Fecal microbiota transplantation(FMT)is a therapeutic approach that targets intestinal microorganisms by transplanting fecal microorganisms from healthy individuals into the gastrointestinal tract of diseased individuals,thus restoring the recipient's disordered gastrointestinal microbiota by restructuring the intestinal flora.However,the mechanism of action and adverse effects of FMT in different diseases have not yet been clarified,thus limiting its wide clinical application.Its use still relies on in-depth preclinical studies;however,highly inconsistent or incomplete experimental details provided in current reports,coupled with a lack of authoritative standards and recommendations,seriously affect the interpretation of the study findings and replication of the experimental procedures,as well as hindering the clinical translation of the result.We therefore review and discuss the key steps of recipient selection and graft sample collection,storage,graft material preparation,and grafting route,with the aim of improving the utilization of experimental animals,consumables,and labor,and providing method ological recommendations and references to achieve replicability and standardization of preclinical FMT studies.

Objective:To investigate the epidemiological and clinical characteristics of human parainfluenza viruses (HPIVs) infection among hospitalized children with community-acquired pneumonia (CAP) in China, and provide basic data for diagnosis, treatment and prevention of HPIVs infection.Methods:From November 2014 to February 2020, 5 448 hospitalized children with CAP were enrolled in 14 hospitals in 11 provinces and municipalities directly under the Central Government in southern China and northern China. Nasopharyngeal aspirates or throat swabs were collected, and the nucleic acids of 18 types respiratory viruses including HPIV1-4 were screened by suspension array technology. Demographic data and clinical information were collected for statistical analysis.Results:The total detection rate of HPIVs in 5 448 children with CAP was 8.83% (481/5 448), and the detection rate in males was higher than that in females (62.79% vs. 37.21%; χ2=0.000, P=0.992). The detection rate of HPIVs in 1~< 3 years age group was higher than that in other age groups, and the difference was statistically significant ( χ2=61.893, P<0.001). The detection rate of HPIVs in the northern region was higher than that in the southern region (9.02% vs 8.65%), but the difference was not statistically significant ( χ2=0.239, P=0.625). The prevalence of HPIV1-4 in northern and southern China was not completely same. HPIV1 was mainly prevalent in autumn in both northern and southern regions. HPIV2 was prevalent in summer in northern China, and the detection rate was low in southern China. HPIV3 reached its peak in both spring and summer in both northern and southern China, but its duration was longer in southern China than in northern China. HPIV4 is mainly popular in autumn in both southern China and northern China. Among 481 children infected with HPIVs, 58.42% (281/481) were infected with HPIV alone, and the main clinical manifestations were cough (90.75%) and fever (68.68%). Out of the HPIV-positive cases, 42.62% (205/481) were co-infected with another type of HPIV or a different virus, while 11.43% (55/481) had co-infections with two or more different viruses. HPIV3 was the most common type of co-infection with other viruses. HPIV3 infection accounted for the largest proportion (76.80%) in 47 HPIVs-positive children with severe pneumonia. Conclusions:HPIVs is one of the most important pathogens causing CAP in children in China, and children under 3 years of age are the main populations of HPIVs infection. The prevalence characteristics of all types of HPIVs in children in the north and south are not completely same. HPIV3 is the dominant type of HPIV infections and causes more severe diseases.

Objective:To explore the application of flipped classroom combined with case workshop in general surgical practice teaching of undergraduate nursing students.Methods:The subjects of this study were nursing undergraduates practicing in general surgery department of a "three A" hospital. The experimental group included 44 interns from July 2019 to January 2020 who were taught by the flipped classroom combined with case workshop teaching mode. The control group included 45 interns from July 2018 to January 2019 who were given the traditional teaching mode. The two groups of students were evaluated for their clinical ability before and after the internship, and their out-department theoretical and operational performances were assessed and the survey of internship satisfaction was conducted. SPSS 19.0 was used for t test and chi-square test. Results:Before the internship, there was no statistical significance in the scores of clinical ability between the two groups ( P > 0.05). After the internship, the overall evaluation scores of clinical ability of the experimental group were (7.11±0.54) points, which were significantly higher than that of the control group (6.42±0.58) points ( t=-5.81, P < 0.001); the total satisfaction scores of the experimental group were (3.46±0.25) points, which were significantly higher than that of the control group (3.09±0.32) points ( t=-6.04, P < 0.001). The operation scores of the experimental group were (90.22±4.70) points, which were significantly higher than that of the control group (86.99±7.39) points ( t=-2.46, P=0.024). Conclusion:The teaching mode of flipped classroom combined with case workshop in nursing undergraduate general surgery practice can improve students' clinical ability and internship satisfaction, and improve the teaching effect of internship effectively.

Objective To explore a method for rapidly establishing a mouse model of atopic dermatitis (AD).Methods C57BL/6 mice served as model animals,and were randomly divided into 3 groups:calcipotriol + ovalbumin (OVA) group (n =6) topically treated with calcipotriol and OVA on the mouse ears,calcipotriol group (n =6) topically treated with calcipotriol on the ears,and control group (n =3) topically treated with 75％ alcohol on the ears.The treatment lasted 12 days.Before the model establishment and on day 14,the photos of the mouse ears were taken,and ear thickness was measured;moreover,blood samples were obtained from the mouse caudal vein,and serum levels of total IgE and OVAspecific IgE were detected.On day 14,the skin tissues of mouse auricles were resected and subjected to histopathological examination.Results On day 14,erythematous swelling,dryness and desquamation occurred on the mouse ear skin in the calcipotriol + OVA group and calcipotriol group,and both the two groups showed significantly increased ear thickness compared with those before the model establishment (both P ＜ 0.001).However,there was no significant difference in the ear thickness between the calcipotriol + OVA group (0.355 ± 0.03 mm) and calcipotriol group (0.370 ± 0.05 mm,q =0.674,P =0.231).Histopathological examination of the ear skin showed more obvious epidermal hyperplasia and infiltration of dermal inflammatory cells including eosinophils and mastocytes in the calcipotriol + OVA group compared with the calcipotriol group and control group.Immunohistochemical study revealed that there was no significant difference in the expression of thymic stromal lymphopoietin (TSLP) and interferon (IFN)-γ among the 3 groups (both P ＞ 0.05),while the expression of interleukin (IL)-13 significantly differed among the 3 groups (F =5.159,P =0.032),and was significantly higher in the calcipotriol + OVA group (77.12 ± 5.46) than in the control group (55.49 ± 9.92,q =3.170,P =0.021).On day 14,the calcipotriol + OVA group and calcipotriol group both showed markedly increased total serum IgE levels compared with those before the treatment,and the calcipotriol + OVA group showed a more significant increase (8 278.56 ± 3 297.68 vs.892.64 ± 82.83 μ g/L,t =4.132,P =0.026).Meanwhile,the serum level of OVA-specific IgE was significandy higher in the calcipotriol + OVA group (192.846 ± 15.391 μg/L) than in the calcipotriol group (8.492 ±:3.879 μg/L,q =22.476,P ＜ 0.001) on day 14.Conclusion The mouse model of allergeninduced AD can be rapidly established by topical application of calcipotriol and OVA for 12 consecutive days,which lays a foundation for further study on allergen-related pathogenesis of AD.

AIM: To investigate strabismus and amblyopia in preschool children in Zhongshan city and to solve the countermeasures.

METHODS: A total of 14 582 eyes of 7 291 children aged 3-7 years in urban area and urban area of Zhongshan city were randomly selected for refractive examination. Before examination, the concentration of 10g/L atropine ointment was used, to determine the corrected vision amblyopia. The ametropic amblyopia was measured by retinoscopy, and corneal mapping method was used to screen the strabismus. Then strabismus and amblyopia of preschool children in Zhongshan were analyzed.

RESULTS: Of the 7 291 preschool children, 687 had ametropia, with the rate of 9.42% and 236 amblyopia with the rate of 3.24%, 13 cases were strabismus, whit the rate of 0.18%. There were no significant differences on ametropia, amblyopia or strabismus between 3-<5 years old group and 5-7 years old group(P>0.05). Of the 236 children with amblyopia, 215 were ametropic amblyopia, account for 91.10%; 13 children with strabismic amblyopia, of which 8 concomitant esotropia, 5 concomitant exotropia; 8 children with deprivation amblyopia; the difference of children number between strabismic amblyopia and deprivation amblyopia was statistically significant(P<0.05). Of the 236 children, more 3-<5 aged children had mild amblyopia than those 5-7 aged ones(P<0.05); less 3-<5 aged children had severe amblyopia than those 5-7 aged ones(P<0.05)

CONCLUSION: The incidence of strabismus and amblyopia in preschool children in Zhongshan is relatively high. It should be screened early, and effective measures should be taken as early as possible to improve the children's vision.

OBJECTIVE To compare the costeffectiveness of two surgical approaches:endoscopic silicone tube intubation(ESTI) and conventional blind silicone tube intubation(CBSTI),in the management of chronic dacryocystitis(CDC).METHODS There were 46 cases of CDC from the Third Affiliated Hospital of Sun Yat-sen University from 2014 to 2015.Randomly,22 CDC patients were included in ESTI,24 patients were performed CBSTI.We analyzed both the final success rate,operating time,intraoperative visual analogue scale(VAS) and the rate of post-operative complications,as well as the final therapeutic effect.RESULTS In ESTI group,17 cases were cured,5 cases were improved and 3 cases were invalid.The success rate was 88.00％.Correspondingly for CBSTI group,14 cases were cured,6 eases were improved and 5 cases were invalid,and the success rate was 80.00％.ESTI was better,but there was no significant in success rate between the two groups (x2=0.881,P=0.644).Besides,the operating time and intraoperative VAS score in ESTI group was (10.32±2.30)min and 2.02±0.86,and they were(25.32 ± 4.87)min and 4.11 ± 1.44 in CBSTI group.So ESTI was better than CBSTI(t=-13.918,P=0.000;t=-6.012,P=0.000).ESTI had fewer complications(x2=4.878,P=0.027).CONCLUSION Compared to CBSTI,ESTI is a minimally invasive and highly effective technique for the treatment of CDC.The visualization of nasal endoscopy is the optimization of CBSTI,and this method need to be popularization and application.

BACKGROUND:Corneal lymphangiogenesis is beneficial to the transport of corneal antigenic materials, and accelerates the process of antigen presentation, thereby playing an important role in corneal immunity. However, due to the paral el outgrowth of corneal blood and lymphatic vessels in transplanted corneas, it is often difficult to accurately evaluate the role of corneal lymphatic vessels in allograft rejection. OBJECTIVE:To explore the development of corneal lymphangiogenesis and angiogenesis in transplanted rat corneas after the blockade of vascular endothelial growth factor C (VEGF-C). METHODS:130 rats used to establish corneal al ogenic transplantation models were equally randomized into two groups:the anti-VEGF-C group and the control group. VEGF-C was blocked in the anti-VEGF-C group by intraperitoneal injection of neutralizing monoclonal anti-VEGF-C antibody every other day for 2 consecutive weeks. Meanwhile, rats in control groups received intraperitoneal injections of saline. Corneal angiogenesis and lymphangiogenesis were characterized using whole mount immunofluorescence, and the immune rejection of the grafts was evaluated by scoring the rejection index (RI). In addition, the expression of VEGF-C was examined by real-time PCR. The relationship of corneal lymphangiogenesis and angiogenesis to RI in transplanted corneas was also characterized. RESULTS AND CONCLUSION:VEGF-C expression was markedly downregulated after VEGF-C blockade. Corneal lymphangiogenesis developed in parallel with corneal angiogenesis in the control group. While there was a mild reduction in blood vessel area (BVA) and a significant decrease in lymphatic vessel area (LVA) in the anti-VEGF-C group (P<0.05). In addition, RI was positively correlated with BVA (P<0.05) and LVA (P<0.05) in the control group. However, although RI was significantly correlated with BVA (P<0.05) in the anti-VEGF-C group, the correlation between RI and LVA was not statistically significant (P>0.05). the graft survival time in the anti-VEGF-C group was significantly increased compared with that in the control group (P<0.05). Our results show that the outgrowth of lymphatic vessels is separated from that of blood vessels in transplanted corneas by blocking VEGF-C. The blockade of VEGF-C has a significant role in preventing corneal lymphangiogenesis in corneal beds, which results in higher al ograft survival rates.

Objective To explore the clinical effect of application of hospital information system in bedsore nursing process analysis.Methods To combine process management and continuous quality improvement organically,establish a complete set of the pressure ulcer management monitoring process,which was completed,networking,continuous for improvement and this process was used for the implementation of high-risk bedsore warning screening and bedsore informing,hospitalized patients with pressure ulcers online report system and level 3 monitoring system,bedsore nursing consultation system and pressure ulcer nursing intervention.Results The application of informatization in the pressure ulcer management process could effectively reduce the incidence of pressure ulcers,prompt bedsore nursing management level to be more standardized,scientific,and modernization.At the same time,it improved the patients' satisfaction degree with nursing work,meanwhile it let managers found that carrying out of pressure sores extended nursing service was imperative.Conclusions Application of hospital information system in bedsore nursing process analysis is satisfying,which is worthy of further development.

Objective To discuss the application effect of real time ratio of patients and nurses in nursing human resource dynamic management.Methods Our hospital made full use of the information platform,inquiring the real time ratio of patients and nurses,in combination with mobile nurse library,implement dynamic vertical management of nursing human resources on the level of the hospital-wide nursing management.The overall manpower cost remained the same through internal reasonable adjustment to achieve the best configuration of human resources and met the clinical needs effectively.Results The running effect was satisfactory from July 2012 till now.All the mobile nurses allocated were 71 person-times and the satisfaction degree of patients increased to 97.96％ in the first half of 2013.Conclusions Application of real time ratio of patients and nurses shows good effect,which is worthy of wide application.

Objective To explore the mechanism of self-awareness in the heavy smokers(HS)by using regional homogeneity(ReHo)combined with resting-state functional MRI(fMRI).Methods Thirty HS and 31 healthy non-smokers(NS)matched for age and sex underwent a 3.0 T resting-state fMRI.The data were post-processed by SPM 5 and then the ReHo values were calculated by REST software.The ReHo values between the two groups were compared by two-sample t-test.The brain map with significant difference of ReHo value was obtained.Results Compared with that in NS group,the regions with decreased ReHo value included the bilateral precuneus,superior frontal gyrus,medial prefrontal cortex,right angular gyrus,inferior frontal gyrus,inferior occipital gyrus,cerebellum,and left middle frontal gyrus in HS group.The regions of increased ReHo value included the bilateral insula,parahippocampal gyrus,white matter of parietal lobe,pons,left inferior parietal lobule,lingual gyrus,thalamus,inferior orbital gyrus,white matter of temporal-frontal lobe,and cerebellum.The difference was more obvious in the left hemisphere.Conclusions In HS,abnormal ReHo on a resting state which reflects network of smoking addiction.This method may be helpful in understanding the mechanism of self-awareness in HS.