After continuous development and improvement, lung transplantation has become the preferred means to treat a variety of benign end-stage lung diseases. However, the field of lung transplantation still faces many challenges, including shortage of donor resources, preservation and maintenance of donor lungs, and postoperative complications. Lung tissue samples removed after lung transplantation are excellent clinical resources for the study of benign end-stage lung disease and perioperative complications of lung transplantation. However, at present, the collection, storage and utilization of tissue samples after lung transplantation are limited to a single study, and unified technical specifications have not been formed. Based on the construction plan of the biobank for lung transplantation in the First Affiliated Hospital of Xi'an Jiaotong University, this study reviewed the practical experience in the collection, storage and utilization of lung transplant tissue samples in the aspects of ethical review, staffing, collection process, storage method, quality control and efficient utilization, in order to provide references for lung transplant related research.

To explore the application of humanistic care in children's fever clinics,the children's fever clinics of Guangzhou Women and Children's Medical Center conducted relevant research using narrative medicine as a guiding concept.This paper elaborated on the medical humanistic dilemmas and narrative care needs in children's fever clinics,and focused on exploring the practice paths of narrative medicine in pediatric with Chinese characteristics from five dimensions,including the cultivation of nursing staff's abilities of professional narrative and humanistic care,the establishment of health lectures featuring narrative patient education,the alleviation of medical anxiety for children and their families,related support of narrative nursing,and caring services.The aim was to improve the narrative care ability of nurses in children's fever clinics,develop methods for pediatric patients that can eliminate the fear of seeking medical treatment,and protect children's physical and mental health.A carrier of care,support,and emotional expression can be provided for parents.The foundation for nursing staff to achieve professional growth through narrative reflection can be laid.Thus,it can assist in establishing a life narrative community relationship between doctors and patients,and jointly explore the meaning of life.

Continuous arterial blood pressure monitoring by radial artery catheterization is an indispensable monitoring technique for children in the perioperative period and critical care, and the factors that affect the success of catheterization have always been the focus of clinical researches. This study reviewed the research progress on the factors related to the success of radial artery catheterization in children from the perspectives of operator's factors, patient's factors, and operation equipment and materials.

Objective:To evaluate the value of serum pepsinogen Ⅰ and Ⅱ combined with gastrin-17 in screening precancerous lesions of gastric cancer in physical examination population.Methods:Serum pepsinogen, gastrin-17 and Helicobacter pylori (Hp) antibody were detected in 18 354 physical examination people from July to December 2017 in Wenrong Hospital, Hengdian, Dongyang. The patients were divided into youth group (18 to 39 years old), middle-aged group (40 to 59 years old) and elderly group (≥60 years old) according to their ages. The correlation between the serological level of the above indexes and age was analyzed; according to the new ABC method, the test results were divided into groups A, B, C and D. The patients in group C and D were examined by gastroscopy. The differences of gastric mucosal atrophy or intestinal metaplasia and other precancerous lesions detected by gastroscopy in different age groups were compared.Results:Finally, 18 354 cases were enrolled, including 9 614 males and 8 740 females. With the increase of age, the proportion of group C and D increased gradually. In group C, 181 cases underwent gastroscopy, including 39 cases of atrophic gastritis, 29 cases of intestinal metaplasia and 3 cases of dysplasia/intraepithelial neoplasia, the detection rate of precancerous lesions was 39.23%; in group D, 94 cases underwent gastroscopy, including 22 cases of atrophic gastritis and 13 cases of intestinal metaplasia, the detection rate of precancerous lesions was 37.23%. The proportion of gastric precancerous lesions in group C and D was 29.63% in the young group, 69.70% in the middle-aged group and 71.58% in the old group, respectively. There was significant difference compared with the young group ( P<0.01); atypical hyperplasia occurred in 2.02% and 9.47% of the middle-aged group and the elderly group. Conclusions:The combined detection of serum pepsinogen Ⅰ and Ⅱ and gastrin-17 levels is of great value in the screening of precancerous lesions of gastric cancer; when this method used for early gastric cancer screening in healthy population, it is necessary to consider the influence of age for the risk stratification of gastric cancer.

Closed-loop hospital management can effectivly cope with the COVID-19 pandemic. In order to ensure the continuity of treatments for hemodialysis patients under closed-loop management and minimize possible medical and infection risks, Huashan Hospital affiliated to Fudan University and 9 hospitals in Shanghai established a hemodialysis alliance in January 2021.The alliance optimized hemodialysis resources within the region through overall planning by preparing sites, materials and personnel shifts in advance, and establishing management systems and work processes to ensure that patients could be quickly and orderly diverted to other blood dialysis centers for uninterrupted high-quality hemodialysis services, in case that some hemodialysis centers in the alliance under closed-loop management.From November 2021 to April 2022, 317 of 1 459 hemodialysis patients in the alliance were diverted to other centers for treatment, accumulating 1 215 times/cases of treatments without obvious adverse reactions. The practice could provide a reference for medical institutions to quickly establish mutual support mode under major public health events.

Objective:To investigate the efficacy of magnesium sulfate combined with labetalol on severe preeclampsia and the effects on serum levels of soluble intercellular adhesion molecule-1 (sICAM-1), vascular endothelial growth factor (VEGF) and pregnancy associated plasma protein-A (PAPP-A).Methods:Eighty-five patients with severe preeclampsia who received treatment in Jinhua Municipal Central Hospital between January 2019 and June 2020 were included in this study. They were randomly assigned to receive treatment either with magnesium sulfate (control group, n = 42) or magnesium sulfate combined with labetalol (observation group, n = 43). Before and after treatment, 24-hour dynamic blood pressure, 24-hour urinary protein excretion and umbilical artery hemodynamics were determined. In addition, serum levels of sICAM-1, VEGF and PAPP-A were detected. Results:After treatment, 24-hour mean arterial pressure, 24-hour urine protein excretion in the control and observation groups were significantly decreased compared with before treatment. After treatment, the 24-hour mean arterial pressure [(116.45 ± 9.63) mmHg vs. (120.74 ± 9.48) mmHg] and 24-hour urine protein excretion [(1.85 ± 0.52) g vs. (2.33 ± 0.75) g] were significantly lower than those in the control group ( t = 2.069, 3.436, both P < 0.05). The umbilical artery resistance index in the control group, and the peak systolic velocity/end-diastolic velocity ratio and the umbilical artery resistance index in the observation group were significantly decreased after treatment compared with before treatment (all P < 0.05). After treatment, the peak systolic velocity/end-diastolic velocity ratio in the observation group was significantly lower than that in the control group [(2.80 ± 0.50) vs. (3.01 ± 0.45), t = 2.034, P < 0.05]. After treatment, serum sICAM-1 and PAPP-A levels were significantly decreased, and serum VEGF level was significantly increased, in each group (all P < 0.05). After treatment, serum levels of sICAM-1 [(548.52 ± 102.74) mg/L vs. (647.52 ± 124.15) mg/L, t = 4.009, P < 0.05] and PAPP-A [(111.74 ± 28.52) U/L vs. (134.24 ± 35.96) U/L, t = 3.200, P < 0.05] in the observation group were significantly lower than those in the control group, and serum VEGF level in the observation group was significantly higher than that in the control group [(32.12 ± 7.45) ng/L vs. (28.17 ± 6.23) ng/L, t =2.659, P < 0.05]. There was no significant difference in the incidence of poor pregnancy outcome between the control and study groups ( P > 0.05). Conclusion:Magnesium sulfate combined with labetalol exhibits good therapeutic effects on severe preeclampsia. The treatment method can improve umbilical artery hemodynamics, and its mechanism may be related to its effect on vascular endothelial function.

Objective: To explore the cumulative effects of unintentional injury among children in rural area, in order to provide information for early intervention of unintentional injury. Methods: Through multistage clustering sampling method, 2 109 primary caregivers of students from 8 rural primary and elementary schools of Heilongjiang Province were recruited. Strengths and Difficulties Questionnaire (SDQ), Injury Behavior Checklist (IBC), Perceptions of Risks and Hazards were used to collect as the risk factors, while Perceptions of Risks and Hazards (PSAPQ), Home Observation for Measurement of the Environment (HOME) and Knowledge, Attitude and Practice for Children Unintentional Injury (KAP) were also used as the protective factors. Risk factors index (RFI) and protective factors index (PFI) were computed in the study. Results: The severity of unintentional injury were positively correlated with SDQ, IBC and perceptions of risks and hazards(r=0.15, 0.23, 0.12, P<0.01), and were negatively correlated with HOME, PSAPQ and KAP(r=-0.25, -0.14, -0.09, P<0.01). Hierarchical linear regression showed that the total scores of SDQ, IBC and environmental of HOME predicted the severity of unintentional injury which could explain 34% variant of unintentional injury. It also indicated that the severity of unintentional injury were positively correlated with RFI (β=0.21) and negatively correlated with PFI(β=-0.18), the interaction was significant(β=-0.11,R2=0.31)(P<0.01). Conclusion Both risk and protective factors of unintentional injury have cumulative effects on the severity of injury among rural children. The relationship between risk factors and injury could be mediated by protective factors.

Objective: To investigate the characteristics of hemolysis, resistance and homology of Staphylococcus cohnii urealyticum. Methods: A retrospective study was carried out on thirteen clinical strains of Staphylococcus cohnii urealyticum. They were re-identified by MALDI-TOF MS. Their colony and hemolytic characteristics on blood agar plates were observed. The co-hemolysis between Staphylococcus cohnii urealyticum and Staphylococcus aureus was demonstrated. The hemolysin genes and drug resistance genes were detected by PCR. Pulsed field gel electrophoresis and mass spectrometry were used to analyze the homology of strains. The susceptibility of strains to antimicrobial agents was detected by agar dilution. Results: The confirmed 13 strains of Staphylococcus cohnii urealyticum showed various levels of hemolysis and had enhanced synergistic hemolysis with Staphylococcus aureus. All strains were susceptible to vancomycin and tigecycline. There were 12 strains which carried mecA gene, 7 strains carried cfr gene, 7 strains carried ermC gene. The 13 strains were divided into 3 groups by MALDI-TOF MS, and 6 types by pulsed field gel electrophoresis. Conclusions Clinical strains of Staphylococcus cohnii urealyticum demonstrated various levels of hemolysis which could be enhanced by Staphylococcus aureus. Although they carried different drug resistance genes, they were all susceptible to vancomycin and tigecycline.

OBJECTIVE：To investigate the intervention effect of Shenfu i njection（SFI）on the nuclear translocation of high mobility group box 1（HMGB1） in lipopolysaccharide （LPS）-induced RAW 264.7 cells. METHODS ： Using LPS-induced RAW264.7 cells as objects ，the histone deacetylase inhibitor RGFP 966 as positive control ，CCK-8 assay was used to screen drug dosage，and the effects of low ，medium and high doses （3，6，12 μL/mL）of SFI on HMGB 1 nuclear translocation in RAW 264.7 cells were observed by immunofluorescence method ；mRNA expression of HMGB 1 in RAW 264.7 cells were detected by real time fluorescent PCR. Western blotting assay was used to determine protein expression of HMGB 1 and Toll-like receptor 4（TLR4）；the expression of HMGB 1 were compared between nucleus and cytoplasm. The levels of HMGB 1，IL-1β and TNF-α in supernatant of cells were detected by ELISA. RESULTS ：In blank control group ，HMGB1 was mainly located in the nucleus ；after LPS induction， HMGB1 migrated from nucleus to cytoplasm. Compared with blank control group ， mRNA and protein （No.81760738） expression of HMGB 1， protein expression of TLR 4 in RAW264.7 cells as well as the levels of HMGB 1，IL-1β and TNF-α in supernatant of cells were increased significantly in LPS group （P＜0.01）. The protein expression of HMGB 1 was decreased significantly in nucleus while was in creased significantly in cytoplasm （P＜0.01）. After SFI treatment ，the nuclear translocation and secretion of HMGB 1 were inhibited in different degrees ；compared with LPS group ，mRNA and protein expression of HMGB 1 in administration groups ，protein expression of TLR 4 in RAW 264.7 cells of positive control group ，SFI medium- and high-dose groups as well as the levels of HMGB 1，IL-1β and TNF-α in supernatant of cells in administration groups were decreased significantly （P＜0.01）. In positive control group ，SFI medium- and high-dose groups ，the protein expressions of HMGB1 in nucleus were increased significantly ，while protein expressions of HMGB 1 in cytoplasm were decreased significantly （P＜0.01）. CONCLUSIONS ：SFI may inhibit the nuclear translocation and secretion of HMGB 1 in RAW 264.7 cells，thus avoiding the activation of inflammatory pathways and the production of inflammatory factors ，so as to reduce the inflammatory response induced by LPS.

Objective To evaluate the ability of Matrix-assisted laser desorption ionization-time of flight mass spectrum (MALDI-TOF MS) on homology analysis of carbapenem-resistant Klebsiella pneumoniae(Carbapenemase-Resistant K. pneumoniae, CRKp). Methods During January 2017 to December 2017, a total of 57 strains isolatedfromChanghai Hospital, Shanghai and 36 strainsfrom Urumqi First Hospital, Xinjiang were included for retrospective study. Inclusion criteria:strains which resistant to one of the carbapenems and with more than 100 peaks in identification mass spectrum. A total of 39 isolates were selected and divided into three groups according to the PFGE typing results:(1) Highly homologous group (17 strains with blaOXA-48 gene); (2) Moderate homology group (16 strains with blaKPC gene); (3)The non-homology group (8 strains with other resistance mechanisms). Mass spectrometry results were analyzed using BioNumeric and the two classification methods in SARAMIS, respectively.The PFGE analysis results were regarded as standard when evaluate the reliability of the other three analytical methods. Results Forhighly homologous group, the analysisresults of KA-A type dientical mass by two classification methods in SARAMIS were accord with PFGE,and the identity mass value is>80％, the similarity is>85％. However, for non-homologous group, the identity mass value is<80％, the similarity is<85％ when compared with PFGE, which indicated that the method based on MALDI-TOF MS was not premium for this group of strains. For moderate homologous strains,the results of two SARAMIS methods for KC-A type havepoor consistency with PFGE, for the identity mass value is<70％, the similarity is<90％. Conclusions Based on MALDI-TOF MS using BioNumeric software and SARAMIS database software could be regarded as a screening method for phylogenetic analysis among CRKp strains with high homology. While, it should not be applied to evaluate homology of the strains with genetic diversity for lacking stability.