Objective To investigate the influencing factors of stroke patients with hypertension and their compliance with antihypertensive drugs, and to provide targeted intervention measures for stroke prevention in hypertensive patients.  Methods Using the method of multi-stage cluster sampling, a total of 59,434 permanent residents aged 40 and above were selected from 48 monitoring sites in 9 cities of Hebei Province from December 2019 to December 2020. Unconditional logistic regression analysis was used to explore the influencing factors of stroke complicated with hypertension and the compliance of patients with antihypertensive drugs.  Results Among the 59 434 subjects, the prevalence rate of stroke was 4.33% and the prevalence rate of stroke complicated with hypertension was 82.47%. The results of univariate analysis showed that the proportion of women, rural areas, dyslipidemia, diabetes, obesity, and people with family history of stroke was higher in stroke patients with hypertension, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that rural areas, dyslipidemia, diabetes, obesity, and family history of stroke significantly increased the risk of stroke, and the OR (95%CI) values were 1.29 (1.03-1.62), 1.39 (1.12-1.72), 1.58 (1.25-1.99), 1.61 (1.22-2.12) and 1.60 (1.26-2.04), respectively. Among stroke patients with hypertension, 92.71% of patients took antihypertensive drugs. It was found that women's compliance with antihypertensive drugs was good, with an OR (95%CI) value of 1.46 (1.01-2.09).  Conclusion The prevalence rate of stroke complicated with hypertension is high in people aged 40 and above in Hebei Province. Hypertensive people should lower blood lipids, control blood glucose, and lose weight as soon as possible to prevent the occurrence of stroke.

Objective To develop the Children's Screen Interaction Quality Questionnaire(CSIQ)suit-able for measuring Chinese children aged 0 to 4 years,and to test its reliability and validity.Methods The purposive sampling method was used,and the guardians of 30 normal children aged 0 to 4 years undergoing physical examinations in the Department of Child Health Care of Guiyang Maternal and Child Health Care Hospital from February to April 2023 were selected as the interview objects.25 initial items were constructed through literature review,semi-structured interviews,and the Delphi expert consultation method.With the convenience sampling method,2 242 guardians of children aged 0 to 4 years old in the small and middle classes of 9 kindergartens in Guiyang City,Zunyi City,and Renhuai City were surveyed for item analysis,exploratory factor analysis,confirmatory factor analysis,and reliability and validity analysis.Results Exploratory factor a-nalysis extracted three factors,namely screen content interaction,reality interaction,and media interaction,with a total of 12 items.The cumulative variance explained rate of the 3-factor model was 69.829％.Confirma-tory factor analysis supported the three-factor model of CSIQ:x2/df=4.424,root mean square error of ap-proximation(RMSEA)=0.066,normed fit index(NFI)=0.955,comparative fit index(CFI)=0.965,incre-mental fit index(IFI)=0.965,Tucker-Lewis index(TLI)=0.955,goodness-of-fit index(GFI)=0.955,and the CSIQ had good convergent validity and discriminant validity.Conclusion The CSIQ has good reliability and validity.

OBJECTIVE To investigate the impact of lysosomal associated membrane protein 2b(Lamp2b)modification on the mucosal immune efficacy of engineered exosome-based vaccines.METHODS In vitro experiments:The murine dendritic cell line DC2.4 was transfected with a plasmid encoding the Lamp2b-RBD fusion protein.Real-time quantitative PCR and Western blotting were employed to assess Lamp2b-RBD expressions,flow cytometry was used to evaluate the proportion of Lamp2b-RBD-positive cells,and immunofluorescence staining was performed to determine their membrane localization.Exosomes were isolated via ultracentrifugation,and their morphology and particle size distribution were examined using transmission electron microscopy and nanoparticle tracking analysis.Western blotting was applied to confirm exosomal marker proteins[cluster of differentiation 9(CD9),CD63,ALG-2-interacting protein X(Alix),and Golgi marker GM130]and Lamp2b-RBD expression.In vivo experiments:① Female BALB/c mice were divided into the Lamp2b-RBD-Exo group and the lipid nanoparticle(LNP)group,and administered intratracheally for mucosal immunization.Pulmonary reten-tion was assessed by immunofluorescence staining.② Female BALB/c mice were divided into three groups:placebo group(PBS group),Lamp2b-RBD-Exo intratracheal administration group,and Lamp2b-RBD-Exo intramuscular injection group(im).Immunizations were performed on days 0 and 14,and on days 7 and 21.The titers of RBD-specific immunoglobulin G(IgG)in serum and RBD-specific IgA and IgG antibodies in bronchoalveolar lavage fluid were determined by enzyme-linked immunosor-bent assay(ELISA).RESULTS In vitro experiments:Lamp2b-RBD-positive cells accounted for 71.16％.Lamp2b-RBD mRNA levels were upregulated 1 979-fold compared with controls,with Lamp2b-RBD proteins localized on the cell membrane.Purified engineered exosomes displayed regular morphology,expressed CD9,CD63,and Alix but not GM130,had an average diameter of approximately 124 nm,and carried 3 009 pg of RBD protein per 1×109 exosomes.In vivo experiments:At 4 h after administra-tion,fluorescence signals were observed in the lung tissues of both the Lamp2b-RBD-Exo and LNPs groups.At 24 h,the fluorescence signal in the LNPs group shifted to the liver,while in the Lamp2b-RBD-Exo group,the fluorescence expanded from the trachea to the bronchioles and lung tissue,showing significantly better distribution and retention capacity than the LNPs group.Seven days after immuniza-tion,both the Lamp2b-RBD-Exo and Lamp2b-RBD-Exo(im)groups induced RBD-specific IgG antibody titers.At 21 days after immunization,Lamp2b-RBD-Exo elicited a higher level of RBD-specific immune response,with serum IgG titers reaching 1∶8 100 and bronchoalveolar lavage fluid(BALF)IgA titers reaching 1∶300.No RBD-specific IgA antibody titers were detected in the BALF of the Lamp2b-RBD-Exo(im)group.CONCLUSION Lamp2b-RBD modification enables efficient RBD protein loading and enhances pulmonary retention of engineered exosomes,thereby inducing potent antigen-specific mucosal immune responses.

Objective:To analyze the predictive value of the prognostic nutritional index combined with inflammatory indicators for clinical outcomes in patients with ischemic stroke, providing a basis for targeted therapeutic interventions and nursing care for patients at potential risk of poor outcomes.Methods:This retrospective cohort study recruited 424 ischemic stroke patients admitted to the Stroke Center of the First Hospital of Jilin University from June 2021 to May 2024 by the convenience sampling method. Collect the general demographic data, routine laboratory examination results within 24 hours of admission, as well as the National Institutes of Health Stroke Scale (NIHSS) scores at admission and discharge of the patients. Based on 3-month functional outcomes, patients were divided into a favorable prognosis group and a poor prognosis group. Univariate analysis, least absolute shrinkage and selection operator regression, and binary Logistic regression were employed to screen predictive variables and develop a nomogram model. Internal validation was performed using the Bootstrap method. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve were drew to evaluate the predictive performance of the model.Results:The favorable prognosis group comprised 256 patients, including 57 females and 199 males, with an age of 61(54, 68) years. The poor prognosis group included 168 patients, with 55 females and 113 males, and an age of 66(58, 72) years. Binary Logistic regression identified age, sex, hyperlipidemia, NIHSS score at discharge, prognostic nutritional index, systemic inflammatory response index, and systemic immune-inflammation index as independent predictors of prognosis in ischemic stroke patients ( χ2 values were 4.52-56.18, all P<0.05). The prediction model demonstrated the area under the curve of ROC of 0.806 (95% CI 0.764-0.849), with an optimal cutoff value of 0.406, achieving specificity of 78% and sensitivity of 68%. The Hosmer-Lemeshow test yielded a non-significant P>0.05, and the calibration curve showed good agreement between predicted and observed outcomes, with a mean absolute error of 0.012. Decision curve analysis confirmed the clinical utility of the model across a wide range of threshold probabilities. Conclusions:The integrated prognostic model combining the prognostic nutritional index and inflammatory indicators demonstrated favorable discriminative ability, robust calibration, and substantial clinical utility. This risk stratification tool shows high applicability for predicting ischemic stroke outcomes, facilitating early identification of high-risk patients with poor prognosis and guiding personalized intervention strategies.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.

OBJECTIVE To investigate the impact of lysosomal associated membrane protein 2b(Lamp2b)modification on the mucosal immune efficacy of engineered exosome-based vaccines.METHODS In vitro experiments:The murine dendritic cell line DC2.4 was transfected with a plasmid encoding the Lamp2b-RBD fusion protein.Real-time quantitative PCR and Western blotting were employed to assess Lamp2b-RBD expressions,flow cytometry was used to evaluate the proportion of Lamp2b-RBD-positive cells,and immunofluorescence staining was performed to determine their membrane localization.Exosomes were isolated via ultracentrifugation,and their morphology and particle size distribution were examined using transmission electron microscopy and nanoparticle tracking analysis.Western blotting was applied to confirm exosomal marker proteins[cluster of differentiation 9(CD9),CD63,ALG-2-interacting protein X(Alix),and Golgi marker GM130]and Lamp2b-RBD expression.In vivo experiments:① Female BALB/c mice were divided into the Lamp2b-RBD-Exo group and the lipid nanoparticle(LNP)group,and administered intratracheally for mucosal immunization.Pulmonary reten-tion was assessed by immunofluorescence staining.② Female BALB/c mice were divided into three groups:placebo group(PBS group),Lamp2b-RBD-Exo intratracheal administration group,and Lamp2b-RBD-Exo intramuscular injection group(im).Immunizations were performed on days 0 and 14,and on days 7 and 21.The titers of RBD-specific immunoglobulin G(IgG)in serum and RBD-specific IgA and IgG antibodies in bronchoalveolar lavage fluid were determined by enzyme-linked immunosor-bent assay(ELISA).RESULTS In vitro experiments:Lamp2b-RBD-positive cells accounted for 71.16％.Lamp2b-RBD mRNA levels were upregulated 1 979-fold compared with controls,with Lamp2b-RBD proteins localized on the cell membrane.Purified engineered exosomes displayed regular morphology,expressed CD9,CD63,and Alix but not GM130,had an average diameter of approximately 124 nm,and carried 3 009 pg of RBD protein per 1×109 exosomes.In vivo experiments:At 4 h after administra-tion,fluorescence signals were observed in the lung tissues of both the Lamp2b-RBD-Exo and LNPs groups.At 24 h,the fluorescence signal in the LNPs group shifted to the liver,while in the Lamp2b-RBD-Exo group,the fluorescence expanded from the trachea to the bronchioles and lung tissue,showing significantly better distribution and retention capacity than the LNPs group.Seven days after immuniza-tion,both the Lamp2b-RBD-Exo and Lamp2b-RBD-Exo(im)groups induced RBD-specific IgG antibody titers.At 21 days after immunization,Lamp2b-RBD-Exo elicited a higher level of RBD-specific immune response,with serum IgG titers reaching 1∶8 100 and bronchoalveolar lavage fluid(BALF)IgA titers reaching 1∶300.No RBD-specific IgA antibody titers were detected in the BALF of the Lamp2b-RBD-Exo(im)group.CONCLUSION Lamp2b-RBD modification enables efficient RBD protein loading and enhances pulmonary retention of engineered exosomes,thereby inducing potent antigen-specific mucosal immune responses.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.

Objective:To analyze the predictive value of the prognostic nutritional index combined with inflammatory indicators for clinical outcomes in patients with ischemic stroke, providing a basis for targeted therapeutic interventions and nursing care for patients at potential risk of poor outcomes.Methods:This retrospective cohort study recruited 424 ischemic stroke patients admitted to the Stroke Center of the First Hospital of Jilin University from June 2021 to May 2024 by the convenience sampling method. Collect the general demographic data, routine laboratory examination results within 24 hours of admission, as well as the National Institutes of Health Stroke Scale (NIHSS) scores at admission and discharge of the patients. Based on 3-month functional outcomes, patients were divided into a favorable prognosis group and a poor prognosis group. Univariate analysis, least absolute shrinkage and selection operator regression, and binary Logistic regression were employed to screen predictive variables and develop a nomogram model. Internal validation was performed using the Bootstrap method. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve were drew to evaluate the predictive performance of the model.Results:The favorable prognosis group comprised 256 patients, including 57 females and 199 males, with an age of 61(54, 68) years. The poor prognosis group included 168 patients, with 55 females and 113 males, and an age of 66(58, 72) years. Binary Logistic regression identified age, sex, hyperlipidemia, NIHSS score at discharge, prognostic nutritional index, systemic inflammatory response index, and systemic immune-inflammation index as independent predictors of prognosis in ischemic stroke patients ( χ2 values were 4.52-56.18, all P<0.05). The prediction model demonstrated the area under the curve of ROC of 0.806 (95% CI 0.764-0.849), with an optimal cutoff value of 0.406, achieving specificity of 78% and sensitivity of 68%. The Hosmer-Lemeshow test yielded a non-significant P>0.05, and the calibration curve showed good agreement between predicted and observed outcomes, with a mean absolute error of 0.012. Decision curve analysis confirmed the clinical utility of the model across a wide range of threshold probabilities. Conclusions:The integrated prognostic model combining the prognostic nutritional index and inflammatory indicators demonstrated favorable discriminative ability, robust calibration, and substantial clinical utility. This risk stratification tool shows high applicability for predicting ischemic stroke outcomes, facilitating early identification of high-risk patients with poor prognosis and guiding personalized intervention strategies.

Objective To study the effect of miR-143-3p on pyroptosis of HCT-116 cells induced by LPS+ATP.Methods The targeting relationship between miR-143-3 p and TLR2 gene was detected by dual luciferase.The pyroptosis model was established after transfection of miR-143-3p mimic.Cell apoptosis was detected by flow cytometry,and the activity of Caspase-1 and LDH was detected by biochemical method.The levels of IL-1β and IL-18 were detected by ELISA.The mRNA levels of NF-κB,TLR2,NLRP3 and GSDMD were detected by q-PCR.The expression of NLRP3 and ASC was detected by immunofluorescence.The protein expressions of TLR2,GS-DMD,p-NF-κB p65 and cleave Caspase-1 were detected by Western blot.Results Dual luciferase assay showed that miR-143-3p targeted TLR2 expression.The expressions of NF-κB,TLR2,NLRP3,GSDMD mRNA and TLR2,GSDMD,p-NF-κB p65,cleave Caspase-1,ASC,NLRP3 protein in miR-143-3p mimic group and si TLR2 group were lower than those in model group.The activity of Caspase-1 and the content of LDH,IL-1β and IL-18 decreased.Conclusion miR-143-3p regulates pyroptosis of ulcerative colitis cells by targeting TLR2 gene and regulating NF-κB/NLRP3/Caspase-1 signaling pathway.

Objective To analyze the infectious indicators,HBV s gene mutations and changes in bioinformatics char-acteristics of HBV DNA+/HBsAg-blood donor.Methods A sample of HBV DNA+/HBsAg-was screened by PCR meth-od,and HBsAg/HBsAb/HBeAg/HBeAb/HBcAb of HBV in the sample were detected by ELISA and chemiluminescence methods.The mutation of the HBVs gene fragment in the sample was sequenced and analyzed,and the bioinformatics analy-sis was performed using analysis software.Results The sample showed HBV DNA+,HBsAg-,HBsAb+,HBeAg+,HBe-Ab-and HBcAb+,with an amino acid unit point mutation(P151L)occurred in the HBV s gene,and the spatial structure changed.Conclusion The spatial structural changes in the gene sequence of HBVs may be the reason for the appearance of serological HBsAg-/HBsAb+/HBV DNA+in the test results.