2 h glucose level: (6.3±1.0) vs (8.1±1.5) mmol/L, t=－5.314; all P<0.05]. The mRNA expressions of mTOR, Rictor and Raptor were significantly higher in the GDM group than in the NGT group (0.051±0.015 vs 0.031±0.011, t=－5.635; 0.038±0.017 vs 0.026±0.010, t=－3.485; 0.036±0.012 vs 0.025±0.011, t=－3.312; all P<0.05). The expression of mTOR, Rictor, Raptor and p-S6K protein in the GDM group were enhanced as compared with those in the NGT group (0.834±0.432 vs 0.386±0.361, t= － 2.249;0.589±0.236 vs 0.262±0.075, t= － 3.726; 0.767±0.345 vs 0.323±0.109, t= － 3.472; 1.847±1.025 vs 0.834±0.432, t=－2.575; all P<0.05). The results of immunohistochemistry also showed that the p-S6K in the placental tissues of the GDM group was higher than that of the NGT group (0.29±0.09 vs 0.18±0.08, t=－3.122, P=0.004). The expressions of mTOR protein (0.190±0.085, 0.301±0.089, 0.419±0.065, 0.562±0.108, 0.412±0.058, F=18.351, P<0.05) and p-S6K protein (0.753±0.150, 1.146±0.289, 2.148±0.188, 2.248±0.115, 2.134±0.214, F=66.242, P<0.05) in JEG3 cells treated with different concentrations of glucose (5.5, 10.0, 15.0, 25.0 and 50.0 mmol/L) were significantly different and increased with increasing concentrations of glucose (r=0.314, P=0.035; r=0.457, P=0.002). ConcLusions The up-regulated expressions of mTOR signaling pathway-related molecules in GDM placenta and high glucose-treated trophoblast cells (JEG3 cells) indicate a possible correlation between mTOR signaling pathway and GDM. However, the specific mechanisms need further study.

This study was aimed to establish a fast determination method of main components in honey. Honey samples from difference production bases were used as study objects. Transmission and reflection spectra of different honey samples were collected with the Fourier transform near infrared spectrometer. The main components in honey (moisture content, fructose content, glucose content and reducing sugar content) were detected by the near infrared quantitative analysis technique. The near infrared quantitative analysis models of moisture content, fructose content, glucose content and reducing sugar content in honey were established by the partial least squares (PLS). The results showed that the correlation coefficient (r) of the moisture content, fructose content, glucose content and reducing sugar content in honey were 0.997 25, 0.973 90, 0.927 94 and 0.952 68, respectively. The root mean square error of prediction (RMSEP) were 0.165 (%), 0.564 (%), 1.300 (%) and 1.270 (%), respectively. It was concluded that determination of main components in honey by the near-infrared spectroscopy technology was a fast and nondestructive determination method with high accuracy, which can be used in the quantitative detection of main components in honey.

This study was aimed to revise and improve the quality standard of Ping-An (PA) Pill. Fructus CaryophylliandFructus Aurantii ImmaturuswereidentifiedbyTLC.Thecontentofcostunolideand dehydrocostunolide were determined by HPLC. The results showed that there were clear spots, good degree of separation, and no negative interference in the TLC identification. The calibration curve of costunolide and dehydrocostunolide were linear at the range of 0.103 4-1.033 5μg (r=0.999 9) and 0.110 1-1.100 5μg (r=0.999 7). The average recoveries were 95.1% (RSD = 2.62%, n = 6) and 98.6% (RSD = 2.84%, n = 6), respectively. It was concluded that the method was convenient and accurate with strong specificity in the quality and quantity control of PA pill, which can be used in the quality control of PA pill.

Objective To explore the distribution of age,reasons for treatment,risk factors,and causes of vulvovaginitis in prepubertal girls.Methods A total of 4 214 prepubertal girls with vulvovaginitis who were admitted to the Girl's Sub-department,Zhongshan Boai Hospital from January 2010 to June 2013 was reviewed retrospectively.All clinical data were from medical records with files.Results Atotalof1 587 patients (37.7％) was0to1 years old,954 (22.6％) ＞ 1 to3 years old,1 289 (30.6％) ＞ 3 to 7 years old,and 384 (9.1％) ＞ 7 years old.Many risk factors were associated with vaginitis,including poor hygiene (2 924 girls; 69.4％),allergies and exposure to allergens (875 girls; 20.8％).Most common reason for treatment was a referral from physical examination accounting for 919 girls (21.8％),followed by vaginal secretions 812 girls (19.3％).The causes of vulvovaginitis of all patients were evaluated,1 771 of which (42.0％) were nonspecific vulvovaginitis,1 309 (31.1％) labial adhesions,375 (8.9％) bacterial vulvovaginitis,266 (6.3％) allergic vulvovaginitis,and 266 (6.3％) affective leg rubbing action.Conclusions Prepubertal vulvovaginitis occurred mainly in infancy and preschool.Floating population was common.They were caused by many risk factors including poor hygiene,allergies,poor urination habits,etc.The most common causes of vulvovaginitis were nonspecific vulvovaginitis and labia adhesion,yet allergies and affective leg rubbing action were the more common causes of recurrent vulvovaginitis.We propose that focusing on girls' reproductive health,timely treating allergic and crossing rub legs and other diseases would help reduce the prevalence of vulvovaginitis in the prepubertal girls.

Objective:To identify monoclonal antibody McAb2 recognizing epitope of Fba of GAS.Methods:The overlapped peptides were synthesized and their abilities to bind McAb2 were detected by dot-ELISA.The predominance amino acids specific for McAb2 were screened using phage 7 peptide library.Results:The result by dot-ELISA analysis demonstrated that the synthetized peptide,amino-acid residues 100-112~(th),could bind McAb2 with high affinity.The predominance amino acids specific for McAb2 were ITPDL,which was located in 100-110~(th)aa of Fba by panning with phage 7 peptide library.Conclusion:The domain and the predominance amino acids of Fba recognized by McAb2 is determined.The results would contribute to the research of the role of Fba on the pathogenic mechanism of GAS,the identification of function of McAb2,and the development of epitope-peptide vaccine.