To investigate the effects of ORF9 gene of porcine circovirus type 2(PCV2)on PK-15,eu-karyotic expression plasmid was constructed and transfected into PK-15 cells,and the effects of overexpression of ORF9 on proliferation,apoptosis and immunization of PK-15 cells were exam-ined by flow cytometry and qRT-PCR.The results showed that ORF9 gene overexpression signifi-cantly up-regulated the expression levels of the ER stress marker gene GRP78,increased the num-ber of S phase cells,accelerated cell cycle progression,increased the apoptosis rate of PK-15 cells,up-regulated the expression levels of apoptosis-related genes caspase-3,caspase-8,caspase-9,p53 and Bax(P＜0.01),down-regulated the expression levels of apoptosis-related genes Bcl-2,up-reg-ulated the expression levels of immune-related genes 1L-8,IL-10,NF-κB and TNF-α(P＜0.01),and down-regulated the expression levels of immune-related genes IL-2,IFN-β and IL-12(P＜0.01).The above results indicate that ORF9 gene may promote the proliferation and apoptosis of PK-15 cells and play a role in the escape process of PK-15 cells.

Objective:To explore the influencing factors and effectiveness of community follow-up in patients with cardiac implantable electronic device (CIED) implantation.Method:A total of 132 patients who received CIED implantation in the Department of Cardiology of Tongren Hospital, Shanghai Jiao Tong University School of Medicine from February 2021 to February 2022 were enrolled in this prospective cohort study. Among them 33 patients were followed up in community health service centers associated with Tongren Hospital (community follow-up group) and 99 matched patients were followed up in the CIED outpatient clinic of the hospital (outpatient follow-up group) with a ratio of 1∶3. The clinical data of the selected patients were collected through a questionnaire survey; the follow-up data were extracted through the CarelinkExpress electronic follow-up platform and the CIED outpatient information system of Tongren Hospital. Adjustment of the treatment protocol or CIED parameters at follow-up, and the referral from the community health service centers were defined as visit with-an-action (VWA). The endpoint of follow-up was the occurrence of major adverse events. The multivariate logistic regression model was used to analyze the factors influencing patient selection for community follow-up.Results:The univariate analysis showed that the frequency of visits to community health service centers and the service contracting rate in community follow-up group were higher than those of outpatient follow-up group ( P<0.05). The multivariate logistic regression analysis showed that the contracted community physician service was an independent influencing factor of patient choosing community follow-up ( OR=2.143, 95% CI: 1.103-4.166, P=0.025). A total of 469 visits of followed up occurred in 132 patients, including 45 community visits and 424 outpatient visits. VWA accounted for 22.2% (10/45) in the community follow-up group, and 17.2% (73/424) in the outpatient follow-up group ( P>0.05). There was no significant difference in the safety and effectiveness indicators (VWA, major adverse events, and unplanned follow-up) between the two groups ( P>0.05). More patients in the community follow-up group walked to the hospital than the outpatient follow-up group ( P<0.05);and the main transportation for the later was by bus or taxi(42(42.4%)or 41(41.4%)). The average waiting time in the community follow-up group was significantly shorter than that in outpatient follow-up group ( P<0.05). The total time required for a single follow-up in the community follow-up group was 50.0 (45.0, 59.5) minutes, which was significantly shorter than that in the routine outpatient follow-up group (107.0 (90.0, 135.0) minutes, P<0.05). Conclusions:The contracting with community physicians is an independent influencing factor for CIED implanted patients to choose community follow-up. The safety and effectiveness of community follow-up are comparable to routine outpatient follow-up, and community follow-up is more convenient.

Objective To investigate the levels of serum N-acetyl-β-D-glucosidase (NAG),neutrophil gelatin-related lipid transporter protein (NGAL) and urinary kidney injury molecule-1 (KIM-1)in children with sepsis and their correlation with the condition.Methods Fifty-eight children with sepsis were selected as the observation group from January 2018 to May 2019 in Guangzhou Red Cross HoSpital,and sequential organ failure assessment (SOFA) score was conducted.According to the score results,all the patients were divided into three groups:mild,moderate and severe group.Meanwhile,58 healthy children were selected as the control group,and the serum NAG,NGAL levels and urinary KIM-1 level in the two groups were detected respectively,and the differences in various indicators among the mild,moderate and severe groups were compared.Pearson correlation analysis was used to explore the correlation between serum NAG,NGAL levels and urinary KIM-1 level and SOFA scores respectively.Results The levels of serum NAG,NGAL and urinary KIM-1 in the observation group were all significantly higher than the control group:(30.53 ± 7.18) U/L vs.(12.36 ± 3.46) U/L,(78.72 ± 12.97)μg/L vs.(30.62 ± 3.24) μg/L,(60.59 ± 10.73) ng/L vs.(22.54 ± 4.25) ng/L,and there were statistical differences (P＜0.05).Serum NAG,NGAL levels and urinary KIM-1 level in the moderate group and the severe group were all higher than the mild group:(31.81 ± 1.41) and (34.24 ± 1.70) U/L vs.(28.11 ± 2.36)U/L,(85.94 ± 5.45) and (94.17 ± 3.91) μg/L vs.(67.45 ± 7.58) μg/L,(67.03 ± 4.63) and (72.17 ± 3.98) ng/Lvs.(51.49 ± 7.08) ng/L,while the levels of serum NAG,NGAL and urinary KIM-1 in the severe group were all higher than those in the moderate group (P＜0.05).Pearson correlation analysis showed that the levels of serum NAG,NGAL and urinary KIM-1 levels in sepsis children were positively correlated with SOFA score (r =0.836,0.935,0.892;P＜0.01).Conclusions The levels of serum NAG,NGAL and urinary KIM-1 in children with sepsis increased significantly,and were related to the severity of the disease,which provides some reference value for the judgment of the sepsis condition.

OBJECTIVE：To compare the efficacy and safety of vancomycin given by continuous infusion vs. intermittent infusion，and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from PubMed ，the Cochrane Library，Embase，Wanfang database ，CNKI and VIP databases ，ranomized controlled trials （RCT）and cohort studies about vancomycin given by continuous infusion （trial group ）vs. intermittent infusion （control group ）were collected during the inception to Apr. 2020. After literature screening and data extraction ，the qualities of RCTs were evaluated by using bias risk evaluation tool recommended by Cochrane system evaluator manual 6.0. The qualities of cohort studies were evaluated by NOS ；Rev Man 5.3 software was used to perform Meta-analysis and publication bias analysis. RESULTS ：A total of 20 studies were included （3 RCTs and 17 cohort studies ），involving 2 380 patients in total. Results of Meta-analysis showed that ，target concentration attainment rate [RR ＝1.24，95％CI（1.12，1.38），P＜0.000 1] and attainment rate of target clinical efficacy [RR ＝1.20，95％CI（1.04，1.38）， P＝0.01] of trial group was significantly higher than those of control group. The incidence of nephrotoxicity [RR ＝0.56，95％CI （0.45，0.70），P＜0.000 01] was significantly lower than control group. There was no statistical significance in the therapeutic efficiency [RR ＝1.02，95％CI（0.95，1.10），P＝0.53]，drug treatment duration [MD ＝－0.50，95％CI（－1.40，0.39），P＝0.27] or mortality [RR ＝1.03，95％CI（0.78，1.35），P＝0.83] between 2 groups. The results of publication bias showed that the probability of publication bias was high when the incidence of nephrotoxicity was used as the index. CONCLUSIONS ：Vancomycin continuous infusion can improve the attainment rate of target concentration and target clinical efficacy ，reduce the incidence of nephrotoxicity ， but can not improve the treatment efficiency. Due to the inconsistent results of publication bias analysis ，the above conclusion needs to be interpreted carefully.

Objective:To explore the effects of structured health education combined with 5A nursing model in patients with diabetic osteoporosis (DOP) .Methods:Totally 204 DOP patients admitted into the First Affiliated Hospital of Zhengzhou University from January 2017 to January 2019 were selected by convenient sampling and divided into the observation group and the control group, with 102 patients in each group. Patients in the control group received routine health education, while patients in the observation group received structured health education combined with 5A nursing model. The Diabetes Test (DKT) , Osteoporosis Knowledge Test (OKT) , Summary of Diabetes Self-Care Activities Measure (SDSCA) and Osteoporosis Self-Efficacy Scale (OSES) were used to evaluate the effects of intervention between the two groups. The levels of blood glucose and bone metabolism indexes before and after intervention and the incidence of complications within 6 months after discharge were compared between the two groups.Results:One month after the intervention, the DKT (19.84±3.52) and OKT (20.18±4.40) scores of the observation group were higher than those of the control group ( t=9.271, 5.987) ; 3 months after the intervention, the scores of diet (5.74±0.49) , exercise (4.18±0.85) , blood glucose monitoring (3.62±0.75) , foot care (5.18±1.14) , and drug management (6.13±0.48) in SDSCA of the observation group were higher than those of the control group ( t=7.540, 7.572, 6.584, 5.193, 6.404) ; the scores of exercise efficacy (41.76±3.15) and calcium efficacy (45.61±4.33) in OSES of the observation group were higher than those of the control group ( t=10.881, 7.011) , and the differences were statistically significant ( P<0.01) . After the intervention, the fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin levels of the observation group were lower than those of the control group, and the levels of bone alkaline phosphatase and osteocalcin were higher than those of the control group, and the differences were statistically significant ( P<0.01) . During the 6-month follow-up, there was no statistically significant difference in the incidence of complications between the observation group and the control group ( P>0.05) . Conclusions:Structured health education combined with 5A nursing for DOP patients can improve their disease awareness, enhance their disease self-management ability and self-efficacy, and have positive significance in improving the blood glucose and bone metabolism indicators.

The United Kingdom is highly experienced in the career development and deployment of health care assistants ( HCA) to cope with shortage of nurses. This paper introduced the HCA entry requirements and career development in UK. The entry requirements include quality requirements, basic training and education requirements, practice certificate training and effect evaluation. Career development includes job promotion and transfer to clinical nurses. In view of the current situation of nursing assistant position in China, this paper made valuable recommendations.

OBJECTIVE:To provide reference for rational use of TCM injection. METHODS:Each 660 medical records were selected from 9 hospitals of Luzhou city before(Jan.-Mar. in 2015)and after(Jan.-Mar. in 2017)administrative intervention and pharmaceutical intervention(called"intervention"for short)according to random number tablet. The consumption sum,DDDs and B/A,utilization,per capita,cost of drug and TCM injection,rational and irrational use were compared before and after intervention. RESULTS:After intervention,total consumption sum and DDDs of 10 TCM injections were decreased in 7 hospitals compared to before intervention,but those of 2 hospitals were increased slightly. Before and after intervention,consumption sum of Xueshuangtong for injection took up the first place among 10 kinds of TCM injection. Top 5 injections in the list of DDDs were the same generally,i.e. Xuesaitong for injection,Xueshuangtong for injection,Shenmai injection,Salviae miltiorrhizae and ligustrazine hydrochloride injection and Safflower yellow for injection.10 kinds of TCM injections with B/A>1 included Xuesaitong for injection, Salviae miltiorrhizae and ligustrazine hydrochloride injection,Safflower yellow for injection and Gastrodin injection. After intervention,utilization rate of 10 TCM injections(24.70%)was significantly lower than before intervention(32.42%),rational rate of TCM injection(61.35%)was significantly higher than before intervention(41.59%),with statistical significance(P<0.01). After intervention,the per capita cost of TCM injection,the incidence of function inconsistency,excessive dose,irrational solvent selection,insufficient solvent amount and non-individual injection were significantly lower than before intervention,with statistical significance(P<0.05). There was no statistical significance in per capita cost of drug,the irrational utilization rate of repeated medication or excessive long treatment course before and after intervention(P>0.05). CONCLUSIONS:The administrative intervention combined with pharmaceutical intervention promote more safe,rational and economical use of TCM injection.

Objective To predict and verify the upstream regulatory microRNA (miRNA)of protein kinase D1 (PKD1),and to investigate its role in cerulein induced acute pancreatitis (AP)in rats. Methods Potential up-stream regulatory miRNA of PKD1 was predicted by using bioinformatics software. Dual luciferase reporter gene system and Western blot were applied to verify the regulation of PKD1 by the selected miRNA. Experimental AP was induced by 6 intraperitoneal injection of cerulein (20 μg/ kg)at hourly intervals after administration of the CY5 - labeled notar-get control (AP group,n = 20)or selected miRNA (treatment group,n = 20),respectively by intraperitoneal injection into rats. Other rats were divided randomly into a normal control group (n = 10)without any treatment. Besides 10 rats in either AP or treatment group were sacrificed 6 hours after the first injection of cerulein,and the rats were all sacri-ficed 24 hours after the first injection. The blood samples and pancreatic tissues of each rat were collected to test serum amylase and lipase activities,or to make hematoxylin - eosin stain for AP pathological scores as well as PKD1 immuno-histochemical staining,respectively. Results TargetScan 7. 1 software analysis showed that miR - 128 - 3p was the po-tential upstream regulatory miRNA of PKD1,which was verified by dual luciferase reporter gene system and Western blot detection. Compared to the normal control group,serum amylase and lipase activities after 6 h exposure to cerulein increased in both AP group and the treatment group[13313. 00(9424. 00 - 15995. 00)U/ L,13552. 00(10399. 50 -18408. 25)U/ L vs. 1430. 50(1214. 25 - 1543. 25)U/ L;547. 00 (515. 00 - 627. 00)U/ L,857. 50(522. 00 -1222. 25)U/ L vs. 34. 00(32. 50 - 34. 75)U/ L],and the differences were significant(χ2 = 8. 715,P < 0. 05;χ2 =9. 115,P < 0. 05),which indicated that the rat models of AP were successfully established. The immunohistochemical scores of PKD1 after 24 h exposure to cerulein decreased in the treatment group[0. 50(0 - 2. 75)scores],compared with the normal control group [4. 00(4. 00 - 8. 00)scores]and the AP group [4. 00(3. 75 - 8. 00)scores],and difference was significant(χ2 = 18. 302,P < 0. 05). Accordingly,the total pathological scores of HE staining decreased significantly in the treatment group,as compared to the AP group (3. 80 ± 0. 85 vs. 6. 90 ± 1. 15,t = 4. 481,P < 0. 01). The results showed that the inflammatory cell infiltration and tissue necrosis were significantly improved after miR -128 - 3p treatment. Conclusions miR - 128 - 3p is the upstream regulatory microRNA of PKD1 which protects pan-creata from necrotic injury and inflammatory cell infiltration in PKD1 - mediated acute pancreatitis.

Objective To explore the expressions and significance of brain natriuretic peptide (BNP),hypersensitive C-reactive protein (hs-CRP),human fibrinogen (Fib),D-Dimer and blood gas analysis in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and pulmonary hypertension (PH).Methods Totally 135 patients with AECOPD were divided into single AECOPD group (n =75) and AECOPD + PH group (n =60).The value of pulmonary systolic pressure (PASP) was measured by echocardiography.Serum BNP,hs-CRP,D-Dimer,Fib levels and arterial blood gas analysis indexes such as p(CO2) and p(O2) were compared between two groups.Results The levels of hs-CRP,BNP,D-Dimer and p(CO2) in AECOPD + PH group were significantly higher than those in AECOPD group (P ＜ 0.05),while p (O2) in AECOPD + PH group was significantly lower than that in AECOPD group.Multiple linear regression analysis showed that the levels of hs-CRP,Fib,BNP,D-Dimer and p (CO2) were positively correlated with pulmonary artery pressure (P ＜ O.05),and p (02) was negatively correlated with PASP (P ＜ 0.05).Conclusion The hs-CRP,Fib,BNP,and D-Dimer participate in the formation of AECOPD complicated with pulmonary hypertension,and systemic inflammation plays an important role in the pathogenesis of AECOPD complicated with pulmonary hypertension.

Objective To explore the expressions and significance of brain natriuretic peptide (BNP),hypersensitive C-reactive protein (hs-CRP),human fibrinogen (Fib),D-Dimer and blood gas analysis in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and pulmonary hypertension (PH).Methods Totally 135 patients with AECOPD were divided into single AECOPD group (n =75) and AECOPD + PH group (n =60).The value of pulmonary systolic pressure (PASP) was measured by echocardiography.Serum BNP,hs-CRP,D-Dimer,Fib levels and arterial blood gas analysis indexes such as p(CO2) and p(O2) were compared between two groups.Results The levels of hs-CRP,BNP,D-Dimer and p(CO2) in AECOPD + PH group were significantly higher than those in AECOPD group (P ＜ 0.05),while p (O2) in AECOPD + PH group was significantly lower than that in AECOPD group.Multiple linear regression analysis showed that the levels of hs-CRP,Fib,BNP,D-Dimer and p (CO2) were positively correlated with pulmonary artery pressure (P ＜ O.05),and p (02) was negatively correlated with PASP (P ＜ 0.05).Conclusion The hs-CRP,Fib,BNP,and D-Dimer participate in the formation of AECOPD complicated with pulmonary hypertension,and systemic inflammation plays an important role in the pathogenesis of AECOPD complicated with pulmonary hypertension.