Objective:To investigate the cultural construction of Traditional Chinese Medicine(TCM) hospitals in Hunan province, for reference in their cultural construction.Methods:A questionnaire was designed according to TCM Hospital Cultural Construction Guidelines by the National Traditional Chinese Administration.From May to June 2020, the questionnaire was used to survey the present situation, existing problems and development suggestions of TCM cultural construction at TCM hospitals of and above the county level in Hunan province. The data were analyzed by descriptive analysis.Results:The survey covered 117 public TCM hospitals in the province and 87 questionnaires were recovered, a rate of 74.4%. In terms of cultural construction in these institutions, various programs were in place at a relatively high proportion in the core cultural value construction. The development of behavioral norms teaching and inheritance was in place at a relatively low proportion, namely 78.8% at tertiary TCM hospitals, 51.8% at secondary TCM hospitals, and only 16.7% at secondary level-B TCM hospitals. In terms of environmental image construction, various programs were in place at a relatively high proportion, yet focusing on themed cultural wall posters culturol bulletin board and other forms of display. At present, the main problems were insufficient funding(86.9%) and talents(82.1%).Conclusions:TCM hospitals in Hunan province highly value the construction of cultural core value and environmental image, but their development in the code of conduct system and other connotation was weak.

COVID-19 has swept globally and Pakistan is no exception.To investigate the initial introductions and transmissions of the SARS-CoV-2 in Pakistan,we performed the largest genomic epidemiology study of COVID-19 in Pakistan and generated 150 complete SARS-CoV-2 genome sequences from samples collected from March 16 to June 1,2020.We identified a total of 347 mutated positions,31 of which were over-represented in Pakistan.Meanwhile,we found over 1000 intra-host single-nucleotide variants(iSNVs).Several of them occurred concurrently,indicating possible interactions among them or coevolution.Some of the high-frequency iSNVs in Pakistan were not observed in the global population,suggesting strong purifying selections.The genomic epidemiology revealed five distinctive spreading clusters.The largest cluster consisted of 74 viruses which were derived from different geographic locations of Pakistan and formed a deep hierarchical structure,indicating an extensive and persistent nation-wide transmission of the virus that was probably attributed to a signature mutation(G8371T in ORF 1ab)of this cluster.Further-more,28 putative international introductions were identified,several of which are consistent with the epidemiological investigations.In all,this study has inferred the possible pathways of introduc-tions and transmissions of SARS-CoV-2 in Pakistan,which could aid ongoing and future viral surveillance and COVID-19 control.

Objective:To evaluate the effects of vaccine switch on the levels of neutralizing antibody (NA) of poliovirus in children aged<12 years.Methods:Subjects aged<12 years from 9 districts in Fujian province were chosen by stratified cluster and complete random sampling method. Blood samples were collected for testing NA of poliovirus by microcell neutralization.Results:A total of 2 134 subjects aged<12 years were selected. The positive rate of NA against PVⅠand Ⅲ were 98.64% and 95.83%; and geometric mean titers (GMTs) were 1∶259.35 and 1∶105.14, respectively. The GMTs presented a trend of decreasing as age increased. Compared to trivalent oral poliovirus vaccine (tOPV), bivalent oral poliovirus vaccine (bOPV) and inactivated poliovirus vaccine (IPV) induced higher GMTs of NA against poliovirusⅠand Ⅲ respectively. Among 182 children aged<5 years, the positive rate of NA against PVⅠ, Ⅱ, Ⅲ were 97.25%, 76.37% and 92.86%. There were statistical differences among the three types ( χ2=44.44, P=0.000). The rate of NA against PVⅡwas significantly lower than those ofⅠand Ⅲ (Ⅱ vs. I: χ2=34.65, P=0.000; Ⅱ vs. Ⅲ: χ2=18.99, P=0.000). And the GMTs of NA against PV Ⅰ, Ⅱ, Ⅲ were 1∶368.96、1∶23.06 and 1∶183.10, which were significantly different ( F=156.54, P=0.000). The GMT of PVⅠwas the highest, PV Ⅲ was the second, PVⅡ was lowest (pairwise comparison showed values of P all were 0.000). The analysis of general linear model showed that the interval between the date of last immunization and the date of sample collection would affect the GMTs of PVⅠand Ⅲ, different vaccine models would affect only the GMT of PV Ⅰ. The age maybe was a confounding factor. But no factors would affect the GMT of PV Ⅱ. Conclusions:After the vaccine switch, the level of NA against PVⅠand PV Ⅲ were still maintaining high level, but the level of PVⅡamong children<5 years was at relatively low level, which indicated that the surveillance should be strengthened.

Objective To study the relationship between different syndromes of AIDS dementia complex (ADC) and different disease severity, age, CD4+ T cell count and infection. Methods Totally 186 patients with ADC were classified into different syndrome types, and the distribution in different degree of disease, different age, different CD4+T cell count and different routes of infection was analyzed. Results There were 48, 51, 15, 37 and 35 cases of deficiency of kidney and marrow, yin deficiency of liver and kidney, deficiency of heart and spleen, syndrome of phlegm obstruction, syndrome of qi deficiency and blood stasis, respectively. Moderate and severe degrees with yin deficiency of liver and kidney were more common. There was statistical significance in the distribution of different syndromes in different degree of disease (χ2=82.495, P=0.000). Deficiency of kidney and marrow, yin deficiency of liver and kidney were more common in different age groups. The distribution of the syndrome types in different age groups was statistically significant (χ2=72.710, P=0.000), the patients were mainly in two age groups of>50–60 years old and>60 years old. The distribution of the syndrom types in diffenrent CD4+T cell count stratum was statistically significant (χ2=66.778, P=0.000). Blood pathway infection mainly included deficiency of kidney and marrow and syndrome of qi deficiency and blood stasis, sexual pathogens mainly yin deficiency of liver and kidney. Conclusion CD4+T cells layers, age group, progression of disease and transmission way are the influencing factors of syndrom type.

Objecve To observe the clinical effect and safety of the Chinese medicine syndrome differentiation combined with HAART for the ADC(acquried immune deficiency syndrom dementia complex). Methods A total of 80 patients with ADC were divided into the treatment group and control group based on random number table, 40 in each group. The patients in the control group were treated by highly active anti-retrovital therapy (HAART). The patients in the treatment group were treated with TCM treatment on the based of the control group. Both groups received the treatment for 3 months.These outcomes were measured: TCM syndrome integral, mini mental state examination(MMSE), daily behavior scale(ADL), change of clinical stage, and adverse reactions. Results The effect rate of treatment group was 82.5%, which was significant higher than 65% of the control group (χ2=8.115,P=0.024). After the treatment, the ADL integral of the treatment group (37.69 ± 5.31vs.33.67 ± 5.16;t=2.528,P=0.021) was significantly higher than that before the treatment; and the ADL integral of the control group(36.96 ± 5.52vs.34.54 ± 4.98;t=2.747,P=0.027) was significantly higher than that before the treatment.But there was no significant difference between the two groups after the treatment (t=2.003,P=0.139). After the treatment, the MMSE integral of the treatment group (24.76 ± 4.43 vs.19.97 ± 5.46;t=1.006,P=0.013) was significantly higher than that before the treatment; the MMSE integral of the control group(24.65 ± 4.36 vs. 20.11 ± 4.87;t=1.035,P=0.014) was significantly higher than that before the treatment. But there was no significant difference between the two groups after the treatment (t=0.953, P=0.347).There was no significant difference between the two groups in the clinical stage change (phase1χ2=1.231,P=0.954; phase2χ2=2.726,P=1.053). There was no adverse reaction in the two groups during the treatment.Conclusions The Traditional Chinese medcine combined with HAART was better than HAART alonein the treatment of ADC.

Objective To study thegenetic and molecula repid emiological characteristics of ECHO29 virusVP1 region coding in Tibet under 5-year-old children in 1999-2000.Method 7 strains of ECHO29 viruses isolated from 659 stool specimens of AFP cases and under 5-year-old patients and some healthy children in Tibet in 1999-2002 were used to extract ribonucleic acid (RNA) while VP1 coding area were amplified by reverse transcription-polymerase chain reaction (RT-PCR) and the nucleotide sequence of PCR products were determined and analyzed.Result A total of 7 strains ECHO29 viruses were isolated from the stool specimens and identified.5 strains were isolated from specimens in 1999 while the other 2 strains isolated from samples in 2000.The complete nucleotides sequence of VP1 region of 7 strains ECHO29 viruses were 876nt coding 292 amino acids.The sequence homology of 7 strains detected ECHO29 viruses was between 75.41％-99.3％ while amino acid homology was between 71.26％-79.69％.The phylogenetic tree of ECHO29 viruses showed 4 genotypes which the isolates from Tibet were belong to Genotype A and C.Conclusion It was first reported that the popular ECHO29 viruses in children in Tibet were proposed to 2 different genotypes in 1999 and 2000.The popular ECHO29 virus epidemic in 1999 was belong to Genotype C,while popular ECHO29 virus in 2000 belong to Genotype A.ECHO29 virus increasingly popular was not found in 2001 and 2002.

OBJECTIVETo investigate the clinical outcome of modified Blair ankle fusion for ankle arthritis.

METHODSBetween November 2009 and June 2012, 28 patients with ankle arthritis were treated, among whom 11 had obvious foot varus deformity, and 17 were almost normal in appearance. There were 13 males and 15 females with an average age of 49.4 years (range, 23-67 years). The main symptoms included swelling, pain, and a limited range of motion of the ankles. The ankle joints functions were assessed by American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score and visual analog scale (VAS) preoperatively and at 1 year follow-up.

RESULTSTwenty-eight patients were followed up for 19.8 months on average (range, 1-2 years). Superficial wound infection occurred in 3 cases, and was cured after debridement; the other incisions healed by first intention without complications. All ankles were fused at 1 year follow-up after operation. The symptom was relieved completely in all patients at last follow-up without complication of implant failure, or nonunion. The postoperative AOFAS ankle and hindfoot score was 83.13±3.76, showing significant difference when compared with the preoperative score (45.38±3.21, P<0.01). VAS was significantly decreased from 8.01±0.63 to 2.31±1.05 at 1 year follow-up (P<0.05).

CONCLUSIONModified Blair ankle fusion has the advantages of high feasiblity, less cost and rigid fixation. It shows high reliability in pain relief and may obtain a good clinical effectiveness.

Adult ; Aged ; Ankle Joint ; surgery ; Arthrodesis ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rheumatic Fever ; surgery

Objective To reveal the genetic characteristics of VP1 encoding region of Coxsackievirus A16 (CA16) in Ningxia Hui Autonomous Region,2010.Methods With specific primers,reverse transcriptase polymerase chain reaction (RT-PCR) were performed to amplify the complete VP1 encoding sequence from CA16 isolates,which were isolates from hand,foot,and mouth disease (HFMD) patients in Ningxia in 2010.The VP1 sequences were determined,and analyzed with bioinformatic software.Results Totally,VP1 of 62 CA16 strains were determined,showing 90.1％-100％ (average,94.5％) identities of nucleotide sequences and 98.7％-100％ (average,99.6％) identities of amino acid sequences.On phylogenetic tree,all of the viruses in this study clustered together with subgenotype B1,which could be divided into clade B1a and B1b further.And viruses from each prefecture in Ningxia included both clade B1a and clade B1b.Conclusions Consistent with CA16 from other provinces,CA16 circulating in Ningxia in 2010 included both clade B1a and B1b.These viruses showed high diversity of VP1 nucleotide sequences,suggesting heterologous CA16 strains were co-circulating in Ningxia in year 2010.

To improve the vocational nursing students' interest in learning physiology,‘four modernizations' teaching method was preliminarily explored in physiology teaching practice.‘Four modernizations' referred to the teaching by using multimedia.Using this method,we can simplify complex issues,inspire students' curiosity and thirst for knowledge,combine with real life,make abstract problem specific,mobilize students' initiative,contact with clinical practice,visualize theoretical issues,strengthen the importance and understanding and make moderate expansion so that professional skills and practicality of nursing can be emphasized.

Objective To explore the clinical effect of holistic nursing in the operation room for surgical children patients. Methods 120 patients required surgical treatment were selected and divided into the control group(45 cases)and the observation group(75 cases)randomly.The control group was given routine nursing,the observation group was given holistic nursing including preoperative interview,psychological care and all the preparations,strict check upon going into the operation room and before surgery,to help children keep graceful position,to cooperate closely with the anesthetist and surgeon,to observe the condition of patients and give good infusion management,to give continued observation of the disease condition after surgery,to make children safe escort back to the ward,and to make transfer with ward nurses.The treatment effect was compared between two groups. Results Two groups of children passed the period of operation and anesthesia safely,without appearing accidental situation.The satisfaction degree of the observation group was significantly higher than the control group.One case appeared operation accident and two cases appeared anesthesia awareness in the control group,and they were correctly handled.No one appeared operation accident and anesthesia awareness in the observation group.The differences between the two groups were significant. Conclusions Application of holistic nursing in the operation room for children patients puts forward higher requirements for nurses.It can help children cooperate with surgery better to achieve better surgical results,which is worthy of promotion.