Objective To explore the application effect of the"ASK-T"aspiration prevention management model in reducing the risk of aspiration in elderly patients with chronic obstructive pulmonary disease(COPD)complicated by dysphagia.Methods 196 of 409 COPD patients with aspiration risk admitted to the Respiratory Disease Department of Guangdong Provincial Hospital of Chinese Medicine,Higher Education Mega Center Hospital from July 2021 to June 2024 were selected as the study object,and 102 COPD patients with aspiration risk admitted from July 2021 to December 2022 were set as the pre-improvement group.The patients in this group received the original nursing process and management mode of the department during hospitalization.94 COPD patients with aspiration risk admitted from January 2023 to June 2024 were set as the improved group,and the patients in this group were introduced into the department and implemented an innovative improvement project:"ASK-T"anti-aspiration management mode and then received nursing management.Patients in both groups were observed and followed up for 4 weeks.The risk grade of aspiration,SSA score,DHI score,aspiration pneumonia and aspiration pneumonia,nutritional status and satisfaction after intervention were compared between the two groups.Result in the improved group was significantly lower than that in the pre-improvement group(P<0.05),and the SSA score,DHI score and total DHI score of patients in the 2 groups were significantly lower than that before intervention(P<0.05).The SSA score,DHI score and DHI total score in the improved group were lower than those in the pre-improved group(P<0.05).The results of 4-week follow-up showed that the scores of NRS-2002 for nutritional risk screening in 2 groups were lower than before intervention(P<0.05),and the scores of NRS-2002 for nutritional risk screening in the improved group were significantly lower than those in the pre-improvement group(P<0.05).The comparison showed that the incidence of aspiration and aspiration pneumonia in the improved group was lower than that in the pre-improved group(P<0.05),and the satisfaction score of patients with the relevant preventive measures was higher than that in the pre-improved group(P<0.05).Conclusion The"ASK-T"aspiration preven-tion management model,when applied in the nursing of elderly patients with COPD complicated by dysphagia,can significantly reduce the risk of aspiration and the incidence of aspiration pneumonia,effectively improve patients' swallowing function and quality of life,and enhance their nutritional status.Furthermore,this model significantly improves patient satisfaction with intervention measures,providing a scientific and effective management strategy for clinical nursing of elderly patients with COPD complicated by dysphagia.It is worthy of promotion and application in clinical practice.

The purpose of this study was to prepare high affinity monoclonal antibodies(mAbs)a-gainst bovine viral diarrhea virus(BVDV)and establish a double antibody sandwich ELISA detec-tion method.BVDV was purified by differential ultracentrifugation and used to immunize BALB/c mice.Hybridoma cells were prepared by fusing spleen cells from the immunized mice with SP2/0 cells.Positive cells were screened by indirect ELISA.A double-antibody sandwich ELISA method for detecting BVDV was developed using monoclonal antibody 4D11 as the capture antibody and HRP-labeled monoclonal antibody 3F3 as the detection antibody.The results of the ELISA and the determination of the variable region gene sequence of monoclonal antibodies indicated that the two monoclonal antibodies recognize different antigenic epitopes.Specificity tests showed that two monoclonal antibodies specifically recognize BVDV and did not cross-react with other bovine viru-ses associated with diarrhea.Indirect immunofluorescence assay and Western blot assay demonstra-ted that both mAbs exhibited strong reactivity with BVDV.The double antibody sandwich ELISA detection method established in this study had good specificity.The sensitivity test revealed that the method could detect a minimum virus amount of 3.1 × 104 TCID50.The reproducibility test showed that the inter-batch coefficient of variation(Cv)was between 2.47％and 7.44％,and the intra-batch Cv was between 1.71％and 9.89％,indicating good reproducibility.The establishment of this method provides an effective technical tool for the rapid diagnosis and prevention and con-trol of BVDV.

The purpose of this study was to prepare high affinity monoclonal antibodies(mAbs)a-gainst bovine viral diarrhea virus(BVDV)and establish a double antibody sandwich ELISA detec-tion method.BVDV was purified by differential ultracentrifugation and used to immunize BALB/c mice.Hybridoma cells were prepared by fusing spleen cells from the immunized mice with SP2/0 cells.Positive cells were screened by indirect ELISA.A double-antibody sandwich ELISA method for detecting BVDV was developed using monoclonal antibody 4D11 as the capture antibody and HRP-labeled monoclonal antibody 3F3 as the detection antibody.The results of the ELISA and the determination of the variable region gene sequence of monoclonal antibodies indicated that the two monoclonal antibodies recognize different antigenic epitopes.Specificity tests showed that two monoclonal antibodies specifically recognize BVDV and did not cross-react with other bovine viru-ses associated with diarrhea.Indirect immunofluorescence assay and Western blot assay demonstra-ted that both mAbs exhibited strong reactivity with BVDV.The double antibody sandwich ELISA detection method established in this study had good specificity.The sensitivity test revealed that the method could detect a minimum virus amount of 3.1 × 104 TCID50.The reproducibility test showed that the inter-batch coefficient of variation(Cv)was between 2.47％and 7.44％,and the intra-batch Cv was between 1.71％and 9.89％,indicating good reproducibility.The establishment of this method provides an effective technical tool for the rapid diagnosis and prevention and con-trol of BVDV.

Objective To explore the application effect of the"ASK-T"aspiration prevention management model in reducing the risk of aspiration in elderly patients with chronic obstructive pulmonary disease(COPD)complicated by dysphagia.Methods 196 of 409 COPD patients with aspiration risk admitted to the Respiratory Disease Department of Guangdong Provincial Hospital of Chinese Medicine,Higher Education Mega Center Hospital from July 2021 to June 2024 were selected as the study object,and 102 COPD patients with aspiration risk admitted from July 2021 to December 2022 were set as the pre-improvement group.The patients in this group received the original nursing process and management mode of the department during hospitalization.94 COPD patients with aspiration risk admitted from January 2023 to June 2024 were set as the improved group,and the patients in this group were introduced into the department and implemented an innovative improvement project:"ASK-T"anti-aspiration management mode and then received nursing management.Patients in both groups were observed and followed up for 4 weeks.The risk grade of aspiration,SSA score,DHI score,aspiration pneumonia and aspiration pneumonia,nutritional status and satisfaction after intervention were compared between the two groups.Result in the improved group was significantly lower than that in the pre-improvement group(P<0.05),and the SSA score,DHI score and total DHI score of patients in the 2 groups were significantly lower than that before intervention(P<0.05).The SSA score,DHI score and DHI total score in the improved group were lower than those in the pre-improved group(P<0.05).The results of 4-week follow-up showed that the scores of NRS-2002 for nutritional risk screening in 2 groups were lower than before intervention(P<0.05),and the scores of NRS-2002 for nutritional risk screening in the improved group were significantly lower than those in the pre-improvement group(P<0.05).The comparison showed that the incidence of aspiration and aspiration pneumonia in the improved group was lower than that in the pre-improved group(P<0.05),and the satisfaction score of patients with the relevant preventive measures was higher than that in the pre-improved group(P<0.05).Conclusion The"ASK-T"aspiration preven-tion management model,when applied in the nursing of elderly patients with COPD complicated by dysphagia,can significantly reduce the risk of aspiration and the incidence of aspiration pneumonia,effectively improve patients' swallowing function and quality of life,and enhance their nutritional status.Furthermore,this model significantly improves patient satisfaction with intervention measures,providing a scientific and effective management strategy for clinical nursing of elderly patients with COPD complicated by dysphagia.It is worthy of promotion and application in clinical practice.

Background Atmospheric fine particulate matter (PM_2.5) can disrupt the metabolic homeostasis of the liver and accelerate the progression of liver diseases, but there are few studies on the effects of sub-chronic PM_2.5 exposure on the liver metabolome. Objectives To investigate the effects of sub-chronic exposure to concentrated PM_2.5 on hepatic metabolomics in mice by liquid chromatography-mass spectrometry (LC-MS), and to identify potentially affected metabolites and metabolic pathways. Methods Twelve male C57BL/6J (6 weeks old) mice were randomly divided into two groups: a concentrated PM_2.5 exposure group and a clean air exposure group. The mice were exposed to concentrated PM_2.5 using the "Shanghai Meteorological and Environmental Animal Exposure System" at Fudan University. The exposure duration was 8 h per day, 6 d per week, for a total of 8 weeks. The mice's liver tissues were collected 24 h after the completion of exposure. LC-MS was performed to assess changes in the hepatic metabolome. Orthogonal partial least squares discriminant analysis and t-test were employed to identify differentially regulated metabolites between the two groups under the conditions of variable important in projection (VIP)≥1.0 and P<0.05. Metabolic pathway enrichment analysis was performed using MetaboAnalyst 5.0 software and the Kyoto Encyclopedia of Genes and Genomes (KEGG). Results A total of 297 differentially regulated metabolites were identified between the concentrated PM_2.5 exposure group and the clean air group. Among these metabolites, 142 were upregulated and 155 were downregulated. A total of 38 metabolic pathways were altered, with 7 pathways showing significant perturbation (P<0.05). These pathways involved amino acid metabolism, glucose metabolism, nucleotide metabolism, as well as cofactor and vitamin metabolism. The 7 significant metabolic pathways were pantothenic acid and coenzyme A biosynthesis; purine metabolism; amino sugar and nucleotide sugar metabolism; arginine biosynthesis; alanine, aspartate and glutamate metabolism; aminoacyl-tRNA biosynthesis; and fructose and mannose metabolism. Conclusion The results from metabolomics analysis suggest that sub-chronic exposure to PM_2.5 may disrupt hepatic energy metabolism and induce oxidative stress damage. Aspartic acid, succinic acid, ornithine, fumaric acid, as well as purine and xanthine derivatives, were identified as potential early biomarkers of hepatic response to sub-chronic PM_2.5 exposure.

Aim To explore the role of the ten-eleven translocation 2(TET2)/ubiquinol-cytochrome C reductase hinge protein(UQCRH)axis in the inhibition of vascular smooth muscle cell(VSMC)apoptosis by fibroblast growth fac-tor-2(FGF-2).Methods Cultured VSMCs were divided into control group,FGF-2 group,and FGF-2+fibroblast growth factor receptor(FGFR)pan-inhibitor LY2874455 group.VSMCs overexpressing TET2(OETET2)or UQCRH(OEUQCRH)were divided into control group,FGF-2 group,and OETET2+FGF-2 or OEUQCRH+FGF-2 group.Ho-echst33342 and PI staining were used to detect cell apoptosis,CCK-8 assay was employed to measure cell proliferation,and Western blot was used to examine the expression levels of apoptosis-related proteins pro-Caspase-3,cleaved Caspase-3,Bax,Bcl-2,as well as TET2 and UQCRH.The NCBI and methprimer websites were utilized for predicting and analyzing CpG island sites in the UQCRH gene promoter.Results FGF-2 could inhibit VSMC apoptosis,promote proliferation,downregulate apoptosis-related proteins cleaved Caspase-3,Bax,TET2,and UQCRH expression,and upregulate anti-ap-optotic protein Bcl-2 expression(compared with control group,P＜0.05).However,it did not affect pro-Caspase-3 ex-pression(compared with control group,P＞0.05).LY2874455 could counteract the effects of FGF-2(compared with FGF-2 group,P＜0.05).Overexpression of TET2 or UQCRH could reverse the anti-apoptotic and pro-proliferative effects of FGF-2 on VSMC,with upregulation of apoptosis-related protein expression and downregulation of anti-apoptotic protein expression(compared with FGF-2 group,P＜0.05).The UQCRH gene promoter region contained three CpG islands.Overexpression of TET2 could upregulate UQCRH expression in VSMC treated with FGF-2(compared with FGF-2 group,P＜0.05).Conclusion FGF-2,by inhibiting TET2 expression and UQCRH expression,reduces VSMC apoptosis and promotes its proliferation.

Objective:To evaluate the effect of preoperative cognitive training on postoperative neurocognitive function in elderly patients undergoing coronary artery bypass grafting (CABG) and/or valve surgery.Methods:Seventy-four elderly patients of either sex, of American Society of Anesthesiologists Physical Status classification Ⅲ or Ⅳ, aged 60-90 yr, with body mass index of 19-28 kg/m 2, scheduled for elective CABG or valve surgery under general anesthesia, were divided into 2 groups ( n=37 each) using a computer-generated random number table method: cognitive training group (group CT) and control group (group C). Group CT was instructed to complete a cognitive training once 1 h per day for 5 consecutive days prior to surgery. Group C did not receive any cognitive training before surgery, and routine nursing was performed. At the 7th day after surgery, the patients′ neurocognitive function was evaluated by the Montreal Cognitive Assessment Scale(MoCA), the Postoperative Quality Recovery Scale (PQRS) was used to assess the patients′ recovery status, and the postoperative complications and morality in both groups were recorded. The patients were assessed using the Geriatric Depression Scale, MoCA and PQRS at the 1st month and 3rd month after operation. Results:The MoCA scores were significantly higher at the 7th day, 1st month and 3rd month postoperatively than in group C ( P<0.05). There was no significant difference in the postoperative case fatality rate and incidence of complications between the two groups ( P>0.05). Significant difference was observed in PQRS scores between the two groups at the 7th day after surgery ( P<0.05), but there were no significant differences in the PQRS scores and Geriatric Depression Scale scores between the two groups at the 1st month and 3rd month after operation ( P>0.05). Conclusions:The cognitive training can improve postoperative neurocognitive function in elderly patients undergoing CABG and/or valve surgery.

Lactic acid bacteria(LAB)were isolated and cultivated from the intestinal contents of rabbits by MRS-CaCO3 solid medium.Identification was achieved through morphological observa-tion,Gram staining,physiological and biochemical characterisation,16S rDNA sequence analysis,and ERIC-PCR analysis.Strains displaying typical Lactobacilli characteristics were exanimated for their biological characteristics,resistance properties,adherence capacity in vitro,colonization abili-ty in vivo,and safety profile.In this study,a total of four strains of Lactobacillus reuteri were iso-lated from rabbits,all of which exhibited typical biological characteristics of LAB.These strains demonstrated inhibitory effects on common pathogenic bacteria in the gastrointestinal tract,with the primary inhibitory substance being bacteriocin.Furthermore,they showed sensitivity to chlor-amphenicol,rifampicin,and erythromycin,and displayed a degree of tolerance to gastrointestinal conditions and high temperature.These stains were capable of successful colonization in rabbits with a higher degree of safety.This study lays a foundation for the development of LAB prepara-tions for the prevention and treatment of rabbit intestinal diseases.

Objective To develop an intelligent management system of documents and records that meets the requirements of ISO 15189 quality management system applied to regional medical laboratory center.Methods Based on the relevant terms of ISO 15189 document and record,an intelligent management system for laboratory documents and records with B/S architecture was established by the help of computer technology.Results The document and record management system stored the quality system documents required for ISO 15189 review as well as the external documents,such as laboratory-related laws and regulations,standard guidelines and expert consensus,which can be accessed by users through a computer or mobile phone.The multi-process control mode was adopted to author-ize the special personnel to complete the compiling,review,approval and,release of the files according to the type and attribute of the documents.The management system of records established 9 special records,319 form records and 20 process records to support the ef-fective operation of the quality system.Conclusion The established intelligent management system for documents and records has fully met the requirements of ISO 15189 on documents and records management,realized the sharing and interconnection of the documents in the given region.It is convenient for the employees to consult the documents and fill in the records in a timely and efficient manner.

Currently liver transplantation is the most effective treatment options for patients with end-stage liver disease, but the lack of donor livers limits the development of liver transplantation. With the increasing usage of marginal donor liver such as fatty donor liver, therefore how to make marginal donor liver play a better role has become a new research hotspot. Although the use of fatty liver as a donor can effectively alleviate the contradiction between recipient demand and donor organ shortage, the risk of early post-transplant graft dysfunction also increases. As donor of fatty liver, the degree of steatoidosis should be moderate or below as far as possible, which significantly reduces postoperative complications and promote the recovery of recipients. Meanwhile, it is essential to monitor the lipid indicators post the surgery, and drug intervention can be added if necessary, which may improve the function of the graft.