[Objective] To investigate the infection status and characteristics of HEV among voluntary blood donors in Ningbo, and to provide a basis for improving the blood screening strategy. [Methods] A total of 12 227 blood samples from voluntary blood donors in Ningbo from June 2022 to May 2023 were tested for HEV serology, enzymology, and nucleic acid testing. Furthermore, HEV gene sequencing was performed for genotyping analysis, and donors with reactive nucleic acid testing results were followed up to confirm their infection status. [Results] The reactivity rate of HEV Ag, anti-HEV IgM and anti-HEV IgG was 0.098%, 0.899% and 29.198%, respectively. There was no difference in the reactivity of anti-HEV IgM and anti-HEV IgG between genders, donation frequencies and donation types (P>0.05). The reactivity rate increased significantly with age (P<0.05). The rate of ALT disqualification (ALT>50U/L) was significantly higher than that in non-reactive samples (P<0.05). The HEV Ag reactivity rate (0.098%) was not correlated with gender, donation frequency, donation type or age. One HEV RNA positive case was found, with a positive rate of 0.008%(1/12 227). It was confirmed to be hepatitis E virus genotype 3 by sequencing analysis. Apart from HEV Ag reactivity, all other blood safety screening items were non-reactive, suggesting this case might be in the acute infection phase. The follow-up results showed that all indicators of the donor's previous blood donation were non-reactive. [Conclusion] Pre-donation ALT detection can reduce the risk of transfusion-transmitted HEV (TT-HEV) to a certain extent, and the effective way to prevent TT-HEV is to detect HEV RNA and serology of donor blood.

Ligand-gated ion channels are a large category of essential ion channels,modulating their state by binding to specific ligands to allow ions to pass through the cell membrane.Purinergic ligand-gated ion channel receptors(P2XRs)and acid-sensitive ion channels(ASICs)are representative members of trimeric ligand-gated ion channel.Recent studies have shown that structural differences in the intracellular domain of P2XRs may determine the desensitization process.The lateral fenestrations of P2XRs potentially serve as a pathway for ion conductance and play a decisive role in ion selectivity.Phosphorylation of numerous amino acid residues in the P2XRs are involved in regulating the activity of ion channels.Additionally,the P2XRs interact with other ligand-gated ion channels including N-methyl-D-aspartate receptors,γ-aminobutyric acid receptors,5-hydroxytryptamin receptors and nicotinic acetylcholine receptors,mediating physiological processes such as synaptic plasticity.Conformational changes in the intracellular domain of the ASICs expose binding sites of intracellular signal partners,facilitating metabolic signal transduction.Amino acids such as Val16,Ser17,Ile18,Gln19 and Ala20 in the ASICs participate in channel opening and membrane expression.ASICs can also bind to intracellular proteins,such as CIPP and p11,to regulate channel function.Many phosphorylation sites at the C-terminus and N-terminus of ASICs are involved in the regulation of receptors.Furthermore,ASICs are involved in various physiological and pathophysiological processes,which include pain,ischemic stroke,psychiatric disorders,and neurodegenerative disease.In this article,we review the roles of the intracellular domains of these trimeric ligand-gated ion channels in channel gating as well as their physiological and pathological functions,in order to provide new insights into the discovery of related drugs.

Delayed lactation activation is a risk factor for early termination of postpartum breastfeeding with high prevalence and adverse effects on the immediate and long-term growth and development of preterm infants,especially very low birth weight infants.This article reviews the delayed lactation activation,evaluation methods of lactation activation in premature mothers and the intervention measures to shorten the delay of lactation activation,in order to provide the basis for the development of relevant studies and the formulation of effective intervention programs.

Delayed lactation activation is a risk factor for early termination of postpartum breastfeeding with high prevalence and adverse effects on the immediate and long-term growth and development of preterm infants,especially very low birth weight infants.This article reviews the delayed lactation activation,evaluation methods of lactation activation in premature mothers and the intervention measures to shorten the delay of lactation activation,in order to provide the basis for the development of relevant studies and the formulation of effective intervention programs.

Objective:To investigate the protective effect of ulinastatin on sepsis-acute kidney injury (SA-AKI) by NF-κB signaling pathway.Methods:Total of 60 mice were randomly(random number) divided into sham group, cecal ligation puncture group (CLP group) and ulinastatin treatment group (CLP+UTI group). Ulinastatin treatment group was intraperitoneally injected with ulinastatin 50 000 U/kg once a day. 24 hours after operation, five mice were sacrificed, the kidney tissues were collected to observe renal histopathology by HE staining. The macrophage infiltration was observed by immunohistochemistry. The remaining mice in each group were used to calculate the survival rate of 7-day after operation. HK-2 cells were stimulated by LPS to obtain the SA-AKI model, and the cells were divided into control group, LPS group and LPS + UTI group. CCK-8 assay was used to detect cell viability, EdU assay was used to detect cell proliferation, and JC-1 assay was used to detect mitochondrial damage. The phosphorylation degree of NF-κB was detected by western blot. Inflammatory factors concentrations of cellular supernatant were detected by ELISA assay.Results:Compared with the sham group, the kidney tissue of mice in CLP group showed that kidney pathological obvious changed, the infiltration of macrophages increased, and the survival rate of mice decreased. CLP+ UTI group reduced the pathological changes and the infiltration of macrophages, improved the survival rate of mice. Compared with control group, LPS group obviously inhibited the cells activity and proliferation of HK-2 cells, damaged the mitochondrial membrane potential of HK-2 cells. Compared with LPS group, LPS+ UTI group attenuated the phosphorylation of NF-κB, decreased the secretion of inflammatory factors, rescued the activity and proliferation of HK-2 cells, and reduced the damage of HK-2 mitochondrial membrane potential.Conclusions:Ulinastatin can reduce mitochondrial damage, inhibit the secretion of inflammatory factors and improve the function of renal tubular epithelial cells through regulating NF-κB signaling pathway.

Physiological parameters monitoring is essential to direct medical staff to evaluate, diagnose and treat critical patients quantitatively. ECG, blood pressure, SpO2, respiratory rate and body temperature are the basic vital signs of patients in the ICU. The measuring methods are relatively mature at present, and the trend is to be wireless and more accurate and comfortable. Hemodynamics, oxygen metabolism and microcirculation should be taken seriously during the treatment of acute critical patients. The related monitoring technology has made significant progress in recent years, the trend is to reduce the trauma and improve the accuracy and usability. With the development of machine vision and data fusion technology, the identification of patient behavior and deterioration has become hot topics. This review is focused on current parameters monitoring technologies, aims to provide reference for future related research.
Humans ; Intensive Care Units ; Monitoring, Physiologic ; Oxygen Saturation ; Technology ; Vital Signs

Objective To investigate the effect of interleukin-1β (IL-1β) on the expression of synaptic protein SNAP-25 in the hippocampus in septic neonatal rat induced by systemic lipopolysaceharide (LPS) injection.Methods Sprague-Dawley (SD) rats were randomly divided into two groups:control group and sepsis group.The rat model of sepsis was produced by intraperitoneal injection of 1 mg/kg LPS,and rats in the control group were injected with an equal volume of 0.01 mol/L phosphate buffered saline (PBS).The expression levels of IL-1β and IL-1R1 in the hippocampus at 1,2 and 3 d,and synaptosomal-associated protein 25 (SNAP-25) at 7,14 and 24 d after LPS intraperitoneal injection were detected by Western blot.After cultured for 24 h,primary hippocampal neurons were divided into four groups including the control group,IL-1β (40 ng/mL) treatment group,IL-1β (40 ng/mL) + IL-1Ra (40 ng/mL) treatment group,and IL-1Ra (40 ng/mL) treatment group.The effect of IL-1β on SNAP-25 expression in primary hippocampal neuron was determined by Western blot and real-time PCR.The purity of hippocampal neurons were identified by NeuN immunofluorescence staining and the activity of neurons were detected by CCK-8 assay.All data were analyzed by SPSS version 22.0.The data were analyzed by student-t test and Dunnett-t test.The interaction effects were analyzed by factorial ANOVA.Differences were considered to be statistically significant if P＜ 0.05.Results Compared with the control group,the expressions of IL-1β and IL-1R1 were significantly increased in the hippocampus at 1,2 and 3 d after intraperitoneal injection of LPS (P＜0.05).The expression of SNAP-25 protein was decreased at 7,14,and 28 d after intraperitoneal injection of LPS (P＜0.05).The purity of primary neurons was about up to 92％.The activity of primary neurons was not relatively changed after treated with IL-1β at a dose less than 40 ng/mL.The level of SNAP-25 protein was obviously decreased in primary neurons at 24 h after IL-1β treatment (P＜0.05).IL-1Ra treatment might reverse the effect of IL-1β on primary neurons (P＜0.05).While,the expression of SNAP-25 mRNA was not statistically different in each group (P＞0.05).Conclusions IL-1β may possibly inhibit the expression level of SNAP-25 protein in the hippocampus in the septic rats through its receptor IL-1R1,which would contribute to cognitive dysfunction of septic neonatal rats in later life.

Objective To investigate microbial characteristics and predisposing factors in gram-negtive bacteria blood stream infection. Methods A descriptive retrospective study was conducted. Patients diagnosed as sepsis with blood culture of G- bacilli and without sepsis were enrolled. The patients were all admitted to ICUs of Guangdong General Hospital from October, 2012 to December, 2014. The clinical characteristics and outcomes were compared. Multiple logistic regression was used to analyse the predisposing factors for sepsis of G- bacilli. Results A total of 148 patients suffered from sepsis of G-bacilli including Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae were enrolled. Single-factor analysis showed that patients with sepsis of G- bacilli infection had older ages, higher incidence of coronary heart diseases or congestive heart failure, cerebrovascular diseases or chronic renal insufficiency, hypertension, also higher incidence of longer length of hospital stay before blood was drawn for culture, and higher incidence using of vasoactive agents and pre-admission intravenous antibiotics and lower plasma albumin level (P < 0.05). Conclusions Coronary heart disease or congestive heart failure, chronic renal insufficiency and pre-admission intravenous antibiotics were independent predisposing factors for sepsis of G-bacilli.

Objective To investigate the risk factors and prognosis of blood stream infection in patients of intensive care unit (ICU).Methods Clinical data of all patients with culture-positive sepsis were collected from all ICUs of Guangdong General Hospital from October 12th, 2012 to December 1st, 2014 for retrospective study.Physiological characteristics and laboratory data were compared between patients with blood culture-positive sepsis group and patients without sepsis of control group.Logistic regression analysis was made to identify the risk factors for blood stream infection.Patients with blood culture-positive sepsis group were further divided into survivor and non-survivor groups according to the clinical outcomes.Physiological and laboratory data were compared between two groups.Logistic regression analysis was also performed to identify the risk factors for mortality.Results There were 299 patients with positive blood culture sepsis admitted in the ICUs in two years.Of them, 250 patients infected with Gram positive cocci including staphylococcus haemolyticus, staphylococcus epidermidis, staphylococcus capitis and staphylococcus aureus accounting for the majority.There were 174 patients infected with Gram negative bacilli including acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniaesubsp.pneumoniae accounting for the majority.A univariate analysis demonstrated that there were significant differences in hypertension (P =0.001), diabetes (P =0.01), coronary heart diseases and heart failure (P =0.000), chronic renal insufficiency (P =0.000), prolonged mechanical ventilation (P =0.000), pre-admission intravenous administration of antibiotics (P =0.000), and hypoalbuminemia (P =0.008) between culture positive group and control group.A logistic regression analysis demonstrated that diabetes [OR =2.158, 95％ CI (1.230, 3.787), P =0.007], chronic renal insufficiency [OR =13.410, 95％ CI (1.715, 104.879), P =0.013], pre-admission intravenous administration of antibiotics [OR =8.375, 95％ CI (5.267, 13.317), P=0.000] were independent risk factors for bloodstream infections in ICU.In patients with positive blood culture, the non-survivor group had patients with higher advance of old age, higher rate of hypertension, coronary heart diseases or congestive heart failure, tumor and chronic renal insufficiency, prolonged mechanical ventilation and higher incidence of surgery and pre-admission intravenous administration of antibiotics compared with the survivor group.The advance of old age [OR =1.023, 95％ CI (1.008-1.037), P =0.002], prolonged mechanical ventilation [OR =1.055, 95％ CI (1.024, 1.088), P =0.000] and hypoalbuminemia [OR =0.933, 95％ CI (0.898, 0.971), P =0.001] were independently associated with mortality of bloodstream infection in ICU.Conclusions Diabetes, chronic renal insufficiency and pre-admission intravenous administration of antibiotics were associated with the development of blood stream infection in ICU.The advance of old age, prolonged mechanical ventilation and hypoalbuminemia were independent risk factors for mortality in patients with culture-positive sepsis in ICU.

Objective To investigate the prevalence and clinical features of fulminant type 1 diabetes.Methods Using data retrieved from Second Xiangya Hospital of Central South University,all patients diagnosed with type 1 diabetes from Jan.1,2001 to Dec.31,2007 were identified.The patients were divided into fulminant type 1 diabetes (F1D) group,typical type 1 diabetes (T1A) group,and idiopathic type 1 diabetes(T1B) group.Their clinical features were compared.Results Eight patients (9.1%) fulfilled the criteria for fulminant type 1 diabetes among 87 newly diagnosed type 1 diabetes,and the percentage of fulminant type 1 diabetes reached 14.0% among type 1 diabetic patients with age of onset of 18 years or older.Patients of F1D group had a markedly higher plasma glucose concentration compared with patients of T1A group and T1B group(P=0.004).Serum amylase was higher in F1D group than that in T1A group(P = 0.021).Four (50%) patients were GADA positive,among whom 1 patient was Coxsackie B virus (CVB) IgM positive and 1 patient was Herpes Simplex virus 1 (HSV1) IgM positive.Conclusions Fulminant type 1 diabetes accounts for about 10% of the type 1 diabetes in the Chinese individuals with ketosis-or ketoacidosis-onset.Patients with this subset of diabetes had severe metabolic derangement.Viral infection and autoimmunity may be involved in the pathogenesis of fulminant type 1 diabetes.