Objective To develop a desorption method for aluminum-adjuvanted recombinant protein vaccines and apply the method to the pre-treatment process for adsorption rate determination of respiratory syncytial virus(RSV) recombinant vaccine intermediates, involving antigen content quantification.MethodsTwo aluminum adjuvants, aluminum hydroxide(AH) and amorphous aluminum hydroxyphosphate sulfate(AAHS), were combined respectively with RSV preF protein to develop a desorption agent formulation(a mixture of 0. 2 mol/L potassium dihydrogen phosphate and 0. 8 mol/L dipotassium hydrogen phosphate). The effects of different treatment methods on desorption efficiency were investigated. The optimal desorption method was validated for its effectiveness in releasing RSV preF recombinant protein from antigen-adjuvant complexes with different formulations and different protein concentrations. Its applicability was also extended to antigenadjuvant complexes of different proteins.ResultsA desorption method was determined: antigen-adjuvant complex + 1%BSA/PBST + high-concentration phosphate(mixed solution of 0. 2 mol/L potassium dihydrogen phosphate and 0. 8 mol/L dipotassium hydrogen phosphate) mixed at a volume ratio of 1∶1∶2, followed by incubation at room temperature for 0. 5 h.This method combined the interfering effects of high-concentration phosphate ions, bovine serum albumin(BSA), and the nonionic surfactant polysorbate 20 on antigen-adjuvant binding, and achieved complete desorption for four RSV preF antigenadjuvant complexes and antigen-AH adjuvant complexes with three different protein concentrations(60-240 μg/mL). The antigen recovery rates detected by ELISA were all within the range of(100 ± 10)%. Compared to the non-optimized common phosphate desorbent, this method significantly improved the post-desorption antigen recovery rate, verifying its high efficiency and stability. It also demonstrated the important synergistic role of BSA and polysorbate 20 in assisting phosphate during the desorption process. This method was also successfully applied to complexes of another RSV preF recombinant protein(DS-CAV1) and human metapneumovirus(HMPV) preF recombinant protein with AH adjuvant, achieving antigen recovery rates above 90%, proving its certain universality and suggesting its potential application in combined respiratory virus vaccines.ConclusionThe established desorption method achieves highly efficient and stable desorption for recombinant RSV preF antigen-adjuvant complexes with different aluminum adjuvants, different buffer systems, and different protein concentrations. It is also applicable to other RSV preF variants and HMPV preF protein, effectively solving the interference problem of aluminum adjuvants in antigen content detection. This provides technical support for the quality control and production process optimization of recombinant RSV vaccines, and also serves as reference for the development of combined respiratory vaccines and other aluminum-adjuvanted vaccines.

[Objective]To explore if the enhanced recovery after surgery (ERAS) protocol for pregnant women with gestational diabetes mellitus (GDM) who are undergoing elective cesarean delivery could cause perioperative glycemic abnormalities and heighten the risk of neonatal hypoglycemia.[Methods]A retrospective analysis was conducted on a cohort of pregnant women with singleton pregnancies who underwent elective cesarean sections and received ERAS between May 1,2022,and October 31,2023,at the Third Affiliated Hospital of Sun Yat-sen University. A total of 150 patients were included in this study,comprising the GDM group (n=75) and the non-GDM group (n=75). The study included pregnant women with good glycemic control (GDM) and maternal age (18-30 years;30-35 years;35-40 years;>40 years),BMI (<18.5 kg/m2;18.5-24.9 kg/m2;25-30 kg/m2;>30 kg/m2),and gestational age (within 7 days). We used these criteria to match 1∶1 non-GDM women as the control group. After administering preoperative oral carbohydrates,we observed the trends of maternal glycemic changes,including hyperglycemia and hypoglycemia,at any time of the day. We also evaluated the incidence of hypoglycemic low Apgar scores in newborns,abnormal pH values in blood gases,and the rate of transfer to the pediatric unit immediately after delivery.[Results]No significant difference was observed in fasting blood glucose levels on the day of surgery between the two groups of pregnant women[(4.4±0.5) mmol/L vs. (4.3±0.5) mmol/L,t=1.395,P=0.165]. The blood glucose peak was reached 30 minutes after consuming 300 mL (42.6 g of low-dose carbohydrate) of a light drink[(7.2±0.9) mmol/L vs. (6.4±0.8) mmol/L,t=5.773,P<0.001],with a subsequent decline in blood glucose levels. At the 120-minute mark,blood glucose had returned to the pre-oral carbohydrate level. The blood glucose levels in GDM groups was significantly higher than those in the non-GDM group (P<0.005). Although the incidence of hyperglycemia was significantly higher in the GDM group than in the non-GDM group at the 30-minute peak blood glucose level after oral carbohydrate intake,and the difference was statistically significant (17.3％ vs. 1.3％,x2=11.354,P<0.001),severe hyperglycemia (≥10 mmol/L) did not occur. The incidence of hypoglycemia was not significantly higher in neonates in the GDM group than in the non-GDM group (22.7％ vs. 28％,x2=0.564,P=0.453). The incidence of neonatal hypoglycemia in the GDM group was not significantly elevated in comparison to the non-GDM group after adjusting for age and BMI (Model 1),primiparity and gestational week of delivery (Model 2),hypertensive disorders of pregnancy (Model 3),cesarean section indications,time of cesarean section,and intraoperative hemorrhage (Model 4),and neonatal weight (Model 5).[Conclusion]In GDM patients with excellent glycemic control,an ERAS regimen with a low oral dose of carbohydrates prior to elective cesarean section does not increase the risk of preoperative serious hyperglycemia in mothers,nor does it increase the incidence of neonatal hypoglycemia.

Confronted with the Coronavirus disease 2019 (COVID-19) pandemic, China has become an asset in tackling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and mutation, with several innovative platforms, which provides various technical means in this persisting combat. Derived from collaborated researches, vaccines based on the spike protein of SARS-CoV-2 or inactivated whole virus are a cornerstone of the public health response to COVID-19. Herein, we outline representative vaccines in multiple routes, while the merits and plights of the existing vaccine strategies are also summarized. Likewise, new technologies may provide more potent or broader immunity and will contribute to fight against hypermutated SARS-CoV-2 variants. All in all, with the ultimate aim of delivering robust and durable protection that is resilient to emerging infectious disease, alongside the traditional routes, the discovery of innovative approach to developing effective vaccines based on virus properties remains our top priority.
Humans ; COVID-19 Vaccines ; COVID-19/prevention & control* ; SARS-CoV-2 ; China/epidemiology* ; Vaccine Development

Objective To analyse the differential metabolites and related metabolic pathways in stable angina pectoris of coronary artery heart disease with spleen deficiency and phlegm turbidity syndrome by serum metabolomics.Methods This study observed 60 patients with stable angina pectoris of coronary artery heart disease with spleen deficiency and phlegm turbidity syndrome and 60 healthy volunteers in the same period.Liquid chromatography-mass spectrometry(LC-MS)was performed on the serum metabonomics.The differential metabolites were identified by multivariate statistical analysis of the original spectrogram and original data,and enrichment analysis of KEGG metabolic pathway was analyzed.Results A total of 60 patients in the group of stable angina pectoris of coronary artery heart disease with spleen deficiency and phlegm turbidity syndrome participated in the study,and a total of 60 healthy volunteers in the control group participated in the study.There was no statistical difference in general information and biochemical indicators between the two groups(P>0.05);Eighteen differential metabolites were found respectively,including phenylacetaldehyde,orthophosphate,guanosine,diethyl phosphate,2-dehydro-d-gluconate,guanine and 5-(2-hydroxyethyl)-4-methylthiazole down-regulated expression,taurocholate,2-propylglutaric acid,8-amino-7-oxononanoate,l-tyrosine,s-sulfo-l-cysteine,cyclohexanecarboxylic acid,porphobilinogen,(r)-acetoin,octanoylglucuronide,melatonin and solanine up-regulated expression,involving phenylalanine metabolism,thiamine metabolism,purine metabolism.Conclusion The differential metabolites reveal the metabolic essence of stable angina pectoris of coronary artery heart disease with spleen deficiency and phlegm turbidity syndrome from the micro level,and can provide clues for clinical early warning of patients with stable angina pectoris of coronary artery heart disease with spleen deficiency and phlegm turbidity syndromet.

Objective To investigate the modification effect of atmospheric temperature on outpatient visits caused by O₃ in Linzhi City. Methods The daily outpatient data, the daily O₃ concentration and daily meteorological data (including daily average temperature, average relative humidity, etc.) in Linzhi City from 2018 to 2019 were collected. The distributed lag non-liner-model (DLNM) was used to quantitatively evaluate the impact of O₃ in different temperature layers on the risk of outpatient visits. Results At low temperature layers, the cumulative relative risk (CRR) of total outpatient visits and non-injury outpatient visits increased by 53.8%（4.2% -126.9%) and 59.1%（5.8% -139.2%）for every 10 μg/m³ increase of O₃ concentration, respectively. The subgroup analysis showed that for every 10 μg/m³ increase of O₃ concentration at low temperature, the CRR of patients with circulatory diseases, men, women, and people being <14 years old and 14-65 years old increased by 152.1% (15.1% - 451.9%), 58.3% (2.1%-145.5%), 49.2% (3.0% -116.1%), 39.6% (2.5% - 90.3%), and 61% (0.8%-157.1%), respectively. Conclusion The average temperature may have a modifying effect on the outpatient visits caused by O₃ in Linzhi City. In general, the cumulative risk increases as the temperature decreases.

Objective To investigate the efficacy of perioperative management in elderly hemorrhoids patients undergoing procedure for prolapse and hemorrhoids(PPH).Methods A total of 128 elderly patients treated with PPH in the Second Affiliated Hospital of Jiaxing University from February 2018 to January 2019 were enrolled and randomly divided into the routine group(n=64)and the intervention group(n=64).The routine group underwent routine postoperative management,and the intervention group received intervention postoperative management as add-on to routine postoperative management.Clinical efficacy was compared between the two groups.Results The frequency of constipation and hematoehezia was less and the hospitalization days were shorter in the intervention group than in the routine group(0.8 ± 0.6 times/d vs.1.2 ± 0.4 times/d,1.3 ± 0.8 times/d vs.2.0± 1.0 times/d,4.9± 1.1 days vs.7.4± 1.3 days,t =4.438,4.372 and 11.744 respectively,all P =0.000).The scores of visual analog scale(VAS) and geriatric depression scale (GDS) had no significant difference between the intervention and routine groups (5.0 ± 1.6 scores vs.5.2 ± 1.3 scores for VAS;22.2± 2.9 scores vs.22.5 ± 2.6 scores for GDS,t =0.776 and 0.616,P =0.220 and 0.269)before intervention,and had significant difference between the intervention and routine groups[2.7 ± 0.7 scores vs.3.2 ± 1.1 scores for VAS;17.2 ± 1.8 scores vs.19.0 ± 2.2 scores for GDS(t =3.068 and 5.066,P=0.001 and 0.000)]after intervention.The scores of quality of life,including physiological function,emotional function,social function,mental health and health status,were higher in the intervention group than in the routine group (all P ＜ 0.05).Conclusions Intervention perioperative management is effective in elderly hemorrhoids patients undergoing procedure for prolapse and hemorrhoids,It can not only effectively improve clinical symptoms and shorten treatment time,but also alleviate pain and improve prognosis and quality of life.

Objective To evaluate the feasibilty of modified osteogenic culturing of goat adipose derived stromal cells(ADSCs).Methods From March,2013 to September,2014,platelet-rich plasma(PRP) was made from goat autogenous vein blood,and abodimoneal fat was aspirated,following aspetic procedure,primary and series passage of ADSCs was established.Osteoinduced ADSCs was carried out according to following group:combinative osteoinduction group(PRP+rhBMP-2 +ADSCs),growth factor group(rhBMP-2+ADSCs),conventional inductive group(dexamathasone+ascorbic acid + ADSCs) and noninductive group(blank group).Converted microscope was used to observe cellular pattern,cell activity,osteocalcin and collagen type Ⅰ level were detected at 1,3,5,7,9,13,17,21 days.Red Alazarin and Von Kossa staining were also assayed at different interval.Results Under observation of converted microscopy,remarkable cell proliferation with abundant ECM was noticed in combinative osteoinduction group,compared with other groups,level of cell activity,osteocalcin,collagen type Ⅰ [(0.82 ± 2.19)AU,(79.82 ± 1.36)U/L at,(78.51 ± 4.32)μ g/ml at]were significantly higher than other groups (P ＜0.05),and remarkable ALP expression and calcifed nodules were also seen.Conclusion PRP can enhance the inductive effect of rhBMP-2,and combinative osteoinduction procedure acts as a satisfactory culturing method.

Objective To explore the main sources of work stress of new nurses in children′s hospital, to analyze the causes, and to provide reference for managers to find out reasonable ways of reducing work stress in new nurses. Methods Phenomenological method was used to explore stress experience of new nurses. A total of 10 new nurses were interviewed by semi-structured talk. Topics were refined by reading, analyzing, reflecting, classifying and refining the interview data. Results Four main stress topics of new nurses included professional knowledge and skills, nature of work, performance evaluation and interpersonal relationship. Conclusions New nurses have great stress at work. Managers should find reasonable ways to relieve their stress, provide help for them, make them adapt to the new environment and work as soon as possible, enhance the sense of ownership and provide better service for patients.