This paper highlights the specific nursing experiences in an early inflammatory bowel obstruction of a patient after the surgery for abdominal cocoon syndrome.Immediately after the surgery,the nursing care focused on prevention of postoperative metabolic disorders,including dynamic monitoring and correction of refeeding syndrome and goal-oriented sequential nutritional support management.Over the period of postoperative recovery,the nursing care shifted to prevention and treatment of early postoperative inflammatory bowel obstruction,including dynamic monitoring and identification of an early postoperative inflammatory bowel obstruction,goal-oriented early postoperative inflammatory small bowel obstruction(EPISBO)fluid therapy together with the traditional Chinese medicine to promote bowel movement and control inflammation,the auricle copper-blade Gua Sha combined with auricular point sticker compression to regulate qi and reduce bowel flatulence,as well as a goal-oriented early mobilisation to prevent a re-obstruction of bowel.The patient discharged at 28 days after surgery without an event.At the 6 months of postoperative follow-up,the patient was found in continuous improvement of relevant indicators and increase of body weight.

Objective To prepare humanized monoclonal antibodies(Mabs)targeting Acinetobacter baumannii(Ab)based on single memory B cell sequencing technology,construct the immune repertoire of the core protein of Ab,hemolysin-coregulated protein(Hcp),and express its Mabs with binding activity.Methods E.coli BL21 harboring the recombinant plasmid pGEX-6p-1-Hcp was constructed.Hcp protein was obtained using protein expression and affinity chromatography.Female SPF BALB/c mice(6～8 weeks old,weighing 18～20 g)were immunized intramuscularly with antigen Hcp to generate specific memory B cells.Single antigen-specific memory B cells were sorted using flow cytometry.The immune repertoire of Hcp was constructed using single-cell sequencing technology,and bioinformatics analysis was performed on the sequencing results.Mabs were obtained using antibody humanization techniques.The in vitro binding activity of the antibodies was detected by ELISA.Results The target protein Hcp with a purity>95%was obtained after expression and purification.The immune repertoire of Hcp was successfully constructed,and the results of BCR clonotype identification and analysis,CDR3 region characteristic analysis,and V-J gene pairing characteristic analysis were achieved.Antibody humanization got 7 Mabs,that is,IgG1-1,IgG1-2,IgG2-1,IgG2-2,IgG3-1,IgG4-1 and IgG4-2.ELISA results showed IgG1-1,IgG3-1,IgG4-1,and IgG4-2 had an antibody binding titer of 1∶1 280,IgG2-2 of 1∶10 240,IgG2-1 of 1∶5 120,and IgG1-2 of 1∶160.Conclusion Single-cell sequencing technology enables rapid,accurate,and efficient construction of an Hcp protein immune repertoire containing extensive antibody information.Utilizing this immune repertoire allows for the expression of Mabs with binding activity.

This paper highlights the specific nursing experiences in an early inflammatory bowel obstruction of a patient after the surgery for abdominal cocoon syndrome.Immediately after the surgery,the nursing care focused on prevention of postoperative metabolic disorders,including dynamic monitoring and correction of refeeding syndrome and goal-oriented sequential nutritional support management.Over the period of postoperative recovery,the nursing care shifted to prevention and treatment of early postoperative inflammatory bowel obstruction,including dynamic monitoring and identification of an early postoperative inflammatory bowel obstruction,goal-oriented early postoperative inflammatory small bowel obstruction(EPISBO)fluid therapy together with the traditional Chinese medicine to promote bowel movement and control inflammation,the auricle copper-blade Gua Sha combined with auricular point sticker compression to regulate qi and reduce bowel flatulence,as well as a goal-oriented early mobilisation to prevent a re-obstruction of bowel.The patient discharged at 28 days after surgery without an event.At the 6 months of postoperative follow-up,the patient was found in continuous improvement of relevant indicators and increase of body weight.

ObjectiveTo analyze the risk factors of dementia among healthy elderly individuals in the middle of their lives. MethodsA total of 175 participants aged 55 to 75 from two communities in Beijing were included from July, 2021 to April, 2023. Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) related risk factors and other demographic data were collected. According to the CAIDE assessment, participants with scores ≥ 9 were as high-risk group, and those with scores < 9 were as low-risk group. They were evaluated with Stroop Color Word Test (SCWT), two elements 1-back task paradigm and the revised Trail Making Test (TMT); measured the grip strength, 30 s forearm flexion tests and five sit-to-stand tests; the average step speed and step length of a 10-meter walk were recorded. ResultsThe average total score of CAIDE was 9.86 in the high-risk group, and was 4.95 in the low-risk group. There was no difference in age between two groups (P = 0.188). There were differences in the proportion of participants of male, less than seven years' education, systolic blood pressure > 140 mmHg, cholesterol > 6.5 mmol/L, body mass index > 30 kg/m², and lack of physical activity between two groups (χ² > 3.116, P < 0.05). The grip strength (t = -4.174), walking speed (t = -2.414), SCWT accuracy (Z = -2.684) were all worse in the high-risk group than in the low-risk group (P < 0.05). Logistic regression analysis showed that walking speed (OR = 25.483), grip strength (OR = 1.133) and SCWT accuracy (OR = 37.430) were independent influencing factors of dementia (P < 0.05). ConclusionWeaker grip strength, slower gait speed and worse inhibitory control might be independent influencing factors of dementia.

AIM: To observe the clinical efficacy of 8-0 polypropylene scleral-sutured fixed intraocular lens(IOL)suspension implantation with the double knots technique in aphakic eyes.METHODS: Retrospective case series study. The data of 30 aphakic cases(31 eyes, 22 males)that underwent IOL suspension in our hospital from January 2021 to November 2022 were collected. The suspension of IOL(AcrySof IQ or Tecnis ZCB00)was performed by 8-0 polypropylene scleral-sutured with the double knots technique. The visual acuity, intraocular pressure(IOP), IOL position and complications with at least 6 mo of follow-up were observed.RESULTS: The mean preoperative uncorrected visual acuity(UCVA, LogMAR)and best-corrected visual acuity(BCVA, LogMAR)were 2.53±0.78 and 0.35±0.26, respectively, which were 0.58±0.26 and 0.36±0.27 at 6 mo postoperatively, respectively. And the differences in UCVA were statistically significant(t=15.408, P<0.01), whereas the difference in BCVA was not(t=-1.677, P=0.104). There were no intraoperative complications, with IOL position all centered, but 3 eyes had IOL tilt, 2 eyes had intraocular hypertension, 5 eyes had corneal edema, and 1 eye had suture exposure postoperatively. There were no complications such as hyphema, vitreous hemorrhage, macular edema, corneal endothelial decompensation, hypotony, choroidal detachment, retinal detachment, fulminant superior choroidal hemorrhage, endophthalmitis, or others.CONCLUSION: The 8-0 polypropylene scleral-sutured fixed intraocular lens suspension implantation with the double knots technique can improve the postoperative visual acuity of aphakic patients, and fewer complications, which is an option for the treatment of aphakia, dislocation of the lens and ligament abnormalities.

SWOT-PEST model was used to analyze the internal advantages and disadvantages,external,opportunities and challenges of tertiary public pediatric hospitals.Based on stakeholder theory,through the literature review method,policy analysis method,combined with the actual work,and summarize its main role and demands.Put forward the development strategy of three-level public pediatric specialty hospital.Through the analysis of interest demands of stakeholders of tertiary public pediat-ric specialty hospitals,the overall development is good at present,but there are still problems that need to be solved urgently.From the perspective of internal and external stakeholders,the optimization strategy involving multiple levels,multiple angles and multiple subjects is proposed to promote the comprehensive development of tertiary public pediatric specialty hospitals.

Objective:To preliminarily investigate the applicability of a poliovirus pseudovirus-based neutralization assay in evaluating the immunogenicity of recombinant poliovirus vaccines and their in vivo potency in rats. Methods:Serum samples from rats immunized with recombinant poliovirus vaccines were tested using both the pseudovirus neutralization assay and the live-virus neutralization assay with Sabin strain. The consistency and correlation of the two methods were analyzed using the Kappa test and Spearman′s rank correlation.Results:For the neutralizing antibodies against typeⅠ, Ⅱ, and Ⅲ polioviruses, the Kappa values for consistency analysis of the two methods were 0.914, 1.000, and 0.751, respectively ( P<0.001), and the correlation coefficients ( R values) were 0.833, 0.927, and 0.859, respectively ( P<0.001). Conclusions:The test results of the two methods are consistent and show a good correlation, indicating that the pseudovirus neutralization assay can be applied to evaluating the immunogenicity of poliovirus vaccines and also can be used in rat potency tests.

Objective:To explore the effects of anhedonia, childhood abuse, and depression on suicidal ideation, and the mediating role of anhedonia in adolescents.Methods:A total of 7 431 middle school students were invited to participate in the study. Suicidal ideation, depression, childhood abuse, and anhedonia were assessed by the Positive and Negative Suicide Ideation Scale (PANSI), Self-Rating Depression Scale (SDS), Childhood Trauma Questionnaire (CTQ) and Temporal Experience of Pleasure Scale (TEPS); according to the score of suicidal ideation, a total score of 36 was used as the cut-off score, all students were divided into the group with suicidal ideation ( n=1 265) and the group without suicidal ideation ( n=6 166). Difference test was performed using independent sample t-test and χ 2 test; Correlation analysis was performed by Pearson correlation; The process macro program compiled by Hayes was used to conduct the regulated mediation model analysis; The mediation effect values and 95%bootstrap confidence intervals of depressive symptoms between childhood maltreatment and suicidal ideation were analyzed by the bootstrap method; Simple slope analysis was utilized to examine the interaction effects for depression and anhedonia. Results:The detection rate of adolescent suicidal ideation was 17.02% (1 265/7 431);Childhood abuse significantly positively predicted depression ( β=0.56, P<0.001); depression significantly positively predicted suicidal ideation ( β=0.59, P<0.001); depression and anhedonia interaction significantly predicted suicidal ideation ( β=-0.05, P<0.001); simple slope analysis indicates that low anhedonia depression predicted suicidal ideation ( β=0.51, P<0.001) than the high anhedonia group ( β=0.47, P<0.001). Conclusion:Depression partially mediates the effects of childhood abuse on suicidal ideation, and anhedonia modulates the effects of childhood abuse on suicidal ideation. As the level of anhedonia gradually increases, the predictive effect of depression on suicidal ideation gradually decreases.

Objective:To explore the effects of anhedonia, childhood abuse, and depression on suicidal ideation, and the mediating role of anhedonia in adolescents.Methods:A total of 7 431 middle school students were invited to participate in the study. Suicidal ideation, depression, childhood abuse, and anhedonia were assessed by the Positive and Negative Suicide Ideation Scale (PANSI), Self-Rating Depression Scale (SDS), Childhood Trauma Questionnaire (CTQ) and Temporal Experience of Pleasure Scale (TEPS); according to the score of suicidal ideation, a total score of 36 was used as the cut-off score, all students were divided into the group with suicidal ideation ( n=1 265) and the group without suicidal ideation ( n=6 166). Difference test was performed using independent sample t-test and χ 2 test; Correlation analysis was performed by Pearson correlation; The process macro program compiled by Hayes was used to conduct the regulated mediation model analysis; The mediation effect values and 95%bootstrap confidence intervals of depressive symptoms between childhood maltreatment and suicidal ideation were analyzed by the bootstrap method; Simple slope analysis was utilized to examine the interaction effects for depression and anhedonia. Results:The detection rate of adolescent suicidal ideation was 17.02% (1 265/7 431);Childhood abuse significantly positively predicted depression ( β=0.56, P<0.001); depression significantly positively predicted suicidal ideation ( β=0.59, P<0.001); depression and anhedonia interaction significantly predicted suicidal ideation ( β=-0.05, P<0.001); simple slope analysis indicates that low anhedonia depression predicted suicidal ideation ( β=0.51, P<0.001) than the high anhedonia group ( β=0.47, P<0.001). Conclusion:Depression partially mediates the effects of childhood abuse on suicidal ideation, and anhedonia modulates the effects of childhood abuse on suicidal ideation. As the level of anhedonia gradually increases, the predictive effect of depression on suicidal ideation gradually decreases.

Objective To determine the serum IgM and IgG antibody levels post-COVID-19 vaccination， and provide scientific evidence for COVID-19 antibody response after vaccination. Methods A total of 980 healthy persons were included in Kunming Third People’s Hospital from July through August， 2021， which had been vaccinated with COVID-19 vaccines and then tested for anti-SARS-CoV-2 IgM and IgG antibodies. Results After the COVID-19 vaccination， 469 persons （positive rate， 47.86%） were positive for anti-IgG antibody. Of them， 75 were males with （positive rate， 39.06%）， and the average IgG level was 0.618 （0.180， 2.526） AU·mL^-1［M（Q₁，Q₃）］； 394 were females （50.00%）， and the IgG level was 0.999 （0.305， 3.334） AU·mL^-1. In addition， 53 persons （5.41%） were anti-IgM antibody positive. Of them， 14 were males （positive rate， 7.29%）， and the average IgM level was 0.057 （0.026， 0.195） AU·mL^-1； 39 were females （4.95%）， and the IgM level was 0.047 （0.027， 0.110） AU·mL^-1. The positive rate of anti-IgG antibody was highest in those aged ≤30 years， which was 51.02% in male （n=25） and 55.88% in female （n=133）. The anti-IgG response differed significantly by gender （χ²=7.401， D=0.135 1， P<0.05）， whereas the anti-IgM response was not significantly different （χ²=1.656， P>0.05）. Among the age groups， anti-IgG antibody level was higher in those aged ≤30 and 51-70 years， with 158 （55.05%） and 122 （52.36%） persons， respectively； the average antibody level was 1.209 （0.426， 4.386） AU·mL^-1 and 1.074 （0.191， 7.670） AU·mL^-1， respectively. The differences in the positive rates of IgG and IgM antibodies and the levels of IgG antibodies among different age groups were statistically significant （P<0.05）. Using Kruskal-Wallis test and Spearman correlation analysis， it showed a high correlation between the IgG and IgM antibodies （r=0.836 4， H=64.82， 20.09， P<0.05）. Conclusion The Anti-SARS-CoV-2 IgG antibody remains high six months post-COVID-19 vaccination， while anti-IgM antibody is low. The IgM and IgG response are higher in the young and elderly. The response differs by gender and age， demonstrating a correlation.