[Objective] To study the molecular biological mechanism for a case of ABO blood group B subtype, and perform three-dimensional modeling of the mutant enzyme. [Methods] The ABO phenotype was identified by the tube method and microcolumn gel method; the ABO gene of the proband was detected by sequence-specific primer polymerase chain reaction (PCR-SSP), and the exon 6 and 7 of the ABO gene were sequenced and analyzed. Homologous modeling of Bw.03 glycosyltransferase (GT) was carried out by Modeller and analyzed by PyMOL2.5.0 software. [Results] The weakening B antigen was detected in the proband sample by forward typing, and anti-B antibody was detected by reverse typing. PCR-SSP detection showed B, O gene, and the sequencing results showed c.721 C>T mutation in exon 7 of the B gene, resulting in p. Arg 241 Trp. Compared with the wild type, the structure of Bw.03GT was partially changed, and the intermolecular force analysis showed that the original three hydrogen bonds at 241 position disappeared. [Conclusion] Blood group molecular biology examination is helpful for the accurate identification of ambiguous blood group. Homologous modeling more intuitively shows the key site for the weakening of Bw.03 GT activity. The intermolecular force analysis can explain the root cause of enzyme activity weakening.

Objective: To analyze the epidemilogical and seasonal characteristics of foodborne Salmonella-associated diarrhea among children aged 0-6 years in Guizhou Province from 2016 to 2023, so as to provide a basis for the prevention and control of foodborne diseases. Methods: Data were extracted from the Foodborne Disease Survellance System for cases reported between January 1, 2016, and December 31, 2023. The incidence, seasonal characteristics, and peak periods were analyzed by the method of concentration and circular distribution. Results: A total of 6 434 cases of diarrhea in children aged 0-6 years were collected, and 455 cases of Salmonella were detected, with a positive detection rate of 7.07%. Salmonella typhimurium was the main serotype causing diarrhea (59.34%). The peak of the disease was from May 3 to September 30, with certain seasonal characteristics. The highest detection rate was found in children aged 1-3 years (8.66%). Among food types, the positive detection rates of Salmonella were relatively high in other foods (17.39%), fruits and their products (10.22%), infant and toddler foods (10.09%), and aquatic animals and their products (9.80%). The processing and packaging methods of food were mainly home-made (9.38%) and bulk food (7.54%). Conclusions The detection rate of Salmonella in children aged 0-6 years is high in Guizhou Province, with strong seasonal characteristics. The detection rates of other foods, fruits and their products, infant and toddler foods, and aquatic animals and their products are high. Enhanced pathogen surveillance for susceptible populations and high-risk foods, coupled with public health education during summer/autumn, is recommended.

OBJECTIVE To discuss the impact of Wenyang lishui formula on ventricular remodeling in rats with pulmonary hypertension-induced right heart failure （RHF） based on the Hippo/Yes-associated protein （YAP） signaling pathway. METHODS Ten rats were randomly selected as the control group. The remaining 63 rats were given a single intraperitoneal injection of monocrotaline to establish the pulmonary hypertension-induced RHF model. The 50 rats that successfully underwent the model establishment were randomly divided into the RHF group， low-dose group of Wenyang lishui formula （4.25 g/kg）， high-dose group of the Wenyang lishui formula （17.00 g/kg）， furosemide group （20 mg/kg）， and high-dose group of Wenyang lishui formula+ Hippo/YAP signaling pathway activator group （17.00 g/kg of Δ Wenyang lishui formula+16 mg/kg of PY-60）， with 10 rats in each group. The rats in each group were given the corresponding drug solution or normal saline by gavage or/andtail vein injection， once a day， for 4 consecutive weeks. During the experiment， the general conditions of the rats in each group were observed； after the last administration， the right ventricular diameter， right atrial diameter， end-diastolic volume， pulmonary artery blood flow acceleration time （PAAT） and its ratio to ejection time （ET） （PAAT/ET）， pulmonary artery pressure and its ratio to pulmonary arterial flow velocity （pulmonary artery pressure/velocity） were measured. The plasma levels of brain natriuretic peptide and angiotensin Ⅱ （Ang Ⅱ） were detected. The pathological changes of the right ventricular tissue were observed， and the collagen volume fraction， the phosphorylation levels of the large tumor suppressor 1/2 （LATS1/2） and YAP， and the protein expression of the transcriptional coactivator of PDZ-binding motif （TAZ） were also detected. RESULTS Compared with the RHF group， the rats in Wenyang lishui formula low-dose and high-dose groups showed improved hair color， movement， diet， and mental state. The atrophy of right ventricular myocardial cells， the increase of inflammatory cells， collagen deposition， and hypertrophy of myocardial fibers were significantly alleviated. The right ventricular internal diameter， right atrial internal diameter， end-diastolic volume， pulmonary artery pressure， pulmonary artery pressure/velocity， the plasma levels of brain natriuretic peptide and AngⅡ ， collagen volume fraction， the phosphorylation level of YAP and protein expression of TAZ were significantly decreased， while the PAAT， PAAT/ET and the phosphorylation level of LATS1/2 were significantly increased （P＜0.05）. PY-60 could significantly reverse the improvement effects of high-dose Wenyang lishui formula on the above quantitative indicators （P＜ 0.05）. CONCLUSIONS Wenyang lishui formula can restore the right heart function of pulmonary hypertension-induced RHF rats， reduce their pulmonary artery pressure， alleviate the pathological changes in their cardiac tissues， and the above effects may be related to the activation of Hippo expression and the inhibition of YAP phosphorylation.

In recent years, prone mechanical ventilation has been widely used to improve oxygenation dysfunction in critically ill patients. During prone mechanical ventilation, the patient's face is compressed for a long time, and due to the difficulty in changing, facial pressure injuries and ocular complications are common and severe. These complications increase patient discomfort, reduce their tolerance and compliance with prone ventilation, and even cause tracheal tube displacement or dislodgement, leading to significant clinical challenges. In order to change this situation, the medical staff of the department of critical care medicine of the Second People's Hospital of Hengshui and the department of critical care medicine of Harrison International Peace Hospital had developed an adjustable facial support pad for prone ventilation, and obtained a National Utility Model Patent of China (ZL 2022 2 3295294.4). The device is composed of a facial support platform, a supporting telescopic foot frame and so on. There are front, back, left and right adjustable tracks below the support cushion platform, which can be adjusted to the best state suitable for the patient's face shape, which can alleviate the facial pressure injuries and ocular complications caused by the different sizes of each patient's face, improve the patient's comfort, and reduce the incidence of facial pressure injury and the occurrence of ocular complications of the patient. The height of the platform is adjusted by the telescopic feet, and there is a hook assembly below, which can be fixed by the clamp of the ventilator tubing, so as to prevent the ventilator tubing from pulling the endotracheal intubation due to the gravity of condensation, resulting in the displacement or even prolapse of the tracheal intubation, and reducing the occurrence of adverse events of tracheal intubation. It is worth promoting in the clinic.
Humans ; Respiration, Artificial/methods* ; Prone Position ; Equipment Design ; Face

Objective To evaluate the clinical outcome of kidney transplantation from donation after brain death(DBD)donors complicated with acute kidney injury(AKI).Methods Clinical data of 216 DBD donors were retrospectively analyzed,and they were divided into the AKI group(n=69)and control group(n=147)according to the Kidney Disease:Improving Global Outcomes(KDIGO)guidelines.Donors in the AKI group were further divided into the KDIGO stage 1 and stage 2-3 subgroups.One hundred and thirty-five recipients were assigned into the AKI group and 288 recipients in the control group.Postoperative recovery of renal function and clinical outcomes of the recipients were recorded.The risk factors of delayed graft function(DGF)were identified.Results The highest serum creatinine(Scr)level,Scr level before procurement,the highest blood sodium level and blood sodium level before procurement in the AKI group were higher than those in the control group.The application duration of vasopressors in the AKI group was longer than that in the control group.In the AKI group,the amount of fluid resuscitation within 48 h was higher,the HCO3-level at admission was lower,and the incidence of diabetes insipidus and hypotension was higher than those in the control group.The highest Scr level and the Scr level before procurement in KDIGO stage 2-3 donors were significantly higher than those in KDIGO stage 1 counterparts(all P＜0.05).Compared with the control group,the incidence of DGF and acute rejection was higher,the proportion of continuous renal replacement therapy was higher,the Scr level within postoperative 90 d was higher,and the urine amount within postoperative 3 d was less than those of recipients in the AKI group.Compared with KDIGO stage 1 recipients,KDIGO stage 2-3 recipients had higher Scr levels at postoperative 3,4,5 and 15 d,and less urine amount at postoperative 2 d(all P＜0.05).Univariate analysis showed that donor age,the highest Scr level,the highest blood sodium level and the amount of fluid resuscitation within 48 h were the risk factors for DGF in recipients after kidney transplantation.Multivariate analysis showed that donor age was the independent risk factor for DGF in recipients after kidney transplantation(all P＜0.05).Conclusions For the application of DBD donors complicated with AKI,active organ maintenance should be performed to alleviate AKI.It exerts no effect upon graft function and survival rate at postoperative 6 months,which may achieve equivalent efficacy as non-AKI donors and may be used as a source of extended criteria donor kidneys.

Objective:To investigate the nutritional risk, incidence of malnutrition, and intake of three major energy-supplying nutrients, analyze changes in their body composition and the possible influencing factors in patients with stomach neoplasms during perioperative period in order to provide a theoretical basis for the nutritional management of patients with stomach neoplasms during perioperative period.Methods:This was a cross-sectional study. A total of 105 patients who underwent gastric cancer radical surgery in the Gastrointestinal Department of Zhongshan Hospital Affiliated to Xiamen University from June 2021 to May 2023 were taken as the research subjects using fixed-point continuous sampling method. They were recruited for screening and assessment using Nutritional Risk Screening 2002 (NRS 2002) and Patient-Generated Subjective Global Assessment (PG-SGA). Nutrients intake during the perioperative period were investigated using the 24-h recall method and dietary diary method, etc. Body compositions were measured using the bioelectrical resistance method.Results:Among the 105 patients, there were 78 males and 27 females, with an average age of (61.5 ± 10.3) years. About 83.8% (88/105) gastric cancer patients were at nutritional risk and 82.9% (87/105) were malnourished. The preoperative and postoperative energy intake were (1 646.1 ± 321.5) and (1 317.2 ± 365.8) kcal (1 kcal=4.184 kJ), respectively, which were significantly lower than the target amount of (1 896.7 ± 262.9) kcal, the difference was statistically significant ( t=6.23, 8.29, both P<0.05).The preoperative body mass, muscle mass, skeletal muscle, fat mass, and skeletal muscle index were (51.5 ± 9.6), (40.8 ± 6.0), (23.6 ± 4.0), (8.3 ± 4.9) kg, and 6.7 ± 0.8 respectively, while the postoperative values were (50.0 ± 9.1), (39.8 ± 6.0), (22.8 ± 3.6), (7.8 ± 5.2) kg, and 6.5 ± 0.8 respectively, with statistically significant differences between the two groups ( t values were 2.89-10.61, all P<0.05). Logistic multivariate regression analysis showed that the operation time ( OR=3.984, 95% CI 1.433-11.080, P<0.05) and energy satisfaction ( OR=0.053, 95% CI 0.005-0.610, P<0.05) were independent influencing factors for the degree of skeletal muscle loss. Conclusions:During perioperative period, the gastric cancer patients had poor nutritional status with insufficient nutrient intake and accelerated loss of body muscle and fat. Therefore, it was necessary to conduct a comprehensive nutritional evaluation for patients with stomach neoplasms during perioperative period in time and take steps to promote recovery by providing individualized nutritional therapy.

Objective To investigate the effects of perineal massage combined with hip joint exercise on the outcome of delivery and mental resilience of primipara.Methods 90 pregnant women in the third trimester(after 36 weeks)who obtained the knowledge about perineal massage from midwife clinic were randomly divided into two groups with 45 cases each.The control group received regular antenatal examination and family self-exercise;the experimental group received perineal massage and hip joint training combined treatment.The delivery outcome,birth experience and maternal mental resilience of the two groups were compared.Results the number of vaginal delivery in the experimental group were higher than that in the control group(P<0.05);the second stage of labor was significantly shorter than that of the control group(P<0.05);the perineal integrity rate was higher than that of the control group(P<0.05);the scores of all dimensions in delivery experience questionnaire were higher than that of the control group(P<0.05);the scores of all dimensions in maternal mental resilience were higher than those of the control group(P<0.05)after intervention.Conclusion The perineal massage which conducted by midwives combined with hip movement can effectively improve the quality of delivery,relieve the negative emotions of pregnant women,improve the psychological elasticity level of pregnant women,and improve the delivery outcomes.

Objective:To explore the application value of computed tomography angiography(CTA)combined with neuron-specific enolase(NSE)and insulin-like growth factor-1(IGF-1)in the disease assessment of progressive cerebral infarction.Methods:A total of 110 patients with suspected progressive cerebral infarction admitted to Shanghai Changzheng Hospital from May 2022 to May 2023 were selected as the study subjects,all of them were tested by CTA.According to the deterioration status,63 cases with progressive cerebral infarction were divided into in the study group(progressive cerebral infarction),and then they were further divided into mild degree(19 cases),moderate degree(25 cases)and severe degree(16 cases)according to the condition of neurological deficit of the score of National Institutes of Health Stroke Scale(NIHSS).Other 47 patients with non-progressive cerebral infarction were divided into the control group.The degree of vascular stenosis,the changes of NSE and IGF-1 levels of each group were analyzed,as well as the changes of NSE and IGF-1 levels of neurological deficit with different degrees.The relationship between CTA,NSE and IGF-1 was further explored,and the assessment value of the combined examination of CTA,NSE and IGF-1 on progressive cerebral infarction also was explored.Results:Compared with the control group,the degree of vascular stenosis and NSE levels of the study group increased,while IGF-1 levels of that decreased,and the differences of them between two groups were statistical significance(t=20.893,24.156,40.209,P＜0.05),respectively.Compared with mild patients,IGF-1 levels decreased and NSE levels increased in moderate and severe patients,and the differences were statistical significance(t=4.689,9.103,18.464,23.672,P＜0.05),respectively.Compared with moderate patients,NSE levels increased and IGF-1 levels decreased in severe patients,and the differences were statistical significance(t=5.408,8.118,P＜0.05),respectively.NSE level was positively correlated with the degree of vascular stenosis(r=0.651,P＜0.05),while IGF-1 level was negatively correlated with it(r=-0.617,P＜0.05).Vascular stenosis and NSE were positively correlated with progressive cerebral infarction(r=0.672,P＜0.05),while IGF-1 level was negatively correlated with it(r=-0.629,P＜0.05),respectively.The area under curve(AUC)values of receiver operating characteristic(ROC)curves of CTA,NSE,IGF-1 and the combination of them were respectively 0.688(95%CI:0.594-0.786),0.710(95%CI:0.609-0.811),0.676(95%CI:0.578-0.775)and 0.822(95%CI:0.734-0.910),and the value of the combination of the three indicators was higher in assessing progressive cerebral infarction.Conclusion:The NSE level is higher in patients with progressive cerebral infarction,and the IGF-1 level is lower.The combination of NSE,IGF-1 and CTA can help to enhance the clinical assessment for progressive cerebral infarction,which can provide beneficial basis for clinical diagnosis and treatment of this disease.

Objective To analyze the effects of immediate multi-vessel percutaneous coronary inter-vention(MV-PCI)and staged vascular intervention(Staged-PCI,immediate PCI for culprit-only followed by a delayed treatment of all other lesions)on the prognosis in elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 417 elderly acute STEMI patients who underwent PCI in Baoding First Central hospital from January 2021 to June 2023 were enrolled,and according to different treatment strategies,they were divided into MV-PCI group(87 cases)and Staged-PCI group(330 cases).A propensity score matching(PSM)model was established based on baseline data of the two groups,there were 84 cases in each group.During a mean follow-up period of 13.5 months,with the occurrence of main adverse cardi-ovascular and cerebrovascular events(MACCE)as endpoint,the incidence of MACCE was com-pared between the two groups after PSM.Cox proportional hazard regression model was used to analyze the risk factors of MACCE.Results Before PSM,there were significant differences be-tween the two groups in terms of age,proportions of hypertension,diabetes and hyperlipidemia,family history,stroke history,peripheral artery disease,preoperative SBP,lesion vessels(such as left anterior descending branch and left circumflex branch),and number of non-diseased vessels(P＜0.05).Kaplan-Meier survival curve showed that the incidences of MACCE and all-cause mor-tality were significantly lower in the MV-PCI group than the Staged PCI group(Plog rank＜0.05).Multivariate Cox proportional hazard regression model showed that MV-PCI was a protective prognostic factor for MACCE(HR=0.263,95％CI:0.105-0.659,P=0.004)and all-cause death(HR=0.236,95％CI:0.007-0.722,P=0.016).Conclusion MV-PCI can significantly improve the prognosis of elderly patients with acute STEMI with multivessel disease.

Objective To explore the correlation of red cell distribution width/albumin ratio(RAR)and fibrinogen/albumin ratio(FAR)with severity of coronary artery disease(CAD)in patients with coronary heart disease(CHD),and to further explore the relationship of RAR and FAR with CAD severity in different glucose metabolic states.Methods A total of 577 CHD patients undergoing coronary angiography(CAG)in Department of Cardiology of Tianjin People's Hospital from January 2021 to December 2022 were enrolled,and according to the results of CAG,412 patients were diagnosed with multi-vessel CAD and the other 165 patients with single-vessel CAD.Their baseline data and results of laboratory tests were collected,and RAR and FAR values were calculated.Univariate and multivariate logistic regression analyses were performed with RAR and FAR as independent variables,and ROC curve was plotted to evaluate the predic-tive values of the 2 indicators for the severity of CAD.Spearman correlation analysis was applied to analyze the occurrence of major adverse cardiovascular events(MACEs)in the patients.Results Logistic regression analysis showed that RAR and FAR were independent risk factors for CAD(OR=1.974,95％CI:1.348-2.593,P=0.000;OR=1.737,95％CI:1.486-2.377,P=0.000).Un-der different glucose metabolic states,RAR had the highest correlation with the risk of CAD in diabetic patients(OR=2.828,95％CI:1.157-7.145),while FAR was associated with a relatively low risk of CAD in diabetic patients(OR=2.217,95％CI:1.533-5.570).ROC curve analysis showed that RAR(AUC=0.776,95％CI:0.731-0.821,P=0.000)and FAR(AUC=0.725,95％CI:0.676-0.774,P=0.000)had predictive value for the severity of CAD in CHD patients.Spearman correlation analysis indicated that RAR and FAR were positively correlated with occur-rence of MACEs in CHD patients(P＜0.001).Conclusion RAR and FAR are independent pre-dictors for CHD patients.RAR has a stronger predictive value for lesion severity in CHD patients with concomitant abnormal glucose metabolism.