Objective To analyze the status of influenza A and B virus infection in patients admitted to Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine from 2022 to 2023,and to provide scientific basis for the adjustment of influenza prevention and control measures in this area.Methods The positive status of influenza A and B virus antigen and nucleic acid were analyzed to deter-mine the prevalence and dominant types of influenza in 2022-2023.The peak of influenza A virus infection in 2023 was analyzed by antigen detection and nucleic acid detection,and the positive rates of influenza A virus detection in patients with different genders and ages were compared.Results In 2022 and 2023,the majority of patients were infected with influenza A virus.There was no significant difference in the positive rate of in-fluenza A virus antigen and nucleic acid detection between male and female patients(P＞0.05).The positive rates of influenza A virus antigen and nucleic acid detection in patients of different ages were statistically sig-nificant(P＜0.05).Compared with other age range,the positive rate of influenza A virus antigen and nucleic acid detection was the highest in patients＞5-10 years old.From February to December 2023,the positive rate of influenza A virus nucleic acid detection(50.91％)was significantly higher than that of influenza A vi-rus antigen detection(28.73％),and the difference was statistically significant(P＜0.05).Conclusion There is no influenza virus infection peak in 2022,and there are two influenza A virus infection peaks in 2023.The positive rates of influenza A virus antigen and nucleic acid detection are different due to different detection methods.

Objective:To establish the gastrointestinal cognition behavior index(GCBI) scale and conduct a preliminary clinical study, to provide a scientific tool for assessing gastrointestinal related cognition and behavior among Chinese residents.Methods:The initial GCBI scale was formed through literature review and experts′ evaluation. From January 1 to December 31, 2022, 323 healthy participants who received medical treatment or check-ups at the First People′s Hospital of Changzhou were selected by convenient sampling method for the initial GCBI scale. A total of 307 valid scales of GCBI were collected, and 98 of them were selected by convenient sampling method for the gastrointestinal quality of life index (GIQLI) scale test. A total of 50 participants of 307 were selected by random number table method for retesting the initial GCBI scale after 2 weeks. The principal component analysis was used for factor extraction to established the formal GCBI scale. From March 1 to May 31, 2023, at the First People′s Hospital of Changzhou, 40 patients with functional gastrointestinal disorder(FGID, FGID group) and 40 healthy individuals (healthy control group) were selected by convenient sampling method for formal GCBI scale test. Pearson correlation analysis and Cronbach′s α coefficient were used to evaluate the criterion validity and reliability of the scale. Rank-sum test was used to compare the total GCBI scale scores and factor scores between the FGID group and the healthy control group. Results:The results of principal component analysis showed that 2 factors and 7 items were finally extracted to establish the formal GCBI scale. The cumulative contribution rate of factor 1 and factor 2 was 84.30%, and the factor load values ranged from 0.721 to 0.913. Pearson correlation analysis showed that the total score of GCBI scale and each factor were negatively correlated with the total score and each factor of GIQLI scale (all P<0.001).The Cronbach′s α coefficient of the total GCBI scale, factor 1, and factor 2 were 0.90, 0.87, and 0.91, respectively. The test-retest reliability correlation coefficient r were 0.98, 0.97, and 0.99 (all P<0.001). The total score of GCBI scale, factor 1 and factor 2 scores of FGID group were all higher than those of the healthy control group(10.00(7.25, 13.25) vs. 2.00(0.25, 3.00), 5.00(3.25, 8.00) vs. 0.50(0, 2.00), 5.00(3.00, 6.00) vs. 0.50(0, 2.00)), and the differences were statistically significant( Z=7.42, 6.82 and 7.04, all P<0.001). Conclusion:The GCBI scale established in this study has good reliability and validity, and is suitable for evaluating the gastrointestinal-related cognition and behavior, and it is helpful for the diagnosis of FGID.

Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.

Despite exciting achievements with some malignancies, immunotherapy for hypoimmunogenic cancers, especially glioblastoma (GBM), remains a formidable clinical challenge. Poor immunogenicity and deficient immune infiltrates are two major limitations to an effective cancer-specific immune response. Herein, we propose that an injectable signal-amplifying nanocomposite/hydrogel system consisting of granulocyte-macrophage colony-stimulating factor and imiquimod-loaded antigen-capturing nanoparticles can simultaneously amplify the chemotactic signal of antigen-presenting cells and the "danger" signal of GBM. We demonstrated the feasibility of this strategy in two scenarios of GBM. In the first scenario, we showed that this simultaneous amplification system, in conjunction with local chemotherapy, enhanced both the immunogenicity and immune infiltrates in a recurrent GBM model; thus, ultimately making a cold GBM hot and suppressing postoperative relapse. Encouraged by excellent efficacy, we further exploited this signal-amplifying system to improve the efficiency of vaccine lysate in the treatment of refractory multiple GBM, a disease with limited clinical treatment options. In general, this biomaterial-based immune signal amplification system represents a unique approach to restore GBM-specific immunity and may provide a beneficial preliminary treatment for other clinically refractory malignancies.

Objective:To investigate the correlation between the expression level of serum exosome miR-29C and postoperative cognitive dysfunction (POCD) in elderly patients undergoing surgery.Methods:A total of 119 elderly patients who underwent elective spinal surgery in the Second Hospital of Shanxi Medical University from January 2021 to January 2022 were selected and scored on the Montreal Cognitive Assessment (MoCA) Scale 1 day before surgery and 1, 7 and 21 days after surgery. The selected patients were divided into POCD group (51 cases) and non-POCD group (68 cases) according to whether the MoCA Scale score decreased ≥2 points 1 day before surgery and 1 day after surgery. S100-β, neuron-specific enolase (NSE) levels and serum exosome miR-29C expression levels were detected and analyzed in all patients 1 day before and 1 day after surgery. Pearson correlation analysis showed the correlation between MoCA Scale score and S100-β, NSE and miR-29C. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of S100-β, NSE and miR-29C for POCD occurrence in elderly patients undergoing surgery.Results:The score of MoCA Scale in POCD group were significantly decreased 1, 7 and 21 days after surgery compared with 1 day before surgery (all P<0.05), while the score of MoCA Scale in non-POCD group were significantly decreased only 1 day after surgery compared with 1 day before surgery ( P<0.05). The levels of S100-β and NSE and the expression level of serum exosome miR-29C in 2 groups were significantly increased 1 day after surgery compared with 1 day before surgery (all P<0.05). Moreover, the levels of S100-β and NSE and the expression level of serum exosome miR-29C in POCD group were significantly higher than those in non-POCD group 1 day after surgery (all P<0.05). There was a negative correlation between the MoCA Scale score and the expression level of serum exosome miR-29C 1 day after surgery in the POCD group ( P<0.05). ROC curve analysis showed that the expression levels of NSE, S100-β and exosome miR-29C 1 day after surgery predicted the risk of POCD in elderly surgical patients with area under the curve (AUC) of 0.891, 0.908 and 0.918, respectively. Conclusions:The occurrence of POCD in elderly patients with surgery is related to the increase of the expression level of serum exosome miR-29C, and the expression level of serum exosome miR-29C is negatively correlated with MoCA Scale score. Early monitoring of the miR-29C expression level can provide a basis for the occurrence and development of postoperative POCD in elderly patients, disease diagnosis and clinical intervention.

Objective:To investigate the effect of modified thoracic nerve block on postoperative analgesia and early recovery of breast cancer patients after modified radical mastectomy.Methods:Sixty female breast cancer patients who were scheduled to undergo modified radical mastectomy in the Second Hospital of Shanxi Medical University from March 2019 to December 2019 were selected, and the patients were all American Society of Anesthesiologists (ASA) grade Ⅰ-Ⅱ. According to the random number table method, the patients were divided into three groups: improved group [third rib approach serratus anterior plane block (SAPB)+pectoralis major muscle superficial anterior cutaneous branch of intercostal nerve block combined with general anesthesia, STG group], SAPB combined with general anesthesia group (SG group) and general anesthesia+postoperative intravenous controlled analgesia pump group (GP group), with 20 cases in each group. VAS scores at 30 min, 2 h, 4 h, 12 h and 24 h after surgery, 15-item quality of recovery scale (QoR-15) scores at 1 d before and 24 h after surgery, sleep duration on the night after surgery, intraoperative opioid dosage, the time between stop medication and awakening, postoperative flurbiprofen ester dosage, nausea, vomiting, dizziness, puncture site infection, pneumothorax, infection and other adverse reactions were recorded.Results:The VAS scores at 30 min, 2 h, 4 h, 12 h, 24 h in the STG group were lower than those in the SG group and GP group, the VAS scores at 2 h, 12 h and 24 h after surgery in the SG group were lower than those in the GP group, and the differences were statistically significant (all P < 0.05). The QoR-15 score at 24 h in the STG group was higher than that in the SG group and the GP group [(137.85±2.81) points vs. (134.80± 2.72) points, (133.80±5.16) points], and the differences were statistically significant (all P < 0.05). The sleep duration on the night after surgery in the STG group and the SG group was longer than that in the GP group [(6.03±0.90) h, (5.48±1.12) h vs. (3.85±1.76) h], and the differences were statistically significant (all P < 0.05). The intraoperative opioid dosage and the time between stop medication and awakening in the STG group and the SG group were lower than those in the GP group, and the differences were statistically significant (all P < 0.05). The postoperative flurbiprofen ester dosage and the incidence rates of nausea, vomiting and dizziness in the STG group were lower than those in the SG group and the GP group, and the SG group was lower than the GP group, and the differences were statistically significant (all P < 0.05). Conclusion:The modified thoracic nerve block can relieve early postoperative pain, reduce the amount of intraoperative opioids, and improve the quality of patients' early recovery without increasing adverse reactions.

Objective:To evaluate the effect of the tight-knit medical association model of precise assistance on nursing quality in assisted hospitals.Methods:The tight-knit medical association model of precise assistance was applied to the assisted hospital, the first stage assistance was provided from January 2015 to December 2016 and the second stage assistance was provided from January 2017 to December 2018. Before the assistance (December 2014) , after the assistance (December 2016) and the second year after the assistance (December 2018) , a total of 210 nurses and 210 patients were respectively selected to investigate the satisfaction with the convenient sampling method. The incidences of falls, in-hospital stress injuries and unplanned extubation in the assisted hospital before and after the assistance were compared.Results:In the second year after assistance, the satisfaction rate of nurses in the assisted hospital was 90.476% (190/210) , which was higher than 69.524% (146/210) before assistance and 78.571% (165/210) after assistance, and the differences were statistically significant ( P<0.01) . In the second year after the assistance, the satisfaction rate of patients in the assisted hospital was 93.810% (197/210) , which was higher than 72.381% (152/210) before the assistance and 82.857% (174/210) after the assistance, and the differences were statistically significant ( P<0.01) . After the assistance, the incidences of falls, in-hospital stress injuries and unplanned extubation of patients in the assisted hospital were lower than those before the assistance, and the differences were statistically significant ( P< 0.05) . Conclusions:The tight-knit medical alliance model of precise assistance can improve the satisfaction of nurses' and patients' satisfaction with nursing work in the assisted hospitals and reduce the incidences of falls, in-hospital stress injuries and unplanned extubation, which can improve nursing quality in assisted hospitals.

Objective To evaluate the effect and safety of extracorporeal shock wave therapy ( ESWT) for knee osteoarthritis ( KOA) and its effect on the articular cartilage. Methods Sixty-three persons with KOA were randomly divided into an ESWT group ( n=32) and a control group ( n=31) . Both groups received routine knee mus-cle strength training, but the ESWT group was also given ESWT ( a total of 2000 pulses at 8 Hz and 2.5 bar pressure) once a week for four consecutive weeks. The control group was given sham therapy at 0.2 bar with the rest of the pa-rameters the same as in the ESWT group. All of the subjects were assessed using a visual analogue scale ( VAS) , the Western Ontario and McMaster Universities Osteoarthritis Score ( WOMAC) , the Lequesne Index and knee cartilage T2 values before as well as one and 8 weeks after the intervention. Results The average VAS score, WOMAC in-dex, and Lequesne index of the ESWT group at 8 weeks after the treatment were significantly better than those before the intervention, and significantly better than the control group' s averages. The T2 values of the ESWT group at 8 weeks after the treatment were significantly better than before the intervention, though not significantly different from those of the control group at that point. No serious adverse reactions occurred in either group, and all of the minor ad-verse reactions had disappeared before the end of the assessment period. Conclusion ESWT can significantly im-prove the lower limb functioning of KOA patients, and its influence on knee cartilage is within the safe range.

Objective: To explore the application effect of "Disease-Characteristics Nursing Quality Improvement" Program (DNQIP) based on Kotter's change model in continuous improvement of patients' satisfaction and nursing quality. Methods: Applicate Kotter's Change Model to implement DNQIP among 61 wards. The differences of patients' satisfaction and nursing quality among 2012 were compared (DNQIP had not been carried out by the whole hospital), 2014 (DNQIP had been carried out by the whole 61 wards) and 2016 (the 5-year-strategy had been realized). Results: The 3-year-scores of patients' satisfaction were(95.94±1.53), (98.18±0.69), (99.43±0.18) points and they were statistically significant (F=31 768.863, P=0.000).The 3-year-scores of nursing quality were (93.96±0.56), (98.56±0.43), (99.62±0.23) points and they were statistically significant (F=3 004.598, P=0.000). The sores of 2014 were statistically improved compared with 2012 and the sores of 2016 were statistically improved compared with 2014 (P<0.01). Conclusions DNQIP based on Kotter's change model is an effective method to improve the patients′ satisfaction and nursing quality.

OBJECTIVE: To analyze variant of SGCA gene in a Chinese pedigree affected with limb-girdle muscular dystrophy type 2D with whole exome sequencing (WGS). METHODS: Multiplex ligation-dependent probe amplification (MLPA) was employed to detect large fragment deletion or duplication of the DMD gene. FastTarget next generation sequencing was used to detect variants of the DMD gene, and the result was verified by Sanger sequencing. After excluding the diagnosis of DMD for the proband, WGS was applied to test the proband and his parents. Suspected pathogenic variants were validated by Sanger sequencing. RESULTS: No variant, deletion or duplication of the DMD gene was detected. Whole exome sequencing showed that the proband has carried compound heterozygous missense variants c.409G>A (p.Glu137Lys) and c.409G>C (p.Glu137Gln) in exon 5 of the SGCA gene, which were respectively inherited from his mother and father. Neither variant was found in DNA derived from the cord blood sample. CONCLUSION The c.409G>A (p.Glu137Lys) and c.409G>C (p.Glu137Gln) compound heterozygous missense variants probably underlie the disease in the proband. Above finding has facilitated genetic counseling and prenatal diagnosis for the family.
Exons ; Female ; Humans ; Muscular Dystrophies, Limb-Girdle ; Pedigree ; Pregnancy