Objective To investigate the risk factors of coagulation with extracorporeal circulation device in uremic patients with continuous renal replacement therapy(CRRT),and establish and verify the risk warning model.Methods A total of 210 uremic patients who received CRRT treatment in the Second Affiliated Hospital of Nanchang University from March 2020 to March 2022 were retrospectively selected as training set,and divided into coagulation group and non-coagulation group according to whether coagulation occurred during CRRT treatment.At the same time,90 uremic patients who underwent CRRT treatment in our hospital from April 2022 to April 2023 were selected as validation set according to the ratio of 7:3.Univariate analysis and multivariate Logistic regression were used to analyze the factors related to coagulation with extracorporeal circulation device in uremic patients with CRRT,and a risk prediction model was constructed.The receiver operating characteristic(ROC)curve was used to verify the prediction efficiency of the model.Results In training set,53 patients had coagulation with extracorporeal circulation device,the incidence was 25.24%.Multivariate Logistic regression analysis showed that age≥60 years old,agitation,decreased blood flow,elevated platelet count,and elevated transmembrane pressure were all risk factors for coagulation in patients with uremia treated with CRRT(P<0.05).The Hosmer-Lemeshow test results of the training set showed that the model had a good goodness of fitting,and area under the curve(AUC)of the model was 0.956(95%CI:0.926-0.985,P<0.05)when CRRT was applied to uremic patients,and the sensitivity was 86.40%,the specificity was 83.80%.The goodness of fitting of the validation set was good.The AUC of the prediction model was 0.946(95%CI:0.915-0.977,P<0.05),the sensitivity was 82.60%,and the specificity was 81.80%.Conclusion The risk early warning model based on the above risk factors has a good prediction effect,and can provide a reference for clinical identification of the occurrence of coagulation with extracorporeal circulation device in uremic patients with CRRT.

Objective:To explore the mediating effect of parental emotional education between family functioning and emotional-behavioral problems in children with amblyopia.Methods:Convenience sampling was used to select children with amblyopia and their parents as study subjects at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from October 2023 to October 2024. The study subjects were surveyed using the General Information Questionnaire, Positive Rating Scale of Family General Functioning, Strengths and Difficulties Questionnaire, and Parental Meta-Emotion Philosophy Scale.Results:A total of 164 questionnaires were distributed, and 151 valid questionnaires were returned, with a valid return rate of 92.07%. The emotional-behavioral problem score for the pediatric patients was (13.64±2.63). The family functioning of children with amblyopia could directly influence their emotional-behavioral problems, and could also indirectly influence their emotional-behavioral problems through parental emotional education, the mediating effect value was -0.636, accounting for 34.96% (-0.636/-1.819) of the total effect.Conclusions:The emotional-behavioral problems of children with amblyopia still need further attention. The conclusion of this study will provide theoretical basis and practical recommendations for subsequent nursing staff to carry out family management interventions for children with amblyopia, thereby reducing their emotional-behavioral problems.

Objective To investigate the risk factors of coagulation with extracorporeal circulation device in uremic patients with continuous renal replacement therapy(CRRT),and establish and verify the risk warning model.Methods A total of 210 uremic patients who received CRRT treatment in the Second Affiliated Hospital of Nanchang University from March 2020 to March 2022 were retrospectively selected as training set,and divided into coagulation group and non-coagulation group according to whether coagulation occurred during CRRT treatment.At the same time,90 uremic patients who underwent CRRT treatment in our hospital from April 2022 to April 2023 were selected as validation set according to the ratio of 7:3.Univariate analysis and multivariate Logistic regression were used to analyze the factors related to coagulation with extracorporeal circulation device in uremic patients with CRRT,and a risk prediction model was constructed.The receiver operating characteristic(ROC)curve was used to verify the prediction efficiency of the model.Results In training set,53 patients had coagulation with extracorporeal circulation device,the incidence was 25.24%.Multivariate Logistic regression analysis showed that age≥60 years old,agitation,decreased blood flow,elevated platelet count,and elevated transmembrane pressure were all risk factors for coagulation in patients with uremia treated with CRRT(P<0.05).The Hosmer-Lemeshow test results of the training set showed that the model had a good goodness of fitting,and area under the curve(AUC)of the model was 0.956(95%CI:0.926-0.985,P<0.05)when CRRT was applied to uremic patients,and the sensitivity was 86.40%,the specificity was 83.80%.The goodness of fitting of the validation set was good.The AUC of the prediction model was 0.946(95%CI:0.915-0.977,P<0.05),the sensitivity was 82.60%,and the specificity was 81.80%.Conclusion The risk early warning model based on the above risk factors has a good prediction effect,and can provide a reference for clinical identification of the occurrence of coagulation with extracorporeal circulation device in uremic patients with CRRT.

Objective:To explore the mediating effect of parental emotional education between family functioning and emotional-behavioral problems in children with amblyopia.Methods:Convenience sampling was used to select children with amblyopia and their parents as study subjects at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from October 2023 to October 2024. The study subjects were surveyed using the General Information Questionnaire, Positive Rating Scale of Family General Functioning, Strengths and Difficulties Questionnaire, and Parental Meta-Emotion Philosophy Scale.Results:A total of 164 questionnaires were distributed, and 151 valid questionnaires were returned, with a valid return rate of 92.07%. The emotional-behavioral problem score for the pediatric patients was (13.64±2.63). The family functioning of children with amblyopia could directly influence their emotional-behavioral problems, and could also indirectly influence their emotional-behavioral problems through parental emotional education, the mediating effect value was -0.636, accounting for 34.96% (-0.636/-1.819) of the total effect.Conclusions:The emotional-behavioral problems of children with amblyopia still need further attention. The conclusion of this study will provide theoretical basis and practical recommendations for subsequent nursing staff to carry out family management interventions for children with amblyopia, thereby reducing their emotional-behavioral problems.

The main protease (Mpro) of SARS-CoV-2 is a highly conserved and mutation-resistant coronaviral enzyme, which plays a pivotal role in viral replication, making it an ideal target for the development of novel broad-spectrum anti-coronaviral drugs. In this study, a codon-optimized Mpro gene was cloned into pET-21a and pET-28a expression vectors. The recombinant plasmids were transformed into E. coli Rosetta(DE3) competent cells and the expression conditions were optimized. The highly expressed recombinant proteins, Mpro and Mpro-28, were purified by HisTrapTM chelating column and its proteolytic activity was determined by a fluorescence resonance energy transfer (FRET) assay. The FRET assay showed that Mpro exhibits a desirable proteolytic activity (25 000 U/mg), with Km and kcat values of 11.68 μmol/L and 0.037/s, respectively. The specific activity of Mpro is 25 times that of Mpro-28, a fusion protein carrying a polyhistidine tag at the N and C termini, indicating additional residues at the N terminus of Mpro, but not at the C terminus, are detrimental to its proteolytic activity. The preparation of active SARS-CoV-2 Mpro through codon-optimization strategy might facilitate the development of the rapid screening assays for the discovery of broad-spectrum anti-coronaviral drugs targeting Mpro.
COVID-19 ; Codon/genetics* ; Cysteine Endopeptidases/genetics* ; Escherichia coli/genetics* ; Humans ; Peptide Hydrolases ; SARS-CoV-2 ; Viral Nonstructural Proteins/genetics*

Objective To validate the effect of anti-infective reconstituted bone xenograft (ARBX) in treating posttraumatic osteomyelitis by one-stage grafting in the adults.Methods With clinical application approval of Medical Command,Logistics Ministry of PLA,ARBX was used to treat 27 adult patients (29 lesions) with posttraumatic osteomyelitis by one-stage grafting after debridement since September 2001.The study analyzed 27 patients (29 grafts) who were followed up for average 26 months (12-63 months).Results The follow-up for average 26 months (12-63 months) in 27 patients showed that infection of 22 patients (24 lesions) was controlled and cured,except for three with failure to control the infection or with recurrence of infection,two with controlled infection but with postoperative nonunion.The infection control rate was 89.7% (26/29) and the cure rate was 82.8% (24/29) ,which were better than the results of traditional therapy.Conclusions ARBX has high osteoinductive activity and enhanced anti-infective capability,which enables it to be used as one-stage grafting to treat posttraumatic osteomyelitis in the adults.

Objective To observe pathological features of peripheral vessel injury caused by ex-plosion shock wave so as to provide theoretical basis for emergency treatment, prevention and complication reduction of war extremity injuries. Methods A total of 18 rabbits were randomly divided into three groups (six rabbits in each group) and placed respectively at 1, 2 and 3 m away from the explosion cen-ter. The animal model with blast injury was made by using fluid dynamite that electrically exploded at 60 cm above the ground. The physical parameters of blast wave were recorded using pressure transducers (PCB, UAS). After explosion, the femoral arteries were examined grossly, histologically and immunohis-tochemically. Results The results showed that vascular endothelial cells were denudated, the spaces of contractile fiber cells increased and appeared puff, the vassular elastic fibers ruptured, flexed and de-formed visibly. Some parts of the vessel wall ruptured completely or partly, leading to bleeding. TUNEL staining and fluorescence microscope found large number of apoptotic cells in endothelium layer, smooth muscle layer and membrana adventitia layer of the blood vessels. Conclusion Explosion shock wave can result in severe large blood vessel injury, which should be paid much attention during treatment of ex-plosion shock injury.

[Objective] To study the effect of anti-infective reconstituted bone xenograft(ARBX)on treating chronic hematogenous osteomyelitis as one-stage grafting.[Method]ARBX was used to treat 24 cases of chronic hematogenous osteomyelitis as one-stage grafting after debridement since September of 2001,17 cases of which were followed up for an average period of 34 months(range,12 to 79 months).[Result]Except 1 case failed to cure,and 1 resulted in recurrence of infection,and 1 with large segmental bone defect nonunion post-operatively,other 14 cases were cured,the cure rate was 82.4% which was better than traditional therapy.[Conclusion]ARBX has high osteoinductive activity and enhanced anti-infective capability,which enables it to be used as primary grafting to treat chronic hematogenous osteomyelitis.

BACKGROUND: Bone morphogenetic protein(BMP) is one of the most important cytokines that induce and promote seed cells to be transformed into osteocytes. Insoluble natural BMP can hardly affect the life of cultured seed cells. The expensive soluble recombinant BMP is also hard to work on the seed cells at the appropriate time and dose. Therefore, gene therapy technique provides us with a brand new idea of using gene-modified seed cells.OBJECTIVE: To transfect exogenous BMP-3 gene into the fibroblasts and screen the positive fibroblast clones that can express BMP-3 stably.DESIGN: Simple sample study.SETTING: Orthopaedic Research Institute, Xijing Hospital, Fourth Military Medical University of Chinese PLA.MATERIALS: The fibroblasts(NIH3T3) were kindly presented by Professor Situ Zhen-qiang of the Stomatological College of Fourth Military Medical University of Chinese PLA.METHODS: This experiment was conducted in the Key Laboratory of Chinese PLA, which belongs to the Orthopaedic Research Institute of Fourth Military Medical University. BMP-3 gene was transfected into the fibroblasts through lipofectamin. The transfected cells were screened by G418. The separated cloned cells were identified through immunohistochemistry. The positively stained cells were the clones of BMP-3 expressing fibroblasts.MAIT OUTCOME MEASURES: The screening concentration of NIH3T3 cells, screening of positive transfected cells, and expression of BMP-3 in screened cells.RESULTS: BMP-3 gene was successfully transfected into the fibroblasts. BMP-3 expressing fibroblast clones were creened and identified through immunohistochemistry. Fibroblast strains with stable BMP-3 expression were obtained.CONCLUSION: The transfection of BMP-3 gene eukaryonic expression vector into the fibroblasts and obtaining of fibroblast strains with BMP-3 expression have laid foundation for the usage of gene-modified seed cells in future research of bone tissue engineering.

OBJECTIVETo assess possible beneficial effect in prevention of osteomyelitis by anti-infective reconstituted bone xenograft (ARBX) in the rabbit.

METHODSA proximal tibia osteomyelitis rabbit model was used in which staphylococcus aureus was injected through a bony window, followed by immediate implantation of three ARBX pellets containing 30 mg of slowly-delivered gentamicin in group A, three pellets of RBX in conjunction with intramuscular gentamicin (30 mg) for 5 days in group B, three pellets of RBX without antibiotic in group C. Specimens were harvested 8 weeks postoperatively for gross observation, radiological, histological and bacteriological evaluation, comparing the three groups with regard to the beneficial effect of the above procedures in preventing osteomyelitis.

RESULTS(1) Bacteria counting, modified Norden scoring, and gross and microscopic evidence for osteomyelitis in group B were less than those in group C (P < 0.01). (2) In group A, bacteria culture and counting yielded 0 values at 8 weeks, while radiologically modified Norden scoring for osteomyelitis gave by far the smallest values among all three groups (P < 0.01) with no evidence of osteomyelitis found in gross and histological examinations.

CONCLUSIONS(1) Conventional systemic administration of antibiotics are reasonably effective in prevention of infection, but the anti-infective effect usually is not strong enough to prevent osteomyelitis when used along with primary bone grafting. (2) Apart from its osteoconductive and osteoinductive effects, ARBX is capable of slowly delivering antibiotics, thus being highly anti-infective when administered locally, so it could be used for primary grafting to repair a contaminated bone defect for effective prevention of osteomyelitis.

Animals ; Bone Transplantation ; methods ; Cattle ; Colony Count, Microbial ; Female ; Gentamicins ; administration & dosage ; Male ; Osteomyelitis ; prevention & control ; Postoperative Complications ; prevention & control ; Rabbits ; Staphylococcal Infections ; prevention & control ; Tibia ; surgery ; Transplantation, Heterologous