To further standardize the diagnosis and treatment of hypertension after kidney transplantation in China,Branch of Organ Transplantation of Chinese Medical Association organized experts in kidney transplantation and cardiovascular diseases to formulate"Guidelines for Clinical Diagnosis and Treatment of Hypertension in Kidney Transplant Recipients in China"based on"Diagnosis and Treatment Specification for Hypertension after Solid Organ Transplantation in China(2019 edition)"in combination with clinical status of hypertension after organ transplantation in China,and referring to the latest guidelines for diagnosis and treatment of hypertension at home and abroad.This guideline was formulated to provide theoretical reference for medical practitioners in the field of kidney transplantation in China,aiming to better control adult hypertension after kidney transplantation,mitigate adverse outcomes and improve the quality of life.

Objective:To analyze the effect of comprehensive rehabilitation intervention on the physical functioning of frail elderly persons.Methods:A total of 318 frail elderly persons were randomly divided into a control group ( n=164) and an observation group ( n=154) to test different interventions. Propensity score matching was used to balance the baseline information between the two groups 1∶1. A total of 200 cases were successfully matched, with 100 cases in each group. Both groups received drug treatment and routine nursing, while the observation group was additionally provided with comprehensive rehabilitation. Before and after 4 weeks of the treatment, both groups were evaluated using visual analogue scale (VAS) scoring for their perception of pain intensity, hand grip strength, gait speed, 6-minute walking distance (6MWD), 5 sit-up time, and the timed up and go test (TUGT). Results:There were no significant differences between the groups in any of the measurements before the experiment. Afterward, all of the outcome measures except gait speed were significantly better among the experimental group than among the controls, on average.Conclusions:Comprehensive rehabilitation can relieve pain, improve the walking, handgrip strength and exercise endurance of the frail elderly.

In China, the level of ambient fine particulate matter (PM 2.5 ) pollution far exceeds the air quality standards recommended by the World Health Organization. Moreover, the health effects of PM 2.5 exposure have become a major public health issue. More than half of PM 2.5 -related excess deaths are caused by cardiopulmonary disease, which has become a major health risk associated with PM 2.5 pollution. In this review, we discussed the latest epidemiological advances relating to the health effects of PM 2.5 on cardiopulmonary diseases in China, including studies relating to the effects of PM 2.5 on mortality, morbidity, and risk factors for cardiovascular and respiratory diseases. These data provided important evidence to highlight the cardiopulmonary risk associated with PM 2.5 across the world. In the future, further studies need to be carried out to investigate the specific relationship between the constituents and sources of PM 2.5 and cardiopulmonary disease. These studies provided scientific evidence for precise reduction measurement of pollution sources and public health risks. It is also necessary to identify effective biomarkers and elucidate the biological mechanisms and pathways involved; this may help us to take steps to reduce PM 2.5 pollution and reduce the incidence of cardiopulmonary disease.
Humans ; Particulate Matter/analysis* ; Air Pollution/adverse effects* ; Risk Factors ; Respiratory Tract Diseases ; China/epidemiology* ; Environmental Exposure/adverse effects*

Objective:To investigate the effects of poly(A) tails with different lengths on mRNA expression in vitro and the passage stability of transcription template with poly (A) tail in Escherichia coli ( E. coli). Methods:Plasmids with poly(A) tails of 38, 60, 103, 125 and 126 (60 nt+ 6 nt spacer+ 60 nt) nt were designed and constructed. Then the plasmids were linearized by single enzyme digestion and used as transcription template for preparing enhanced green fluorescent protein (EGFP)-mRNA. EGFP-mRNA containing poly(A) tails of different lengths were transfected into 293T cells and the expression of EGFP was detected by flow cytometry. As to stability test, the template plasmids with poly (A) tail of 125 and 126 nt were transformed into E. coli TransStbl3 and Top10 competent cells. Seven clones were selected for culture and plasmid extraction, and then the plasmids were digested by restriction enzyme and detected by capillary electrophoresis. For passage stability, three correctly sequenced clones of each group were selected for continuous passage at 37℃, and the plasmids were extracted and digested every two generations for capillary electrophoresis. At the same time, the correctly sequenced clones of 125 nt group were also passaged at 30℃, and the plasmids were also extracted and digested every two generations for capillary electrophoresis. Results:The transcription templates with poly(A) tail of different lengths were successfully constructed. Flow cytometry showed that the fluorescence expression of the template plasmids with poly (A) tail of 103 and 125 nt were significantly higher than that of 38 and 60 nt. The fluorescence expression of the plasmid with poly (A) tail of 126 nt was significantly higher than that of all other groups. The percentages of stable sequences of the template plasmid with poly(A) tail of 125 nt in TransStbl3 and Top10 competent cells were 76% and 91%, respectively. The results of continuous passage showed that poly(A) tail of 125 nt could be stable to the 4th generation at 37℃ in both TransStbl3 and Top10 competent cells, and stable to the 16th and 10th generations at 30℃. The percentages of stable sequences of the template plasmid with poly(A) tail of 126 nt in TransStbl3 and Top10 competent cells were 95% and 48%, respectively. The results of continuous passage showed that poly(A) tail of 126 nt could be stable to the 12th generation at 37℃ in both TransStbl3 and Top10 competent cells.Conclusions:The length and composition of poly(A) tail in mRNA affected the expression of target protein. Adding a spacer with a length of 6 nt to poly(A) tail and low temperature culture were both helpful to improve the stability of the template plasmid, which provided a reference for the design and preparation of in vitro transcription template of mRNA vaccine.

Objective:To prepare a recombinant hemagglutinin trimer (HA-Tri) vaccine against influenza viruses and to study its immunogenicity in a mouse model.Methods:A stable CHO cell line that could express HA-Tri was constructed. Western blot, single radial immunodiffusion, protein particle size detection and N-glycosylation site analysis were performed for qualitative and quantitative analysis of the recombinant protein. According to the different treatment conditions such as dosage and adjuvant, BALB/c mice were divided into 11 groups and subjected to consistent immunization procedures. Serum neutralizing antibody titers were measured on 56 d after the first immunization to evaluate the immunogenicity of HA-Tri.Results:The constructed CHO cells could secret and express HA-Tri proteins. The HA-Tri proteins were biologically active and capable of forming precipitation rings in the single radial immunodiffusion. The particle size of HA-Tri was approximately 18.79 nm and 10 N-glycosylation sites were detected, including high mannose, complex glycoforms and heterozygous glycoforms. After prime-boost immunization, there was no statistically significant difference in the titers of neutralizing antibodies induced in mice by 3.75 μg of HA-Tri in combination with RFH01 adjuvant and 15 μg of monovalent vaccine stock solution ( P=0.431 2, U=36). Serum antibody titers in the HA-Tri+ RFH01 groups were higher than those in the corresponding HA-Tri groups without RFH01 adjuvant, and the highest titer was induced in the 15 μg HA-Tri+ RFH01 group, which was 1 280. Conclusions:The recombinant HA-Tri protein was successfully prepared. HA-Tri in combination with RFH01 adjuvant could induce humoral immune responses against influenza viruses in BALB/c mice, which would provide reference for the development of influenza virus recombinant subunit vaccines.

Objective:To evaluate the immunogenicity of a quadrivalent subunit vaccine combined with RFH01 adjuvant in a mouse model.Methods:Identification tests were performed on four monovalent influenza virus subunit vaccine stock solutions according to the methods described in Part 3 of the Chinese Pharmacopoeia 2020 Edition. In the study of the quadrivalent subunit vaccine combined with RFH01 adjuvant, 460 female BALB/c mice (6-8 weeks old) were randomly divided into 46 groups including experimental groups, vaccine control group, negative control group and blank group with 10 mice in each group. In the study of the quadrivalent subunit vaccine in old and young mice, 80 female 10-month-old and 80 female 10-week-old BALB/c mice were randomly divided into 16 groups ( n=10) including monovalent influenza virus vaccine group, quadrivalent subunit vaccine group, quadrivalent subunit vaccine+ RFH01 adjuvant group, chicken embryo quadrivalent split vaccine control group and PBS group. All mice were immunized by intramuscular injection. At 21 d after the primary immunization, a booster immunization was conducted using the same strategy. Blood samples were collected at 21 d and 42 d after the primary immunization for serum separation. Haemagglutination inhibition (HI) test was performed to detect the antibody levels in mouse serum samples. Results:After the booster immunization, the positive conversion rates in all vaccine+ RFH01 adjuvant groups reached 100%, and the geometric mean titers (GMTs) of serum antibodies were significantly higher than those of the vaccine groups without RFH01 adjuvant. There were significant differences in serum antibody titers between the monovalent/quadrivalent subunit vaccine groups with and without RFH01 adjuvant. After the booster immunization, the titers of serum antibodies against H1N1, H3N2, B/Victoria and B/Yamagata in the 10-week-old mice were significantly higher than those in the 10-month-old mice.Conclusions:The monovalent and quadrivalent influenza virus vaccines in combination with RFH01 adjuvant could elicit higher antibody titers in young (6-10 weeks old) and old (10 months old) mice, showing good immunogenicity.

Intrinsically disordered proteins (IDPs) are proteins or protein regions that fail to get folded into definite three-dimensional structures but participate in various biological processes and perform specific functions. Defying the traditional protein "sequence-structure-function" paradigm, they enrich the protein "structure-function" diversity. Ubiquitous in organisms, they show extreme hydrophilicity, charged amino acids, and highly repetitive amino acid sequences, with simple arrangement. As a result, they feature highly variable binding affinities and high coordination, which facilitate their functions. IDPs play an important role in cell stress response, which can improve the tolerance to a variety of stresses, such as freezing, high salt, heat shock, and desiccation. In this study, we briefed the characteristics, classifications, and identification of IDPs, summarized the molecular mechanism in improving cell stress resistance, and described the potential applications.
Freezing ; Intrinsically Disordered Proteins/metabolism* ; Protein Conformation

Objective:To express the head domain of influenza A virus hemagglutinin (HA) in a prokaryotic expression system and to evaluate its immunogenicity.Methods:The genes encoding the HA head domains of H1N1 and H3N2 influenza viruses were cloned into pET-22b(+ ) prokaryotic expression plasmid. After the induction with IPTG, the fusion proteins rH1N1-HA and rH3N2-HA containing HA head domain and His-tag were expressed and obtained from E. coli BL21. SDS-PAGE and Western blot was used to verify the expression of the recombinant proteins. Rabbits were immunized with multiple doses of the purified recombinant proteins to obtain polyclonal antibodies against the HA head domains of H1N1 and H3N2. The immunogenicity of the recombinant proteins was evaluated in BALB/c mice. Results:rH1N1-HA and rH3N2-HA induced protective antibodies (geometric mean titer ≥40) in mice and could be used as protective antigens. Polyclonal antibodies against rH1N1-HA and rH3N2-HA could be used as important materials for Western blot, ELISA and other immunological assays.Conclusions:The HA head domains prepared in this study could be used as protective antigens to induce protective antibodies in mice. Polyclonal antibodies against the HA head domains could be used for immunological and serological studies of influenza A viruses.

Objective:To explore the effect of precision nursing based on evidence-based concept in the perioperative period of patients with total knee arthroplasty (TKA) .Methods:From January 2018 to December 2020, 200 TKA patients admitted to the First Affiliated Hospital of Zhengzhou University were selected as the study subject by convenience sampling. The patients were divided into the control group and the observation group according to simple random sampling with 100 cases in each group. The control group adopted routine nursing, while the observation group conducted precise nursing based on evidence-based concept on the basis of the control group. The incidence of postoperative complications and knee function between the two groups were compared.Results:The incidence of complications in the observation group was lower than that in the control group, with a statistically significant difference ( P<0.05) . At one, three and six months after operation, the knee function score of New York Hospital for Special Surgery (HSS) in both groups showed an upward trend. The HSS scores of the observation group at one, three, six months after operation were higher than those of the control group, and the difference was statistically significant ( P<0.01) . Conclusions:The precision nursing based on the evidence-based concept has a definite effect in the perioperative nursing of patients with TKA, which can reduce complications and improve the knee function.

Objective:To explore the optimal postpartum nursing intervention method of elderly second-birth parturient based on the best evidence and evaluate its effect so as to improve the quality of clinical nursing.Methods:Based on the best evidence obtained from the previous study, the optimal nursing examination index of the elderly second parturient was established, and the evidence of best practice was obtained by using the evidence-based nursing method, and the 2017 revised version (the third edition of) Johns Hopkins evidence-based nursing practice model) was used to guide nurses to apply the evidence to clinical practice. During the period from March to May 2019, the baseline review was completed, including 82 pregnant women and 43 nurses. The evidence was incorporated into clinical practice in June 2019. From July to October 2019, the same indicators and inclusion and exclusion criteria were used to evaluate the effectiveness of evidence application in 43 nurses (including midwives) and 85 elderly second-child parturients in obstetric wards (including baby-friendly areas). The anxiety, depression, maternal satisfaction and nurses' correct implementation rate of the best evidence were compared before and after the application of evidence.Results:After the use of evidence-based intervention, the implementation rate of nurses was above 80%. The anxiety score of parturient decreased from 55.29±10.11 to 41.74±10.35, the difference was statistically significant ( t value was 8.55, P<0.001), and the depression score decreased from 57.77 ±8.32 to 47.86 ±9.33, the difference was statistically significant ( t value was 7.23, P<0.001). Maternal satisfaction increased from 92.68% (76/82) to 98.82% (84/85), the difference was statistically significant ( χ2 value was 3.92, P< 0.05). Conclusion:The result of practice shows that through evidence-based nursing intervention, we can further standardize the postpartum optimal nursing paradigm of elderly second-child parturients in China. Reduce postpartum anxiety and depression and improve maternal satisfaction. And quality review still needs to be continuously promoted and implemented in clinical practice in order to continuously improve the quality of nursing and ensure sustainability.