Objective To investigate the binding interaction between the calmodulin(CaM)mutant D130V and the IQ motif of the car-diac Cav1.2 channel.Methods The binding of mutant CaM-D130V to the IQ motif was predicted by fold recognition modeling,homology modeling,and protein docking.The plasmid was transformed into Escherichia coli BL-21 sensory cells via heat shock at 42 ℃ to induce the expression of glutathione S-transferase(GST)fusion protein.The protein was extracted by ultrasonic fragmentation and purified using GS-4B beads.PreScission protease was applied to remove the GST.SDS-PAGE was performed to detect the purity of protein.A GST pull-down assay was conducted to detect the interaction between CaM-D130V and IQ motif.Results Protein docking results showed that both CaM-WT and CaM-D130V could bind to the IQ motif of the cardiac Cav1.2 channel,but the binding sites of the mutant CaM-D130V to the IQ motif were reduced,and its binding conformation was changed compared with the CaM-WT,with decreased binding energy(|S|reduced from 48.086 6 kcal/mol to 47.309 5 kcal/mol).The GST pull-down assay indicated that the binding of CaM-D130V to IQ motif significantly decreased(P＜0.01),and the affinity was significantly reduced at 2 mmol/L Ca2+concentration compared with CaM-WT.Conclusion The reduced binding ability of CaM-D130V to the IQ motif of the cardiac Cav1.2 channel may contribute to functional alterations in the channel.These findings provide a theoretical basis for understanding the pathogenesis of CaM mutant-associated cardio-vascular diseases as well as targeted therapies.

Objective To investigate the binding interaction between the calmodulin(CaM)mutant D130V and the IQ motif of the car-diac Cav1.2 channel.Methods The binding of mutant CaM-D130V to the IQ motif was predicted by fold recognition modeling,homology modeling,and protein docking.The plasmid was transformed into Escherichia coli BL-21 sensory cells via heat shock at 42 ℃ to induce the expression of glutathione S-transferase(GST)fusion protein.The protein was extracted by ultrasonic fragmentation and purified using GS-4B beads.PreScission protease was applied to remove the GST.SDS-PAGE was performed to detect the purity of protein.A GST pull-down assay was conducted to detect the interaction between CaM-D130V and IQ motif.Results Protein docking results showed that both CaM-WT and CaM-D130V could bind to the IQ motif of the cardiac Cav1.2 channel,but the binding sites of the mutant CaM-D130V to the IQ motif were reduced,and its binding conformation was changed compared with the CaM-WT,with decreased binding energy(|S|reduced from 48.086 6 kcal/mol to 47.309 5 kcal/mol).The GST pull-down assay indicated that the binding of CaM-D130V to IQ motif significantly decreased(P＜0.01),and the affinity was significantly reduced at 2 mmol/L Ca2+concentration compared with CaM-WT.Conclusion The reduced binding ability of CaM-D130V to the IQ motif of the cardiac Cav1.2 channel may contribute to functional alterations in the channel.These findings provide a theoretical basis for understanding the pathogenesis of CaM mutant-associated cardio-vascular diseases as well as targeted therapies.

Objective To investigate the clinical value of matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF MS)in rapid detection of carbapenemase produced by Klebsiella pneumoniae and Pseudomonas aeruginosa.Methods A total of 60 strains of Klebsiella pneumoniae and 80 strains of Pseudomonas aeruginosa isolated from Pizhou People's Hospital affiliated to Xuzhou Medical University from January 2022 to October 2023 were collected,including 30 strains of carbapenem-resistant Klebsiella pneumoniae(CRKP),30 strains of carbapenem-sensitive Klebsiella pneumoniae(CSKP),50 strains of carbapenem-resistant Pseudo-monas aeruginosa(CRPA)and 30 strains of carbapenem-sensitive Pseudomonas aeruginosa(CSPA).Three detection methods were applied,i.e.,modified carbapenem inactivation method(mCIM),colloidal gold immunochromatography and Autof MS 1000 mass spectrometry identification system to evaluate the ability of Autof MS 1000 mass spectrometry identification system in detecting carbape-nase production of Klebsiella pneumoniae and Pseudomonas aeruginosa.Results The results of Autof MS 1000 mass spectrometry iden-tification system were consistent with those of both mCIM and colloidal gold immunochromatography.Carbapenemase was detected in 28 of the 30 CRKP strains,and it was negative in 2 CRKP strains.Carbapenamase was detected in 15 of the 50 CRPA strains and it was negative in 35 CRPA strains.Thirty strains of CSKP and 30 strains of CSPA were all Carbapenemase negative.The coincidence rate of the results of the three methods in the detection for carbapenase was 100％.Conclusion The result of Autof MS 1000 mass spectrome-try identification system has been consistent with those of mCIM and colloidal gold immunochromatography.It not only has the charac-teristics of cost-saving compare with of mCIM method,but also hold the advantages of fast speed and high accuracy of colloidal gold im-munochromatography method.Thus,Autof MS 1000 system can be used for the rapid identification of carbapenemase produced by Kleb-siella pneumoniae and Pseudomonas aeruginosa.

Objective:To retrieve, evaluate and summarize the evidence on exercise therapy in patients with breast cancer related lymphedema, so as to provide basis for clinical practice.Methods:According to the "6S" evidence resource pyramid model, all the evidence on exercise therapy for patients with breast cancer related lymphedema, including clinical guideline, expert consensus, best practice information book, Meta-analysis, systematic review and other evidence, were searched layer by layer from top to bottom in British Medical Journal (BMJ) Best Practice, UpToDate, Guidelines International Network, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Agency for Healthcare Research and Quality, National Comprehensive Cancer Network, National Lymphedema Network, International Society of Lymphedema, Yimaitong, Cochrane Library, China Biology Medicine, PubMed, Web of Science, China National Knowledge Infrastructure, and WanFang Data. The search period was from January 2000 to October 2021. Two researchers conducted literature quality evaluation, evidence extraction and summary.Results:A total of 28 articles were included, including one best clinical practice, one clinical decision-making, 7 clinical guidelines, three expert consensus, and 16 systematic reviews. A total of 40 best pieces of evidence were extracted from 7 aspects, including exercise guarantee, exercise instructions, exercise form, exercise intensity, exercise time, exercise frequency, and follow-up and health education.Conclusions:Exercise therapy is very important for patients with breast cancer related lymphedema. In the process of applying evidence, medical and nursing staff should combine the actual situation to form a professional medical team, fully consider the patient's physical and mental condition and exercise habits, dynamically adjust and develop personalized exercise plans based on the patient's health status and preferences, thereby improving the effectiveness of exercise therapy and patient's quality of life.

Objective:To screen high-risk population of chronic obstructive pulmonary disease (COPD) and to analyze the risk factors in Haicang District of Xiamen City.Methods:A questionnaire survey was conducted from February 2023 to May 2023 among residents who visited or underwent physical examinations at five community health service centers in Haicang District of Xiamen City selected by cluster sampling method. The self-designed general information questionnaire, COPD population screening questionnaire (COPD-PS) and COPD screening questionnaires (COPD-SQ) were applied in the survey. Individuals with COPD-PS scale>5 or COPD-SQ scale>16 were defined as COPD high-risk group. The association of COPD risk with gender, age, smoking, family history of COPD, history of tuberculosis, history of COVID-19 infection, and using coal/woodstove for cooking or heating was analyzed with chi-square test and binary logistic regression analysis.Results:A total of 4 260 questionnaires were distributed and 4 221 valid questionnaires were collected with a recovery rate of 99.6%. Among all respondents there were 1 904 males (45.11%) and 2 317 females (54.89%); and 217 individuals aged 40-<50 (5.14%), 434 aged 50-<60 (10.28%), 2 194 aged 60-<70 (51.98%), 1 302 aged 70-<80 (30.85%) and 74 aged≥80 (1.76%). The results showed that there were 269 respondents (6.4%) scored≥5 on the COPD-PS scale, 534 residents (12.7%) scored≥16 on the COPD-SQ scale, 646 (15.3%) scored≥5 on the COPD-PS scale or≥16 on the COPD-SQ scale. Male gender ( OR=2.592, 95% CI:2.135-3.146), second-hand smoke exposure ( OR=3.763, 95% CI:2.944-4.810), frequently catching cold before the age of 14 ( OR=3.804, 95% CI:2.927-4.944), history of tuberculosis ( OR=2.575, 95% CI:1.224-5.418), hypertension ( OR=1.547, 95% CI:1.277-1.875), and diabetes ( OR=1.791, 95% CI:1.027-3.121) were independently associated with the high-risk of COPD, while the history of COVID-19 ( OR=0.583, 95% CI:0.476-0.714) was a protective factor for COPD risk. Conclusion:Males, exposure to second-hand smoke, frequently catching cold before the age of 14, history of tuberculosis, hypertension, and diabetes will increase the risk of COPD, while the history of COVID-19 is a protective factor.

Motabolic bariatric surgery is a fast and effective method for the treatment of obesity and obesity-associated diseases. In order to maintain weight loss and prevent complications, self-management of bariatric and metabolic surgery patients undergoing metabolic bariatric surgery is very important. This paper summarizes the research status, assessment tools and influencing factors of self-management of patients undergoing metabolic bariatric surgery. This paper also puts forward the problems to be solved in current research and practice, aiming to provide a reference for future research and improving the self-management ability of patients undergoing metabolic bariatric surgery.

Objective:To investigate the predictive value of C-reactive protein (CRP), neutrophils-lymphocytes ratio (NLR) and leukocyte-erythrocyte ratio (LER) for aspiration pneumonia (AP) in patients with acute cerebral infarction (ACI).Methods:Retrospective analysis was performed on 989 consecutive hospitalized ACI patients in 2021 who were free of infection within 48 h after ACI onset. General information, past medical history, CRP and complete blood count within 24 h after admission were collected. NLR and LER were calculated based on neutrophil, lymphocyte, leukocyte and erythrocyte count. ACI patients were divided into two groups: non-AP group ( n = 883) and AP group ( n = 106) according to whether they had AP 48 h after admission. Spearman correlations of CRP, NLR and LER with AP were analyzed. The receiver operator characteristic (ROC) curves were plotted to evaluate the predictive values of CRP, NLR and LER for the occurrence of AP in ACI patients, and the sensitivity and specificity at the optimal cut-off value were also calculated. Logistic regression analysis was used for further verification. Results:Compared with the non-AP group, CRP, NLR and LER were significantly higher in the AP group ( P<0.05). Spearman correlation analysis showed that AP was positively correlated with CRP, NLR and LER ( r = 0.42, 0.36 and 0.35, P<0.01). ROC curve analysis showed that CRP, NLR and LER had certain predictive value for AP in ACI patients ( P<0.05), and the area under the curve (AUC) was 0.8917, 0.8349 and 0.8269, respectively. The optimal cutoff values of CRP, NLR and LER were 12.70 mg/L, 4.40 and 1.89 ×10 -3, respectively, with the sensitivity and specificity of 79.25% and 86.41%, 71.70% and 84.94%, and 75.47% and 79.95%, respectively. Multivariate Logistic regression analysis showed that CRP ( OR=6.65, 95% CI: 3.70-11.98, β=1.90, P<0.001), NLR ( OR=2.84,95% CI: 1.60-5.03, β=1.04, P<0.001) and LER ( OR=3.51, 95% CI: 2.00-6.16, β=1.26, P<0.001) were independent risk factors for AP in ACI patients. Conclusions:CRP, NLR and LER at baseline show certain predictive value for the occurrence of AP in ACI patients, and CRP has the strongest predictive power.

Objective:To establish the norm of the Chinese version of Karitane Parenting Confidence Scale (KPCS) in urban areas of China.Methods:From August to December 2017, the parents of 2 216 children (<36 months old) were selected from 15 cities (Beijing, Lianyungang, Hangzhou, Chengdu, Xi′an, Guangzhou, Changsha, Jinan, Guiyang, Ningbo, Dalian, Qinhuangdao, Maanshan, Chongqing and Wuhan) in 14 provinces by stratified random sampling. The general demographic characteristics and parents′ parenting confidence were collected by a self-made questionnaire and KPCS Chinese version. The percentile norm was established. P 3, P10 and P 25 were used as the criteria to define the degree of lack of parenting confidence. Results:The age of mothers was (30.67±4.29). The age of the father was (32.50±4.99) years old. There were 726 (32.76%), 759 (34.25%) and 731 (32.99%) infants in 6-12, 12-23 and 24-35 months old groups. The total scores of P 50, P 25, P 10 and P 3 of KPCS (Chinese version) of infant parents in urban areas in China were 41, 38, 33, and 29 respectively. When the scores of parents were 34-37, 30-33, and ≤ 29, they were judged as mild, moderate, and severe lack of parenting confidence. There was no significant difference in the Chinese version of KPCS between parents of different age groups and parents of different gender (χ2=3.53, P=0.171; χ2=1.41, P=0.236). Each factor score≤ P 3 is defined as the boundary score, and the corresponding boundary scores of "parenting" "support" and "competence" were 13, 9, and 5 respectively. Conclusion:The Chinese version of KPCS can be used to assess the parenting confidence of infants in urban areas of China. It can used as one of the bases for scientific and objective evaluation of the parenting status of families.

Objective:To establish the norm of the Chinese version of Karitane Parenting Confidence Scale (KPCS) in urban areas of China.Methods:From August to December 2017, the parents of 2 216 children (<36 months old) were selected from 15 cities (Beijing, Lianyungang, Hangzhou, Chengdu, Xi′an, Guangzhou, Changsha, Jinan, Guiyang, Ningbo, Dalian, Qinhuangdao, Maanshan, Chongqing and Wuhan) in 14 provinces by stratified random sampling. The general demographic characteristics and parents′ parenting confidence were collected by a self-made questionnaire and KPCS Chinese version. The percentile norm was established. P 3, P10 and P 25 were used as the criteria to define the degree of lack of parenting confidence. Results:The age of mothers was (30.67±4.29). The age of the father was (32.50±4.99) years old. There were 726 (32.76%), 759 (34.25%) and 731 (32.99%) infants in 6-12, 12-23 and 24-35 months old groups. The total scores of P 50, P 25, P 10 and P 3 of KPCS (Chinese version) of infant parents in urban areas in China were 41, 38, 33, and 29 respectively. When the scores of parents were 34-37, 30-33, and ≤ 29, they were judged as mild, moderate, and severe lack of parenting confidence. There was no significant difference in the Chinese version of KPCS between parents of different age groups and parents of different gender (χ2=3.53, P=0.171; χ2=1.41, P=0.236). Each factor score≤ P 3 is defined as the boundary score, and the corresponding boundary scores of "parenting" "support" and "competence" were 13, 9, and 5 respectively. Conclusion:The Chinese version of KPCS can be used to assess the parenting confidence of infants in urban areas of China. It can used as one of the bases for scientific and objective evaluation of the parenting status of families.

Objective To investigate the clinical characteristics of bloodstream infections in obstetric patients and analyze the distribution and antimicrobial susceptibility of the pathogenic organisms. Methods The clinical data of bloodstream infections in obstetric patients treated in the Third Affiliated Hospital of Guangzhou Medical University from December 2014 to December 2017 were studied retrospectively. Results A total of 111 cases were identified, including 31(27.9％)during pregnancy and 80(72.1％)after delivery. Most(79.3％, 88/111)of these patients had obstetric disease or complication, and urinary, abdominal or intrauterine infection was found in 15(13.5％)cases. All patients had fever, and 7 cases showed septic shock. After treatment, 109(98.2％)patients were cured, despite infectious abortions in 6 cases. A total of 118 isolates were collected, including 31(26.3％)from pregnant women and 87(73.7％)isolates from puerperants. Gram-negative organisms, gram-positive organisms and Candia accounted for 58.5％, 39.0％, and 2.5％, respectively. The most common pathogens identified were Escherichia coli(44.1％), Enterococcus spp.(22.0％), and Staphylococcus spp.(5.1％). The prevalence of ESBLs-producing strains was 62.5％ in E. coli. All the E. coli strains were susceptible to piperacillin-tazobactam, imipenem, and tigecycline. No Enterococcus isolates were resistant to vancomycin or tigecycline. About 88.5％ of the Enterococcus strains were susceptible to ampicillin. Conclusions Bloodstream infection in obstetric patients usually occurs after delivery, probably resulting in septic shock or infectious abortion. The main pathogens are gram-negative bacteria and Enterococcus spp. The prevalence of ESBLs-producing strains was high in E. coli. Most of the Enterococcus strains were susceptible to ampicillin.