Objective:To explore the current status and training needs of nurses' knowledge, belief, and behavior regarding the good limb positioning in stroke patients with hemiplegia.Methods:From November to December 2023, convenience sampling was used to select 1 708 nurses from 30 ClassⅢ hospitals in 17 provinces across the country, who worked in departments such as Neurology and Rehabilitation. The self-designed General Information Questionnaire, Knowledge, Belief and Behavior Questionnaire for Putting Good Limb Position in Clinical Nurses, and self-designed Training Status and Needs Questionnaire for Good Limb Positioning were used for online surveys. Multiple linear regression was used to analyze the influencing factors of nurses' knowledge, belief, and behavior in good limb positioning.Results:A total of 1 622 valid questionnaires were collected. Nurses scored (135.64±25.93) on the Knowledge, Belief and Behavior Questionnaire for Putting Good Limb Position in Clinical Nurses, with the lowest score rate of 65.65% in the knowledge subscale and the highest score rate of 88.16% in the belief subscale. Multiple linear regression analysis showed that education level, working years, department, and whether they received training were the influencing factors of nurses' knowledge, belief, and behavior in good limb positioning ( P<0.05). 92.23% (1 496/1 622) of nurses were willing to receive training on good limb positioning, and 70.10% (1 137/1 622) of nurses participated in training on good limb positioning. Conclusions:Nurses generally have a moderate level of knowledge, belief, and behavior towards the good limb positioning, with room for improvement in their knowledge and behavior. However, their belief is relatively positive. Nursing managers should actively carry out training on good limb positioning based on the different characteristics and needs of nurses, improve their ability to good limb positioning.

Esophagogastric variceal bleeding (EGVB) is one of the main complications of decompensated portal hypertension, especially in patients with liver cirrhosis, and it often has a high mortality rate. Medication combined with endoscopy is the main prevention and treatment method for EGVB, while transjugular intrahepatic portosystemic shunt (TIPS) combined with variceal embolization can also be selected for some high-risk patients, and individualized diagnosis and treatment of portal hypertension based on hepatic venous pressure gradient should become the latest consensus and the main strategy. This article mainly reviews endoscopic therapy and TIPS for the prevention and treatment of EGVB patients with decompensated portal hypertension in terms of selection of indications, incidence rate of complications, and respective advantages and disadvantages.

Objective: To investigate the effects of lactoprotein iron chelates on rats with iron deficiency anaemia (IDA), so as to provide insights into developing and utilizing novel iron supplements. Methods: Seventy weaning female SPF-graded rats of the SD strain were randomly divided into the control group (A), model group (B), ferrous sulfate group (C), lactoferrin group (D), lactoferrin iron chelate group (E), Casein oligopeptide iron chelate group (F) and whey protein oligopeptide iron chelate group (G), with 10 rats in each group. The rats in group A were fed with normal diet, and the others were fed with poor iron diet for IDA modeling. The corresponding interventions were given by intragastric administration once a day. The iron ion concentrations of group C, E, F and G were 2.0 mg/kg, and the protein and oligopeptide concentrations of group D, E, F and G were 2 000 mg/kg. Body weight and hemoglobin of rats were measured weekly during 21-day intervention. At the end, peripheral blood samples were collected, and blood routine, iron metabolism and liver function indicators were determined. Results: After the intervention, among blood routine indicators, the rats in group C, E, F and G showed elevated hemoglobin, red blood cell, mean corpuscular volume and hematocrit, and decreased free protoporphyrin and mean corpuscular hemoglobin concentration when compared with the rats in group B (all P<0.05); among iron metabolism indicators, the rats in group C, E and G showed elevated serum ferritin, the rats in group C, E, F and G showed elevated serum iron, the rats in group C, D, E, F and G showed decreased unsaturated iron binding capacity and total iron binding capacity when compared with the rats in group B (all P<0.05); among liver function indicators, the rats in group E and G showed decreased alanine transaminase when compared with the rats in group B (both P<0.05). Conclusions Lactoprotein alone could not completely improve IDA in rats compared with traditional iron supplement (ferrous sulfate). Lactoprotein iron chelate, especially whey protein oligopeptide iron chelate, could significantly improve IDA, iron reserve and liver function damage in rats.

In order to learn from the advanced experience of postgraduate education in foreign first-class universities, Harvard University, Johns Hopkins University and London School of Hygiene and Tropical Medicine were selected as the objects in this study to analyze and compare the advantages and characteristics of their postgraduate training model, curriculum setting and teaching resources, thereby providing suggestions for the reform and development in the cultivation of master of public health and preventive medicine in China.

Objective:To investigate the clinical features of IgD multiple myeloma (MM) and the effect and prognosis of daratumumab-based combination therapy.Methods:The clinicopathological data of a IgD MM patient with disease progression and extramedullary infiltration treated with daratumumab in the Affiliated Hospital of Qingdao University in December 2019 were retrospectively analyzed.Results:The 74-year-old woman was diagnosed as IgD MM by bone marrow aspiration and immunofixation electrophoresis. The patient was given VD (bortezomib, dexamethasone), RD (lenalidomide, dexamethasone) and ID (ixazomib, dexamethasone) regimens. In June 2020, the patient developed multiple subcutaneous nodules, and she was assessed as progressive disease with extensive extramedullary infiltration. After treated with daratumumab-PAD (liposomal doxorubicin, bortezomib, dexamethasone) regimen, the patient's subcutaneous nodules were significantly reduced and partially disappeared, and the general condition was significantly improved. But the patient was in a cachexia state and finally died of the irregular treatment and disease progression.Conclusions:IgD MM has a low incidence and a short survival period, and there is no uniform standard treatment. The early application of daratumumab combined with proteasome inhibitors, immunomodulators, cytotoxic drugs and hematopoietic stem cell transplantation may improve the overall survival of patients.

Objective:To investigate the nutritional and metabolic risk factors associated with recurrence in patients with newly diagnosed ulcerative colitis (UC), so as to allow better clinical prediction of recurrence.Methods:A retrospective cohort study was conducted. Patients newly diagnosed with UC (mild and moderate) from the People's Hospital of Xinjiang Uygur Autonomous Region were screened based on prespecified inclusion and exclusion criteria from January 2016 to January 2019. Patients were followed up regularly for three years. Subgroups were determined according to the presence or absence of recurrence. The patients in the UC recurrence group were further stratified according to the time to recurrence into short-term (0-6 months), mid-term (6-12 months) and long-term (12-36 months) recurrence groups. The nutritional and metabolic risk factors related to recurrence were evaluated by univariate analysis and multifactorial logistic regression analysis, and the predictive value was evaluated via receiver operating characteristic curve. The risk factors were then compared across the 3 subgroups with recurrence.Results:A total of 210 patients newly diagnosed with UC (mild and moderate) were included, including 38 experiencing recurrence within 0-6 months, 27 within 6-12 months, 24 within 12-36 months, and 121 without recurrence. There were no statistically significant differences in gender, age, smoking history, and family history in the recurrence group compared with the non-recurrence group. Univariate analysis suggested significant differences in homocysteine, folate, total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), apolipoprotein A/B (ApoA/B), 25-hydroxy vitamin D 3, and body mass index (BMI) between recurrence and non-recurrence groups ( P < 0.05). Multifactorial binary logistic regression analysis suggested that homocysteine ( OR = 0.869, 95% CI: 0.782 to 0.965, P = 0.009), triglycerides ( OR = 0.176, 95% CI: 0.060 to 0.519, P = 0.002), LDL ( OR = 0.256, 95% CI: 0.089 to 0.733, P = 0.011), 25-hydroxy vitamin D 3 ( OR = 0.937, 95% CI: 0.895 to 0.0.982, P = 0.006), and BMI ( OR = 1.319, 95% CI: 1.162 to 1.498, P < 0.01) were independent risk factors for UC recurrence. The predictive efficiency of individual risk factors in descending order was as following: LDL (AUC = 0.762, Youden's index [YI] = 0.42, cut-off value = 2.345), triglycerides (AUC = 0.718, YI = 0.361, cut-off value = 1), homocysteine (AUC = 0.666, YI = 0.283, cut-off value = 13.265). There were no statistically significant differences in gender, age, smoking history, and family history across the short-term, mid-term and long-term recurrence groups. There were significant differences in HDL and ApoA/B levels between the short-term and the long-term recurrence groups ( P < 0.05). Conclusions:Recurrence of the disease in UC patients results from the combined effects of multiple factors. The changes in homocysteine, triglycerides, LDL, 25-hydroxy vitamin D 3, and BMI in UC patients should be proactively monitored to prevent recurrence.

Despite recent studies, relatively few are known about the diversity of fungal communities in the deep Atlantic Ocean. In this study, we investigated the diversity of fungal communities in 15 different deep-sea sediments from the South Atlantic Ocean with a culturedependent approach followed by phylogenetic analysis of ITS sequences. A total of 29fungal strains were isolated from the 15 deep-sea sediments. These strains belong to four fungal genera, including Aspergillus, Cladosporium, Penicillium, and Alternaria. Penicillium, accounting for 44.8% of the total fungal isolates, was a dominant genus. The antiaflatoxigenic activity of these deep-sea fungal isolates was studied. Surprisingly, most of the strains showed moderate to strong antiaflatoxigenic activity. Four isolates, belonging to species of Penicillium polonicum, Penicillium chrysogenum, Aspergillus versicolor, and Cladosporium cladosporioides, could completely inhibit not only the mycelial growth of Aspergillus parasiticus mutant strain NFRI-95, but also the aflatoxin production. To our knowledge, this is the first report to investigate the antiaflatoxigenic activity of culturable deep-sea fungi. Our results provide new insights into the community composition of fungi in the deep South Atlantic Ocean. The high proportion of strains that displayed antiaflatoxigenic activity demonstrates that deep-sea fungi from the Atlantic Ocean are valuable resources for mining bioactive compounds.

Despite recent studies, relatively few are known about the diversity of fungal communities in the deep Atlantic Ocean. In this study, we investigated the diversity of fungal communities in 15 different deep-sea sediments from the South Atlantic Ocean with a culturedependent approach followed by phylogenetic analysis of ITS sequences. A total of 29fungal strains were isolated from the 15 deep-sea sediments. These strains belong to four fungal genera, including Aspergillus, Cladosporium, Penicillium, and Alternaria. Penicillium, accounting for 44.8% of the total fungal isolates, was a dominant genus. The antiaflatoxigenic activity of these deep-sea fungal isolates was studied. Surprisingly, most of the strains showed moderate to strong antiaflatoxigenic activity. Four isolates, belonging to species of Penicillium polonicum, Penicillium chrysogenum, Aspergillus versicolor, and Cladosporium cladosporioides, could completely inhibit not only the mycelial growth of Aspergillus parasiticus mutant strain NFRI-95, but also the aflatoxin production. To our knowledge, this is the first report to investigate the antiaflatoxigenic activity of culturable deep-sea fungi. Our results provide new insights into the community composition of fungi in the deep South Atlantic Ocean. The high proportion of strains that displayed antiaflatoxigenic activity demonstrates that deep-sea fungi from the Atlantic Ocean are valuable resources for mining bioactive compounds.

OBJECTIVE: To analyze the effect of occupational stress on abnormity of serum total cholesterol and triglyceride in male steel workers. METHODS: A total of 3 957 male steel workers from an iron and steel group company were selected as study objects by judgment sampling method. Occupational stress was measured by the Chinese version of Job Content Questionnaire. The serum total cholesterol and triglyceride levels were measured using fasting venous blood. RESULTS: Among the 3 957 workers,the detection rate of occupational stress was 56. 8%,and 55. 0% of them showed high social support. The abnormal rates of total cholesterol and triglyceride were 21. 8% and 40. 9%,respectively. The multivariate logistic regression analysis showed that workers with high social support had high risk of abnormal total cholesterol and abnormal triglyceride than workers with low social support( P < 0. 05) after adjusting for confounding factors such as age,education level,marital status,body mass index,smoking and drinking alcohol,tea. The odds ratio of abnormal total cholesterol in occupational stress workers was 1. 17 times of that of non-occupational stress workers. No association was found between occupational stress and abnormal triglyceride( P > 0. 05). CONCLUSION: Occupational stress may be associated with abnormity of total cholesterol in male steel workers. Social support is an important influences factor to the abnormity of total cholesterol and triglyceride in male steel workers.

Objective To explore the significance of serum levels of interleukin(IL)-33,21,17, 6,the positive rates of anti-cardiolipin antibody(ACA)-IgG,ACA-IgM and anti endothelial cell antibody (AECA)-IgM in diagnosis of Kawasaki disease and prediction of coronary artery lesions. Methods Seventy children with Kawasaki disease were selected as Kawasaki disease group,and the children were divided into abnormal ultrasonic group(11 cases)and normal ultrasonic group(59 cases)according to the result of cardiac ultrasound. Fifty children with upper respiratory tract infection or bronchitis were selected as control group.The serum levels of IL-33,21,17,6 and positive rates of ACA-IgG,ACA-IgM, AECA-IgM were detected.Results The serum levels of IL-33,21,17 and 6 in Kawasaki disease acute stage were significantly higher than those in control group:(127.43 ± 10.87)ng/L vs.(69.67 ± 6.38)ng/L, (130.43 ± 11.22) ng/L vs. (87.56 ± 7.76) ng/L, (1 243.38 ± 612.08) ng/L vs. (397.26 ± 182.16) ng/L, (438.35 ± 101.78)ng/L vs.(213.74 ± 104.52)ng/L;the positive rates of ACA-IgG,ACA-IgM and AECA-IgM were significantly higher than those in control group: 37.1%(26/70)vs.8.0%(4/50),32.9%(23/70) vs.6.0%(3/50)and 34.3%(24/70)vs.8.0%(4/50),and there were statistical differences(P<0.01).The acute stage serum levels of IL-33, 21, 17 and 6 in abnormal ultrasonic group were significantly higher than those in normal ultrasonic group:(135.92 ± 11.56)ng/L vs.(123.48 ± 10.14)ng/L,(138.29 ± 11.86) ng/L vs.(128.08 ± 10.94)ng/L,(2 042.47 ± 968.43)ng/L vs.(1 096.59 ± 502.82)ng/L,(495.58 ± 103.04) ng/L vs. (402.67 ± 98.26) ng/L; the positive rates of ACA-IgG, ACA-IgM and AECA-IgM were significantly higher than those in normal ultrasonic group:7/11 vs.32.2%(19/59),8/11 vs.25.4%(15/59) and 7/11 vs. 28.8% (17/59), and there were statistical differences (P < 0.01 or <0.05). In Kawasaki disease, the acute stage serum levels of IL-33, 21, 17 and 6 were significantly higher than those in subacute stage:(127.43 ± 10.87)ng/L vs.(94.48 ± 8.56)ng/L,(130.43 ± 11.22)ng/L vs.(91.78 ± 8.03) ng/L, (1 243.38 ± 612.08) ng/L vs. (527.12 ± 236.94) ng/L and (438.35 ± 101.78) ng/L vs. (308.41 ± 144.09)ng/L,and there were statistical differences(P<0.01).Conclusions IL-33,21,17,6 and ACA-IgG, ACA-IgM, AECA-IgM participates in the process of Kawasaki disease vasculitis and coronary artery damage,which can assist the early diagnosis of Kawasaki disease and predict the coronary artery lesions.