Purpose/Significance To classify the elderly according to their heterogeneous health status,and to explore the potential categories and influencing factors status,so as to promote the precision of health information services for the elderly.Method/Process Based on the data of the China health and retirement longitudinal study(CHARLS)database in 2018,the elderly are classified according to their health status by the method of latent class analysis,and the main influencing factors are identified by regression analysis.Result/Conclusion The elderly could be divided into 4 categories according to their health status.Age,sex,education level and retirement sta-tus are significant factors affecting the health grouping of the elderly.According to the heterogeneous health characteristics of the elderly,the service optimization strategy should be provided to promote the physical and mental health of the elderly.

Objective:To clarify the anatomical characteristics and adjacent relationship of the superior segment of the inferior vena cava during laparoscopic surgery.Methods:In December 2018, two frozen and two fresh adult cadavers were dissected. The chest of the frozen cadavers was opened along the bilateral midline of the clavicle, the anterior pericardial wall was opened, and the superior vena cava and the inferior vena cava was dissected. The abdominal cavity was opened along the midline of the abdomen, the left and right hepatic lobes were turned over, the inferior vena cava and the second hilum of the posterior segment of the liver were exposed, and the hiatus of the inferior vena cava was opened and entered the pericardium.The anatomical characteristics and adjacent relationship of the superior segment of the inferior vena cava were observed, and the length of the superior segment of the inferior vena cava was measured. The fresh frozen cadaver patients underwent laparoscopic surgery.Five 12 mm trocars were placed at the side of umbilicus, right rectus abdominis about 4 cm from umbilicus, midline of abdomen about 6 cm above umbilicus, right axillary front about 2 cm below inferior edge of liver, left midline of clavicle about 2 cm below inferior edge of liver. Laparoscopic-assisted turning of the left and right hepatic lobes, exposing the posterior inferior vena cava and the second hilum of the liver, opening of the vena cava hiatus into the pericardium.The anatomical characteristics and adjacent relationship of the upper diaphragmatic segment of the inferior vena cava were observed.Results:In two autopsies, the inferior vena cava entered the chest through the cava sulcus of the liver and the phrenic foramen cava, and then through the fibrous pericardium into the right atrium. The length from the diaphragm of inferior vena cava to the right atrium was 1.67 cm, 2.57 cm. In laparoscopic operation, the diaphragm entrance of the posterior segment of the liver inferior vena cava, the second hepatic portal and the inferior vena cava could be well exposed.The diaphragm could be opened along the hole of the vena cava with a relatively non vascular anatomical layer of adipose tissue.There was a large anatomical gap between the pericardium and the right atrium, and the inferior vena cava, the superior vena cava and the right atrium could be well exposed, and the whole diaphragm could be completely and continuously exposed from the bottom to the inferior vena cava at the entrance segment of the right atrium.Conclusions:There was a relatively avascular anatomical layer beside the inferior vena cava. During laparoscopic operation, opening the diaphragm through the abdominal cavity could safely enter the pericardium and expose the inferior vena cava, the superior vena cava and the right atrium, which provides a possibility for the removal of Mayo Ⅳ grade inferior vena cava tumor thrombus through this approach.

Purpose: This study was to investigate the work experience of newly recruited male nurses during the COVID-19 pandemic. Methods: With a phenomenological approach, this qualitative study was adopted semistructured interviews by phone or video calls. A total of 9 male nurses newly recruited for the COVID-19 wards in Chinese hospitals were interviewed for this study. And Colaizzi's method was applied for evaluation in the data analysis. Results: Based on our findings, three themes were extracted. First, the newly recruited male nurses showed negative emotions at the beginning of COVID-19 epidemic, which was caused by changes in working conditions and content, but also prompted the nurses to change the way of coping with the crisis. Second, they gradually mastered the working skills and psychological training to cope with COVID-19 and developed a positive attitude toward life and a high sense of professional responsibility. Finally, we learned about their needs to respond to public health emergencies such as the COVID-19 pandemic. Conclusion COVID-19 is a disaster for all of humanity. The newly recruited male nurses are an important force in emergency rescue. Although they suffered from short-term negative emotions, they quickly adapted to the crisis. In order to better prepare for future emergencies, the disaster response capacity of newly recruited male nurses needs to be further improved. In addition, newly recruited male nurses have a strong demand for timely and personalized career development guidance.

Purpose: This study was to investigate the work experience of newly recruited male nurses during the COVID-19 pandemic. Methods: With a phenomenological approach, this qualitative study was adopted semistructured interviews by phone or video calls. A total of 9 male nurses newly recruited for the COVID-19 wards in Chinese hospitals were interviewed for this study. And Colaizzi's method was applied for evaluation in the data analysis. Results: Based on our findings, three themes were extracted. First, the newly recruited male nurses showed negative emotions at the beginning of COVID-19 epidemic, which was caused by changes in working conditions and content, but also prompted the nurses to change the way of coping with the crisis. Second, they gradually mastered the working skills and psychological training to cope with COVID-19 and developed a positive attitude toward life and a high sense of professional responsibility. Finally, we learned about their needs to respond to public health emergencies such as the COVID-19 pandemic. Conclusion COVID-19 is a disaster for all of humanity. The newly recruited male nurses are an important force in emergency rescue. Although they suffered from short-term negative emotions, they quickly adapted to the crisis. In order to better prepare for future emergencies, the disaster response capacity of newly recruited male nurses needs to be further improved. In addition, newly recruited male nurses have a strong demand for timely and personalized career development guidance.

To improve the specific recognition and presentation of virus-like particle (VLPs), and to develop immune-targeted VLPs vaccine, the gene fragment encoding OVA₂₅₇₋₂₆₄ peptide was inserted into the VP3 gene of foot-and-mouth disease virus (FMDV) between the 171th and 172th amino acids (aa) or 173th and 174th aa by reverse PCR. The recombinant proteins were expressed by using Escherichia coli and assembled into chimeric VLP (VLP(OVA)) in vitro after purification. The VLP(OVA) was measured by dynamic light scattering and transmission electron microscopy. The recombinant protein and the assembled VLPs were evaluated by Western blotting, enzyme-linked immunosorbent assay and laser scanning confocal microscopy to confirm the insertion of OVA₂₅₇₋₂₆₄ peptide into VP3 and its location. The results show that insertion of OVA₂₅₇₋₂₆₄ into the 173th and 174th aa of FMDV VP3 did not affect the assembly of VLPs. The VLP(OVA) in size was larger than VLPs, and the OVA₂₅₇₋₂₆₄ peptide was located on the surface of VLP(OVA).
Animals ; Escherichia coli ; genetics ; Foot-and-Mouth Disease ; virology ; Foot-and-Mouth Disease Virus ; genetics ; Recombinant Proteins ; genetics ; metabolism ; Vaccines, Virus-Like Particle

OBJECTIVETo investigate the correlation of apolipoprotein AI (ApoAI), ApoB, ApoB/ApoAI and the severity of brain white matter lesions (WML).

METHODSA total of 648 patients with WML confirmed by brain magnetic resonance imaging (MRI) were divided into mild WML group (=386) and moderate to severe WML group (=262) according to evaluations with the Fazekas scale. The demographic data, blood biochemical parameters and the levels of ApoAI, ApoB and ApoB/AI ratio were compared between the two groups to identify the risk factors of moderate to severe WML.

RESULTSUnivariate analysis showed that age, gender, hypertension, diabetes, coronary heart disease, previous stroke, homocysteine, HDL-C, ApoAI, and ApoB/AI ratio all differed significantly between the two groups ( < 0.05), but ApoB levels were similar between them ( > 0.05). Multivariate logistic regression analysis revealed that with ApoAI and ApoB/AI ratio as the continuous variables, after adjustment for the compounding factors, ApoB/AI ratio was an independent risk factor (OR=11.456, 95% : 3.622-36.229, < 0.001) and ApoAI was an independent protective factor for moderate to severe WML (OR=0.068, 95% : 0.018-0.262, < 0.001). With the upper quartiles of ApoAI level (1.38 g/L) and ApoB/AI ratio (0.58) as their respective cutoff values, patients with a high ApoAI level and a low ApoB/AI ratio were found to have the lowest incidence of moderate to severe WML ( < 0.001).

CONCLUSIONSAn increased ApoB/AI ratio is an independent risk factor and an increased ApoAI level is an independent protective factor for moderate to severe WML.

Objective To investigate the relationship between the serum high sensitive c-reactive protein (hs-CRP) and prealbumin (PAB) and the acute heart failure during the early stage of acute myocardial infarction (MI) patients.Methods A total of 181 MI patients (male:n =154,85.1％ vs.female:n =27,14.9％),admitted between Seppember 2010 and September 2012,were enrolled.They were divided into heart failure group (n =114,63.0％) with Killip classification recorded and control group (n =67,37.0％) without heart failure.The levels of serum hs-CRP and PAB were determined from the venous blood in the followed morning after admission.The clinical data were analyzed by logistic regression,Spearman correlation,and ROC curve.Results The serum level of hs-CRP (mg/L) in the heart failure group was significantly higher than that in the control group (P =0.000),while the serum level of PAB (mg/L) in the heart failure group was significantly lower than that in the control group (P =0.000).High level of hs-CRP and low level of PAB were significantly correlated with Killip classification (rhs-CRP =0.234,Phs-CRP =0.003 ; rPAB =-0.321,PPAB =0.000).Serum hs-CRP (P =0.023,OR 1.086,95％ Cl 1.012-1.167) and PAB (P =0.038,OR O.991,95％ CI O.983-0.999) were the independent risk biomarkers of acute heart failure subsequent to myocardial infarction determined by multivariate logistic regression analysis.The area under the ROC curve:AUChs-CRP =0.722,95％ CI 0.651-0.786; AUCPAB =0.723,95％ CI 0.652-0.787.Conclusions With high level of serum hs-CRP or low level of serum PAB during the early stage of acute myocardial infarction,patients were predisposed to the development of acute heart failure consequently.Both of them are the independent risk biomarkers of acute heart failure subsequent to myocardial infarction.Furthermore,they were significantly correlated with severity of the heart failure in terms of Killip classification.

Objective To investigate the predictive value of serum uric acid for patients with traumatic brain injury.Methods A total of 330 patients with traumatic brain injury (Glasgow Coma Scale score,GCS:3-14) admitted to the First Affiliated Hospital of Soochow University between November 2010 and October 2012 were enrolled.They were divided into a survival group (GOS:2-5) and a non-survival group (GOS:1).The levels of serum uric acid were measured from venous blood in the morning of the second day after admission.Clinical data were analyzed by logistic regression model,spearman correlation,and ROC curve analysis.Results Spearman correlation analysis showed that serum uric acid was significantly correlated with GCS (r =-0.270 1,P =0.000) and GOS (r =-0.251 2,P =0.000).Age,GCS,pupil reaction and serum uric acid were determined as independent predictors for death by logistic model.The adjusted OR of uric acid was 1.0048,(95％ CI:1.001 9-1.007 6,P =0.001).The area under the ROC curve was 0.718,(95％ CI:0.666-0.766),the optimal cut-off value determined by the Youden index was 304 μmol/L (sensitivity:60.24％,specificity:78.14％,correctly classified:73.64％).In the core model (Age + GCS + Pupil reaction),theR2 value was 0.476 4.With uric acid added into,the predictive power of the model increased to R2 =0.510 5 (7.2％ increased).Conclusions The level of serum uric acid is significantly correlated with the severity of TBI and could be used as an independent predictor for death.

Objective To investigate the value of plasma soluble triggering receptor expressed on myeloid cells-1 as a diagnosis marker of sepsis.Methods Articles on plasma soluble triggering receptor expressed on myeloid cells-1 as a marker of sepsis which were public published in the PubMed,Ovid,Springer,Wanfang database from 1991-2012 were searched and conducted a meta-analysis by MetaDiSc and Stata.Results Seven articles were selected to the meta-analysis according to the inclusion criteria,of which cut-off values varied signicantly from studies.Due to the data heterogeneity (I2 ＞ 50％,P ＜0.05),random model was used to pool the effect sizes.The overall combined effect sizes:sensitivity =81％ (95％CI:0.76-0.86); specificity =81％ (95％ CI:0.76-0.86); DOR =30.03 (95％ CI:7.89-114.37) ; AUC of SROC =0.905 9; Q*-0.837 6.Deek' s funnel plot showed little publication bias.Conclusions Plasma soluble triggering receptor expressed on myeloid cells-1 may be a useful adjunctive tool for the diagnosis of sepsis.However,further studies are needed in order to identify the best cut-off value in the diagnosis of sepsis.

ObjectiveTo study the way for establishing prediction model of acute pancreatitis with secondary multiple organs dysfunction syndrome (MODS) in the early stage.MethodsThe linical data were collected from 113 hospitalized patients with acute pancreatitis admitted from October 2008 to October 2011.Some biomarkers within 48 h after the onset of acute pancreatitis were statistically analyzed by univariate and multivariate binary logistic regression analysis in order to establish the prediction model evaluated by the ROC curve. ResultsThere were statistically significant differences in lactate dehydrogenase ( LDH ),serum creatinine ( CR),serum albumin ( P ＜ 0.05 ) identified by univariate regression analysis.These independent risk factors in the regression model were:ln (P/1 -P) =2.243 +0.002 × LDH + 0.014 × CR - 0.186 × ABL,likelihood ratio test ( x2 =66.46,P =0.000) ; in the ROC curve analysis:AUC 0.927 (95％ CI:0.875 -0.980),the best cut- off value of the model predicting probability was 0. 177 (sensitivity 82. 14％,specificity 85.88％,correctly classified 84.96％ ).ConclusionsEfficient prediction model could be set up by the logistic regression analyzing the early risk factors in multiple organ dysfunction syndrome following acute pancreatitis.