Objective To investigate the evaluation value of lymphocyte count(LYM),interleukin(IL)-6 and D-dimer on the severity in the patients with sepsis.Methods The clinical data in 107 patients with sepsis admitted and treated in the Emergency ICU(EICU)of this hospital from January 2023 to November 2023 were retrospectively analyzed.The basic clinical data,laboratory routine inflammatory indicators,im-mune indicators,coagulation indicators and the related disease condition score within 24 h after entering EICU were collected.The patients were divided into the sepsis group(n=54)and septic shock group(n=53)ac-cording to whether or not septic shock occurred.The multivariate logistic regression model was used to ana-lyze the influencing factors of septic shock occurrence,the receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency,and Spearman correlation method was used to analyze the correlation between LYM,IL-6 and D-dimer with septic shock occurrence in the patients with sepsis.Results The se-quential organ failure assessment(SOFA)score,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score and the levels of LYM,CRP,IL-6 and D-dimer had statistically significantly differences between the two groups(P＜0.05).The multivariate logistic regression analysis results showed that LYM,IL-6 and D-di-mer were the influencing factors of septic shock occurrence(P＜0.05).The ROC curve analysis results showed that LYM,IL-6 and D-dimer alone or combination detection all had certain predictive value for septic shock occurrence,but the area under the curve(AUC),sensitivity and specificity of the three combined detec-tion were higher than those of detection alone.The Spearman correlation analysis results showed that IL-6(r=0.407)and D-dimer(r=0.482)levels were positively correlated with the severity of septic shock,while the LYM level(r=-0.513)was negatively correlated with the severity of septic shock(P＜0.01).Conclusion The combination application of LYM,IL-6 and D-dimer could effectively evaluate the severity of the patients with sepsis.

OBJECTIVE To investigate the expression and clinical significance of Periostin in tissues of patients with chronic rhinosinusitis(CRS).METHODS Real-time quantitative PCR and immunohistochemistry were used to detect periostin expression in eosinophilic CRS with nasal polyps(ECRSwNP),non-eosinophilic CRS with nasal polyps(non-ECRSwNP),CRS without nasal polyps(CRSsNP),and control tissues.Correlations between periostin levels and blood eosinophil percentage(Eos%),Lund-Mackay score,modified endoscopic score,and Japanese epidemiological survey of refractory eosinophilic chronic rhinosinusitis(JESREC)score were analyzed.Additionally,changes in SNOT-22 and VAS scores were compared at different preoperative and postoperative times.The predictive value of periostin for ECRSwNP was evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Periostin expression was detected in all groups(ECRSwNP,non-ECRSwNP,CRSsNP,and controls),with predominant localization in the basement membrane and mucosal subepithelial lamina propria.Significantly elevated periostin levels were detected in the ECRSwNP group compared to the other three groups(P<0.001).Furthermore,Periostin mRNA expression showed significant positive correlations with blood Eos%,JESREC score,and Lund-Mackay score.SNOT-22 and VAS scores were significantly elevated in the ECRSwNP group at preoperative evaluation and 9 months postoperatively(P<0.001).ROC curve analysis demonstrated that periostin had a substantial predictive value for ECRSwNP(AUC=0.957).CONCLUSION Periostin plays a crucial role in the pathogenesis of chronic rhinosinusitis,contributing to the diagnosis,severity assessment,and prognosis evaluation of ECRSwNP,while offering potential therapeutic targets for CRS management.

Objective To investigate the relationship between serum dephosphorylated uncarboxylated ma-trix Gla protein(dp-ucMGP),oncostatin receptor(OSMR),C1q tumor necrosis factor-related protein 15(CTRP15)and the degree of coronary artery disease and in-stent restenosis after percutaneous coronary inter-vention(PCI)in patients with acute coronary syndrome(ACS).Methods A total of 162 ACS patients who underwent PCI in this hospital from January 2021 to January 2023 were selected as the research objects.Ac-cording to the degree of coronary artery disease,the patients were divided into low lesion group(n=48),me-dium lesion group(n=80)and high lesion group(n=34).According to follow-up records,the patients were divided into stenosis group(n=40)and non-stenosis group(n=122).Serum dp-ucMGP,OSMR and CTRP15 levels were detected,and general clinical data were collected and analyzed in ACS patients.Multivariate Logis-tic regression was used to analyze the influencing factors of in-stent restenosis after PCI.The receiver operat-ing characteristic(ROC)curve was drawn to analyze the predictive value of dp-ucMGP,OSMR and CTRP15 for in-stent restenosis after PCI.Results Compared with the low lesion group,the serum levels of dp-ucMGP in the medium lesion group and the high lesion group were increased(P<0.05),while the levels of OSMR and CTRP15 were decreased(P<0.05).Compared with the medium lesion group,the serum level of dp-uc-MGP in the high lesion group was increased(P<0.05),while the levels of OSMR and CTRP15 were de-creased(P<0.05).The lesion length,preoperative stenosis degree,stent length and serum troponin I,N-ter-minal pro-B-type natriuretic peptide,C-reactive protein(CRP),dp-ucMGP levels in stenosis group were higher than those in non-stenosis group(P<0.05),while OSMR and CTRP15 levels were lower than those in non-stenosis group(P<0.05).The area under the curve(AUC)of dp-ucMGP,OSMR and CTRP15 alone and in combination for predicting in-stent restenosis after PCI was 0.839,0.849,0.838 and 0.922,respectively.The AUC of combined prediction was higher than that of dp-ucMGP(Z=2.304,P=0.021),OSMR(Z=2.073,P=0.038),and CTRP15(Z=2.414,P=0.016)alone.Stent length and CRP,dp-ucMGP levels were risk fac-tors for in-stent restenosis,while CTRP15 and OSMR levels were protective factors(P<0.05).Conclusion In ACS patients with in-stent restenosis after PCI,serum dp-ucMGP level is increased,and OS-MR and CTRP15 levels are decreased,which are related to the degree of coronary artery disease and in-stent restenosis after PCI,and have certain auxiliary predictive value for in-stent restenosis after PCI.

【Objective】 To explore the distribution of serological markers related to samples whose serological test results were inconsistent with HBV DNA test results among voluntary blood donors in Xi′an. 【Methods】 A total of 71 HBsAg ELISA positive and NAT non-reactive (ELISA+ /NAT-)blood samples were collected from Shaanxi Blood Center from November 1, 2022 to April 30, 2023. The serological markers of hepatitis B were detected by electrochemiluminescence method, and the HBV S region and C region gene fragments were amplified by nested-PCR. 【Results】 The positive rate of nested-PCR in double ELISA+ /NAT- group(n=30) was statistically higher than that of ELISA+ /NAT- group(n=41)(60% vs 24.4%, P<0.05). Donors in double ELISA+ /NAT- group were all first-time blood donors, with the positive rate of anti-HBc in serum of 100%, and the serological pattern was mainly positive for items 1, 4 and 5 items(80%). Among the ELISA+ /NAT- group, 31.7% were repeat blood donors, with the positive rate of anti-HBc in serum of only 19.51%, and the serological patterns were mainly single anti-HBs positive (43.90%) and all negative (36.58%). 【Conclusion】 There are false positives in the test results of ELISA+ /NAT- group, which leads to unnecessary blood discarding. Meanwhile, the samples with negative NAT may have low levels of HBV DNA, which may lead to missed detection. It is suggested that multiple systems and methods should be applied to trace the blood donors who are HBsAg positive and NAT non-reactive, so as to improve the accuracy of HBV screening of blood donors and reduce blood waste.

Objective:To analyze the mutation of T-cell and B-cell epitopes derived from HBV PreS-S protein in occult hepatitis B virus (OHBV) and investigate the biological mechanisms of occult hepatitis B virus infection (OBI) and HBsAb positive OBI.Methods:The PreS-S region of OBI samples were amplified by nested PCR, the products were sequenced and HBV genotypes were determined. The mutations of T-cell and B-cell epitopes derived from HBV PreS-S protein were analyzed and compared among groups of HBV genotypes and the presence of HBsAb. The affinity of the high frequency of T-cell epitope substitutions were analyzed by SYF PEITHI, the changes of antigenic characteristics of high frequency of B-cell epitope substitutions were analyzed by Ab Designer, Expasy ProtParam tool, Epitope Prediction and Analysis Tools.Results:The PreS-S region of HBV was amplified in 21 samples, including 4 HBsAb+ OBI B, 6 HBsAb-OBI B, 6 HBsAb+ OBI C, 5 HBsAb-OBI C. The mutation rates in PreS-S region of OBI were significantly higher than wild type HBV strains(OBI Bvs. WT B: 2.64%: 0.66%, P<0.001; OBI Cvs. WT C: 3.67%: 1.19%, P<0.001). The mutation rates of the immunoreactive area were significantly higher than non-immunoreactive area in OBI (OBI B: 3.57%: 1.86%, P=0.005; OBI C: 4.78%: 2.65%, P<0.001). The mutation rates of the immunoreactive and non-immunoreactive area in OBI C were higher than OBI B, but there was no statistically significant difference (immunoreactive area: 4.78%: 3.57%, P=0.107; non-immunoreactive area: 2.65%: 1.86%, P=0.142). The mutation rates of T-cell and B-cell epitopes of HBsAb-OBI were higher than HBsAb+ OBI, although there was no significant difference (HBsAb-OBI Bvs. HBsAb+ OBI B: 4.17∶3.01, P=0.303; HBsAb-OBI Cvs. HBsAb+ OBI C: 5.65∶4.26, P=0.207). The affinity analysis of 4 high frequency T-cell epitope substitutions, including T47A/K, S174N, L175S, V177A, showed that the changes of affinity of most mutation sites were not obvious; the antigenicity analysis of 3 high frequency B-cell epitope substitutions, including G73S, K122R, I126M/T, did not show noticeable changes and the hydrophilicity, surface accessibility of some mutation sites were even better than wild strain. Conclusions:The mutation rates in PreS-S region of OBI were significantly higher than wild type HBV strains. The mutation rates of the immunoreactive area were higher than non-immunoreactive area in OBI. The variant activity of OBI C was higher than OBI B. The mutations of OBI might occur randomly and were not selected by antibody pressure. Single epitope and multi-epitopes combinational mutations might be a reason for OBI.

Objective To analyze the relationship between plasma mitochondrial DNA(mtDNA),macrophage inflammatory protein-1α(MIP1α)and monocyte chemotactic protein 1(MCP-1)in vastus lateralis tissues and postoperative muscle atrophy,recovery of hip function in patients with hip fractures.Methods A total of 86 patients with hip fractures and 43 patients with coxitis in Jinan Eighth People's Hospital were enrolled as hip fracture group and coxitis group between October 2020 and October 2022,respectively.The lateral muscle tissues were collected as samples during surgery.The level of plasma mtDNA was detected by real-time fluorescence quantitative polymerase chain reaction.Before surgery,levels of serum interleukin-6(IL-6)and tumor necrosis factor α(TNF-α)were detected by enzyme-linked immunosorbent assay.Before surgery,cross-sectional areas of types Ⅰ and Ⅱ vastus lateralis fibers were detected by immunofluorescence method.Before surgery,expression levels of MIP1α and MCP-1 proteins in lateral muscle tissues were detected by Western blot.All patients with hip fracture were effectively followed up for 6 months after surgery.At 3 and 6 months after surgery,total lean mass(TLM)and unaffected limb lean mass(ULLM)were detected by DXA.Results The level of plasma mtDNA in hip fracture group was higher than that in coxitis group before surgery[(4.12±0.53)vs(2.37±0.36),P＜0.05],levels of serum IL-6 and TNF-α were higher than those in coxitis group[(34.68±6.14)pg/ml,(21.54±4.12)pg/ml vs(12.74±3.06)pg/ml,(10.81±2.71)pg/ml,P＜0.05],cross-sectional areas of types Ⅰ and Ⅱ vastus lateralis fibers were smaller than those in coxitis group[(4321.45±441.36)μm2,(2384.38±247.11)μm2 vs(5417.63±553.27)μm2,(3569.24±368.22)μm2,P＜0.05],and expression levels of MIP1α and MCP-1 proteins were higher than those in coxitis group[(2.34±0.25),(2.47±0.28)vs(1.18±0.15),(1.95±0.23),P＜0.05].In patients with hip fracture after 6 months of follow-up,there were 53 cases with good prognosis and 33 cases with poor prognosis.The level of plasma mtDNA in poor prognosis group was higher than that in good prognosis group before surgery[(4.53±0.52)vs(3.87±0.44),P＜0.05],levels of serum IL-6 and TNF-α were higher than those in good prognosis group[(35.97±5.32)pg/ml,(20.74±4.27)pg/ml vs(33.51±5.16)pg/ml,(22.83±4.33)pg/ml,P＜0.05],cross-sectional areas of types Ⅰ and Ⅱ vastus lateralis fibers were smaller than those in good prognosis group[(4174.26±434.60)μm2,(2309.56±246.18)μm2 vs(4394.42±450.12)μm2,(2430.97±250.72)μm2,P＜0.05],and expression levels of MIP1α and MCP-1 proteins were higher than those in good prognosis group[(2.47±0.28),(1.95±0.23)vs(2.26±0.24),(1.82±0.21),P＜0.05].TLM and ULLM at 6 months after surgery were lower than those at 3 months after surgery in good prognosis group and poor prognosis group(P＜0.05).At 3 and 6 months after surgery,there was no significant different in TLM or ULLM between good prognosis group and poor prognosis group(P＞0.05).Conclusion Traumatic stress injury will increase level of plasma mtDNA in patients with hip fracture,which will induce the increase of systemic inflammatory indexes(serum IL-6,TNF-α)and inflammatory factors(MCP-1,MIP1α)levels,aggravate muscle atrophy and cause postoperative decline of hip function.

Objective:To analyze the status quo, hotspots and fronts of emergency nursing training research at home and abroad in the past ten years, and to provide reference and ideas for the efficient development of emergency nursing training in China.Methods:CiteSpace 6.2.R2 software was used to visually analyze the Chinese and English literatures on emergency nursing training included in CNKI and Web of Science core databases from January 1, 2013 to June 1, 2023.Results:A total of 1 177 Chinese literatures and 1 163 English literatures were included. The number of foreign articles in this field increased year by year, while the number of domestic articles showed a downward trend since 2018. There were many stable core author groups and core institution groups in foreign countries, while there was less cooperation among domestic authors and institutions. The common research hotspots and frontiers at home and abroad focused on broadening the training audience of emergency nursing, innovating the training methods of emergency nursing, strengthening the evaluation of the effect of emergency nursing training, and paying attention to the training experience and needs of nurses. Foreign researches also focused on specialized nurses, interprofessional education and nurses′mental health, etc, and the research direction was diversified.Conclusions:The development stages of emergency nursing training researches at home and abroad are different, and the research hotspots are different. In the future, we should learn from foreign research, strengthen interdisciplinary cooperation, improve the depth and breadth of research, and strengthen the cooperation between authors, institutions and countries to promote the high-quality development of emergency nursing training research in China.

Inflammatory bowel disease (IBD) is a formidable disease due to its complex pathogenesis. Macrophages, as a major immune cell population in IBD, are crucial for gut homeostasis. However, it is still unveiled how macrophages modulate IBD. Here, we found that LIM domain only 7 (LMO7) was downregulated in pro-inflammatory macrophages, and that LMO7 directly degraded 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3) through K48-mediated ubiquitination in macrophages. As an enzyme that regulates glycolysis, PFKFB3 degradation led to the glycolytic process inhibition in macrophages, which in turn inhibited macrophage activation and ultimately attenuated murine colitis. Moreover, we demonstrated that PFKFB3 was required for histone demethylase Jumonji domain-containing protein 3 (JMJD3) expression, thereby inhibiting the protein level of trimethylation of histone H3 on lysine 27 (H3K27me3). Overall, our results indicated the LMO7/PFKFB3/JMJD3 axis is essential for modulating macrophage function and IBD pathogenesis. Targeting LMO7 or macrophage metabolism could potentially be an effective strategy for treating inflammatory diseases.

【Objective】 To explore the population characteristics, the reasons for deferral and the changing trend of unqualified rate of blood test of voluntary blood donors in Xi′an, so as to provide a data support for recruiting low-risk regular blood donors, reducing unqualified rate, improving blood safety and blood quality. 【Methods】 The age, gender, occupation, education and unqualified blood test of voluntary blood donors in Xi′an area from 2012 to 2021 were classified and analyzed retrospectively. 【Results】 The number of voluntary blood donors in Xi′an increased year by year from 2012 to 2021, while the overall unqualified rate of blood test kept decreasing, with an overall unqualified rate at 2.36%, which was at a middle level in China. There were more male blood donors than female donors, and the highest proportion of blood donors in terms of age, occupation and education was between 21-30 years old group (40.19%), other occupation group(21.75%), and undergraduate and above group (32.61%) respectively. The total unqualified rate was ALT (0.68%)>HBsAg (0.55%) > anti -HCV (0.48%) > anti -TP (0.43%) > anti -HIV (0.17%). The unqualified rate of blood donors aged 31 to 40 was the highest. With the increase of academic qualifications, the unqualified rate generally showed a gradual downward trend. The unqualified rate of soldiers, teachers, civil servants and medical workers was low, while the unqualified rates of various items of students were high. There were seasonal differences in the total number of blood donors, the total unqualified rate and the unqualified rate of each item (except anti -HIV). 【Conclusion】 The voluntary blood donors are mainly males, aged 21 to 30, with other occupations and with bachelor degree or above. Regular voluntary blood donation teams in this area should be established among soldiers, teachers, civil servants, medical workers and highly educated groups, and more attention should be paid to health consultation for workers, farmers and students before blood donation.

For the treatment of postherpetic neuralgia, drugs have always played a major but unsatisfactory role. As auxiliary or alternative therapies for postherpetic neuralgia, non-pharmacological interventions, such as electrical stimulation and repetitive transcranial magnetic stimulation, not only have shown favorable efficacy, but also can decrease adverse reactions to drugs with high safety and patient acceptance, and are benificial for management of patients with postherpetic neuralgia.